This is part two of a six part series on pornography, truama, and healing intimacy.

To really explain how trauma has had a profound impact on sex we will have to dive a bit deeper into what trauma is.  In my last post I explained how trauma changes the way the brain works, and in this post I’m going to explain a bit about how that can turn into a mental health problem. 

One of the biggest questions people ask in therapy regards diagnosis. It’s easier to get your head around something that has a name and can be defined. Psychologists often use the old saying “If you can’t define it, you can’t measure it.” If you can’t define what the problem is then you can’t measure whether or not your client is improving. There is one small problem with that method of thinking—what happens when someone’s struggle doesn’t fit the mold? How do we understand the impact that trauma has on sex and sexuality when we don’t really understand all the shapes that trauma takes?

I often come across the misconception that everyone with trauma either has PTSD or doesn’t actually have trauma.  But what about people who don’t fully meet the criteria for PTSD, but clearly meet part of it and it is clearly caused by a traumatic experience? The Diagnostic and Statistical Manual used for diagnosis does account for this to some extent. In the section on trauma related disorders it offers several disorders other than PTSD that can be used to define a set of symptoms related to trauma or stress when someone does not meet all the criteria for PTSD. The struggle with this is that in the common vernacular PTSD is equivalent to having trauma.   

The reality is much different. When we consider that the most common diagnosis for people who seek mental health treatment is an Adjustment Disorder, which is classified as a trauma-related disorder and accounts for about 50% of all inpatient psychiatric diagnoses, then we begin to get a better picture. The reality is that most people are probably struggling with some form of trauma reaction and how their support systems have responded has likely played a major role in how healthily they have dealt with it.  

The way a person’s support system, for instance the parent of a child, responds to a person’s traumatic experience will directly impact his or her perception of the event. In the case of pornography exposure (or other sexual exposure by another minor) among children there is often either minimization or correction.  

Minimization is when parents do not express sufficient concern regarding the event (for any number of reasons), and the children internalize that they are overreacting to what happened.  These children will then attempt to reinterpret the physiological processes as normal and their psychological responses as abnormal.  If instead there is correction or discipline (for any number of reasons) the child internalizes that they are reacting correctly to something that is their fault. The child will likely reinterpret their physiological process as abnormal and their psychological response as normal.

If parents respond by normalizing both the physiological and psychological processes and the responses then the child can respect that what they felt was normal but that it was also harmful.  The parents can then discuss whether their minds and bodies are ready for those experiences.  A script for pornography exposure might look something like: “It is very normal for people to be curious about these things, but at your age your mind and body are not ready for them. It’s my job to protect you until you are older and I’m very glad you told me (or I found out) because it will help me do my job better. I’m really sorry that this happened before you were ready, and if you have any questions I will do my best to answer them honestly.”  

When this process doesn’t happen in a healthy way it induces a shame-based view of sex that tends to drive people either towards a shameful or shameless treatment of sexual experiences.  In the next post I’ll talk about the specific ways this impacts children as they try to connect emotionally to those around them. 

Footnotes:

*DSM-5, page 265ff: Reactive Attachment Disorder, Disinhibited Social Engagement Disorder, Acute Stress Disorder, Adjustment Disorder, Specified Specific Trauma or Stress Disorder, and Trauma of Stress Disorder Unspecified.   All the information I discuss in this post can actually be found with further bibliography and footnoting in the DSM-5.