Sex Addiction-Induced Trauma Model

http://theinstituteforsexualhealth.com/about-us/sai-trauma-model/

Sex Addiction-Induced Trauma is a psychological term to describe the clinically significant post-trauma symptoms caused by the direct impact of sex addiction on self and others (Minwalla, O., 2011 ; Minwalla, O., 2012 ; Jason, S. and Minwalla, O., 2008; Steffens, B. and Means, M., 2009).  Sex addiction-induced trauma describes both the traumatic impacts and the traumatic symptoms that result from the direct impact of the sex addiction and it’s associated chronic patterns of sexual acting out, relational perpetration, emotional and covert abuse, psychological manipulation and torture, and the reality of a deceptive compartmentalization.  The clinical complexities and the degree and extent of psychological destabilization, ego fragmentation, relational and social ruptures, and post-traumatic stress symptomology are often profound among partners impacted by sex addiction patterns (Minwalla, O., 2012).

Sex addiction-induced trauma is particularly acute around discoveries (finding out about sexual acting out, deception and relational violations), disclosures (being told about sexual acting out, deception and relational violations) and around the continued traumatic incidents that result from the presence of sexual addiction in an intimate relationship and family system.  Partners often present with a set of symptoms related to post-traumatic-stress disorder (PTSD), complex post-traumatic-stress disorder (C-PTSD) and rape trauma syndrome (RTS), including psycho-biological alterations, re-experiencing of the trauma, social and emotional constriction, constant triggering and reactivity, significant anxiety, emotional arousal and labiality, hyper-vigilance, dissociative symptoms, and sexual trauma symptoms similar to sexual rape (Minwalla, O., 2006 ; Minwalla, O., 2012)

A critical injury of SAIT is foundational reality-ego fragmentation that impacts ego functionality, the ego’s ability to perceive and adapt, thus compromising foundational psychological stability.  Furthermore, there are often intense relational ruptures and destabilizing attachment injuries, which impact core dynamics of human dependencies, security and basic human reliance (Minwalla, O., 2011).

Sex addiction-induced trauma is a highly specific type of trauma that involves nuanced symptoms that can sometimes include fear and panic of potential sexual disease and contamination, social repercussions, fear of child safety, terror and panic about the potential of child molestation, severe gender wounding, social isolation, social misrepresentation, financial loss and domestic embezzlement, collusion in violation, embarrassment, complex humiliation and profound shame (Minwalla, O., 2012).

Due to the normative societal psychology of gender-based violence, the sex addiction field remains dominated by the “co-sex addiction model” and is yet to even term a specific name for sex addiction-induced trauma, or even recognize or legitimize it’s existence.

Persons impacted by this type of trauma deserve clinical treatment and the lack of provision is a form of gender-based violence and a violation of human rights.  Despite cultural, institutional and professional confusion, resistance, and denial, SAIT symptoms are actually natural and expected human responses to profound impacts and are normal human reactions rooted in human survival and biology.

“Naming the syndrome of complex post-traumatic stress disorder, represents an essential step toward granting those who have endured prolonged exploitation, a measure of the recognition they deserve.  It is an attempt to find a language that is at once faithful to the traditions of accurate psychological observation and to the moral demands of traumatized people.”  (Herman, J., 1997, p. 122)

https://mindingmatters.com/725/

Partner and Family Trauma as a consequence of Sexual Addiction/Compulsion

This article is an excellent summary of Dr. Omar Minwalla’s SAIT (sex addition induced trauma) model which critically challenges the current treatment approach for individuals and their impacted partners and families. Sex addiction induced perpetration has multiple levels of impact , often seen in a constellation of symptoms manifested as complex PTSD. For more information on Dr. Omar Minwalla please visit his website at the link below:

http://theinstituteforsexualhealth.com

Sex Addiction-Induced Perpetration (SAIP) goes Undiagnosed and Untreated.

Sex addiction-compulsivity disorders include dynamics of perpetration, violation and abuse, which go undiagnosed and untreated in existing treatment models.

– Dr. Omar Minwalla, The Institute for Sexual Health (ISH); 2014

The focus of traditional sex addiction-compulsivity treatment models tends to be on diagnosing and stopping specific sexual behaviors, referred to as, sexual sobriety (Carnes, P., 2001; Coleman, E., 1990; Coleman, E., 2011).  From a clinical treatment perspective, it is correct and necessary to implement behavioral containment and stop destructive or problematic behaviors.  However, this is where most treatment ends, rather then also treating the other patterns of abuse of human beings and violations of human rights, termed “sex addiction-induced perpetrations” (SAIP) (Minwalla, O., 2011; Minwalla, O., 2012).

The problem is sexual acting out disorders are not just sexual behaviors (Minwalla, O., 2012), but are also abusive conduct patterns and complex pathologic systems, which often include elaborate deceptive compartmentalized sexual-relational realities and systems of abusive covert management (Jason, S., 2008; Minwalla, O., 2011; Minwalla, O., 2012).  These are patterns of methodical planning over time, careful construction of manipulation of others and cognitive schemas well maintained in order to keep a compartmentalized reality protected from discovery (Jason, S., 2008).  It takes pre-planning to sexually-act out in many instances, sometimes requiring days of strategizing against the integrity of vital relational stability and family infrastructure required for health.  In fact, maintaining a compartmentalized sexual or relational reality within a family system and relational intimate life takes profound energy to orchestrate and maintain, requiring careful and skilled methodology.  This is not simply impulsive or compulsive sexual behavior.

