Written in the Scars: Sex Addiction as an Attachment Disorder

John Beveridge (UKCP, ATSAC) discusses how disrupted attachment impacts core beliefs and sexual behaviours associated with sexual addiction, and how this manifests in the therapeutic realm.  

Having trained in attachment theory, when I assess sex addicts coming into therapy, I look for experiences of early relational trauma, abuse, and abandonment.

‘Attachment Theory is in essence a spatial theory: when I am close to my loved one I feel good, when I am away I am anxious sad or lonely’ (Holmes 1993: 67). There is a biological imperative for animals to stay attached to the herd, and so it is for humans. Mitchell and Black (1995) write that John Bowlby recognised that babies come pre-programmed with attachment behaviours including: sucking, smiling, clinging, crying, and following.  These are designed to elicit an emotional response so that caregivers form relationships with us, upon which our survival depends.

If parents do not attach, unattended children are naturally at risk of accident or predation, and, since this knowledge is wired into us, fear of abandonment persists across the lifespan. We do not like to think of the emotional damage that might result from different kinds of abuse and parental neglect, ranging from the abandonments of emotional absence, to the gross impingements of physical and sexual abuse. Ronald Fairbairn, a contemporary of Bowlby, recognised that children who are abused need to cling to the belief that their parents are good people.  In order to preserve this illusion, they must develop a ‘moral defence’, which Greenberg and Mitchell, describe thusly, ‘The child separates and internalises the bad aspects of the parents – it is not they who are bad, it is he. The badness is inside him; if he were different, their love would be forthcoming’. (Greenberg & Mitchell 1983: 170).

This raises an important question for our work, namely why are unpleasant experiences, early conflicts, not dropped and forgotten, but instead become restructured systematically throughout life? Mitchell and Black write that: ‘The child bonds to the parents through whatever forms of contact the parents provide, and those forms become lifelong patterns of attachment and connection to others’ (Mitchell & Black 1995: 115).

Relational bonds can be broken through disaster, accident or misfortune, such as; parental death, adoption, separations through hospitalization, operations, and illness, or children being born prematurely. When these events occur at a pre-verbal age, it can make later historical description of distress in therapy impossible because it is inconceivable in language and may only be retained as body memories. The most sacred bonds of trust are always broken when children are sexually abused. In families where there are powerful sexual secrets caused by incest, or illegitimacy, or the raising of a sibling’s child by the parents as their own, or adults having affairs and secret addictions to porn, then atmospheres are created where nothing is really as it seems.

Core beliefs are formed in infancy which affect how people see themselves and how they believe they are going to be responded to in relationships. For addicts, the knowledge of their separation anxiety and the risk of losing their original caregivers has to remain out of awareness, so distractions have had to be intense and dramatic. In a sex addict’s early life, engaging in sexual activities, which bring escape, intensity, numbing, and distraction, might seem like a creative solution to emotional problems, but the relief it provides only approximates to the advantages of being held in a secure attachment. To avoid feeling vulnerable, which is inevitable in relationship, many sex addicts retreat from intimate involvement with family or friends who they see as impediments to their secret lives. Sexually addicted people are attracted to all-or-nothing thinking and the excitement of high-risk behaviour. I keep telling my patients, “Exciting does not always mean pleasant”.

Sexual acting out is often used by people who feel shame around having any emotional needs. Addicts survive in the present, by literally, ‘making a drama out of a crisis’. They can then be in a state of powerlessness over their addictive behaviour, believing that they have only themselves to blame, particularly when damaging and self-defeating consequences become apparent. This seems baffling, masochistic, and perverse, even to those engaging in it. The wells of self-hatred, fear, and self-loathing run deep. Sometimes therapy becomes necessary when the client may have an experience with loss, or they encounter an external crisis, which provides an emotional ‘live link’ to the place in their relational history where they felt most helpless and vulnerable. This can be caused by; the threat of separation, or divorce, or illegal activity, or public disgrace, and, in some cases, all of the above.

As animals, we are conditioned to react to threat by fighting, fleeing, or pretending to be dead. In recovery we are dealing with the depressive effects of low self-esteem, which has deepened in the addictive vortex of trying to recover alone and failing to make progress.

It has to be recognized that, under threat, just thinking about sex produces dopamine which has an immediate sensory payoff. Because acting out to regulate unwanted feelings has become a ‘default setting’, recovering addicts will experience stress when they are expected to be intimate, open and honest. There has to be a desire to relinquish intensity and excitement, which is a big ask in an instant culture where waiting, being still and holding on to feelings which offer no ‘quick return’ is actively discouraged. Psychodynamic support is needed to find the dysfunctional relational dynamics which continue to trigger anxiety when the addictive payoffs no longer work.

People feel at the mercy of their emotions if, when growing up, their feelings were not explained to them. Now, in therapy, the addict might revisit their traumatic relational past which, as an infant, they had to survive alone. The field of addiction therapy is largely populated by therapists who are recovering addicts themselves and I believe that we cannot take people to, or be with them in, places we have not been willing to visit ourselves. If a therapist has not encountered this experience then, triggered by the client’s emotional vulnerability, they might behave in the same way that the original caregivers did, who abandoned or abused the child. Therapists can be drawn into present day problem-solving, feeling under pressure to help the client escape their terrifying feelings and they might try to hurry the patient through this process.

IMG_4857  John is an attachment based Psychoanalytic psychotherapist working in North and Central London in private practice. Trained at the Bowlby Centre London and in Supervision at SAP (Society of analytical psychology) John has also trained at The Institute for Group Analysis (IGA) He has studied PIT Trauma Reduction and Sex Addiction at the Meadows Arizona, trained in sex addiction with Paula Hall and with Thaddeus Birchard.  He teaches therapists in training at and runs groups for sexually compulsive men at Dr Thaddeus Birchard & Associates.  John enjoys spreading understanding about Sex addiction through writing and public speaking. He is the author of ‘The Exclusion Zone’ chapter to The Therapeutic Frame in the Clinical Context.  (2003, Maria Luca Ed.), and ‘The Tangled Web’ in  Love in the Age of the Internet. Attachment in the Digital Era. (L. Cundy, Ed.) re-edited for The Politcal Self: Understanding the Social Context for Mental IIlness. 2017 (R. Tweedy, Ed.)  John can be contacted via the ATSAC website, via telephone (+44 (0)7979 862 765) and via email john50beveridge@gmail.com