PTSD

Twenty-three years ago if someone had told me that I would one day be writing about post-traumatic stress disorder in spouses of sex addicts, I would have wondered what planet they were from.   At the time, I was living my dream—homesteading in Vermont.  Our little piece of heaven had a farmhouse with a big front porch, complete with swing, where I sat sipping tea and watching the fireflies dance by night or in the morning, the sun rise over the hills that surrounded our pasture.
 
We had a huge barn with a cow and a horse in residence.  There were also  a dozen Rhode Island Red laying hens who busily popped out an egg a day while four dozen Cornish Cross chickens and five turkeys (who went by the names Thanksgiving, Christmas, Tom, Dick, and Harry) were living the good life with plenty of sun and room to amble about and a great diet of grains, grass, and all the bugs they could peck out in the pasture where they took their daily dirt baths while waiting to have their names changed to Dinner.
 
We also had a huge organic garden where I grew potatoes, corn, and a multitude of different kinds of squash, pumpkins, and beans as well as various varieties of lettuce and onions.  Many was the time when everything on our table was raised right there and that gave me a great deal of satisfaction and happiness.  My children, whom I was homeschooling at the time, were growing up into wonderful, smart, caring teenagers who were enjoying riding horses and three-wheelers and haying in the summer as well as skiing and riding snowmobiles in the winter and traipsing through the snowy woods in the early spring to tap maple trees and gather sap.
 
My marriage was about to enter a crisis from which it never recovered.  Through a series of events, I discovered that my husband was living a secret life of sexual addiction with very extensive acting out.  The son of career missionaries, Jack (not his real name) had grown up in Africa (Congo and Kenya) where his parents worked with the indigenous people.  When I met him, he was a member of the White House Honor Guard.  This meant he had a White House security clearance, which entailed an exhaustive background check, so I automatically assumed some things about his character and so did everyone who met him—he was a very personable guy.  My friends and family described him as a “super nice, squeaky clean guy”.

Secret life revealed
The revelation that there was another side to Jack came just after our 19th anniversary.  I would later learn that the length of the marriage before disclosure is one of the key factors in onset of PTSD in spouses. (Steffens & Rennie, 2006)  because you suddenly realize you have been living in a lie and you wonder “Who ARE you?” about the person you’ve been waking up next to for years and years.
 
To be clear, I did know something was going on and for years had tried to figure out what.  I’d been for lots of counseling to see if I could unearth anything and got nowhere except for various pastors and counselors thinking there was something wrong with me for thinking there was something wrong in my marriage.  At one point, I asked Jack if he was cheating on me and he said he would never do anything like that and then got very upset and said I was mean for even thinking such a thing.
 
He kept everything well-hidden.  Even his best friend who worked with him every day didn’t know, perhaps because Jack was very good at his persona and could lie with all the right affects to make you think he was telling the truth.  Later, when everything was revealed, Jack’s therapist told me he was a pathological liar.  Jack seemed pleased with that diagnosis.  “I fooled everyone,” he said, smiling.  “I was slicker than O. J.” (At the time, we had just gone through the O. J. Simpson trial and Jack’s self-identification with someone who had murdered his wife—yes I believe O. J. did it—chilled me to the bone).
 
Research has shown that denials are commonly used when a partner is cheating on a spouse(Zitzman & Butler, 2009).  Those denials create a cognitive dissonance in the spouse, where you have to decide who you’re going to believe—the feeling in your gut (even when there’s absolutely no evidence to validate it) or the person you’re married to whom everyone adores. The lies deepen the trauma when everything is finally revealed because you’ve been repeatedly reassured that there is nothing to see here. “Denials prior to disclosure of infidelity add to its traumatic nature.”(Steffens & Rennie, 2006)
 
“ . . . the revelation of sexual addiction is particularly traumatic, in that the betrayed partner often hears about multiple sexual encounters, staggered over time . . .  every time the betrayed partner thinks they’ve heard it all, they are re-traumatized with additional horror stories.”(Steffens & Rennie, 2006)

Trust is completely shattered—trust in the addict, trust in yourself, trust in those you went to for help who told you you were imagining things, and trust in people you don’t even know because you’re wondering what secret they’re hiding, too. The ground under your feet no longer feels solid.  A whirlwind of deception has shattered the illusion that was your life and suddenly you realize, “Toto, we’re not in Kansas, anymore.”
 
 Sexual addiction
 To understand why spouses of sex addicts experience such trauma it’s necessary to understand a bit about sexual addiction and how pornography influences perception of sex and sexual partners.
Sexual addiction is a particular category of cheating.  While the DSM has no formal category for sexual addiction (and there is considerable discussion in the field as to how this behavior should be labeled or if it should be labeled at all.  Still, many working in the addiction field recognize it as a problem.(Sugrue, Carnes, Klein, Coleman, & Raymond, 2003)
 
Dr. Patrick Carnes, one of the foremost experts on sexual addiction, “estimates three to six percent of the population are facing sexual addiction. It remains unclear whether one gender has a higher incidence of sexual addiction than the other. Research by Dr. Carnes shows that approximately 20 – 25% of all patients who seek help for sexual dependency are women. (This same male-female ratio is found among those recovering from alcohol addiction, drug addiction, and pathological gambling.)(Carnes)
 
Sexual addiction could be an affair of the mind, where pornography is a virtual third party that is replacing a normal, healthy sexual relationship in a marriage, or it could be a full-blown sexual addiction that has escalated into hiring prostitutes and/or random hook-ups or even crime.
 
