Hey WJM. First off, do you see a therapist or have you seen one who specializes in PTSD and sexual trauma? Working with my therapist has helped me with a lot of disassociation from my body and working on healing trauma I had with my body when it comes to sex. It’s been a game changer. That said, I know therapy isn’t accessible to everyone, but if you haven’t already, I’d look into it.
Have you read Healing Sex? This book is written for women survivors of CSA, I would 100% check it out.
In my own therapy, The Body Keeps the Score was very helpful.
So personally I’ve struggled with anxiety around sex and my own dysmorphia with my body. Not exactly the same situation, but I still understand that feeling of anxiety locking you in essentially and you can’t experience pleasure, and really just freeze in the moment. It truly sucks!
Honestly what worked best for me was a mixture of things, but some of the heavy hitters that helped me were doing body work alone (both just holding parts of my body in a non-sexual way but then also masturbation as well) so I became more comfortable with my body, which being comfortable with my body helped me feel safe around others as well. Exposure therapy also helped. In this case, it was discussing with my therapist things that scared me and raised my anxiety to try in a more controlled setting. Either with myself or my partner. So for example, I’d set a goal with my therapist to do a position with my partner that I’d avoid because it makes me anxious. We’d discuss it before, then check-in during to see how I was doing, and then process after (I usually did a check-in after with my partner, and processed how I felt more in-depth with my therapist).
Exposure therapy can be tricky though, you don’t want to raise your anxiety too much, so it’s something I’d for sure suggest doing with the guidance of a therapist. But being very intentional with approaching things that were causing my anxiety to spike really helped.
FWIW, I’ve had both good and bad experiences with cannabis and sex. Edibles relax me and are great! Smoking? Nope, just makes me hyper aware and makes it worse. So might have to play around there to find something that works, either format, dose, or a specific strain.
I also take meds for my anxiety, and that helps my overall health, which also helps keep anxiety at bay all around.