Integration of trauma-based, cognitive, behavioral, systemic and addiction approaches for treatment of hypersexual pair-bonding disorder

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Abstract
Serendipitously, the study of sexual abuse victims has resulted in a new understanding of paraphilia and sexual compulsivity. Frequently men and women who are sexually and physically abused present clinically with compulsive repetitive reenactment of early trauma in their sexual imagery and/or behavior. Utilizing a post-traumatic stress model, compulsive behavior is understood as a natural response to early trauma, which is later maintained by the association with release and pleasure, as well as becoming a habitual means of coping with stress. Comprehensive treatment requires a focus on completion of the cycle of original trauma and allowing and enabling direct expression of the intense affect embedded within these memories. The Masters and Johnson model of treatment combines this innovative trauma-based approach with a combination of cognitive, behavioral, and 12-step approaches in the treatment of sexual compulsivity. Providing a structured environment with eight hours of focused treatment daily, the sexual compulsive faces the fears of intimacy with others, learns social skills for competent, appropriate interaction with peers, and is taught dating and relationship skills for pair bonding and assertiveness and problem-solving skills for dealing effectively and powerfully with his environment. Cognitive restructuring of distorted core beliefs by tying them to the events during childhood which contributed to their development is vital to the treatment. Relapse prevention is utilized to break addictive cycles and provide effective coping responses to triggers or links to acting-out. Family members are invited into treament whenever possible or desirable. The combination ofll-step, cognitive-behavioral, systemic, and trauma-based approaches increases treatment effectiveness, as demonstrated in our long-term research follow-up investigations.

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