Stop worrying and love the boy
November 11, 2009 3:06 PM   Subscribe

A medical issue has caused memories of rape to resurface and ruin my sex life. I have no money for therapy. Do I have any options other than being a mess and making both me and boyfriend totally miserable?

About seven years ago, when I was a teen, I was drugged by a seemingly friendly guy and his companions, stuffed into the back of a car, and gang raped all night in a strange apartment. In the morning, they drove me to the edge of town and left me, bleeding and half-dressed. Somehow I wound up at a hospital, was treated for internal uterine lacerations and other complications, and sent on my merry way.

I've had years of therapy to mitigate the obvious ramifications. Some catharsis was reached when the men were apprehended and accordingly sentenced. It took a very, very long time to trust men again, but now I'm in a healthy relationship with the best guy in the world for the past 8 months. He knows my past and has been unflaggingly supportive. Our sex life is (was?) really great, though a little spotty during times when I'd fall in a funk. A month or two ago I had some medical complications arising from old tears and scar tissue in my uterus, which caused heavy bleeding, cramping, loss of soft tissue, extreme fatigue, anemia etc. I've been in and out of the hospital for weeks, and my boyfriend and I couldn't have sex until I was cleared by my OB/GYN. Meanwhile, my subconscious has re-forged a connection between sex and pain/rape that leaves me mortified of any remotely sexual activity.

Today I was cleared, but I'm terrified of having sex. Rationally I know I'm fine, and that consensual sex is good and fun, but even non-intercourse things leave me terrified. I have vivid nightmares of the rape all over again, something I haven't gone through since the first three years after I was attacked.

I have no money for therapy. All my money has gone to paying, out of pocket, my medical bills. I've tried some of the free and sliding scale therapists in NYC, but they were all bad fits or generally unhelpful. The only therapists that have worked for me in the past have been highly skilled, very expensive professionals who are experienced with victims of extreme sexual trauma. The hospital case worker was so overworked that she had my file switched with another patient's file and didn't realize her mistake until 45 minutes into a 50-minute session.

I don't want to lose this guy (who has a naturally high sex drive and has been swallowing his frustration and putting on a kind, brave face for my part) and our sex life to these harrowing anxieties. I know it's not his fault, I know he didn't cause this pain, but the very idea of sex has me bound in knots. I feel so incredibly guilty, despite my boyfriend's seemingly endless patience and understanding.

Are there any books I can read that address anxieties over sex among rape survivors? Any affordable therapy recommendations or other information can be directed to:
posted by anonymous to Human Relations (22 answers total) 3 users marked this as a favorite

Wow. This sounds pretty terrible. However, the first thing that came to my mind is to slow down. Quit thinking about your boyfriend's high sex drive and give yourself a break. I once had a cervix biopsy done and they said to wait a couple days for sex, I told my partner to wait at least a week and then I'd see. It's just that once you have people all up in your junk, you need some space. And my little anecdote was in regards to a minor procedure that was over and done with in an hour.

You might look into stuff online about women getting back into sex after a birth. The advice I hear is to "take it slow." You need to take it slower. Your boyfriend has access to lots of free porn on the internet and I presume he has one working hand. Why don't you give yourself one month from today to revisit the issue? Tell him this. And during this month, you guys should practice holding hands, being sweet, getting to know each other. Pretend you've just started dating and aren't ready for sex yet. Tell him that he needs to be on board with this completely (no pressuring you, no trying to take it to the next level) if he wants you to come back around at all. A month is really no time at all.
posted by amanda at 3:38 PM on November 11, 2009 [4 favorites]

Please visit RAINN (Rape, Abuse & Incest National Network). There's a ton of good info on their site, and you can search for rape crisis counseling by ZIP code. I'm sorry this is happening to you. It's really really good that you're reaching out for help.
posted by rtha at 3:39 PM on November 11, 2009

Staci Haines, full stop.

