This is going to be the beginning of an extended cycle of posts on "healthy sexuality for combat veterans," a subject that desperately needs to be addressed. There's too much to cover in just one sitting, though, so stay tuned for a few here because we're first going to have to cover the problem, in depth, before we can turn to some of the solutions. It's really pretty surprising that no one is talking about this stuff professionally -- other than the veterans themselves, if they can ever work up the courage to. So here goes. I have my "focus group" of veterans: they're telling me what they want to hear discussed out in the open.
You'd be surprised, as I was, if you reviewed the literature on veterans and PTSD, and found literally almost nothing written on this subject. Well, unless you count references to "sex addiction." Addiction, really? That's apparently a tell-tale marker for chronic PTSD. Ahhh...but thankfully "sex addiction" isn't all that firm a professional diagnosis. What seems like addiction to one, seems like the actual engine of life, to another. And fortunately we're able here to consider both perspectives as we talk about it.
Here's one of the best items we've found in the literature, and it's from Aphrodite Matsakis, Ph.D.'s book, Vietnam Wives. It talks about sex for the veteran with PTSD as "the total stroke." Here goes:
"On one level, this intense need for sex [on the part of the combat veteran] can be related to the veteran's loneliness. Socially isolated people are often lonely. Although they may desire to be separate, their isolation often results in their becoming "stroke deprived" -- they do not receive the smiles, the hugs, the compliments, or any of the visual, verbal, or physical recognitions (strokes), large or small, which naturally come about when with supportive others. In this state of deprivation, the vet may turn to sex to meet his social and relationship needs. Sex becomes a substitute for in-depth emotional communication, or even casual socialization.
One vet called sex the 'total stroke.' For a long time, he believed that sex would satisfy all his hungers -- his hunger for sex, as well as his hunger for human companionship and intimacy. Like many persons, he confused sex with love and emotional closeness. When sexual activity without communication left him unsatisfied, he increased his sexual activity. Even after more sex, however, he still felt restless and empty inside. Eventually he found that some communication with his sexual partner and more time spent socializing with others, not more "pure sex," helped satisfy him.
On another level, the vet's need for sex can be intense because, biologically, sexuality is "the antithesis of anxiety." As has been repeatedly proven in studies of both men and women, anxiety interferes with sexual performance, especially with orgasm. Conversely, it is difficult, if not impossible to be anxious while highly sexually aroused. Hence, for some vets, sex is more than sex. It is a form of tranquilizer or sedative for their anxieties and other tensions. Not only does sex provide a sense of physical peace, but an emotional peace as well...in this sense, sex can be used like a mood-altering drug."
Says Jonathan Shay, M.D., Ph.D., in his book, Achilles in Vietnam:
"The overwhelming majority of combat veterans whom I have known are painfully aware of the absence of intimacy, tenderness, light playfulness, or easy mutuality in their sex lives. For many, sex is as sure a trigger of intrusive recollection and emotion from Vietnam as the sound of explosions or the smell of a corpse. Sex and anger are so intertwined that they often cannot conceive of tender, uncoerced sex that is free of rage. When successful treatment reduces their rage, they sometimes report that they have to completely relearn (or learn for the first time) the pleasures of sex with intimacy and playfulness."