How Do I Stop Being Scared of Sex?

Estimated reading time: 16 minutes

Doctor’s Note: today’s column involves a brief discussion of suicide and suicidal ideation

Hi Dr. NerdLove,

I’m a mental health therapist who has been really glad to have your blog as a resource to recommend to some of my clients. Even if I give the same advice, it lands differently coming from you than from a twenty something lady. I have a “theoretical-to-me-but-not-to-others” question.

I’m in my late twenties, am 99% sure I’m asexual and aromatic (sex repulsed for myself, sex neutral for others after a lot of hard work in therapy), and have lived with OCD since a young age. While most of my symptoms are well managed, the symptoms that remain are related to sex – specifically avoiding it and any reminders of it because the obsessions that arise trigger so much fear.

If I were not asexual and aromatic and wanted to have a sexual relationship, the process to get comfortable with sex would be daunting. This is a situation some people find themselves in, wanting sex but scared due to trauma, OCD, etc. The best practice treatment for OCD, and PTSD, include a very strong exposure component – repeatedly doing the scary thing bit by bit until it isn’t scary any more. This is often accomplished by creating a personalized subjective units of distress scale (aka: how scared am I zero to ten?), a fear hierarchy (rating different feared task using the SUDS and starting with the lowest and then moving upwards), alongside cognitive and self regulation strategies.

However, at some point, someone who is scared of sex (or the germs that spread during sex, or the intrusive thoughts/trauma memories they have during sex, or not-just-right experiences during sex, or body related fears during sex, or irrational pregnancy related fears during sex, or moral/religious scrupulosity fears during sex, or….) is going to need to have sex to become less scared of it – irrational fears don’t respond to reasoning – and portions of that will likely not be enjoyable.

The process for me would look something like:
1) go on a date
2) hold hands in private
3)hold hands in public
3) nonsexual touch on torso in private
4) nonsexual touch on torso in public
5) kiss in private
6)kiss in public
(Skip maybe ten steps here- fill in with your imagination)
16) have sex

(Add some more steps at the end for more scary variations of whatever the least scary variation of sex was in step 16).

So, here’s the question… how in the world would I go about finding a romantic/sexual partner that is willing to repeat each step 10 to 15 times, with me visibly panicking for maybe the first 5 times? I think “is turned on by sexual contact with someone scared of the contact” or “likes having sex with a partner who didn’t enjoy it” is a potentially dangerous quality to be selecting for. Now, not everyone who has fears related to sex would necessarily have the same number of tasks on the hierarchy or same intensity of fear, but I can’t cover every scenario here. Just wanted to give an example to ensure that we’re on the same page for the therapy process I’m describing.

I’m also aware that a specialized sex therapist might have more therapeutic strategies that I’m not familiar with that could dial back some of the unpleasantness, but I don’t think it would remove it entirely.

I know sexual surrogates exist and would be an option, but they are few and far between. Some people who are scared of sex are already in relationships that might have enough commitment or love to overcome this barrier, but many relationships wouldn’t. So what would you advise in this/these kinds of situations?

Thanks,
Scared of Sex

So, right off the bat, I want to give my standard disclaimer that Dr. NerdLove is not a real doctor. As a mental health professional, you’re far better equipped than me to handle some of these questions. So I want to strongly recommend that you (or anyone else to whom this would be relevant) take my advice with all appropriate levels of salt. And probably run them past someone who has actual credentials (beyond the best doctorate $30 could buy) before putting them into practice.

But my first question would be “is this necessarily something that needs to be fixed?” I’m hesitant to suggest how asexual or aromantic might try to change; the idea that not experiencing sexual attraction or feeling romantic love are flaws to be fixed can be kinda dehumanizing. If this isn’t a problem – that is, you (or whomever) are generally ok with not being sexual, then I don’t see any real need to fix it, especially if it’s not materially affecting your life.