That book changes lives, and it has a great chapter to read for your partner as well. It's just so good to know that you're not alone, and that other people have addressed these anxieties and gone on to have empowered sex lives.

Please don't feel guilty about not being able to have sex right now. I always liked to think "My fear doesn't mean I'm broken, it's actually my mind and body working together to try to protect me." Your feelings are valid, and working back towards a normal sex life, whatever that is for you, means patiently teaching your body that it doesn't have anything to fear anymore.

Haines suggests starting with things that help you feel safe with him touching you--back rubs, foot rubs, cuddles, bubble baths, gentle kisses--and then slowly incorporating more sexual touch on the way to intercourse, or whatever it might be that you want to work towards. That gradual approach, centered on your feelings, is the right approach to take here. She also has some great exercises and tips for staying connected and embodied and not dissociating during sexual activity.

If you have specific questions, MeMail or e-mail me, I'm happy to talk more about my own experiences with the issue.
posted by besonders at 3:39 PM on November 11, 2009 [2 favorites]

Oh, also! Delay those medical bills. It'll take months before they start any kind of collections and sometimes things get paid in the meantime. Look into negotiating payment or getting them reduced (you must do this before they go to collections, though). Your mental health is more important and you can tackle those bills later.
posted by amanda at 3:40 PM on November 11, 2009 [1 favorite]

This isn't directly what you asked, but amanda has a good point...if paying your medical bills is adding to your anxiety, talk to the billing departments about negotiating your bills.

1) Insurer's "contracted" payment amounts is usually lower than the amount that they charge someone who is paying cash. They "write off" the difference. Ask them if they'd consider doing this for you.

2) Talk about a payment plan, i.e. breaking up the big bill into manageable chunks.

All I can tell you about the emotional issues that you're coping with is to try to remember that whatever you're feeling is okay, and that you're doing the best you can with the tools that you have. Worry about yourself, not your boyfriend's sex drive.
posted by radioamy at 4:05 PM on November 11, 2009 [2 favorites]

I'd advise a sex break. Like a month. Where you just agree you're not going to have it. I understand he's been waiting and so on, but I think that the pressure that you're under to feel normal all of a sudden is dragging you down by both feet.

I think you need to take a little vacation from this to regain your equilibrium, not put all of your efforts into being into having sex again. I think that, in itself, might feel a little like coercion.

So that's my recommendation: sex break. Rest period. It's okay to step back--if you were in any other kind of strength building activity, you get into ruts and plateaus. Breaks help you regain the strength to go back and work on it later.
posted by A Terrible Llama at 4:05 PM on November 11, 2009

Hey, Amanda said the same thing!
posted by A Terrible Llama at 4:07 PM on November 11, 2009

You experienced an unthinkable trauma and the fact that you've been able to overcome it to the extent that you have speaks to your strength and resilience. I hope you realize how difficult that is, and how proud of yourself you should be for coming this far.

It sounds like you're experiencing symptoms of PTSD. It is of course natural for that kind of experience to creep up on you again. It will never go away completely. I understand that you feel guilty because you want your boyfriend to be happy, but this happened to you. You didn't ask for it. You're dealing with it the best way you can. I'm sure your boyfriend knows that. And if he doesn't, be sure to communicate that. You're very lucky to have someone so patient and understanding in your life. Be sure to communicate your appreciation to him as well. Make him aware that this is going to take some time and you understand it's a bit of a setback, but please don't try to rush things because you feel pressure to keep him around and satisfied. This is your recovery we're talking about. If he's worth it, and if he believes you're worth it, he'll continue to be patient. Your mental health is more important than his physical needs, and will be especially important if you plan to have a life together in the future.

