In this segment from episode Starting The Conversation Around Sexual Anorexia, we begin with what looks like a familiar path—trauma responses—but quickly uncover a deeper, more insidious truth: how intimacy, when distorted by early harm, can turn into a war zone. Janet's story isn't just about survival. It's about expectation, submission, and the silent cultural scripts many women are forced to internalize about marriage, sex, and safety.

In this deeply personal bonus segment from Episode 104 Starting The Conversation About Sexual Anorexia, we hear more from Janet Bentley, a woman navigating the silent emotional toll of sexual anorexia within her marriage. What begins as a quiet irritation toward her partner, Simon, unravels into a poignant reflection on internalized shame, intimacy avoidance, and the emotional impact on those who love us.

She courageously details her struggle to name what she was experiencing, her relief in discovering Patrick Carnes' work on the sexual addiction spectrum, and the painful vulnerability of sharing that journey with her partner.

In this segment, Janet reflects on her lifelong struggle with intimacy and the emotional walls built from trauma, exploring the complex relationship between Female Sexual Interest/Arousal Disorder (FSIAD) and sexual anorexia—two conditions often conflated but profoundly distinct.

Perfectionism as Protection: Janet shares how perfectionism, an unhealthy coping mechanism, became her shield from past trauma, providing control while distancing her from deeper emotional wounds.

Terror of Intimacy: Janet vividly describes the escalating fear that intimacy evokes—initially sexual, but eventually manifesting in everyday acts like holding hands or engaging in emotional conversations.

Survival vs. Connection: Janet's story reveals a heartbreaking paradox where her greatest desire—intimacy—is also her greatest fear, trapping her in profound loneliness even within marriage.

Clinical Insights (Host Reflection): The segment explores the clinical perspective, highlighting how FSIAD in the DSM-5 categorizes a lack of desire or arousal biologically and culturally, yet often fails to capture the lived reality of trauma survivors.

Beyond the DSM: Janet's narrative underscores how clinical terms like FSIAD may fall short, illustrating a gap between diagnostic categories and real-world experiences, especially when trauma is central.

Understanding Through Listening: The episode emphasizes the importance of validating individual experiences and listening deeply to understand mental health challenges beyond conventional frameworks.

Female Sexual Interest/Arousal Disorder (FSIAD), according to DSM-5, is specifically defined around desire and arousal issues experienced by those assigned female at birth, combining two previous diagnoses (low desire and arousal issues) into one. Sexual anorexia, although not officially recognized in the DSM-5 or ICD-11, focuses on an intense fear-driven avoidance of intimacy, distinctively linked to trauma rather than simply desire or arousal issues.

Kyle sits awake at 2 AM, the glow of his laptop revealing a single word in the search bar: "avoidance." He scrolls past harsh phrases like fear of intimacy and sexual withdrawal that feel like accusations. Then one term stops him—"sexual anorexia." For the first time, he wonders: What if I'm not broken, but scared? And what if scared has a name?

This episode of Mental Health Rewritten explores the little-discussed realm of sexual anorexia, a term for fear-driven intimacy avoidance often rooted in trauma. Though not officially listed in the DSM-5, sexual anorexia is a profoundly real experience, marked not by mere disinterest but by an instinctual, protective shutdown of the body and emotions in the face of intimacy. It's a concept that can help survivors put a name to what was once shrouded in shame.

Narrative storytelling and expert insight intertwine as we follow Kyle's journey and others like him. Survivor Janet Bentley shares her struggle with physical closeness after sexual abuse, describing how discovering the term sexual anorexia transformed her self-understanding from silent shame to shared understanding. Janet's personal account — from feeling isolated and "broken" to finding hope in healing after sexual abuse — illustrates the power of naming trauma and seeking support. Her experience led her to found the Courageous Survivors nonprofit, creating a safe space for those with similar stories.

Renowned clinician Dr. Alexandra Katehakis offers compassionate commentary on why the mind and body respond this way. She explains how deeply embedded trauma can hijack the nervous system (drawing on the Polyvagal Theory of Dr. Stephen Porges) and cause a fight, flight, or freeze response during intimacy. Listeners learn how the body may literally shut down or go numb when triggered — not as dysfunction, but as the nervous system's attempt to feel safe. Dr. Katehakis discusses somatic healing techniques and the slow rebuilding of safety, trust, and consent in a relationship, highlighting the neurobiology behind why "the body remembers what the mind wants to forget."

