The traumatic impacts of deceptive sexuality on the intimate partner and relationships.
Deceptive Sexuality and Trauma (DST): A Clinical Model
In this recent conversation with Anne Blythe of Betrayal Trauma Recovery, Dr. Minwalla discusses complex trauma shaping and damage to the second brain which can occur during the covert phase of a Secret Sexual Basement.
Fundamental Concepts from The Secret Sexual Basement white paper.
Is it sex addiction or actually unhealthy masculinity and sexual entitlement? Gender pathology as a significant missing piece in understanding compulsive sexual behavior and sex addiction disorders.
An educational metaphor to facilitate a foundational understanding of deceptive sexuality and the clinical term, deceptive, compartmentalized sexual-relational reality (DCSR)
Compulsive sexual behavior and sex addiction is not just a sexual problem but an Intimate partner and domestic abuse problem.
Naming, or not naming, chronic patterns of abuse, violation and harm in intimate relationships due to deceptive sexuality
The professional evolution from the co-sex addiction model towards a betrayal trauma model among sex addiction professionals: Interview with Dr. Stephanie Carnes.
The focus of traditional sex addiction-compulsivity treatment models tends to be on diagnosing and stopping specific sexual behaviors, termed “sexual sobriety.”
How we have all been indoctrinated into the normalization of integrity abuse disorders in intimate relationships and family systems.
Time for professionals to recognize their diagnostic mislabeling of the intimate partner or spouse.
Partners of sex addicts need treatment for trauma By Omar Minwalla, Psy.D., Originally published in The National Psychologist, July/August 2012
The Minwalla Model is a clinical psychology and clinical sexology model used to diagnose, treat, and understand clinical symptoms related to DST, utilizing contemporary and innovative approaches to understanding sexuality, gender, abuse, and trauma.
Couples and individuals dealing with problematic sexual behaviors might typically hear the terms compulsive sexual behavior disorder, sexual addiction, infidelity used to describe their experiences. But these words don’t fully capture the holistic nature of what actually goes on in these situations. An exclusive focus on sexual behaviors is incomplete, as problematic sexual behaviors are often accompanied by a tragic pattern of abuse and injury that deeply impacts partners and family members for years to come.
Deceptive sexuality and trauma (DST) presents a more complete picture of the presence and impact of sexual acting-out behaviors. Deceptive sexuality refers to problematic sexual behaviors in combination with associated patterns of domestic and intimate partner abuse that frequently leads to devastating traumatic injuries. In other words, deceptive sexuality is a clinical syndrome that involves two pathological systems: one that relates to the inability to control sexual urges or behaviors and/or sexual entitlement (which we call compulsive-entitled sexuality, or CES), and another that includes integrity violations and abusive actions (integrity-abuse disorder, or IAD).
Many people suffer from deceptive sexuality and experience significant psychological, social, and life consequences as a result. These individuals, along with their partners and family members, often seek professional treatment and need clinical support. Unfortunately, we lack a formal, professional consensus on how to best to diagnose and treat this issue.
The majority of people who struggle with repetitive and problematic sexual behaviors and seek clinical intervention are in relationships (often intimate partnerships or marriages), have families, and may be parents as well. In fact, most clinicians working with these individuals indicate that one of the primary motivators for treatment is the impact on the partnership, the marriage, and/or the family.
What has not been part of the focus in any of the dominant diagnostic and treatment models is that patterns of repetitive and problematic sexual behaviors are often part of a deceptive, compartmentalized sexual or relational reality (DCSR) within the context of intimate relationship(s). DCSRs are intentionally hidden and separated from the rest of the person’s life and reality, which has a huge, negative impact on the person’s partner and family.
Traditional clinical models for understanding sexual acting out problems have focused solely on the repeating sexual behaviors, while often ignoring the chronic sociopathic and abusive behavioral patterns. Essentially, these models have focused on only one part of a two-part problem. In doing so, they have neglected and omitted other significant problematic behaviors from clinical recognition and treatment.
