Sex Addiction And The Dissociated Self [PORTABLE]

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Linda Hatch is a psychologist and certified sex addiction therapist specializing in the treatment of people with sex addiction and their partners and families. Linda also blogs on her own website at sexaddictionscounseling.com

Sex addicts often seem to have two distinct personalities. Often they will report to me that they experience themselves that way. One personality is thoughtful, loving and responsible while the other is self centered, impulsive and primitive.

If you make a cursory search of the Dr. Jekyll and Hyde idea along side that of sex addiction you will find a myriad of popular and scholarly references dealing with this parallel and arguing about whether the original Jekyll and Hyde story was in fact depicting a person in the grip of addiction.

I believe that all of these processes which underlie the addicts appearance of multiplicity have as their basis the addicts fundamental disconnection from self and others. There are a number of ways in which this plays out in practice.

Sex addiction has been described as a disease of extremes. Pia Mellody (2003) gives an excellent account of the dysfunctional family issues that give rise to this tendency to think and react in extremes. She believes that in some families, the child either experienced caregivers who had difficulty seeing and expressing things moderately, or they had caregivers who left them with the feeling of not being heard, of being invisible.

Addicts often see themselves as all good or all bad. They experience their good self and their bad self as totally disconnected when in fact they are both part of the same person. When something goes wrong in an addicts life it becomes an emergency. When they have a slip, all is lost. In treatment sex addicts begin to see the possibility of both feeling integrated and acting with integrity.

Then too, a dissociative state, zoning out, comes easily to sex addicts because many of them used dissociation as children to escape painful experiences. So the habit of dissociation, being outside of oneself, is a skill the addict may employ to detach from any stressful situation. But all of this does not imply dissociative identity disorder or multiplicity.

The cycle of sexual addiction typically intensifies with each repetition, requiring more of the same sexual fantasies and behaviors or more intense sexual fantasies and behaviors to reach or maintain the same neurochemical high. This transforms the cycle from a repetitive loop into a downward spiral, leading to relationship, work, health, financial, legal, and other crises. And all these crises can qualify as triggers, setting the cycle in motion yet again.

Restored Hope Counseling Services is a Christian mental health counseling center providing therapy to individuals, couples, and families who are walking through emotional or difficult life experiences. We serve the Novi area of Michigan, including such cities as Northville, Plymouth, Canton, Livonia, Farmington, Farmington Hills, South Lyon, and Royal Oak. We focus on marital/couples therapy, sex addiction recovery, trauma and abuse recovery, infidelity, family therapy, group therapy, anxiety, and depression.

This type of behavior is not unlikely to result in genital injury due to the amount of time and energy devoted to masturbation. While usually the injury and pain is not sought for pleasure, the binge compulsive masturbator will not use physical damage as a guide toward stopping or self-care. Instead, they will likely continue their sexual activity, even hurting themselves further and bringing about more shame.

Of particular interest in examining this form of self-harm behavior is to look at the associated neuropathways. The arousal neuropathway is about pleasure and intensity. One of the most common methods of stimulating arousal pathways are high-risk sex, which masturbating to the point of injury would be included in. The numbing neuropathway produces a calming, relaxing, soothing, or sedative process. Masturbation creates an analgesic experience in the brain.

Treatment and recovery for the compulsive masturbator can also be a varied and complex issue. Most commonly, the first suggestion after therapeutic engagement is a celibacy contract, which involves a prescribed period of no sexual activity with self or others, any pornography, chat rooms, affairs, etc. The primary goal of the celibacy period is to allow the fear, anxiety, pain, and shame that the client has been endeavoring to escape from the opportunity to surface. It is in this place of affective awareness that the client can often for the first time begin to glimpse the myriad of issues they have sought escape from and the ritualized fantasy they have often engaged in.

During this celibacy period, the clinician has the opportunity to obtain a detailed sexual history, a detailed family of origin history, and begin the sacred process of understanding how the client became socialized around their sexually compulsive behaviors as well as the process of self-harm as an escape mechanism.

We critically review the concepts of sexual addiction, sexual compulsivity, and sexual impulsivity and discuss their theoretical bases. A sample of 31 self-defined sex addicts were assessed by means of interview and questionnaires and compared with a large age-matched control group. A tendency to experience increased sexual interest in states of depression or anxiety was strongly characteristic of the sex addict group. Dissociative experiences were described by 45% of sex addicts and may have some explanatory relevance. Obsessive-compulsive mechanisms may be relevant in some cases, and the addiction concept may prove to be relevant with further research. Overall, results suggested that out of control sexual behavior results from a variety of mechanisms. We propose an alternative theoretical approach to investigating these mechanisms based on the dual control model and recent research on the relation between mood and sexuality.

REVIEW OF CNS, ANS AND HPA AXIS DEVELOPMENTA brief review of the developing central nervous system (CNS), autonomic nervous system (ANS), and hypothalamic-pituitary-adrenal system (HPA axis) elucidates precisely how affective disturbance causes neurobiological deficits in infancy, how these deficits undermine both emotional and intellectual growth, and how such damage may manifest as sexual addiction.

The centrality of secure attachment to the eventual development of the self stems from its interrelationship with the sensation of anxiety. If the caregiver is chronically anxious or is depressed enough to be emotionally unavailable, the infant will experience danger. Thus fear flourishes where attachment is weak, leaving the infant in a state of hyperarousal with high levels of cortisol, an increased heart rate, an activated sympathetic system mobilized into the fight-or-flight mode, and dissociated rage and panic. In the 1950s, Ainsworth and Bowlby (1991) studied infant attachment patterns in what came to be called the Ainsworth or Infant Strange Situation Procedure. Three distinct attachment styles were identified by this study, with a fourth named in 1986 by Main and Solomon: the secure attachment style, the anxious-avoidant, the anxious-ambivalent, and the anxious-disorganized (Main & Solomon, 1990).

Patients with a dismissing attachment style often lack awareness of their emotional states. Usually from emotionally distant or rejecting families, such individuals most likely have developed prefrontal cortical pathways that over-regulate the limbic brain input, restricting both affect and activity. In addition, these patients are deficient in insight, which travels affect-mediated neuronal pathways of the right hemisphere to link previously unrelated ideas and to allow self-monitoring.

Ambivalently attached individuals are similarly incoherent reporters about themselves, but demonstrate more explicitly the anxiety, anger and fear marking their personalities. In contrast to dismissing patients, individuals displaying a preoccupied manner of attachment have developed cortical pathways that generally under-regulate both affect and actions, and this under-regulation allows their verbal and behavioral responses to bypass the controlling neocortex and short-circuit any judgment about what they say and do. Typically, their caregivers were unpredictable, leaving them feeling constantly out of control, tense, and at the mercy of their own immediate impulses. Again unlike the laconic dismissing patient, the preoccupied individual may overwhelm the therapist with emotional material. The speaker remains caught up in past attachment experiences, and is irrelevantly verbose, especially when recounting childhood material. He maintains connection through negative affect, which may present as complaints, criticism, and rage. These individuals have very little capacity for self-soothing or becoming vulnerable with others, but tend to stay in relationships via their anger.

Dissociation can be described as feeling disconnected from the self, the world, or reality. Someone experiencing dissociation may not remember what happens during the episode. They might also feel as if they are observing themselves from an outside perspective.

DID can cause distress and emotional strain. People with DID also have an increased risk for self-harm and suicidal thoughts. They may feel powerless to maintain their identity, afraid of what their alter states might do while in control, and frustrated with their inability to remember events. 2b1af7f3a8