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Anyone who has experienced sexual abuse can sometimes face difficulties with developing or re-engaging with intimate and sexual relationships. But there are things that can help to make you feel more comfortable, explore intimacy, and have a healthy and fulfilling sex life. This section will look at the definition of intimacy, explore some challenges that survivors of sexual violence may face in this area, and suggest some tips and coping strategies which you may find help to improve your intimate relationships and sexual wellbeing. This section might be difficult for some survivors to explore. If it does not feel right for you, please look after yourself and stop reading. You can always come back to this page at another time. 

1 What Is Intimacy?

Intimacy is a closeness between people in personal relationships. It is developed over time as you connect with someone, care for them, and share experiences with them. Although sex is often an important part of a close intimate relationship and can increase feelings of intimacy, sex and intimacy are not one and the same. There can be intimacy without sex and sex without intimacy.

Types of intimacy
  • Emotional Intimacy – you are able to share a wide range of both positive and negative feelings without fear of judgement or rejection
  • Physical Intimacy – the delight in being sensual, playful, and sensitive through touch and bodily sensation in sexual intimacy that is joyful and fulfilling for both partners
  • Intellectual Intimacy – sharing ideas or talking about issues or even hotly debating opinions while still respecting each other’s beliefs and views
  • Spiritual Intimacy – discussing how spirituality works in our lives, in such a way that we respect each other’s particular spiritual needs and beliefs
  • Conflict Intimacy – the ability to work through our differences in a fair way, and reach solutions that are broadly and mutually satisfactory, recognising that perfect solutions are not part of human life
  • Work Intimacy – you are able to agree on ways to share the common loads of tasks in maintaining your home, incomes, and pursuing other mutually-agreed goals
  • Parenting Intimacy – if you have children, you have developed shared ways of being supportive to each other while enabling your children to grow and become separate individuals
  • Crisis Intimacy – you are able to stand together in times of crisis, both external and internal to your relationship and offer support and understanding
  • Aesthetic Intimacy – being delighted in beauty, music, art, nature and a whole range of aesthetic experiences and each of us is prepared to support the other’s enjoyment of different aesthetic pleasures
  • Play Intimacy – having fun together, through recreation, relaxation or humour.

Building and maintaining intimacy in relationships is likely to be a lifelong project. It is not something you do just once. It is useful to recognise that what builds intimacy in relationships changes, as people’s preferences and choices change over time.

Video – Fear of Intimacy – YouTube
Click here to watch The School of Life’s animation on understanding the fear of intimacy.

Video – The Challenge of Being Close – YouTube
Click here to watch The School of Life’s animation on the challenges of getting close to other people, and why this can be frightening.

Please note: These links will take you away from The Survivors Trust Resources website. The links are being provided for informational purposes only. The Survivors Trust bears no responsibility for any advertising content shown on external websites and videos.

Click here for a guide on how to clear your YouTube browsing history.

Love language

If you were asked, could you identify your preferred ‘love language’ and that of your partner(s) from the following list?


  • Words of affirmation – compliments, words of appreciation, positive feedback about specific things your partner has done
  • Quality time – togetherness – giving undivided attention, more than just physical proximity.
  • Quality conversation – talking about your day, keeping each other up-to-date, expressing your feelings, being available to listen with care
  • Receiving gifts – putting time and thought into creating/buying gifts. The gift of your ‘self’ – simply being there at crucial times
  • Acts of service – doing practical tasks for your partner e.g. household chores. Particularly, doing these without being asked
  • Physical touch – loving touch and affection can be important for people, in addition to sexual touch.

Knowledge of your own and your partner’s preferred ways of relating is important. Just as important is letting people know and acting on these preferences in ways and at times when it will build intimacy.

2 Experiencing Intimacy as a Survivor

Survivors of childhood sexual abuse (CSA), rape and sexual trauma can experience a range of sexual difficulties which can be distressing and affect sexual and intimate relationships. While some survivors experience few or no difficulties, others feel that their ability to have satisfying sexual intimacy has been forever damaged. The spectrum of sexual difficulties can range from suppressing sexual feelings and avoidance of all sexual activities through to indiscriminate sexual encounters, and compulsive sexual behaviour.

