When coping becomes its own problem

Coping and compulsions

Many survivors find ways to numb what they feel: alcohol, drugs, sex or pornography, gaming, overworking, overexercising. These can start as a way to survive and grow into problems of their own. Understanding why can help you respond with compassion instead of only frustration.

In short

Substance use is strongly linked to childhood abuse, and the link is just as strong for men as for women.
Compulsive sexual behavior, including compulsive porn use and some infidelity, is another common way survivors cope.
Early trauma can change the brain's reward system, which helps explain why one compulsion is sometimes swapped for another.
Understanding the cause doesn't erase the harm these behaviors do. Both things can be true.

Alcohol and drugs

The CDC-Kaiser Permanente Adverse Childhood Experiences (ACE) Study looked at how hard childhood experiences, including sexual abuse, affect health later in life. People with four or more of these experiences had roughly 7 times the risk of alcoholism and 10 times the risk of injecting drugs, compared with people who had none.

The most common explanation is self-medication. Abuse often leads to PTSD, and its symptoms, like painful memories, shame, constant alertness and anxiety, are exhausting. Drugs and alcohol can dull them for a while. But it's a short-term fix for a long-term wound, and it often adds a second problem on top of the first.

This matters for men in particular. Women report childhood sexual abuse about three times as often as men. But one study found that once other factors were accounted for, the link between abuse and substance use was nearly the same for both. Because men's abuse is less often recognized, their drinking or drug use is more likely to be treated on its own, without anyone addressing the trauma underneath.

Not every survivor develops a substance problem, and not everyone with a substance problem was abused. But when both are present, treatment that addresses both the trauma and the addiction together tends to work better, with lower relapse rates, than treating the addiction alone.

Compulsive sexual behavior

A note on words.

You may hear the terms "sex addiction" or "porn addiction." Neither is an official diagnosis. The World Health Organization recognizes compulsive sexual behavior disorder, but classifies it as an impulse-control problem, not an addiction. Researchers mostly say "hypersexuality" or "compulsive sexual behavior." We use those terms here because they describe the pattern without passing moral judgment.

Compulsive sexual behavior can take many forms, including compulsive pornography use, frequent casual sex, compulsive masturbation, and some kinds of infidelity. What they share is a pattern of using sex to manage feelings, even when it causes harm.

Childhood sexual abuse predicts hypersexuality in both men and women.
For people who were abused both as children and again later in life, the effect builds, and it builds more strongly in men.
In one study of adult men, sexual abuse and emotional abuse were the two strongest predictors of compulsive sexual behavior. Emotional abuse is often overlooked, even though it was nearly as strong a predictor.

Researchers think early trauma disrupts how a person learns to attach to others and manage emotions. Compulsive sexual behavior can become one way of coping with that, much like drinking or dissociation.

Infidelity

Research links childhood trauma to infidelity through attachment, the way we learned to trust and bond with others as children. A survivor who learned early that people close to him can hurt him may bring deep fear, shame or secrecy into his relationships. Explaining this isn't excusing it. If he has been unfaithful, the hurt to you is real, and it's okay to need support and boundaries of your own.

It works the other way too. When a survivor is cheated on, it can hit especially hard, reopening old wounds of betrayal and abandonment.

Why one struggle can turn into another

Brain research helps explain why these patterns cluster together. Early abuse and stress can change the brain's reward system, the circuits that handle pleasure, motivation and self-control. The changes aren't simply "too much" or "too little." The system becomes dysregulated, and those changes can last for decades.

Drug use, gambling, gaming, compulsive sexual behavior and compulsive exercise all involve this same reward circuitry. That's why some people who stop one behavior find another taking its place: he quits drinking and starts gaming for hours, or stops one compulsion and begins exercising compulsively. This isn't a sign he isn't trying. The underlying need is still looking for an outlet.

For you, this means the specific behavior may matter less than what it's doing for him. Treatment that addresses the trauma underneath gives him the best chance of lasting change.

Be careful with bold claims about porn and the brain.

You may read that pornography causes "brain damage" or works exactly like a drug. The research on that is still debated among scientists. The broader link between childhood trauma and the reward system is well established. The porn-specific claims are not.

What you can do

Try to see the behavior as a sign of pain he hasn't been able to face yet, while still being honest about how it affects you.
Look for help that covers both trauma and the specific behavior. A therapist who treats addiction but not trauma, or trauma but not addiction, may only get halfway.
Be aware that "Certified Sex Addiction Therapist" (CSAT) is a credential for treating compulsive sexual behavior. It is not training in helping abuse survivors. See Find help for what to look for.
Set the boundaries you need to stay safe and well. Supporting him doesn't mean accepting everything.

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