Episode 91: Healing Sexual Trauma

Hi, I'm Suzanne Noble, and you're listening to Sex Advice for Seniors. And today I'm with Erica Shiershan. You call yourself a somatic psychotherapist. That's right, isn't it? And you do EMDR, which I've also experienced and was very beneficial. We can discuss what that is, but welcome to Sex Advice for Seniors, Erica.

Thank you, Suzanne Noble Noble. It's a pleasure to be here.

And you are where?

I'm in San Francisco, California.

Oh, brilliant. I'll be there. Well, I'll be in, in California in August. Looking forward to that. I have some family there, So hello to my West Coast family who may be listening. And, you know, today we're going to be talking about a subject that I understand that is one of the areas that you focus on, which is around trauma and sexual trauma. And we spoke just, just a few minutes ago about the episode that we've— that I've done previously talking specifically about abuse that sometimes takes place in boarding schools, specifically if you are an older man living in the UK and may have had your first sexual experiences in a very unpleasant way, which then informs how— and you consider— may inform how you consider sex and sexual relationships in your adult life. And you said you had some thoughts around that. I'm curious to hear them.

Yes. Well, it was specifically, um, your guest mentioned that boys who were sexually assaulted felt pleasure, and I wanted to expand on that. Um, so the reason I really want to expand on that is because these feelings of pleasure are at the root of deep feelings of shame for many survivors, both male and female.

Mm-hmm.

Um, and there are physiological reasons why it happens. It's beyond the survivor's control, and it's important if they felt pleasure that they know it was not an invitation to be sexually assaulted and it was a physiological response, because I see this in my practice quite a bit. Mm-hmm. Um, and It's just, there's so many ways that shame can come up for survivors, unfortunately, and this one tends to be especially painful. So, um, in many cases what's known as arousal non-concordance was at play. I don't know if that's something you've talked about on here, but physiologically the genitals determine what's sexually relevant resulting in a genital response. And the brain determines what's sexually appealing, resulting in a subjective arousal response. Research on adults and arousal concordance shows that there's about a 50% overlap in males between genital response and subjective arousal. This number drops significantly to an average of just 10% overlap for women. So just because they felt pleasure, uh, the children of, of sexual assault especially, it doesn't mean they wanted to be assaulted or raped, of course. And, and, um, even if they experienced arousal concordance, they were not capable of giving consent, and in most cases they didn't understand what was happening to them. So this is one reason it happens so frequently with children, because they don't even know what's going on, um, often. And it's someone that they trust who's doing this to them, who's groomed them, you know, who might be telling them they're special or something else along those lines. And, and, um, it's— there's this big 'this doesn't compute,' right, happening in, in their whole system. So Um, and it also can happen to adults. I don't see it as, as frequently in adults, but it can happen. Um, and if it did, they were likely in a freeze state, and, um, they could have also been drugged or intoxicated, all of which make it impossible to consent. So if you're okay with it, I want to give an example from my own life of when this played out for me. And, um, it's, it's not an experience of, um, a successful rape, so I'm hoping it won't be triggering to anybody. Um, but it is a sexual assault, so Suzanne Noble: When I was 25, I received a series of acupressure sessions from the best friend of my yoga teacher, and midway through what would be my last session, the practitioner moved his hands to points on my upper inner thighs, and physiologically my body responded the way it was designed to, as a sensation of arousal washed over me. I quickly realized this was an arousal pressure point. At the same time, my brain's subjective arousal was nonexistent. My brain put on the brakes and yelled no. So I immediately grabbed a sheet and held it to my chest, sat up, looked him in the eyes, and firmly said, what are you doing? This is not okay. And he took his hands off me and dropped his head in shame, apologized, and pleaded with me not to report him.

Wow.

So I was lucky.

Yeah.