The episode also explores how these trauma responses fit (or don't fit) into clinical labels. We delve into Female Sexual Interest/Arousal Disorder (FSIAD), the official diagnosis for low sexual desire in women, and why such labels often fail to capture the nuance of trauma-related intimacy avoidance. This discussion shines light on the inadequacy of one-size-fits-all diagnostic terms when intergenerational shame and personal trauma histories are involved. By blending Kyle's fictional story, Janet's real-life testimony, and Dr. Katehakis's scientific expertise, the narrative challenges the stigma around sexual avoidance. Intimacy avoidance born from trauma is recast not as a life sentence of dysfunction, but as a protective response that can gradually be understood and healed.

Join host Dominic Lawson in this conversation that destigmatizes sexual anorexia and offers hope for trauma recovery. From the quiet pain of avoidance to the slow steps of reconnection, Mental Health Rewritten invites you to reconsider intimacy after trauma through a new lens — one of empathy, understanding, and the radical act of naming our truth out loud. This episode is a compassionate guide toward healing after sexual abuse, reminding listeners that what feels like "brokenness" can, in time, become a story of courage and reconnection.

Mental Health Rewritten, created by the OWLS Education Company, in collaboration with theUmmah Collective Group is hosted, written and produced by me, Dominic Lawson

Executive Producers Kenda Lawson and Dr. Whitney Howzell

Cover art was created by Alexandria Eddings of Art Life Connections.

Some music was provided by DJ Krate Digga of the Mighty SoundChampz Crew

Understanding Sexual Anorexia: Defining sexual anorexia as an extreme fear of sexual intimacy and compulsive avoidance of sex, viewed through a trauma-informed lens rather than as mere lack of desire.

Intimacy as a Triggering Threat: How past sexual abuse or deep-seated shame can make intimacy avoidance a self-protective response, with the body's nervous system instinctively shielding the survivor (e.g. freezing or shutting down during closeness).

Personal Story of Recovery: Janet Bentley's candid account of her journey healing after sexual abuse – from decades of feeling alone with intimacy fears to discovering the term sexual anorexia and finding empowerment in naming her experience.

Expert Insight and Somatic Healing: Dr. Alexandra Katehakis's commentary on trauma and the body – discussing Polyvagal Theory, somatic therapy, and how understanding the neurobiology of trauma (e.g. fight/flight/freeze responses) can inform gentle healing and the rebuilding of trust and consent in relationships.

Beyond Diagnostic Labels: An exploration of clinical terms like Female Sexual Interest/Arousal Disorder (FSIAD) and why such diagnoses may fall short. The conversation highlights the limitations of traditional labels in addressing trauma-related intimacy issues, questioning whether what is often pathologized as dysfunction is actually a normal adaptive response to abnormal experiences.

Intergenerational Shame and Stigma: Insight into how shame around sexuality – often passed down through families or cultural messages – can compound trauma, and the importance of breaking silence and stigma. The episode emphasizes creating a supportive social context that validates survivors' experiences instead of adding to their shame.

The Power of Naming and Storytelling: A central theme of turning "silent shame into shared understanding," demonstrating how putting words to one's experience (like calling it sexual anorexia) can be a first step in trauma recovery. Through Kyle's fictional narrative and Janet's real story, the show illustrates that naming the problem opens the door to community, professional help, and hope for change.

Courageous Survivors – Nonprofit founded by Janet Bentley to support adult survivors of sexual trauma.

The B Word Podcast (Episode with Janet Bentley)* – Janet shares her story of sexual trauma and healing.

Book – Sexual Anorexia: Overcoming Sexual Self-Hatred by Patrick J. Carnes, PhD – A pioneering look at sexual anorexia and its ties to trauma (Hazelden, 1997). (Explores fear of intimacy and provides recovery strategies.)

Book – The Sexual Healing Journey by Wendy Maltz, LCSW – A compassionate guide for survivors of sexual abuse to reclaim healthy intimacy (Updated Edition, 2012).

Polyvagal Theory (Dr. Stephen Porges) – An influential framework explaining how the autonomic nervous system (vagus nerve) responds to trauma and safety cues. (Helps make sense of "freeze" and shutdown responses in intimacy.)