“Sexual addiction is often progressive. While addicts may be able to control themselves for a time, inevitably their addictive behaviors will return and quickly escalate to previous levels and beyond. Some addicts begin adding additional acting out behaviors. Usually addicts will have three or more behaviors that play a key role in their addiction—masturbation, affairs, and anonymous sex, for instance. In addition, 89% of addicts reported regularly “bingeing” to the point of emotional exhaustion. The emotional pain of withdrawal for sexual addicts can parallel the physical pain experienced by those withdrawing from opiate addiction.”(Carnes)
 
Ariel Castro, who held three women in captivity for a decade so he could use them as sex slaves, blamed his addiction to pornography for the repeated rapes and torture he inflicted on these women.   At his sentencing, Castro said, “I believe I am addicted to pornography to a point that it really makes me impulsive and I don’t realize what I’m doing is wrong.” Mr. Castro said it was his habit to watch pornography for two to three hours a day.(Guarino, 2013)
 
Carnes writes:
“Like an alcoholic unable to stop drinking, sexual addicts are unable to stop their self-destructive sexual behavior. Family breakups, financial disaster, loss of jobs, and risk to life are the painful themes of their stories.”(Carnes)
 
Like Castro, sex addicts often experience “severe consequences due to sexual behavior, [but they are unable] to stop despite these adverse consequences.  In Patrick Carnes’ book, Don’t Call It Love, some of the losses reported by sex addicts include:
    •    Loss of partner or spouse (40%)
    •    Severe marital or relationship problems (70%)
    •    Loss of career opportunities (27%)
    •    Unwanted pregnancies (40%)
    •     Abortions (36%)
    •    Suicide obsession (72%)
    •    Suicide attempts (17%)
    •    Exposure to AIDS and venereal disease (68%)
    •    Legal risks from nuisance offenses to rape (58%)”(Carnes, 1992)
 
Internet pornography adds fuel to the fire
Porn makes up 30 percent of all the data transferred across the net” — which means it is a HUGE industry. “Every second 30,000 people are watching porn. To meet that vast demand, a new porn video is produced every 39 minutes. That’s according to YouTube channel All Time 10s, which has compiled 10 incredible facts about the porn industry. Among which are: “20 percent of men admit to accessing porn while at work. Also, 25 to 33 percent of the people who watch Internet porn are women… although only two percent of paying porn site subscribers are female”.(Miles, 2012)

While it is difficult to get an exact figure of the revenues generated by porn because so much of it is part of the underground economy, estimates of the annual take vary widely from close to $100 billion worldwide to $20-30 billion; however, sources estimate that the take is higher than the revenues of the top technology companies combined: Microsoft, Google, Amazon, eBay, Yahoo!, Apple, Netflix and EarthLink. Porn’s annual take also exceeds the combined revenues of ABC, CBS, and NBC(Women’s Services and Resources, Brigham Young University)(Media, 2013) No bets on its relationship to FOX’s revenues, although according to Harvard researcher Ben Edelman, 8 of the top 10 porn-watching states voted Republican in the 2008 presidential election.(Endelman, 2009)

Pornography is increasingly mobile: “By 2015, mobile adult content and services are expected to reach $2.8 billion per year, mobile adult subscriptions will reach nearly $1 billion, and mobile adult video consumption on tablets will triple. We are already starting to see an increase in mobile adult content. One in five mobile searches are for pornography and 24% of smartphone owners admit to having pornographic material on their mobile handset.”(Covenant Eyes Internet Accountability and Filtering, 2013)

Clearly, porn is a huge part of our cultural consciousness and it is creating problems with our sexual behaviors.

According to Carnes,  “over 70% of sex addicts report having problematic on-line sexual behavior. Two-thirds of those engaged have such despair over their internet activities that they have had suicidal thoughts. Sexual acting out online has been shown to manifest in similar off-line behavior. People who already were sex addicts find the internet accelerates their problem. Those who start in the on-line behavior quickly start to act out in new ways off-line.”(Carnes)
 
This becomes problematic for marriages, since “the majority of people struggling with sexual addictions and compulsivities involving the Internet are married, heterosexual males.”(Manning, 2006)
 
Pornography re-wires the brain
Viewing pornography is often viewed as a harmless pasttime, but it’s not.  In her 2004 testimony before the U. S. Senate Committee on Commerce, Science & Transportation, Dr. Judith Reisman said,

Thanks to the latest advances in neuroscience, we now know that pornographic visual images imprint and alter the brain, triggering an instant, involuntary, but lasting, biochemical memory trail, arguably, subverting the First Amendment by overriding the cognitive speech process. This is true of so-called “soft-core” and “hard-core” pornography. And once new neurochemical pathways are established they are difficult or impossible to delete.

Pornographic images also cause secretion of the body’s “fight or flight” sex hormones. This triggers excitatory transmitters and produces non-rational, involuntary reactions; intense arousal states that overlap sexual lust–now with fear, shame, and/or hostility and violence. Media erotic fantasies become deeply imbedded, commonly coarsening, confusing, motivating and addicting many of those exposed. (See “the Violence Pyramid” at http://www.vbii.org/violence.html)

Pornography triggers myriad kinds of internal, natural drugs that mimic the “high” from a street drug. Addiction to pornography is addiction to what I dub erototoxins — mind-altering drugs produced by the viewer’s own brain.

