Therapist Unplugged
Therapist Unplugged
Intimacy and Overcoming Sexual Trauma with Heather Caballero: Part 2
Have you ever wondered how past experiences shape your present relationships, especially when it comes to something as deeply personal as sexual trauma? In this follow-up to our previous episode, Heather Caballero returns to delve deeper into the intricate ways past experiences shape our present relationships, particularly in the wake of sexual trauma. Drawing inspiration from Gabor Maté’s transformative work, we explore how trauma isn’t just about what happened but how it’s processed, distinguishing between ‘big T’ and ‘small T’ traumas.
With expertise and compassion, this episode provides practical insights for therapists and anyone looking to heal from or better understand sexual trauma. Whether you’re navigating intrusive memories or supporting someone on their journey, this conversation offers tools for reframing the past and empowering resilience.
Therapist Unplugged is brought to you by The Montfort Group. Each episode will feature the unplugged views of guests and fellow therapists as we navigate hot topics, therapy trends and the world around us.
*The Montfort Group provides a serene, calming setting where you can feel challenged, supported, and motivated. Our skilled therapists bridge specialized backgrounds and varied philosophies together to create one unified strategy. Rather than steer you away from your own natural abilities, we help you maximize your unique strengths. We do not view a broken history as the end of a story, we see it as an opportunity for a new beginning.
Welcome to Therapist Unplugged, and today's guest is my colleague, heather Caballero. We are doing Hi, heather. This is our second episode, or our second issue, on sexuality, intimacy and so much more, and today's topic is sexual trauma.
Speaker 2:Heather, yes, I feel like it's one of those things where I'm like I'm excited, but it's also like such a heavy topic.
Speaker 1:It's a very heavy topic and one that is hard for clients to process. It can be hard for therapists to talk about Heather.
Speaker 2:Absolutely. I feel like as a topic, it's one of those that it's really easy for it to be triggering to the client, triggering to the therapist, particularly if they're not super experienced or comfortable talking about even sex in the first place, let alone stories of sexual trauma.
Speaker 1:All right, well, let's dive in. I know you're very comfortable talking about this and it's also a topic that you are keenly interested in. Yes, in our first episode on this, you talked about how you were drawn to work with clients who have gone through trauma. However, you want to describe or define what trauma is, because it can be different things for different people.
Speaker 2:It definitely is. I think, in this case, what I would define as trauma is something that we feel afflicted with remembering.
Speaker 1:So tell me what you mean when you use the word afflicted.
Speaker 2:I feel like that's a word that for me, encompasses the idea of it coming up unwanted, the idea of remembering it. It's something that happens and might feel out of control and feels like it's taking something from you in the moments that you remember that you don't want to be given and I think that's one of the things is that, especially with sexual trauma, so many people can define it only as violent rape or something that is really easy to look at and say, well, that's trauma. But I think it's really important to say that if there is something that is coming up again and again in your mind and in your sex life in a way that it feels like it's getting in your way, it feels like an affliction of remembering that thing, that's trauma.
Speaker 1:I think what I'm understanding from what you've described is that trauma is also defined by how a person responds to that thing experience or memory, which reminds me of something I've heard Gabor Maté describe in his book the Myth of Normal, which is that trauma is how a person. What defines trauma, whether it's with a big or a small T? A big T might be a sexual assault. A small T might be undesired, unwanted attention. How a person responds to that experience is, then what defines the trauma, as opposed to it being only the event that took place.
Speaker 2:That's so well said, Laurie, and I think there's some other instances that even in like the idea of combat trauma, there's some really interesting research about the idea of like hey, two people might be in the same encounter and one may walk away from it with all the symptomology and the diagnosis of PTSD from it. They're afflicted with remembering that moment and the other person might not. And so even in the case of like the exact same experience, it depends entirely on how someone walks away from it and how it sticks with them. That defines the instance of it getting in their way.
Speaker 1:Yeah, that's my understanding too. I think that there were some. And again Gabor Mate talks about the Holocaust and what was the difference in terms of how survivors then went on to manage their lives and build lives, or being capable, because the affliction of that experience was understandably so horrific. Heather, talk to me a little bit about what's the sexual trauma? How does it present in therapy? Because sometimes people may come in without the intent of talking about sexual trauma. It might be, something else.