It sounds like what you need is cognitive-behavioral therapy as opposed to counseling, though both would be beneficial. I second the RAINN suggestion. I also agree that you need a break from sex. Make a plan with the bf to take a period of time to abstain. Engage in other activities together. See how you feel after that period of time is up. This is something you can and will overcome. Just give yourself time and please don't worry about him. You need this.
posted by blackcatcuriouser at 4:53 PM on November 11, 2009

You need a better referral source. You have a very specific need and you should only be working with someone who has extensive training in treating rape survivors. Picking sliding scale therapists at random to treat sexual violence trauma can do more harm than good, I've had this stressed to me by psychologists in Philly who do this kind of work. The bottom line is that there are a ton of shitty therapists out there and a lot of therapists who think they know a lot more than they do and think they are qualified to treat a broader spectrum of people than they should (that's a quote from a Penn clinical psych professor I know). You can find a good sliding scale therapist with this expertise, you just need someone in this field to direct you to them. I don't work in this field nor am I in NYC so I can't honestly help you in finding a referral source, but I can tell you that you should be taking referrals only from either other rape survivors who have found quality sliding scale treatment or from an agency that works with rape survivors and maintains a list of quality counseling resources.
posted by The Straightener at 4:56 PM on November 11, 2009 [3 favorites]

It sounds like what you need is cognitive-behavioral therapy as opposed to counseling...

Do you work with rape survivors? How long have you worked with them and how long did you train in the field? I'm curious, because this is a very specific clinical recommendation that you're making, as well as a symptom diagnosis, that as a mental health professional I would not make over the Internet based on the information provided here.
posted by The Straightener at 4:59 PM on November 11, 2009 [4 favorites]

Semi-tangent: I don't know if you could do it at this point if if you'd want to, but have you looked into suing the men to pay your medical bills?
posted by Ashley801 at 5:45 PM on November 11, 2009

Have you considered explaining your specific situation to the social work office at the hospital where you were treated? They may know some better resources, and may be able to help you manage your existing medical expenses. If your surgeons work regularly with survivors of sexual violence, they may also be equipped to provide referrals to specifically experienced professionals who would consider taking your case for a reduced fee.
posted by fairytale of los angeles at 5:54 PM on November 11, 2009

Have you contacted the New York City Alliance Against Sexual Assault? They have a big list of places where rape survivors can get free or low-cost assistance. I'd ask your boyfriend to start at the top of the list and keep calling until he finds someone to assist you. I doubt its going to take long.

I would also advise you to get in touch with the New York State Crime Victims Assistance Board and see what financial help they can provide you. Plainly stated, your medical bills are a result of the crime that was committed against you, and most states will assist you in paying them. This brochure has details.

Finally, if you can stomach the idea, hiring a victim's rights attorney and suing the men that did this in civil court for damages might or might not be an idea you want to explore.

You are a brave and strong person!
posted by anastasiav at 7:03 PM on November 11, 2009 [2 favorites]

I am the survivor of an extremely traumatic rape myself. To find a good therapist, I would suggest contacting a local nonprofit organization designed around sexual assault. A preliminary listing I googled is here.

The only nonprofit I've worked with is Women Organized Against Rape (WOAR) in Philadelphia. At the organization a 24-hour hotline was maintained for people to call in times of need either just to talk to someone or specifically to get recommendations for the kinds of things you need. There were also sliding scale counselors there trained in sexual assault response and there were individual and group therapy options.

As a data point, I found that CBT as suggested above helped me resume a "normal" life the most, but that is definitely something to discuss with a professional. The therapist I worked with had an excellent metaphor for CBT: she said that while the assault only took up a page in the book of my life, consciously and subconsciously that book kept falling off of the shelf in front of me and opening to that page, so that I couldn't help but look at it before I put it away again.

Another thing that helped me a lot (though ultimately I had to stop doing because it ended up being too emotionally trying, but I would trade my time doing it for anything) was becoming a hotline volunteer for WOAR. In order to volunteer I had to take a 40-hour long class (free, offered by them) on sexual assault ramifications and coping strategies and how to talk to victims. I learned a lot about how normal my reactions are in that class.

