Sex and Love Addiction: The Roots of Trauma in Addiction
By: Kayla Mann
Southern New Hampshire University
The field of addictions is full of challenging issues that put society and families searching for answers on how we can create change. One major issue hidden beneath addiction is trauma. This is a topic that continues to be the center of many research studies, in order to provide increasing evidence to support trauma’s association to addiction. Many people who are unfamiliar with addiction are still unaware that addiction is rooted in trauma. If people had a better understanding of the trauma that underlies addiction would they be more apt to show compassion and care for this segment of our society? And would they be more apt to work towards increasing rehabilitation services for people who are experiencing addictions of all kinds? I believe the answer is yes. We need to educate and inform the public as well as work towards policy reform that moves towards rehabilitation rather than punishing, retraumatizing, labeling and marginalizing an already vulnerable segment of our society.
What exactly is trauma and how does it affect each individual? The word trauma is derived directly from the Greek word for wound; while a wound, in essence, is a physical rupture of tissue, the neuropsychiatric definition also contains a sense of rupture: in safety of body and mind (Sharma, Gonda, Dome & Tarazi, 2020). It is no surprise that countless research studies have linked trauma to addiction. The strongest positive associations found in research were between trauma and adverse childhood experiences (ACEs). One study thoroughly reviewed 29, 841 relevant studies on trauma and 3,054 were specifically included in a meta-analysis that showed these associations (Thege et al., 2017). This evidence points to the blameless vulnerability that these children faced, in which many of them have become the low bottom drug addicts--labeled, judged and pushed to the sides of society. They were the powerless victims to abuse, neglect, and sexual trauma, and many are still the victims of a society that does not understand them. Society needs to be educated and understand the relationship between childhood trauma and its link to addiction for change to actualize. Society must be educated and understand that most addicts are self medicating, have found a survival mechanism through substance or process addictions and need rehabilitative services that are easily accessible.
Everyone experiences trauma differently and it does not have to be the most severe events that disrupt the feeling of safety & security. Sometimes things that may not appear to be traumatic from the outside may be traumatic to the individual. These seemingly smaller events do affect people in a similar way. As well, some people who experience traumatic events are able to modulate the experience with healthy coping styles. Whatever the cause, the repression of feelings and emotions may lead to the manifestation of addictions. Further research would need to be conducted to determine this hypothesis.
The focus of my study on addictions will explore the relationship between trauma and sex & love addiction. With sex and love addiction, two main components have been found: sexual abuse history and disorganized attachment to caregivers, both resulting in intimacy disorders, compulsive sexual behavior, attachment disorganization, and the gravitation towards reproducing similar traumatic scenarios (Schwartz & Southern, 2017, Thege et al., 2017). Why do people continually find themselves stuck within the same revolving patterns and cycles of abuse over & over again? The famous psychotherapist Freud (1914/1958; 1920/1954) described the efforts of the person to resolve developmental trauma through repetitive compulsions, by which the forgotten memories and contexts are repressed or replayed, either actually or symbolically, in an attempt to gain mastery over the experience of neglect, abuse, or trauma (Schwartz & Southern, 2017). My personal view is synonymous in that people find themselves in the same scenarios over and over again until they are able to purge & process these deep wounds, step over & out of the cycle, break the bonds which impede their growth and ultimately transcend into a new reality. Once individuals and families are able to process these depths, they will be able to set healthy boundaries, leave toxic situations, gain stability, make new choices on how they will behave, react with less intensity, and find greater security within themselves.
