Two things about this blog post: One…it comes with a trigger warning, including self-harm talk and some information that may be triggering for people with sexual trauma. Two…I was a little all over the place writing this. Stick with it for me; it was information I was excited to share, to maybe provide a little hope for others as well.

I have an interesting relationship with pain and pleasure. And I have an even more interesting relationship with my body. I am sure this is the case for many with sexual trauma and PTSD. I am working on tuning back into my body despite the discomfort I often feel.

My go-to reaction to discomfort is to ignore or dissociate. My experience goes something like this…A sensation arises that feels uncomfortable or perhaps brings up a visceral reminder of past trauma, and I suddenly feel nothing. Maybe my mind goes elsewhere. Maybe I focus on the numbed out or floating feeling in which I no longer exist in my own body (depersonalization). Maybe I change my physical environment or the topic of conversation to avoid. Maybe I retreat into a trancelike, completely faded-from-life type of dissociation, where everything is right in front of me but feels far away, nonexistent, or in the past or future (derealization).

The times I stick with the sensation, I tend to fight it. “Oh, this feels awful; Let me tense every muscle in my body so I can’t feel it anymore and gut the rest out.” Of course, that feels just as terrible. Headaches, muscle aches, inflammation, gut issues, nerve problems. It’s all there, and it all sucks.

Dr. C. and I have done some work with dual awareness. Really, it’s her encouraging me to do it and having me practice in session when possible. I try to do it when things come up for me outside of session, but it’s harder without real-time coaching.
**Dual awareness is being intentional about holding a memory or sensation from the past AND staying present and grounded. It’s a way to process flashbacks and trauma safely without becoming flooded when things come up.

For me, it’s neither fun nor desirable, but it is helpful when I can stick with it. I learn about myself and find regulation gets a little easier each time. Sticking with the sensations and staying present is definitely NOT my default mode yet, though.

I want to come back to the relationship I have with pain and pleasure, but I want to provide an example and result of practicing dual awareness in real time. I go for massages on a semi-regular basis. For me, it is necessary. The muscle tension I live with is rough. I have pain and/or headaches almost every day, and thanks to my gut issues, I can’t really have pharmaceutical help (ibuprofen, muscle relaxer, or anything else)…not that I really want more pills. Anyway, I’ve been logging heart rate, stress, recovery, and strain data for seven years, including processing data for specific activities such as running, weightlifting, hiking, and massages. When I get a massage, I log it and can see its effect on the above-mentioned statistics. Prior to today, my lowest heart rate during a passage was 70 beats per minute, with an average of 75. The average for all massages is much higher than that. Probably the majority of previous massages entailed more of a “zone out” approach than a “lean in.” Today was different, though!

Today I had a full-body massage (I usually stick to just my back and neck because of the migraines). I knew I needed the full-body today, thanks to delayed-onset muscle soreness that hit much harder than I expected. I needed some blood flow to help with the soreness before I got the “workout flu.” I knew it would be a struggle with the sensations that would come up. Instead of my regular “disappearing act,” I stuck with every sensation and every thought. I consciously reminded myself that this was a massage by a licensed professional. I reminded myself that the sensations I was feeling, though familiar and associated with trauma, were my body relaxing. It was the sensation of letting go of tension and feeling pleasure. I don’t like the feeling, but I also long to enjoy it (the pleasure vs. pain conundrum). But today I let myself breathe through it. My mind didn’t go to the past, even though it felt like that was where my body was. My mind stayed with the present moment. I felt every sensation, smelled every scent, heard every sound, and occasionally chatted to stay engaged with the person doing the massage. When my data came in, it was obvious there was a difference from previous sessions.

From an all-time minimum heart rate of 70 beats per minute and an average of 75 beats per minute to a low of 58 beats per minute and an average of 67 beats per minute during today’s session. Not every time will go like this, but it means it is possible.

So now, the relationship I have with pain and pleasure…
When I experience painful touch, I usually feel a twinge of pleasure (one I am not immediately bracing against). It’s as if pain provides a wonderful dopamine hit for me. It’s a subtle tingly feeling with a surge of numbing, watery warmth. It’s been over 1900 days since I cut myself, and that is the feeling I always felt when I would slice through my flesh. It was a momentary, fleeting feeling that made an unbearable few moments feel a little more bearable. It never lasted, and ultimately, it didn’t help. Now, during my massage, I experienced the same sensation quite a bit. The pressure on my sore muscles kept giving me little hits of dopamine, and with that, little waves of the tingly, numbing warmth. A tolerable but somewhat uncomfortable feeling, given that I was with someone making this happen. What I found more difficult were those same sensations when there was no pain. I realized today that the dopamine hits from pain are the same pleasurable hits as those from non-painful touch or sensations. The difference is that the pleasure from pain is dampened compared to the intensity of the pleasure from non-painful sensations. When I realized that, I breathed, settled, and did my best to allow myself to feel the waves come and go in a safe context. Practice will make this easier, I hope, because it was a challenge. Despite the struggle, heart rate data doesn’t lie. I was calm and relaxed. I wasn’t tensing to avoid the sensations. I was actually feeling them and breathing through the temptation and natural inclination to brace.

Most importantly, this is a start to living in the present without traumatic emotional, physical, and cognitive memories ruling me. And I might just develop a different relationship with pain and pleasure in my body.