This blog is a continuation of my last post, which you can find here!
Once a client begins to intellectually comprehend that the trigger responses they have been experiencing are part of the parasympathetic nervous system’s response to danger, the therapist can begin to invite them to try some somatic inquiry. Somatic inquiry is the first step used in techniques like Mindfulness Based Stress Reduction (MBSR), created by Jon Kabat Zinn* who codified a Buddhist tradition into a secular, step-by-step technique.
After they begin to intellectually understand the way the body reacts automatically when triggered, the therapist can gradually begin to ask permission to ask them if they are experiencing somatic responses like this during sexual encounters or at other times. Indeed, the therapist can ask them if they have had any of these reactions in the session itself as the therapist was discussing this information or asking them questions. This second step is introducing somatic inquiry, an invitation to begin noticing what is occurring physically and emotionally in the here and now.
These slow-paced therapeutic interventions of Somatic Trauma-Informed Sex Therapy can lead to a new language the client creates or chooses to describe the bodily states and symptoms that are triggered by sexual and erotic intimacy. The sex therapist can gradually invite the client to introduce mindfulness meditation, slow yoga, tai chi or any other slow present-focused movement practice to help the client calm their nervous system and create more skills and thus agency to regulate themselves when triggered. The sex therapist, if working with the survivor and their partner, can then introduce the concept of a choreographed ‘safe space’, a position that they go to immediately if the survivor becomes triggered during a sexual experience. This intervention was introduced by Wendy Maltz in her book The Sexual Healing Journey. This is a position the survivor states is the position they feel most safe with their partner and will help calm them. An example might look like this: a survivor sits up in bed, she and her partner both put robes on and she sits up cross-legged, faces her partner, they both close their eyes, take deep breaths while the survivor’s hands are placed face down on top of their partner’s open palms. This very choreographed position comes solely from the survivor who asks her partner whether they are willing to do this for them to help downregulate the trauma reaction in her body.
Using Developmentally Age-Appropriate Sex Education To Begin the Building Blocks of Sex Esteem®
For some sexual abuse/assault survivors whose trauma occurred in childhood or early adolescence, the opportunity to learn the norms around sex education, anatomy, and sexuality functioning at age appropriate levels was usually completely absent. One way to provide this information is to ask a client if they could pinpoint the age they emotionally feel internally rather than the present age, what age would they say they are? Many clients can pinpoint the point at which their psychological and emotional development froze. Offering a client who feels grossed and/or disgusted by adult terms for sexual acts is counter therapeutic. Instead it’s helpful to offer a sex ed book that is written for children (if their abuse started in early years) or teens with diagrams rather than more graphic photos or imagery. A book like You Know, Sex: Bodies, Gender, Puberty, and Other Things by Cory Silverberg and Fiona Smyth is an animated book for middle school-aged children that cover topics like anatomy, body autonomy, disclosure, stigma, harassment, pornography, trauma, masturbation, consent, boundaries and safety.
It’s crucial to let the client know that sexual consent is necessary and needs to be crystal clear for every type of sexual interaction. Survivors need to be taught that sexual consent can be withdrawn at any time, even in the middle of an encounter including what behaviors they want to engage in, what protective barriers they expect each of them to use and what areas of their body are off limits. Sexual trauma survivors also need to learn that consent cannot be inferred in silence unless there is an agreed upon non-verbal signal discussed ahead of time and agreed to by a partner. A sexuality-educated erotically-informed trauma therapist must have enough training and comfort in themselves in order to discuss terms like devising a safe word or non-verbal signal and ahead of a sexual encounter that will be honored by your partner.
Helping sexual assault trauma survivors re-engage with their own bodies and with their partners using somatic trauma informed sex therapy and bibliotherapy is multi-disciplinary approach for survivors and their partners as they work their way into consensual sexual pleasure.
