Treatment-Induced Trauma Harms Victims

I was abused by my church leader. That has actually been more traumatizing to me than the actual betrayal because I was going to someone for help and I was being abused by proxy because he believed all of the things that my ex was saying.

Anne Blythe, founder of Betrayal Trauma Recovery

I compare it to a child who is being sexually abused who has the courage to speak up and tell someone and when that person does not believe them or tells them they must have imagined things, or they shouldn’t talk like that, the victim pulls away and is even more hurt. When I have worked with abuse survivors, the ‘not being believed’ they say is worse than the actual abuse. I think for partners there is a level of this that is true as well; not being heard, believed, seen, valued adds to, and in some situations, intensifies the trauma.

Dr. Barbara Steffens, author of Your Sexually Addicted Spouse: How Partners Can Cope and Heal

Abuse and Addiction Are Not “Couples Issues”

When an abusive partner who acts out sexually, or identifies as a “sex addict”, harms his partner by his behavior, it is his problem that he has brought into the relationship.

Addiction is something in the individual that affects a marriage but a lot of times people try to treat it as a couple’s issue. And it’s not.

Dr. Barbara Steffens, author of Your Sexually Addicted Spouse: How Partners Cope and Heal

Why, then, do therapists and clergy so often counsel women to treat his decisions to control, manipulate, and act out sexually, like it’s a “couple’s problem” by initiating couple’s therapy and counseling sessions?

Couples Therapy Harms Victims of Emotional Abuse

I think that therapists are trained to recognize domestic violence physical abuse but they don’t have a lot of awareness of emotional, verbal, and especially psychological abuse and manipulation. So again, they are going to see this as a communication issue rather than a power issue, a control issue, or an abuse issue.

Dr. Barbara Steffens, author of Your Sexually Addicted Spouse: How Partners Cope and Heal

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Full Transcript:

Anne (00:00):
Welcome to Betrayal Trauma Recovery. This is Anne. I am honored and delighted to have Barb Steffens here today. She has just about every certification <laugh> available. Welcome, Barb.

Barb (00:19):
Thanks for having me. I really appreciate the opportunity. That’s an awful lot of initials after my name. My kids really get after me about all that, but it’s kind of what we do in, in this field, so –

“There’s not a lot of knowledge about this topic in general”

Anne (00:30):
It’s awesome. You’re well trained and the expert in this area, and so that’s why I’m so honored to have you here today. Partners of Sex addicts have difficulty finding appropriate support and help for themselves. Why do you think it’s so difficult to find appropriate support?

Barb (00:48):
First, there’s not a lot of knowledge about the topic in general. I teach in a counseling program and I know that when I look at the course offerings, there’s very little that’s even being taught to therapists that are getting trained about sex addiction or compulsion in general, let alone talking about the impact on the family. So I think it starts there for the help providers. There’s not a lot of public education on the topic, and it still tends to be one of those things that people don’t understand and so they don’t wanna talk about it. So there’s just very, very little information out there. I think the general, let’s say therapist or counselor, if this comes into their office, maybe they have some awareness of addiction, but they don’t make the leap to trauma for the family member or the wife, the spouse. Also, sometimes people think they know just enough cuz they read one book or something, and so then they start saying, yes, I can help this population and end up not being helpful and sometimes hurtful. But I think overall it’s just a lack of conversation and information. Certainly a lack of training.

“I’m fighting two different fronts – society and the church”

Anne (02:05):
I’ve been talking to my mom about this and it seems like I’m fighting two different fronts – society in general, and their misunderstanding of the issue. And then also the church, which has such a misunderstanding, you’d think that they’d be on opposite sides and they kind of are. But at the same time, because it’s so misunderstood with both populations, it’s difficult to be able to teach it because the religious community sees it a certain way and they think that you should heal in a certain way that at least for me was not helpful at all. And then society in general accepts pornography or they don’t understand the trauma aspect of it. So yeah. I think that makes it so difficult too.

“They don’t talk about it”

Barb (02:46):
It really does. And I’m really glad you brought up faith community, because I too have found that they don’t talk about it. They’re afraid to talk about it, or when they do, they lack adequate information. And especially when the wife and the spouse goes for assistance, they can get crazy kind of advice that can really be hurtful too. Like just be more sexual, of course. And your husband’s looking a pornography, you must be not doing something you’re supposed to do. So those kinds of things don’t help at all. Trying to get into faith communities to educate them on this is extremely difficult. And I think they have a lot of fear. They don’t wanna talk about it. I think also we know that leadership in faith communities are struggling with this as well. So it also can be a hindrance to talking about the topic.

