Signs of a Porn or Sex Addiction Relapse

When a client who is trying to avoid a sex addiction relapse has had a slip I can often tell before they say anything about it.

At first I wasn’t sure what it was that I was seeing; whether it was just intuition or whether they were actually doing something different.  And with some clients I could tell right away and with others I couldn’t.  So what was the difference?

Signs of a relapse

When I see clients who have had a slip since the last time I saw them I can sometimes spot the following signs:

A difference of style.  The addict who is coming in laden with the knowledge that he has had a slip will likely be thinking about the fact that they have to discuss it with me.  This often results in their seeming to be superficially jocular or casual.  They seem to be tap dancing, probably because they feel embarrassed or ashamed about having let themselves and me down.

A difference in cognition.  To a greater or lesser extent, a sex addict who has had a slip or a relapse will be suffering from the aftereffects of their drug.  In order to go into the slip in the first place, the addict will have had to let go of part of their rational thinking, the part that has to do with weighing consequences, and thinking logically about the decision they are about to make.  This suspension of higher order thinking, being in the “bubble” as it is called, may have residual effects on their apparent ability to think clearly and communicate clearly.

Lack of focus.  The addict who has had a slip may seem scattered in the aftermath.  They are not completely able to integrate what they know they have done to endanger their recovery and part of them doesn’t want to think about it or about anything else.  They may deflect or divert the conversation and go off on tangents.  They may even be questioning their interest in recovery, their need to change or the appropriateness of the program.

When are these signs missing?

Why is it sometimes easier for me as a therapist to spot a client who has relapsed than it might be for other people in their life, even their partner?  And when are they able to fool me as well?

I think the answer has to do with the level of commitment to recovery that the addict has achieved.  Most of my clients are trying to be honest with me.  When they have something to say that they would previously have lied through their teeth about, they have an automatic high level of cognitive dissonance about it which causes some visible distress symptoms.

Likewise when the addict is still somewhat on the fence about whether and how much of their sexual acting out they really want to give up, then they will be better able to lie to themselves and therefore their deception will be more impenetrable.

It follows that the more someone has become committed to recovery the more difficult it will be for them to conceal the truth from someone they are close to.  When an addict has not really given up the need for secrecy as a way of life, they will more readily adopt a false persona that may be hard to see through.

An addict who has lied to his wife for years and then gotten into recovery may be better able to slip into old deceitful habits with her than with a new person such as a therapist.  The addict may have been doing well in recovery so far but when it comes to intimate relationships, recovery is more than just avoiding sex  addiction relapse. Relationship recovery and the building of honesty and trust is a long term process that involves revamping the entire basis of the relationship.

Find Dr. Hatch on Facebook at Sex Addictions Counseling or Twitter @SAResource

Is Sex Addiction Treatment Anti Sex?

Those who think that sex addiction treatment is anti-sex are not paying attention.  Some people who say they are “sex positive” claim that sex addiction therapists shame or judge their clients for their sexual behavior.  They go on to conclude that we are “sex negative” and wish to limit people’s sexual choices.

This is a big topic but I want to try to clarify some points about sex addiction treatment and its underlying assumptions.

Sex addiction is largely a self-defined problem

Sex addiction treatment does not label people as having a problem with their sexual behavior.  Rather we try to help people make that determination for themselves.  We do not assume that they are having too much sex or that their unusual sexual activities are unhealthy.

The idea the sex addiction therapists want everybody to have “missionary position” sex with an opposite sex partner in a committed relationship is a complete misrepresentation.  I had a client who got aroused by being choked during sex.  This is unorthodox, maybe even dangerous, and I don’t go out of my way to recommend it, but it wasn’t a problem for her because I thought there was something wrong with it.  Rather she herself decided it was a problem in her life.

How people decide sexual behavior is a problem

The criteria for whether or not someone has a sexual addiction or problem sexual behavior rely on the person’s own report of what is going on in their life.  Among these criteria are the ideas that the behavior has negative consequences in the person’s life.  These include such things as the following.

  • The pattern of sexual behavior is such that it gets in the way of their having or maintaining a kind of relationship that they want.  Often a spouse or partner insists that their behavior is out of control and intolerable.  And often the prospect of losing a loved one makes it clear to the client that they want to change their sexual behavior.  Other times the person’s sexual behavior prevents their being able to establish an intimate relationship with anyone.
  • The behavior causes them significant problems in their life such as getting fired for using pornography at work, getting hurt or arrested due to behaviors like indecent exposure, spending their paycheck on strip clubs and prostitutes or bringing sexually transmitted diseases home to their family.
  • Sometimes the consequences of the behavior have to do with internal discomfort, the feeling “I don’t want to be like this the rest of my life.”  In this case the negative consequence is the fact that the person can no longer ignore the extent to which their sexual compulsiveness or sexual preoccupation goes against their own value system.  I have heard people say “I don’t want to be that old guy sitting home alone watching internet porn for hours” or “I don’t want to keep spending all my time looking into neighbors’ windows hoping to see someone nude.”

