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

What is a Certified Sex Addiction Therapist (CSAT)? Frequently Asked Questions

What is involved in becoming a certified sex addiction therapist or counselor?

First, an important point to remember is that only therapists already licensed or otherwise credentialed in their particular counseling field (e.g. psychologists, clinical social workers, marriage counselors, pastoral counselors) are eligible to enroll in the CSAT training.

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