(Content warning: sexual violence, emotional and physical abuse)

Many survivors of sexual assault experience difficulties during sexual activity after being assaulted. They often find their emotional and physical attitudes and reactions toward sex have changed. I am one of those survivors.

A few years ago, I was manipulated by someone I thought I could trust, and then I was raped by that person. As a result, I was diagnosed with post-traumatic stress disorder, generalized anxiety disorder, and clinical depression.

When I finally felt comfortable enough to start dating again, I was fortunate enough to meet a man who would later become my husband. We are now in a happy, healthy marriage.

But it wasn’t easy to get where I am today. If you asked me three years ago if I would ever have a healthy relationship, much less feel safe in a room alone with someone, I would definitely have cried on the spot. After my assault, any type of sexual activity felt like I was betraying my own body. I often asked myself, “How can I put my body through sex when the same act was essentially used to punish me before?” When I first started dating my now-husband, my sex drive was at an all time low, and I found myself becoming easily irritated and closed off. But I decided, if I wanted to continue building up our relationship, it was time for me to deal with my trauma and the issues that stemmed from it.

“Trauma robs you of the feeling that you are in charge of yourself,” writes Bessel A. Van der Kolk in his book The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. “Sooner or later you need to confront what has happened to you, but only after you feel safe and will not be retraumatized by it.”

So when you’re ready to start the healing process, here are some things you can do:

Communicate With Your Partner

Communication is key when building any type of relationship, not just ones where one or more partners have a history of sexual assault. For many rape survivors, the mere idea of having sex can trigger anxiety attacks, fear, mistrust, and confusion. It’s important for people with trauma to discuss their past with their partners in as much detail as they wish to provide. And it’s important for people one the other side of this discussion to be considerate of where their partner is in their journey. It’s imperative that the listener be empathetic and never place the blame on or otherwise judge the victim.

When we were first dating, I told my husband about my history of sexual assault and abuse and, him being the wonderful person he is, he reacted with respect and sensitivity. Talking about my trauma, even to someone as emotionally supportive as my husband, induced several panic attacks. It was one of the hardest things I’ve ever had to do. However, the end result of intimacy with my husband was worth wading through the sludge of my traumatic past.

“Empowered communication was one of the most powerful tools that I was able to wield against my trauma,” says writer and public speaker Jo Beckwith. “Today, I still deal with issues revolving around my trauma, but partially because of this improved communication, my issues are markedly better than they were even a year or two ago.”

Create Guidelines for the Bedroom

Survivors of sexual assault may still have certain triggers, such as certain types of physical touch. It’s important to note what your triggers are and implement guidelines with your partner before engaging in any sexual activity. As always, whether you’re single, in a casual relationship or married, consent is always the number one priority. It’s important your partner respect your boundaries.

“When you talk to your partner, I would also recommend talking about going slow and having plenty of check-ins,” says sex therapist Vanessa Marin. “Having sex with a new person can be anxiety-inducing for anyone, but for survivors, there’s often an added layer of anxiety. Communication can go a long way.”

Creating guidelines with my husband helped me rewire my brain so I could feel comfortable, loved, and nurtured during sex, as opposed to my brain detecting sex as hurtful or as an obligation. Additionally, it helped me to remember that there are other ways to enjoy intimacy. There’s always good old-fashioned hand-holding, cuddling, intimate dinner dates, and other ways to show love and affection.

Recognize It’s Not Just About Sex

Sexual assault is traumatic. It is an experience during which you have not been in control, and healing happens by taking back that control.

For many survivors of sexual assault, triggers aren’t necessarily solely sexual. They can also be emotional, and, for the most part, they focus around the control that was lost during the assault. After my assault, if someone were to make me feel humiliated, belittled, or patronized, even as a “joke,” I would automatically feel overly-embarrassed, agitated, anxious, and/or just generally untrusting of that person.

It was important for me to find activities, like writing, that helped me regain control of my body and my life. For others, that control could be obtained from exercise, meditation, yoga, and/or therapy. In a recent study published by Tracey Shors, Ph.D., professor of behavioral and systems neuroscience at Rutgers University, she suggests that women with a history of sexual violence against them can significantly reduce intrusive trauma-related thoughts by practicing 30 minutes of meditation followed by 30 minutes of exercise twice a week.

If you’re on this journey, remind yourself it’s going to be a work in progress. Everybody heals differently, and it’s normal to grapple with a mixed bag of emotions. Many survivors say focusing on healing is what helps them form stronger bonds with their partners as well as repair their relationships with themselves.

You can reach out to someone at the National Sexual Assault Hotline for free 24/7 by calling 1-800-656-HOPE. You can also visit RAINN.org for more resources.