When Self-Soothing Turns to Self-Sabotaging

“Trauma is not what happens to you. Trauma is what happens inside of you as a result of what happened to you.” -Dr. Gabor Mate

Let's break it down… What is trauma? 

Trauma describes the impact a stressful or overwhelming event has on your brain and autonomic nervous system. It’s how YOU experience a painful event, not how your parent experienced it, or your friend, but how it affected YOU. Think of trauma as a loss of connection to ourselves, our bodies, others, our families, and even the world around us. The brain mediates all those social, behavioral, emotional, and cognitive functions and developments, and threat responses. Understanding this can help us work toward healing our wounded inner child. 

That takes us to… what is Sexual Addiction? 

A common question one may ask here could be, “Why can't I control myself?” Sex addiction can be defined as a pathological relationship to a mood-altering experience, like sex, that the individual continues to engage in despite negative consequences or efforts to stop. Your brain is engaging in behaviors in response to those emotional and behavioral cues, such as childhood trauma, sexual abuse, loneliness, and depression. Dr. Michael Barta terms these childhood traumas as “adverse developmental experiences” (which you will read about a little further down). Our brain plays a vital part in understanding and managing compulsive sexual behaviors. Our amygdala and hippocampus store strong memories of reward and produce intense conditional cravings when those “cues'' from the environment are presented. This response can then result in one compulsively acting out in sexual behaviors. The etiology of sex addiction has been found to be rooted in trauma and abuse. In an assessment of sex addicts by Patrick Carnes and Marie Wilson, 97% of participants reported emotional abuse, 81% reported sexual abuse, and 72% reported physical abuse in their childhoods. It is clear that trauma and sex addiction are inevitably connected. 

Think of addiction as a sort of “math equation”:

Intense & persistent cues/cravings + wanting/seeking behaviors - processing of past negative experiences = an addicted response. 

Putting it all together…

Trauma-Induced Sexual Addiction, coined by Dr. Michael Barta, was developed after years of extensive research and assumes that the start of sex addiction lies in a damaged autonomic nervous system. This could be due to emotional neglect when a person is a child, lack of attunement, or any early wounding event that could predispose a person to addiction due to damage in the neurological system. Again, this model, Trauma-Induced Sexual Addiction, supports that the addiction is related directly to adverse developmental experiences in early childhood. There is an addiction cycle - imagine a continuous circular cycle consisting of threat to self, followed by distorted thinking, isolation, self-regulation, acting out, shame, consequences, compensation, and back again to the threat-to-self phase. Before healing, treatment, and therapy, addicts live a double life. However, the goal is to have only ONE life - one embodied with integrity, understanding, and healthy emotional regulation. 

How this Addiction is Diagnosed

The DSM-5-TR, (Diagnostic and Statistical Manual, 5th Edition, Text Revision) that therapists use to diagnose addiction and mental health disorders does not use the term “sex addiction”. Instead, the DSM-5-TR lists “other specified sexual dysfunction” that could be used for a hypersexual disorder. In the ICD-11 (International Classification of Diseases, 11th Edition), the recommended diagnosis would be “Compulsive Sexual Behavior Disorder”.  The similarity in both of these diagnostic manuals surrounding sex addiction is the essential requirement of the persistent failure to control the intense, repetitive sexual urges or impulses resulting in repetitive sexual behavior that causes severe distress in one’s life. Again, both of these diagnoses agree that if a person continues the behavior despite persistent or recurring financial, social, physical, or psychological problems caused or exacerbated by the behavior, then they are considered for the diagnosis above. 

Trauma’s Role in Sexual Addiction

How it impacts the brain & the nervous system:

Simply put, the path to addiction starts with unhealthy self-soothing or regulatory behaviors. It is important to note that not all regulatory behaviors become addictions, but all addictions start as regulatory behaviors. These “regulatory behaviors” start as an unconscious attempt to regulate those big feelings, such as fear, depression, shame, anxiety, and even powerlessness when there is no caregiver to aid the child in times of chaos or emotional turmoil. It’s an attempt to stop pain, so we self-regulate with maybe a substance or behavior to bring us out of that fight or flight state with our sympathetic nervous system. Types of regulation behaviors can include sex, pornography, fantasy, food, exercise, drugs, alcohol, and even thinking obsessively, or compulsively. Even suicidal ideation could be a regulatory behavior. The goal (in the moment) is to get the pain to stop. Those behaviors that do not become addictive, (i.e., lying or entitlement) usually act as “protectors” to addiction. 

