The human body has an inherent physiological mechanism that allows it to rest and rejuvenate itself after periods of intense activity or stress. This process is called "the fight-or-flight response" and involves the release of hormones such as adrenaline and cortisol which increase heart rate, breathing rate, blood pressure, energy levels, and strength.
When this reaction persists for prolonged periods without interruption, it can lead to hyperarousal - a state characterized by heightened anxiety, irritability, insomnia, and difficulty concentrating. In veterans who have experienced combat trauma, chronic hyperarousal often interferes with their capacity to experience sexual pleasure and relaxation in intimate settings because it disrupts the natural balance between sympathetic and parasympathetic nervous systems.
Hyperarousal affects the autonomic nervous system - the part of the brain responsible for regulating involuntary functions like digestion, respiration, and cardiac rhythm. It increases activity in the sympathetic branch and suppresses activity in the parasympathetic branch. The former triggers the "fight-or-flight" response while the latter encourages rest and relaxation. Chronic hyperarousal causes excessive activation of the sympathetic nervous system leading to an imbalance between these two branches. When the parasympathetic system becomes weakened, it makes it difficult for veterans to achieve emotional equilibrium during sex or other moments of intimacy. As a result, they may find themselves feeling anxious, tense, and unable to fully surrender themselves emotionally or physically to their partner. This can create a sense of detachment from their sexual experiences, reducing arousal and pleasure over time.
Chronic hyperarousal can manifest as a range of physical symptoms that make it challenging for veterans to enjoy sex. These include increased heart rate and blood pressure, sweating, dry mouth, and muscle tension. For some individuals, this leads to performance anxiety, which further exacerbates any feelings of shame or guilt associated with sexual intimacy. Others might have difficulty achieving orgasm due to heightened physical sensations such as pain or numbness caused by nerve damage sustained during combat. In either case, chronic hyperarousal prevents them from being present in the moment and engaging in meaningful connections with their partners.
There are several evidence-based treatments available for managing hyperarousal and improving sexual function among veterans. Cognitive-behavioral therapy (CBT) is one approach that focuses on reframing negative thoughts and beliefs about sex while developing coping mechanisms for stressful situations. Mindfulness meditation has also been shown to be effective in reducing chronic hyperarousal through breathwork exercises that stimulate the parasympathetic nervous system.
Medication like selective serotonin reuptake inhibitors (SSRIs) may help balance brain chemicals that contribute to hyperarousal, but they should always be used under medical supervision.
Trauma-focused couples therapy can address underlying issues related to intimacy and communication between partners so they can better support each other's needs and healing journeys together.
How does chronic hyperarousal interfere with veterans' capacity to experience sexual pleasure and relaxation in intimate settings?
Hyperarousal is a term that refers to an increased state of alertness or tension in response to stressors (e. g. , combat exposure) that may result in difficulties concentrating, relaxing, sleeping, and engaging in sexually intimate relationships. Chronically elevated levels of arousal can cause individuals to feel constantly "on edge," leading to difficulty experiencing physical and emotional satisfaction during sexual encounters.