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How does trauma impact our physical bodies–and our sexual lives?

I’ve been wanting to read The Body Keeps the Score by Bessel Van der Kolk for several months now. It’s been highly recommended by so many who study and work in the field of sexual trauma, and so, when we left for vacation, I loaded it on my Kindle, all ready to see the insights on sex lives today after trauma, the effects of childhood trauma, and the effects of abuse in relationships.

(affiliate links below for the book!)

UPDATE: I’ve learned, since publishing this post, that the author himself has mistreated his employees, likely causing trauma, and was fired from his job as head of a trauma center. This really saddens me. What he wrote was ground-breaking, and the insights below are still valid. I just wish that the person who made them has also lived a life of integrity. 

Body Keeps the Score - SEX and YOUR BODY SERIES: The Body Keeps the Score and Sexual Trauma

Since we’re talking about sex and your body this month in our February series, I was planning on trying to summarize it in a blog post, and talk more about recovery. But instead, on reading it, I saw something really interesting about the way that we talk about sex in the Christian community, and it’s actually that which I’d like to focus on in this post.

But first, I’ll try a short summary (and this is going to be a pathetic summary because there’s so much in the book, and it’s just amazing, and I’ll never do it justice).

Here’s how trauma is formed:

“Whenever we feel threatened, we instinctively turn to the first level, social engagement. We call out for help, support, and comfort from the people around us. But if no one comes to our aid, or we’re in immediate danger, the organism reverts to a more primitive way to survive: fight or flight. We fight off our attacker, or we run to a safe place. However, if this fails–we can’t get away, we’re held down or trapped–the organism tries to preserve itself by shutting down and expending as little energy as possible. We are then in a state of freeze or collapse.” Bessel Van Der Kolk

The Body Keeps the Score

And because the trauma is unable to be resolved, the parts of our brain that are activated during trauma stay activated, even when the danger has passed. And this has dire consequences for our daily lives.

Van der Kolk shows in the book the two different forms of reactions to trauma–people in extreme agitation and emotional arousal (not sexual arousal, but having one’s panic buttons constantly pushed); or people who are completely shut down, unable to feel emotions, connections, or experiences–“in an effort to shut off terrifying sensations, they also deadened their capacity to feel fully alive.

And in the book he explains the science behind what happens; the history in the field of psychology and psychiatry that has tried to help these people (and how they have spectacularly failed on so many levels), and then different treatments which have been found to be very effective, including EMDR, yoga, integrative family systems (which I personally found fascinating), biofeedback (which sounds amazing), theatre, and more.

Trauma actually changes our brains by activating certain areas and keeping them activated, and that will show up in other ways in our bodies–hence “the body keeps the score.” To resolve many of our physical and emotional ailments, we have to help our brain restore proper balance and leave the heightened trauma response behind.

He showed how so many of the things that we label mental disorders–like obsessive compulsive disorder, depression, anxiety, and more–can actually be reactions to trauma. And yet we treat them as if they are the disease itself. 

Nowhere is this more tragic than in the case of child abuse, where so many behaviour problems in children actually stem from chronic trauma at home, where they are not safe. And yet we medicate them and give them labels rather than addressing the trauma in their home life. He makes the case that this is the biggest public health crisis in North America today.

At the heart of trauma is a feeling of being unsafe.

Trauma is caused when you cannot control what is happening around you, especially when you are in danger. While in the first part of the book he talked about trauma from specific, isolated events, like war, or car accidents, or assaults, later in the book he showed how trauma can be caused by living in an unsafe environment, like child abuse. Chronic trauma, where we never feel safe, has horrendous repercussions.

But let’s tease that out for a moment. 

What, exactly, is involved in feeling unsafe? 

It’s feeling as if you have no agency. That who you are, fundamentally, is being ignored and doesn’t matter. One of the ways we feel safe is that we feel as if we are seen.  When we aren’t seen, especially on a continuing basis, that can cause trauma.

“Trauma almost invariably involves not being seen, not being mirrored, and not being taken into account.” 

“Being ignored or dismissed can precipitate rage reactions or mental collapse.”

“… knowing that we are seen and heard by the important people in our lives can make us feel calm and safe.”

Bessel Van Der Kolk

The Body Keeps the Score

Being seen matters! As Van der Kolk says, this is especially true in those relationships which are supposed to be the closest:
“The holes in the soul that result from not having been wanted, not having been seen, and not having been allowed to speak the truth.”  Bessel Van Der Kolk

The Body Keeps the Score

What if too much Christian teaching on sex tells women that you’re NOT seen?

One of the measures that we were looking at in our Bare Marriage survey was sexual pain.

Pelvic floor physiotherapists have known for years that those who are conservative religiously are more likely to experience sexual pain. What we were hoping to tease out was why–what teachings specifically make this more likely?

I won’t go into all the details, because I’d like to save most of it for our upcoming book The Great Sex Rescue, but I can tell you that feeling as if a husband has a need for sex that you don’t share, and feeling as if you have an obligation to meet that need, leads to higher rates of vaginismus (vaginal muscle contractions that make intercourse painful, if not impossible). And that’s exactly the teaching that is in the book Love & Respect (a message that Focus on the Family says is an “biblically-based, empowering message for women, remember), and far too many others.

I’m not arguing that sex isn’t an important and necessary part of marriage, by the way. But how we talk about it matters; and framing sex as only something that a husband needs and is owed, and a woman must provide, is unbiblical and makes her needs and feelings invisible.

When we feel as if we don’t matter, as if our needs don’t matter, as if we are invisible–our bodies feel under attack. We go into fight, flight, or freeze mode.

As I was reading The Body Keeps the Score, I couldn’t get our survey results about vaginismus out of my mind.