A disorder of chronic lying in a family system is pathology and requires treatment, regardless of sexual acting out or not. Chronic patterns of establishing and maintaining a deceptive, compartmentalized sexual-relational system in an intimate relationship or family system, is pathology and harmful, which is more accurate in description then simply “compulsive pornography use”.  The process of gaslighting an intimate partner (Jason, S., 2008), the process of intentional psychological manipulation of victim’s reality (Jason, S., 2008) or any human being over time is a form of emotional and psychological abuse and torture, eroding and damaging the victim’s survival instincts and intuition (Minwalla, O., 2011), regardless of sexual behaviors (Jason, S., 2008).  Clearly, there exist many symptoms of pathology, beyond the single symptom of “lack of control of specific sexual behaviors” or “compulsivity”.

Sexual sobriety alone is an inadequate treatment model (Minwalla, O., 2011).  Sex addiction-induced perpetration (SAIP) is clinical pathology (Minwalla, O., 2012).  However, within traditional treatment models (Carnes, P., 2001; Coleman, E., 1990), there exists no established diagnostic or clinical formulation for sex addiction-induced perpetration (SAIP) and no treatment, methodology or clinical paradigm that accounts for and treats sex addiction-induced perpetration (SAIP).  This is a serious omission in the field and in clinical practice (Minwalla, O., 2012). The reality here is that the preoccupation with diagnosing and treating these complex pathologies as simply “compulsive or impulse control disorders” (Carnes, P., 2001; Coleman, E., 1990), and focusing on treating sexual behaviors, while avoiding and omitting the proper diagnosis of abuse and covert violence, leaves dynamics of serious pathology untreated (Minwalla, O., 2011; Minwalla, O., 2012).

This also means that the people harmed, the victims of these dynamics of abuse, are rendered invisible (Minwalla, O., 2012; Herman, J., 1997).  Their trauma and experiences are not being accounted for in clinical treatment models and their suffering is being dishonored by the complete omission, silence and denial that pervade in existing treatment models.  They are dishonored by the professional practice of being satisfied with simple behavioral control over specific sexual patterns (sexual sobriety) as the primary objective of treatment.

Victims need recognition of the patterns of harm and abuse they experience and have endured, which goes way beyond the Pollyanna descriptions of “hurt and betrayal” caused by specific sexual acting out behaviors.  Furthermore, female victims are violated further by being labeled “co-sex addicts” (Carnes, P., 1991) routinely by professionals and “educated that they have a disease of self-perpetration”, rather then being afforded therapeutic intervention for abuse and assessment and treatment for consequent acute and complex trauma (C-PTSD) (Steffens, B., and Means, M., 2009; Jason, S., and Minwalla, O., 2008; Minwalla, O., 2011).

The Sex Addiction-Induced Trauma Model (SAITM) (Minwalla, O., 2011) accounts for the clinical management and treatment of both sexual behaviors and sexual compulsivity-induced perpetrations (SAIP) (Minwalla, O., 2011).  According to the model, sex addiction-compulsivity disorders are defined as, “a complex system of sexual, personality, and masculinity pathology, which may include the maintenance of a deceptive, compartmentalized sexual-relational reality, sexual-relational acting out behaviors, and other patterns of perpetration, abuse and violation that causes serious PTSD and C-PTSD (SAIT) in victims, all which requires a clinical management and treatment paradigm (SAITM)” (Minwalla, O., 2011).

The model proposes clinical management that includes assessing and diagnosing sex addiction-induced perpetrations and providing appropriate safety, stabilization, and clinical de-escalation for victims.  Clinical management would also provide methodological treatment for perpetration-focused management, clinical resolution, and psychological integration.  Clinical treatment would also include relational, family and social considerations, as indicated, in a perpetration-victimization and post-traumatic clinical context and conscious framework (Minwalla, O., 2011; Minwalla, O., 2012).

The American Psychological Association’s (APA) Intimate Partner Abuse and Relationship Violence Working Group (APA, 2002c) concluded,

“We suggest that those involved in partner violence have specialized treatment needs and that those who treat them must do so with sensitivity and from a base of knowledge that comes from specialized training.  Psychologists who do not have the requisite training potentially endanger their clients, and likely commit an ethical violation.  Those who are teaching psychologists-to-be but who do not teach them about partner violence are abrogating their responsibility and risk perpetrating the conditions which foster this problem” (American Psychological Association, 2007).

Perpetration requires treatment and appropriate clinical intervention, not defensive denial, silence and professional avoidance.   Clinical pathology that contributes to serious harm and violation of others and human rights requires an organized clinical methodology and direct clinical management, not undefined, underdeveloped or squeamish clinical approaches.  After all and in fact, it is often these dynamics of sex addiction-induced perpetrations (SAIP) that often “induced trauma” and does more human damage, and accrues more human cost, then sexual acting out behaviors alone ever possibly could.