Because I had a combination of this non-concordance and my autonomic nervous system took me into a sympathetic state, commonly known as fight-flight. Rather than a dorsal vagal state, commonly known as freeze, which is what happens to— in most betrayal traumas and in, in most sexual assaults in general, the person will go into the freeze state where, if that had happened, I wouldn't have been able to sit up and confront him. Yeah, yeah. And, you know, if I'd been in arousal concordance, I may have tolerated this all, us all going further. So, um, so in this case, I was really lucky. And I think part of why I was able to remain in sympathetic was because I had that connection. Like I'd had— I'd already been to him several times. I knew him, I knew his good friend. Yeah, and that helped quite a bit, I think. Um, if he'd been a stranger— like, I've worked with a lot of survivors who've had negative experiences and assaults during a massage or something similar to this. So, um, and, and if I'd been a child again, like, I wouldn't have known what was going on. And how could I know how I feel about it if I don't know what is even happening? And, um, to my body, like, what are these sensations? Or, you know, if, if I was familiar with it, I still wouldn't have had the capacity to consent.

Yeah, yeah.

But I would have been probably again in a freeze state.

Yeah, yeah, absolutely. And how—

or dissociative, Suzanne Noble Noble, sorry.

It's difficult, isn't it? Because if our earliest sexual experience was, as we've said earlier, non-consensual, but it was pleasurable, and then we get to our adult life and we— and that pleasure is associated with something that happened to us earlier that was actually non-consensual, then there's a conflict there. And I see this sometimes with people that I, you know, that I've been really close to, that they reveal this to me and they're confused by it. It's like, what does— what did this mean that I seem to enjoy it? Enjoy meaning, you know, I was experiencing arousal, as you say. But at the same time I didn't consent and I knew it was wrong. So it's about how, how do you resolve that conflict? Because I see that so often in, you know, and I've heard that so often from that type of story from mainly men. But, you know, as you say, the proportion is higher, much higher than would— than women, who I suspect it's because, you know, if a guy takes a shower and he starts washing his penis, it often just gets hard. Like, he's not— he's not trying to do that. It's just the physical sensation starts switching things on in the brain that says, this feels good, I'm gonna— I'm gonna go with this. So, you know, you can appreciate why somebody might if somebody— if they were being touched and things did happen like that, that they might think, ah, that means it's— that means I must be getting turned on.

Yeah, you're absolutely right. I see so much confusion and shame when this is at play, and, um, I do see it quite a bit in, in childhood female survivors. I, and I think because of the innocence and that confusion when it's happening. But it, it is more common in males. And I, what I like to treat it with is EMDR. It really helps get it, the, the negative belief that was sort of embedded in their subconscious at that time about themselves, that somehow they are wrong or bad. For what happened to them, and it, it really transforms that belief and integrates the trauma at the same time. So it's really effective for this. Um, yeah, and you know, there's so many other ways that the trauma plays out in survivors, so I don't want to only talk about this, uh, but I just felt like it's, it's so important for any listener who might have experienced this to not in any way blame themselves for anything they felt. Absolutely.

And can you explain, because no one has been on ever that did an EMDR, so probably a lot of people have no clue what that even means and how, um, and how it works.

So EMDR stands for Eye Movement Desensitization and Reprocessing, and it uses bilateral stimulation. So in, in my case, I do it the way it was designed initially by Francine Shapiro over 30 years ago, but just, I hold up my hand with two fingers up and I just move it from side to side and you follow along with your eyes. And, um, and of course we are targeting something very specific, and we're checking in also with the negative belief, and we contain it in between sessions. So it usually takes around 6 or so sessions depending on what we're targeting. So, you know, the bigger the trauma, the more sessions it's going to usually take, um, unless you've already done a lot of EMDR, and then it tends to go quicker. But it's, um, it's amazing. It still amazes me every week because the results I see from it. And there can be some discomfort while we're doing it because it will take you through the emotions, the sensations and the thoughts, um, that, you know, were present at the time. And what's nice though is you see the number going down each session until it gets to a zero, where the trauma will truly feel in the past. It won't trigger you any longer because it's where it belongs, and all of the pieces, all of the fragments of the trauma have been integrated. So it brings about a lot of relief when it's done properly and, um, when everything that needs to be targeted is targeted around the trauma.