Trauma, insecurity, anxiety, depression and other psychological disorganizations are difficult to endure, often hidden, and emerge as a voyage---a voyage where individuals are simply seeking relief. Some examples of experiences that have strong predictions of adult psychopathology are caregiver psychological unavailability, physical abuse, sexual abuse, and serious distortions in the infant-caregiver relationship (Sroufe 1988, as cited in Schwartz & Southern, 2017). In the face of confusing or frightening caregivers, these children were confronted with the irresolvable conflict of striving to flee from the source of fear yet they had to flee to the source of fear because those were their caregivers (Sroufe 2005, as cited in Schwartz and Southern, 2017). “Symptoms related to reminders of the exposure manifest as intrusive thoughts, flashbacks and nightmares, which invoke the same emotional, psychological, and physiological state experienced during the original exposure and lead to reliving of the trauma. Activation symptoms manifested as hypervigilance, impulsiveness, agitation, irritableness, anger, hypervigilance, impulsiveness, agitation, irritableness, anger, hyperarousal, exaggerated stress sensitivity and insomnia. And deactivation symptoms manifested as avoidance, withdrawal, emotional detachment, derealization, depersonalization, dissociation or depression” (Burton, Feeny, Connell & Zoellner, 2018; Sherin & Nemeroff, 2011, as cited in Sharma et al., 2020). The sense of safety, security and love that every human needs now presents with a severe distortion filled with pain, freight, confusion, and unwanted memories that leave them desperately seeking to escape.
These traumas are carried with that person throughout their life, until they find the healing sufficient enough to transcend the past. When these events occur in childhood and continue through adulthood, a particularly challenging split begins in the psyche which distorts the development of the personality, neurocognition, socialization, affect regulation, and sexual behavior. Many trauma survivors must also face the psychological distress of re-abandonment-- as oftentimes no one supports their experience, denying it, covering it up, keeping the family secret and that innocent, vulnerable child becomes the scapegoat of family & society. This leads to a severity of abandonment issues as well as psychological affliction. Disordered attachments to caregivers, internal splitting of how they view the caregiver between good and bad creates a disassociation. Love addiction and sexual behavior serves as both an outlet for disassociation from affect regulation and a means for trauma resolution by reenactment (Schwartz & Southern, 2017). Sex and love can then create an addictive cycle as it becomes a functional means of self-soothing and modulating intense emotions in which the individual responds to stress by escaping into fantasy, or copes with distress by numbing and escaping into an illusion of intimacy (Schwartz & Southern, 2017).
Sex and Love addiction is what addictions professionals call a process or behavioral addiction. A process or behavioral addiction is the compulsion to continually engage in an activity or behavior despite the negative impact on the person’s ability to remain mentally and/or physically healthy and functional in the home and community (American Addiction Centers, 2021). With the advent of social media, dating apps, online access to pornography, objectification of women in the media, the subliminal message of “sex sells” that is ingrained throughout our society’s media, the changing gender roles, changing religous climate, the changing of social institutions, increased divorce rates, rise in addiction, rise in mental health disorders, the increase of two parent house holds both working full time and an overall decrease in stable families, it is no surprise that we have more and more people engaging in these process addictions.
Social norms are an important part of the field of addictions because it is assumed that young people are strongly influenced by what they perceive to be the group norms among their peers hence there is a strong likelihood that they will think and behave in similar ways (Martin, 2011). Common social norms that are looked at in the field of addictions analyze normative beliefs- or the belief about what a social norm really is, anticipatory socialization--the way people think about their future social life, false consensus--the incorrect belief that others are like us when it comes to unhealthy behavior, and pluralistic ignorance--the incorrect belief that others behave differently than us when it comes to healthy behavior (Substance Abuse Social Norms Approach, n.d.).
Social norms have posed a major impact on the acceptability of sex and love addiction in our society. Men and women are both socialized, within the context of media and pop culture, to chase either sex or love. For women, they are introduced to the ideas of fairy tale romance, unattainable beauty, and the perfect family life, all of which are infiltrated into the psyche from a young age. These unrealistic ideologies often leave us feeling unfulfilled, with shattered dreams not come true. For men, social norms tell him that to be a true man he must have multiple sexual encounters, have the most attractive & sexy woman, to disregard her mind & focus on only her body, and that sex is the only appropriate way to emotionally connect with a female. As “toxic culture” is perpetuated, both men and women are affected by the social norms of which they are influenced. Women are socialized to believe that the only way to access the love and romance they desire is by becoming a sexual object; beautiful, fit, sexy, complying, and consenting to sex or touch without protest. Men, in contrast, are also socialized to believe that “scoring women” and “putting notches on their belt” define success as a man and hierarchy among their peers (Philpot, Brooks, Lusterman & Nutt, 1997). With the advent of social media, dating apps, and various other online avenues, these sex and love relationship behaviors are becoming socially acceptable throughout our culture. These social norms vary among different subgroups and societies around the world, and are influenced by the social institutions within those societies or communities.
