Often, sexual pleasure and sexual aggression become psychologically intertwined when a rape survivor experiences arousal during rape. In Matt Atkinson's words, "Sex, which is supposed to be healthy, harmless, pleasurable, and mutual, has been disfigured by rape or abuse." One woman exclaims, "The word 'no' doesn't seem to count. My own body didn't listen to it. So it's as if I never said it." Though it might feel this way to a victim, the word 'no' stands on its own. To paraphrase the woman's therapist: The sensation is not an expression of pleasure or consent – it is simply a physical sensation.