Speaker 1:It could be a phobia. It could be something else that contributes to them feeling stuck. Tell me a little bit about how you get to that and what happens in therapy when you're dealing with sexual trauma.
Speaker 2:I think the most common way that I first get that in and that moment of seeing that someone might be carrying sexual trauma with them is, honestly, a somewhat hidden way.
Speaker 2:It's when clients come in and say, like you know, I don't know what's wrong with me, but I have these issues or these things that get in my way with sex and I'm not enjoying it in this way. I don't feel like I'm wanting the things that I should be wanting. I don't feel like I'm wanting the things that I should be wanting. I don't know what's wrong with me.
Speaker 2:And it comes up more often than not, I find, especially with those small T traumas, but even with the big T traumas, this idea of like, well, I am broken and there's something about my sexuality that is wrong. And that's usually the moment where I find, okay, there is something that they are afflicted with remembering that is coming in, getting in their way of sex and then causing them to turn to themselves and say you're not reacting right, you're broken. And that's the belief that I really want to get in and be able to say, like hey, it is not you that is wrong. There is a memory that is getting in the way of what you want to be able to happen in those moments.
Speaker 1:That must be really a revelation on so many levels for someone to stop, pause and think okay, what was that experience? I mean, I have had an experience in couples therapy, for example, where this is a couple that really connected, actually over drug use when they became sober. There were other things that started to surface, not the least of which that there had been sexual abuse by an athletic coach on the male partner that he had never, never, never shared with anyone. It was an intuitive sense I had, based on body language and facial expression, and, as he connected with that afflicting thought, I physically watched him become afflicted, talking out loud and processing this with you now as I reflect. But what you're saying rings true.
Speaker 2:And you know what's really interesting? It's something that they talk about in the Body Keeps the Score.
Speaker 1:What book is that? Sorry to interrupt you, heather, but can you share with our listeners what you're talking about? The book.
Speaker 2:The Body Keeps the Score.
Speaker 1:I usually know the author off the top of my head, I think it's Bessel van der Poel.
Speaker 2:Yes, one of the specific studies that he talks about is they had people who had experienced trauma write out just kind of an account of the experience of it and then they would go under CT scans. In that moment, with the CT scan going, someone would like get on mic and in their earpiece whatever read them. That account that they had written and those brain scans, we saw the brain lighting up, as if it were re-experiencing that exact same. Like all of the regions of fight or flight, freeze, all of that, it was lighting up all of the areas, and specifically as well, the areas of our brain that allow us to put things into words, that give us speech. Those areas became less available in those moments. So not only do we, in that afflicted moment, become afflicted as our brain basically returns to that state, but we become less able to discuss that experience.
Speaker 1:So what are we doing in talk therapy, heather, this makes me question what we do in talk therapy.
Speaker 2:I think in that case, the instance of going in and becoming a team that reopens that pathway, it's like unclogging a drain to a certain extent. You know in that moment it's like all of a sudden you're closing the place where water can escape and the tub is filling up fast. But what we are doing, by process of really taking the time to stop and put words together, we're taking the time to unplug that drain and give that water somewhere to go.
Speaker 1:Where does the water go? Heather?
Speaker 2:Well, isn't that an existential question?
Speaker 1:Sorry, I couldn't help myself. Where does the water go? Heather.
Speaker 2:I think that's an interesting thing because if I were to stick with this metaphor, some of the responses that people might have like anger, frustration those are actionable responses where we're trying to get that water out. And it might be an area where we're getting that water out by pouring it all over somebody that we don't want to be hurting. It's like a tub is flooding. I got to get this water out, kind of response and the hope is that we can find ways to drain that water and places to put it that you can kind of send it off, rejoin the river, go down the drain as it is supposed to go, kind of the sewage.
Speaker 1:I don't know, I guess we just no, I guess we just have to find out where the drain is. Oh my goodness. Okay, pardon me, I'm sorry. This is therapist unplugged and the phone just rang. I'm terribly sorry. I'm terribly sorry for the interruption. You never know what's gonna happen on this podcast. I swear to god, it could be that laurie doesn't hit record. Did I hit record? Yes, I did. Oh God Now.
Speaker 2:Okay, okay, okay Thank.
