Interview conducted by Claire Vasseur, Slow Sex & Love Life. This interview is part of our series on healing, somatic approaches, and intimate reconnection.
How trauma lives in the body
Marie-Claude, you work specifically with people who have experienced sexual trauma. Where do you begin — how do you understand what trauma actually is, physiologically?
The frame I come back to, because it is the most clinically useful, is Bessel van der Kolk’s formulation: the body keeps the score. This is not metaphor. After a traumatic experience, the nervous system encodes the event not only as a memory that can be recalled but as a physiological state — a pattern of activation, arousal, and protection that can be re-triggered by any stimulus sufficiently similar to the original event.
In the context of sexual trauma, this means that intimacy — sensory, relational, physically close — can activate the body’s threat-response systems independently of any conscious decision. A person can be entirely willing at the level of intention and simultaneously experience an automatic freeze, dissociation, muscular bracing, or shutdown response. This is not ambivalence. It is physiology. When physical pain or gynaecological conditions compound the picture, the body’s protective reflexes and the trauma response can reinforce each other in ways that require both medical and somatic attention.
The important clinical implication is that talking about the experience — however important for some dimensions of healing — does not directly address this somatic encoding. The nervous system needs to learn safety at a physiological level, not just a cognitive one.
What does that learning look like in practice — how do you work with someone whose body has learned to associate intimacy with threat?
Very slowly, and beginning nowhere near the traumatic material.
The first phase of my work is always resourcing: helping the person develop an embodied experience of safety, regulation, and capacity. Before we touch anything difficult, I want them to know — in their body, not just their head — what it feels like to be calm. To breathe fully. To feel the ground beneath them.
This phase can take months. Clients sometimes arrive expecting to “process the trauma” in a few sessions, and I have to communicate that we are building the container first. An adequate container is the prerequisite for everything else.
Only when the nervous system has sufficient regulatory capacity — when the person can tolerate some activation without being overwhelmed, and return to regulation without being destabilised for days — do we begin to approach the material that carries more charge.
Working with the body: specific techniques
Can you describe some of the specific body-oriented techniques you use, and why they work where verbal therapy alone doesn't?
Several approaches are central to my practice.
Somatic experiencing (developed by Peter Levine) works with what he calls the incomplete defensive response — the survival action (fight, flight, freeze) that was interrupted at the moment of trauma. In the body, this incomplete response remains as a kind of suspended physiological charge. Somatic experiencing helps the nervous system complete that response through small, titrated movements — sometimes barely perceptible micro-movements of the limbs or spine — releasing the stored activation in manageable doses.
Breath tracking is fundamental. Trauma reliably disrupts breathing: the diaphragm, a key respiratory muscle, often freezes or becomes chronically restricted in response to threat. Re-establishing full, rhythmic diaphragmatic breathing is not just calming — it directly activates the parasympathetic nervous system through the vagal nerve. For many of my clients, learning to breathe fully again is one of the most profound experiences of the therapeutic process.
Titration is perhaps the most important principle across all techniques. We work with very small increments of activation — just enough to be present with something difficult without being flooded. This is the neurological opposite of re-traumatisation: instead of re-entering the full intensity of the experience, we approach its edges, stay long enough for some processing, and return to safety. Over time, the window of tolerance expands.
What role does touch play in your practice, and how do you navigate the complexity of using touch with survivors of sexual trauma?
Touch in therapy is a complex and ethically careful territory, which is precisely why it requires both extensive training and absolute transparency with clients.
In my practice, touch is always consensual, always explained, and always under the client’s control. I work only within very clear boundaries: hands on the upper back, the shoulder blades, the hands, sometimes the base of the skull — areas that carry significant postural and autonomic significance but are not intimate or sexual.
The reason touch can be valuable — when used carefully and with full consent — is that it provides direct proprioceptive input to the nervous system. For a person whose nervous system has learned to associate all physical contact with threat, experiencing safe, boundaried touch within a clear therapeutic relationship creates new somatic learning that is not accessible through words alone.
That said: touch is never assumed, never pressured, and never employed before a substantial foundation of trust and explicit consent has been built. For some clients, we never work with touch at all — and that is entirely valid.
Reclaiming intimacy after trauma
When a client is ready to return to intimacy — whether alone or with a partner — how do you approach that transition?