Further, these models and practitioners do not view those who create and maintain deceptive, compartmentalized sexual or relational realities (DCSRs) as experiencing a form of mental disorder or abuse problem. Instead, the focus of traditional approaches is on the diagnosis of the sexual behaviors (compulsive or addictive), the lack of sexual control, the cause of the sexual behavior patterns, and the negative consequences experienced by the person who is sexually acting out. The primary problems with these models include:
Failure to recognize the abuse. The first problem with traditional clinical models is that they don’t acknowledge the patterns of emotional, psychological, and relational abuse perpetrated on intimate partners and families of those with deceptive sexuality. Deceptive sexuality is indeed a particularly destructive form of intimate partner abuse and domestic abuse. Often, there are ongoing patterns of abuse that victims experience for years, and the consequences are significant.
Failure to recognize the trauma. Traditional clinical models do not recognize or understand the trauma symptoms experienced by these partners and family members. Sadly, however, this type of trauma is pervasive, intensely distressing, and in need of timely and appropriate diagnosis and treatment. Traditional models have ignored these trauma-related symptoms, and few practitioners in the psychological field as a whole have a solid conceptualization of this type of trauma.
Failure to recognize and support the victims. In addition to not recognizing the trauma, many clinical models lack consciousness about the victims of deceptive sexuality. There has been a profound neglect of the partners and families who are exposed to, and impacted by, these problems. Traditional treatment models have either excluded partners and family members from clinical consideration or, even more damaging, have tended to misdiagnose them. Some models rely on general couples or sex therapy approaches, while others still use victim-blaming interventions based on the traditional concepts of co-sex addiction and codependency. Partners are often “educated” that their responses and reactions are actually part of the relationship problem or are symptoms of a co-addiction that require treatment and management. Unfortunately, none of these approaches appropriately recognize, diagnose, or attempt to treat the victimization and specified trauma-related symptoms.
Failure to identify a disorder. The field frequently uses terms such as sex addiction, compulsive sexual behavior, out of control sexual behavior, and impulse control problem, or infidelity. But these terms do not attempt to describe any type of abuse problem, sociopathic behavior patterns, or conduct disorder. The field has clearly failed to recognize the presence and impact of deceptive sexuality as a type of disorder. There is no established awareness of an integrity-abuse disorder as the cause of the abuse/trauma. And there are no notable efforts put towards recognizing the role of a systemic abuse problem in causing significant trauma-related symptoms.
Unfortunately, abuse and trauma caused by deceptive sexuality are buried in the shadows of normalization, denial, and our collective lack of insight.
This needs to change.
Abuse and trauma caused by deceptive sexuality must be researched and more deeply understood by psychological practitioners and clinical researchers. We must better understand so that we can develop effective diagnostic and treatment approaches that address both sexual behaviors and abuse patterns that result in experiences of short- and long-term trauma.
The Deceptive Sexuality and Trauma (DST) Model expands the understanding, diagnosis, and treatment of sexual acting out disorders. It identifies deceptive sexuality as a form of domestic abuse. It represents a clinical step forward in the field and a significant advancement in the treatment of sexual acting out. This model confronts the traditional and current models of treatment and brings a critical set of new arguments to the ongoing debate related to sex addiction, compulsive sexual behaviors, and infidelity. This new clinical paradigm is organized around three foundational clinical concepts: compulsive-entitled sexuality (CES); integrity-abuse disorder (IAD), and a resulting specified type of trauma among victims (deceptive sexuality trauma).
The DST Model revises the clinical paradigm of sexual acting-out behaviors in at least three important ways:
The DST Model expands the traditional, single-concept diagnosis of either sex addiction or compulsive sexual behavior to include compulsive-entitled sexuality (CES), recognizing the role of sexual entitlement as a major factor that contributes to problematic sexual behavior patterns.
The DST Model gives attention to the roles that conduct disorder and covert psychological and relational abuse behaviors play in sexual acting-out behaviors and considers these pathological patterns to be a type of integrity-abuse disorder (IAD).
The DST Model identifies partners and family members of people with Deceptive Sexuality as victims of abuse who often experience devastating trauma symptoms. As such, this model shines a light on the abuse-victim dynamic that so frequently occurs in these situations and challenges the codependency view that has often been associated with the single-concept diagnosis of co-sex addiction.
