Counseling/ Sexuality

Sexual trauma is different for each individual who experiences it. Some individuals experience trauma as children, while others are adults. Some clients may be very communicative about their trauma, while others may have difficulty talking about it at all. Marriage, couple, and family counselors who work with clients who have experienced sexual trauma must take these individual differences into consideration as they work to help such persons achieve greater intimacy in their relationships.

To prepare for this Assignment, select one of the following cases. Consider how the client’s trauma history may be affecting his or her mental, physical, emotional, and sexual functioning.

Then think about counseling strategies you might use to help this person achieve greater intimacy.

Case #1: Tony, age 45

Tony is a single, attractive, heterosexual male who has a successful career as a physician. He has sought counseling services, stating that he wants to “work on my commitment issues.” Tony states that he would like to find a loving partner, get married, and have children. He reports that he has dated frequently throughout his adult life, but “it rarely gets past the third or fourth date.” He describes one longer-term relationship with a woman named Karen, which lasted for three years, although Tony says that the couple dated “on and off” during that time.

During his first session, Tony admitted that he is afraid of commitment and, when he has really been interested in a woman in the past, he has noticed that he gets “really afraid of getting hurt and thinks of some reason to run away.” He acknowledged that he feels lonely, but he did say that he has a lot of male friends with which he spends time.

When asked during this first session if he had ever been abused in any way, Tony denied having had such experiences. However, during his third session, Tony said, “You know, I wasn’t completely honest with you in our first meeting. I wasn’t sure I could trust you enough to tell you this at the time, but now that I know you better, I feel like I can share with you that I was molested when I was a boy by my aunt. It went on for about 3 months before she moved away. I’ve never told anyone about it, and it’s hard for me to talk about it now. But, I don’t know if it has anything to do with the things we’ve been talking about, so I thought I’d better mention it.”

Case #2: Beth, age 29

Beth has been married to Don for 3 years. Beth and Don are seeking couples counseling because the couple wants to start to try to have children, but their lack of sexual relationship threatens to make that an impossible dream. Beth and Don admit that they have never consummated their relationship.

Don has known since early in the couple’s dating relationship that Beth was raped by a stranger about six months before they started dating. Since that time, she has been unable to even think about having sex without having a panic attack and crying. Beth appreciates that Don has been extremely patient and understanding as she has undergone extensive therapy to work on her post-traumatic stress disorder (diagnosed by her individual psychotherapist). However, she admits that she is afraid that he will leave her because she is “not willing to have sex with him right now.”

Beth and Don both make clear that having children is an important goal of theirs. Beth says, “I have always wanted to be a mother. I know that having sex is a necessary step to making that happen. It’s killing me that I’ve still not been able to have sex with Don. I just want to get over this once and for all and be able to have sex like a normal couple and have kids, too.”

The Assignment

•Explain how the trauma history in the case study you selected may be influencing the client’s mental, physical, emotional, and sexual functioning.
•Explain counseling strategies you might use to help him or her achieve greater intimacy. Be specific and provide examples.