Attention Deficit Disorder and Sex Addiction: What’s the Connection?

A large number of sex addicts have attention deficit hyperactivity disorder (ADHD)

Dr. Rory Reid of UCLA did research in 2007 and 2011 in which groups of men in treatment for sex addiction were assessed for ADHD and in which 23%-26% were found to meet the criteria for adult ADHD.  Almost all of these (97%) were of the “predominantly inattentive type” rather than being predominantly hyperactive. (The prevalence of ADHD in the general population is 3-5% according to Reid.)

Can impulsivity or low self-concept explain the correlation?

Dr. Reid also gathered evidence about whether ADHD might be “driving” sex addiction due to the impulsivity of people with attention deficit as children.

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Intimacy Disability and the Loneliness of Sex Addicts

Addicts are profoundly lonely. They may be active and sociable; they may have friends. But in terms of the deeper emotional connection to a partner, they tend to keep themselves on a starvation diet. The loneliness of course is self-imposed. Addicts are not addicts because they are making up for the fact that they don’t happen to have a lover. Their addiction and their emotional isolation are both related to a deep fear of intimacy. It has always been striking to me that they should suffer so much in their alienation.

Childhood issues

I find that most often sex addicts are not aware of how fearful they are about intimate relationships.  They have most likely come from families in which they received inadequate or inappropriate forms of connection with adults. Without realizing it, they have adopted a way of behaving based on fear and the avoidance of intimate connection.

I have heard many addicts tell me that as a child they felt ignored discounted, abandoned or invisible. This is their model of close relating; it is one of intense pain and stress. And this can be true despite the fact that their family life and childhood appeared outwardly “normal“.

Intimacy avoidance and sexual acting out

Many sex addicts are using their addictive acting out behavior as a substitute for an intimate connection. Their addictive behavior provides an illusion of some kind of connection, reinforced by sexual gratification in a situation that is safe. Sexual acting out is emotionally safe because it requires nothing from the addict on an emotional level.

For the typical sex addict, this way of finding gratification without intimacy is not a matter of wanting to be selfish and controlling, although that is how it ends up looking. But rather it is a way of finding an escape from negative emotions and achieving some gratification without having to experience intense discomfort and fear. Sometimes it is due to sexual inhibition and shame. Other times it is the fear of letting their guard down and feeling that they will inevitably be hurt. Or it involves feeling so unworthy and unlovable that they cannot feel free to be who they are. Usually it is a combination of the above.

Intimacy avoidance in relationships

The intimacy avoidance that goes along with sex addiction shows up in relationships in a number of ways.

  • Avoiding sex

Sexual connecting in the context of an intimate relationship can be too difficult for an addict to do comfortably. Even if they are very attracted to their partner or would-be partner, they may try to create emotional distance. For example, they may be emotionally absent during sex or lost in fantasy, they may want to drink alcohol as a way to be less present during sex, or they may avoid sex altogether.

  • Avoiding physical intimacy

Sex addicts often come from families in which there was an absence of physical touching and affection. Thus they may feel that hugging, cuddling, etc. are awkward and uncomfortable. Some addicts were smothered by physical touching in an inappropriate way and they too may avoid physical affection due to feeling vulnerable.

  • Not being able to express their needs

Many sex addicts isolate themselves emotionally by avoiding letting the other person in on what they feel, need or want. This is a fear of being unworthy or of being rejected or hurt.

  • Being self conscious around people or in social situations

Often addicts substitute a role or facade for actually showing up emotionally. They may play a role, eg teacher, guru, performer, etc. with people instead of just being able to be who they are and take their chances.

  • Withdrawing into work or another addiction

Some addicts escape the demands of intimacy by becoming swallowed up in work or exercise or other hobbies that take them away from their partner and other potentially intimate contacts.

  • Fleeing intimate connection

Many addicts can enter a relationship but leave before it becomes too intimate. They may think this is a fear of commitment, or not the “right person”, when in reality they feel inadequate to the demands of a relationship and/or fear being abandoned by anyone they are close to.