Two theories of addiction that we will discuss now are the personality and disease models of addiction. The personality model reports that people who become addicted tend to have an “addictive personality.” These traits include being related to others who have developed addiction, experiencing other mental health disorders, adventurous and risk-taking, disconnected and cautious, obsessive and compulsive, apathetic and unable to self-regulate. As discussed earlier, if adverse early childhood experiences have such a positive association to addiction and the personality is being formed in early childhood, then there is a clear link leading back to trauma.
“Trauma is regarded as an event so intense that it is impossible for the subject to integrate this experience on a symbolic level and thus foster a pathological active formation of personality structure and affective forces” (Fuchshuber, Hiebler-Ragger, Kresse, Kapfhammer & Unterrainer, 2018). Research shows that the emergence of the addictive personality is reflective of childhood developmental disruptions and interconnected to caregivers with untreated mental, emotional, & attachment disarrangement, as well as their own unprocessed trauma history.
When looking at the disease model in regards to sex and love addiction we can focus on research conducted around the hormone Oxytocin (OT). OT is involved in the process of motherhood in which it is released during childbirth, breastfeeding, and during nurturing social interactions. Exposure to adverse childhood experiences (ACE) and early life trauma has been found to impact not only responses to OT administration, but also to behavioral outcomes (Sharm et al., 2020). Genotype carriers of OT receptor SNP rs53576 may be more severely impacted by insecure caregiver attachments resulting from early life trauma due to their increased receptivity to social cues (McQuaid et al., 2013, as cited in Sharm et al., 2020). Various other changes in allele expression have been studied that show a connection to what the disease model of addiction would consider brain changes that affect the disease process of addiction. In regards to sex and love addiction especially--attatchment, intimacy, and nurturance found through compulsive behaviors serve as a way to release OT which their bodies are deficient and to mediate the affect dysregulation that they experience. The changes present in this psycho-biochemical process align with the disease model of addiction and may have important future implications for various treatment modalities.
As we can see, trauma has a strong association to addiction in which it affects both personality development and brain chemistry. Understanding that the strongest links to addiction are from adverse childhood experiences, we can shift our perspective from the low life addict to the innocent child. It is my hope that our society can move towards a rehabilitative model in dealing with various illegal activities and addictions. Incorporating harm reduction, rehabilitative law enforcement and peer based recovery models.
Peer based recovery can be defined as the process of giving and receiving nonprofessional, nonclinical assistance from individuals with similar conditions or circumstances to achieve long-term recovery from psychiatric, alcohol, and/or other drug-related problems (Tracy & Wallace, 2016). Peer based recovery for sex and love addiction include groups such as Sex & Love Addicts Anonymous, Sex Addicts Anonymous, Co-dependence Anonymous, Love Addicts Anonymous, Sexaholics Anonymous, Sexual Complusive Anonymous, Sexual Recovery Anonymous, SMART recovery for Sex Addiction, in-patient rehabilitation groups for co-dependency or sex & love addiction, Celebrate Recovery, and more. In these groups, peers support one another through sharing their experience, sharing recovery tools, being there for emotional support, keeping each other accountable, helping each other through the steps, understanding the particular addiction, sponsoring, being recovery partners, and giving each other the feeling of not being alone in their addiction.