Now, you mention that any reminders of sex or sexuality can be triggers… that is something that probably needs to be worked on. There’s a difference between “can’t function in society because OCD/trauma/intrusive thoughts/incredible repulsion” and “don’t want a sexual relationship”. The former makes life borderline unlivable. The latter, less so. And since sex is a part of life and a part of society, so the odds of running into something that may be a trigger for you are very high.

As far as treatments or therapies go… I don’t know if exposure therapy would necessarily go as far as “ok, to truly be over this, you need to go out and have sex,” even as part of a program of gradual exposure and desensitization. There’re a few quite a few steps I could see in between, from gradual exposure to advertising, going from G rated films to PG, even (theoretically) up to something like The Red Shoe Diaries or other soft-core shows or movies. I could also see moving from platonic touch in non-sexual places, to holding hands, to giving or receiving a kiss on the cheek. But recommending actual intercourse? As I said: not a medical professional, but I’m having a hard time seeing that as being part of standard therapy or even passing an ethics committee. But I could well be wrong. 

I do wonder if cognitive behavioral therapy might be a good supplement, or even used instead of exposure, especially if the OCD manifests more as unwelcome and intrusive thoughts. CBT exercises are very good at helping people deal with anxieties, irrational or unwanted thoughts and getting one’s emotions and brain under control. Going through those exercises, especially in combination with an anti-anxiety medication might be incredibly helpful for folks who find these issues to be restrictive or crippling.

I’m also a believer in non-conventional ways of dealing with anxiety. Sometimes, playing into the world that the anxiety creates can also give solutions. Just as some folks with paranoid schizophrenia have found relief by having “legal” rulings handed down that forbid the CIA/aliens/Atlanteans/whatever from spying on someone’s thoughts, finding ways to mitigate or obviate the cause for anxiety can be helpful. If someone’s afraid of an unwanted pregnancy, taking steps that make pregnancy impossible (outercourse, mutual masturbation, oral sex, anal sex, etc.) may provide relief. You can’t get pregnant from oral sex, after all. The same with religious or social related fears; if someone in a position of authority, real or percieved, gives the official thumbs up, that can also help.

But in scenarios where the person is actually, actively trying to be ok with having sex or sexual contact with another person? First, I’d highly recommend screening folks in advance and only dating people who are going to be cool with taking things slower than a sloth crawling through molasses in January. While these folks may be rare on the ground, having an understanding and supportive partner will be vital. You want someone who knows this is going to be a process of potentially months if not longer, who’s willing to commit to that and not make comments or hints that they want it to be going faster or doing more.

I’d also suggest setting up a system of safe-words. As I said to Trying To Be Less Touchy, safe-words have utility outside of just BDSM scenarios. If you want to try to be more physical but also know that you may have atavistic or severe reactions, having an easily communicated signal that quickly signal “this is ok”, “yes, I’m freaking out, but keep going, I’m trying to push past this” and “STOP IMMEDIATELY” will be invaluable, both to you and to the person you’re being physical with. Having these in place in advance will mean that you feel empowered (since you’ll know you can pull the ripcord at any time) and your partner won’t have the (very reasonable and understandable) fear of pushing too far and causing even more trauma.

And yes, in this case, sexual surrogates can be a big help. This is, quite literally, part of what they’re trained for. But as you said, they’re very uncommon and the legality of the profession is dubious. However, seeking sexual surrogates out and talking about their processes and procedures for working with a client with issues like yours may give some insight on how you or your therapist may want to proceed.

But more than anything else, my recommendation (besides FOR THE LOVE OF GOD DON’T DO EXPOSURE THERAPY WITHOUT THE GUIDANCE AND DIRECTION OF A TRAINED, LICENSED AND CREDENTIALED PROFESSIONAL) is communication, communication, communication. If there’re landmines that need to be either dug up or avoided, then making sure that one’s partners, now and in the future, know where they are and what sets them off will be beyond vital. This is an area where being unafraid to communicate your needs and boundaries clearly are going to be of utmost importance, both for your emotional safety and your partner’s.

