New Treatment Models for Teen Porn Addiction

The enormous global proliferation of online pornography has made a vast array of sexually explicit material available to a large teen audience on laptops, tablets and smart phones. And if smart accessories catch on, you will soon be able to wear your pornography.

Online pornography accounts for such an overwhelming proportion of internet traffic that a new search engine has been created specifically for adult content. It was designed by two former Google employees and searches only for pre-screened adult content that is free of illicit or malevolent intent. It is also designed to protect the user from cookies and other forms of identity tracking. The site was launched on September 15th and according to the founders has “taken off like a rocket.”

Internet porn has long been seen as more readily accessible than riskier and more costly habits like prostitutes, massage parlors or anonymous hook-ups. This in turn makes it more easily available to youth, with the typical first exposure being in the pre-teen years.

Effects of porn on teens and young adults

A study published this summer in the by the UK’s Institute for Public Policy Research surveyed 500 18-year-olds about the impact of porn on their lives. Most of the respondents reported that accessing pornography was common throughout their school years, began in their early teens and had a damaging effect on their sexual and relationship lives.

Dr. Anthony Jack, a researcher and neuroscience professor at Case Western Reserve University stated that recent studies show “…widespread rates of sexual dysfunction… such that approximately 50% of late adolescents of both sexes report sexual dysfunction of clinical severity”.  (See “Your Brain on Porn” by Gary Wilson)

Another study published this month by researchers in the US found that among a sample of over 900 emerging adults in college more frequent porn viewing was correlated with a greater number of sexual hook-ups and one night stands.

Other recent studies of the brain activity of chronic porn users have begun to show detrimental effects such as:

• Less gray matter and reduced reward center activity while viewing sexually explicit imagery, i.e. desensitization.

• A weakening of nerve connections between the reward centers and the higher brain centers thus increasing impulsiveness and impairing decision making.

• Porn induced erectile dysfunction

As one of the researchers put it, “…regular consumption of pornography more or less wears out your reward system.” And clinicians here and abroad are seeing many more young adults and teens who can achieve erection and ejaculation with porn but not with a real person.

Treating the young porn addict: three models

The current crop of very young addicts have some special characteristics. The pre-teen brain is not fully mature and their emerging sexuality programs them to react powerfully to sexual stimuli. Getting hooked on porn at an early age can be damaging in at least three different ways. These in turn require interventions very different from the years of addiction treatment and relapse prevention that are appropriate for most adult addicts.

I. The drug-driven model

Jeff’s addiction appears to have come about through the habit-forming nature of porn itself in the absence of any other obvious psychopathology.

At first I thought Jeff was just like any other sex addict client, only younger. He had been watching porn on his computer since he was 13, and at age 18 he realized he had begun to fixate on child porn. Fortunately this scared him enough that he came clean to his parents who put him in a 6 week residential program for sex addiction.

After the residential program Jeff saw me for therapy for about a year. He also attended weekly Sex Addicts Anonymous meetings. He was an attractive, sophisticated kid with a sunny disposition, but at 20 he was still a virgin who had never dated a girl. While he was seeing me he began dating a very appropriate same-age young woman and eventually began a robust sexual relationship with her. Although that relationship ended he never returned to porn use that I know of. I am as certain as I can be that he had no residual attraction to children.

What is striking is that although Jeff went along with the usual program of sex addiction recovery, what seems to have worked for him was just getting away from porn! With abstinence, it seems his young brain rebalanced and in a period of months he was able to resume normal sexual development. He became more outgoing and began college with the ambition to become a filmmaker. Jeff needed a structure that would allow him to stay away from porn along with some outside support to get his life back on a normal track.

II. The trauma model

Brad discovered internet porn at 12 and became instantly hooked. He reports that his use escalated very rapidly as did his sexual tastes. He was binging on porn very heavily every day. While still in his teens he says that he quit, primarily out of exhaustion. His sexual interest diminished to zero and as of his mid 20’s he reported that his libido seemed to be permanently gone. He attributes this result to a kind of virtual sexual trauma.

There is some research that would support the idea that very early exposure to sexually explicit material can have effects on the developing psyche similar to actual sexual assault. The young mind is not ready to deal with the shock, adrenaline and stress of the hyper-arousal caused by porn. It thus constitutes a violation which can leave lasting sexual scars. Brad correctly sought out treatment with a specialist in sexual trauma rather than sex addiction.