The neuroscience behind peer based approaches are linked to the neurotransmitters that regulate both normal and abnormal brain functioning, as well as addiction neurocircuitry. Oxytocin is particularly important in sex and love addiction due to its connection with bonding & socialization. It facilitates bonding and connecting to “the object of our desire” (Hilton, 2016), which fuels the neurobiology behind sex and love addiction. It has been found that oxytocin is released during male arousal, erection, and ejaculation, as well as in uterine contractions during both orgasm and childbirth (Hilton, 2016). Oxytocin is an important neurotransmitter involved in motherhood including its activity in birth, breastfeeding and bonding. Attachment disorganization, a factor that has been linked to sex and love addiction, has an associated link with oxytocin disruptions during early life. It was found that adults “who were exposed to any form of childhood maltreatment had lower oxytocin levels in the cerebrospinal fluid compared to controls (Heim et al., 2009, as cited in Olff et al., 2013). This points to clear evidence as to why seeking human connection through love & sex has served as a way to self medicate.
In peer based recovery models, we can see the same positive neurobiological effects of human connection. The increase in connection and support that is found within these groups can be a powerful modulator in appropriate releases of oxytocin and other neurotransmitters. A recent research study shows that oxytocin stimulates dopamine release during social interactions (Smith, 2017). The social support found in peer based recovery groups must then assist in the release of oxytocin and dopamine, therefore providing modulation for stress, fear, anxiety, depression, and withdrawal. Oxytocin has been advertised as a universal ‘‘love hormone’’ as the remedy against loneliness, fears, and intimate relationship & sexual problems (Olff et al., 2013).
Peer based recovery models assist in paving the way for new neuropathways to be created by working on abstinence, impulse control, connection to a higher power, learning new ways of thinking, changing perspectives and beliefs, processing traumas and resentments, coping with fear, having guidance from peers, and helping others to recover from the same addictions. “Psychosocial interventions for both behavioral addictions and substance use disorders often rely on a relapse prevention model that encourages abstinence by identifying patterns of abuse, avoiding or coping with high risk situations, and making lifestyle changes that reinforce healthier behaviors” (Grant, Potenza, Weinstein & Gorelick, 2010). However, there are limitations to peer support groups because they cannot replace the need for formal treatments or supervisory clinical guidance due to peers not having sufficient training to manage psychiatric conditions or high-risk situations, they still offer an augmentation to treatment that provides many benefits to individuals with addictions (Tracy & Wallace, 2016).
Harm reduction is an approach that decreases risks for people who are not at the point in their journey to be in complete abstinence. Recovery is a process and many times it is a process that deals with severe trauma, emotional pain, and unconscious patterns. The process is like peeling back layers of a spiritual, mental, & emotional onion. It is a process that has stages, downward trajectories, turning points and sometimes during this journey the pain is too much for people to stop the behavior at that time. This is where harm reduction approaches can assist in decreasing the risk of even darker trajectories and increase the chances of life, recovery, and service.
Harm reduction in sex and love addiction aims at reducing the risks to the individual by increasing condom use, contraceptives, and educating on sexually transmitted diseases. For love addiction, harm reduction may look like having laws to protect against domestic violence (which is not a right granted in every country), battered women’s shelters, legal assistance for victims of abuse, protective orders, and no contact orders. Harm reduction techniques for love addiction may also look like education on what mental, verbal & emotional abuse looks like and recognizing red flags or abuse tactics. Understanding the cycles of abuse, creating safety plans, and understanding what healthy relationships are, would all be considered harm reduction strategies.
Harm reduction assists in decreasing neurological damage by decreasing the risk of trauma produced by the addiction. Mental and emotional abuse, contraction of disease, unexpected pregnancies, abortion, and unplanned parenthood are all factors that can increase mental, emotional and social stress for individuals and the people affected by the addiction. Reducing the potential for more traumatic events is a primary tool of harm reduction. “One of the most prominent adverse neuropsychiatric consequences of traumatic exposure is post traumatic stress disorder (PTSD), a persistent and severely distressing neuropsychiatric disorder characterized by several symptoms” (Burton, Feeny, Connell & Zoellner, 2018; Sherin & Nemeroff, 2011, as cited in Sharma et al., 2020). PTSD changes the brain chemistry and can further perpetuate addiction in the individual and those surrounding them. Harm reduction reduces the potential for children to be born to parents with untreated PTSD, who are emotionally and financially incapable of raising them. It reduces the impact on society, on the family members or foster families who must care for the children, actual or potential. It can reduce the risk of children being raised in abusive homes and continuing the devastating effects of unprocessed trauma.
