Citation

Turner M. Psychiatr. Clin. North Am. 2008; 31(4): 713-727.

Affiliation

mtshrink@aol.com

Copyright

(Copyright © 2008, Elsevier Publishing)

DOI

10.1016/j.psc.2008.06.004

PMID

18996309

Abstract

This article discusses women who have sexual compulsivity, a disorder that is intensely shame-based and difficult to treat. The case studies presented show the family preconditioning of abandonment in childhood through inadequate care, abuse, neglect, and the presence of other addictions. As children, these women searched for something to soothe their distress when they could not rely on their caregivers. Maladaptive coping mechanisms, such as masturbation, food, romantic or violent fantasies, and any behavior to would gain attention, maintained their sanity in childhood. However, these behaviors also advanced to autonomy, eliminating the option of choices. In adulthood, the numbing of psychic pain by these found solutions became a preoccupation around which life was organized. Consequences developed and as the disease progressed, large amounts of time were regularly lost in fantasy and ritualistic behaviors, causing life to become unmanageable. The fear of being discovered, loneliness, and sexually transmitted diseases typically escalates to spiritual bankruptcy and eventual spiritual, psychological, and possibly physical death. The dilemma is too deep and powerful for women to heal themselves over time, partly because of her impaired thinking, unresolved trauma, and desperation-driven repeat of the behaviors. Proper intervention and treatment can make a difference. Restoration to full health takes years, requiring diligence, motivation, and a therapist who is knowledgeable, committed, patient, and willing to use all available modalities. Trust is a huge issue for these women, and even when taking a positive risk in therapy, trauma responses from early childhood may be evoked. These women are exquisitely sensitive to criticism, but if feeling safe most can learn to trust and will respond to help, because they long to be restored to their values, be self-sufficient, and have a voice that is respected. Uncovering sexual secrets from previous generations, still present in the families-of-origin, helps patients put their problems in context. Treatment can be successful if patients develop a capacity to bond, can tolerate the psychic pain of disclosure, are willing to be accountable, are resilient, and can forgive themselves and others. The rewards for this endeavor are great. The successful interruption and healing of patterns of abuse, shame, and distortions of intimacy and sexuality is a great contribution to society.

Language: en