The TINSA Foundation of Self-Regulation starts with an adverse developmental experience, also known as a “trigger” (such as a person, place, memory, feeling, or thing). After this, you could experience one of three things: first, a sympathetic response where you feel tense, shaky, impulsive, angry, or tight, and this results in a regulatory behavior, like sex, drugs, alcohol, fantasy, masturbation, etc. Secondly, after you trigger, you could have a dorsal vagal reaction where you feel cold, numb, frozen, helpless, confused, hopeless, or ashamed, and this results again in those regulatory behaviors mentioned above, like sex, masturbation, drugs, alcohol etc. The third and last is a ventral vagal response, where after you are presented with a trigger, your response is calm, engaged, safe, clear, connected, focused, and even receptive. There is no regulatory behavior after this response. This ventral vagal reaction is our goal to gain control over these automatic reactions. 

Healing & Recovery:  

Whole. Alive. Authentic. Recovery is a lifelong process: learning to cope, being vulnerable and authentically you, being whole, being calm. Using a trauma-induced sexual addiction lens can help addicts learn how to regulate those behaviors, express emotions, and find healthy alternatives to self-soothing in order to rewire those old behavior patterns. 

The first stage in using a trauma-induced sexual addiction approach to recovery involves understanding your self-regulation and stopping the addiction. To move forward, the self-regulated addictive behavior must stop completely. Up until now, the addict has been living in isolation, dishonesty, fear, secrecy, and manipulation. The addict's primary way of relating to others so far has been through self–regulated safety. They lack trust in others and may typically think, “I can't rely on him/her, I only have myself to trust” or “I can’t let them know the true me or they may reject me”. They only think about doing this life alone, which will typically lead back into that unhealthy self-regulation that may result in betrayal, rejection, etc. 

The second stage is about learning to trust something stronger than ourselves -  to develop healthy outer regulation. An addict does not know healthy regulation, and may not trust others just yet. This looks like healing your dysregulated nervous system by relying on other stronger, healed nervous systems to aid in your own. It could sound scary, having to trust others, but without adequate emotional support and nurturance, we’d only have ourselves to rely on. This is where we start to practice honesty, vulnerability, and integrity. Joining groups and seeking treatment with a Certified Sex Addiction Therapist (CSAT) is a great start and one of the best ways to begin outer regulation on your healing journey. 

Support is a key element in sustaining your recovery. This can involve weekly therapy sessions, but MAXIMIZING that support is vital. David Fernandez and colleagues analyzed a recent membership survey of sex addicts anonymous, SAA (N=2,190) and found that 67% of members had participated in individual therapy before attending the sex addicts anonymous group and that 81% were still engaging in individual therapy while also participating in sex addicts anonymous group. This suggests that 12-step and other support groups are one of the many tools that you can utilize for ultimate support in your recovery.

The third stage is finding and maintaining true intimacy through interregulation. This is the final transition of self-regulation into consistent intimacy with partner, family, and others. This interregulation occurs between two systems that are secure, healthy ventral vagal systems interacting. You’re no longer making excuses for your behaviors. This is recovery. 

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References:

Barta, M. (2018). TINSA®: A neurological approach to the treatment of sex addiction. CreateSpace Independent Publishing Platform.

David P. Fernandez, Daria J. Kuss & Mark D. Griffiths (2021) Lived Experiences of Recovery from Compulsive Sexual Behavior among Members of Sex and Love Addicts Anonymous: A Qualitative Thematic Analysis, Sexual Health & Compulsivity, 28:1-2, 47-80, DOI: 10.1080/26929953.2021.1997842

Schmidt, P. (n.d.). Diagnosing and understanding sex addiction. Dr. Paul F. Schmidt. https://mynewlife.com/diagnosing-and-understanding-sex-addiction/. 

Trauma and addiction impacts all areas of your life, but so does recovery. If you need guidance or support navigating these issues, to find out more about our approach, or to connect with a therapist that is right for you, contact us for a free phone consultation. Our team of therapists are experienced and specifically trained in treating complex trauma, addiction, betrayal trauma, and rebuilding relationships.

About the Author

Devon Weathers is Clinical Mental Health Counseling graduate student and Certified Sex Addiction Therapist candidate. Devon specializes in working with individuals with process addiction, substance addiction, trauma, and relational issues.