Aftershocks: One Survivor’s Recovery

Hey there, readers. Welcome back to this series on the physical effects of sexual⁠ trauma⁠ . You can find the first two articles in this series here and here.

In this third installment, we hear from a survivor who developed substantial physical concerns after her trauma experiences. Kayla* is a survivor of multiple episodes of sexual trauma, and she has undergone extensive care for her post-traumatic symptoms.

Kayla was candid about her experiences on the road to recovery. She shared her story with me in the hopes of shining a light on an under-recognized issue and helping other survivors feel less alone in their recovery journeys.

Kaylas Story of Survival and Recovery

When Kayla shared her story with me, I was struck by how familiar it sounded. As a pelvic health professional and sexual health advocate, I’ve heard many stories like hers – but if you don’t work in this space, you may not realize how common these experiences are. Kayla and I hope that her story helps other survivors feel that help and hope are possible after sexual trauma.

Kayla has survived multiple instances of sexual trauma. As a minor, she was sexually abused by a family member. Later, she experienced sexual trauma at the hands of a cycling coach.

Kayla was struggling with pain and numbness running down her left leg when she first sought care for her physical symptoms. She was also experiencing some numbness in her perineum⁠ (the underside of the pelvis between the genitals⁠ and anus⁠ ). She had injured her upper hamstrings (the muscles on the back of the thigh), and wondered if this injury was causing the numbness in her leg. In the years since that injury, Kayla has realized that this hamstring injury likely occurred during the sexual assault⁠ by her cycling coach: her muscles were extremely tense during the assault, and this tension caused significant strain to the attachment between her hamstrings and her pelvis.

The chiropractor from whom she sought care told Kayla that some of her symptoms might be coming from her pelvic floor. Curious, Kayla went home and decided to investigate: when she inserted a finger into her vagina⁠ , she could feel all the internal muscles on the left side actively twitching.

At her chiropractor’s recommendation, Kayla began seeing a pelvic physical therapist. She and her PT uncovered a wide variety of physical concerns to address, some of which Kayla hadn’t previously recognized.

The spasms in Kayla’s pelvic floor muscles were indeed contributing to the numbness and pain in her left leg. They also caused a lot of tension around her anus—so much so that even light pressure around the anal opening felt extremely intense for her.

Because Kayla’s pelvic floor muscles were constantly tense and twitching, they were unable to perform their jobs correctly. She experienced involuntary leakage of pee (urinary incontinence) and periodic inability to control her bowel movements (fecal incontinence). Her urethra⁠ (the tube through which pee exits the body) had descended from its normal position, almost to the point where it was outside her body.

Kayla spent over a year attending regular sessions of pelvic PT. She has also received extensive mental health care, and she has participated in a variety of support groups for survivors of sexual trauma. In the late twenty-teens, she participated in Heather’s program for survivors, Sacred Cycle, where she engaged in counseling, art therapy, Rolfing, and various outdoor therapies like guided mountain biking and equine therapy.

Kayla has invested a lot of time, energy, and effort into her recovery. It shows. She told me that she feels better today than she did when she first sought care…but that doesn’t mean it was easy. Kayla spent more than 8 years and at least $10,000 seeking care for the physical effects of her traumatic experiences; she had pain and other physical symptoms for at least 4 years before she started treatment. She saw more healthcare professionals than she can count, and she learned to advocate for herself to get the care she needed.

Life in Recovery

Even now, years later, not every day is sunshine and rainbows. Kayla still experiences physical sensations and symptoms linked to the trauma she survived. She still occasionally struggles with urinary and fecal incontinence. She has distinct patterns of muscle tension that flare up when she is under stress: she’ll feel tightening in the muscles in her neck, shoulders, and between her shoulder blades.

Kayla’s old pattern of pain and numbness in her pelvic floor and left leg can also crop back up when she is stressed: this is particularly true when she has to be around her childhood abuser at family gatherings. Tightness in her pelvic floor can affect Kayla’s breathing: her breathing muscle (the diaphragm) and her abs often cramp in response to pelvic tightening.