Intimacy avoidance and loneliness

The same addict who is doing everything to avoid intimacy will often feel desperately needy and lonely. Sometimes the addict is aware of a longing for connection; other times the addict lives without intimate relating but doesn’t quite know what is missing or why they push people away. Isolation and loneliness can then become the excuse and the occasion for sexual acting out such as online sex, sexual massage parlors, prostitutes, etc. It is only in recovery that the addict can recognize his or her own lack of intimacy ability and begin to practice new behaviors to overcome their fears of being known and connected.

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

5 Signs you are Involved with a Narcissist

Basically you can’t get close to a narcissist.  A relationship with a narcissist will be a problem, and the more narcissistic they are the more it becomes impossible.

Sex addicts and addicts generally are often described as narcissistic, but many non-addicts are narcissists as well.  Trying to have a relationship with a true narcissist can be an extremely tortuous and confusing experience.

The continuum of narcissism

Many psychological disorders are now being talked about as existing on a “spectrum”, that is they are not like other diseases where either you have them or you don’t.  With spectrum disorders the set of symptoms can range from very mild to very severe.

As I have discussed previously, narcissists at the mild end may be labeled as having narcissistic personality traits such as self centeredness and vanity; those labeled as having narcissistic personality disorder will be mostly oblivious of the needs of others and will focus on maintaining a false and grandiose sense of a self.  At the outer most extreme the narcissist becomes akin to a sociopath, feeling so over-entitled and so lacking in conscience or empathy that they are opportunists and even criminals.

Many sex addicts and other kinds of addicts have what is called a narcissistic defense system, that is they have a façade of self importance which merely covers a deep seated lack of self worth.

What to expect with a narcissist

Narcissists are cut off from others by their underlying insecurity but they nevertheless can become expert at manipulating people in order to draw them in.  They can be habitually seductive as a way of finding validation and power in relating to people generally.  They are fundamentally impossible to connect with in the following ways.

  • The narcissist needs you to be focused on him.

He or she may initially show  great interest and appreciation for you.  This is gratifying but is skin deep.  It is done to get you to focus on them.  They may give lavish praise and compare you favorably to others; in this way they manipulate you into trying to keep their good opinion thus becoming more and more focused on what they think about you (and everything else.)  And you become unconsciously afraid to displease the narcissist or incur his disapproval.

  • The narcissist needs to see anyone they are close to as special.

The idea here is that the narcissist needs to feel he is wonderful and that he wouldn’t be seen associating with anyone who wasn’t wonderful too.  He sees you as a reflection of his own specialness.  This does not really say anything about how he really feels about you, what is important to the narcissist is how you make him look to others and to himself.

  • The narcissist will be controlling and demanding.

You may feel constantly thrown off from what you were doing or thinking about because the narcissist will come at you with their needs and wants.  Narcissists will have their own agenda most of the time.  They will use their judgmental attitude, their scrutiny of you and their strong opinions to enforce that agenda.

If you have already become involved you may be sacrificing yourself in a million little ways and even feeling that your life has been taken over.  This is a far cry from a real relationship in which the partners’ lives together involve mutual decision making and genuine listening.

  • Narcissists will be volatile when they are challenged.

Since their façade of superiority is just a façade, the narcissist will be cut to the quick if they feel criticized in any way.  Their first line of defense will be to discount and devalue whatever or whoever has pricked their bubble.  But they will be deeply affected and may harbor rage or resentments.  This makes it impossible to express your true feelings or needs and to have them be heard.

  • Narcissists will bail out when you stop feeding their narcissism.

You may be unable to shake the feeling that the relationship is tenuous because it is.  It is possible to puncture a narcissist’s false self very easily.  And since your worth to him or her lies in your ability to reinforce their self image, you can become a hindrance if and when you stop mirroring their perfection.

Someone who has milder narcissistic traits is probably using their grandiosity as a defense, as is the case with most sex addicts in treatment.  In recovery they can gain a stronger sense of self worth and let go of the narcissistic defense system.  With treatment, these people may be more able to connect to their insecurities and you may find that they both want and have a genuine capacity for a healthy relationship.

