Mindfulness as a tool to mitigate sexual difficulties experienced by trauma survivors

There is growing evidence that childhood sexual abuse may be linked to the development of sexual difficulties in adulthood2 ^,3 ^,4 . Studies indicate that other types of childhood interpersonal trauma, including emotional and physical abuse, parental neglect, or bullying, are also linked to sexual difficulties in adulthood5 ^,6 . Here are three ways to understand the links between these types of trauma and sexual difficulties:

1. Childhood interpersonal trauma is usually experienced within important relationships, such as with parental figures or peers. Damages sustained in these relationships tend to leave significant relational scars, such as discomfort with intimacy or fear of abandonment5 . The repercussions of childhood interpersonal trauma impact people’s sex lives since sexuality also involves a particular level of intimacy and vulnerability.
2. People who have experienced childhood interpersonal trauma may develop strategies to reduce trauma-related suffering, such as substance use or dissociation, which cuts which, prevents individuals from experiencing the present moment7 . These avoidance strategies tend to maintain or worsen the relational and psychological consequences of the trauma, impeding sexual health and sexual well-being.
3. An intimate relationship involves closeness and healthy interdependence between partners, which can be uncomfortable for people who have experienced interpersonal trauma. In fact, these individuals may live with the fear of being victimized, traumatized, or hurt again5 . This avoidance of intimacy may, over time, translate into low sexual desire, or manifest as pain during sex, difficulty letting go and reaching orgasm, erectile difficulties, or aversion to sex8 .

Mindfulness to promote sexual well-being

Mindfulness has increasingly been documented as a way to support sexual well-being in adulthood9 . Mindfulness is the state of awareness that arises when one pays attention to experiences in the present moment, with acceptance and without judgment10 . By promoting contact with oneself, with others, with one’s sensations and experiences, and by remaining anchored in the present moment rather than with traumatic memories from the past mindfulness can gradually reduce avoidance strategies. Mindfulness can promote well-being and sexual health in six ways9 ^,11 ^,12 ^,13 ^,14  :

• Ability to observe your sensations, with curiosity, openness, and without judgment; 
• Acceptance of yourself and your body as it is;
• A greater ability to connect with others intimately and authentically; 
• A better understanding of yourself, which gradually leads to an increase in self-esteem;
• Conscious actions, anchored in listening to yourself, your limits, and your values; 
• A capacity to experience sexuality in a holistic way, for instance by focusing less on performance, in prioritizing connection with others as a motivation for sexual intimacy, by including all sensations in sexual experiences, etc. 

Despite its benefits, mindfulness can cause trauma survivors to re-experience painful experiences from the past. Therefore, it is important to promote the trauma-sensitive mindfulness approach15  by considering the following points:

• As soon as you notice an emotion, sensation, or thought emerging, try to remain attentive, curious, and nonjudgmental towards that experience (e.g., avoid labeling a sensation or emotion as "good or bad," "positive or negative" at this stage of observation, to welcome the experience as it arises).
• If you decide to cultivate sexual mindfulness, be sensitive to what feels safe (for example, choosing who to have sex with, where, and in what context, postponing an activity, or saying no when needed). A safe environment is essential for sexual healing and wellness.
• Practice sexual mindfulness by adapting the environment to your five senses, according to your preferences. For example, adjust the lighting, sounds, and smells. Feeling comfortable in your physical environment can help you stay mindful.
• If you are in an intimate relationship, you can work with your partner. Communicate what you like and ask what pleases them sexually. Notice what your five senses are telling you (preference for type of touch, paying attention to sensations depending on whether your eyes are open or closed, etc.).
• Incorporate mindfulness practices into your daily life. Integrating mindfulness practices, such as meditation or mindful walking, can create benefits that can be transferred to your sex life. Feel free to adjust your practices in a very flexible way, such as meditating with your eyes open, using anchors that calm you (breathing, body sensations, or an external object as a focus), showing self-compassion, and remaining kind to yourself when you encounter difficulties.

Dealing with sexual difficulties when you have past traumatic experiences is a non-linear learning process that usually takes time. By being patient, putting in the effort, having self-compassion, and getting professional help when needed, the consequences of past traumas are better metabolized, making room for sexual fulfillment.