The condition itself looks like a classic reaction to trauma. As Van der Kolk explains,

“When people are chronically angry or scared, constant muscle tension ultimately leads to spasms, back pain, migraine headaches, fibromyalgia, and other forms of chronic pain.”

Bessel Van Der Kolk

The Body Keeps the Score

Muscle contractions and tense muscles are common symptoms of trauma. And vaginismus contracts muscles in such a way that makes intercourse difficult, if not impossible, as if the body itself is rejecting sex.

This doesn’t mean that all vaginismus is trauma-related; it’s clear that it’s a multifaceted condition that can be caused by many things that affect the pelvic floor.

But what our surveys found was a reason that vaginismus may be a trauma reaction in some women: that too much Christian teaching leaves women feeling invisible and powerless when it comes to sex. And our bodies naturally rebel against that, even if our minds don’t seem to be.

And this trauma can be activated whether or not our husbands agree with this “obligation sex” message, by the way, because it is not our husbands who are necessarily causing the trauma. It’s the teaching in the first place. You may have the kindest husband in the world who wants sex to be totally mutual and doesn’t want to force anything, but the teaching has made you feel invisible and unsafe, and it is that to which your body may be reacting.

As Van der Kolk says, one of the biggest reasons for trauma in close relationships is the mindset:

“I feel like an object, not a person.”

When we feel as if we don’t matter, as if our needs don’t matter, as if we are invisible– our bodies feel under attack. We go into fight, flight, or freeze mode.

We can’t walk in sexual wholeness while still feeling like objects.

While the go-to treatment for sexual pain is pelvic floor physiotherapy–and I highly recommend that, by the way–what our survey results tell me, and what this book tells me, is that it’s not only pelvic floor physiotherapy that we need. If rates of sexual pain are higher when people believe certain things, then part of the treatment has to be challenging those beliefs and giving people back their agency. 

“Trauma robs you of the feeling that you are in charge of yourself…The challenge of recovery is to re-establish ownership of your body and your mind–of your self.” Bessel Van Der Kolk

The Body Keeps the Score

God does not intend for people to be used! And yet think of how often our teaching has made it sound like allowing yourself to be used is a good thing. We may hear this, and we may even believe it. But our bodies and our emotions often rebel directly against it, because it makes us feel unsafe. We may get sexual pain. We may have a huge drop in libido. We may feel chronically angry. We aren’t deliberately causing these things, but our bodies are trying to protect us from feeling unsafe.

Recovery from this involves: “restoring a sense of agency, engagement, and commitment through ownership of body and mind.”

In other words, treatments that focus on helping the body physically be able to have sex without addressing HOW we have sex or WHY we have sex may fail. We can’t solve the problem of vaginismus while still remaining in the same mindset that caused the chronic trauma–that a person is not seen; has no agency; doesn’t matter. It’s like trying to treat a child’s behavioural problems without removing them from an abusive household.

Maybe the answer is to challenge our beliefs about sex, and see God’s real intention–and that’s what I wrote The Good Girl’s Guide to Great Sex for. It shows how sex was made for women AND for men, and that our needs and desires and wants are central to good sex, not incidental or peripheral. Sex isn’t a one-way obligation; it’s something that is meant to be mutual in every way.

(Because trauma impairs our rational brain’s function, changing beliefs in and of themselves can’t solve trauma. We have to give the body itself a chance to resolve it physically, by giving a person more control during sexual encounters; giving them more agency, etc. But more on that on another day!).

All of this reminded me of the Bible story of Hagar, Abraham, and Sarah.

If you may remember, God had promised Abraham that he would have a son, and that from this son God would make a great nation. The problem?

Abraham and Sarah were both really old, and Sarah was barren. So in desperation, Sarah suggested that Abraham have a child with her slave Hagar.

Nothing in the Bible story tells us that Hagar was a willing participant. She wouldn’t have had a say in it. This was sexual assault. Her feelings and needs didn’t matter.

Later, Abraham did have a child with Sarah, and now Hagar and her son Ishmael were threats to Isaac, the child of the promise. And so Abraham sends Hagar and her son away.

While she is in the desert, God provides for her.

And here’s where things get interesting. Hagar is the first person in Scripture who is given the honor of bestowing a name upon God. And the name that she chooses?
“The God who sees me.”

After being sexually assaulted, forced to carry a baby, and then abandoned, never having her needs or wishes taken into account, being invisible and used to meet other people’s needs, God sees her.
And being seen makes all the difference.

What I also hope will come from our survey, and our upcoming book, is an awareness that far too much Christian teaching around sex actually can cause trauma by telling women they aren’t seen and aren’t important, and that they exist to be used (as penis homes, in Mark Driscoll’s words). 

This is not the biblical way to see sex, and I showed a better way in The Good Girl’s Guide to Great Sex, and we’ll be tackling this head on in the upcoming The Great Sex Rescue.

God sees us.
And being seen makes all the difference.

But far too many Christian resources still preach it, and it is having real-world ramifications on women’s bodies. I know this grieves God, who sent His Son to set the captives free. May we find a way to talk about sex that involves a mutual knowing, a mutual giving, an other-centered outlook rather than an obligation and entitlement model.

As Leslie Vernick said, “A spouse is a person to love, not a body to use.” If the way we talk about sex reduces women to objects, then no wonder women’s libido is often killed, and so many women experience sexual pain.

The body, after all, keeps the score.

If you’re intrigued by this, do check out The Body Keeps the Score by Bessel Van der Kolk! It is fascinating, and my husband really enjoyed reading it, too, as a physician.

The Body Keeps the Score - SEX and YOUR BODY SERIES: The Body Keeps the Score and Sexual Trauma

What do you think? Has your body kept “the score”? Could the way that we talk about sex be hurting women? Let’s talk in the comments!

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