Healthy sexual intimacy is usually considered to be a physical expression of love, bonding, and commitment between partners. The term ‘making love’ is often used to reflect the multiple dimensions associated with the biological act that can be involved during sex. For some, preserving their first acts of intimacy to be with someone special or after marriage can be an integral part of a person’s identity and belief system, often forming the foundation for starting a family of their own and having children. These aspects can have additional devastating effects on anyone who has experienced sexual abuse and be the source of socio-cultural as well as personal difficulties. For more information about virginity and other concerns a survivor of rape and sexual abuse may have
click here.

For people who have experienced sexual violence, confusion and uncertainty around intimacy is understandable. Some people who perpetrate sexual abuse invest considerable time and effort in getting to know their victim, to build trust and a sense of intimacy in order to commit sexual abuse. The person committing sexual abuse might even tell themselves that they love the survivor and that this is a mutual relationship. When sexual abuse involves such a profound betrayal of trust, it is not surprising that closeness in future relationships can evoke discomfort and be difficult to manage. An experience of sexual abuse can lead to:


  • Reluctance to trust someone or let anyone get close
  • Perceiving any expression of care or attention as a sign of sexual interest or precursor to sexual activity
  • Wariness about sharing personal information, due to the way it has been manipulated and used in the past
  • Uncomfortableness with gentle touch or touch without prior specific agreement
  • Difficulties with any sexual intimacy, due to the fact it can trigger flashbacks.

These difficulties, although not insurmountable, can take some time and patience to work through. This can be compounded if a survivor might feel pressured to speak about a history of sexual abuse (something they may not have previously told anyone about) in order to address these.

Understanding the impact of CSA and sexual violence

Some survivors avoid sexual intimacy due to fear and mistrust, or because sexual contact is physically and emotionally painful. Survivors can experience physical complications during sex such as pain on penetration or erectile difficulties. In addition, they can experience flashbacks, intrusive memories or phobic reactions to certain parts of the body or specific sexual acts. As they become overwhelmed with fear and shame, they are more likely to dissociate  which prevents them from being present and unaware of what is happening, which can make them vulnerable to being engaged in sexual acts that they are unable to consent to.

Alternatively, some survivors become hyper-sexual and engage in indiscriminate sexual behaviour with numerous sexual partners yet experience little or no sexual pleasure. This is often a way of getting any need for love and affection met, or to prove that they have not been sexually damaged. Although this is primarily a way to reclaim power and feel more in control of sexual encounters, it can lead to compulsive sexual behaviour which is often deeply unsatisfying.  Rather than indiscriminate sexual behaviour being ‘triumph over trauma’, it may reflect not being able to say ‘no’ which can make survivors vulnerable to sexually abusive relationships in which love and hurt become intertwined and confused.


To manage sexual difficulties, survivors can rebuild a safe sexual foundation, reclaim their sexuality and take sensual pleasure in their body. This can be achieved through a greater understanding of what it means to be sexual, how sexual experiences and sexual violence impacts on survivors, and how to develop intimacy and sexual trust to have safe and healthy intimate relationships.


Sexual Health

It is always advisable after any sexual assault that you at least get professional advice around risks of any sexually transmitted infections. This can be done in complete confidence through sexual health services. It is normal to feel worried or anxious about your own sexual health and the risks to any intimate partners. You may even be concerned about getting pregnant. Your local sexual health services can discuss a range of options, tests and treatments following sexual assault and you do not have to disclose that you were sexually abused if you do not feel comfortable to do so. However, most services have staff that are trained and equipped to deal with victims/survivors in a sensitive and appropriate way. For more information about pregnancy following sexual abuse click here.

The 'betrayal' of the body

The pleasure of physical intimacy through non-sexual closeness, such as hugs and cuddles, which then become sexualised can be a source of confusion. Ordinarily healthy, affectionate physical touch can become tainted with the demands of being sexual and satisfying someone else’s needs. This can distort survivors’ understanding of care, affection, love, and sex. It can also affect being able to say ‘no’ without evoking feelings of guilt or shame, which can be played out in adult sexual relationships.

Many survivors feel betrayed by their body, especially if they felt physical pleasure during the sexual abuse they experienced. Feeling aroused can cause survivors to blame themselves and believe that they wanted the sexual contact. It is important to remember that abusers tend to deliberately touch and engage in specific sexual acts that are designed to arouse in order to shift responsibility for the abuse onto the survivor. In making the survivor complicit in their abuse and inducing shame of being sexually aroused or having an orgasm, they reduce the likelihood of the survivor disclosing the abuse.