Anyway, hope something I've typed helps you. Mefi-mail me anytime.
posted by sickinthehead at 7:05 PM on November 11, 2009 [1 favorite]

I forgot to finish this paragraph above:

As a data point, I found that CBT as suggested above helped me resume a "normal" life the most, but that is definitely something to discuss with a professional. The therapist I worked with had an excellent metaphor for CBT: she said that while the assault only took up a page in the book of my life, consciously and subconsciously that book kept falling off of the shelf in front of me and opening to that page, so that I couldn't help but look at it before I put it away again. And that CBT makes the page so familiar and mundane that looking at it doesn't matter anymore.
posted by sickinthehead at 7:08 PM on November 11, 2009

my god. i'm sorry, i don't have much of anything helpful to tell you, except that i am so sorry you had to go through this. and i haven't been raped, so this may not be as you may find it from someone who has, but i agree you should take a break from sex. one month, with option to renew. the pressure can't be helping. your partner wouldn't want you to be "holding your nose" to have sex with him. maybe if all the pressure is off, you can allow yourself to feel how you feel & be ok with that? again, i'm just so sorry.
posted by apostrophe at 7:27 PM on November 11, 2009

There's a video that kind of "goes with" that Stacey Haines book. It's very gentle and reassuring, and definitely something you could watch with your partner.

I wish you the best with this.
posted by serazin at 7:30 PM on November 11, 2009

Stop worrying and love the boy

Stop worrying about that, and love yourself. The boy knows you love him. Allow him to love you by being patient and giving you the time and support you need. It's hard to do that sometimes because you want to support him, but you're the one who is suffering from this more, and it's his turn to support you. Sometimes the hardest and best thing you can do for your partner is simply to allow them to support you.

Rationally I know I'm fine, and that consensual sex is good and fun, but even non-intercourse things leave me terrified. I have vivid nightmares of the rape all over again, something I haven't gone through since the first three years after I was attacked.

Rationally, you're not fine. And that's okay. It makes perfect sense. Your body is hurting and remembering why this hurt started and trying to protect you. I'm not a therapist, but I suspect that any therapist who is worth your time will tell you that shutting down these feelings is not going to help. We don't learn to feel safe again by ignoring threats and fears. We learn that by establishing our safety net and surrounding ourselves with positive comforting things. Give yourself permission to take the time to let your body find that again.
posted by heatherann at 7:37 PM on November 11, 2009 [2 favorites]

I don't think the "sex break for x amount of time" is a good idea. Even if it's couched in terms of "revisiting" the subject after [insert number of days here]. Any such timeline is going to put too much of a burden on you to be 'better' in an arbitrary amount of time. As it is, you're watching the clock. You're toes are already tapping away, saying 'get on with it already.' Please don't put more pressure on yourself.

So I might be reading way too much into your post, but here goes. Sorry about the length.

I'm worried about this "swallowing his frustration and putting on a kind, brave face." He's a good guy. He cares about you. He does not want to pressure you. He's being sweet.

But but but but. Being sweet is not the same thing as being helpful. Putting on a kind, patient veneer over his frustrations does several things - for him, they're driven underground. He starts to have feeling he's not 'supposed' to have - anger at what happened to you, frustration at the drop off in sex. Perhaps he's lonely too - not having sex means loosing a certain connection to you. You're going through something that happened before he came along. In so many ways, it does not include him. So you've gone into this place - that you need to go into - but he can't go with you. So a lot has been lost. He's having feelings he doesn't think he can or should share with you - because he's a good guy. He's being patient. He's sweet. But there's a disconnect - he's swallowing his frustrations, fears, anger and loneliness because, well, what else would a good boyfriend do?

