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Answer by Dr. Laura
PhD Mental Health Nurse & Sexual Assault Nurse Examiner
Thank you for your thoughtful question about understanding sexual arousal and intimacy after trauma. Let me provide some information that I hope will help you understand both the physiological and emotional aspects of what you're experiencing, with particular emphasis on an essential point: arousal never equals consent.
One of the most crucial things to understand about sexual arousal is that it's an automatic bodily response, similar to how our pupils dilate in darkness or our hands sweat when we're nervous. Our bodies can respond physically to sexual stimuli even when we absolutely do not want or welcome that stimulation. This involuntary response can happen during consensual encounters, during assault, or even when remembering or being triggered by past experiences. Many survivors experience confusion or shame about having had physical responses during assault, but these responses are purely physiological and never indicate consent or desire. Consent can only be given through clear, enthusiastic, conscious agreement - never through bodily responses alone.
Sexual arousal involves our autonomic nervous system - the same system that controls our "fight, flight, freeze, or fawn" responses. When activated, this system triggers a cascade of physical reactions: increased heart rate, faster breathing, muscle tension, and specific genital responses like vaginal lubrication. These physical responses happen automatically, regardless of our conscious desires or emotional state. Understanding this separation between physical response and conscious desire is particularly important for survivors.
The adrenaline rush sensation you described - similar to the feeling before a roller coaster plunge - demonstrates how our bodies process both excitement and fear through similar pathways, releasing the same stress hormones, including adrenaline and cortisol. For survivors of sexual assault, these physical sensations can feel particularly confusing because the body might have difficulty distinguishing between excitement about potential intimacy and the alertness that comes from past trauma. Think of it like your body speaking two languages simultaneously - the language of desire and the language of protection - and sometimes these messages can overlap or feel contradictory.
Your experience of wanting intimacy while simultaneously feeling fear represents what trauma specialists call an "approach-avoidance conflict." Imagine it like standing at the edge of a swimming pool on a hot day - part of you wants to jump in for relief and connection (the approach), while another part remembers a time you struggled in water and wants to stay safely on the deck (the avoidance). Both impulses serve important protective functions as you heal.
Trauma can dysregulate our nervous system, making it more sensitive to potential threats. Picture it like a highly sensitive smoke detector that might activate not just for actual fires, but also for steam from cooking. Your body's alarm system might similarly activate not just for genuine threats, but also for experiences that share even small similarities with past trauma. This isn't a malfunction - it's your brain working overtime to protect you.
Moving toward healthy intimacy after sexual assault often involves gradually rebuilding trust with both others and your own body. This process requires patience and self-compassion. Many survivors find success in working with trauma-informed therapists who can help develop specific strategies for managing triggering sensations and building comfort with arousal at a safe, controlled pace. These might include grounding techniques, mindfulness practices, and exercises to help you stay present in your body rather than disconnecting when sensations become intense.
Remember that healing isn't linear - you might feel ready for intimacy one day and need distance the next. These fluctuations are completely normal and valid. Your body and mind will often signal what they need, and learning to trust these signals is a crucial part of healing. Most importantly, experiencing desire for intimacy doesn't invalidate your trauma, just as having fears about intimacy doesn't mean you won't be able to have fulfilling relationships in the future.
Thank you so much for asking this question. You deserve intimacy and healthy relationships. We appreciate you trusting us with this.
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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.