In this ISSM Podcast episode, clinical psychologist and sexologist Marieke Dewitte explores the complex impact of sexual abuse on survivors’ bodies, relationships, and sexuality. She explains how trauma can alter stress responses, body image, trust, and sexual functioning, including patterns such as hyper- or hyposexuality, genital pain, dissociation, and sexual risk-taking. Dr. Dewitte details common triggers in daily life and during sexual activity, including sensory cues and threats to safety or control, and clarifies the misunderstood phenomenon of automatic genital arousal during abuse. She then outlines a stepwise, trauma-focused therapeutic approach that prioritizes bodily and emotional safety, trust, boundaries, and agency before directly addressing sexual difficulties. Emphasizing trauma-informed care, she highlights the importance of predictability, validation, collaboration, and building on resilience to help survivors gradually reconnect with their bodies, intimacy, and pleasure. Interview by Shelly Varod.