For those wanting to understand the neurobiological underpinnings of how desire rebuilds after trauma, our article on the neurobiology of sexual desire provides a complementary scientific framework.
The transition to intimacy is not a destination we move toward as a prize at the end of therapy. It is part of an ongoing process of reclaiming the body — and it happens gradually, with a lot of attention to what is emerging in each moment.
Practically, I often work with clients on conscious self-touch as a first step: slow, non-sexual, deliberate contact with their own skin — hands, arms, face. This seems small, but for someone who has been dissociated from their body, learning to touch themselves kindly and without urgency is a significant achievement. It re-establishes the relationship between self and body before introducing any relational dimension. As that reconnection deepens, the space for erotic imagination and conscious fantasy gradually re-opens — often as a gentle, internally generated signal that desire is returning on the client’s own terms.
From there, for clients with partners, I work with what I call consensual contact protocols — structured ways of being physically close with very clear parameters. Not sexuality, but presence. The goal is to generate enough positive somatic experience within physical closeness that the nervous system begins to update its associations. The Trauma Research Foundation has published frameworks for this kind of graduated re-approach to intimacy that inform my practice.
The Trauma Research Foundation provides research and clinical resources that underpin much of this contemporary body-informed approach to trauma and intimacy.
What role do partners play — and what do partners need to understand about supporting someone through this process?
Partners play a crucial role, and they often feel helpless — which is understandable and worth addressing directly.
The most important thing a partner can offer is unconditional patience without withdrawal. This is harder than it sounds. It means being present with someone who is not available for intimacy in the ways that were previously expected — without interpreting that as rejection, without letting frustration leak into the relationship, without gradually emotionally withdrawing as a self-protective response.
Withdrawal — even gentle, understandable withdrawal — sends precisely the relational signal that a nervous system shaped by betrayal is most sensitive to: that presence is conditional, that intimacy is not safe. This can deepen the trauma response rather than allowing it to resolve.
What partners can do concretely: attend a session together when the client is ready. Learn the language of nervous system states. Offer non-pressured physical presence — sitting beside, holding hands, breathing together — so that the body can begin to learn that closeness is possible without threat.
What transformation looks like
What does healing look like at the end of this process — what changes for your clients?
The relational dimension of this reconstruction is explored in depth in our guide to couple intimacy rituals.
I resist “healing” as a concept that implies a clean endpoint, because the process is more continuous than that. What I see change — often profoundly — is the quality of relationship with the body itself.
Before effective therapeutic work, many trauma survivors experience their body as an unreliable or even hostile territory — something that responds unpredictably, that cannot be trusted in intimate contexts, that carries sensations they cannot regulate. After sustained psychocorporeal work, clients describe a growing sense of inhabiting their body — of being at home in it, of its responses becoming legible rather than threatening.
In terms of intimacy specifically: the changes are often quieter than expected. Not dramatic liberation, but a gradual increase in availability — the ability to be present in physical closeness without dissociating, the ability to tolerate and even enjoy sensation without the nervous system activating a threat response. And over time, for many: genuine pleasure, genuine desire, genuine connection.
The most meaningful measure is not any particular sexual capacity. It is the degree to which a person feels free in their own body. That freedom, when it arrives, is not something taken away by trauma — it is something reclaimed.
Quick facts: common misconceptions about sexual trauma and therapy
- FALSE You have to describe the traumatic event in detail to heal from it.
- TRUE Somatic approaches can support healing without requiring verbal narration of trauma.
- FALSE If enough time has passed, the trauma should no longer affect you.
- TRUE Trauma is encoded in the nervous system, not in a timeline — it remains active until processed.
- FALSE Loving, consensual intimacy automatically heals past sexual trauma.
- TRUE New positive experiences are valuable but do not automatically override established physiological patterns.
- FALSE People who have experienced sexual trauma cannot have fulfilling sexual lives.
- TRUE With appropriate support, intimate reconnection is genuinely possible.
3 key takeaways
- Sexual trauma is stored physiologically, not only as memory — body-oriented therapy addresses the somatic encoding that verbal therapy cannot always reach.
- Healing is paced and graduated: the nervous system needs to build regulatory capacity before approaching difficult material, and this cannot be rushed.
- Partners' unconditional, non-withdrawing presence is one of the most powerful external factors in trauma recovery — not through doing more, but through staying.