Center for Healthy Sex – Dr. Alexandra Katehakis's therapy center in Los Angeles, offering resources on sex addiction, sexual anorexia, and trauma recovery.

Diagnostic status of "sexual anorexia": Medical News Today – "Sexual anorexia: Symptoms, treatment, causes, and more." Confirms that sexual anorexia is not an official DSM-5 diagnosis.

Patrick Carnes definition: Patrick Carnes' book Sexual Anorexia defining it as "the emptiness of profound deprivation, a silent suffering". Also describes the fear-driven avoidance and how it can mask as disinterest.

DSM-5 Female Sexual Interest/Arousal Disorder: (NIH/NLM) – "Female Sexual Interest/Arousal Disorder." Explains that FSIAD in DSM-5 merged the prior desire and arousal disorders for women and is distinct to females.

Polyvagal freeze response: Reclaim Therapy Blog – "Understanding the Freeze Trauma Response" by Sarah Herstich, LCSW. Provides an overview of Polyvagal Theory (Dr. Stephen Porges) and the three neural pathways: social engagement, fight/flight, and dorsal vagal freeze when threat overwhelms.

Trauma and sexual dysfunction statistic: Journal of Sexual Medicine review (Pulverman, 2018) – "Impact of Childhood Sexual Abuse on Women's Sexual Health." Indicates that in random community studies, 25–59% of women with CSA histories have sexual dysfunction, highlighting the strong link.

Avoidance behaviors and symptoms: LovePanky (educational blog) – "Sexual Anorexia: 19 Signs…" Enumerates signs like fear of sex, avoidance of anything sexual (even revealing clothes or media), and judging one's own sexuality – matching the episode's descriptions.

Marital rape legal history: CriminalDefenseLawyer.com – "Marital Rape Laws." States that marital/spousal rape is illegal in all US states only since 1993, and notes the prior marital exemption laws.

Current bodily autonomy debates: The Nation (June 2023) – "The Supreme Court Has Dealt Another Devastating Blow to Women." Describes a recent SCOTUS ruling (Medina v. Planned Parenthood) as part of "the assault on bodily autonomy." Illustrates ongoing legal battles over women's control of their bodies.

Simone de Beauvoir on women's bodies: The Second Sex via PhilosophyNow summary – Beauvoir observed that society makes a young woman feel her body is objectified and shameful (e.g. men's leering causing her to wish to be "invisible").

Virtual reality therapy for sexual trauma: ABC News (Apr 2018) – "Inside the VR therapy designed to help sexual assault survivors heal by facing attackers." Reports on psychologists using VR scenarios to help rape survivors confront fears in a safe, controlled way.

In this special reflection episode of Mental Health Rewritten, host Dominic Lawson celebrates 40 days of the podcast's journey with over 1,000 subscribers and nearly 13,000 downloads. Dominic shares heartfelt gratitude for listeners' impactful messages, highlighting how powerful storytelling can transform conversations about mental health.

Listeners discover the deliberate use of the gentle chime within episodes—a signal indicating insights grounded in respected clinical texts, DSM-5 and ICD-11, ensuring a balance of accuracy, clarity, and empathy.

Dr. Justin Dodson offers additional commentary from Episode 102: "Rewriting the Conversation Around Pornography," deepening the exploration of Gio's compelling story and the complexities surrounding pornography's impact on mental health.

Gio's Personal Revelation: Listeners experience an intimate and candid moment as Gio explains his involvement in OnlyFans to his ex-girlfriend and mother, revealing the nuanced emotional landscape behind personal choices and societal judgment.

Mental health is everyone's conversation. Through empathy, accuracy, and courageous storytelling, Mental Health Rewritten continues reshaping our understanding, breaking stigma, and fostering essential dialogue.

In this segment from episode 103, Rewriting The Conversation Around Sexual Assault, psychotherapist Havi Kang explores how societal perceptions around trauma, sexual assault, and mental health are evolving, highlighting the influence of movements like #MeToo and increased online dialogue.

Dr. Justin Dodson joins the conversation to discuss the significant impacts when education about sexual health and trauma is suppressed, illustrating consequences from personal and professional perspectives.