Speaker 1:God, okay, folks, we did an entire podcast several weeks ago that I forgot to hit record, and so I'm just a little paranoid.
Speaker 2:Yeah, our last, our last sex episode. Yeah, of course.
Speaker 1:Of course, we't record the last sex episode, my God, All right. So, heather, talk to me a little bit about what your approach is, or how you work with clients who may or may not be aware that what they're bringing to you is rooted in some sexual trauma, or how they've responded to an event or series of events at some point in their life. Where do you start with all this?
Speaker 2:One of the things I want to say is that, generally, I don't like to bring in language, language that a client has not brought in.
Speaker 1:I like to use theirs.
Speaker 2:So like, for example, sometimes the idea of the word trauma can feel so loaded for people. Even calling it trauma is not typically something that I do, unless the client does, and there may be times where it comes up and I'll be like do you have any feelings about the word trauma? Does it feel like it fits here? Does it change your perspective of it if we use the word trauma but more feel like it fits here?
Speaker 2:Does it change your perspective of it if we use the word trauma but more often than not, especially for those lowercase t traumas of like, say, you know, something that I encounter more often is the idea of like well, I said yes because I felt pressured, and it's that pressure may be internal, it may be external, it may be a combo of them, but there's still kind of this idea of like I, just that moment of like, that feeling of pressure that pushed them to say yes when they didn't want to, and how that might be, even in times where they feel a lot more comfortable. A paralyzing concept of is it a real yes, am I feeling pressured? And then they start maybe even drawing into their own head about it, and what I like to do is returning to that idea before, how it usually comes up is the idea of I don't know what's wrong with me, I'm broken. In this way, kind of diving into like which part of the sexual experience is feeling so frozen for you and then saying like all right let's first.
Speaker 2:I really like to talk about some of the science behind it. Give them some of the language of like hey, these are the things that are normal, these are the responses like which everything pretty much is normal. But here are some of the ways that we can kind of say like okay, so in that moment, with the idea of context and gas, pedal and brakes and all of that, what do you feel like is happening within all those constructs? Sometimes it comes out like the memory that's getting in the way. Sometimes it really comes forward as like oh well, this is what I'm in my head about and the memory comes a lot later. But typically those concepts are pretty tied together.
Speaker 1:I don't know if that's answering your question I'm trying to understand sort of the overview because, of course, as an emotionally focused therapist, what I'm hearing is that there is some normalcy.
Speaker 1:First of all, you're using the language that the client brings in, so we're not going to throw words like trauma and so on to the client, because we want to honor and be present with their experience by using their words, by sitting with them and meeting them where they're at.
Speaker 1:I would imagine that going slow is important, taking time to really understand the framework with which a person considers what's happened to them, normalizing yes, this makes a lot of sense. This is not about being broken at all. This is about how your body and your mind and your heart protect you right by responding a certain way to something that even now, as you're considering where you are at this stage in your life, when you think back to something where you said yes, but had conflicted feelings, wasn't really sure, kind of didn't, couldn't hear your own voice as loudly as you hear it today, I'm curious about where you bring in that sort of that emotional component of it. Seems to me this is like really deep in terms of a person's relationship with themselves and intimacy with themselves, and I'm not talking about sexual intimacy with yourself, although that's certainly an important piece of it, I'm sure at some point in the process. Although that's certainly an important piece of it, I'm sure at some point in the process. But just that whole relational piece of it.
Speaker 2:I don't know I sound like I'm babbling right now, but I'm just. I'm curious. So this is generally what I go to if there feels like there's an open door to it. It's not exclusive the idea of the memory coming up in that moment and then we have some sort of bodily response right, Our brakes are hit, we have that moment of freeze, we have that moment of doubt. There's something that hits stop, evacuate.
Speaker 2:And what I really like to sit with clients on is that idea of like hey, that pressing of the stop button that is really really important work your mind and your heart and your body have been doing for you to protect you.
Speaker 2:Because oftentimes I see clients turning towards that stop button being hit and saying I'm mad at you, I hate you, I'm frustrated at this moment. And I really like to sit with them and say like, that button being pressed is something that you learned to do because you needed it and it has protected you from some really hard moments at some point, really hard moments at some point. And if right now, we were to turn towards that stop button and say like hey, thank you for the work that you've done to keep me safe. And then asking like hey, how can I let you know that I am safe now to be able to set you aside? And I find that to be a really powerful thing to turn to with clients that stop instinct. That's not a bad thing, that's not something to be angry at yourself on, it's a protection that now I'd like to turn to and say how can we teach that instinct that you're safe?