A common misconception is that sexual arousal during sexual abuse is evidence that the victim/survivor must have wanted the abuse to happen, which can lead to self-blame and making it harder to legitimise it as abuse. It is important that survivors recognise that sexual responses during sexual abuse are normal physiological responses to touch in certain areas of the body and are
not a sign of sexual desire or that they are responsible for the abuse.

It is important to realise that having an erection, becoming lubricated, or having an orgasm are natural responses in the presence of sexual touch. Erections can be involuntary and happen in a variety of situations, including fear and stress. Similarly, vaginal lubrication is an automatic biological reaction which acts as a natural form of protection from tissue damage. In these circumstances this does not indicate sexual desire or arousal, or that the sexual contact was desired or wanted. 


Remember: our bodies are biologically programmed to become aroused, experience pleasure and orgasm in the presence of sexual stimulation. An automatic arousal response during sexual abuse does not make the victim/survivor culpable.  

Sexual arousal and sexual desire

It is important to try and distinguish between sexual arousal and sexual desire. Sexual arousal and sexual desire are two separate things; you can be sexually aroused without the desire to be sexual, or to engage in a sexual experience. It is important to be aware that sexual arousal is a normal response to sexual stimulation. What is not appropriate is an abuser coercing or forcing a person to have sex.


Remember: your body responded to the sexual stimulation and not to the person.

Once the sexual arousal system has been activated, and there is continued stimulation, it will naturally tend to lead to pleasurable feelings, and even orgasm in older children and adults. Survivors who experienced involuntary erections, ejaculation, pleasure, or orgasms during rape or sexual abuse are not responsible or to blame for the abuse. It is the body which responded to the sexual stimulation, not to the person. More importantly these normal physical responses were exploited by the abuser(s) to make you feel bad and ashamed.


Sexual identity

Survivors may also experience confusion about their sexual identity or preferences. A survivor attracted to people of the same sex may worry that the abuse ‘made them’ gay, lesbian or bisexual, and consequently they can feel bad about their sexual feelings, while heterosexual survivors abused by a person of the same sex may worry that their abuser thought they were ‘gay’ and chose to abuse them as a result. This may lead a survivor to develop homophobic feelings or behave in a way that over-exaggerates perceived gendered traits and behaviours or find ways to avoid sexual attention, such as wearing baggy and bland clothing.


These difficulties should not be judged, as they often represent aspects of the abuse in which avoiding sex is a way of saying ‘no’, which a survivor was not able to in the past. Any compulsive sexual behaviour is often a re-enactment of the sexual abuse experience and is rarely experienced as pleasurable or satisfying, but rather as self-loathing, shame, and disgust.

Click here for a list of common sexual difficulties due to childhood sexual abuse and sexual trauma:
  • Fear of intimacy and sex
  • Dissociation – to cope with the trauma of sexual violence
  • Sexual identity confusion
  • Response-inhibiting problems, such as fear and arousal and desire dysfunctions
  • Anger towards self, shame, and guilt
  • Avoidance of sexual contact
  • Sexual arousal
  • Rushing through sex to get it over with
  • Compulsive masturbation – with no relief
  • Post-Sex Depression – anger, rage, sadness during or immediately after sex
  • Increased risk of contracting a sexually transmitted infection (STI).

Additionally, survivors may experience a range of sexual problems:

  • Intense premenstrual symptom
  • Chronic breast and pelvic pain
  • Vaginismus
  • Dyspareunia
  • Erectile dysfunction
  • Premature ejaculation.

Remember: if you are experiencing any of these physical symptoms, contact your GP or sexual health service for specialist healthcare advice.

3 – Healthy Sex Life

Sex can be fun, and can be good for you, too. Climaxing during sexual activities releases a flood of the hormone oxytocin, which improves your mood. Regular sex can improve your heart health, reduce stress and depression, improve your self-esteem, and help you sleep better. Snuggling together underneath the sheets can also makes you feel closer to your partner and enhances your sense of intimacy. 

