The Cost of Not Feeling: Experiential Avoidance, Autonomic Arousal, and Sexual Distress in Couples Seeking Relationship Therapy

Research has demonstrated that exposure to childhood cumulative trauma (CCT) has significant consequences on development, particularly in the sexual domain. Avoidance mechanisms and activation of the autonomic nervous system, frequently observed among CCT' survivors, may play a role. While studies have explored how these variables relate to survivors' sexuality, they have often failed to account for potential dyadic-level effects. The primary aim of this paper is to examine the role of autonomic arousal (AA) and experiential avoidance (EA) in the associations among CCT and sexual distress in distressed couples. A sample of 211 mixed-gender couples entering relationship therapy were recruited in a community clinical practice in Canada. They completed validated questionnaires assessing CCT, AA, EA, and sexual distress. Path analysis based on the Actor-Partner Interdependence Model revealed significant small actor effects. Women's CCT was related to higher AA and EA. In turn, EA was related to higher sexual distress (R² = 9.7%). In men, CCT was related to higher AA, which was, in turn, related to higher sexual distress (R² = 11.0%). Results highlight distinct mechanisms linking CCT to sexual distress between partners. Moreover, results suggest the relevance of assessing sexual distress in couples, and of utilizing trauma-informed approaches.