PTSD and Sexuality
Although it is not a requirement for diagnosing a woman with Post-Traumatic Stress Disorder (PTSD), about 90% of them report sexual dysfunction, according to Rachel Yehuda, Ph.D. at the conference for the International Society for the Study of Women's Sexual Health (ISSWSH) I attended recently in San Diego. Many therapists who have clients with PTSD make the assumption that this shows up when women have "psychological" reasons to have low sexual desire and activity. They often think that if the traumatic event was sexual in nature (such as sexual exploitation or rape), of course there would be a sexual difficulty. But, it turns out that loss of libido is present regardless of the type of upsetting event that happened.
Yehuda went on to explain why. In the brain, the amygdala is involved in the emotion of perceiving an event. For example, one might think, "A tiger! I'm afraid!" But, also in the brain is the hippocampus which is involved in assessing the context of an experience. So, one would adjust one's response but noting, "Oh, but this tiger is in a zoo. I'm safe."
In the brain, substances called catecholamines affect what one thinks about a situation. Those thoughts can trigger distress. And, as it turns out, distress can trigger more catecholamines, which can trigger more thoughts and, in turn, more distress. Yehuda stated that if catecholamine levels are too high, this may result in what she called an "over consolidation" of memory and that leads to PTSD. This happens if the event is very distressing or if normal coping mechanisms are not engaged.
It's difficult to engage "normal coping mechanisms" when an event happens that is highly unpredictable and cannot be controlled. These two factors contribute to the occurrence of PTSD. So, the overconsolidation occurs.
So, where does sex fit into all of this?
A woman who can think about a life event and say, "These things happen," will not develop PTSD. But, a woman who after a life event says, "I'm not going to be the same," will develop PTSD.
Women who have PTSD are in a state of being numb. They tend to avoid the feelings of general arousal (not sexual, but more what we think of as alertness and vigilance) because it takes them out of their numbness. That is stressful and exhausting.
Arousal (the sexual kind) is required for sexual interest and response, but it is very difficult for women to choose to be aroused since it requires that they not be numb. It can also bring them closer to the memory in the amygdala of feeling afraid. And, it turns out, they are lacking a safety context because during the stressful event, safety was very much in doubt for them. So, staying numb feels like a safer choice and that makes sex out of the question.
In addition to this dynamic, people with PTSD may also have sleep disturbance, medication side effects, chemical dependency and abuse, and other psychiatric conditions that do not easily predispose a person to choose to be sexual. All in all, sexual lack of interest caused by PTSD must be treated with an understanding of the brain structures and neurotransmaitters, the nature of sexual arousal's similarities to general arousal, and other difficulties that can develop as a result of a traumatizing event.
I received an email inquiry about therapy yesterday from an Iraq War soldier and I have a hunch that I'll be putting Dr. Yehuda's ideas into practice.
Related Topics:
Technorati Tags: PTSD, sexuality, sexual dysfunction
Yehuda went on to explain why. In the brain, the amygdala is involved in the emotion of perceiving an event. For example, one might think, "A tiger! I'm afraid!" But, also in the brain is the hippocampus which is involved in assessing the context of an experience. So, one would adjust one's response but noting, "Oh, but this tiger is in a zoo. I'm safe."
In the brain, substances called catecholamines affect what one thinks about a situation. Those thoughts can trigger distress. And, as it turns out, distress can trigger more catecholamines, which can trigger more thoughts and, in turn, more distress. Yehuda stated that if catecholamine levels are too high, this may result in what she called an "over consolidation" of memory and that leads to PTSD. This happens if the event is very distressing or if normal coping mechanisms are not engaged.
It's difficult to engage "normal coping mechanisms" when an event happens that is highly unpredictable and cannot be controlled. These two factors contribute to the occurrence of PTSD. So, the overconsolidation occurs.
So, where does sex fit into all of this?
A woman who can think about a life event and say, "These things happen," will not develop PTSD. But, a woman who after a life event says, "I'm not going to be the same," will develop PTSD.
Women who have PTSD are in a state of being numb. They tend to avoid the feelings of general arousal (not sexual, but more what we think of as alertness and vigilance) because it takes them out of their numbness. That is stressful and exhausting.
Arousal (the sexual kind) is required for sexual interest and response, but it is very difficult for women to choose to be aroused since it requires that they not be numb. It can also bring them closer to the memory in the amygdala of feeling afraid. And, it turns out, they are lacking a safety context because during the stressful event, safety was very much in doubt for them. So, staying numb feels like a safer choice and that makes sex out of the question.
In addition to this dynamic, people with PTSD may also have sleep disturbance, medication side effects, chemical dependency and abuse, and other psychiatric conditions that do not easily predispose a person to choose to be sexual. All in all, sexual lack of interest caused by PTSD must be treated with an understanding of the brain structures and neurotransmaitters, the nature of sexual arousal's similarities to general arousal, and other difficulties that can develop as a result of a traumatizing event.
I received an email inquiry about therapy yesterday from an Iraq War soldier and I have a hunch that I'll be putting Dr. Yehuda's ideas into practice.
Related Topics:
Technorati Tags: PTSD, sexuality, sexual dysfunction
3 Comments:
New York Philharmonic Orchestra –How some members sexually abuse young college girls
The most traumatic experience in my life turned out to how some of the musicians of the NY Philharmonic Orchestra manipulated my wife.
