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I understand that sexual arousal can sometimes occur during trauma flashbacks for survivors. I'm seeking to understand from a mental health perspective: Is it psychologically healthy or harmful to engage in consensual sexual activity (either alone or with a partner) when experiencing these trauma responses? How can survivors navigate these complex physical reactions in a way that supports healing?

Dr. Laura

Answer by Dr. Laura

PhD Mental Health Nurse & Sexual Assault Nurse Examiner

Thank you for reaching out with this important question. I am hearing your concern about navigating these complex feelings and responses and will try to provide information to support you the best I can. Experiencing sexual arousal during flashbacks is a reaction that many survivors encounter, but I understand that it can be both confusing and distressing. Please know that you're not alone.

Physical arousal during flashbacks is a common physiological response that many survivors experience, though it can feel isolating or distressing. This happens because our nervous system creates unconscious connections between past trauma and physical responses - similar to how our heart might race when we remember a frightening experience. These automatic bodily reactions occur outside our conscious control and don't reflect desire or enjoyment of the traumatic memories.

When flashbacks trigger arousal, it's crucial to understand that this is your body responding to stored trauma memories, not a reflection of your feelings about the traumatic experience itself. Just as we can't control whether our hands shake when we're nervous, we also can't control these automatic trauma responses. This understanding can help reduce feelings of shame or confusion about these reactions.

The question of whether to engage in sexual activity during these responses is deeply personal and can affect different survivors in varying ways. Some find that consensual sexual activity helps them reclaim their bodily autonomy and reduce the power of flashbacks, almost like rewiring those neural pathways with new, chosen experiences. Others might discover that sexual activity during flashbacks makes it harder to stay grounded in the present moment or intensifies their distress.

The key consideration is how these choices affect your healing journey. Think of it like learning to swim after a near-drowning experience - some people find it healing to gradually return to the water in a safe environment, while others might need different approaches to process their trauma. Neither approach is inherently wrong; what matters is whether it supports your personal healing process.

If you choose to engage in sexual activity during or after flashbacks, it's helpful to develop awareness of whether you're staying connected to the present moment or getting pulled into trauma memories. This might mean checking in with yourself about:

  • Whether you feel grounded in your current surroundings
  • If you can maintain awareness of your present-day safety
  • How your emotions shift before, during, and after
  • Whether the experience leaves you feeling more or less regulated

Developing a toolkit of grounding techniques can be valuable. These might include focusing on current sensory experiences (what you can see, hear, or touch in the present moment), using breathing exercises, or engaging in gentle physical movements that remind you of where and when you are. Think of these techniques as anchors that help you stay connected to the present when flashbacks try to pull you into the past.

Working with a trauma-informed therapist can provide crucial support in understanding your specific responses and developing personalized strategies for managing flashbacks. They can help you explore the nuances of your experiences and find approaches that promote healing rather than reinforcing trauma patterns.

Healing from trauma isn't a linear journey - it often involves periods of progress, setbacks, and new understanding. Be patient with yourself as you learn to navigate these complex experiences. Thank you for asking us this complex question. We appreciate your trust. 

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Grounding activity

Find a comfortable place to sit. Gently close your eyes and take a couple of deep breaths - in through your nose (count to 3), out through your mouth (count of 3). Now open your eyes and look around you. Name the following out loud:

5 – things you can see (you can look within the room and out of the window)

4 – things you can feel (what is in front of you that you can touch?)

3 – things you can hear

2 – things you can smell

1 – thing you like about yourself.

Take a deep breath to end.

From where you are sitting, look around for things that have a texture or are nice or interesting to look at.

Hold an object in your hand and bring your full focus to it. Look at where shadows fall on parts of it or maybe where there are shapes that form within the object. Feel how heavy or light it is in your hand and what the surface texture feels like under your fingers (This can also be done with a pet if you have one).

Take a deep breath to end.

Ask yourself the following questions and answer them out loud:

1. Where am I?

2. What day of the week is today?

3. What is today’s date?

4. What is the current month?

5. What is the current year?

6. How old am I?

7. What season is it?

Take a deep breath to end.

Put your right hand palm down on your left shoulder. Put your left hand palm down on your right shoulder. Choose a sentence that will strengthen you. For example: “I am powerful.” Say the sentence out loud first and pat your right hand on your left shoulder, then your left hand on your right shoulder.

Alternate the patting. Do ten pats altogether, five on each side, each time repeating your sentences aloud.

Take a deep breath to end.

Cross your arms in front of you and draw them towards your chest. With your right hand, hold your left upper arm. With your left hand, hold your right upper arm. Squeeze gently, and pull your arms inwards. Hold the squeeze for a little while, finding the right amount of squeeze for you in this moment. Hold the tension and release. Then squeeze for a little while again and release. Stay like that for a moment.

Take a deep breath to end.