“They don’t want to admit that their behavior is causing this much trauma in someone else”

Anne (03:39):
Plus the fact that it’s trauma. And with the trauma model we’re identified as actual true victims. Not that we need to stay in victim mode, or not that we don’t have choices, or not that we can’t be empowered, but I think for a faith community that might have many men who are struggling with this, they don’t want to admit that their behavior is causing this much trauma in someone else, and that they have left a trail of destruction. You know, they’d rather have it be well this is my part and your part is you asked me too many questions, or you did this, or you did that, or you didn’t make dinner like you were supposed to. Or one of my coaches said that her religious community told her that she needed to win him over with her godly demeanor. So that’s type of stuff is re-traumatizing to women.

Distorted Thoughts & Beliefs

Barb (04:35):
And what you’re describing are a lot of the common features that we see in someone who’s engaging in compulsive sexual behavior. They have distorted thoughts and beliefs. Those responses from faith communities just sound like so much of the distorted thinking that people have when they’re engaged in this compulsive behavior. It’s somebody else’s fault. It’s really not that bad. No one needs to know, no one needs to get hurt. They minimize, they rationalize, they blame shift. And so unfortunately, what a lot of places, when they’re not adequately trained or they don’t wanna talk about it, they do the very same level of harm that the person does who is betraying their spouse. They use the same tactics.

Institutional Abuse Can Be Just as or MORE Traumatizing Than Intimate Betrayal

Anne (05:24):
Absolutely. I was abused by my church leader during this time of disclosure, and it that that has actually been more traumatizing to me than the actual portrayal because I was going to someone for help and I was abused. I I say abused by proxy because he believed all the things that my ex was saying. Yeah. So describe treatment induced trauma.

What is Treatement-Induced Trauma?

Barb (05:47):
Treatment- Induced Trauma is just a, a way of describing that process that happens when in this situation we’re talking about the partner or the spouse goes to someone that they have an expectation that that person can help me. And then in that process they find themselves feeling harmed. And sometimes the harm in that setting can feel worse than the original betrayal. Because you go feeling betrayed, you’re very needy, you need to go and tell someone, get some assistance, and then when you’re not believed or blamed or minimized, it just adds to the level of trauma. I compare it to a child who’s being sexually abused, has the, the courage to speak up and tell someone. And when that person doesn’t believe them or tells them that they must have imagined things or they shouldn’t talk like that, then that person pulls away and is even more hurt when I’ve worked with abuse survivors than not being believed they say is worse than the actual abuse.

“Taking the risk to go and tell someone, then not being heard”

(06:58):
And I think for partners, there’s a level of that that’s true. That not being heard, seen, believed, valued, just adds to and in some situations really intensifies the trauma. So that’s what we say. There’s a clinician that also calls it institutional betrayal, and she describes it as, again, this expectation that this place or this person I’m going to is there for me, and then when they turn against me, they add more level of harm and trauma to the individual. So that’s what it is. And I can tell you that since I’ve started doing this work, I hear it all the time. I get emails, letters, phone calls from women from all across the United States and many other countries, and they’re all describing this, that similar experience of taking the risk to go and tell someone and then not being heard or being harmed in the process. And it really angers me because by now there’s enough information out here that I would think people would know what not to do, but it, it still occurs.

Couple Therapy is Counter-Indicated When Abuse is Present

Anne (08:08):
One of the things that I see is that the addict is so good at lying and manipulating that they are believed over the victim repeatedly. And so that is so difficult because how do you get away from that if someone’s lying about you and someone is manipulating the support that you’re trying to get. And that leads me to think that it’s way better to get help for yourself without dragging your husband in so that you can kind of get a clear picture of what’s happening and get solid with what you are doing. I know in cases of abuse, couples counseling, for example, is counter-indicated until two years after the last abuse episode and yet I would tell therapists that he’s been abusing me, and they’d say, okay, let’s keep doing couples therapy. You know, they wouldn’t say, okay, then we need to stop and he needs to get help for his abuse. And so it was just, it’s really difficult to want to get help to be willing to get help to actually make the effort to get help and then be harmed further.

Abuse is NOT a Marriage Issue

Barb (09:15):
Yeah. And I think a lot of times what happens, because we don’t have a lot of information on what sex addiction is or what treatment might look like, a lot of times the first person that the spouse goes to is either their clergy who’s going to look at it as a marriage issue or a couple’s counselor who’s going to view it through the lens of a marriage issue. And addiction is not a marriage issue. Addiction is something that’s in the individual that affects the marriage. But a lot of times people try to treat it as primarily a couple’s issue and it’s not. And I think again, that’s where a lot of partners are, just as you’ve described, harmed, not understood or abused within the session and the therapist doesn’t catch it. And I also wanna talk about the word abuse that you’re using here.

