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Ask a Therapist: How Can I Learn to Trust Others and Myself?

We've rounded up questions submitted by survivors of sexual violence surrounding vulnerability, intimacy, trust and validation and asked a trauma therapist to share insights on how to manage and overcome these challenges.

Q: I get so anxious when I have to go to the doctor. I hate being touched and looked at by strangers, even though I know most doctors have the best intentions. Being that vulnerable is emotional torture for me. What can I do to make the experience better?

First of all, I want you to know that this is so so so normal. Intense anxiety about doctors visits happens for people who haven’t been sexually assaulted so when there’s been an assault, it’s even harder. Second, having a primary care physician will be helpful so they can get to know you. If you have to see someone new every time, that can be extremely difficult.

Does your doctor know about your assault? If not, it would likely be helpful to tell them and explain how now doctor appointments are extra vulnerable for you. If it feels hard to say to them, most doctors offices have a way you can email your provider or you can write a note and ask the nurse to give it to the doctor before they come in.

If you’re needing to have any sort of testing done that feels even more vulnerable--having to be bare chested for an EKG or having a pelvic exam or even having an abdominal ultrasound—I suggest telling your doctor beforehand that you suspect it will make you incredibly anxious and they might prescribe you an anxiety medication to take beforehand to make it more tolerable.

Q: I am currently dating someone who knows about my past experiences, but it’s still hard for me to enjoy sex. I’ll get flash backs sometimes or just feel like my body is going into fight or flight mode and I lose the emotion. The worst part is I always end up apologizing, even though I know my reaction isn’t my fault. I want to enjoy being intimate, and I want to show my partner I’m enjoying it but a lot of the time I’m just not. What can I do?

This might not be what you want to hear, but, honestly, if you’re having flashbacks and your nervous system is panicking (the fight or flight feeling) and you’re not even having fun or in the emotion, I’d recommend you stop having sex with your partner for now so you can work on your trauma without being triggered so intimately. You and your partner can intimately connect in other ways still—does making out feel good and not triggering? what about cuddling? You’ll need to take a step back from sex for a little while and relearn that intimate touch is not a threat.

Seeing a therapist who specializes in sexual assault trauma would be helpful. There’s also a book by Wendy Maltz, The Sexual Healing Journey, that could be helpful. It even includes some exercises you and your partner can try to teach your body that intimate touch isn’t threatening in a safe context.

Q: I don’t trust people anymore, especially men. I always feel like I’m being used and I constantly question others’ love for me. I’m always assuming they just want to be with me for my body. How can I learn to trust people again?

When I have clients who are struggling with trust in a similar way, I notice that their difficulty with trust has gotten them to isolate themselves to a certain extent. Teaching yourself how to trust will feel risky and hard...and it’s also worth it because there has to be a little bit of trust for connection to be built.

That being said, the absolute best way for anyone to build trust with people is by having firm, clear boundaries. It might sound backwards, but having clear boundaries and communicating them to people lets them know what’s okay and what’s not okay. When people respect your most basic boundaries, you can trust them a little and see if they can be trusted with a little more.

For example, I might have a boundary about alcohol use and I let my friends know that I don’t feel safe around people who are drinking. Then, when a friend invites me over to her place for dinner and she’s got a bottle of wine open on the counter, it’s okay for me to reiterate the boundary saying, "Hey, I’d really prefer if we could spend time together without alcohol being involved—it makes me anxious.” She has the opportunity to gain your trust by saying “I totally forgot. I’ll put it away. Do you want a sparkling water?” That little moment and lead to more and more little moments of letting people show you that they are worthy of your trust.

Q: I’ve needed so much validation since being assaulted and it sucks, because I haven’t always been like that. What steps can I take to get back to the real me?

We all need validation. It’s how we feel seen and understood in the world. I’m guessing that you’re saying that your need for validation is coming from a place of insecurity, maybe even worry that you’re being judged. If I’m right, then your first steps are about acknowledging the stories that are running in your mind. When we don’t have all the information about a situation and especially when we feel insecure, our brains fill in the gaps to make a story that makes sense.

For example, if we are at dinner and you keep taking out your phone to text, I might make up a story about how you’re bored and I’m just a boring person and we aren’t as good friends as I thought. That could be true but there could also be 117 other things going on. Acknowledging the story I’m making up in my head and fact-checking it (saying, “Hey, you’re checking your phone a lot and I’m making up this story in my head about it being because you’re bored—what’s going on?”) with you will keep me in a state that feels like the real me rather than the insecure, needy feeling you’re experiencing.


Don't miss Part 1 of our "Ask a Therapist" blog series here: "How Does Sexual Assault Impact the Mind and Body?"

Do you have a question you'd like answered as part of our "Ask a Therapist" blog series? Click here to submit a question.

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