Many difficulties in sexuality stem from early childhood experiences. Current research shows that in order for a child to develop in healthy ways, the child must develop strong attachment bonds to loving caregivers in its environment. The child needs the stability and empathy of a consistent, loving caretaker in order to form healthy attachment patterns that will enable the child to develop into a healthy adult, who is also capable of forming stable and healthy attachment bonds in adult relationships. Many difficulties that individuals experience in their relationships, whether it is sexual anxiety or out of control sexual behavior, are coping mechanisms designed to address the attachment difficulties they experienced in childhood. These mechanism then become entrenched adult patterns that are directed at regulating intimacy in close relationships. Much of these kinds of difficulties in intimacy can be traced to difficulties in the attachment patterns of the individual in early life and childhood. These ruptures in healthy attachments of the child can also be viewed as early forms of trauma.
Likewise, specific instances of early trauma can profoundly impact the course of an individual’s sexual development. These traumas, depending on their nature, severity, and age of onset, can create dysfunctional patterns of behavior, ranging from sexual dysfunction and anxiety, to sexual compulsivity and re-enacting, to disturbing sexual thoughts and obsessions. These traumatic events, whether acute or chronic, can profoundly rupture an individual’s ability to form healthy bonds and attachments with important individuals in the individual’s environment. These attachment difficulties can manifest themselves as difficulties in intimacy. Sexual dysfunctions and compulsions are often a defense strategy employed unconsciously by an individual to regulate these anxieties around intimacy. Sexuality often manifests as a symptom of an individual’s attachment rupture. Someone’s sexuality and their struggle in intimacy can be understood deeply by exploring the connection between their sexual symptoms and their attachment experience.
Often, someone’s sexual thoughts and behavior are used as a coping mechanism to deal with past traumas and disturbing events from the past. These behaviors, whether sexual compulsivity, anxiety, dysfunction, or specific fetishes, are used as a means to make sense of and master the traumatic events. Often certain dysfunctional behaviors will be replayed over and over in order to achieve a sense of mastery over traumatic events in the individual’s life. In this way, the individual may feel a sense of powerlessness or being out of control when caught in a cycle of harmful and compulsive behavior.
Psychotherapy can be used effectively to address these kinds of sexual concerns. A psychotherapist trained in working with clients who have sexual difficulties can help the client process and regulate their own emotions, to confront pathogenic and dysfunctional beliefs about one’s sexuality, and create proper boundaries for the expression of healthy sexuality. An integrative approach would combine cognitive-behavioral as well as psychodynamic techniques, along with psycho and sexual education to help clients understand the basis of their own problems, as well as help to adopt more healthy ways to think about and express their sexualities.