SEX AND Combat PTSD: What Sex is like with a Rottweiler in your Head
Sex feels 'different' to veterans returning from combat. Exposure to death and danger in such a high-intensity environment twists and turns their perspective on life and pleasure.
Post-traumatic Stress Disorder (PTSD) is the brain's noble attempt to cope with this kind of perspective change and keep you out of future danger. The watchdogs of the brain -- the amygdala and hippocampus -- pay close attention to what is going on outside of the body and prepare it to snap into action at the slightest perceived threat.
Following a life-threatening trauma, the brain reprograms itself to be extra-sensitive to outside threats. We are born with a Lassie-type watchdog, but when we encounter sudden, traumatic and life-threatening experiences, the brain transforms Lassie into a rottweiler -- ready and able to handle the next dangerous threat. With the rottweiler brain, a soldier is better able to cope with bombs exploding next to him, to awaken at the slightest provocation, to be alert to the tiniest of twigs snapping, and to turn off frivolous emotions -- allowing him to act calmly under pressure. This natural and effective system has kept us alive ever since men we fought other cavemen.
The trauma only turns into a "disorder" when the brain does not return to the Lassie-type of watchdog when bombs are no longer going off and the veterans is in the safety of his home/country. PTSD is another way of saying that the brain has difficulty seeing safety anymore. Any loud noise, war-familiar smell, or car backfiring can mistakenly trigger the rottweiler brain to alert the rest of the body to "fight or flee". On the home front this can be experienced as "anxiety" and "jitteriness", flashbacks, sleeplessness, numbing and/or hyper-vigilance.
A feeling of loneliness and isolation can lead to drug or alcohol abuse as the struggling trauma-survivors self-medicate, to "even out" their moods. Eventually, symptoms of depression and feelings of helplessness can emerge.
Where Sex Fits In
PTSD overshadows sex. From the brain's perspective, it is simply more important for the body to stay alive than it is to have sexual pleasure (or to reproduce). It is difficult to feel sexy when your body is on high alert.
Researchers have found that 80% of men with PTSD experience significant sexual difficulties. Most describe a feeling of their old sexual self being gone. Many others report, that they have lost their desire for sex, are having difficulty getting an erection or controlling ejaculation and problems connecting with their lover.
Little or No Interest in Sex
Many soldiers leave for combat with sexy images of their girlfriends/wives tucked carefully away in their duffle bags, in MySpace pages, or in the delicious parts of their memories. Images of breasts and pussies dance playfully in their heads. These same soldiers and partners believe that they will return to their old feisty sex-lives as soon their feet hit the pavement of their hometowns. But the war has given them a new perspective on life, love and pleasure. Just as they lose their innocence in combat, many also lose their desire for sex on the home-front. "When so much bad is happening in the world, sex seems frivolous", one soldier said.
Other veterans reported that they did not allow themselves to become sexually aroused out of guilt. Since their buddies -- who had died or had been more severely injured than they -- could no longer enjoy sex, so how could they?
One vet reported that he was too sad after seeing what horrible things people can do to each other to be able to get fully aroused anymore.
While many soldiers report their interest in sex has dropped since combat-experience, it was found in many cases to be a result of conditions associated with PTSD -- such as depression, anxiety and drug abuse. Anxiety and depression are well-known sexuality- crushers.
The body was made to be sexual; in its natural state, it wants to have pleasure. In an attempt at re-accessing that pleasure, many vets have found various strategies to try to get back what they used to enjoy.
Controlling Sex
One popular strategy is to control the sexual experience in such a way as to be able to perform sexually (for their own release or to please a partner), without triggering uncomfortable memories. For instance, they may attempt to direct where they have sex, what position they do it in, what acts are performed and for how long.
John, who has been back from Iraq for 6 months, can only have sex doggy-style after he has had several drinks, while his wife stays perfectly still. John is a loving husband and a great father. He wants to please his wife, but the only way he can have sex with her is to control every aspect of each sexual encounter. A few bad sexual experiences, during which intrusive war-memories triggered him to freeze and lose his erection, have caused him to worry that he will "freeze up" again or won't be able to keep his erection. Such concerns challenge his feelings of manliness and of being the protector - all of which is too much for him to bear.
Neither he, nor his wife, is content with this arrangement. He knows he is not pleasing her, but this is the only way he can manage to have intercourse.
Wanting Sex NOW
Matsakis, an expert in relationships after combat, describes how sex can be an escape, a tranquilizer or a way to connect socially for some vets,
"Some women describe their mates as almost always insisting on sex…The urgent quality to their desire cannot be attributed solely t their need for sexual gratification. In the sex act, their men seem to be seeking not only sexual release but security, self-esteem, and, in some instances, perhaps a sense of superiority, or "victory", as well. When refused by their partners, they feel desperately unloved."
By seeking sex they may unknowingly be seeking the most potent sedative and bonding agent in the body, oxytocin. Oxytocin is a hormone released with "positive touch" and/or orgasm. It is what is responsible for that sleepy feeling after sex and what makes us want to snuggle up closer to our partner. Sex can be one way of getting a shot at sleepiness and bonding (through oxytocin) when it is most needed.
Numb Sex: No Emotion Allowed.
Some vets may feel desire for sex and intimacy but when they take action to pursue the urge they lose the sexual feeling. They just "turn on". Their brain has learned to cut out emotion altogether during times of (dis)tress -- even during the positive (eu)stress of sex -- in order to avoid the pain associated with trauma.