Abuse is NOT a Communication Issue

(10:07):
I think that therapists are trained to recognize domestic violence, physical abuse, but they don’t have a lot of awareness of emotional abuse, verbal abuse, especially psychological abuse and manipulation. And so again, they’re gonna see that as a communication issue rather than a power issue, a control issue, or an abuse issue. So they need more training on how to identify those types of abuse. A lot of times people think the only trauma is the discovery of the secrets, and that’s, that’s horrific, that’s traumatic. But what’s missed in a lot of help settings is that ongoing emotional abuse that has occurred before the addiction is even found out and it’s already done tons of damage and harm to the relationship, but particularly to the victim, to the person that’s on the receiving end of that.

And What About if They’re Just Manipulating You And/Or The Therapist?

Anne (11:05):
And then sometimes the continued abuse for addicts who are in quote unquote recovery. They’re not actually in recovery, they’re not showing recovery behaviors.

Barb (11:18):
Right. They may have stopped they behaviors, they acting out behaviors, but they haven’t taken on or started to practice healthy relational behaviors

Anne (11:28):
Or in some cases, I don’t know if they’ve stopped acting out sexually at all, I think. Right. Sometimes they may be lying. They may be hiding things better and just talking the talk because they found out what they need to say in order to get their wife off their back.

“How is a partner supposed to start to heal when the traumatizing has not stopped?”

Barb (11:43):
I did a workshop a few years ago at a large conference that is there for the sex addiction community, and I called it When the Chaos Doesn’t Stop. And I wanted to do that workshop because when partners, let’s say at six months to a year after discovery and partners are still not getting better in their view, I’m doing that in quotation marks. You can’t see me doing that, but I am, the partners aren’t getting better. And so what I tried to do was uncover the issues that get in the way of partner recovery. And most often it’s because either there’s ongoing sexual acting out that has not been uncovered yet. He’s lying and or the ongoing chronic emotional abuse, manipulation, psychological abuse, and gaslighting. Just the things you were describing, you know, the recovery behavior really hasn’t kicked in yet. So how is a partner supposed to start to heal when the traumatizing has not stopped?

Anne (12:46):
Exactly.

“Trauma occurs where the partner is blamed for her not getting better when she is still not safe in the relationship”

Barb (12:47):
Yeah. And so we pathologize the partner for not getting well, rather than looking at what is going on in the relationship that she still doesn’t feel safe. And to me that is a huge place where treatment induced trauma occurs where the partner is blamed for her not getting better when she is still not safe in the relationship.

Anne (13:08):
I see that time and time again. Yeah. And it’s so distressing to me because the women in these situations are feeling guilty, they’re feeling terrible, they can’t figure out why they don’t feel good when the behaviors they’re describing to me and their husbands sound terrible. and I’m thinking, your therapist isn’t picking this up. You know, you’re not being protected, like you’re not safe and nobody’s picking this up. There’s been a lot with the anti pornography movement and the movement to bring pornography addiction out into the light to not shame addicts and to give them more voice and to maybe normalize it a little bit so they don’t feel as deviant or as terrible. But in that same vein, I think in some ways the normalizing it has made it so maybe it’s not as bad as people –

“How has this impacted you (the abuser) as a human being in your relationships with other people?”

Barb (14:00):
Well, they’re not addressing the behaviors that go along with, or the behaviors that then become a, you know, as a result of chronic viewing of pornography or the other types of sexual acting out that can happen with this type of addiction. They’re looking at the acting out behaviors alone, not looking at how is it impacting the character and getting in the way of that individual caring about having empathy for the people that they’re harming. So they can talk about how to control their behavior. So they’re not using porn, but they’re not addressing: How has this impacted you as a human being in your relationships with other people?

Anne (14:41):
As people try to get help, but they’re not getting the appropriate help, what are the effects of these treatment related injuries?

Treatment-Induced Trauma Makes it More Difficult for Victims to Get Help

Barb (14:49):
One of the saddest impacts is that it gets in the way of spouses, of partners going and getting help for themselves. Who wants to go get help and be told that you’re part of the problem, that there’s something wrong in you, or this wouldn’t have happened to you. And then if they don’t agree with that, then they pull away and say, well, I can’t trust telling this to anybody because all I’m doing is getting blamed for it. And so they pull away and they don’t seek help again. So to me, that’s the greatest damage because we know that people who don’t get help, who are being traumatized or who are in chronically unsafe abusive relationships, they can develop more long-term chronic mental health issues. So it just adds to the level of distress for the spouse. So for me, that’s the greatest impact. But also there’s that secondary trauma that the partner experiences.