III. The hybrid model

Ken is a happily married man in his late 20’s. He entered treatment for an addiction to porn and masturbation dating from childhood. He had no other sexually addictive behaviors but he had significant early trauma. His father died of a cocaine overdose when Ken was a toddler. Ken became the “man of the house” at age 3 and soon after had a serious illness requiring months of hospitalization. He had an unhealthy relationship with his narcissistic, demanding mother. Also as a child he witnessed his teenage sisters being molested by an older cousin.

After about 8 months of abstinence from porn and with the support of group therapy Ken has shifted gears. His relationship with his wife whom he adores is going well and he is comfortable with a new-found intimacy with her. In fact Ken no longer presents as an addict; he does however have issues that he knows he needs to work on. In particular he knows he has never fully understood or worked through his early childhood experiences and he is working his way out of his enmeshed relationship with his mother. He is appropriately seeking help for these problems and appears to be at zero risk of relapse into porn addiction.

So the good news is that the youthful porn addict’s brain can recover and resume a more normal developmental trajectory. And given that their only addictive behavior is internet porn and that their total time of usage relatively short, they do not have to overcome addiction as a pervasive and deeply entrenched coping style. They can get cured and stay cured. The bad news is that there is as yet so little awareness of the risks to children and teens on the part of the medical profession, the academic community, schools and the public at large. As with so many public health issues, prevention and education are sorely needed.

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

Online Relationships: Real or Fantasy?

When I “e-meet” someone, that is connect online, I often have strong and immediate feelings that I like them or that I don’t, even though I have never seen them or talked to them in person.  It is not a stretch to see that this feeling of connection can be experienced by many people as an intimate and even sexual attraction.  (I have dealt with the topic of connecting sexually through cybersex vs. real sex in another post.)

The reality basis of online connecting and “she sounded cute on the phone”

Part of the sense of immediately knowing someone from very little actual information has to do with the fact that we as humans may be using our gift for “rapid cognition” as it is described by Malcolm Gladwell in his book  Blink: the Power of Thinking Without Thinking.

Gladwell also uses the term “thin slicing” to describe the phenomenon by which we can sometimes evaluate situations and make decisions almost instantaneously, with a seemingly miniscule amount of information and without actual logical reasoning.

This is a scientific description of what I think of in some situations as “intuition”.  I am reminded of my surprise when first hearing men say things like “she sounded cute on the phone.”  “She sounded cute?”  How does somebody sound cute looking?

Regardless of what we call it, it does seem that we can get a powerful and sometimes fairly accurate idea of what someone is like with limited actual input and without the aid of analytic thought. And this is especially true as people scan for sexual cues.  But surely there is much more that we don’t know that may be crucially important in determining whether they could be a close friend or lover.

However, in connecting online we have come into contact with someone with whom closeness and even intimacy could be a real possibility as opposed to the millions of people we wouldn’t even want to know.  We have used our intuition and our computer tools to give us better odds than we would ever have otherwise.  And of course this is the numbers game that online dating and friendship sites depend on.

The fact that we can connect in real ways online has become a pervasive and important part of life.

The fantasy element in online relating and the bridal veil

As a sex addiction therapist I deal with many people who have fantasy relationships online including sexual chat, hook-ups, cybersex experiences, and finding prostitutes.

Obviously for sex addicts online relationships can be part of a pattern of intimacy avoidance and usually involve splitting off part of the addict’s life that deals with sex, often at the expense of real intimacy with a partner.

But the fantasy element of online relating can enhance the illusion of intimacy for addict and non addict alike.

I think of the experience of online intimacy as having a “value added” element. What we add is our imagination of reality in order to complete the online picture which is always incomplete.  These value added elements appeal to our all-too-human needs.  Here are a few.

  • Intimacy without accountability.  In online relationships we don’t owe each other anything and we don’t have to do anything we don’t want to do.  We can just enjoy each other and then walk away from the computer.
  • Perpetual romance.  In an online romance we can idealize the other person and since the fantasy is never contaminated by reality we never have to let go of our ideal.  This allows us to avoid real intimacy and puts in its place a “story” we can concoct about the essence of the relationship—one that fits out best fantasies.
  • Idealizing our self image.  In online relating we can curate and embellish our own image. People can and often do deceive others and indulge in a fantasy of being better looking, more successful, smarter, younger or whatever helps alleviate their insecurities.
  • The excitement of the unknown.  The element of mystery, surprise and sometimes danger involved in the online encounter is powerful fuel which can propel us further into the “relationship” and the excitement can be an end in itself.