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

Ogling Other Women Can be a Real Problem for Partners of Sex Addicts

Many wives and partners of sex addicts complain of their partner ogling other women.  A man who can’t help staring at other women may be just a rude guy or his ogling may be part of a pattern of sexually compulsive behavior.  If you are the partner of such a man you will know that it is crazy making.  There are a million ways for a man to brush aside your concern and make you feel that you are overreacting.  It is “gaslighting” on steroids.

I have worked with many sex addicts and their partners for whom ogling is a serious problem. By that I mean often the sex addict will be unable to stop looking at attractive women and will be using the images of sexy women he sees in passing as a way to be swept away, to feed a fantasy life, and to avoid the person he is with.

I saw one sex addict who admitted that he ogled in this way; that he looked at women “from the neck down”.  He was happily married yet he saw himself as being sexually compulsive in this one area.  He claimed he would do anything to stop because it hurt his wife so much.  When he couldn’t stop looking at another woman in a restaurant on his honeymoon it was a wake up call for his wife (and him).

The three second rule

Sex addicts in recovery are told to follow the three second rule, meaning that although you can’t help glancing at or noticing someone, you can give yourself three seconds to stop looking.  At that point you can hopefully manage to redirect your thoughts away from sexual objectification and into seeing the person as a person (a student, someone’s daughter, etc.) and to wish them well.

One of the partners of sex addicts who wrote to me  challenged this idea.  Her partner is a recovering sex addict who ogles women.  She wrote:

“His comment to me about three seconds was that he rarely if ever looks that long because he wants to avoid discovery. He is very subtle about his looking, yet he is able to get a potent hit, even though his eyes only “flick” briefly onto a woman’s body. So basically, someone could look for under three seconds and get a potent sexual hit. In other words, it’s really not about the amount of time. It’s about the intent, the hunting, the feeding, the drinking in, the filling up.”

She describes also:

“…a different person I know who captures image impressions of women’s bodies and files them away mentally for later fantasy use. These also could be just very brief glimpses of someone’s cleavage or of someone in an every day position that is sexually titillating to the viewer.”

This woman’s partner is not unusual.  Many sex addicts complain that they are helpless because there are just so many sexy women around and they can’t help looking at them.  And yet ogling can feed an addiction by adding to what some sex addicts call their “data base” of sexual imagery that they can call up at a later time to use for masturbation or even during sex.  It can feed what is essentially a stash of mental pornography even if they have been successful in giving up an actual pornography addiction.

One thing is for sure; if a man has already identified himself as having problematic, compulsive sexual behavior then his ogling is probably one of his array of sexually addictive behaviors.

What ogling does

Remembering images and having fantasies is not at all pathological in itself.  And to some extent the level objectification of women that is involved in ogling is an everyday occurrence in our culture.

But as I noted elsewhere, the American Psychological Association talked about ogling as one step along a scale:

“with sexualized evaluation (e.g. looking at someone in a sexual way) at the less extreme end, and sexual exploitation, such as trafficking or abuse, at the more extreme end.”

Sexual objectification of women (and men) is rampant in our culture and it is probably getting worse.  As a form of objectification, ogling may or may not be a dangerous trend, but can seriously interfere with a person’s ability to relate in an intimate relationship.

Ogling as a form of sexualizing and objectifying people is so common among sex addicts as to be almost universal.  And it can also provide a direct trigger to relapse in an addict who gets swept into fantasy.

For some sex addicts looking at women in a sexual way is part of their addictive ritual.  They feel deprived of sex, even rejected by the women they look at and this paves the way for them to escape into their other sexually addictive behaviors such as internet porn.

Is ogling voyeuristic?

As I discussed in a prior post it may not be possible for most of us to tune out sexy women.  But sexual looking and sexual evaluation of strangers can be seen as unwanted and invasive in itself, quite apart form its impact on partners of sex addicts.  Some women may want to be looked at, but some may feel slimed or even violated by it.  And since the ogler has not way of knowing it’s best to assume that there is something uninvited and even potentially voyeuristic about it.