Yeah, I mean, my experience of it, and the reason I really like it so much as a technique, is It's really quick, so it doesn't require you to go into therapy for 10 years and re, you know, re-engage with all the stuff that you're trying to overcome. I like that about it. The second thing I like about it is that, well, it works. That's the other thing. And you do, you know, I've done it probably 3 or 4 times for different things. And I think the thing that's worth pointing out about EMDR is it was used initially to, um, for, uh, people that came out of the war and were heavily traumatized, wasn't it? That was, I think, one of the original uses for it, or it's certainly used for that.

Um, it, it is used for trauma and for phobias and phobias. Also be good with anxiety. Um, I don't— I'm not that familiar with any research that was done on it with veterans early on. I honestly haven't investigated that, but she came— Francine Shapiro came up with it in an interesting way. She, she was noticing that she'd feel better after she'd go on a walk, and so she started analyzing, well, what's happening here? And she realized that when she would walk, she would move her eyes from side to side. Oh, wow. And so she started playing with that and created this whole method. There's obviously a lot more to it than that, but, um, but that was what I learned, that how it originated.

Yeah, no, I mean, it's an incredible— I used it for phobias because I'm scared of heights. So, you know, I used it for that and it has, it has helped. Generally helped, and I've used it for other things as well. But I think for anyone that is struggling, then, like you say, with, with a, with a trauma or phobias or anxiety, it is definitely worth connecting with somebody who does EMDR, I think, as a first step, just because it can cut through so much that so many other forms of therapy seem incapable of doing. And, and like you said, serious trauma, 6 sessions. For me, it was like 2. And, you know, it's not great for a therapist though, because obviously you don't get your 10 years of a client. And, and the guy went to see said to me, I hope after 2 sessions I don't have to see you anymore. I thought, well, you, that means you need to get a lot of clients if you're, if you're fixing them that quickly, but, you know.

Yeah. Well, that's interesting that he said after 2 sessions, I would never say that. I, I can't guarantee that it's only going to take 2 sessions and no, typically no EMDR therapist can guarantee how long it's going to take, how many sessions. Um, but, um, For the sexual assault clients that I treat, it usually takes 1 year to, to 2, depending on the severity, number of assaults that they've been through. Um, a lot of times that we've cleared up the sexual trauma in 1 year by targeting it through a number of modalities that I use, and then, um, they want to stay on to clear up other traumas after that, um, relational traumas usually from childhood, that sort of thing. So, um, you know, a year isn't much in comparison to— like, I spent 17 years in therapy trying to heal from sexual trauma and other traumas, and, um, not realizing how much the sexual traumas were impacting me and my choices I was making and just every aspect of my life. Because, you know, I would tell the therapist about them, but they really weren't addressing them. So, um, I am very much results-driven, and I don't want survivors to go through that. So, like, similarly to that therapist with you, I, I'm like, I would maybe say that about a year or 2 years, but I wouldn't say 2 sessions.

Yeah, mine was, mine was, mine was light though. Mine was literally, I can't stand going up lots of steps. So it wasn't, it wasn't anything that was, you know, I think terribly significant. So let's talk about how trauma shows up in later life, and how you see it showing up in later life with some of your older clients.

Yeah, so a lot of times it kind of lays hidden for a good long time, like we kind of push it away. Our, you know, subconscious mind And it's a survival mechanism, like we needed to do that. We didn't have the resources we needed to heal at the time. And then many of them have just gotten busy raising a family and survival stuff. And then around the time, sometimes around the time that children are going off to college, they'll start their symptoms will start to worsen, right? And, um, and they'll start to realize, you know, it's really their body's screaming at them like, it's time to do this work, really getting their attention with these symptoms. And, um, I think it can help to know that because I think a lot of people feel like, you know, what's wrong with me, and those sorts of feelings. But it's really that things are right now, that you can do this work now. It doesn't feel like that when it's happening because the symptoms can be quite disruptive and uncomfortable. So they might start having flashbacks. Um, that happened to me also. So I was in my 40s after the 17 years of therapy, and, um, the flashbacks started after, um, after being in a, uh, training where I was a body worker at that time, and my hands just suddenly went numb.