Sometimes, Kayla experiences pain during sex⁠ . Her partners have been cisgender⁠ men, and penile- vaginal intercourse⁠ can be painful at times, even with a partner⁠ she loves and trusts. When this happens, any attempt at intercourse⁠ can “feel like fire” or “like a dull serrated knife”, so she and her partner will stop the encounter.

Kayla told me that nowadays, it almost feels like her “shock system” (i.e., the sympathetic nervous system⁠ within the CNS) is completely worn out⁠ . She’ll sometimes feel decreased sensation or total numbness in her limbs and other body parts, as though the nerves in that area have simply clocked out of work for the day.

In light of these symptoms, I asked Kayla how she has handled her subsequent sexual relationships and how she approaches talking to her partners about her trauma history.

How Kayla Talks with Her Partners

In the early period⁠ after her traumatic experiences, Kayla coped by drinking heavily before sexual encounters; this is a common coping strategy among survivors of sexual trauma. As she embarked on her recovery journey, Kayla made the conscious decision to not engage in sex if she or her potential partner had been drinking—at all. She has relaxed her stance on this in recent years and will now allow a drink or two, but she still avoids sex altogether if either party is drunk.

Kayla is also very proactive about discussing her trauma history with her sexual partners: she usually shares within the first few encounters. Sometimes, Kayla will drop a hint to let the other person know to expect the conversation later: she’ll tell her partner that she’d like to set aside time later to share some important information about her past.

When she sits down to talk with her partner, Kayla tells them, “If you want to be with me, you have to know this.” She’ll explain the physical effects she experiences as a result of sexual trauma. Often, she explains the pelvic floor muscles and how issues in these muscles can cause problems with sex, pain processing, and more. Sometimes, she’ll even ask her partner to touch the left side of her pelvic muscles so they can feel the tension and spasms that still happen there.

If Kayla feels uncomfortable with the person’s response to her story—or with anything about the circumstance she’s in—she’ll remove herself from the situation. She believes in advocating for herself with her sexual partners the same way she did with her doctors when she was first searching for care (more on this to come).

Playing the Long Game

When I asked Kayla if she had any advice for other survivors experiencing physical impacts from sexual trauma, she had several helpful suggestions:

  • Be your own best advocate for your care.
    • Kayla learned the hard way that not all healthcare is created equal. At times, she has had to switch providers because the first clinician lacked the training or knowledge to give her the care she needed. She has also learned to screen her providers: if a doctor or other professional seems unwilling to discuss sensitive topics like pelvic floor problems, Kayla doesn’t stick around – she moves on to find someone who will listen and respond to her concerns.
  • Break down the recovery process into chunks – you don’t have to tackle everything at once.
    • When you’re recovering from sexual trauma, there can be a lot to tackle: mental health, physical impacts, emotional recovery, etc. Kayla found it helpful to focus on one or two areas at a time, even if this meant she needed to take a break from another type of therapy. This has made the burden of recovery on her time, energy, and finances easier to manage.
  • Recovery takes time – be patient with yourself and the process.
    • Again, each person’s journey to recovery from sexual trauma looks different. For Kayla, it took many years and a good chunk of money to get where she is today, and she’s still working through some elements of the recovery process. Other survivors may find that they improve more quickly or more slowly—and both situations are equally valid.
    • Keep in mind that what has worked for Kayla may or may not work well for you. There’s no script for trauma recovery, so take what you liked from her story, and leave the rest.

*Kayla's name has been changed to protect their privacy.

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  • Caitlyn Tivy PT, DPT, OCS

The last installment in a series on the physical effects of sexual trauma. To conclude the series, we’re talking about talking: namely, how to talk with sexual partners about any physical effects that you have experienced as a survivor of sexual trauma.