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Facilitating women's need for sexual recovery

April 7, 2014
by Germayne B. Tizzano, PhD
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Germayne B. Tizzano, PhD

Trauma affects a woman’s sense of self. To support a woman fully in her recovery, it is imperative to look at the world through the eyes of the survivor. Annihilated by the cruel violation committed by a perpetrator, a young woman can view her core identity as inherently flawed, tarnished and undeserving of self-worth. Her emotional and physical boundaries are likely to be blurred. In essence, there is a confusion of where do I start and others begin. Her personal preferences and needs for safety—a healthy and necessary part of her psychosexual development—are not defined.

There is no anchor of consistency she can fall back on when facing even simple life choices, let alone complicated ones involving intimacy. In her quest to survive the violations of her core identity, the young woman attempts to overcome the traumatic experiences by searching for means to squelch the unbearable feelings she no longer can suppress, via sexually intimate encounters. What becomes readily apparent is how quickly her behavior can escalate into substance abuse to numb the somatic feelings and psychological distress that result from unresolved violent episodes against her body, mind, and soul.1 Subsequently, to survive, her mind and body adapt through dissociation and fugue states.

She feels a pervasive sense of hopelessness, internalized anger and rage, and may harm herself. Her low self-esteem and distorted body image can lead her into being victimized in exploitive relationships.2 Drug use and violent relationships often are seen in the trajectory that young women with abuse histories live. As an all-too-familiar path and frequently as their perceived destiny, chemically dependent women reinvent the wheel, so to speak, in an unsuccessful attempt to conquer the demons they experienced in childhood.

In an effort to numb her somatic feelings of psychological distress, a woman with a trauma history can spiral into substance abuse. As a child survivor of sexual abuse, a young woman can find that her capacity to understand her sexual likes and values can be hindered and even fractured by intrusive remembrances of violence usually brought against her by someone she was supposed to trust.

Shame, guilt and hopelessness brought on by the abuse can injure her sense of self-efficacy, feelings of worthiness, and coherent sense of sexual identity. For women with trauma histories, substance abuse often begins during adolescence, a key stage of sexual development.3 Without effective intervention, drug use and abusive relationships can quickly become their life’s course.    

Absent of sexual recovery, a woman with a trauma history has no voice, no capacity to understand the inner workings of her mind and physical being. To understand the challenges that face the woman who has survived sexual assault, it is of relevance to take a close look at how she has lived with the experience of sexual trauma.

Case scenario

In treatment, the counselor who bears witness to the soul of a woman as the victim may see the terrified child whose body may remember what her mind’s speech center cannot recall from years past.4 This disconnect of the body with the mind can be explored in therapy as a means to bridge the gap between what was, what is, and what can be for the survivor.

Penelope’s story below describes her conflict over betraying her right to her own body in order to please her boyfriend Jake, and her desire to establish healthy boundaries.

Penelope, a.k.a. “Pinkie,” is a 23-year-old woman who was referred to treatment by the courts and admitted to a woman’s residential facility for multiple substance addictions. She has a 13-month-old daughter, Lydia, who is currently in the custody of the county’s Children's Services. Pinkie's visitation with her child is supervised because of her past neglect resulting from her addiction. Pinkie has been in a two-year abusive relationship and has been involved in sex work to survive and maintain her drug usage.

When asked by the caseworker whether she was ever hurt as a child, Pinkie said that her father messed with her when she was about 9. He told her he wanted her to be a good wife and was going to teach her how to treat a man. Pinkie reported that her drug use accelerated when she reached puberty.

     In her relationship with her counselor, Pinkie shares how she has seen herself as a sexual person:

     I didn’t think much about my sexuality before treatment. It wasn’t something I had control over. I based all my ideas of myself on what I had experienced—my father raping me when I was younger, my relationship with Jake, and working for the johns. I know I felt ashamed when I thought about my sexuality, and that having sex made me feel dirty and used—even if it was with Jake. Having sex with him, I was usually just going through the motions, and sometimes it was more than I could handle emotionally, but I never thought about whether I wanted it or not. It was just something I had to do in order to keep Jake happy. I felt like it was worth it to be loved.

     I didn’t consider how it affected me much either. Even having sex with the johns. I couldn’t use condoms with them, and never got tested for STDs, since I figured getting treated wouldn’t change anything when I could just get the same thing again. To me, that was just part of the job and I didn’t think about whether I wanted to be doing it or not.