Wow.

And, um, after he'd done a demo on someone's neck, and he'd actually asked me to volunteer. And I— my first thought was like, yeah, I know he's such an expert, I'd love to volunteer. But the word no came out of my mouth. And then it was like right after that when we went back to practice that I— my hands went completely numb. And I didn't realize at the time, but, but I was having dissociation taking place, and then flashbacks came on board. And that was sort of a big turning point where I started to understand how much it was stored in my body, and that, you know, you can't just ignore it or push it away, or you've really got to go through the healing work.

Yeah. And do you sometimes see that, you know, I've spoken a lot about the fact that I, I find that sometimes menopausal women tell me that they, you know, they've lost their libido, their— everything seems to have gone. And, you know, they're, they're probably never going to have sex again. And do you think that some of that is a manifestation of earlier, um, experiences that were not terribly pleasant of sex? And, and part of that is the body's way of saying, okay, you don't have to do that anymore.

I do. I, uh, so quite a few survivors will go toward sexual aversion for a time in their healing. Or they might go through it and not be healing. And, you know, sometimes it can be helpful if they're in the healing stages to, to take a break for a while. But it's best if it's a choice, right? If it's a conscious choice. And so about 20% will go the other direction and be very sexual, and repetition compulsion can play out, which is a term that Freud came up with where, you know, you put yourself in similar circumstances hoping for a better outcome, and it kind of— it's not done consciously. Um, so, so about 20% of survivors go in that direction, um, at least with females. So that the numbers may be higher with males around that. And, um, yeah, I, I think there's a lot of reasons why people go toward aversion. One of them is that a lot of survivors have pelvic floor issues, so they might have a lot of pain during intercourse, or they might have erectile dysfunction happening. And so, you know, it just doesn't feel pleasurable. Um, and again, like, the healing can help quite a bit with those symptoms. Like, the, the pain is often due to constricting, and it's involuntary constricting happening. And if you think, like, at the time of the trauma, The only way the body could try to protect itself, because this person was usually bigger and overpowering you, or again, like, you were drugged or you froze. Um, it's usually a combination of, you know, they're bigger, they overpower you, you freeze. They— you, you never hear about rapists raping people smaller than them, do you? No. I mean, sorry, the other way around. Bigger than them. Yeah, you never hear about that. It's— no, so they're always overpowering someone, uh, in more ways than one. And, and so, you know, their body went into constriction, constricting, and they hold on to that pattern. And by doing somatic work Um, and EMDR, you can help undo that pattern.

Yeah. So what exactly is somatic therapy? It's something to do, as I understand it, with bodywork. Is that right?

Well, it doesn't— so different practitioners do it differently. Some bring in touch, but I believe the majority don't. Use touch at this point. Um, so it's wonderful either way. It's working with the patterns of movement and constriction, um, gestures, that sort of thing in the body. And, um, you know, every emotion has a sensation connected to it. So one thing that is— happens where people who have unintegrated, unhealed trauma is that they are cut off from their body. So that also plays into aversion. So they, they have— again, it's not a conscious choice, but they've numbed out, they've disconnected, they dissociate a lot. Any of those. And so they don't really have an awareness of sensations in their body. Yeah, yeah. So we have to begin first of all with helping them start to get in touch with cultivating a sense of safety in themselves, or relative safety, and, um, then help them begin to notice what sensations are present for them and understand that they don't have to be afraid of them, that they're always coming and going, just like emotions, and changing. And there's ways that they can work with them. So it, it's a really important piece of the healing work as well, because trauma is stored in the body.

