The man on my therapy couch tells me he "explodes" with his partner. He shamefully confesses verbally abusing her and cries as he tries to understand why he hurts the person most dear to him. The night before she had gone out with a group of girlfriends and as time ticked by, and she extended drinks into dinner, he felt more and more anxious, fearful and finally terrified.
He had drunk a bottle of alcohol and snorted a gram of cocaine. By the time she came in the door, he violently attacked her with harmful painful words, got into his car and drove away for the night. The week before I had performed an Adverse Childhood Experience [ACE] assessment on this man. His high score indicated that he was a survivor of childhood trauma.
His mother left when he was a toddler, he witnessed his father abuse his stepmother, and received physical abuse from his father plus he has memory of sexual abuse by his nanny. He and his partner presented to me with low sexual interest. He was in love with and attracted to her but had little desire to be sexual. This had been his adult pattern of ruined relationships and he needed answers why.
In 1998 the CDC uncovered a link between childhood trauma and chronic diseases people develop as adults as well as social and emotional problems. This includes heart disease, lung cancer, diabetes and many autoimmune diseases, as well as depression, violence, being a victim of violence, and suicide. They called it the CDC'S Adverse Childhood Experiences Study.
I knew that this man was sexually functional but he had a brain on fire that precluded any form of healthy intimate attachment. In order to get him sexually interested I needed to get his brain rewired. Anyone who has been subjected to childhood emotional, physical, sexual abuse as well as neglect and abandonment, has a compromised ability to attach in a secure and loving way.
In the last two and a half years I have shifted my focus of fascination from the workings of the human genitals to the structures, wiring and firing of the human brain. Perhaps it was my disenchantment with the therapeutic interventions I had at my disposal that brought me a lack of good enough results when working with human pain and suffering.
Traumatic stress literally rearranges the brain's wiring -- specifically areas dedicated to pleasure, engagement, control, and trust.
Presented as sexual symptoms, human suffering is what actually underlies my work. Consider that one in three women and one in five men in our country are survivors of childhood abuse; I accepted and adjusted my practice and acknowledged that most of my clients need trauma work, not sex therapy.
This is how your brain on fire makes you feel.
As a traumatised adult you see your partner as a potential enemy because your brain fires up when there is any form of conflict or difference of opinion. You feel as if you are constantly in a war zone. Your intimacy and ability to attach securely are severely compromised.
You wake with an underlying sensation of anxiety, dread, nervousness, fear, being overwhelmed, depression and no libido. You adjust your life to escape these difficult feelings of emotional discomfort, like using/misusing medication, talk therapy, exercise, sex, gambling, hours online or alcohol and drugs. Yet the fire in your brain rages on. This is not sexy nor intimate.
Since the 1970s, Bessel van der Kolk entered the brain arena with a focus on PTSD. He recognised the far-reaching impact of trauma on the whole person. In Dr Van der Kolk's most recent 2014 book, "The Body Keeps the Score: Brain, Mind, and Body in the Treatment of Trauma", he transforms our understanding of traumatic stress, revealing how it literally rearranges the brain's wiring -- specifically areas dedicated to pleasure, engagement, control, and trust.
He developed the term Developmental Trauma Disorder [DTD]. This diagnosis refers to children who survived abuse and neglect during their childhood, within their caregiving system. And the consequent ongoing trauma as they develop into adults: See if you fit into this definition of DTD, do you have:
- an inability to regulate your emotions?
- difficulty attaching to partners?
- behaviour regressions and constant shifts in emotions?
- aggressive behaviour towards your self and others?
- sleep and eating disturbances?
- multiple somatic problems, from gastrointestinal distress to headaches?
- chronic feelings of ineffectiveness?
- inappropriate, out-of-control, acting-out sexual behaviour?
- substance-abuse problems?
- risk-taking behaviour?
- use anger and aggression as a way of managing conflict?
- inability to relax and be in your body?
- depression?
- anxiety?
- inability to trust others?
- inability to enjoy being sexual?
- sexual dysfunction or lack of desire?
- fear of an intense sexual and emotional bond with a partner, i.e. cannot sustain attachments another person?
The good scientific news is that there are good solutions to putting out the fire in your brain and rewiring it so that you can feel in control of your emotions and behaviours.
Developmental trauma disorder is also known as an attachment or bonding disorder. Being a neglected, abused or abandoned child leaves you scant ability to safely and securely attach to your first primary relationship, namely your parents or caregivers. This changes the wiring of the brain. The brain goes into survival mode full-time. You anticipate being abandoned, abused, neglected by your partner so you are on the defence, guarded, unsafe, untrusting.
In other words, the very skills you need in order to have healthy sexual and relational intimacy are denied to you. In sexual situations you are frozen, numbed and disassociate. You do whatever you can to avoid intimacy as the overwhelming stressors you anticipate may trigger you into past pain and memories... or uncomfortable arousal states. Sex workers, anonymous online sex, multiple partners, infidelity, lack of commitment, are common ways to avoid closeness with one person.
The good scientific news is that there are good solutions to putting out the fire in your brain and rewiring it so that you can feel in control of your emotions and behaviours.
Over 30 years ago, Jon Kabat-Zinn developed Mindfulness Based Stress Reduction [MBSR], which brings together mindfulness, meditation and yoga. Numerous research findings validate Mindfulness as a method for bringing mind and body together to manage medical and psychological illnesses, ranging from depression to sexual dysfunction. Being present in the moment, breathing, meditation, yoga, has shown to lower blood pressure and reduce overall arousal and emotional reactivity. This primes you to tolerate intimacy and sexuality.
Tips on how to feel safe with intimacy:
- Accept that lying next to someone involves a tremendous degree of vulnerability.
- Only do this if you feel your body and self are respected.
- Feel you have the right to body and emotional integrity.
- Feel entitled to have feelings and sensations of pleasure.
- Be able to say "yes' and "no".
- Be able to set limits.
- Be able to protect yourself from harm.
- Be able to move to enhance your comfort and pleasure.
- Know that intimacy is about two individuals of equal power entering into a mutually agreed upon encounter.
- Seek secure partners for intimate attachment.
- Be sure to get professional counselling.
Trauma is unbearable and intolerable. Ask any rape survivor, combat soldier or child who has been molested. It takes so much energy to keep functioning while carrying the memory of terror and the shame of utter weakness and vulnerability. You can see how damaging this is in an intimate relationship. Intimacy and sexuality depend on safety. Trauma disallows safety and intimacy requires attachment, while trauma finds attachment terrifying.
Find a traumatologist and learn how to live with your trauma. Whilst the memories may never disappear, the feelings can be better managed. This will allow you your right to intimacy and sexual safety.