The CERTS model for healthy sex

The CERTS Model for Healthy Sex, developed by sex therapists and authors Wendy Maltz and Beverly Holman, outlines that five basic conditions need to be met in order for sex to be healthy: consent, equality, respect, trust, and safety.

Please note that this does not suggest consensual sexual preferences or practices where partners choose not to practice any of these elements are unhealthy or abnormal.

  • CONSENT means you can freely and comfortably choose whether or not to engage in sexual activity. This means you are conscious, informed, and able to stop the activity at any time during the sexual contact
  • EQUALITY means your sense of personal power is on an equal level with your partner. Neither of you dominates or intimidates the other
  • RESPECT means you have positive regard for yourself and for your partner. You also feel respected by your partner based on how your partner is treating you
  • TRUST means you trust your partner on physical and emotional levels. You accept each other’s needs and vulnerabilities and are able to respond to concerns with sensitivity
  • SAFETY means you feel secure and safe within the sexual setting. You are comfortable with and assertive about where, when and how the sexual activity takes place. You feel safe from the possibility of negative consequences, such as unwanted pregnancy, sexually transmitted infection, and physical injury.
Click here for signs of a healthy sex life:
  • Sexual activity is consensual
  • Sexual activity is mutual
  • You feel connected to your partner
  • You are able to communicate with your partner. You are able to freely express your desires, without having feelings of fear, intimidation or feelings of guilt. This includes expressing your needs, what you like, what you do not like, and your sexual fantasies. If you are not able to express these verbally, you could try writing them down
  • You are able to be honest with your partner and share whether you are having difficulties with them. This could be around body image, shame, self-consciousness, changes in libido, or reaching orgasm
  • You have a broad definition of sex
  • You are knowledgeable about sex and understand desire, arousal, and your sexual arousal cycle
  • You use physical touch to build connection and trust. You and your partner explore each other’s bodies, and not just for sexual intercourse
  • You feel able to seek help if necessary, for example, from a psychosexual therapist.
Click here for some common factors that can affect your sex life:
  • Exhibit avoidance behaviours and not want to talk about their feelings and memories. Unfortunately, these memories have a way of surfacing unexpectedly, and can throw the survivor into a whirlwind of emotion and anxiety 
  • Be triggered during intimacy by a range of stimuli including certain music, cologne or perfume, a particular kind of touch, certain tones of voice, etc. Survivors often have direct memories, in addition to body memories, that are non-verbal and deeply embedded. Even feelings of sexual arousal can trigger conflicting feelings of shame, fear, and worthlessness
  • Appear to cope well for periods of time, and then falter in times of stress, or at different points on their healing journey. Coping mechanisms that suppress traumatic reactions take huge emotional energy. Sometimes a survivor may just not have the reserves to effectively cope
  • Lash out in anger during intimate moments. This often hides vulnerability, grief and loss. It’s not usually directed at the partner, but rather at the abuser. Sometimes it’s easier to focus on the lack of romance, their partner’s constant need for sex, or some other complaint, rather than see the reasons for their own diminished libido or sexual dysfunction that was caused by the abuse, with the resulting feelings of anxiety and revulsion

Other factors that can affect your sex life, including medical conditions:

  • Diet – too much food, especially salty food, can reduce libido
  • Stress
  • Triggers to childhood sexual abuse, sexual violence or bad experiences
  • Avoidance – fear, too busy
  • Sticking to the same routine – can help familiarity, but can be boring
  • Difficulties communicating what you like and do not like
  • Negative body image – low self-esteem
  • Drinking too much
  • Not enough sleep
  • Smoking
  • Weight problems
  • Some medications
  • Physical health conditions – diabetes; heart disease; cancer; chronic pain; arthritis; low testosterone; multiple scleroses (MS); low oestrogen; HIV and Aids; menopause; andropause; Parkinson’s disease; loss of bladder control; inflammatory bowel disease (IBS
  • Mental health conditions – depression; post-traumatic stress disorder (PTSD);


Spending time together and engaging in lots of honest, open communication are good ways to build the foundation for a good sexual relationship. That is why it is recommended to build a strong friendship with a partner first, before becoming lovers.


Adopting the recommended CERTS criteria does not ensure that you’ll experience terrific sex, but it can help you towards knowing you have minimised the possibility of something bad resulting from your sexual experiences.