How does this ‘brain sabotage’ occur? Brain scientists tell us that “in 3/10 of a second a visual image passes from the eye through the brain, and whether or not one wants to, the brain is structurally changed and memories are created – we literally ‘grow new brain’ with each visual experience.  Largely right-hemisphere visual and non-speech stimuli enter long-term memory, conscious and unconscious. Any highly excitatory stimuli (whether sexually explicit sex education or X-Rated films) say neurologists, which lasts half a second within five to ten minutes has produced a structural change that is in some ways as profound as the structural changes one sees in [brain] damage…[and] can…leave a trace that will last for years.(Reisman, 2004)

Pornography acts like a drug. Because of the neurological and biochemical changes porn produces, porn addiction is more likely to recidivate than any other addiction. The endorphins and encephalins released while viewing porn (particularly internet porn) make it more addictive than cocaine.  “One of the pioneering researchers of this problem, the late Dr. Al Cooper, described on-line sexual behavior as the ‘crack-cocaine’ of sexual compulsivity.”(Carnes)

In addition, porn is also a leading cause of erectile dysfunction.  As a result, young men in their 20s are now experiencing erectile dysfunction that is directly tied to their use of porn, particularly Internet porn.  According to the Director of Dartmouth College’s Parton Health Center, Dr. Mark Peluso, the last three years have witnessed an upsurge in the number of male students reporting erectile dysfunction and other sex-related problems.
 
“They can’t get an erection or maintain an erection with a female partner,” Dr. Peluso said. “In the majority of cases, the patients were habitual viewers of pornography, and had no difficulty with sexual performance when they were by themselves.  The exact mechanism has yet to be determined, . . . but there may be neuroadaptive changes in the brain that impair sexual function in habitual pornography users.”(Schmidt, 2012)

Porn-related ED isn’t just happening at Dartmouth. Similar results came out of a survey of 28,000 Italian men that was conducted by a group of medical experts affiliated with the Italian Society of Andrology and Sexual Medicine. 

The head of the Society is Carlos Forsta. At Forsta’s clinic, 70 percent of the young men the clinic treated for sexual performance problems had been using Internet pornography heavily. . .(t)here are “gradual but devastating” effects of repeated exposure to pornography over a long period of time . . . (According to) Forsta, the problem “starts with lower reactions to porn sites, then there is a general drop in libido and in the end it becomes impossible to get an erection.”

So what accounts for the correlation between pornography and erectile dysfunction? .  .  .  there is a detrimental feedback loop that can emerge between the brain and the penis when men rely heavily on pornographic images to masturbate (particularly internet porn).  Specifically, overstimulation brought on by viewing pornography can produce neurological changes—specifically, decreasing sensitivity to the pleasure seeking neurotransmitter dopamine—which can desensitize a person to actual sexual encounters with a partner.  These neurochemical changes not only contribute to a person becoming “addicted” to pornography but they can also make it incredibly difficult to abstain from viewing pornography entirely.

Men who rely excessively on pornography to reach orgasm will often complain of withdrawal-like symptoms when they decide to go cold-turkey.  Such men describe feeling “sexless,” leading many to become anxious and depressed about their diminished libido.  Evidence suggests, however, that libido does eventually return—usually within 2-6 weeks of continued abstinence—as evidenced by the gradual return of morning erections as well as spontaneous erections throughout the day.  “Recovery” is possible and many men have reported going on to experience extreme physical pleasure during intercourse with their partners after abstaining from pornography.(Latham, 2012)

A more detailed explanation of pornography’s biochemical effects can be found at http://yourbrainonporn.com/erectile-dysfunction-question

 

Affect of porn use on intimate relationships
Pornography usage has a profound effect on the marital bond.  “Married women who perceived greater levels of Internet pornography consumption tended to have the greatest levels of distress than any other group of women. Bridges, Bergner, and Hesson-McInnis’ (2003) research is significant because it supports the assertion that married women generally are distressed by their husbands’ use of sexually explicit material and that this may threaten the stability of the marital bond.”(Manning, 2006)
 
It’s likely this is because studies show that even soft-core porn causes a decrease in satisfaction with one’s partner, a trivialization of rape, and an increase in aggression towards women(Zillman, 2000)
 
Prior to the advent of Internet pornography, two of the most frequently cited researchers in the area of pornography’s effects were Dolf Zillman and Jennings Bryant. Zillman and Bryant’s (1984, 1988b) findings sparked considerable debate and criticism for a number of reasons: (a) for being limited to experimental situations, (b) for lacking real punishment or social controls, (c) for using college students as the normative group, and (d) for the ethical inability to produce real violence (Davies, 1997).
 
With that said, many consider their results to be reliable and valid, and their work has continued to be referenced for nearly two decades.
 
