One of the most difficult things for me to deal with as a therapist is the aftermath of sexual trauma. And I know that the trouble I have with this is only a tiny fraction of the difficulty my client has as he or she faces his/her past. I share with you a correspondence I’ve had with a 36-year-old man from Boston named Trent.

Dr. Dick,
When I was 10 years my parish priest molested me. It went on for over a year. Mostly, I’ve been able to put this behind me. I’ve been married over a year to this really great gal. She’s been very understanding and supportive, and we love each other very much. A couple of weeks ago when we were having sex, my wife started to massage my bottom. This was the first time someone touched me there since I was 10. At first it felt good, but then I remembered how I felt when I was a kid and freaked out. I started to cry. My poor wife was devastated at the thought of triggering this painful memory. I told her it wasn’t her fault, but we haven’t had sex since. I’m worried, but I don’t know what to do.

Working through a sexual trauma, like the one Trent experienced as a kid, is difficult. But it is essential for regaining a healthy sense of the sexual self. I told Trent—and this applies to any anyone else who has had regrettable early sexual experiences in their past—that I strongly suggested that he and his wife engage a sex-positive therapist to help them get back on track.

Many people have dealt with some kind of sexually related trauma in their lives; however, some is more severe than others. Emotional scar tissue and painful memories may linger, but you can learn to insulate yourself from the disruptive effects of the past in the present. Thanks to the indomitable human spirit, most of us live through our difficulties and go on to develop healthy, integrated sex lives.

Sensate focus is a process that helps individuals move through painful sexual memories and heal the rift between the affected parts of the body and the pleasure they can produce. I thought this technique would be of particular value for Trent because of something he’d said: “At first it felt good, but then I remembered how I felt when I was a kid and freaked out.” This tells me that he was able to enjoy the sensations before the association with the molestation kicked in and ruined everything. Sensate focus offers a way to short-circuit this disruptive connection and rewire it for pleasure instead of pain.

What follows are structured therapeutic touching exercises for couples. They are not a prelude to sex. You need to be clear on that. Your genitals will be involved. There will be pleasure and arousal, for sure. But the object of this process is to desensitize the trigger (in Trent’s case, his butt), then re-sensitize it for pleasure. These exercises take about an hour one day a week over the course of a month. If you embark on this course, make sure that you dedicate that kind of time commitment. Please, don’t short-change yourselves; this is an investment in your sexual health and wellbeing.

You and your partner will take turns being the one touched and the one doing the touching. Both of you will have 30 minutes to touch and 30 minutes to be touched: 15 minutes lying on your front; 15 minutes on your back.

Week 1—Breaking the Ice
Structured touching will be unfamiliar to you at first. I want you to use this first session to connect with each other in a sensual and playful way. I want each of you to explore every inch of your partner’s body from head to toe, first the back of the body then the front. This first week, however, avoid one another’s genitals.

This isn’t massage, where touch is directed toward pleasuring your partner. Sensate focus exercises are about gleaning information. Focus on how it feels to touch different parts of your partner’s body in a non-seductive way. Be aware of the different textures contours and temperatures. Use different pressures—heavy and light; different strokes—long and short. Use fingertips, palms, the back of your hands and forearms.

When you’ve finished the first 30 minutes, swap places. This will work best if the one being touched relinquishes control as much as possible. Keep verbal communication at a minimum. Once the hour is over, thank one another for the experience and get on with the rest of your day. Don’t try to process things right then and there, just sit with the sensations. Or better still; write your feelings in a journal that you might want to share later.

Week 2—Making Things More Interesting
Building on what you learned in the first week; this time, kick it up a notch by expanding the structured touching to include anal and genital areas. These are sexually charged zones, but the touch must remain non-seductive. Begin the exercise with some full-body touching before moving on to the new areas. Again, the emphasis is on obtaining information and awareness of physical sensations.

This is where things got a bit challenging for Trent. When his wife touched his butt, I told him I wanted him to want stay in the moment and focus on who was touching him and why. Trent’s wife was not touching him in a sexual manner; she was gathering information.

Staying in the present helps take the edge off. If anxiety builds, deep breathing can help you to relax. Your partner will probably be very nervous too, so breathing together can be helpful.

A guided touch technique can also be useful. Place one of your hands on top of your partner’s and guide it over your trigger area. Try using more or less pressure as you see fit. Remember your trigger spot is just like every other part of your body. Even though an early trauma has sensitized this area to be off bounds, sensate focus exercises will re-sensitize and reintegrate it with the rest of your body. You’ll have to trust me on this.

Week 3—Mutual Touching
This week, we move on to mutual touching. However, it must remain structured and non-seductive, both in the giving and receiving. Mutual touch will provide a more natural form of physical interaction than the previous weeks. You’ll also be shifting attention from how it feels to touch to being aware of how your partner is receiving your touch. Keep verbal communication to a minimum. Let your body tell your partner how you are enjoying the touch. If you must talk, assign a number code to the touch you are receiving: 5 being, ho-hum, 1 being Yowsa!

Remember, no matter how sexually aroused you become, this is not a prelude to sex. If you need to release your sexual tension, feel free to masturbate afterward. No partnered sex during the exercises. Okay?

Week 4—Bringin’ It Home
This last week of exercises continues the mutual touching, with a focus on overcoming any final reservations you have about your trigger zone and the pleasure you derive from it. More of your partner’s touch should focus on that area. For Trent, I advised that his wife include a nice lotion or personal lube for this investigation. (Touching with a wet hand is different from touching with a dry hand.) While concentrating on his butt with one hand, I suggested she fondle his genitals with the other. By playing with the energy around Trent’s sphincter, his wife was able to redirect it and help him reconnect his ass to the rest of his body.

Try receiving your wire’s touch in different positions. Being proactive will facilitate the healing. While she is touching your trigger area, move your butt toward her to meet the caress. You’ll immediately see how being in control will help you move beyond any remaining anxiety. You are not just being passive recipient anymore; you are actively involved with inviting the pleasure. If there are still reservations, take it slow until they too, melt away.

Once he’d freed up his ass for pleasure, I told Trent be sure to incorporate butt play into his future lovemaking repertoire, but I also reminded him to take as much time as he needed to resolve the issue. There is no quick fix. I assured him, though, with diligence and care, sensate focus would remove the fear and shame of the molestation, and replace it with a sense of wholeness, joy and pleasure.

Good luck