Ask yourself:                 


  • CONSENT: Can I freely and comfortably choose whether or not to engage in sexual activity? Am I able to stop the activity at any time during the sexual contact?
  • EQUALITY: Is my feeling of personal power on an equal level with my partner? Does neither of us dominate the other?
  • RESPECT: do I have a positive regard for myself and for my partner? Do I feel respected by my partner? Do I feel supportive of my partner and supported by my partner?
  • TRUST: do I trust my partner on both a physical and emotional level? Do we have a mutual acceptance of vulnerability and an ability to respond to each other with sensitivity?
  • SAFETY: do I feel secure and safe within the sexual setting? Am I comfortable with and assertive about where, when, and how the sexual activity takes place? Do I feel safe from the possibility of unwanted pregnancy and/or sexually transmitted infections?
The Maltz Hierarchy of Sexual Interaction

Wendy Maltz developed the Hierarchy of Sexual Interaction as a progressive model for understanding sexual relations. It provides a way of evaluating sexual behaviour within the context of relationships. Sexual energy is presented as a benign, natural force, which can be channelled in either destructive or life-affirming ways. The model presents six levels of sexual interaction: three negative levels (impersonal, abusive, and violent) and three positive levels (role fulfilment, making love, and authentic sexual intimacy). As a tool in sexual abuse and addiction treatment, couples therapy, and sex education, the hierarchy helps individuals understand the need for communication, safety and trust, and points to authentic sexual intimacy as a peak experience in human sexual relating. 

Ground rules

If you are looking to develop healthy sexual and intimate relationships, it can help to agree on boundaries and ground rules with your partner. This might include telling each other that you love each other, paying each other compliments and permitting each other to initiate or stop sex. It is important that any partner can say ‘no’ without the other feeling hurt, rejected or humiliated.

A particularly important ground rule is that touch, such as hugs or cuddles, do not always need to lead to sex but are merely an expression of affection. In discussing and establishing mutually agreed ground rules, you can significantly improve the quality of your sexual relationship.

If you find it too terrifying to have sex with another person you may need to put sexual intimacy on hold for now. You may find it easier to express your sexuality alone in other ways. This should always be a choice and is personal, hence not something that needs to be judged by others. If you feel pressurised to enter a sexual relationship if you are not ready for it and you are struggling how to say ‘no’ you can always talk to a trusted person or professional. It is not okay for anyone to be pressuring you or anyone else into having sex and could even be a criminal offence. 
Click here to read Womens Aid’s article on coercive control.

Remember: while many sexual difficulties can be worked though by yourself, or with your partner, you can always seek extra support through specialist support such as counselling or psychosexual therapy.

Developing healthy intimate and sexual relationships can feel difficult for survivors of rape and sexual abuse, but with time and practice these relationships can become easier.

Click here for some important statements to remind yourself of as you go on this journey:
  • You have the right to develop healthy attitudes about sex
  • You have the right to receive accurate sexual information
  • You have the right to sexual privacy
  • You have the right to protection from bodily invasion or harm
  • You have the right to your own feelings, beliefs, opinions, and perceptions about sex
  • You have the right to set your own sexual limits
  • You have the right to say no to sexual behaviour
  • You have the right to experience sexual pleasure
  • You have the right to be in control of your sexual experience
  • You have the right to control touch and sexual contact
  • You have the right to stop sexual arousal that feels inappropriate or uncomfortable
  • You have the right to develop your own sexuality according to your sexual preferences and orientation
  • You have the right to have a loving partner
  • You have the right to have a partner who respects you, understands you, and is willing to communicate with you about sex
  • You have the right to talk to your partner about my sexual assault and/or sexual abuse
  • You have the right to enjoy healthy sexual pleasure and satisfaction.

4 – Intimacy & Sex Toolkit

Intimacy and sexuality can be very difficult areas for survivors to explore. Remember to look after yourself. Go at your pace, and if anything does not feel right to you, stop and try something else when you feel ready to do so. Remember that you have come so far in your journey of recovery and try not to be hard on yourself if some of these tips are too difficult for you at the moment.