In other words, sex addiction therapists don’t go out looking for addicts and trying to convince people that they have a problem.  This just doesn’t happen.  Addicts come to us in pain, often in crisis.

What happens in sex addiction treatment?

An initial period in which the addict abstains from all sex provides a way for the addict’s head to clear; it is not intended as a way of life.  Much as it is impossible to do counseling with someone who is high on drugs or alcohol, it is also hard to deal with a sex addict who is high on his/her drug of choice.  Sex addiction treatment proceeds to:

  • Help the addict define and understand the behavior that is of concern
  • Help the addict understand the origins of the behavior i.e. what drives it and its roots in early life experiences
  • Understand the role of other addictions such as drugs, alcohol, gambling or work as they interact with or support the sexual behavior.
  • Help the addict see that he/she is not alone; connecting with other addicts reduces shame and allows for an honest an open dialogue.

When we do sex addiction treatment in this way we are helping clients develop their own definition of sexual recovery and giving them the tools to get there.

Find Dr. Hatch on Facebook at Sex Addictions Counseling or Twitter @SAResource

Do Happily Married Men Go to Prostitutes?

I’ll go out on a limb and say that a married man who visits prostitutes repeatedly is probably not the happiest kid in the sandbox.  Although the wives of such men may feel the behavior reflects on their desirability, my experience tells me that such a pattern of behavior doesn’t have anything to do with the wife’s attractiveness.  It says something about the man who, most often loves and feels committed to his partner.

Paying for sex on a regular basis is not the norm, even for single men.  And it can be a sexually addictive behavior, in which case it has to do with the man’s emotional problems including his problems dealing with relationships.

Who are these men who pay for sex?

An article published earlier this year called What Kind of Men go to Prostitutes?  reviewed some of the recent research and survey data on men who visit prostitutes.  The studies indicate that between 1 and 3 percent of men in the U.S. have gone to a prostitute in any given year and about 14 % of men have paid for sex at some point in their lives.

The studies also indicate that men who hire prostitutes are only slightly more likely to be single than married.  And furthermore they do not appear to differ much from the general population of men.  The men’s reasons for having hired prostitutes were seen as predictable: wanting more sex, being unhappily married, being insecure about dating, wanting the excitement of risk, and wanting power and control.

An outcome study of men who attended a “John School”, a criminal diversion program for men who are arrested for paying for sex, reported that:

“Johns report a variety of reasons for why they purchase sex including the feeling that buying sex is an addiction. Interviews with “Johns” revealed that 83 percent of participants identified buying sex as an addiction (my italics) (Durchslag & Goswami, 2008).  Additionally, research suggests that men who participate in the commercial sex industry often view women as commodities and feel a sense of entitlement to sex. Interviews revealed that men who did not have a regular sexual partner also legitimized purchasing sex (Monto, 2000).”

The Johns as a group also consisted of married and single men.  Were all the married men paying for sex because they were unhappily married?  This is unlikely, because Johns as a group are characterized as unhappier than other men.  And besides, if they have problems with sexual behavior this could account for their unhappy marriage as much as the other way around.

Unfortunately there is not enough known about the demographics of the John population or the prevalence of psychological problems.  These are still very much being debated.

Paying for sex and sex addiction

I feel on firmer ground talking about the kinds of relationship dynamics that are commonly seen in men who show up for sex addiction treatment where paying for sex is one of their compulsive behaviors.

As with sex addicts in general, men who visit prostitutes most often have other sexually addictive behaviors.  These can include compulsive porn use, cybersex, strip clubs, and sometimes offending behaviors like exhibitionism and others.  Going to prostitutes is thus part of an pattern of sexually addictive acting out behaviors.

The fantasy element in sexually addictive behavior

Whatever the specific behavior, sexual acting out is always largely a fantasy.  It takes place outside of the person’s “real life” and it functions as a drug.  While engaging in the sexually addictive behavior, the addict escapes whatever is painful and achieves a totally gratifying experience on his own terms.  This implies that the man has issues that he cannot resolve, or issues he would rather escape than allow his adult self to face head-on.

The avoidance of intimacy in sexually addictive behavior

Paying for sex is exactly the same as any other sexually compulsive behavior in that it is part of a pattern of intimacy avoidance.  What is the addict escaping from when he is avoiding intimacy with a partner?  It is not that the prostitute has so much more to offer than the spouse.

The sex addict experiences intimate bonds as frightening and overwhelming.  Being with a prostitute is safe, limited and controlled interaction.  The addict can relax and feel safe from the dangers of getting hurt, abandoned, rejected or feeling inadequate.   The sex addict feels unlovable and insecure and meets his needs for sexual abandon in a contrived, compartmentalized way.

Sex addicts feel bad about their addictive behavior afterward but they continue to do it.  If a man who is not an addict visits a prostitute he may feel many things but he will not be driven to repeat the experience.

Find Dr. Hatch on Facebook at Sex Addictions Counseling or Twitter @SAResource