Zillman and Bryant’s (1984, 1988b) work is useful to give an overview of the kinds of effects general pornography (not Internet pornography) has been associated with, as well as those that have fuelled debate. Zillman and Bryant found the effects of repeated exposure to standard, non-violent, and commonly available pornography included:

(a) increased callousness toward women;

(b) trivialization of rape as a criminal offense;

(c) distorted perceptions about sexuality;

(d) increased appetite for more deviant and bizarre types of pornography (escalation and addiction);

(e) devaluation of the importance of monogamy;

(f) decreased satisfaction with about the value of marriage; (h) decreased desire to have children; and (i) viewing non-monogamous relationships as normal and natural behavior (Drake, 1994)(Manning, 2006).

Zillman and Bryant’s research was done on porn that was much softer than what is available today.  In a study analyzing more recent top-selling pornographic content, 304 sex scenes were observed for both physical and verbal aggression:

 icon-hand-o-right 88% of scenes contain physical aggression (principally spanking, gagging, slapping, etc.)

icon-hand-o-right 49% of scenes contain verbal aggression (primarily name-calling)(Bridges, Wosnitzer, Sun, & and Liberman, 2010)

 

So, what does all this mean for spouses?
First, it means that even though their sex addict partner may have been very good at hiding his/her sexual addiction, the spouse has likely been living for years in a relationship where she/he has been devalued and possibly exposed to verbal and/or physical aggression without knowing why.

 

The spouse has also likely been feeling enormous confusion about his/her attractiveness due to the sex addicts withholding sex from his/her primary partner, a condition researchers Weiss and Carnes call “sexual anorexia”.

Any activity that might bring the addict and his partner closer are the very things he will seek to avoid altogether or sabotage if “threatened” with closeness. So he’ll keep her at bay by:

§  Withholding love/emotional closeness from his partner, often leaving her feeling unloved or unwanted. For the benefit of others watching, sexual/emotional anorexics may put on the appearance of being affectionate in public with her but withdrawing again as soon as they are alone together

§  Withholding praise or appreciation from her

§  Controlling the money for the household (that way he maintains the power, leaving her weakened. This can be enacted whether he earns money or does not contribute financially. Again, either way, he is the one in control, not her)

§  Withholding emotional interactions from her

§  Withholding spiritual connection from her

§  Withholding sexual relations with her (all sex therapists know that whoever says no in the sexual relationship maintains all the power)

§  Controlling her by using silence or anger

§  Staying so busy that there’s no alone time with his partner, either by working, watching TV or any other activity that takes him away from her

§  Blaming the spouse and refusal to look at his part in any relationship issues

§  Ongoing or ungrounded criticism of her that causes isolation, especially if they are headed towards emotional and/or sexual intimacy anorexia.(Partners of Sex Addicts Resource Center, 2013)

Even though the spouse may have intuitively known for years that something was wrong, disclosure of the addiction is a two-edged sword.  On the one hand, the spouse is relieved to know they weren’t nuts thinking something was going on.  On the other hand, most sex addicts aren’t trench-coat-wearing perverts.  “Sex addicts come from all walks of life – they may be ministers, physicians, homemakers, factory workers, salespersons, secretaries, clerks, accountants, therapists, dentists, politicians, or executives, to name just a few examples.”(Carnes) Many of them are leaders in churches and civic organizations.

So, discovering their spouse has been involved in something that is so far outside of the way they are perceived is hugely traumatic for the partner.  So is the realization that they have been repeatedly lied to by the person they felt should have been the one person who always had their back.  This is relational betrayal adds to the trauma.

As noted above, sex addicts are often very good at creating public impressions of being a loving and devoted spouse, while being quite cold when in private.  So when disclosure occurs, family and friends may not believe that this “super nice” person is capable of engaging in these kinds of destructive behaviors.  Instead, they may discount the spouse’s reporting of the problem or even blame her because he’s such a “nice guy.”  This adds to the spouse’s sense of betrayal.

In addition to finding her normal support systems unavailable, there is the sting and humiliation of the public judgment of outsiders who insist that the spouse must have known what was going on and just choose to close her eyes to it.

In her testimony (at her divorce hearing), Christie Brinkley painted herself as a happily married woman who was unaware that her husband of 10 years had a pornography addiction and spent $3,000 a month purchasing graphic images online before graduating to a full-blown affair with Diana Bianchi, 18, whom he hired after meeting her at a local toy store in 2005.

“My world was completely shattered,” she said of the moment that she was told of her husband’s infidelity . . . “My life as I knew it had vanished.”

But marriage experts said she simply wasn’t telling the truth when she said she didn’t know something was wrong in her marriage before the affair was revealed. The truth, according to nationally-known psychotherapist Dr. Gilda Carle, is: “She knew. Every single person always knows. They may not know the details but they know something.”(Divorce360.com staff)

Dr. Carle’s disparaging view of Christie Brinkley fits the traditional approach to treating the spouse of a sex addict, which has been to pile on to the spouse’s confusion a judgment that there is something inherently wrong with the spouse.  Dr. Barbara Steffens research shows that “(t)he spouse or partner of a sexual addict bears a great burden and experiences disruption in response to the out-of-control sexual behaviors of the addict . .  wives of sexual addicts (WSA) have been described by most sexual addiction professionals as bringing psychological and relational difficulties with them into their primary relationship with a sexual addict.”(Steffens & Rennie, 2006)

The presumption has been that untreated trauma and other personality characteristics both influenced their choice of spouse and the ability to disengage from problematic marital dynamics.(Cebulko)

The current addiction model views sexual addiction as a family disease. The popular conceptualization of the responses and treatment needs of WSAs centers upon the women’s addictive or obsessive relationship with an addict and predisposition to the development of co-addiction due to the WSAs’ traumatic and dysfunctional pasts. In the current addiction model, WSAs frequently receive referrals to 12-Step groups and are encouraged to focus upon their own recovery programs. The WSA is “in recovery” when she refrains from attempts to control the husband’s sexual acting out and becomes less reactive emotionally to his addictive behaviors.

