Now along comes a college professor discussing her own book that describes how reading self-help books on sexual abuse can lead women to believe that they have been abused when, in fact, they haven’t.  In the London Telegraph, Dr. Jo Woodihouse is quoted as saying that the checklists in such books are too broad, asking questions about family relationships in general, or having romantic relationships that haven’t worked out.

In my clinical experience, I have had only a very few clients that have come in not necessarily believing they had been abused, but wondering if abuse had taken place.  They usually come to this conclusion because they have nightmares or unwanted thoughts about being molested.  In my mind, the important thing adults is not to explore whether or not abuse took place, but why they have are carrying around such negative thoughts about being damaged or sex being bad or uncomfortable.  I can honestly say I have never had a client come into my office with a checklist in hand proclaiming they “knew” they had been abused.

I think that self-help books on healing from sexual abuse are best read with the guidance of a therapist.  Most self-help books on the topic make that suggestion, because just the act of reading about abuse can be upsetting and trigger unwanted memories and feelings.  The reader can feel hopeless or desperate, when in fact there is help to heal from abuse.

I could definitely see a person who has grown up in unhappy circumstances reading a book about abuse and identifying with victimhood and suffering, perhaps needlessly.  But suffering is suffering, and it deserves to be taken seriously.  Problems can occur if a person wants to pursue civil suit against a perpetrator if the accusations are false.  However, the fact that someone takes false abuse to that level suggests that there is much pain that needs to be attended to and treated appropriately.  I am uncertain it is helpful to blame the author or the reader for the possibility of false memories of abuse.

In my mind, I wouldn’t want to discourage anyone from reading self-help books on abuse.  My clients have generally found such books to be very helpful, because they realize that they aren’t alone with their problem.  They start to understand why they behave as they do, or why they struggle mentally with certain feelings about themselves and others.  I do caution people to only read a chapter or so at a time, and to give themselves a chance to process and reflect on what they have read.  No sense in becoming overwhelmed when the point is to feel a sense of control over one’s self.

I would be very interested in what blog readers think about self-help books about sexual abuse.  Are they helpful?  Or better still, what would be helpful and what would be detrimental in such a book?  I welcome your opinions.

Meanwhile, I am hoping there will be follow-up on this story in the press to see if and when Dr. Woodihouse believes such materials can be beneficial to readers.

I was, of course, very happy to see this common but misunderstood set of conditions covered on national television.  I was a bit disappointed, though, that the segment did not include the perspective of a health psychologist or sex therapist.  There are researchers and clinicians that work with women that have pelvic pain disorders and their partners.

Here’s why a sex therapist can be helpful.  The women in the program complained of psychological problems such as feeling inadequate as a female, lacking support from a partner, embarrassment about the condition, and fears about ever being able to have normal sex again.  All of these problems are things that a few sessions with a psychologist can help.  Not only that, but a sex therapist with a background in health psychology can help women with sexual pain to relax and cope better with discomfort.

The fact is, of course, that if women are steered in the right direction by organizations like the NVA, their gynecologist, or an online search, they can find medical help for the problem of sexual pain.  There are surgery, topical solutions, and medications available.  However, in my clinical experience, some women achieve partial relief.  They are able to have more comfortable sex, but not necessarily pain free.  They also are sometimes left with damaged self-esteem.

Also, a study just released in JAMA confirms that chronic pelvic pain is sometimes associated with past childhood sexual abuse.  It isn’t that the pain is in the woman’s head; it’s that past abuse makes her susceptible to this and other health problems.  Physicians and physical therapists, therefore, need to assess their patients in this regard.

Aside from myself, there are definitely other sex therapists that are willing and able to help women with sexual pain; the best resource I know of is AASECT.

Kind regards,

Dr. Stephanie Buehler

Next, my colleague and fellow sex therapist Stephen Braveman, MFT, was featured in an article in Rolling Stone on a teenage boy who was molested by his teacher.  Outwardly, the relationship may have appeared to be consensual and even condoned.  Deeper investigation, however, shows that the boy became extremely distressed over the relationship.  It affected his grades, his relationships with peers, and his mental health.

Finally, as I was casually researching topics today for both of my blogs, I happened across two more articles, one in the Star News and one on a NYC news website about female teachers molesting students.  Both the Rolling Stone article and this one have a similar theme, that there is a prevalent myth that boys are unaffected by sex with a woman in a position of authority.  In fact, it is because of this myth that many boys may not come forward if they have been bothered by a similar sexual experience.

Another myth is that boys cannot be coerced into sex.  But erection is an automatic response to stimulation; it doesn’t necessarily take consent for intercourse to take place between a female and male.  Many men have reported to me incidents of forced intercourse or fondling with older women.  Some, though not all, felt quite traumatized by the experience.

The most important key to becoming a survivor is perhaps to realize that the shame of unwanted sex should all be directed toward the perpetrator and not the victim.  Shedding feelings of shame and guilt can be a big step toward healing from sexual abuse, whether it was perpetrated by an authority figure or a woman who exploited someone’s youth and naivete.

An important tool for any man to have in his self-help tool box for recovering from sexual abuse is Michael Lew’s book, Victims No Longer.  The book details the stories of many men who have recovered from sexual abuse.  It also tells men how they can overcome the effects, including difficulty with intimacy, sexual aversion or sexual promiscuity, and numbing their feelings.

As we spoke about the usefulness of sex therapy as an adjunct to medical treatment, Dr. Krychman mentioned how difficult it was for women that have sexual pain problems like vaginismus and that have been sexually abused to come to therapy.

I understand.  Most every woman who comes into my office who has been sexually abused–whether they’ve been diagnosed with a sexual pain problem or not–is not exactly thrilled to be there.  After all, talking about sexual abuse is very difficult.  It brings up feelings of shame, guilt, helplessness, and even disgust.

When women do come in, it is often because they cannot have sex with their partner, either because of sexual pain or because they are being “triggered” and cannot tolerate the physical sensations of lovemaking.

Here is what I know:  If I don’t go slowly, don’t go at the woman’s pace, I’ll lose her as a client.  And that’s the last thing I want to do.  And I have also learned that I need to stay focused on the solution.  So we talk about the abuse when necessary, and try to “go there” only when it will be fruitful in getting a woman towards the goal of having a healthy sex life.

Most of the time–with 8 or 9 out of 10 women, I would say–things go well.  Women start to reclaim their sexuality for themselves and to see that they can enjoy sex.

And, if they have vaginismus or another sexual pain problem, they are thrilled to see how well the psychological services complement the medical services that they receive.

If you are a woman who has been sexually abused and want to reclaim your sexual health, either for yourself or to have a better sexual connection with your partner, please don’t hesitate to call.

And do sign up for the RSS feed for this blog, there is LOTS of information on this blog alone that would be helpful for you to read.  And sign up for the free book, too–even if you are not ready to be sexual, reading about sexually healthy thoughts and behaviors can be very helpful to you.

Kind regards,

Dr. Stephanie Buehler, Director