Sex Addicts are Codependents Too

If you are a clinician working with sex addicts you may be struck by how often the addict is desperate to save their marriage or relationship.  Sometimes to the point of being so obsessed with holding onto their relationship that it interferes with their focusing on treatment.

It may not be immediately obvious why this is so.  Addicts appear to be focused mainly on themselves. Typically they:

-are sexually compulsive outside of the relationship

-are intimacy avoidant

-use coping skills which create distance

-lead a double life

We typically think of the spouse or partner of the addict on the other hand as the codependent:

-fearful of abandonment

-enmeshed and preoccupied with their partner

-emotionally constricted or volatile

-subject to self-doubt and insecurity.   

And yet most married sex addicts entering treatment (more often they are men but by no means always) exhibit exactly these signs of codependency. They may exhibit them more than their supposedly “co-addict” partners.

Origins of codependence

People who exhibit codependence have typically had some kind of stress or inadequacy in their relationship with their care-givers early in life.  This is sometimes referred to as “relational trauma.”  This early relational trauma causes the child to grow up with mistrust of those close to him and to be insecure and avoidant regarding relationships and sometimes regarding the world in general.

Instead of growing up with a strong internalized sense of self, the codependent survives childhood by using one or another “strategy” by which to adapt to a less than nurturing situation.  These strategies, like numbing out, distracting oneself, suppressing feelings, being over compliant, etc. take different forms depending on the kind of relational stress and the nature of the relationship with the parents. 

But bottom line, the development of the sense of self is impaired in an attempt to get the caregiver’s approval or love.  The codependent’s core belief is “my worth as a person depends on my value to someone else.”

In what way are sex addicts codependent?

Although sex addicts may have a façade, a “narcissistic false self” as it is sometimes called, they have typically grown up with some serious disruptions in their intimate relationships with caregivers.  This can take the form of abuse, but not always.   Often the parents of addicts are distant, repressed, rigid or disengaged. 

Patrick Carnes has pointed out that relational trauma is “a powerful factor in the genesis of addictions and compulsions.”  In Carnes’ theory the addict shares the same fears, mistrust and basic sense of unworthiness as a codependent.  The lack of a strong sense of self and of self worth underlies the intimacy avoidance of addicts and the tendency to medicate their fears with sex and to split their sex life off from their normal life.

The belief that they are unworthy and that they are only lovable to the extent that they can please someone else, can lead to the addict’s extreme fear of abandonment and rejection by the very partner that they have betrayed.

A passage in the Co-Dependents Anonymous “Big Book” states this point clearly:

“Since the very nature of existence is relationships, and I had a disease that precluded my ability to maintain healthy relationships, I began to see that I was pretty well screwed.

I think of the disease of codependence as a tree. 

The roots of the tree are my childhood abuse and neglect.  The branches are my acting-out behaviors I developed to cope with life.  Both the roots and the branches have to be healed (my italics). 

I cannot stop the acting-out without healing the damage that spawned the behavior, and likewise, I cannot work on the roots if I’m still medicating myself with my addictions.”

Understanding and working through these underlying early childhood issues will dismantle the unconsciously held core beliefs and allow for the emergence of a real self and real intimacy with another.  Find Dr. Hatch on Facebook at Sex Addictions Counseling or Twitter @SAResource

Not Sure if You’re a Sex Addict?

It is normal to feel uncertain about this question.  Addictions are partly self-defined; especially “process” addictions like gambling, food and sex addiction.  Doctors and therapists don’t go out of their way to look for sex addicts.  If someone comes to me for sex addiction help it is because they suspect that they are having a problem with some sexual behavior that is out of control or is causing serious problems.  A sex addiction therapist may help them decide if that is true and can evaluate other possible causes or co-occurring condition.  The official criteria and categories of sex addiction may help in the beginning.

But even after a person has sought help or support groups for sex addiction, they may continue to wonder if they really are a bona fide sex addict.  This is so common as to be a predictable occurrence at some point in recovery.

Someone who has serial affairs or who has a habit of watching a lot of internet pornography may find him or herself sitting in an SAA (Sex Addicts Anonymous) meeting next to a person who did jail time for viewing child porn or who compulsively visits prostitutes or who exposes himself on buses.  The behaviors of addicts are so varied that it invites comparison.  “Am I really the same as him? Surely my problem is qualitatively different and less serious!”

Doubt is not the same as denial or minimization (although these can be involved as well.)  Other things can cause a person to wonder whether they should define themselves as a sex addict.

Sex addiction may not be the “primary” addiction

Many recovering alcoholics and drug addicts have a tendency to use sex as a substitute drug.  Even if they recognize they are doing this they may discount it as secondary to or a product of their chemical dependency.  See also my post on alcoholics and sex addiction

This tendency to discount sexual issues is especially common when there is an “addiction interaction”.  This is the situation where addicts have more than one addiction (and a great many do) and where the two interact in various possible ways.  A sex addict may use drugs as a part of a ritual prior to sexual acting out or as a way to numb the shame afterward.

Addictions may be fused with other addictions

When two or more addictions are only engaged in at the same time (drinking always goes with seeing prostitutes, drugs are always involved with gambling and sexual acting out) they are said to be “fused”.  This makes it very hard to identify one addiction as the primary one and so the addict may go from one program to another or feel confused as to why they cannot see any change.  When different addictions lead back to one another then the addict must quit all of them at the same time if at all possible.