And for you - you see his frustration. You know it's there - it's the elephant in the room. You know there's got to be a clock ticking somewhere. You just can't find it - because he's swallowed it. You feel the weight of all of his feelings - but they're amorphous, like shadows. You can't respond to shadows and can only guess at their original shape. The easiest guess at their shape is the most obvious - sex. I suspect part of your guilt is that you sense that he wants something you can't, right now, give him - sex, affection, physicality, sensuality. Another dimension of the guilt is that you're (rightly) not entirely buying the kind, brave face - but you have no way to articulate that without calling into question what a good boyfriend he's been to you. Since all of this is happening in the dark, you both feel guilty. It's hard. Everyone is trying mightily to the right thing.

You're re-experiencing a primal trauma. You're body is screaming to be nurtured and protected. Trauma forces us back to the basics - sleep, food, comfort, safety. You have to give yourself these things before anything else. Please don't accept even the smallest gesture of physical nurturance from you boyfriend if violates your sense of safety and comfort. Decline it because you respect your healing process and because you respect him. He'll know when you're forcing yourself - and that will breed still more guilt for both of you.

I think the other posters are right - fight for good therapy, use free/low cost resources where you can, redirect your finances to pay for a good counselor.

As for your relationship. Can you give your boyfriend space to be open about what he is feeling - all of it, his frustrations, fears, impatience, anger? Can you give him that space while at the same time giving yourself the physical and emotional freedom you need to heal yourself? It's very difficult - I know. You will naturally feel pressured. You may find some strength in carrying the tension that comes with respecting your needs while he gives full voice to his.

Best of luck You have my upmost respect and admiration. Apologies again for the length and if my speculations went too far off the mark.
posted by space_cookie at 11:51 PM on November 11, 2009 [5 favorites]

I think that the first thing you need to do is make a conscious decision to trust the boy. Say that this next little bit is going to be hard for you and that his support has meant the world to you.

Then you are going to have to process some of that remainder of fear that has yet to be processed. It will come out in drips and drabs for the rest of your life. Where the change is going to come from is in how you relate to those feelings. Your problem is simple--your gut is set to a level which makes it hard for you to connect with people in every day life. It also goes off when the physical injuries you received pain you. Your danger sense is going off in regular life. It is your desire to continue living a regular life and enjoy sex is being interfered with by your feeling threatened.

So you're gonna have to find a way to experience those emotions and get them out without it wiping you out.

I suggest you slowly and gradually test how you can tolerate affection and sexual activity. I'd work up, over a period of weeks, from handholding to actual sexual behavior. In other words, test whether or not these feelings of fear of sex are accurate. Set aside a 30 minute period once a week where you and him can do the testing, say Saturday. You could do whatever, like the first week when you guys are doing something like watching a movie, he could hold your hand on and off for 30-minutes. Then move up to hugging, arm around waist, dancing. A slow escalation.

While this stuff is happening, you are going to feel somewhat afraid. But more importantly, I want you to focus on how you feel right before you start the testing and give a rating of 1-100 on how difficult will be to do the scheduled test and rate how difficult it really was.

Keep doing this until you start to feel better.
posted by Ironmouth at 11:54 PM on November 11, 2009

I don't have anything to add that hasn't already been said but if you're looking for books to help you then I found The Sexual Healing Journey to be quite useful. It wasn't so much an instant solution as a reassurance that it wasn't an unusual feeling and that there was a way to move forward. There are also suggestions of exercises you can try with your partner to help you feel more comfortable with sexual activities.
posted by Laura_J at 6:41 AM on November 12, 2009

A therapist I work with gave me this list of institutes that offer low-cost and/or sliding scale therapy.

NPAP- National Psychological Association for Psychoanalysis

The White Institute

American Institute for Psychoanalysis

Institute for Contemporary Psychotherapy

She said the drawback to them is that you're seeing someone who is in training, but the benefit is that your therapist meets about your case regularly with an very experienced, expert therapist. She said it's like getting expert therapy for the cost of a trainee. None of these places are specifically for sexual trauma, but you could probably talk to someone there about what they can offer.
posted by Mavri at 8:45 AM on November 12, 2009

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