Hello, readers. Welcome back to this series about the physical effects of sexual trauma. The first two articles in this series can be found here and here.
In this third installment, we hear from a survivor whose traumatic experience left her with significant physical challenges. Kayla* is a survivor of multiple sexual traumas and has received extensive treatment for post-traumatic symptoms.
Kayla spoke candidly about her experience in recovery. She shared her story with me to shine a light on a little-known issue and help other survivors feel less alone in her recovery journey.
Kayla'A story of survival and recovery
When Kayla shared her story with me, I was surprised at how familiar it sounded. As her pelvic health specialist and her sexual health advocate, I've heard many stories like hers. But unless you work in this field, you might not realize how common this experience is. Kayla and I hope that her story will help other survivors feel that help and hope are available after sexual trauma.
Kayla survived multiple sexual traumas. She was sexually assaulted by her family when she was a minor. She later suffered sexual trauma at the hands of her cycling coach.
When Kayla first sought treatment for her physical symptoms, she was struggling with pain and numbness in her left leg. She was also experiencing some numbness in her perineum (the lower part of the pelvis between the genitals and anus). She had injured her upper hamstring (the muscle on the back of her thigh), and wondered if this injury would cause paralysis in her leg. In the years following that injury, Kayla realized: this The hamstring injury likely occurred during a sexual assault by her cycling coach. During the assault, her muscles became extremely tense, and this strain caused significant strain in the attachments between her hamstrings and pelvis.
The chiropractor she saw told Kayla that some of her symptoms could originate in her pelvic floor. Intrigued, Kayla decided to go to her house and investigate. When she inserted her fingers into her vagina she could feel all the internal muscles on her left side twitching vigorously.
At the recommendation of her chiropractor, Kayla began seeing a pelvic physical therapist. She and her PT discovered a variety of physical issues that needed to be addressed, some of which Kayla had not been aware of before.
Spasms in Kayla's pelvic floor muscles actually caused numbness and pain in her left leg. They also caused a lot of tension around her anus. So even light pressure around her anal opening felt extremely intense to her.
Kayla's pelvic floor muscles were constantly tense and spasming, making them unable to do their job properly. She experienced involuntary leakage of urine (urinary incontinence) and periodic inability to control bowel movements (fecal incontinence). Her urethra (the tube that carries urine out of the body) was lowered from its normal position, almost to a point outside the body.
Kayla spent over a year attending regular sessions with a pelvic PT. She also received extensive mental health care and participated in various support groups for survivors of sexual trauma. In her late 20s, she joined Sacred Cycle, Heather's program for survivors, and participated in a variety of outdoor therapies such as counseling, art therapy, Rolfing and guided mountain biking, and equine therapy.
Kayla invested a lot of time, energy, and effort into her recovery. This shows: She said she feels better today than when she first received treatment. But that doesn't mean it was easy. Kayla spent more than eight years and at least $10,000 treating the physical effects of her traumatic experience. She suffered from pain and other physical symptoms for at least four years before beginning her treatment. She met countless medical professionals and learned how to advocate for herself to get the care she needed.
life of recovery
Even after all these years, there is still sunshine and rainbows every day. Kayla says she still experiences physical sensations and symptoms related to the trauma she survived. She still struggles with occasional urinary and fecal incontinence. She has a unique pattern of muscle tension that becomes evident when she is stressed. You will feel the muscles in her neck, shoulders, and between her shoulder blades tense.
Kayla's pain and numbness in her pelvic floor and left leg can also return during times of stress. This is especially true if you have to be around your childhood abuser at a family gathering. Tension in the pelvic floor may be affecting Kayla's breathing. As the pelvis tightens, the breathing muscles (diaphragm) and abdominal muscles often cramp.
Sometimes Kayla experiences pain during sex. Her partner was a cisgender man, and her penile-vaginal intercourse could be painful at times, even with a partner she loved and trusted. When this happens, her attempts at intercourse may “feel like fire” or “like a dull, serrated knife,” so she and her partner will stop making out.
Kayla said these days she feels like her “shock system” (i.e. the sympathetic nervous system within the CNS) has completely failed. She will sometimes notice decreased or complete numbness in her limbs and other parts of her body. It's as if the nerves in that area haven't been working properly for a day.
Given these symptoms, I asked Kayla how she handled subsequent sex and how to talk to her partner about her history of trauma.
How Kayla Talks to Her Partner
Initially after the traumatic experience, Kayla coped by drinking heavily before sexual activity. This is a common coping strategy used by survivors of sexual trauma. As she began her recovery journey, Kayla made a conscious decision that she would not have sex at all if she or a potential partner had been drinking. She's softened her stance on this in recent years, so much so that she now allows herself a drink or two, but still avoids sex altogether when she's drunk either way.
Kayla is also very active in discussing her trauma history with her sexual partners. She usually shares in her first few meetings. Sometimes Kayla will drop a hint to let the other person know to expect a conversation later. She will tell her partner that she wants to set aside time later to share important information about her own past.
When she sits down to talk to her partners, Kayla tells them, “If you want to be with me, you need to know this.” She will describe the physical effects she experiences as a result of her sexual trauma. She often explains the pelvic floor muscles and how problems with these muscles can cause problems with sex, handling pain, and more. Sometimes she even asks her partner to touch the left side of her pelvic muscles so she can feel the tension and spasms that are still happening there.
If Kayla feels uncomfortable about the other person's reaction to her story or the situation she is in, she will remove herself from the situation. She believes she should advocate for herself with her sexual partners just as she did with her doctor at her first appointment (more on that later).
playing long game
When I asked Kayla if she had any advice for other survivors experiencing the physical effects of sexual trauma, she had some helpful suggestions.
- Be your own best advocate for your care.
- Kayla learned the hard way that not all health care is created equal. At times, she had to change her health care providers because her first clinician lacked her training or knowledge to provide the care she needed. She also learned how to select her own providers. When doctors or other professionals are reluctant to discuss sensitive topics like her pelvic floor issues, Kayla finds someone who will listen and respond to her concerns rather than just stay by her side.
- Break the recovery process into several chunks. You don't have to do everything at once.
- When recovering from sexual trauma, there is a lot to address, including mental health, physical impact, and emotional recovery. Kayla found it helpful to focus on one or two areas at a time. Stop other types of treatment. This made the burden of recovery on her time, energy, and finances more manageable.
- Recovery takes time. Be patient with yourself and the process.
- Again, the process of recovering from sexual trauma looks different for everyone. It has taken Kayla many years and a significant amount of money to get to where she is today, and she is still working through some elements of her recovery process. Other survivors may find that they improve faster or more slowly, and both situations are equally valid.
- Keep in mind that what worked for Kayla may or may not work for you. There is no script for trauma recovery, so take what you like about her story and leave the rest alone.
*Kayla's name has been changed to protect her privacy.