Many writers within the professional sexual addiction treatment community conceptualize the WSA’s initial response to disclosure as a crisis and respond accordingly, while working towards encouraging the WSA to enter her own recovery program for her illness . . . For WSAs, this means that, although she is told that her husband’s addictive or compulsive behaviors are not about her, she is also told that she carries her own disease that contributes to the continuation or deepening of the sexual addiction. Her attempts to “fix” the addict are therefore viewed as symptomatic of her own addictive illness, co-addiction. The co-addict in recovery demonstrates health by her ability to focus upon her own life and detach from the addict by reducing her obsession with her spouse’s life and behaviors. Her trauma history contributes to her distress as these past traumas are triggered by the act of sexual betrayal.(Steffens & Rennie, 2006)

I found a presumption that the partner of a sex addict is an inherently unhealthy individual who needed to be treated using the addiction model to be true when I went for help after discovery of Jack’s addiction.  I was told that I had selected Jack as a partner “like a heat seeking missile” because I was dysfunctional BEFORE I met him.

I was asked if I had my own addiction and if I had been sexually abused.  When I said, “No” to both, I was not believed.  I was labeled as a “co-dependent” and a “co-addict” simply because someone I loved had an addiction.  Instead of therapy giving me tools to heal from the trauma of betrayal, I was now fighting for my own sense of who I am.  Steffens calls this “therapy induced trauma”((Hall) Moison & Steffens, 2013)

“The current literature often paints an unfavorable portrait of women married to hypersexual men suggesting that they exhibit various psychopathology including clinical depression, anxiety, chemical dependency, eating disorders, and suicidal ideation (Wildmon-White & Young, 2002). These observations can inadvertently suggest that these are dysfunctional women who, along the course of their challenging lives, chose dysfunctional husbands. This implication potentially moves the focus from the marital dyad and from the consequences of having an unfaithful hypersexual spouse, instead placing it on the wives themselves. Although these findings are possibly true for some, it contradicts our clinical experience . . . “(Reid, Rory, Carpenter, Bruce,Draper, Elizabeth, 2011)

Although sexual addiction was found to have serious and negative effects on the marital relationship and create significant distress in the spouse, Reid, Carpenter, and Drake’s research found that “We can only conclude that at the time of assessment—when, for the spouses of hyper-sexual men, they were aware of their husbands’ behavior—the wives were, on the whole, psychological healthy, although admitting low positive emotions.”(Reid, Rory, Carpenter, Bruce,Draper, Elizabeth, 2011)

I’m loving the results of this research because it helps me recover a sense of myself as a woman who was prior to disclosure and is today psychologically healthy, even though I experienced extreme trauma following the disclosure of my husband’s addiction.

 

The Stress Response
Although as stated above, both men and women develop sexual addiction, for the purposes of this paper, going forward, I will use the word “wives” to describe the partner of a sex addict.

Although the therapeutic community may label the husband’s behavior an “addiction”, the wife primarily perceives it as “infidelity”. “The presented definition of infidelity identifies different forms of infidelity to include emotional, physical, romantic, and/or any other form of sexual and/or emotional act that anyone in the relationship may perceive as some form of a breach of trust and/or violation of agreed-upon norms. For example, the viewing of pornography, unbeknownst to the other partner can meet criteria for infidelity based on this definition . . .”(Dean, 2011)

At the time of disclosure of infidelity, wives are faced with a psychological challenge of enormous proportions.  Their marital bond is experiencing a significant threat; their financial security is experiencing a significant threat due to questions about the future stability of the marriage; their sense of self is experiencing a significant threat, due both to their own questioning of how and why such a thing could happen and also the judgment of others.  The fear these perceived threats generate is significant and it has a physical impact on her body.

The flight or fight mechanisms in our body are wired to have strong reactions to events where we feel intense fear due to real or perceived threats.  This stress response is a survival mechanism so we can respond to the threat either by getting out of Dodge or by standing our ground and doing whatever is necessary to save our life or the life of someone else.  “The stress reaction begins with the amygdala, an almond shaped structure deep in the brain’s emotional center – the limbic system. The amygdala scans incoming signals from the senses for anything that could cause distress. If a threat of any kind is perceived, the amygdala acts like an alarm system, instantaneously sending a message of crisis to all parts of the brain.”(Goleman, 2005)

During a stress response,” the sympathetic nervous system releases general stimulants such as noradrenalin (also known as norepinephrine) into the brain and adrenalin (also known as epinephrine) into the body”. (Tennant, 2005)

“The body shuts down processes associated with long-term care. When under immediate threat,digestion, reproduction, cell repair and other body tasks related to long-term functioning are unimportant.Of immediate importance is survival. Increased blood sugar can provide extra energy for muscles. Increases in cortisol counter pain and inflammation. Blood pressure increases. Blood is diverted from our extremities to our major muscles to provide us with extra strength. Increased endorphins can help us ignore physical pain.

