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ABSTRACT This paper discusses the sexual consequences of non-sexual traumatic experiences. While there is a large literature on the sexual effects of traumatic events in the sexual domain, relatively little has been written about the development of psychosexual problems following other traumatic experiences. Here, this phenomenon is discussed and illustrated. Data from a series of clients are provided, with some detailed case examples. Pathways to the development of sexual impairment from non-sexual trauma are also discussed. The need to enquire about sexual functioning in the overall clinical assessment of traumatized individuals is emphasized. Finally, some comments are made on treatment.
Introduction
Psychosexual dysfunction can result from a variety of causes (Bancroft, 1989; McConaghy, 1993). It is now well established that a history of sexual trauma can lead to the development of significant sexual difficulties. The extensive literature on the consequences of rape provides a wealth of evidence that the experience of rape often leads to frank sexual dysfunction in the victims (e.g. Becker, et al., 1986; Feldman-Summers, et al., 1979). Loss of libido, anorgasmia, and sexual aversions and phobias are common among these effects. Disturbances in intimacy and inability to trust also arise and in turn cause, and contribute to, the sexual problem. Males who have been raped or sexually assaulted are also known to develop sexual dysfunction (Mezey & King, 1989). Equally, it has been found that sexual abuse in childhood can also have serious negative consequences on the person's later sexual functioning (e.g. Courtois, 1979; Finkelhor, 1990; Jehu, 1988). Further, there is strong evidence that those who have been sexually tortured (e.g. forced penetration with objects; infliction of pain on the genital organs) can develop sexual dysfunction (e.g. Lunde & Ortmann, 1990).
These sexual consequences of what are essentially traumatic experiences of a sexual nature are perhaps not surprising. The trauma and the consequential dysfunction are both in the same domain.
Non-sexual traumatic events
Sexual problems are also caused, or contributed to, by traumatic events of a non-sexual nature. This has been featured less extensively in the literature, but there are many reports. The extensive literature on the traumas related to war and combat exposure contains many examples of this. Zahava Solomon's (1993) work with combat-exposed soldiers in Israel has shown...