They Are:
1.Before we married, the flute player, Musician #1,used
emotional/sexual abuse, fear and rape on my wife. I remember sitting
in the audience during a masterclass and suddenly, I was just
watching, the police came and escorted me out of the building. He
saw me and was looking for sexual conquest, another notch on his
belt for my wife. During private lessons, he would teach breathing
lessons and sexual touch my wife to arouse her. He made her drive 2 hours to New Jersey to his house one night. I was playing a musical show and did not know. I found out many of these events way after they happened. He arrived late and yelled at her for waiting in the car in the street. Inside, he got what he wanted. Another time, he made her drive to Hartford, CT since he was a teacher at Yale University. He was always yelling and angry with her. He used the techniques of emotional abuse, sexual abuse, fear, anger and rape for a promise with a job with the orchestra. What did I get-gonorrhea. He did not recognize. He always told my wife that she was using him to make me jealous, a common technique using blame to abuse. He went in and came out of mental institutions his entire career. When he had sex with my wife-2x, he would get mad and make her leave the house late at night. He was evil. The last time he came out of a mental institution, on the same day, he hung himself on the shower rod. For some reason, I felt a sense of closure and in a weird way was happy. I know many girls from the 70's while I was a music student. They se a psychologist, suffer from PTSD, are depressed and afraid to tell their husbands who do not know since they have children and a marriage. But since that time, he destroyed many girl's lives and made them go into denial of being raped. It is natural for women to go into this state and try to forget since some are submissive and taught this since they were young.
2. Musician #2- During lessons he would try to undress my wife by
unbuttoning her shirt to cop a feel and get oral sex. He never
succeeded but his wife was in the house. In addition, he came over
our house and acted as a friend of mind while behind my back he was trying. My wife was in a state of fear and afraid to tell me. Well,
he was an alcoholic and drank himself to death. He was into
collecting guns and rifles and I wonder if this had an affect on
creating fear to my wife.
3. Musician #3- He would invite my wife to NY Philharmonic
rehearsals and give her the impression of a job. Then ask my wife to
lunch and have a lesson in his Manhattan studio. In his home in
Brewster, NY, he would try in his studio the common abuse methods by impressing his students with his playing but he was not a good teacher since he did not know how to teach the methods to achieve these goals in playing. Meanwhile, while he tried, I was waiting in the car outside and his wife was in the house a real low life bas.......d.
Today there is one person left.(3 out of 4 have died). What a relief. Anger has left and I wait for God's justice. I contacted many
offices and executives of the NY Philharmonic and no one replied. I consider myself an advocate for this form of rape. Recently, a clarinetist was revealed for doing these pervert actions. The Philharmonic spoke to him; imagine. He should have been taken out with handcuffs during a concert for all to see and for him; be revealed for his actions for the last 30 years.
TO All GIRLS AND WOMEN
Never take a lesson in his private studio or take an invitation to lunch or meet the orchestra at a rehearsal as a false idea that you will get a job. Take your lesson at the college with the door unlocked or opened. If he grabs you from behind during a lesson after getting frustrated, denied by his sexual advances or gets angry, give him dead weight and fall to the ground. This works all the time and he will not be able to support you. On the way down, strike with your elbow real hard in his family jewels. Brain to Pain. Then, with a fist, hit him in the temple and mouth, right and left hand combo, then 2 strikes to his chest and abdomen. When he is down, give him a light karate chop on his throat. Say this to yourself everyday. It is a karate technique to act quickly. Don’t panic or be fearful. Pre-meditate on this action. He will never expect it. Then SCREAM. There will be other people that will hear you. If sex should happen, call the police to take you to the hospital for STD and DNA testing. Keep a log of hours of date, time and place if he should make any sexual advances or comments during your lessons throughout the year. Lawyers need this information. Invite other friends to set this teacher up by carrying an iPod with a speech recorder in their pockets or purse. Watch Texas Walker Ranger and Jackie Chan movies on TV to develop courage and simple techniques to develop your skills. Subscribe online to the mayo clinic. They will describe things that will develop later on in life to you like PTSD, anger, depression, bad marriages and etc. There are many different types of rape. SPEAK OUT. MEDITATE ON SELF DEFENSE AND ACT QUICKLY. I know, I was tough and faced a similar situation. I told him to stop and reported him to the authorities at the college. Things are more sensitive today and the courts and universities will believe the girl, not the man. Remember, you did not come on to him! Don't worry about your instrument because it can be replaced by insurance or by suing him. Speak with your parents. They pay tuition and have a say in the school. He deserves to be hurt. Most older men have this fantasy for younger girls. They will not stop and when they get it and you may have fallen in love, then you will get dumped for his next sexual conquest. Don’t be afraid to hurt him because he will hurt or kill you. Let’s face it. Who comes first, you or him. The answer is a no brainer. Never go to his house even though his wife is there. He tried that on me in his studio. Nothing stops their ego of being in the Philharmonic. It’s too bad they cannot play different jobs. They are not versatile musicians like studio musicians. Their playing ability is limited to the same repertoire. They are evil. Meditate on defending yourself. It works!
Dawn
Thanks Dawn, I was raped growing up regularly by my father, and every now and then by his other family members. Girls are viewed as sex toys in his family; my mother was abused physically and mentally by him. She has the mind of a 13 year old, and other mental disabilities. My father raped her and kept her locked in the bed room. He enjoyed humiliating us, me my little sister and mom, by pulling off our clothes in public. I'm 25 now and I have a fear of men. I'm strait; I just can not be near a guy. I have anxiety attacks if we accidently bump in the grocery store or somewhere. I just freak out when a man looks at me. I'm trying to get over all that, but in my head, all I can think of is being raped again. Now I have another tool to add to my tool belt of confidence. I'm going to memorize your strategy, and have faith that I can fight off unwanted sexual advances. Thanks again! MC
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