Lifestyle tips

Here are some suggestions that you can do on your own or with your partner to calm your body and mind and manage any symptoms of anxiety you are experiencing around intimacy and sexuality:

  • Spend time with supportive loved ones. Go for a walk, grab some morning coffee, or talk on the phone
  • Practice relaxation strategies. Find time for prayer, meditation, yoga, or progressive muscle relaxation
  • Go for a morning walk. Taking time to enjoy the outdoors, get some fresh air, and move your body can help regulate your mood and emotions
  • Keep a journal. A journal can offer a consistent place to write and process your feelings and experiences.

For more tips, visit the Stress, Panic & Anxiety and Wellbeing sections of our website.

Tips for improving intimacy and healthy sex
Take your time

No matter how busy you are, sex is one part of your day that you should try not to rush. Don’t skimp on foreplay. Those extra minutes that you spend touching, kissing each other or being romantic can help get you aroused and make sex more pleasurable. When you slow down, you also get more time to spend with your partner. That is good for your relationship overall.

Be affectionate

Not every romantic encounter has to end in sex. You and your partner can find pleasure in many other ways. Take a bath together or give each other a sensual massage. Teach each other how you like to be touched. Or just cuddle.


Sex is a potent stress reliever, but it’s hard to get in the mood when you are experiencing stress. After a tough day, do something calming together to relax you. Listen to soft music. Practice relaxation exercises such as deep breathing or meditation. Research shows that mindfulness meditation helps people get more in tune with their bodies during sex.

Reclaiming sexuality

After experiencing rape or sexual abuse, you may feel that your sexuality has been taken from you. Here are some tips to help you reclaim your sexuality.

  • Explore what it means to be sexual – feelings about the body, what feels good, what feels uncomfortable, what produces shame, what is pleasurable
  • Sensory pleasure – explore touching and stroking
  • Challenge attitudes and beliefs – shame, expectations, performance
  • De-conditioning – break old associations, identify triggers, desensitisation, change sensory cues
  • Embodiment – research sensorimotor techniques
  • Communication – try speaking to your partner about sex for one minute and build this up slowly
  • Labelling of arousal and feelings – practice emotional and sexual literacy
  • Process sexual arousal to understand reactions – understand your peak sexual experience and fantasy
  • Reclaiming the body and sexuality – self-exploration, touching, stroking, pleasure for pleasure’s sake
  • Identify triggers – if can help to write them down
  • Breaking associations – change your sensory cues.
Understanding your emotional reactions

Fear can affect the emotional temperature of sexual relationships. You may feel overwhelmed by powerful feelings during sex such as terror, shame, humiliation, or anger that you fear you cannot contain. You may experience flashbacks or intrusive memories during sexual stimulation which can lead to ‘tuning out’, or dissociation. This is because sexual intimacy triggers the same bodily sensations as experienced during sexual abuse which can evoke a trauma response. 

Your terror, anxiety or anger in turn triggers a range of defensive reactions such as detachment, withdrawal or aggression. This can be frightening to both you and your partner, especially if the link to sexual abuse has not been made. It does not mean that you do not love and care for your partner, it is a conditioned response as a result of the trauma you have experienced. In linking such responses to sexual abuse, and identifying the triggers that induce fear, anger or dissociation, you can begin to take control of them.

It can help to identify any triggers that you experience during intimate moments and sex.

Remember: identifying triggers associated with sexual abuse may evoke strong and overwhelming trauma reactions. Trust your own judgment whether you are ready to do this or any other activity within this resource.

Click here for some common examples:


  • Cigarette smoke
  • Alcohol
  • Body odour – breath, sweat
  • Dust
  • Aftershave
  • Sexual secretions.


  • Heavy breathing
  • Music
  • Tone of voice
  • Spoken words and phrases
  • Sexual sound
  • Peripheral noise – radio, TV, children playing
  • Silence.



  • Time of day or night
  • Waking up
  • Seasons
  • Holidays
  • Feasts and celebrations
  • Visits.



  • Bedrooms, bathrooms, sofas
  • In the car
  • Tents
  • School, church, cinema, woods, trips… anywhere reminiscent of where abuse took place
  • Unfamiliar places.



  • Physical orientation in space
  • Being in a certain sexual position
  • Dreams
  • Being physically moved by someone.


Physical Sensations

  • Kissing – saliva
  • Sexual arousal
  • Sexual responses
  • Touching
  • Feeling fear, shame, dirty
  • Excitement
  • Exercise – increased heart rate, palpitations, sweat.