In their past sex-life, they were able to "give in" to their partners and to abandon themselves to pleasure. This type of abandonment into pleasure, so necessary to arousal or orgasm, may now feel overwhelming to some vets and make it difficult to do when he can't feel much of anything.
One effective method to steer clear of going numb, losing your erection or getting triggered into feeling overwhelmed is to avoid sex altogether.
Arousal is different
What used to turn the young soldier on may have become tainted by war. The fantasies he used to enjoy may no longer work.
For example, some soldiers find the nude images of breasts and curved asses (which used to bring them to high levels of arousal) have been replaced by the nudity of war -- the gruesomeness of dead bodies or broken and torn flesh. In some cases, it is their own scarred or missing flesh, that either turns them off or embarrasses them, in front of a partner and yanks them out of the sensual experience.
Sensuality Hurts or doesn't feel anything at all
The sensation of numbing with sexual stimulation may not just be psychological in nature. Your skin actually "feels" less when under stress. In order to get aroused, you need blood to flow to the skin. Your skin starts to flush in all the right places (particularly the genitals), allowing women to lubricate and men to get erections.
Under stress, your body pulls blood away from the skin and puts it where it needs to go in order to get away from the threat -- your muscles. For a vet suffering from PTSD, the rottweiler in his head is telling his body to react as if it were in danger, even if there is none. As a result, blood doesn't make it to the skin to "sensitize it". They may bleed less or experience less pain if their skin is cut or hurt in an attempt to get away from danger, but they actually feel less. For the vet whose brain can't distinguish between real and perceived stress his skin may feel numb during sex.
Erection Problems Having difficulty in getting an erection is the most common problem that men with PTSD face. 69% of the men with PTSD reported erection-problems. Erections need blood-flow that is fueled by some sort of sexual stimulation -- either a thought or a sensation. Intrusive war-thoughts can easily get in the way of those sexy thoughts or sensations. Blood is stopped from flowing to the skin (and penis) when the body is perceives stress or danger. Basically, if the rottweiler is around, you can kiss your erection goodbye.
Premature Ejaculation
Premature Ejaculation is the second most common issue PTSD sufferers face. They are able to feel arousal and have blood flow to erogenous zones like the skin and penis. If a sudden smell or image triggers the rottweiler to surface, the body will either lose the erection or ejaculate -- often at the least opportune of times.
Intimacy Issues
Trouble in connecting to a lover is one of the biggest complaints discussed by both veterans and their partners, and even in couples who are otherwise doing well in their relationship. Most couples show some form of increased communication after combat, but the communication is often incomplete, misunderstood or unsatisfying. Some vets can get aroused and orgasm with masturbation but not with a partner. Even though they have an attractive partner whom they love wanting to have sex with them, they still can not get aroused.
Physical intimacy is difficult for the vet because he may "freeze up" or become "numb" to anything causing him to feel unguarded. Sex requires a vulnerability that many combat vets can no longer indulge in. They have learned never to be vulnerable, because vulnerability can open you up to danger. They fear losing control or becoming overwhelmed by a flashback. These feelings do not shut off immediately after arriving in a safe environment. The brain still sees danger, even in the safety of the matrimonial bed.
Treatment for PTSD:Another Blow to Sex
The very treatment for PTSD, can give another blow to the body's ability to get those sexual juices flowing, or to reach that peak of pleasure of orgasm. One of the most effective treatments for PTSD are anti-depressants. The anti-depressants of choice are SSRIs (serotonin re-uptake inhibitors) and are well known to interfere with the ability to orgasm. Minutes or hours of sexual stimulation may pass without the desired release that comes with orgasm; it looms over every thrust and vibration to such a degree that frustration finally takes over, and the whole thing comes to naught. And knowing you will be faced with this frustration every time you try to have sex will eventually lead to loss of desire.
The Positive Side: Redefining your Sexuality
Your sex life does not have to be lost to PTSD, however. It is treatable, and in most cases, when the brain shakes itself loose of the rottweiler, many sexual problems correct themselves. And if handled with care even better sex lives can result.
An Opportunity to Establish Positive Sexual Patterns
Eventually, every couple will fall into a sluggish sex-trap, where they no longer venture outside their set routine. A prolonged separation, coupled with intense trauma, force any couple out of an old routine. It is up to the couple to choose with what routine they would like to replace the old one. This can be an exciting opportunity to discover a new, healthy and sexy life.
A chance to connect more deeply with your partner
Coming home forces people to communicate in order to heal. Many vets report experiencing tremendous support from their partner and an increased feeling of being a "team". Going through something this profound together can create bonds that are difficult to access otherwise.
Enjoying Other Activities that would have been Unexplored Before
Sexuality is more than just intercourse! Physical or emotional injuries from combat can interfere with ability to have intercourse. At first take trauma can feel like the end of the world. But one of the great battles of sexologists is to get people to stop focusing on intercourse so much. There is a world of other activities such as sensual massage and oral or anal exploration that can heighten a sexual experience to a level that most couples never explore because they rely on intercourse as a staple. Precious gifts stand to be gained from going through a life altering experience of trauma.
Trauma can open up an opportunity to shake us out of old, and often unhealthy or unproductive sexual patterns. It can redefine our sexuality to make it what we always wanted it to be and in the process discover jewels of pleasure we never knew were there to want.
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