“It’s the extra trauma that doesn’t need to be there”

(15:50):
So not only are they working through the betrayal trauma in their relationship, but now they’re working through the betrayal trauma that they experienced at the hand of a clergy member, a therapist or some other help provider, a physician. A lot of people will go to a physician to talk about what’s going on and try to get, say, medication or something and the physician can do things that are harmful as well. So it’s the extra trauma that doesn’t need to be there. That shame that comes when a partner is blamed for what happens to them. Partners experience that. Anyway, that’s kind of our first response is, well, you know, what’s wrong with me that this happened? How did I not know what did I do or not do that my husband is acting this way, but then when a care provider shames them or blames them as well, that just heaps more shame on the partner.

Anne (16:46):
Yeah. And it’s a extended form of the abuse too.

Barb (16:50):
Yes. Yeah. There’s a lot of gaslighting that happens to partners and it’s not all within the relationship.

Anne (16:57):
Exactly. In your estimation, what can partners look for in treatment or help providers to avoid this secondary injury?

Seeking Help? Try This Advice

Barb (17:06):
Partners are getting a lot more wise now that there are more and more resources available to them. Much like what you guys are doing, this is phenomenal that you are offering this kind of information for spouses. So getting educated, but really asking questions before you start working with a care provider. So ask, you know, what kind of model do you use for working with partners? How do you view the partner? Do you believe all partners are codependent? Ask the therapist or the coach, if I don’t agree with you, is it okay for me to say, can we do something different? Or if it’s not working, how do you handle it? If a client says, this isn’t working for me, can we try another approach? And if you have a therapist or a coach say, well, this is how I always do it and it works, then you might wanna think differently.

(18:03):
Or have second thoughts about that. You want a therapist or a coach who is aware of what you need and that that’s their primary focus is on getting to know you and identifying how they can help you and allow you to be a very active part of the process. Unfortunately, I hear a lot of times partners go to get help and they’re given a program to follow and first we do this and then we do that. And there’s not a lot of room for individual needs for unique treatment opportunities. They’re just looking at one size fits all kind of way of, of working with partners. And I’ve never found that to work.

Ask Questions! Lots of Questions!

Anne (18:47):
Yeah. Me either.

Barb (18:49):
We’re all different, aren’t we? Yeah. So just ask questions. Ask questions about how do you work with partners? What’s your belief around how did this happen? What’s your understanding of the model around codependency or co addiction versus trauma? What books have you read? What training do you have? I’m always encouraging partners. Find someone that has specific training as clinicians. I’m a clinician and a coach, so I’m gonna put on my clinician hat right now and say I am bound by ethical codes that say, if I am declaring that I am a specialist in something, I darn well better be able to demonstrate that I have specialized experience training and supervision in that area. And unfortunately, a lot of therapists say, well, I treat blah, blah, blah, and they list them. But if you ask, well, where did you get specialized training? Well, no, I, I haven’t. I’ve, I’ve read a book or something like that. So, so ask, how did you get this training? Who supervised you and what is the model of the training you got?

Anne (19:57):
Yes. Yes. What can a partner do if she has experienced treatment induced trauma?

“What can a partner do if she has experienced Treatment-Induced Trauma?”

Barb (20:03):
I think the most important thing to do, if you can not take responsibility for what someone else did or didn’t do that you needed, I think, like we were talking about earlier, you shouldn’t have to train your treatment provider, your caregiver. So don’t own it, but also go and talk to someone about it. When I’m working with my clients, if there’s prior treatment or some kind of treatment induced trauma that they experienced, like from their faith community, that’s part of what we do is processing that, talking about it, working on ways to find healing for that so that it doesn’t fester, it makes it more difficult in the healing, but it certainly is not insurmountable. It just needs to be discussed and worked on to be healed through, don’t keep it to yourself.

Anne (20:59):
Do you recommend picketing?

Seek Help, Talk it Through, Seek Safety

Barb (21:01):
I have not. But if, if the you know, the treatment induced trauma is severe and you talk through it with a therapist and it seems like, boy, this is not only they didn’t understand, but this is a clear ethical violation, then certainly a partner has every right to complain and you can do that privately, go to that therapist or that clergy member and talk to them about how it hurts. Certainly don’t do that right away. You wanna feel strong and empowered and safe enough to do that. But that might be helpful. Sometimes there’s the level of complaint to a state board, if it’s a licensed individual against, that’s usually more extreme using an antiquated model or not understanding how to help, that might not be the level to which you file a formal complaint, but that’s always an option. But I would always encourage that, talk that through with someone so that you know what all your options are and then do what, what fits for you?