In this segment, host Dominic Lawson pauses the narrative to ground the discussion in clinical reality. With the term "trauma" now widely used in cultural and digital discourse, this segment brings clarity to its true clinical definitions, as outlined in the DSM-5 and ICD-11. The conversation reframes trauma not just as catastrophic events but also as chronic, cumulative experiences—what clinicians call "small t trauma.

Why It Matters:

This segment reinforces our mission to rewrite mental health narratives by ensuring that language, especially around trauma, is used responsibly and compassionately. It's a call to acknowledge lived experiences, even when they don't fit the stereotypical mold of trauma.

In this segment of Episode 103, "Rewriting the Conversation Around Sexual Assault," Mental Health Rewritten explores the often-overlooked experiences of men who have survived sexual violence. With poignant insight from Havi Kang and Dan Woerheide, the episode challenges pervasive myths that silence male survivors and hinder healing.

In this segment, hosts Dominic Lawson and Dan Woerheide explore the enduring psychological toll of sexual assault, turning their focus to Complex PTSD (C-PTSD).

Dan reflects on the harrowing process of forensic exams for survivors—a clinical necessity that often reactivates trauma. Despite the compassion of SANE (Sexual Assault Nurse Examiner) professionals, the experience underscores how systemic procedures can inadvertently retraumatize those they've been designed to help.

Dominic introduces listeners to the concept of Complex PTSD, a diagnosis that goes beyond the acute symptoms of traditional PTSD. Unlike PTSD, which often follows a single traumatic event, Complex PTSD emerges from chronic, inescapable trauma—such as childhood abuse, captivity, or intimate partner violence.

Dominic also touches on the lack of formal recognition for C-PTSD in the DSM-5, where it is instead often subsumed under the ambiguous category of "Other Specified Trauma- and Stressor-Related Disorder." This gap reflects an ongoing debate in psychiatry but presents real challenges for survivors seeking validation and appropriate care.

Through Dan's testimony and Dominic's clinical context, this segment underscores Mental Health Rewritten's mission: to elevate hidden narratives, question institutional frameworks, and humanize the psychological aftermath of trauma.

In this powerful and necessary episode of Mental Health Rewritten, we open with a deceptively simple question: "Is this sexual assault?" From that moment forward, we begin a journey that challenges long-held beliefs about consent, trauma, and silence, especially when the abuse doesn't look the way we expect it to.

At the heart of this episode is Maria, a fictional composite of real stories. We explore the types of harm that don't come through force, but through the absence of consent, emotional pressure, or the quiet rewriting of boundaries inside long-term relationships.

But Maria's story is just the beginning.

We're also joined by Ashley-Lauren Elrod, a survivor whose candid testimony spans over a decade of sexual abuse, much of it at the hands of family members. Her story is raw and revealing of how trauma fragments memory, distorts identity, and leaves lingering questions like: Who am I outside of what happened to me? How do I tell the truth when the people who hurt me are the ones who raised me?

Together with expert voices—therapists Havi Kang, Dr. Justin Dodson, Dr. Alex Katehakis, and Dan Woerheide—we examine:

Why sexual assault in marriage is still so often denied or minimized

How dissociation becomes the mind's defense when the body can't escape

What gaslighting looks like in everyday language—and how it erodes self-trust

The difference between love and entitlement, and how one can masquerade as the other

What real trauma-informed healing requires—from clinicians, partners, and communities

We also confront institutional betrayal through the lens of the Larry Nassar and USA Gymnastics case, using it as a sobering parallel: If world-class athletes weren't believed, what does that say about the everyday survivor sitting silently at your dinner table?

This episode is a call to rethink what sexual harm looks like—not just in headlines, but in homes. It's about naming what happened, even when the world tells you it wasn't "bad enough." And it's about rewriting what healing looks like, starting with truth.

Mental Health Rewritten, created by the OWLS Education Company, in collaboration with The Ummah Collective Group, is hosted, written, and produced by Dominic Lawson.

Executive Producers: Kenda Lawson and Dr. Whitney Howzell Cover Art: Alexandria Eddings of Art Life Connections

Some music was provided by DJ Krate Digga of The Mighty Sound Champz Crew

Bureau of Justice Statistics – Criminal Victimization, 2021: This U.S. Justice Department report provides official data on crime reporting rates. It shows that only 21.5% of rape/sexual assaults were reported to police in 2021 highlighting the underreporting problem and reasons victims cite (fear of reprisal, etc.) bjs.ojp.gov.