The publication of this article was made possible thanks to our partner, the Interdisciplinary Research Centre on Intimate Relationship Problems and Sexual Abuse (CRIPCAS), and the Fonds de recherche du Québec.  

To cite this article: Marcoux, L. & Godbout, N. (2023, January 9th). Mindfulness as a tool to mitigate sexual difficulties experienced by trauma survivors. TRACE Blog. https://natachagodbout.com/en/blog/mindfulness-tool-mitigate-sexual-difficulties-experienced-trauma-survivors 

• 2Bigras, N., Godbout, N., & Briere, J. (2015). Child sexual abuse, sexual anxiety, and sexual satisfaction: The role of self-capacities. Journal of Child Sexual Abuse, 24(5), 464-483.
• 3Baumann, M., Bigras, N., Paradis, A., & Godbout, N. (2020). It’s good to have you: The moderator role of relationship satisfaction in the link between child sexual abuse and sexual difficulties. Journal of Sex & Marital Therapy, 47(1), 1-15.
• 4Vaillancourt-Morel, M. P., Godbout, N., Labadie, C., Runtz, M., Lussier, Y., & Sabourin, S. (2015). Avoidant and compulsive sexual behaviors in male and female survivors of childhood sexual abuse. Child Abuse & Neglect, 40, 48-59.
• 5 a b c Bigras, N., Daspe, M. È., Godbout, N., Briere, J., & Sabourin, S. (2017). Cumulative childhood trauma and adult sexual satisfaction: Mediation by affect dysregulation and sexual anxiety in men and women. Journal of Sex & Marital Therapy, 43(4), 377-396.
• 6Bigras, N., Godbout, N., Hebert, M., & Sabourin, S. (2017). Cumulative adverse childhood experiences and sexual satisfaction in sex therapy patients: What role for symptom complexity? Journal of Sexual Medicine, 14(3), 444–454.
• 7Myers, I. J., Berliner, L., Briere, J., Hendrix, C. T., Reid, T., & Jenny, C. (2002). Treating adult survivors of severe childhood abuse and neglect: Further development of an integrative model. JEB Myers, L. Berliner, J. Briere, CT Hendrix, T. Reid, & C. Jenny. The APSAC handbook on child maltreatment.
• 8Godbout, N., Bakhos, G., Dussault, É., & Hébert, M. (2020). Childhood interpersonal trauma and sexual satisfaction in patients seeing sex therapy: Examining mindfulness and psychological distress as mediators. Journal of Sex & Marital Therapy, 46(1), 43-56.
• 9 a b Dussault, É., Fernet, M., & Godbout, N. (2020). A metasynthesis of qualitative studies on mindfulness, sexuality, and relationality. Mindfulness, 11(12), 2682-2694.
• 10Kabat-Zinn, J. (2003). Mindfulness-based interventions in context: Past, present, and future. Clinical Psychology: Science and Practice, 10(2), 144–156
• 11Laumann, E. O., Paik, A., & Rosen, R. C. (1999). Sexual dysfunction in the United States: Prevalence and predictors. JAMA: Journal of the American Medical Association, 281(6), 537–544.
• 12Bossio, J. A., Basson, R., Driscoll, M., Correia, S., & Brotto, L. A. (2018). Mindfulness-based group therapy for men with situational erectile dysfunction: A mixed-methods feasibility analysis and pilot study. The Journal of Sexual Medicine, 15(10), 1478-1490.
• 13Brotto, L. A., & Basson, R. (2014). Group mindfulness-based therapy significantly improves sexual desire in women. Behaviour Research and Therapy, 57, 43-54.
• 14Leavitt, C. E., Lefkowitz, E. S., & Waterman, E. A. (2019). The role of sexual mindfulness in sexual wellbeing, Relational wellbeing, and self-esteem. Journal of sex & Marital Therapy, 45(6), 497–509.
• 15Treleaven, D. A. (2018). Trauma-sensitive mindfulness: Practices for safe and transformative healing. W. W. Norton & Co.