A review of the long-term effects of childhood sexual abuse (CSA) is sobering. Research has identified numerous detrimental effects:
- low self-esteem,
- social and economic failure,
- social insecurity and isolation,
- difficulties with intimacy,
- sexual problems,
- substance abuse,
- eating disorders,
- post traumatic stress,
- a sense of helplessness, and
- an increased likelihood of being raped or being the victim of domestic violence.
The apparent common denominator in these conditions is the profound injury done to one’s ability to trust and attach to another human being.
While it is generally recognized that abused males have a more difficult recovery from CSA, I find there are two conditions that are more prevalent among female survivors. These conditions are sexual anorexia and sexual aversion disorder.
You may be more familiar with the type of anorexia that occurs when a person, usually a young woman, obsesses over how to avoid food. Over time, this condition can lead to numerous health concerns – and can even be fatal, as shown by the 1983 death of singer Karen Carpenter. This condition has a parallel known as sexual anorexia.
Sexual anorexia occurs when a person – again, most often a woman – fails to possess a healthy, sexual desire. This person will most likely be unaware of the hidden drivers that compel her behaviors. These victims can be in otherwise loving marriages, but have no interest in expressing any type of sexuality. They will often fail to initiate sexual contact, but usually report that once sex is underway, they are able to enjoy the exchange.
The impact of sexual anorexia on marriage can be profound. This condition can force an unhealthy celibacy onto the spouse, or worse, help lead the spouse to a false sense of entitlement to pornography, masturbation, or extramarital sexual involvement. These behaviors, in turn, further erode intimacy in the relationship and can facilitate a destructive cycle that threatens the marriage.
Sexual Aversion Disorder
Of the two disorders, Sexual Aversion Disorder is the one that carries official diagnostic criteria from the American Psychological Association. In terms of symptoms, this disorder is more severe.
An individual who suffers from a more active form of Sexual Aversion Disorder, finds sex to be repulsive, without exception. According to the DSM IV, “The essential feature of Sexual Aversion Disorder is the aversion to and active avoidance of genital sexual contact with a sexual partner.”1 Some individuals’ aversion extends to all sexual behaviors, including kissing and touching. A person’s reaction “may range from moderate anxiety to and lack of pleasure to extreme psychological distress.”2
This disorder can injure the patient’s spouse at a deep level. The passive indifference of sexual anorexia is one thing, but the active repulsion of sexual aversion is quite another. The spouse may begin to wonder if maybe he is sickening to his wife, rather than just the act of sex.
It’s important to note that not every survivor of CSA will suffer sexual dysfunction, and not everyone who suffers anorexia or aversion has been sexually abused. Nevertheless, these conditions strongly correlate with CSA and can continue to injure the survivor as well as his or her spouse or future mate.
The husbands or wives of these individuals will need to be patient and understanding. In most cases when this kind of problem affects a couple’s marriage, there was a time when the conflicted spouse was forced into unhealthy sexual experiences as a child, or even as an adult in an abusive relationship. The Christian marriage can be a safe place where old wounds are healed as husband and wife yield themselves to each other in the safety of their marital commitment.
Although this is only a brief overview of these conditions, if this seems to fit you or someone you love, it is worth talking to a professional. Any unresolved trauma has the potential to lead to further injury or addictions. There is hope for recovery. This healing starts when a person suffering anorexia or aversion takes “ownership” of this condition. He or she will acknowledge that this condition can only further injure the marriage – and both spouses – if left untreated. Seeking whatever resources are needed is part of this healthy ownership of the problem. Compassion for each other and respect for the marriage can motivate both spouses to do whatever it takes to restore the pleasure and joy of marital sexuality.