Predatory Flirting and Intriguing as Sex Addiction Symptoms

When I first heard the term “predatory flirting” in connection with  sex addiction symptoms I was taken aback. Predatory sounds like something criminal, but flirting seemed so normal and harmless. But the term describes a symptom, a behavior, which is characteristic of certain sex addicts.

Who engages in predatory flirting?

One type of sex addict, dubbed the Seduction Role addict by Patrick Carnes, is particularly likely to engage in a lot of flirting.  The seduction addict gets his “fix” by getting women interested in him sexually or romantically.  The seduction is everything.  One seduction sex addict told me that the real high was the first kiss.  After that he would begin to lose interest and start looking for the next conquest.

The related concept in describing sex addiction symptoms is “intriguing.”  Like flirting, intriguing is a way to create a feeling of private, personal intensity.  It is a way of establishing through some subtle means such as coded comments, private jokes or pointed eye contact, that you and the other person share a connection that no one else is a part of.

Other sex addicts whose preferred behavior is serial affairs have flirting and intriguing as sex addiction symptoms.  They may use flirtation as a way to line up their sexual supply.  They follow through with the sexual liaison but can only take things so far.  A real relationship is frightening and overwhelming.  The addict will find a way to end things and move on to the next affair.  Many serial seducers are married and are investing most of their sexuality in their secret life.

Sex addicts who are addicted to romantic seduction and affairs are driven by the need to constantly re-establish their attractiveness to the opposite sex.  They are as insecure as most other kinds of sex addicts and often feel that their sexual attractiveness is all they have to offer.  They fear that if they do not hook people sexually then there will be no reason for people to be around them.

What does predatory flirting look like?

Normal flirting is a casual and tentative way of initiating contact that may become romantic.  It is the first step in a possible courtship and lets someone know that we are potentially interested.  It involves saying things that are more personal, intense, suggestive or flattering than we would say to just anyone and then if there is a response, following up with real attempts to get to know the person better.

Smoke and mirrors

When it is predatory, flirting is intense but not sincere.  It is designed to capture the person’s interest and attraction but it is not backed up by any genuine interest.  Rather it is just a habitual way that the addict approaches anyone in a broad category of target people.  It is almost automatic, a default position which represents the addict’s safest way of relating.

Wholesale sexualizing

If you know the seduction sex addict well and you observe them flirting, you will see that they are rather indiscriminate in who they flirt with.  They want to captivate everyone, from the waitress to their mother-in-law.  Also, they will begin flirting right away with someone who is attractive looking even if they don’t know them and will never see them again.

Deniability

Another feature of the seduction addict’s predatory flirting is that it is eminently deniable.  It is throwing out a lure while and the same time pretending that there is no such thing going on.  It is suggestive of something but it is hard to pin down, and this vagueness is frequently a part of predatory flirting.

One type of predatory flirting involves being over-attentive or caring toward a woman.  This suggests that the addict has a real interest in her and also that he is a caring and generally good guy.  This may be a consciously seductive scheme or not.  But often the woman will get interested in this “nice” guy and approach him back only to be told that she has misinterpreted the situation.

Intensity without intention

The predatory flirter will throw out seemingly suggestive comments designed to create a feeling of connection with not other intention than to get the woman’s attention on him. I observed a seduction addict I know run into a woman whom he had seen once before somewhere.  She remarked that it was a coincidence to which he responded: “There are no coincidences.”  It is the initial stage of the empty seduction, the attempt to create a feeling of intensity without intention.

Why is this process predatory?

The addict’s lack of intention or ability to follow through in establishing a relationship with his target women are not just sex addiction symptoms in the abstract.  What the behavior means is that he is being exploitive and insincere.  He is using his ability to hook the woman into thinking he is interested in her when in fact he is using her to get an addictive hit, to make himself feel attractive.

This kind of seductiveness and compulsive flirting is a distortion of what flirting is really for.  It is a symptom of a problem that underlies most sex addiction: deep insecurity and the fear of intimacy.   Find Dr. Hatch on Facebook at Sex Addictions Counseling or Twitter @SAResource

6 Ways Recovering Alcoholics Deny Sex and Intimacy Issues

Many recovering alcoholics and drug addicts have problems with sex and intimacy.  Even though they have been in 12-step recovery, they may still have intimacy issues.