Yeah, I mean, I have a friend and who, who, who had, who was struggling with her back and spine and had experienced trauma at a young age and a series of pretty horrible events. And, and I was reminded when you were speaking about her experience when she finally was able to have surgery on her back, what she recognized was that she'd stored all this trauma in her body, which had led to this, you know, to just really bad back problems, quite significant, that needed to be operated on. And in, in the healing process, when she started to process, well, why, you know, what did this 'Why did I ever end up with these back problems?' She realized that exactly what you're saying, that she'd internalized all this trauma and was completely out of touch with her body, completely unaware of, of how all of that was manifesting actually through the disintegration ultimately of her spine. And in recovery, she started connecting more with their body and recognizing like, oh, if I do some— if I do a plank, if I, if I do this, if I do that, I, my muscles are going to be, be stronger. I'm going to be developing my core. I'm going to be able to do this. But it took a significant amount of, of time for her to connect the fact that all of this stuff was working against her, essentially, that this trauma was directly manifesting in her body, saying, I'm not having this anymore, and just literally breaking down. Right. And I think, and I suspect that many people struggle in their bodies in all different sorts of ways and don't associate some of the stuff that may have happened to them earlier in their lives with why this is all happening now, you know. Yes, that connecting with your body is about connecting with your whole body and your brain, and not just about going off and doing some exercise and hoping that, you know, everything's going to be better, that it's all, you know, it's all working together. And I know that for her, the trauma was directly related to what happened physically to her, and it unfortunately, it took something quite serious for her to tally up the two. And I suspect that's not uncommon.

No, it's not. And the example I gave of myself even was, was, um, that sort of same realization how much this has been impacting me all this time on, you know, physically, emotionally, on every level. And, um, and I have a list on my healingsexualtrauma.com website of symptoms that some of your listeners might feel helpful for them to, you know, see if they recognize any of those symptoms. It's actually a blog post on that site on the symptoms. Um, there's, there's so, it's so complex. Everything is so interwoven with the body-mind. And the whole problem with having unintegrated trauma is that you get caught in these cycles of being in sympathetic state or the dorsal vagal, the freeze state, too much of the time. Like, we dip into those states a little bit in healthy ways, but people who are experiencing trauma symptoms are in those states a lot of the time, and it releases toxic amounts of cortisol and noradrenaline and adrenaline, which, you know, in healthy doses we need, but when we get too much of it, it causes all kinds of problems. And so you see eventually a lot of people with autoimmune disorders and There's a lot of things that might come before that, but, um, a lot of survivors have digestive issues because when we go into sympathetic, immediately blood rushes away from the prefrontal cortex and we have more blood going to the limbs. So it's also going away from the intestines, the whole digestive tract, and the reproductive organs. So this goes back again to sex drive, right? So So if your blood's rushing away from your sexual organs while you're, you know, having— you're triggered or having some type of, you know, you're dysregulated.

Yeah, yeah, yeah, for sure. No, I mean, I think there's— you know, I looked at your website and obviously there's depression, there's, you know, digestive issues. There's so many ways that this turns up. I suspect many people are just wandering around in this extreme state of discomfort, not really putting the two and two together around all of this. I mean, I think it's fascinating. It's also really sad because unless you know that this is partly what's causing it, you know, the likelihood of any sort of recovery, I would imagine, is pretty slim. So, you know, I hope that people listening might think about maybe something that's happened might be leading to all of this if they're, you know, if they're struggling in some way. So, yeah.

Yeah. And it could be other trauma as well.

Yeah, absolutely. Yeah. Yeah. Well, thank you very much. We have reached the end of our of our podcast. And I'm really grateful for you coming on the, on the show and for us having the opportunity to talk about this. And like usual, we'll be posting the way that everyone can find you, all your social media if you've got any. And thank you so much.

You're so welcome. I just want to say it's never too late to heal. So please, everyone know that. And I appreciate this opportunity. It was great to get to chat with you, Suzanne Noble Noble. Thank you.

Thank you.