Speaker 1:That's very, very important because it completely reframes the sense of oh, I must be broken. It has nothing to do with being broken. In fact, how fabulous is it that you found the brakes to keep you safe, to protect you, and what a wonderful response and expression that is in response to an experience that didn't feel safe and that you never want to have happen again, and you know it can be really hard to. And that didn't feel safe and that you never want to have happen again, and you know it can be really hard to. And I don't know, heather, if you experienced this. There are behaviors that really served a purpose for an extended period of time and in this process of shaking up and digging a little deeper and so on, it can be very, very tough to let go of the protective behavior or putting the brakes on, when the brakes also perhaps get in the way or prohibit the very thing you long for.
Speaker 2:Yeah.
Speaker 1:Right, exactly so that must be quite a process.
Speaker 2:It is, I think sometimes. That's why, for me, I really like the question to be how can we tell those breaks that you're safe? You know, I'd be afraid that, like, if just saying like all right, how do we take pressure off the brakes? How do we make that moment and that behavior stop, as it's been practiced for so long? Because you know then you might be pulling away that protection when at times perhaps it is still useful, Perhaps it is still necessary.
Speaker 2:And so having that question of like all right, being able to notice like this is a moment where you're safe, and how can you communicate to that, to the instinct, is a way that I like to interact with it.
Speaker 1:And how do you build trust? It's like trusting yourself. You know that's hard.
Speaker 2:Oh my gosh, especially when and I think I touched on this our last podcast talk but especially when, in cases of past trauma, there is the feeling that, whether you froze in the moment or whether there was sexual arousal, as is normal to respond to sexual stimuli, even if it's not wanted or like feeling sometimes of saying, well, I can't even trust my body to respond right in those moments. So how can I trust it now? Trust is shattered by the experience of the trauma.
Speaker 1:It's a lot. It's a lot. It takes such courage, such tremendous courage, to walk through this. It really does. It takes such courage for our clients to come in and to collaborate and to be active participants in their healing. It's really hard work, heather. What is it particularly about this area that you are so drawn to?
Speaker 2:If I were to fall back to what we talked about, as far as the experience of trauma kind of takes away some of our ability to put things into words. I am someone that being able to tell our stories and being in the privileged position of being the caretaker of someone's stories is something that I value highly and I, you know, I also write. I love the concept of putting things into words and I feel like, in particular, when our stories have taken our ability to tell them, there is something really powerful and rewarding to me about being able to walk with someone to give them that ability back to tell their story.
Speaker 1:That's so powerful the privileged position of taking care of people's stories and helping them with language so that they feel like they can tell that story, because telling stories is so important in a way that allows us to feel seen and heard, even in those moments of shame and feeling like we're less than, or that we're broken or that we are to blame. The other piece about sexual trauma is the tremendous shame that can be associated with those experiences and how people will think that they are in some way to blame for what happened. I should have spoken up, I should have known better, I should, I would, I should have, could have, would have. That often, you know, plays out in tandem with all of the other aspects of that experience Just the tremendous shame.
Speaker 2:Oh my gosh, and especially alongside. I'm sure you've had the experience of seeing this and I'd be curious to hear some of the moments that might spring to your memory but especially when society perpetuates those questions that lead us towards shame and self-blame, like what was she wearing? Why was she drinking that much? Kinds of concepts. And like, like, how much that encourages this practice of asking ourselves those questions in a way that blames ourselves.
Speaker 1:I've heard that many times in my therapy room, where women who have been sexually assaulted start to second guess themselves.
Speaker 2:Yes, Hearing that from a client. Did this really happen? How do you interact with that?
Speaker 1:I sit and listen, I don't debate. I really want to understand more about what. Is it about that experience that you're now starting to second guess? Tell me more about what you experienced, validating also that it makes sense to second guess because when you have that experience, you're also not fully present. There are many people who leave their bodies. I mean, the whole experience feels so surreal. There's a kind of surreal experience around all of that and it can be such that did that really happen? Well, a second, and then the second guessing starts.