They may have great difficulty following through with relationships and instead go for repeated seductions in which they use the feeling of falling in love as a substitute high.  Other recovering chemical dependency people become sexually compulsive with online hook-ups or internet pornography as their new drug of choice.  Still others have intense, high drama relationships in which they seek to control the other person out of fear.  As they often say, “I don’t have relationships, I take prisoners.”

Denial mechanisms

Recovering alcoholics and drug addicts may use denial mechanisms to avoid seeing their problems with intimacy and sexuality.  When we talk about being “in denial” what we mean is that the addict is using one or more habitual ways of thinking about a situation which serve to eliminate the need to take the situation seriously or to do anything about it.

 

Minimizing

This is the tendency to see anything to do with sex and relationships as relatively minor and harmless.  The alcoholic/addict may argue that behaviors like compulsive porn use, preoccupation with online hook-ups, or frequent visits to prostitutes are not nearly as risky or life threatening as chemical dependency.  Also they may rely on the argument that sexual acting out is entirely legal and that it is victimless.

Rationalization

Sex addiction can creep into the recovering addict’s life because it is a drug that can substitute for the previous addiction.  The addict may “rationalize” this use of sex as a drug on the basis that it makes sense to rely on sex because it is a way to stay away from another addiction.  They may argue that “love” is a good thing and that being hooked on sexual behaviors “keeps me out of trouble.”

Compartmentalizing

Recovering alcoholics and addicts can appear to be leading a normal life.  As practicing alcoholics and drug addicts, their daily functioning was probably much more compromised in a much more obvious way than that of the practicing sex addict.  Sex addicts can keep their sexual behavior compartmentalized and hidden.  Out of sight out of mind.  Thus the addict can convince himself and everyone else that there is nothing wrong.  There may be not obvious consequences and there may be no one in the addict’s life who ever calls him on his behavior.

Projection

Recovering addicts often take a superior and derisive attitude toward sex addicts.  This grandiosity is a part of a narcissistic defense system that many addicts have and that covers up a sense of inferiority.  It can also take the form of machismo and sexism in which recovering alcoholics or addicts may engage in seductive and sexually predatory behavior toward people in their recovery groups.  This is sometimes referred to as “13th stepping.”  It is a need to feed the ego and to feel better by seeing other people as worse off.  Thus recovering alcoholics and addicts may even take the attitude that sex addiction recovery is a kind of joke.

Undoing

Recovering addicts and alcoholics often attribute their sexually compulsive behavior to something other than sex addiction.  They very commonly are aware that they behave in a sexually inappropriate manner prior to chemical dependency recovery and they attribute that to the fact that they were high on drugs or alcohol.  Drugs and alcohol allowed them to overcome their inhibitions and behave in overtly excessive ways sexually.

What they fail to see is that the sexually compulsive behavior is a drug in its own right and has the same roots and their chemical dependency.  They may also attribute their sexually addictive behavior to another psychological problem such as bipolar disorder.  In any case, these are ways of saying that a pattern of sexually addictive behavior doesn’t exist because it is really just a byproduct of something else.

Intellectualizing

This can take various forms in which the alcoholic uses semi-logical argument as to why they cannot or need not do anything about a problem.  One form is to take a victim role, i.e. to feel helpless and hopeless about changing how they relate to intimacy and relationships.  They argue that they have already worked a program and that there is nothing more they can do.  In other words this is as good as it gets.

Recovering alcoholics and drug addicts often have little or no experience with healthy intimate relationships.  Their primary relationship has been with a chemical and they are most often avoidant of true intimacy.

It is important for those of us in the sex addiction field to help educate chemical dependency professionals and people in the recovery community about the next phase in sobriety and about the importance of gaining relationship skills and becoming “intimacy-abled.”

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

Denial in Sex Addiction: Delusion, Distortion and Dissociation

Denial in sex addiction is a form of distorted thinking. In fact it is a masterpiece of distorted thinking. Breaking through denial marks the beginning of addiction treatment. This is just as true for sexual addiction and behavioral addictions generally as it is for chemical dependency.

