The Analysis
When a young girl who is just becoming a sexual person is raped, Berman explains, the trajectory of her development is dramatically altered. Berman has seen many patients who try to regain control of their relationship to men through hypersexuality. But their unfulfilling encounters only cement the sexual trauma, leaving the women feeling even more disconnected than before. Berman compares Ava to a child who grows up with an alcoholic parent and then, as an adult, repeatedly chooses alcoholic partners in an attempt to rewrite and heal the past. In Ava's case, the mental equation has been: "If I can have sex with this person and then turn it into a relationship, that's going to validate me."

"I totally hear you," Ava tells Berman. "I think that's right on."
The Advice
Berman has four recommendations:

1. "My reading is that you've been very casual with your sexuality because you've never really owned it as the great gift that it is." Continuing with celibacy is a good idea for now, she advises, but Ava should ask herself what kind of partner would deserve her sexual gift.

2. In Berman's analysis, the rape—and the fact that no one took it seriously—has prevented Ava from building a long-lasting sexual relationship, and she urges her to try to find closure in order to move past it. "Have an honest conversation with your mother," Berman suggests. "Tell her how hurtful her response was and how it has affected your life." Writing a letter to the rapist, even if she never sends it, could also be a powerful way to heal the trauma, says Berman.

3. Ava's comment about not having a good time during sex also worries Berman; it implies a tendency to disassociate, which could almost become a replication of the rape. When Ava does have sex again, it will be important to let her partner know that she doesn't have orgasms vaginally but does manually or orally ("a pretty common female experience," Berman notes).

4. For now, Ava should try "owning" her sexuality by honoring her body through self-stimulation, almost like a meditative practice. "Light candles," Berman says. "Take a bath. I'm a huge fan of vibrators, but in your case, using one could almost continue the disconnect because you wouldn't be literally touching yourself."

This makes immediate sense to Ava. "What you're suggesting is self-reverence."

"Self-reverence," Berman repeats. "I think that is a great way to describe it."

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