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Issues with Talking to Therapist about Sex After Childhood Abuse

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I’ve been in therapy for 3 years with a great therapist. He has been a true godsend. The problem is, I’m having difficulty talking to him about sex, I was abused as a child and spent over 30 years, blaming myself for what happened. But now I feel ready to enter a intimate relationship with someone, however, my lack of confidence and my inexperience have made me very nervous about sex. I have wanted to talk with him about some of the details about my childhood abuse, to try to work through some of my fears and anxiety, I just don’t know how to even start the conversation.
I have always viewed sex as being a shameful act and the thought of talking to him has caused me such embarrassment that I’ve spent whole sessions with him without talking at all. How would you suggest I handle this?

Issues with Talking to Therapist about Sex After Childhood Abuse

Answered by on -


A serious discussion of sex is unnecessarily anxiety producing for most people. For a sexual abuse victim it is, of course, even more anxiety producing. However, there are many other personal topics that are equally difficult to discuss with even your primary care physician. Nonetheless, these topics must be discussed if you are to receive the help available from a trained professional. In short, it’s something you have to do, like it or not.

I am not suggesting that you should talk about sexual issues with a highly skilled and professionally certified dentist. No matter how good your dentist is, he is simply not equipped or trained to deal with sensitive personal issues. Your therapist is so trained. Of all possible professionals, no one will be easier to talk to than a therapist. They are prepared to deal with sensitive, personal, embarrassing, issues and to do so in the most sensitive way. Nonetheless, you are likely to initially experience some nervousness but it is likely to quickly pass, often shortly after beginning the discussion.

You might try telling your therapist that there are sexual issues that you would like to discuss but are hesitant and nervous to do so. Tell him that you will write the topics down or that perhaps you have already written the topics down and you would like to have him read them when you are not present. He will then use his judgment and training to help you address those issues. Perhaps it will amount to no more than him reading your statements after your session and providing you with feedback upon beginning your next session. Or perhaps he will ask you simple questions to begin the process and purposefully not ask for answers that might be too personal in nature and may keep it on a very high clinical level. You have confidence in your therapist and have given him a very high rating both in your mind and in the letter that you have written here.

You are hesitant to broach the subject of sexual issues with your therapist and as I have already stated that is not unique to you but is common to most individuals, in therapy or not. One thing that I can promise you, is that your initial anxiety will decrease and substantially so, once you begin to discuss this with your therapist. It is difficult for you to discuss this now but surprisingly quickly it will become like any other topic discussed in counseling. That holds true for virtually everyone in counseling, including sexual abuse victims. I hope I have helped in some small way – good luck.

Dr. Kristina Randle

Issues with Talking to Therapist about Sex After Childhood Abuse

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Kristina Randle, Ph.D., LCSW

Kristina Randle, Ph.D., LCSW is a licensed psychotherapist and Assistant Professor of Social Work and Forensics with extensive experience in the field of mental health. She works in private practice with adults, adolescents and families. Kristina has worked in a large array of settings including community mental health, college counseling and university research centers.

APA Reference
Randle, K. (2019). Issues with Talking to Therapist about Sex After Childhood Abuse. Psych Central. Retrieved on December 4, 2020, from
Scientifically Reviewed
Last updated: 23 Jan 2019 (Originally: 24 Jan 2019)
Last reviewed: By a member of our scientific advisory board on 23 Jan 2019
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