Without treatment, the set of ideas, rationalizations and beliefs that constitute a system of denial become more and more entrenched and tend to spread, becoming a world view which supports a deceptive and disordered way of life.

Even for a practicing sex addict, there are moments of clear-headedness when he or she suspects that they are engaging in a problematic or pathological pattern of behavior. But that awareness does not hold up. Why? Because denial is distorted thinking in the context of a semi-dissociated (i.e. “checked out”) state. Continue reading

Do You Have to Say “I am a Sex Addict” Forever?

Sex addicts, like alcoholics in AA, typically identify themselves as: “I’m so-and-so, and I’m a sex addict.”  Some will say “I’m a recovering sex addict.”  As with the traditional model of alcoholism, they see their problem as chronic: manageable but incurable, like some physical diseases.

I have lately come to believe that sex addicts can recover.  I think there comes a point when they can say “I’m a recovered sex addict.”

Recovering begins with getting sexually abstinent

The 12-step model which originated with Alcoholics Anonymous became the basis for the other fifty-odd 12-step programs that came later.

As with other addictions, sex addiction recovery requires that addicts “kick” the habit first. For SAA members, each person defines their problematic, addictive sexual behaviors.  These are sexual behaviors that are compulsive, go against the person’s values, are dangerous, or cause serious problems.

For one person abstinence may be refraining from exposing himself to women in movie theatres and on buses.  For another it may mean abstaining from extramarital affairs and internet pornography.  Each person decides a set of behaviors they need to avoid and then counts as days of “abstinence” consecutive days of avoiding those behaviors.

These “bottom line” or “inner circle” behaviors as they are called are usually decided on by the addict in collaboration with the therapist or sponsor.  As recovery progresses the addict may add behaviors to the inner circle or take other behaviors out.

Why abstinence is essential in starting addiction recovery

In addition, sex and porn addicts are usually expected to have an initial period of several months of total abstinence from all sex including masturbation and sex with a spouse.  This is because for the sex addict, sex is literally a drug.  It is necessary for the sex addict to go through withdrawal in order to allow his brain chemistry to stabilize and his head to begin to be clear of the delusional preoccupation with the drug or behavior.

As a therapist, I can tell you that I would find it impossible to treat someone’s psychological problems if they were using drugs.  This is equally true with sex addicts.  A person’s drug of choice is bound to be stronger and more effective in the short run than anything I can offer in the way of relief.  Before I can do therapy I must get the client to address this and other “therapy interfering behaviors” as they are called.

What comes after abstinence?

Sex addiction treatment, like the 12-step program model, is designed to go beyond quitting a drug or behavioral addiction.  This is because abstinence alone will not make you stay sober. 

In order for recovery to be lasting, the addict must delve into their life history and arrive at an in depth understanding of the ways they are damaged and how that damage has led to their addiction.  In working through what is usually some kind of early relational trauma, the addict no longer needs to let old fears and insecurities direct his or her behavior.  The addict can then become, as recovering people say, “comfortable in their own skin.”

Without this deeper level of psychological change, most addicts cannot stay away from some form of addictive behavior.  They may manage a period of abstinence for months and even years, but their adjustment to life is fragile and unsatisfactory and they eventually get into trouble again.

The fruits of a fuller recovery

Recovery begins and ends with connection.  In the beginning addicts are in hiding, leading a double life of deception and shame.  The initial commitment to get into recovery involves a decision to connect with a group or person such as a 12-step program group or a therapist.  This is an initial act of faith based on little more than being fed up with the way things are.  This is a big step in itself, since believing in and connecting with anyone is often a stretch for an addict.

But what begins as a connection with a person or an SAA meeting grows into a deeper and wider connection; a connection with one’s own innermost self, with one’s significant other, with community, with meaningful work and with humanity.  The addict “grows up” to become a fully functioning adult who lives in contentment and integrity.

