One of the hallmarks of both complex PTSD and borderline persona; disorder (BPD) is a feeling of constant anxiety, agitation and apprehensiveness, As a result of feeling trapped and imprisoned in this distressing state, individuals become desperate to escape it which frequently leads to behaviours that they later regret. Briere et al. (2009) stress the importance of addressing these behaviours, also referred to as TENSION REDUCTION ACTIVITIES when assessing complex trauma. One example of a dysfunctional tension reduction activity that may be resorted is compulsive sexual behavior.
I expand upon these behaviours and their relationship to borderline personality disorder and complex PTSD that has come about as a result of childhood trauma.
COMPULSIVE SEXUAL BEHAVIOUR/HYPERSEXUALITY/EROTOMANIA:
Hypersexuality also referred to as erotomania, or, more straightforwardly, sexual addiction, has been linked to traumatic experiences during the sufferer’s childhood. This does not imply, of course, that all those who suffer childhood trauma will go on to become hypersexual in adulthood, nor that there aren’t other causes (there are – such as some neurological conditions which it is unnecessary for me to go into here). Erotomania can be defined as a persistent and enduring, intensely powerful compulsion to indulge in sexual activity, whether that activity is solitary or with another/ others.
Although it affects females (in such cases, yet another term is sometimes used – ‘nymphomania’) it is more common amongst men. Clearly, it is no easy task to judge when a ‘normal’ sexual appetite escalates to such extremes that it is classified as erotomania; nevertheless, clinicians generally classify sexual addiction as being a pathological condition when it substantially interferes with day-to-day functioning, including friendships, relationships, work and lifestyle in general.
DISSOCIATION: Clinicians regard addiction to sex as a coping mechanism that allows the sufferer to ‘dissociate or, in other words, to mentally ‘escape’ from feelings of intense emotional distress (including clinical depression, severe anxiety and intense loneliness brought about by social isolation).
SYMPTOMS: Symptoms include – – frequent, anonymous sex – frequent use of prostitutes – obsession with online porn/sexually-oriented chatrooms/phone sex – view of others as mere sex-objects – obsessive masturbation (can be even as much as 10-20 times per day) and, at the more severe end of the scale, symptoms may include: – indecent public exposure – voyeurism – bestiality
ROLE OF CHILDHOOD TRAUMA IN THE DEVELOPMENT OF EROTOMANIA: Severe childhood trauma, as we have seen so often in other articles I’ve written for this site, often causes the adult who experienced it to develop conditions that give rise to deep-rooted psychological and emotional distress. Erotomania may then result as a defence mechanism (i.e. the need to dissociate as discussed briefly above). Not infrequently, drink and/or drugs may be used during sexual activity in order to intensify its dissociating effect.
RESPONSE TO DISTRESS:
Research by Gilliland (2015) found that individuals suffering from hypersexuality experience significant levels of stress and distress in connection with intrapersonal and interpersonal domains (the interpersonal domain refers to an individual’s ability to manage /regulate his/her emotions and set and accomplish goals (Hoyle and Davisson, 2011) whereas the interpersonal domain refers to how one manages one’s relationships with others.
Gilliland also points out the importance of this relationship (endorsed by similar studies) when it comes to considering how a person’s hypersexuality should be treated.
EFFECTS AND TREATMENT: Whilst the sexual activity associated with erotomania may bring temporary relief from emotional pain and suffering, this tends to be heavily outweighed by the negative effects of sexual addiction. The first port of call for the sufferer of erotomania is usually the GP (in the UK). However, because of the sensitive nature of the subject, some prefer to initially see an expert in sexual therapy.
As we saw above, one reason why those who have suffered childhood trauma may become addicted to sex is that the act of sex helps them to ‘blot out’, or make themselves feel ‘numb to’, or ‘dissociate’ from unbearable emotional pain connected to their early life experiences (for example, those who have suffered severe childhood trauma may go on to develop borderline personality disorder and a major symptom of this condition is a propensity to develop addictions – including sex addiction). Indeed, because most people who suffer from sex addiction are generally unwilling to discuss their problem with others, the fact that they are suffering from it only becomes apparent when they develop a trusting relationship with a therapist who they initially went to see for help with other addictions such as alcoholism or drug abuse.
Alternatively, they may have initially gone to see their therapist in order to seek treatment for depression, anxiety or low self-esteem (all of which are also more common in those with a history of childhood trauma). Currently, sexual addiction is regarded as being similar in nature to addiction to chemical substances because the act of sex seems to have a similar ‘numbing’ effect (see above) on feelings of mental anguish (however, it should be noted that, as a discrete condition, ‘sex addiction’ is not yet (at the time of writing) included in the Diagnostic And Statistical Manual Of Mental Disorders. Sexual addiction can manifest itself in a number of ways, including :
- Internet Pornography
- Compulsive use of prostitutes
In fact, sexual addiction is NOT the same as simply having a high sex drive (indeed, a high sex drive can be a sign of good psychological health) but involves a compulsive quality that brings about negative results (for the sufferer, those s/he comes into contact with or both). Sexual addiction can seriously, adversely impact upon the individual’s quality of life. For example, it may :
- cause financial problems
- result in the spreading of sexually transmitted diseases
- lead to legal problems
- impair relationships
Once a person suffering from sex addiction recognizes that s/he has a problem that is significantly spoiling his/her quality of life, seeking help from a therapist can be very helpful. Confiding in a trusted, accepting, empathetic therapist can help to reduce feelings of shame related to the addiction and the therapist can provide advice about how to avoid triggers and how to develop healthier and more functional coping mechanisms to deal with negative feelings. Therapies used to treat sex addiction include cognitive behavioural therapy and psychodynamic therapy (the latter may be more appropriate when the problem is clearly related to childhood issues).
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