Anne (22:03):
For me being stuck in that, wanting to pick it, not that I would literally wanna do that, but phase sometimes where I think this has to change, this is an institutional problem that I see within my church and it needs to change. I don’t know how to change it. I don’t even know where to start. Last night I spent a lot of time actually just praying, what do you want me to do? God, I don’t know how to even overcome this. I don’t even know if that’s healthy for me in my recovery to worry about the institution as a whole or feel like the, the weight of that is on my shoulders. But because I talk to so many women about it, I think someone has to do something and maybe that is me. You know, I, I don’t know. It’s just such a difficult thing to,

Speaking Up & Sharing Your Voice is Bringing About Change

Barb (22:49):
It, it really is short of picketing. I don’t know if picketing would be helpful, but going and talking or doing education  the, the services that you provide through your podcast, through the coaching that you do, that is making a difference. That’s bringing about change. You know, the model is changing in the sex addiction field and in large part it’s because spouses and partners have gotten educated, they have found support, they are connected with other people that believe similar things. And the consumer in this case is changing the institution because they are speaking up. When we do educational programming, we are making change too. So as an organization, we’re looking at what else can we do? We wanna promote more research, we wanna do more community education in different communities to help just raise the topic and talk about it. So there’s a lot of things that we can do. It’s up to the individual on what makes sense for them and what’s safe for them to do, because this is risky stuff. It’s, if you go and start to talk out loud in a community setting about this because we don’t talk about sex addiction, it really can feel emotionally dangerous.

“I have experienced it as a call on my life”

Anne (24:15):
And dangerous in other ways too. Like dangerous to your reputation. Dangerous too. I mean, and that’s probably what you meant by emotionally dangerous. Yeah. But it’s just, it is really risky and it’s not something that I necessarily would like to do, but I think it needs to be done. And I appreciate everything that you personally have done and Yeah. We owe a great debt to you, actually. Thank you.

Barb (24:38):
Well, I have really experienced it as a call on my life that any time I am having the opportunity to talk to someone about partners, spouses of sex addicts and what they need, I know that I’m not just speaking for me, I am speaking on behalf of spouses and partners everywhere that don’t have a voice or don’t know how to use their voice. So whatever opportunity I have to verbalize and to stress how extreme this need is for ethical and appropriate care for partners, I’m gonna do it.

Anne (25:15):
Thank you, thank you, thank you, thank you. From all of us. So I will, I’ll be the collective voice of thanks. Thank you.

Barb (25:23):
Yeah. And I’m not alone in doing it. We have a phenomenal group of people.

“It’s an amazing community”

Anne (25:30):
I’m very grateful to associate with the eight coaches that I do, and also frequently talk with Dr. Jill Manning, who is super helpful and yeah. Anyway, it’s, it’s an amazing community. The coaches at Betrayal Trauma Recovery are in all different time zones and we provide all of our services online. We’re trying to provide it for women where they are and when they need it, because so many women are so busy with their children or their work schedules that Yeah. Just one more thing, in addition to all the trauma is very difficult, which may be a reason why women don’t get help is because they’re so overwhelmed with everything that they have going on.

Barb (26:07):
Oh, absolutely. Absolutely. I am always amazed when my clients who are in the throes of crisis, somehow or another find their way to think clear enough to get to my office and to get back home. So knowing that they can have additional support just by picking up a phone, going online, I love that.

“We are here, you are supported, you can come.”

Anne (26:27):
Shouting out in, into the void of the universe, we are here, you are supported, you can come and yeah, it doesn’t matter where you live, you can find us and we, we are here for you. So it’s really cool.

Barb (26:39):
Yes. I wanna say to partners that are listening to this, that I’m so proud of you for doing what it takes to get support and information that you’re seeking it out. Cause that takes risk, especially if you’ve already ventured into reading things or hearing things that didn’t make sense to you or hurt you. And if you are still seeking, you are courageous and amazing. So I want you to know that those of us that understand that and that are especially trained in how to help you, we wanna do whatever we can to help connect you to what you need. I’m really, really grateful for these types of podcasts. Thanks so much for the work that Betrayal Trauma Recovery is doing, because there’s nothing more isolating, I don’t think, than being the spouse of someone who’s been sexually, compulsive, sexual acting out. It’s so isolating, so shaming, so scary to think about telling someone. So just taking a risk to listen to a podcast takes courage. So I wanna thank you for that and I wanna commend you for that.

Anne (27:57):
Dr. Stephens, thank you so much for being here and thank you for pioneering this for women all over the world who are desperately seeking information and help.