Feeling peaceful and alive, feeling secure and happy, helping others, these are worth the effort.  But I believe that in gaining this, the addict can be confident that he or she has truly changed.  They are not the same person and thus I believe they can say “I used to be a sex addict; now I’m a recovered sex addict.”

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

4 Spiritual Practices You Don’t Know You’re Doing

Spirituality and spiritual enlightenment are mystified in our culture. By mystified I mean made to seem mysterious and esoteric. I think this is mistaken thinking. In the world of addiction recovery many people balk at joining 12-step groups because the spiritual emphasis is alien or elusive and they cannot relate to the idea of surrender to a higher power.

The 12-step literature is deliberately vague about what is meant by a faith or by a spiritual awakening. But even for people who are very religious there can be something that is not working for them.

A religious client of mine put it well. He said basically that his religion had not been adequate to help him to overcome his sexually problematic behavior. Although he continued in his religious life, he was open to another kind of spirituality as part of his recovery.

I have argued in a previous post that one does not need the concept of a higher power to succeed in recovery and I proposed practicing certain attitudes and behaviors that promote spirituality. These ideas which are now increasingly accessible and a number of excellent writers draw on a variety of spiritual traditions without requiring any kind of religious faith. Their emphasis on mindfulness, meditation and intuition has now become well established in the scientific literature as an evidence-based aspect of treatment.

But in addition to spiritual practices that can be cultivated, I believe there are many things we do in the course of our daily life that draw upon our spirituality. These are things we are not aware of as being spiritual per se, but which serve a necessary purpose in our everyday attempt to regain our equilibrium and cope with inevitable challenges big and small.

I will describe some of these, in no particular order, and give a rationale as to how each is an expression of our spirituality.

Schadenfreude. This refers to the rather base impulse to take some pleasure in someone else’s misfortune. We all do it. Sometimes it’s gloating but very often it’s relief: “At least I haven’t lost my job, or my money or my health, etc.” In other words, “It could be worse.” And hidden in this line of thought is a very important concept; that of gratitude, the idea that life is pretty darn good. Gratitude is a key concept in maintaining contact with reality. In taking our thoughts away from what is lacking and focusing on how lucky we are, we are brought back into the present. We are taken out of the frame of mind of never having enough, of being deprived, or being a victim. We let go of the “if only” mentality and enter into the feeling of the present moment without judgment. It doesn’t get any more spiritual than that. Gratitude is the royal road to acceptance.

“Whatever!” This is what we say when we hit the wall. We are in a situation where we care a lot about the outcome; a test we will pass or not, a meeting that could go well or badly, an operation, even whether or not our partner is telling the truth. At the “whatever” point we are allowing ourselves to let go. Letting go of outcomes is one of the premier spiritual moments and we experience it instinctively when we give up on obsessing about something that is out of our control. Letting go of outcomes does not mean thinking that everything will turn out great, but it implies a kind of faith that we can retain our perspective and our serenity no matter what.

Running away. By this I mean making a conscious choice to hide or isolate one’s self temporarily. This could be getting away from a party or gathering that feels alienating, withdrawing from an unpleasant conversation, carving out quiet time at home, or walking out of a movie. This is a spiritual practice in two ways. It involves listening to an inner voice or intuitive sense that something is not right. In listening to this voice we are practicing getting in touch with or becoming aware of what we are feeling in the moment and being willing to trust that awareness. But isolating, deliberately being alone, also serves to provide the outer stillness that allows us to get centered in inner stillness, to shut out all the noise both inside and outside our heads. This is essential to mindfulness and meditation.

Empathy. Feeling sorry for someone else is powerful spiritual practice. When we pity someone it may or may not do anything for them but it helps us. We are noticing another person not just with our eyes but with our feelings. This involves letting go of any other feelings of resentment or judgment we may have had about the person. It also involves letting go of our separateness; we identify with another being and in so doing we are, at least momentarily, experiencing a oneness with them and letting go of the illusion of our separate ego identity.

There are many resources for spirituality (mindfulness) practices and guided meditations available that do not depend at all on sectarian religion. For more on spiritual practice and guided meditations I recommend the work of Sam Harris  available online at www.samharris.org.

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