Visual Stimuli

  • Men, women, children
  • Ethnicity
  • Water, cars, clothes, candles, semen, penis, sexual aids, pornography
  • Hair – hair colour, facial hair, body hair, pubic hair
  • Facial features – eyes, eyebrows, nose, lips, teeth
  • Body characteristics – size, build, shape, colouring, hands
  • Images present during abuse, such as wallpaper, pictures, furniture, icons
  • Light, darkness, vision obstructed.


Interpersonal Dynamics


  • Personality
  • Attitude
  • Gestures of caring.
Changing sensory cues

Once you have identified these triggers or sensory cues, you can erase or replace them with new sensory cues that are associated with your present loving relationship. If you deem that it is suitable, you may want to discuss this with your partner and explore how you can make changes to find new ways to experience pleasure that do not repeat the sexual stimulation experienced during the abuse. Changing sensory cues can really help you to reclaim your sexuality and allow you to feel pleasure for pleasure’s sake and significantly reduce or even eliminate feeling guilty, dirty, or ashamed. 

Click here for some tips which may help you to change your sensory cues:
  • Vary your sexual positions
  • Introduce pleasant smells such as scented candles, body oil or lotions to offset the unpleasant smells and to change the experience of being touched
  • Vary the light by using candles, low lights, or brighter lights
  • Change the sound by talking in a loving way, or by being silent, or other sounds such as music
  • Try to find new ways to experience pleasure that do not repeat the sexual stimulation used by the abuser(s)
  • Experiment with having sex in different settings, especially if the abuse was in the bedroom
  • Experiment with who initiates sexual contact, or by taking more control of the process to offset the abuse experience.
Seeking support

For many who survive sexual assault, difficulties developing intimate and sexual relationships can get easier over time. However, for some, these problems may linger and even become more difficult to manage. Fortunately, there are treatments available that have been found to help. 

See your doctor

Sometimes the solution to better sex is in your medicine chest. Some drugs, such as antidepressants and blood pressure medicines, can reduce your sexual desire. The problem could also be a medical condition like heart disease, vaginal dryness, multiple sclerosis, or depression. Schedule a check-up to find out whether a health issue might be affecting your sex life. Be honest with your doctor about the problem, so you can find the right answer.

Talk to a sex therapist

A sex therapist is the person to see if something is bothering you in the bedroom. Therapists are licensed psychologists or social workers who can address problems such as a lack of desire, trouble getting an erection, or problems reaching orgasm. You can meet with a therapist alone or together with your partner.

Sessions with a certified sex therapist can improve intimacy issues by helping you communicate better, guiding you through touch exercises, and educating you about arousal and desire. If your problems stem from other issues, talk therapy may also benefit your whole relationship.

Your GP or local sexual health services can help you access support from a psychosexual counsellor. Click here to visit the
NHS webpage on this subject.

Psychotherapy has been proven effective in treating symptoms of post-traumatic stress disorder following sexual assault. While there are a variety of psychotherapy techniques, two with growing evidence of their effectiveness are cognitive processing therapy and prolonged-exposure therapy:


  • Cognitive processing therapy (CPT) helps people confront unpleasant memories and thoughts associated with the sexual assault. During CPT, your therapist will also guide you to correct any maladaptive, unrealistic, or problematic thoughts driving your post-traumatic stress disorder (PTSD) symptoms.
  • Prolonged-exposure therapy targets any learned behaviours that people engage in or avoid in response to situations or thoughts and memories associated with the sexual assault. The hope is that by confronting feared emotions, thoughts, and situations, you can learn that anxiety and fear will lessen on their own.

You can find a therapist in your area who provides these treatments.

Support groups

Joining an online or in-person support group provides the opportunity to connect with other survivors of sexual assault and get advice on overcoming the challenges associated with that trauma.


Support groups provide an excellent opportunity to develop supportive, trusting, and healthy relationships with other people with a shared experience. Your primary care physician or mental health professional is often the best place to start when searching for a local support group. 

Video – Alain de Botton on Sex– YouTube
Click here to watch The School of Life’s video, featuring psychologist Alain de Botton talking about sex. Contains flashing images.

Video – The Danger of Being Too Polite in Love – YouTube
Click here to watch The School of Life’s animation on the danger of being too polite in loving relationships.