Speaker 1:I validate that surreal experience also as a way of your body disconnecting with something that you were highly conflicted about or you felt that you didn't have control over. It really depends on the person and how it all comes up. In terms of the context, heather, but I would say I sit with that. Also. In terms of the context, heather, right, but I would say I sit with that. Also. Validate, of course, it feels that way. Here is also, and here is what you've reported to me about that experience yeah, and I am not questioning. I am sitting here listening to you and I am not questioning or doubting what you're telling me.
Speaker 2:That's how I respond, you know, based on the context of what the client is, what a person sharing with me. That's so powerful in that vein of putting stories into words and being able to tell stories. Part of that experience, of being able to tell your story, is being able to have someone validate you, to be able to share that experience and connect with someone, and I feel like then, being able to provide that connection and validation is so unspeakably valuable.
Speaker 1:It reminds me of a goal or something that is in such a central part of the client therapist relationship. My relationship with my clients is, regardless of the story, no matter what they bring in. I see you, I hear you, I feel you and I'm sitting in present time with you. I hear you, I feel you and I'm sitting in present time with you. I am here and I am present with you. I am accompanying you through this story and I think that that is such a central part of therapy, regardless of what's brought you in.
Speaker 2:Yeah, absolutely.
Speaker 1:But what intrigues me particularly about sexual trauma is that it can be a highly specialized area of therapy. There are things that we have to consider and to be aware of. We have to bring ourselves into the therapy room and being authentic and considerate in how we respond to our clients, so that it's safe to express the shame and the self-doubt and the lack of trust and judgment I should have known better. Oh really, how would you have known at the age of six that you should have known better?
Speaker 1:Tell me Exactly. It's that kind of dial, I don't know. It's very powerful work when you start working with a client in this arena. Where do you start? What is that first session like?
Speaker 2:So I think one of the really interesting things about knowing that they're coming in to talk about sexual trauma, that I really see there's this moment of tiptoeing around the topic and that might be accompanied with the phrasing of like oh, I don't know if this is too much to say, or I don't know if this is TMI or just like saying something small.
Speaker 2:I see them testing the waters as far as, like you know. Can I talk to you about sex? Can I talk to you about the nitty gritties of sex? Can I talk to you about like dirty sex?
Speaker 1:Can.
Speaker 2:I talk to you about scary sex experiences and it's like each one almost feels like a little bit of a deeper layer and I want to say with a grain of salt that like it's there's a dual edged sword to this, because you don't want to bring forward a concept about sex that might be triggering to someone when you don't know what their triggers are around sex.
Speaker 2:But usually I take that moment when they are testing the waters about sex, are testing the waters about sex, and that's when I kind of escalate it just a teeny bit, just as a way of like we'll be like, oh, you know, like when, when you're with a partner like I don't know if this is TMI, and I'll just be like no, we're good to talk about sex. Like I try to say some part of the word explicitly, whether it's some piece of anatomy, some process like orgasm or what have you, and I really try to show it like face, energy, wise, that like yeah, sex, let's go for it, kind of thing. I'm like totally comfortable with it, to really illustrate to them that like you're allowed. I think that question of am I allowed is the first one that I see a client ask without explicitly saying so.
Speaker 1:I will sometimes say and Jess, there's nothing you can tell me? That will set my hair on fire. Yeah, really, there's nothing you can tell me. It's a good phrasing. Yeah, yeah.
Speaker 1:Well, heather, listen, as always, this has been a really, really informative session, I hope, or episode. I say session because I'm in my therapy mode here, but this is really important for people to hear. I feel like sex, sexuality, sexual identity, all of that. We have lots and lots to learn. There's much more to talk about and I look forward to revisiting this topic again, because one of my goals is to normalize and to create safety and a welcome to people out there who are questioning, who need some direction or just want a safe place to talk, that they can come to us at TMG and know that we are open and ready to hear their stories. So, thank you so much. Anybody interested in making an appointment to see Heather, you can schedule right online at themontfortgroupcom or you can call our office at 214-810-2615 and schedule something over the phone. Heather, thank you again for today. As always, it's so much fun to talk about sex, absolute delight. Let's talk about sex baby. Yeah, okay, all right, heather. Thank you so much, my dear, take care. Bye-bye.