And of course, if someone treats those boundaries around sex or touch as a problem or an annoying hurdle… well, that’s a person who just self-selected out of your dating pool. Being gentle, understanding, respectful and patient are going to be absolute must-haves.

But again, this is assuming that these are things that the ace or aro person wants to fix. Sometimes the problem isn’t with the person, but in who other folks think that person should be.

Good luck.

Hi Doc, I have been reading your articles for a long time but there’s one problem I never really found an answer to. And that’s dealing with romantic loneliness.

I suffer from social anxiety and clinical depression. I was diagnosed when I was a teenager and have been in therapy and taking medications ever since. Due to my problems I never finished high school and was a shut-in for many years.

I have improved since, CBT helped the most and I found a drug combination that helps a bit. I’ve left my parent’s house and finished a university program that might allow me to get accepted to a CompSci degree (which was a dream I’ve had and a goal I set for myself). I work part time and go to a gaming group once a week. And even though i have to force myself to go, I made friends there. I even had a girlfriend a couple of years ago, though it dissolved pretty quickly because she perceived my social anxiety as me rejecting her.

All this leads to my problem, I’m lonely. I go to sleep every night wishing there was a woman who loved me next to me. Nothing helps this feeling. The only time I didn’t feel like this was when I had a girlfriend, and when she stopped loving me, that loneliness came back. Because I focus on school and “going out” I’m exhausted all the time, and I currently can’t deal with a relationship without giving up on something else.

How do i deal with this loneliness? It’s really eating me inside. I honestly wish I could have a lobotomy and feel nothing. Or go to sleep and never wake up. My therapist tells me I should focus on the positive things in my life and achieving my goals, but it feels like I’m lying to myself. I think romantic love is a fundamental human need, and I’m missing it. I have been missing it for years. Is there anything i can do to stop feeling like this?

Thanks, and I wish you a life full of hope and happiness.

– Lonely

First and foremost, Lonely, let me point out something that didn’t just leap out of your letter, it put on flashing lights and waved semaphore flags around like it was guiding Maverick in for a carrier landing: “I honestly wish I could have a lobotomy and feel nothing. Or go to sleep and never wake up.

Dude. DUDE. I really hope this is hyperbole for effect because, because if taken at face value, this is suicidal ideation. That is something that you need to be talking to your therapist about. If you’re legitimately feeling this way, I want you to close your laptop and contact your therapist right now. And if you can’t get ahold of them, I want you to call the National Suicide Prevention Hotline by dialing 988. I am utterly serious. This is something that needs to be your first and highest priority.

Now as for the rest… as I’ve said many, many times before, Dr. NerdLove is not a real doctor. However, I’m someone who’s dealt with mental issues of his own and I can tell you from experience: you’re dealing with some hardcore depression, man, and I’m wondering if you’ve actually got it under control. You mention that you’ve found a medical combo that works. But does it? Or did it, but now it isn’t working, or is working less well than before?

Based on the things you write, I think that maybe you need to talk to your psychiatrist about either changing your dosage or trying a different medication. Not all antidepressants work for everyone, and it can take time to find the medication and dosage that works for you. If it’s not working, or it’s not working enough, don’t be afraid to tell your doctor. It’s your body and your brain; you know better than anyone if the meds are or aren’t doing their job.

Incidentally the same is true about therapists. Finding the right therapist is a lot like finding a romantic partner. You want someone you feel “gets” you, who you click with and who actually understands your needs. Sometimes you will find therapists or counselors who aren’t right for you, who may not understand you or who may just not be listening. If you feel like you aren’t clicking with them or that you’re not improving, then it may well be worth leaving them and finding someone else. Again, this isn’t a “it didn’t work after the first week, time to bounce” situation, but you don’t want to stay a patient just because you’ve been with them for a long time either.