You can see the effects of these changes to the body in many of the symptoms of stress, such as racing heart, dizziness, nausea, shortness of breath, shaking, feeling hot and flushed, and sweating . . . Multiple traumas or repeatedly being exposed to life-threatening events can have a further impact on your body and mind. Parts of the brain can become sensitized, causing you to be on high alert and to perceive threats all around, leaving you jumpy and anxious.

Other parts of the brain associated with memory can actually shrink, making it difficult to consolidate and form new memories. Prolonged stress can affect the development of a number of health issues, including diabetes, obesity and hypertension. And repetitive stress affects our moods, brings on anxiety disorders, and affects our experience of chronic pain and our ability to control food intake. (Matta, 2013)

Normally, once the threat is removed, our body and mind quiet down and resume normal function with the shaky feelings that are part of the stress response to an event mitigating over time.

Those in a marriage to a sex addict often experience an ongoing sense of threat of infidelity because although some wives leave immediately upon disclosure, for many, decisions about how to handle this situation take time, especially if their husband’s decide to enter therapy in a bid to save the marriage.

The extreme stress the wife experiences following the disclosure of threat of infidelity due to a sexual addiction is traumatic in nature.  “The impact of infidelity can be traumatic (Ortman, 2005) and has been referred to as an ‘’interpersonal trauma’’ based on the trauma-like reactions experienced by the nonparticipating partner (Gordon, Baucom, & Snyder, 2004, p. 214). The professional literature on infidelity provides multiple references and examples of the ‘‘interpersonal trauma’’ (Glass, 2000; Gordon et al., 2004; Ortman, 2005; Scheinkman, 2005; and Zola, 2007) associated with such cases; however, the traumatic reaction is often linked solely to the nonparticipant (i.e., injured, offended) partner.”(Dean, 2011)

The trauma theory of a wife’s reaction to disclosure of her husband’s sexual addiction views the responses and needs of the wife through a different lens than the “addiction model” does.

Rather than conceptualizing her symptomatic responses as arising from her own dysfunction and addiction, the WSA’s (wife of a sex addict) responses serve as a reaction to a stressor that is traumatic in nature, in predictable emotional, behavioral, and physiological ways as her mind and body attempts to survive and adapt to a dangerous situation. Attempts to avoid painful stimuli and scan the environment for dangers are common reactions among trauma survivors.

In the case of SAC, the WSA becomes hypersensitive to any indication that the threat has returned through behaviors she observes in her husband or through emotional reactions in response to a perceived cue or reminder of the threat. Obsessive and intrusive thoughts of the disclosure and of her husband’s actions that caused injury occupy her mind and energy, as she seeks what she cannot find: safety in an unsafe situation. One woman described the impact of initial discovery this way: “In one moment, your heart and breathing stops. You have been completely thrown into an alternate universe. Nothing will ever be the same and you know it.” Her world has changed.(Steffens & Rennie, 2006)

 

Post-traumatic Stress Disorder (PTSD)
Steffens research found the traumatic nature of disclosure of sexual addiction was so severe that a “ . . . full 71.7% of the WSAs demonstrated a severe level of functional impairment in major areas of their lives, as measured by the PDS Functional Impairment Score that reflects the PTSD diagnostic Criteria F. Criteria F required ‘significant distress or impairment in social, occupational, or other important areas of functioning’ to meet the requirements for PTSD diagnosis (APA, 2000, p. 468). For example, one woman stated, ‘I was shocked. I threw up, couldn’t sleep, couldn’t eat, cried constantly, couldn’t work.’ Another stated, ‘It impacted me severely emotionally and physically. It was devastating.’”(Steffens & Rennie, 2006)

Although PTSD is a relatively new psychiatric disorder, first occurring in 1980 in the DSM-III, the construct of PTSD has really been around for a very long time, but around by other names. Instead of being described by the psychiatric diagnosis, it was described by the event that caused it.(National Center for PTSD, 2009)

According to the Mayo Clinic, (Mayo, 2011) post-traumatic stress disorder symptoms typically start within three months of a traumatic event. In a small number of cases, though, PTSD symptoms may not appear until years after the event.

Post-traumatic stress disorder symptoms are generally grouped into three types: intrusive memories, avoidance and numbing, and increased anxiety or emotional arousal (hyperarousal).

Symptoms of intrusive memories may include:(Mayo, 2011)

Ø  Flashbacks, or reliving the traumatic event for minutes or even days at a time

Ø  Upsetting dreams about the traumatic event

Symptoms of avoidance and emotional numbing may include:(Mayo, 2011)

Ø  Trying to avoid thinking or talking about the traumatic event

Ø  Feeling emotionally numb

Ø  Avoiding activities you once enjoyed

Ø  Hopelessness about the future

Ø  Memory problems

Ø  Trouble concentrating

Ø  Difficulty maintaining close relationships

Symptoms of anxiety and increased emotional arousal may include:(Mayo, 2011)

Ø  Irritability or anger

Ø  Overwhelming guilt or shame

Ø  Self-destructive behavior, such as drinking too much

Ø  Trouble sleeping

Ø  Being easily startled or frightened

Ø  Hearing or seeing things that aren’t there

Post-traumatic stress disorder symptoms can come and go.

