How Trauma Can Affect Women’s Intimacy and Relationships

Sabrina Stoorman, LPC-S, CSAT-S, is Clinical Director at Willow Healing Center and Director of Family Services for Meadows Behavioral Healthcare. She joined Meadows Behavioral Healthcare in 2016, and has specialized in women’s trauma, relationships, sexuality, and intimacy throughout her career.

That focus now guides her work at Willow Healing Center, which specializes in women-specific trauma and its co-occurring issues: intimacy and relationship challenges, eating disorders, substance use, anxiety, depression, and difficulty regulating overwhelming emotions. 

“There’s a powerful experience in watching women who’ve experienced complex trauma, trauma of a relational and sexual nature, be able to reclaim their voice, their boundaries, their capacity for connection and closeness, and identify what they need to be safe,” she says.

In the following interview, she shares why women initially seek treatment, her approach to whole-person healing, the concept of “carefrontation,” and how she guides clients through pain and processing.

Q: When do you see women seeking care for intimacy issues? How are they first diagnosed?

I think what a lot of people don’t realize is that intimacy and relational issues really deeply intersect with what many people commonly seek treatment for: trauma, substance abuse, eating disorders, mood disorders. 

If a woman has learned that in her traumatic experience closeness isn’t safe, or that closeness requires a transaction — if her worth and safety in closeness becomes conditional — then what we’re going to see is that she may develop ways of controlling her body, her relationships, or her environment to create that sense of safety. 

What we’re really looking at in treatment is how someone’s trauma is manifesting itself in the way that they show up in relationships and the way that they move through the world.

 Q: What do you mean when you talk about women’s intimacy challenges?

When I use the word intimacy, I really mean much more than sexuality. I mean intimacy as “into-me-you-see” — that I can have a deep, authentic connection with myself, and I don’t have to lose that connection while having a vulnerable and intimate connection with another person. 

Intimacy is really our capacity to be deeply known. It’s our capacity to know ourselves, trust, be vulnerable, set boundaries, communicate what we need to others, tolerate closeness, and remain connected to ourselves while we’re also staying connected to another person.

And for many women who come to treatment, those things have been profoundly disrupted by trauma. For them, sometimes intimacy shows up as desperately needing connection, or becoming terrified as soon as someone gets close. Sometimes it can look like overfunctioning in relationships, or it can look like people-pleasing, difficulty saying no, or fully losing yourself in another person. And sometimes it looks like sexual behavior that becomes disconnected from what you actually want.

Relationships can hold so much pain, but they can also hold so much of our healing. So we want to help patients learn how to build safer connections, feel in control and empowered, and to be safe with those connections.

Q: What are common experiences or patterns you see in women coming into treatment?

What all of our patients have in common is that trauma has impacted their ability to safely connect, and they may have developed some maladaptive behaviors that are helping them regulate, protect themselves, or feel connected. A lot of women who have experienced trauma have experienced extremes throughout their journey. That can look like extremes of control, chaos, abandonment, enabling behaviors, or criticism. 

Underneath that trauma, we are going to find a lot of the same human needs across all of our patients, regardless of what they’re coming in for: I need to feel safe. I need to feel worthy. I need to be able to regulate something that feels unbearably overwhelming. I need connection, I need control, I need escape. 

We don’t need to judge or label a person because of those needs; we need to understand what someone’s problematic or maladaptive behavior is doing for them.

What I really want women to experience in treatment is: I can be fully seen here, in all of my humanity, in all of my perfect imperfections, including those parts of myself that I’m not proud of. I don’t have to stay stuck in those patterns any longer. I can be loved for all of it, and I don’t have to continue to choose these options.  

Q: How do intimacy issues impact the client’s family or relationships?

Something that has become very important to me as a clinician is learning how to zoom out — to be able to see an individual’s larger system: their community, their partnerships, their families, and their generational history. That helps us understand what functions and greater needs her initial behaviors are meeting, even if they’re not truly serving the actual underlying need. 

At Willow Healing Center, we don’t treat symptoms in isolation. We’re treating the whole person. The goal isn’t simply symptom reduction — the goal is helping the woman who comes to us develop new ways of regulating herself, new ways of relating to people, new ways of experiencing being present in her body and moving through the world. 

Q: You’ve spoken about “carefrontation” as central to your approach. What does that mean, and how does it show up in your work?

I consider a lot of the work I do to be rooted in what I call “carefrontation.”

Carefrontation is essentially compassion with a backbone. It means empathy and accountability are not mutually exclusive. Boundaries can still come with warmth; they do not automatically equal rejection. I can care deeply about you and still tell you truths that might be difficult to hear. It’s believing in someone enough to tell them the truth – to stay connected with that person while they hear and digest that difficult truth. 

My job isn’t to make a truth sound pretty or sound comfortable — my job is to hold a safe space for someone to face a truth that may have brought them into hiding, habits of control, or other patterns that have brought them to treatment. When it comes to my team and my patients, I care about you enough and believe in you enough to say the thing that is difficult to hear, to help you face that uncomfortable truth— not from a place of judgment, but because I believe in what any human is capable of. 

I have seen change come out of some of the darkest places in humanity in my career, and it has been one of the biggest privileges to witness someone stepping into their power, where they can have both accountability and empathy for themselves and for others.

Q: You’ve talked about a “systemic ripple effect” of healing. Can you explain what that looks like for families?

In working with families, doing relational and intimacy work, I’ve learned that the healing experience doesn’t stop with the person who comes to treatment. We exist in systems — our families, our communities, our partnerships. We are one whole, dynamic person, and we are part of a greater system. 

So when one person heals and makes successful, sustainable change, it creates a ripple effect of healing in their families and communities. That’s one of my favorite parts of the work I do as a clinician and leader — getting to see a person leave treatment and go home to their family, and relate to them in an entirely new way. That change can create space for the people around them to experience healing of their own, which can continue to ripple outward through relationships, families, and communities.

Q: What do you want people to understand about Willow Healing Center’s holistic approach to treatment?

We are not looking to put patients into a box. The women who come to Willow Healing Center often have complex stories. They are usually complex individuals themselves, and that requires a treatment team that engages in complex thinking. As a leader and clinician, it’s my responsibility to foster an environment that creates safety and connection, and helps put all the pieces together. 

Women often come to Willow Healing Center with multiple, interconnected concerns rather than one isolated issue. Mood disorders, substance use, eating disorders, betrayal, trauma, and other challenges can overlap and interact with one another, often developing in response to a person’s experiences. Our job isn’t to decide which area someone might be struggling in is “the real problem.” Our job is to see how all of the pieces in one whole person fit together.

Q: What do you want your clients to understand about you as a clinician?

Something my credentials don’t say on paper is how deeply I care about the women that I work with. This work is such a huge part of my heart, and it is the greatest and most humbling honor to watch a woman step into her power, to reclaim her voice, safety, connection, and ability to trust. I’m just in awe of anyone who has the courage to do that, and I’m willing to step into that journey alongside them. 

I’m not afraid of complex cases. I’m not afraid of big emotions. I’m here to be alongside you and help you learn how to navigate that. I’m not afraid of sitting with someone in the middle of something deeply painful, and my job isn’t to try to make that feel better immediately; my job is to hold space for you in that moment. Healing is not always comfortable.

It is such a privilege to help women discover they don’t need to be defined by the worst thing that has happened to them. They don’t need to be defined by the behavior that they are ashamed of. We can be seen, we can be known, and we can step into our power, and therefore step into change.

If you or a loved one are seeking care for issues surrounding sex, intimacy, or relationships, please get in touch.