On a practical level… well, I’m not gonna lie, my dude. I don’t think you’re in a place where you can handle a romantic relationship. I understand how lonely you are, but being in a relationship means being in good working order. Think of it like a car; the car doesn’t need to be almost fresh off the factory floor, but you do need it to be able to get you where you need to go in a safe and efficient manner. It’s ok if the engine knocks and makes weird noises or the upholstery is torn and the paint job is down to primer, or it shudders a bit as it shifts gears, but if the engine is prone to stalling or the brakes are weak, you’re putting yourself in danger.

What you describe in your letter is very much the latter, not the former. If you’re laying in bed hoping that you might not wake up the next day, you are not in a place where you are able to handle a romantic relationship. While I won’t say relationships are “work” in the sense of “you have to constantly grind to keep it to a baseline of acceptible non-misery”, there are stresses and tensions in even the happiest relationship and you need to be able to navigate them. And if the only thing keeping you from feeling like oblivion is more desirable is a romantic partner? That means you’re not going to be able to navigate them. Not only does it mean that you’re not in a headspace to deal with the stress, but someone else being responsible for your mental and emotional well-being is a hideous amount of pressure to put on someone. 

I also note that one of the things you don’t talk about are your non–romantic relationships. These are important, possibly more important than even your romantic ones. Yeah, I get equating your loneliness with a lack of romance, but romance isn’t the only form of companionship out there. Having a solid base of relationships – family (biological or of choice) and friends – will help erase that loneliness and make missing a romantic partner that much easier to deal with.

It also sounds like you may be putting your emphasis on the wrong things. When you say “going out”, are you talking about being social with friends, or going out to try to meet potential partners? If its the latter? Well.. honestly, I’d say it’s time to let that one go. If it’s the former? Maybe solidifying your friendships and making them your focus would be better for you. Having a good life, one that leaves you feeling satisfied and fulfilled, with folks who care about you and you can rely on is important. It creates a strong and stable foundation to build on. Without that foundation, even the most passionate romance isn’t going to last; it’s like trying to build a skyscraper in a marsh.

One more thing to consider: I realize it’s hard to hear this, but you can’t rely on external sources for happiness and fulfillment. When another person is your sole source of happiness or joy and life without them is empty and meaningless, you’re setting yourself up for an unstable, unhappy life. You’ve created a situation where your emotions and life are outside your control and influence. It becomes something that can be taken from you. You need to have your own, internal source of validation and security, otherwise you’ll never be able to fully relax, fully engage or fully trust someone. You’ll always be looking for the next shoe to drop, because you know that the situation is precarious and could fall apart at any moment. That, in turn, means that you’ll always have this core of anxiety and insecurity at the center of your relationship, which becomes its own self-fulfilling prophecy. Sometimes in order to find the love of your life, you have to have a love of your life. That is: you have to have a good life first, and then find a love that will complement and improve it, not one that completes it. That missing piece has to come from within.

But seriously: talk to your therapist now about those thoughts and feelings, my man. You’ve got to be your first and highest priority. Do it now.

Good luck.

Oh, a couple more things before I go.

First: I’ll be doing a live Q&A for my Patrons on December 29th, with Q&As open to my general audience coming in the future. If you’re interested in taking part, consider supporting the site by becoming a patron at patreon.com/DrNerdLove; patron questions will get priority in future live streams.

Second: As the we’re coming to the end of the year, I have a couple requests. First, since January is National Break Up Month, I’m putting out a call for questions about ending relationships: when you need to end it, how to end a relationship the right way, when a relationship can be fixed and how to handle break ups – either as the dumper or the dumpee. As always, submit your questions via the submission form, or send them to [email protected] with “National Break Up Month Question” in the header.

Third: Since that’s also a hell of a downer, for February – especially for Valentine’s Day – I want to hear your Relationship Wins. Tell me about ways you and your sweetie turned things around, what you’ve learned about making things work, how you two solved problems together or otherwise made each other’s lives better. Let’s share some happiness and spread hope, especially in a month when a lot of folks may feel at their lowest. Who knows, maybe you’ll see your story featured here.