Article – Sexual Health: Habits of Couples Who Have Great Sex – MedicineNet
Click here to read about some common habits for a healthy, fulfilling sex life.

Please note: These links will take you away from The Survivors Trust Resources website. The links are being provided for informational purposes only. The Survivors Trust bears no responsibility for any advertising content shown on external websites and videos.

Click here for a guide on how to clear your YouTube browsing history.

5 – Supporting a Survivor as an Intimate Partner

It can feel difficult to support your partner through challenges related to sex and intimacy.

Here are some tips which might help:
  • Educate yourself about the impact of sexual abuse, so you can create safety in the relationship. Seek help if you need it. Remember that you are not alone
  • Remember that we all have issues to overcome, lessons to learn, and healing from various life challenges. Commit to a mutual relationship where you both give and take and are willing to learn from each other. It is rare for a person to never have experienced trauma of some kind in their life. Being in a relationship with someone who has experienced sexual violence or abuse may tap into your own unresolved issues. This can be an opportunity for you to make your own changes and to learn from your partner
  • Assure your partner that you believe them and that you are there for them. Many survivors feel damaged and fear rejection
  • Offer a break from the conversation if things get too difficult for either of you
  • Be willing to stop sexual interaction if your partner is being triggered or experiencing anxiety. Be prepared to give up some, or all, sexual contact for a period of time. Your partner may need some time that is free of expectations and pressure. Safety in the relationship is essential
  • Face the issues directly, and work on solutions while remaining sensitive to your partner and his or her needs
  • Create a list of touches that are safe. This is dynamic and it could change over time, so there is a need to continuously check in with your partner and ask permission at every turn
  • Try not to take things personally and try not to respond in kind if your partner gets angry or upset. Remember that intense feelings can come from the person’s abusive past. Sometimes, as feelings of trust and safety increase, your partner may push back because they feel too open and vulnerable. Being able to stay in the moment and help to emotionally ground them by reminding them that they are safe and that you are not their abuser can help them regain their equilibrium
  • Take care of yourself and cut yourself some slack if you do not say or do things perfectly. It can be very challenging to be in a support role. Taking care of your emotional and physical wellbeing is critical, so that you have what it takes to continue to be a supportive partner. Click here to visit our wellbeing page for tips on this
  • Accept your partner for who they are, and where they are, on their healing journey. Blaming them, or putting pressure on him or her to hurry up and get better, is detrimental to them and to your relationship
  • Be honest about how you are feeling, especially if you are struggling and/or feeling those feelings that are ‘unacceptable’ to you. Try to put what you are feeling into words rather than remaining silent. Reach out for help and support. Silence, or non-communication, can lead to bitterness and resentment and can be damaging for your relationship
  • Use your support network of friends and family, or consider talking to a counsellor, or the partner of another survivor. Just being able to honestly express some of the challenges can help to provide perspective and hope
  • Express your commitment and love for your partner. Let them know they are not alone, and that you are in this together. Creating and maintaining trust is not about trying to fix things for your partner, rather, it is about being present for, and with, them.

For more information on supporting a survivor, visit the Supporting Survivors section of our website.


6 – Helpful Resources for Intimacy & Sex

Useful contacts

The Survivors Trust

Umbrella agency for over 120 member organisations which provide specialist support to men, women and children who are survivors of sexual violence.
Helpline: 08088 010818


My Body Back Project

Agency offering cervical screening, contraceptive care, STI testing, maternity care services and sexual wellness workshops to survivors of rape and sexual abuse.

  • Sanderson, C (2016). The Warrior Within: A One in Four Handbook to Aid Recovery from Sexual Violence 3rd Edition. London, One in Four
  • Augsburger, D. (1988). Sustaining Love. Regal Publishing
  • Chapman, G. (2004) Five Love Languages: The Secret to Love That Lasts. Northfield
  • Graber, K. (1992). Ghosts in the Bedroom. Health Communications
  • De Beixedon, Y (2010). Lovers and Survivors: A Partner’s Guide to Living With and Loving a Sexual Abuse Survivor. Robert Reed Publishers
  • Maltz (2012). The Sexual Healing Journey: A Guide for Survivors of Sexual Abuse (Third Edition). M Morrow
  • Haine, S (2007). Healing Sex: A Mind-Body Approach to Healing Sexual Trauma. Cleis Press.