Sexual acting out may not be continuous

When we think of a compulsive behavior we think of the person as seeking it constantly.  Sometimes this is the case and sometimes not.  There are many sex addicts who have a pattern of intermittent acting out with “down time” between their episodes of sexual acting out.  The period between acting out may be caused by remorse, or it may just be that the cravings for that behavior do not return as powerfully right away.

This episodic pattern can be of any length.  And during the periods between acting out, the addict may think they are in good recovery.  Therapists look for a situation in which the addict can go a week, a month or even several months without acting out and then relapse, almost like clockwork.  This is like the smoker who claims he can quit because he’s done it hundreds of times.   They seem to have some control and can quit for a particular period of time—just not for good.

Also it is not unusual for sex addicts in the first year or two of recovery to get totally turned off to sex.  This is a swing to the opposite extreme of sexual anorexia but does not represent real sexual sobriety.

The person who can sexually “act out” in moderation

There are probably some people who engage in secret, illicit or even risky sexual behaviors but who really are using the behavior as an occasional escape, and one over which they have a lot of control.  It is hard to say how many such people there are but I suspect there are a lot given the current prevalence of porn use, cyber sex, and sexual hook-ups (not to mention infidelity).  These people would probably not show up in a sex addiction clinic.   But the dividing line is such that those behaviors engaged in by someone who really is an addict will eventually lead to more frequent, more destructive or more serious sexual acting out behavior.

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

Chronic Sex Addiction Relapse: Letting Go Once and For All

Sometimes I feel as bewildered and frustrated as my sex addiction clients when they periodically slip up and engage in their addictive behavior, even as they seem to be making progress in their recovery.  (See also the excellent article by Dr. Patrick Carnes entitled “The Perfect Storm: Assessing for Sex Addiction”)

What is it that makes some recovering sex addicts continue to relapse frequently?  Why are some sex addicts seemingly unable to cut the cord?  I believe that beyond the question of “hitting bottom”, the process of letting go of an addiction is similar to the loss of a relationship and that some addicts get stuck at various stages of the grieving that loss.

Addiction as a relationship

The idea of an addiction as a relationship has been around for a long time.  Sex addiction, like addiction generally, has been defined as a primary relationship with a mood altering experience.  That experience may be a chemical such as a drug or alcohol or it may be an activity such as gambling or sex.  Whatever the chemical or activity, there is some evidence that the brain mechanisms involved in the addiction are all similar.

But beyond brain chemistry, brain alteration and changes in mood (excitement, euphoria, soothing), addictive activity is also something that develops like a relationship.  And the activity as well as everything leading up to it and surrounding it becomes like a friend or even a loved one.

This affection for our addictive activity is not entirely illogical.  For most addicts, their “drug” is something that they have relied on to regulate their emotions, escape stress, and even maintain their ability to function.  A porn addict I know once said “Miss January (his name for his addiction) is always there for me.”  It has served the addict well in some sense.  Yet it also has destructive potential and usually goes against the addict’s own value system.  Hence it is a relationship that needs to end.

In sex addiction treatment a commonly used exercise is that of having the client write a good bye letter, a “Dear John” letter, to his or her addiction.  In this letter the addict “breaks up” with his addiction, often acknowledging that the addiction was important, fun and will be missed.  This exercise underlines for the addict the fact that he or she is letting go of something important.  Whether it is giving up porn, prostitutes, compulsive hook-ups, or fetishes it is going to amount to a real loss.

Grieving the loss

All grief is about the struggle or process involved in coming to acceptance of a loss.  Loss is stressful.  In fact one definition of stress is “a loss or the threat of a loss”.  And so the loss of an addiction is stressful, challenging and potentially even traumatic.

Most sex addicts have a history of childhood relational trauma.  The drug, the “relationship” with a fantasy became a way to endure stress and to substitute something for what was missing in reality.  In dysfunctional families intimacy is fraught with danger and self doubt.  The addictive fantasy involved in much sexual acting out is one of being able to be gratified in a way that feels safe.

Getting stuck in the grief process and relapse

It is possible to get stuck at any point in the process of letting go.  Even once past the denial phase and even after acknowledging the need to let go of the behavior, there may be predictable stages of anger, bargaining, and depression.  A good example is the addict who knows that porn blocking software would hugely improve his chances of getting free of porn addiction but who either rebels against getting it installed, finds excuses, or finds ways around the filters.  I have seen clients use their GPS or their children’s devices when other outlets are blocked.  This addict is stuck in anger and possibly old rebellion against authority.  He or she is saying “you can’t make me.”

Bargaining can go on for a long time too.  The addict makes a deal with their treatment program that says basically “If I get XYZ then I will be able to let go of my addiction”.  This can mean that the addict is going to support group meetings, going to therapy, and reading all the right books but is not willing to experience change.  He is waiting for it to feel right to stop being an addict.  Or he is waiting for a “sign” or for a new relationship to save him etc.  The unpleasant reality is that in giving up the addiction there is nothing that will immediately take its place.  No way to avoid experiencing some sense of loss.

Some addicts go along way down the road to recovery but still can’t give up their addictive behavior completely.  They find that the loss of the addiction brings on depression.  They endlessly analyze why they have relapsed this time.  They feel they cannot tolerate stress or loneliness.  But there is no way to eliminate all of life’s stresses and challenges.  Eventually they begin to realize that they can experience unpleasant feelings without reaching for a drug.    This is the point in a sex addict’s recovery when he or she has turned a corner and is finally done with acting out.  They know it and you can see it.  They will come to acceptance and begin to be solid in their sobriety.

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