The term "traumatic stress" refers to an event that causes intense fear, helplessness, or horror; it may also cause an individual to feel threatened, vulnerable, or unsafe. Examples of traumatic events include military combat, natural disasters, terrorist attacks, physical assaults, accidents, abuse, or serious illnesses. Many people who experience trauma develop symptoms such as flashbacks, anxiety, sleep disturbances, intrusive thoughts, anger outbursts, and social withdrawal. They may struggle with their relationships, work, school, family life, finances, and emotions. Sexual dysfunction is another common consequence of trauma. Veterans often have difficulties initiating or maintaining sexual desire due to changes in sexual arousal patterns and emotional responsiveness. This article will discuss what relational adaptations are necessary when trauma alters a veteran's sexual arousal patterns or emotional responsiveness. The article will provide examples of specific behavioral interventions and treatments for this condition.
The article will present research evidence to support these findings.
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Trauma-related sexual dysfunctions can be divided into two categories: hypoactive (low) and hyperactive (high). Hypoactive sexual arousal disorder (HSDD) involves difficulty becoming sexually aroused or maintaining arousal during sexual activity. Hyperactive sexual arousal disorder (HSAD) involves excessive sexual urges and behaviors that are difficult to control. Both types of trauma-related sexual dysfunction are related to altered neurobiological pathways, impaired communication between brain regions, reduced sensitivity to dopamine and serotonin, heightened stress responses, and dysregulated hypothalamic-pituitary-adrenal (HPA) axis function. In HSDD, there is decreased activation of the ventral striatum and amygdala while the prefrontal cortex is overactivated. In contrast, HSAD is associated with increased activation of these regions, which may result from high levels of cortisol secretion. These neurobiological changes contribute to reduced motivation, pleasure, and sexual satisfaction. Traumatic experiences also increase negative beliefs about intimacy and relationships, such as "I am unworthy of love," "I don't deserve a fulfilling relationship," and "My partner doesn't understand me." This further diminishes motivation and sexual responsiveness.
The first step in treating trauma-related sexual dysfunctions is establishing trust and safety with the client. Building rapport, empathy, and understanding can help clients feel comfortable enough to share their thoughts and emotions without judgment. Secondly, couples therapy can be helpful for improving communication, resolving conflicts, and learning healthy coping strategies. Thirdly, behavioral interventions such as sensate focus exercises can help clients become more aware of their bodies and learn new ways of experiencing pleasure.
Medications such as selective serotonin reuptake inhibitors (SSRIs), bupropion, or naltrexone can enhance sexual arousal by increasing dopamine and serotonin transmission. Some therapists use mindfulness meditation, breath work, yoga, and guided imagery to address trauma memories and restore sexual responsiveness. Research shows that cognitive behavioral therapy (CBT) and eye movement desensitization and reprocessing (EMDR) can reduce PTSD symptoms and improve sexual functioning in veterans.
What relational adaptations are necessary when trauma alters a veteran's sexual arousal patterns or emotional responsiveness?
One of the most important things that veterans with PTSD need to do is to understand their traumatic experiences and how they have affected them. They should also take time to learn what has changed about themselves because of the trauma. This includes understanding any changes in sexual arousal patterns or emotional responses. It's important for veterans to seek professional help if they feel like they need it in order to work through these issues.