I experienced many of these symptoms following disclosure of my husband’s addiction. I had years of insomnia. I felt numb and completely hopeless about the future. I felt intense shame and guilt.  I couldn’t engage in activities that I had previously enjoyed.  I couldn’t remember much; in fact, I have huge blanks about events that occurred around the disclosure. I couldn’t concentrate—it was like I had ADD—I just couldn’t complete tasks that I’d been easily able to do before.  My lack of ability to concentrate also showed up as not being able to read—it was as if the words were pasted to the page and they couldn’t get into my brain (Dr. Steffens and I discussed this during our interview and she said not being able to read was something her clients had also reported.  The interview is posted at the top of this page).  I startled easily.  I avoided close relationships because I didn’t know who or what I could trust.  I had troubling flashbacks to events that had occurred in my marriage.

Women who wrote to me after reading my book An Affair of the Mind often wrote about also experiencing many of these symptoms.

I found these symptoms extremely distressing:  it was as if I had lost myself and I didn’t know how to find myself again.  Nothing I did to try and recover the woman I had thought I was worked and I realized that for the first time in my life I was broken in a place that I couldn’t fix merely by an act of my will.  After years of feeling beaten up by the addiction model approach that I was being treated with, I finally found a Harvard-trained therapist who understood what I was going through who diagnosed me with post-traumatic stress disorder.  Unfortunately, shortly after that diagnosis, my marriage ended and I was not able to continue treatment.

Working on article has been very therapeutic as it’s given me a better understanding of how my brain has responded to trauma and a way to address the various symptoms with self-compassion instead of self-judgment (“Oh, that’s just the PTSD showing up—it’s OK, you’re doing a great job of handling all this.”)  As a result, for the first time in over 20 years, I’ve found the symptoms starting to abate.  I so want that for others who are struggling to rebuild their inner world.

 

How the trauma treatment model differs from the addiction treatment model
The trauma treatment model starts from the position that the wife’s response to the trauma of disclosure is a “normal” response to a traumatic event and then interprets her behavioral responses as efforts to find safety (a healthy response) rather than effort to control (a codependent response).

Addiction theory views the WSA as carrying an illness into a relationship from which she must recover, while trauma theory views her as someone who had a bad thing happen to her.  Trauma theory also posits that the survivor can find healthy ways to cope and adapt to the trauma exposure. Both models promote recovery and growth. However, the trauma model acknowledges the significant destructive event of disclosure of repeated infidelities and betrayals and conceptualizes her reaction as typical and expected response to an extreme stressor, and given the danger she perceives.

As one woman described the disclosure event, “These events rocked me to the core of my soul.” Another stated, “It left me shell shocked. I’m hypervigilant and skeptical of everything, even when I try not to be.” A trauma model respects the devastation in the life of the WSA, through no action of her own.

Treatment from the trauma perspective shares common goals and interventions with the addiction model, but also suggests some important differences. Rather than addicted and pathological, the WSAs’ most disruptive behaviors are framed as attempts to adapt to a serious threat and thus she can be encouraged to try new adaptive strategies that can provide what she is seeking: an increased sense of empowerment and safety.(Steffens & Rennie, 2006)

Trauma treatment is a combination of coaching and therapy and includes “witnessing the wife’s pain” as well as tools for self-care and implementing boundaries to create a sense of personal empowerment rather than the learned helplessness that trauma induces.

 

Conclusion
The trauma model for treating spouses of sex addicts comes from a place of profound respect for the pain the spouse is experiencing and addresses her not as a “sick” individual but as an individual who is grieving a great betrayal and loss of a significant attachment.

The trauma model has met resistance in the therapeutic community that has been trained to view addiction as a “family disease”; however new research is disputing the idea that spouses are inherently unhealthy.  According to Steffens, wives are reading her book and then presenting her book to their therapists and saying, “Read this and then we can talk.”((Hall) Moison & Steffens, 2013)

The Association of Partners of Sex Addicts Trauma Specialists (APSATS) is a non-profit organization founded by Steffens dedicating to professional training and certification, public education, research, and advocacy for treatment of sex addiction-induced trauma.  Click here to learn more about APSATS.

This is a very encouraging development for spouses of sex addicts and one I’m grateful to be associated with.   Back when I wrote An Affair of the Mind, I had no idea the ripple effect it would generate as the first to advocate for the pain of the spouse. Truly, this is an awesome in the awful. icon-heart 

References

(Hall) Moison, L. S., & Steffens, B. (2013). Part one of three parts: How sexual addiction affects spouses
. Retrieved November 23, 2013, from http://www.youtube.com/watch?v=GRLmE71oW6s

Goleman, D. (2005). Emotional intelligence. New York: Bantam Books.

Barak, A., Boniel-Nissim, M., & Suler, J. (2008). Fostering empowerment in online support groups. Computers in Human Behavior, 24(5), 1867-1883. doi:http://dx.doi.org/10.1016/j.chb.2008.02.004

Bridges, A., Wosnitzer, R., Sun, C., & and Liberman, R. (2010). Aggression and sexual behavior in best-selling pornography videos: A content analysis update. Violence Against Women, 16(Oct.), 1065-1085.

Carnes, P.International institute for trauma & addiction professionals. Retrieved November 30, 2013, from http://www.iitap.com/about-us/media

Carnes, P. (1992). Don’t call it love (First ed.). New York, NY: Bantam.