The DST Model proposes that compulsive-entitled sexuality (CES) and integrity-abuse disorder (IAD) cause individuals to sexually act out in ways that lead to significant traumatic injuries for their victims. Importantly, the model recognizes that in such situations, abuse problems exist in addition to sexuality issues. Further, this model replaces existing victim-blaming models with abuse-trauma awareness and treatment approaches.
Compulsive-Entitled Sexuality (CES) refers to an inability or an unwillingness to control sexual urges or behaviors, even when they cause significant negative consequences. People may experience CES because of a compulsive-addiction disorder and/or a pathological level of perceived sexual entitlement. Indeed, many patients present with at least some behavioral control problems and sexual entitlement perceptions.
Examples of CES include a lack of ability to control impulses or a desire and sense of entitlement, to engage in problematic patterns of pornography use, infidelity, prostitution, cybersex, flirting, and sometimes this can extend into clinical concerns such as sexual offending, abuse of power in the workplace, etc.
The Deceptive Sexuality and Trauma Model proposes that CES is one of the primary symptoms of the deceptive sexuality diagnosis. In addition to being a main driver of problematic sexual behavior patterns, CES also plays a big role in associated abusive behaviors such as lying, deception, and psychological manipulation.
The other primary criteria of the deceptive sexuality diagnosis is integrity-abuse disorder (IAD), which is a type of conduct disorder that is defined by a significant lack of integrity and a covert relational abuse system. IAD is characterized by sociopathic patterns of behavior (antisocial behaviors that are characterized by long-term patterns of disregard for, or violation of, the rights of others, deficits in conscience, deception and manipulation, impulsivity and recklessness, a lack of empathy toward others or remorse, coupled with a disregard for social norms or moral conduct). These types of behavior patterns can lead to repeated harm and abuse within relationships, particularly with intimate partners and family systems.
The creation and maintenance of a deceptive, compartmentalized sexual or relational reality (DCSR) in the context of an intimate relationship is a form of intimate partner abuse (or domestic harm when there is a family system), often including patterns of lying, psychological manipulation of others’ realities (gaslighting), violation of sexual and emotional fidelity, covert deceptive tactics, blaming the victim and the relationship, and defensive lack of responsibility. Deceptive sexuality and having a DCSR is also inherently a form of abuse in that it relies on dominance and control by intentionally preventing others from knowing the truth. It prohibits partners from being able to respond in healthy ways based on being informed about their reality. Further, deceptive, compartmentalized sexual or relational realities are fundamentally dehumanizing, treating others as objects to be used and exploited for purposes that serve the abuser.
The Deceptive Sexuality and Trauma Model proposes that these abusive, deceptive, and manipulative behaviors, which happen within an intimate relationship and in combination with sexual acting-out problems, meet criteria for a type of conduct disorder/sociopathic pattern known as IAD. IAD, along with CES, is a primary criteria and symptom of the deceptive sexuality diagnosis.
Deceptive sexuality often involves the victimization of others through entitled sexuality and patterns of psychological, emotional, and relational abuse. The harm that is done often constitutes intimate partner abuse as well as harm to the family system.
Deceptive Sexuality Trauma (DST) is a psychological term that describes both the traumatic impacts and the trauma symptoms caused by deceptive sexuality. Many partners and family members of those with deceptive sexuality develop symptoms that meet most of the criteria for post-traumatic stress disorder and complex trauma, including exposure to extreme stress, intrusive re-experiencing trauma, constant or episodic triggering, reactivity associated with hyperarousal and hypervigilance, persistent avoidance, and negative alterations in both thoughts and mood, including anger and rage.
Some experience anxieties about potential disease and contamination, fears about child safety, social isolation, embarrassment and shame, and intense relational rupture and attachment injuries. Acute post-traumatic stress often occurs around the time that a partner finds out about the sexual acting-out behaviors and the deceptive, compartmentalized, sexual-relational reality (DCSR).
Complex trauma gradually develops in response to the long-term progressive patterns of psychological, emotional, and relational harm that are associated with maintaining a deceptive, compartmentalized sexual or relational reality (DCSR). Complex trauma-related symptoms include progressive negative alterations to emotional functioning, thoughts, self-perception and self-awareness, relational integrity and relational functioning, perceptions of the abuser, and how the person relates to other human beings and their life or reality. Complex trauma may also impact a person’s survival instincts and erode their ability to rely or depend on their second brain.