Centers for Disease Control and Prevention (CDC) – National Intimate Partner and Sexual Violence Survey (NISVS): The CDC's research on sexual violence prevalence. According to recent CDC findings, approximately 1 in 4 women and 1 in 13 boys in the U.S. experience sexual abuse in childhood. nationalchildrensalliance.org

Academic Review on Revictimization: "The Prevalence of Sexual Revictimization: A Meta-Analytic Review" (Trauma, Violence, & Abuse, 2017) – A study synthesizing data on how often survivors of sexual abuse experience new incidents later. It found nearly 50% of survivors faced revictimization on average. nsvrc.org, though estimates vary. pubmed.ncbi.nlm.nih.gov

Institutional Betrayal Case Study – Larry Nassar and USA Gymnastics: News investigations and a 2019 U.S. Senate report document how USA Gymnastics and Michigan State University failed to stop Nassar. Example resource: The Guardian report "How was Larry Nassar able to abuse so many gymnasts for so long?" which describes how complaints were ignored in favor of protecting reputations. theguardian.com. Also see ESPN's piece on victim-blaming in this case. espn.com.

"Ideal Victim" Myth in Sexual Assault: For context on this concept, see Nils Christie's work in victimology and modern commentary such as "The 'Perfect Victim' Myth" by Kim Machray (Empoword Journalism, 2023), which explains how societal stereotypes of a "blameless, ideal victim" can marginalize many survivors. empowordjournalism.com.

Complex PTSD – ICD-11 vs. DSM-5: World Health Organization's ICD-11 includes Complex PTSD as a diagnosis distinct from PTSD. ptsd.va.gov. In contrast, the DSM-5 (the American manual) does not formally recognize "C-PTSD" as separate. (See the U.S. National Center for PTSD explainer on "Complex PTSD: History and Definitions.)

RAINN – Rape, Abuse & Incest National Network (U.S.): The largest U.S. anti-sexual violence organization. RAINN operates the National Sexual Assault Hotline at 1-800-656-HOPE and online chat support rainn.org. They offer help 24/7 for survivors, plus extensive educational materials and referrals.

National Sexual Violence Resource Center (U.S.): NSVRC provides research, toolkits, and a directory of local services. nsvrc.org. (While not a hotline, NSVRC is a hub for understanding sexual violence and finding support by state or territory).

1in6 (U.S. & Global): A nonprofit specializing in male survivor support. Provides anonymous online chat groups and resources for men who've experienced sexual abuse. Named after the statistic that at least 1 in 6 men have experienced abusive sexual experiences by age 18. 1in6.org.

National Child Abuse Hotline (U.S.): For anyone affected by child sexual abuse (survivors, parents, concerned individuals). Operated by Childhelp at 1-800-4-A-CHILD (1-800-422-4453), 24/7 confidential crisis counseling and referrals nationwide.

National Domestic Violence Hotline (U.S.): Many sexual assaults occur in the context of intimate partner violence. The NDVH (🌐 thehotline.org, or call 1-800-799-SAFE) offers support and can connect survivors of partner or marital sexual abuse to local services.

DoD Safe Helpline (Worldwide, for U.S. Military Community): An anonymous 24/7 hotline for members of the U.S. military (active or veteran) affected by sexual assault. Accessible worldwide via phone or online chat (🌐 safehelpline.org). rainn.org

International Resources – "NO MORE" Global Directory: A comprehensive global directory of sexual assault and domestic violence helplines by country (🌐 nomoredirectory.org). If you're outside the U.S., this resource (developed with the UN) helps locate local support services anywhere in the world. nomoredirectory.orgnomoredirectory.org.

Rape Crisis England & Wales (UK): National network of centers for sexual violence survivors in the UK. Offers a 24-hour phone helpline at 0808 802 9999 and online resources (🌐 rapecrisis.org.uk). (For Scotland, see Rape Crisis Scotland; for Ireland, see Dublin Rape Crisis Centre, etc.)

Ending Violence Canada – Sexual Assault Centre Directory: A Canadian resource listing provincial sexual assault centres and crisis lines. Survivors in Canada can find local support services via this directory endingviolencecanada.org.