Cebulko, S. S.The experiences of women whose husbands use internet pornography. Dissertation Abstracts International Section A: Humanities and Social Sciences, . (621557420; 2006-99001-027).

Covenant Eyes Internet Accountability and Filtering. (2013). Pornography statistics annual report 2013. Retrieved December 1, 2013, from http://www.covenanteyes.com/pornstats/

Dean, C.,. (2011). Psychoeducation: A first step to understanding infidelity-related systemic trauma and grieving. The Family Journal, 19(1), 15-21. doi:10.1177/1066480710387487

Divorce360.com staff.Christie brinkley’s break-up. Retrieved November 30, 2013, from http://www.divorce360.com/divorce-articles/news/celebrity/christie-brinkleys-breakup.aspx?artid=1161

Drake, R. E. (1994). Potential health hazzards of pornography consumption as viewed by psychiatric nurses. Archives of Psychiatric Nursing, 8(2), 101-106.

Endelman, B. (2009). Markets:  Red light states:  Who buys online adult entertainment? Journal of Economic Perspectives, 23(1), November 20, 2013-209-220.

Ferguson, Tom,,. (1996). Health online : How to find health information, support groups, and self-help communities in cyberspace. Reading, Mass.: Addison-Wesley.

Guarino, M. (2013). Cleveland kidnapper ariel castro blames pornography addiction: Credible?. Retrieved November 29, 2013, from http://www.csmonitor.com/USA/Justice/2013/0802/Cleveland-kidnapper-Ariel-Castro-blames-porn-addiction.-Credible

Latham, T. (2012). Does porn contribute to ED? Psychology Today, (May), November 20, 2012.

Manning, J. C. (2006). The impact of internet pornography on marriage and the family: A review of the research. Sexual Addiction & Compulsivity, 13(2-3), 131-165. doi:10.1080/10720160600870711

Matta, C. (2013). How trauma can affect your mind and body. Retrieved November 23, 2013, from http://psychcentral.com/blog/archives/2013/04/18/how-trauma-can-affect-your-body-mind/

Mayo, C. S. (2011). Posttraumatic stress disorder (PTSD). Retrieved November 23, 2013, from http://www.mayoclinic.com/health/post-traumatic-stress-disorder/DS00246

Media, F. S. (2013). Pornography statistics. Retrieved November 30, 2013, from http://www.familysafemedia.com/pornography_statistics.html

Miles, K. (2012). Ten facts about porn industry:  All time 10′s shows how big the adult industry is. Retrieved December 1, 2013, from http://www.huffingtonpost.com/2012/10/29/ten-porn-industry-facts-all-time-10s-video_n_2039449.html

National Center for PTSD. (2009). What is PTSD? Retrieved November 23, 2013, from http://www.ptsd.va.gov/professional/ptsd101/course-modules/what-is-ptsd.asp

Partners of Sex Addicts Resource Center. (2013). Sexual anorexia. Retrieved November 20, 2013, from http://www.posarc.com/partners/sexual-anorexia

Reid, Rory, Carpenter, Bruce,Draper, Elizabeth,. (2011). Disputing the notion of psychopathology among women married to hypersexual men using the MMPI-2-RF. Journal of Sex & Marital Therapy, 37(1), 45-55. doi:10.1080/0092623X.2011.533585

Reisman, J. The science behind pornography addiction: Committee on Commerce, Science & Transportation, U. S. Senate, (2004). http://www.commerce.senate.gov/public/index.cfm?p=Hearings&ContentRecord_id=e8088f9f-d8d2-4e82-b012-46337c6f9456&Statement_id=d744db10-1a94-4899-a3ea-fcf5cf0d6493

Schmidt, S. (2012). Parton medical clinic sees rise in erectile dysfunction. Retrieved November 20, 2013, from http://yourbrainonporn.com/middleburry-college-physician-sees-rise-ed-blames-por

Steffens, B. A., & Rennie, R. L. (2006). The traumatic nature of disclosure for wives of sexual addicts. Sexual Addiction & Compulsivity, 13(2-3), 247-267. doi:10.1080/10720160600870802

Sugrue, D., Carnes, P., Klein, M., Coleman, E., & Raymond, N. (2003). The debate:  Sexual addiction and compulsion. ( No. 31). New York, NY: Sexuality Information and Education Council of the United States.

Tennant, V. (2005). The powerful impact of stress. Retrieved November 23, 2013, from http://education.jhu.edu/PD/newhorizons/strategies/topics/Keeping%20Fit%20for%20Learning/stress.html

 Wiederhold, B. K. (2011). Editorial. Journal of CyberTherapy and Rehabilitation, 4(1), 7-8.

Women’s Services and Resources, Brigham Young University.Pornography. Retrieved December 2, 2013, from https://wsr.byu.edu/pornographystats

Zillman, D. (2000). Influence of unrestrained access to erotica on adolescents’ and young adults’ dispositions toward sexuality. Journal of Adolescent Health, 27(Aug), 41.

Zitzman, S. T., & Butler, M. H. (2009). Wives’ experience of husbands’ pornography use and concomitant deception as an attachment threat in the adult pair-bond relationship. Sexual Addiction & Compulsivity, 16(3), 210-240. doi:10.1080/10720160903202679