Partners of Sex Addicts Need Treatment for Trauma

Partners actually often experience clinically significant sex addiction-induced trauma (SAI-Trauma)

By Omar Minwalla, Psy.D. 

Originally published July 23, 2012

The National Pyschologist

The field of clinical treatment and therapeutic intervention for the spectrum of disorders related to compulsive sexual behavior and sex addiction is still a newly emerging field, yet to even gain legitimacy within the larger psychological community.

Research, professional debate and clinical development have been predominantly focused on the nature of sex addiction, how to describe and classify it diagnostically and how to best treat the addict. In the context of such advancements, there has concurrently been a profound neglect of partners and spouses of sex addicts.

Traditional treatment models for sex addiction have systematically excluded partners. Current clinical models that actually do address the partner or spouse of sex addicts have developed and are fundamentally organized around the single-concept and diagnosis of co-addiction or codependency, which basically understands the partner as having her own disease termed co-addiction or co-dependence.

The concept of co-dependence comes directly out of Alcoholics Anonymous and was adopted by the sex addiction field and applied to partners and spouses. Codependency is defined as a process addiction — an addiction to certain mood-altering behaviors, such as a tendency to behave in overly passive or excessively care-taking ways that negatively impact one’s relationships and quality of life.

While the sex addiction field and its practitioners wander between either no substantial model or the co-addiction model for understanding and treating partners, the reality of what partners experience and their actual clinical needs continue to be minimized, obscured and gravely misunderstood.

Partners actually often experience clinically significant sex addiction-induced trauma (SAI-Trauma), which is the specific type of trauma and traumatic symptom clusters that result from the direct impact of the sex addiction and the associated chronic patterns of sexual acting out, relational perpetration, emotional abuse, deception, betrayal, psychological manipulation and compartmentalization. The clinical complexities and the degree and extent of psychological destabilization, ego fragmentation, relational and social ruptures and post-traumatic symptoms seen among partners are profound.

Sex addiction-induced trauma is particularly acute around discoveries (finding out about sexual acting out, deception and relational violations), disclosures (being told about sexual acting out, deception and relational violations) and around the continued traumatic incidents that result from the presence of sexual addiction in an intimate relationship and family system.

Partners often present with a set of symptoms that match symptoms similar to rape trauma syndrome (RTS) and complex post-traumatic-stress disorder (C-PTSD), including psycho-biological alterations, re-experiencing of the trauma, social and emotional constriction, constant triggering and reactivity, significant anxiety, emotional arousal and hyper-vigilance. Sex addiction-induced trauma is a highly specific type of trauma that involves nuanced symptoms that can include fear and panic of potential disease and contamination, fear of child safety and potential of child molestation, social isolation, embarrassment and shame and intense relational rupture and attachment injuries.

What most people outside the field do not know is that despite the significant symptoms of trauma that partners experience, the traditional sex addiction field to this day still ignores these trauma-related symptoms and focuses instead on diagnosing partners as “co-addicts” and emphasizing treatment of codependency. It is common for trauma to never be mentioned. In fact, often a partner is “educated” that her responses and symptoms are actual “symptoms of co-addiction” that need treatment and management.

In fact, few practitioners in the sex addiction field even know the term “sex addiction-induced trauma.” The field, entrenched in outdated patriarchal constructs and a narcissistic framework, is largely still unresponsive to the clinical needs of this population. The alarming discrepancy between the help that partners of sex addicts desperately need and the professional therapeutic care that exists is a serious health crisis in the field of sex addiction and the psychological field in general.

Existing models for treating partners of sex addicts that are based solely on co-addiction and codependency are inadequate, clinically contra-indicated and wrought with ethical and moral challenges. Partners and spouses of sex addicts are a profoundly and clinically traumatized population who are disenfranchised from adequate, informed care and ethical treatment.

There are many, many partners and spouses who continue to be further harmed, confused, disoriented and re-traumatized by traditional co-addiction treatment interventions that focus on educating and helping partners with their “own disease” called co-addiction while ignoring the treatment of trauma and C-PTSD. In fact, the co-addiction model as it manifests in the treatment of partners and spouses of sex addicts, and applied most often to women, is a form of gender-based violence.

There is a serious need for professionals in the field to own the inherent responsibility to do no harm and to mobilize around efforts that advance the clinical treatment of partners. Particularly in the context of the Internet and the emergence of cyber-sexuality, there is an increasing need to understand partners impacted by sex addiction and compulsive sexual behavioral patterns.

Such efforts would include both theoretical and applied research, needs assessments on this population and an increase in rigorous intellectual and academic debate and discussion regarding the co-addiction model versus C-PTSD/SAI-T. Specific focus on clinical intervention is imperative and how to integrate sex addiction-induced trauma into the treatment of partners.

There is also a dire need for both professional and public education on the impact sexual acting out has, and is having, on the lives of women, children and men, particularly in the context of the cyber-sexual evolution we find ourselves. This is a call for compassionate and responsible action.