Why do some brides still wear veils covering their faces until after they are officially married?  This archaic gesture conveys not only the idea that the bride is pure and untouched, but also serves to prolong until the last possible moment, the fantasy of what physical and sexual intimacy will be like.  In this way veils are a precursor of the mystery and fantasy involved in online encounters.

As with so many things the online relationship can be great or it can become a problem, a substitute for off line relating and even an obsession.  We are still learning how to navigate this new world.

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

“I’m So Sorry”: Do Sex Addicts Really Mean it?

Celebrity sex addicts from high profile politicians to iconic sports stars whose secret behavior is exposed are quick to apologize.

We see them on television, often with their betrayed spouse beside them, saying how sorry they are and apologizing to their fans, constituents, partners and the world at large for betraying their trust and violating their own values. But can they really be sorry right away?

One’s first and maybe cynical impression is that they are not so much sorry about what they did as they are sorry that their life has been turned upside down. And indeed, in sex addiction treatment, it is not unusual for the addict to initially experience a flood of emotion and remorse just from realizing the full meaning and enormous impact of their behavior. A colleague of mine refers to this outpouring as “narcissistic tears.” They have come face to face with their own human flaw.

Sex Addiction Treatment Stresses Remorse

The accepted protocols for treating sex addiction as well as the 12-step programs stress the need for the addict to come out of the self-centered universe of addiction and begin to see the damage done to others as well as to him/herself. But it is understood that although the initial crisis period results in a flood of shame, the basic change needed for what is known as genuine “victim empathy” to emerge requires years.

As a trainee I observed my supervisor interviewing a new sex addiction client. The client said “But I’m really a good man.” I was surprised when my supervisor responded “No you’re not.” This kind of confrontation is sometimes important in helping to shake loose the addict’s narcissistic false self image.

What is involved in real remorse?

In some instances we can be truly sorry right away. If a bus lurches and you step on someone’s foot you immediately say “I’m sorry”. And in this instance you really are sorry, because you had no ability to control your hurtful behavior. You have immediate empathy and concern for the person even if they are inwardly – or outwardly – cursing you for being such a clod.

The betrayal of other people (and oneself) that accompanies the ongoing sexual acting out of an addict is a different kind of hurt. Losing your balance on a moving bus and stepping on someone’s foot has, as least for most people, no particular connection with their sense of who they are. It is an involuntary act that says nothing about us, hence it is easy to accept that we have (involuntarily) hurt someone.

But if you as an addict have been habitually finding selfish ways to secretly meet your own needs at the expense of other people then “I’m sorry I hurt you” doesn’t seem to cut it.

In the immediate aftermath of the disclosure of a sex addict’s secret life it is clear to everyone, except maybe the addict, that he or she is still the same person. There cannot be an instantaneous transformation. Every bit of fear, conflict, low self worth, and lack of integrity is still there.

Real remorse and victim empathy can only happen when the addict has done enough self exploration and acquired enough self awareness to function in an entirely different way. Major basic change of this kind involves;

• A shift from impression management to honesty and transparency

• A shift from a habit of avoiding, controlling and placating others to a genuine ability to express feelings, needs and vulnerabilities

• A shift from grandiosity and self-centeredness to an ability to really listen to another and to be comfortable being influenced by a partner

• A shift from a compartmentalized life to an ability to share all the parts of oneself with another person

In other words, the addict becomes integrated, stronger, more centered and more available to bond. For those who know the person well, these changes are often very obvious. We feel the addict to be more sincere, more serious and more grounded. And perhaps the most obvious way that this new found integrity is expressed is in the addict’s commitment to recovery for its own sake. The addict is not longer going to meetings and therapy to please someone else or burnish his/her image. Recovery will have become unmistakably important in and of itself.

Implications for partners of sex addicts

The initial feelings accompanying disclosure may be an important motivator in getting the addict to commit to his/her own recovery going forward, including the wish to make it right with the partner.

But although the addict feels some immediate relief in knowing that he has come clean and that help is on the way, the partner who chooses to stick around will often have a much harder time recovering. A large part of the reason for this is that the process of bringing about deeper inner change sometimes seems glacially slow.