Traditional approaches to treatment include in-patient/outpatient rehabilitation centers, peer based recovery groups such as the 12 steps, SMART recovery groups and religious recovery groups. There is limited research into the effectiveness of these methods, however, the research that is available shows a mild to moderate success rate. The mild rates of success in abstinence based recovery programs point to the continued need for harm reduction and alternative treatment methods. Contemporary treatment approaches such as various types of psycho, behavioral or family therapy; yoga & meditation, diet & exercise, and alternative healing modalities such as reiki & hypnotherapy provide additional rehabilitation pathways for diverse populations that are not responding to traditional approaches. In any case, a combination of the different approaches has the greatest chance of success with diverse populations. Addictions professionals are ethically required to serve diverse populations to the best of their ability and continue in education or research as needed to serve. Exposure to various types of treatment and resources, as well as advocacy for clients to continue in recovery and harm reduction despite abstinence, will broaden the potential for the healing of the individual, the family, children and society.
Research on sex and love addiction treatment reveals the complexity of this particular behavioral addiction. “Sex and love addicts present with multiple addictions, strong psychological defenses, and trauma histories, which often result in lengthy treatments” (Griffin-Shelly, 2009). Sex and love addicts typically have poor boundaries in which they may either attach or sexualize professionals or other clients. Poor boundaries manifest in various ways in sex and love addiction and this will be a major area of focus and caution in treatment. Boundary issues may present with clients or therapists becoming enmeshed as people with sex and love addiction may give compliments and advancement cues.
Countertransference and reenactment of the client’s trauma in the therapeutic relationship is, of course, quite possible if not inevitable due to their trauma histories (Griffin-Shelley, 2009). Attraction and any negative feelings the therapist has towards his or her client, need to be monitored and managed appropriately which may be particularly susceptible to manipulation with this population (Griffin-Shelley, 2009). Therapists need to be aware of their motives and any outstanding family of origin issues that may become triggered during treatment. Therapists also need to be cautious of clients taking their feedback and seeing it as abusive.
Ethics is a strong consideration for professionals working with sex and love addicts, as well as anyone with severe trauma. Ethics should always be considered when working with every client, however, due to the likelihood that sex and love addicts have severe trauma, extra care must be taken. One “therapist found himself in the situation where a female sex and love client indicated that she desired a sexual relationship with him. Since she was an incest victim, he realized the closeness of the therapy interaction triggered her abuse history in a way that she did not realize” (Griffin-Shelley, 2009). This is only one example of the potential ethical challenges that professionals may face when working with this population. The NAACAD code of ethics states that professional boundaries are of utmost importance during challenging situations. Supervision, documentation, and guidance is recommended from an experienced colleague. Another potential risk involved in working with sex and love addicts is the potential for them to seek out dual relationships. This does not have to be sexual. Even platonic relationships can cross boundaries quickly as sex and love addicts attach easily, may try to call the therapist beyond reasonable parameters or even become obsessive in their attempts to be around them. This is something that therapists should be aware of and will require strong, firm rules to follow with these clients.
As we can see, recovery from sex and love addiction is a multilayered process that often deals with cross addictions, trauma history, and attachment disorders. Harm reduction techniques can be a great way to introduce awareness and pave a way forward into recovery. When the individual is ready, peer based recovery approaches can provide on-going support for people with sex and love addictions. Multimodal approaches including peer based recovery, harm reduction, traditional and alternative treatment methods will continue to benefit clients in or out of their addictions. We may ask ourselves again--if people within our society had a better understanding of the trauma that underlies addiction would they be more apt to show compassion and care for this segment of our society and move towards a rehabilitative model for all addictions? It is the hope of many psychology and other progressive professionals that rehabilitation models to addiction will be in our world’s future.
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