Blogs - Dr Amrit Kaur Clinical Psychologist, Singapore and Asia Pacific

Sex after Trauma

You think you’re over your traumatic experience, but there it is. Your partner’s disappointed face as you say once again, “Not tonight, honey”. Not because of poor libido, but because of a range of images and feelings that strike terror in your body at the thought of having sex. Can Sexual Desire be Restored after Sexual Trauma? So many women who experienced sexual trauma – whether through years of groming, daterape or simply unwanted touch. Sexual abuse or sexual assault can happen to anyone at any point in our lives, regardless of age, gender, or socio-economic status. Many women who seek out trauma therapy come to the point when they are over the worst, only to find themselves feeling the familiar feelings of terror, and overwhelm in the bedroom. It’s common for survivors to feel dissociated, hypervigilant, anxious, and experience symptoms of trauma like flashbacks, nightmares, or panic attacks. When it comes to sex and intimate relationships, these symptoms can feel like insurmountable obstacles. If you’re single, you may feel profoundly scared of dating again, anxious about being alone with someone new, or experience feelings of isolation and loneliness. If you’re partnered, you may feel an aversion to having your significant other touch you, fear engaging in sexual activities you once enjoyed, or simply want to withdraw from the relationship altogether. If it was your partner who committed the assault, the repercussions can be even more complicated. Even if in a safe and secure relationship, sex can remain triggering in so many ways. The lack of consent during the assault experience has a crippling efffect on our sense of safety and changes our own relationship with others. Clients have described panic at the sight of their husbands hovering over them, and they experience overwhelming memories of being overpowered that make it impossible to continue the act. Others find that touch to specific parts of the body (stomach, back, breasts etc) can bring back painful flashes of being hurt. If sex is tainted by trauma, please get in touch at dramrit.sg@gmail.com. In my practice I have worked with hundreds of sexual abuse survivors. We work on the trauma experience extensively, but then turn our focus specifically to sex-related triggers. I urge women who find themselves triggered by the sex act to reach out. There is so much that we can do together that will help transform your most intimate relationship.

Living with Dissociative Identity Disorder

Imagine waking up each morning uncertain of who will greet you in the mirror. Your memories flicker and fade, with different parts of you holding fort in different parts of your life. Inside your mind, different voices jostle for space, each with their own desires and fears. This is the reality for those living with Dissociative Identity Disorder, a misunderstood and often sensationalised condition. What is Dissociative Identity Disorder Dissociative identity disorder (DID) is a mental health condition where you have two or more separate identities that are dissociated – separated or disconnected – with each other. Affecting 1.5 percent of the global population, Dissociative Identity Disorder used to be called Multiple Personality Disorder, or Split Personality Disorder, which is perhaps a better way of describing the challenges it presents. People with Dissociative Identity Disorder may experience several different personalities, usually referred to as alters. Many describe their alters as distinct individuals who live inside their mind. These alters might have different names, personalities, and even likes and dislikes. These alters can sometimes take over, leaving the person with memory gaps (amnesia) that go way beyond normal forgetfulness. The presence of amnesia is often an important symptom that leads the to the eventual diagnosis. The personalities are often quite different from each other, with some being male, and others female. The personalities are also diverse in that one may be outgoing and brave, and another traumatised, and wanting to stay safe at home. They will speak in a different tone, use different body language, and even have different behaviours, memories, thought patterns or expressions. DID is widely portrayed in movies, but not often accurately. Dramatic stereotyping can hurt. As one Reddit user put it, “People think I’m supposed to be a villain or have superpowers because that’s what they’ve seen in movies. In reality, I’m just struggling to live my life like everyone else.” The following is a client, James’ (not his real name) take on what life with Dissociative Identity Disorder is really like. “Although I am the one who is around most of the time, my alters tend to take control of the body from time to time. This is not an automatic switch – my head begins to hurt just as this starts to happen.” James describes being sometimes aware that an alter has taken over, and able to look and listen in on their interactions. Other times, he feels cut off, and completely disconnected from his body and from the other alters. His mannerisms change, his voice change, and even his likes and dislikes change with this occurrence. He is sometimes aware of other alters in the background of his mind – they play, interact, fight, make jokes. At other times, his mind goes silent and its hard to communicate with them. Someone on a forum explained it like this: “My brain feels like a house with a bunch of rooms, each room belonging to someone different. Sometimes, I can’t open certain doors, and other times, one of the ‘owners’ takes over while I watch from the sidelines.” Origins of Dissociative Identity Disorder These alters aren’t random—they usually exist for a reason, and in response to unendurably painful experiences. Almost overwhelmingly, DID is the product of trauma, and should be seen through that lens. Most of my clients with DID report childhood histories of severe physical abuse, parental neglect, abandonment, and sexual abuse. In its essence, DID is the creative way the mind copes when severe trauma makes it necessary to block memories, and prioritize functioning. The Weirdness of Lost Time A big part of Dissociative Identity Disorder is the struggle with memory gaps, often called “lost time.” Many people share stories of losing chunks of their day or waking up somewhere new without knowing how they got there. One post on social media detailed, “I woke up on a bus heading to a city I’d never been to before. I had no clue how I got there or why I was going. Later, I found a notebook in my bag with handwriting that wasn’t mine—it was from one of my alters.” A client described a similar situation. After three years of staying largely at home during Covid, he enrolled in a course to further his education and push himself to overcome his very intense fears around his safety outside of his house. One day, he remembered waking up, getting dressed, and walking to the bus stop to make it to school on time. What seemed like just moments later, he found himself in bed, playing computer games and eating snacks. Looking at the clock, it became apparent that he had missed most of his day. Unbeknownst to him, a more fearful, traumatised alter with memories of being abused had taken over while he was at the bus stop, and walked him home where they thought he would be safest from dangerous others. Relationships Can Get Tricky Making things harder is the fact that alters don’t always see people the same way—the main personality might trust someone, while an alter doesn’t, leading to mixed feelings or unpredictable reactions. In my own therapy, I’ve had clients present looking for therapy, only to have an alter cancel the next week because they are mistrustful of me. I’ve had to initiate conversations with willing alters in the first few sessions, just so they have a chance to ask me their own questions separately, and build trust individually One blogger shared, “My partner thinks I completely changed overnight, but I haven’t. I’m trying to explain to her that one of my alters doesn’t trust her, even though I do. It’s like an internal tug-of-war.” Its hard to stay in relationship in this situation, but I’ve heard enough positive stories to know that this is possible. The client above (who struggled to return to school after Covid) learnt more about his alters and got to know them better. As he worked deliberately to get to know each alter, he learnt how