(For other regions: many countries have similar organizations or hotlines – e.g. 1800-RESPECT in Australia, the Women's Helpline in India, etc. See the NO MORE Global Directory above for an extensive international list.)

Book – The Body Keeps the Score (2014) by Dr. Bessel van der Kolk: A best-selling book on how trauma impacts the body and mind, and paths to healing. Explores phenomena like dissociation, flashbacks, and the neuroscience of trauma in an accessible way. (Penguin Books)penguinrandomhouse.com

Book – It Didn't Start with You (2016) by Mark Wolynn: An insightful look at intergenerational trauma. Explains how trauma can be passed down through family generations and offers strategies to break the cycle (psychologytoday.com). Good for understanding how family history of abuse or trauma might affect someone's mental health in the present.

Book – Trauma and Recovery (1992; updated 2015) by Dr. Judith Herman: A foundational text by a psychiatrist that coined the concept of Complex PTSD. It covers the impact of sexual and domestic violence, the importance of survivor empowerment, and stages of recovery. (BasicBooks).

Documentary – Athlete A (2020): A Netflix documentary about the USA Gymnastics sexual abuse scandal. Follows investigative journalists and survivors (like Maggie Nichols, "Athlete A") as they expose Larry Nassar's crimes and the institutional cover-up. An impactful look at how a powerful institution silenced victims and how the truth finally came out.

Documentary – Resilience: The Biology of Stress & the Science of Hope (2016): Explores the science of Adverse Childhood Experiences (ACEs) and toxic stress. Shows how childhood trauma (including abuse and neglect) can affect health across a lifetime, and highlights initiatives to build resilience and break intergenerational cycles of trauma. rocofilms.com. (Director: James Redford).

Toolkit – The Trauma Toolkit (Klinic Community Health, 2013): A comprehensive guide (available free online) for trauma-informed approaches. While aimed at service providers, it's written in plain language about what trauma does to the brain, body, and how healing can occur. Includes sections on grounding techniques, understanding dissociation, and cultural/historical trauma. 🌐 trauma-informed.ca

Sidran Institute (Trauma/Dissociation Resources): A nonprofit organization that focuses on helping people understand and recover from traumatic stress and dissociative disorders. Their website offers fact sheets on conditions like Dissociative Identity Disorder, grounding skills for flashbacks, and how to find a trauma-informed therapist (🌐 sidran.org).

National Child Traumatic Stress Network – Resources on Childhood Trauma: NCTSN (🌐 nctsn.org) provides guides for both survivors and parents. For example, "Why Don't They Tell? Teens and Sexual Assault Disclosure" (NCTSN, 2008) is a resource explaining barriers that youth face in disclosing abuse.

NSVRC Guides to Healthy Sexuality Education: The National Sexual Violence Resource Center has materials to help parents and educators talk about consent and sexuality early. E.g., "6 Resources to Help Parents Talk to Kids About Consent" and "It's Time... to Talk to Your Children about Healthy Sexuality". These tools can empower families to replace silence with informed, age-appropriate dialogue – echoing the episode's message that education is a form of protection (nsvrc.org).

Survivor Recovery Workbooks: The Courage to Heal Workbook by Laura Davis (a companion to the classic book The Courage to Heal) is a practical guide full of exercises for women and men healing from childhood sexual abuse. Another option for male survivors is Victims No Longer by Mike Lew, which addresses the unique challenges men face and includes first-hand stories and recovery strategies.

Support for Complex Trauma: "Coping with Trauma-Related Dissociation" (2011) by Kathy Steele et al. – a workbook for survivors of severe trauma who experience dissociation. It provides grounding techniques and coping skills in an easy-to-understand format. For those interested in the clinical perspective, the International Society for the Study of Trauma and Dissociation (ISSTD) offers free fact sheets on understanding dissociative disorders and complex PTSD.

Memoirs and Personal Stories: Sometimes, hearing another survivor's story is healing. A few noted memoirs: Know My Name by Chanel Miller (survivor of the Stanford University assault, reclaiming her story), Missoula by Jon Krakauer (investigative book with survivors' experiences in a college town), and The Sum of My Parts by Olga Trujillo (one woman's journey healing from dissociative identity disorder caused by childhood abuse).