The literature on sex addicts and partners reports that on average it takes a year to begin to rebuild trust. Often it seems to take longer than that.  I believe this is not only because the addict needs to “behave” for long enough to establish credibility, and not only because the addict must walk the walk of making amends. It is also because the partner can tell whether and to what extent basic inner changes are taking place. And in the long run this is essential to the credibility of the addict’s expressions of empathy and remorse.

This article originally appeared on Recovery Brands:  http://www.recovery.org/pro/articles/im-so-sorry-when-do-sex-addicts-really-mean-it/

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

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

Losing a Partner Complicates Sex Addiction Recovery

A sizable number of couples stay together through the upheaval of sex addiction. According to my educated estimate about half of all sex addicts in sex addiction recovery are working with a partner to try to repair the relationship.

By the same token many sex addicts end up losing their partner following the disclosure of sex addiction and the ensuing crisis. I have found that there are complications for recovery in both situations.

If the sex addict’s partner chooses to stay in the relationship, then the sex addict has certain advantages. The presence of a partner (and possibly children) very often provides a strong motivation for the addict to follow through with treatment and recovery. No matter what the addictive behavior, internet porn, prostitutes, hook-ups, etc. the married sex addict has a lot to lose by failing to get “sober”.  Also the presence of a partner adds a level of accountability. If the addict is truly engaged in recovery, then he or she will be committed to transparency and honesty with a partner and in general. Agreeing to tell all can help to give the addict a reason to be more conscientious about avoiding situations that might lead to relapse.

But what happens when the addict comes clean to a partner, becomes sincerely engaged in recovery and then the partner or spouse leaves? I would like to share my observations as to the impact of divorce on sex addiction recovery; both the negative impact and to whatever extent, the positive impact as well .

Negative impact of break-ups

  • Apart from the loss of motivation and accountability that was connected to the relationship, separation and divorce add serious emotional stresses to the situation. The end of any relationship, even a bad one, is experienced as a loss. This means that even for a person who was not struggling with addiction and recovery, there would be grief and deep feelings of abandonment.
  • As I have discussed elsewhere,  sex addicts tend to be highly co-dependent themselves even though they have lead a secret life outside their relationship. They are insecure and tend to base their self worth on the perceptions of others. The rejection of a break-up only reinforces their feeling of unworthiness which in turn can derail any new found sense of strength in recovery.
  • The turmoil surrounding a separation or divorce can become a serious distraction from the addict’s recovery routine. The mechanics of leaving familiar surroundings, finding a place to live, arranging to see their children if there are any, and dealing with the legal process of impending divorce proceedings can sap the addict’s energy and resources.
  • Addicts in a break-up will be experiencing a great deal of emotional pain and distress. Their typical way of dealing with negative emotions in the past was through escape into their addictive behavior. Thus the added emotional distress of shame and rejection increases the motivation to reach for their “drug”.
  • Most sex addicts have a problem dealing with boredom and loneliness without wanting to act out sexually. Isolation is not helpful to sex addiction recovery and the fact of suddenly being on their own can be a big risk factor, especially if break up has left them feeling less motivated to engage with supportive people.
  • The addict can become obsessed with the partner who has rejected them, thus leading them into destructive fantasies and delusional thinking. They may fantasize that they can win the partner back, or they may ruminate and become angry and resentful. They may also become obsessed with finding a new partner immediately in order to bolster their damaged sense of self and restore parity with the person they have lost. All of this obsessing and emotion pulls the addict away from reality and from the need to address their own recovery and growth.

Is there any upside to break-ups?

Obviously there may be advantages for the spouses and partners who feel that moving on is in their own best interests. But what about the addict? I believe that after the immediate crisis of the break-up and its impact on sex addiction recovery have subsided, the addict will be in a better position to assess the intimacy problems that almost certainly characterized the relationship. I contend that practicing addicts are drawn to partners and styles of relating that do not demand. In that sense, I think the practicing addict promoted a sort of dysfunctional situation both because it was somehow familiar and because it provided a situation that at once allowed and was an excuse for sexual acting out.

In sex addiction recovery, the divorced or separated addict has a chance to recover from the addiction and to learn a new kind of relating built on intimacy and trust.

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

It’s OK to Have Bad Sex: The Sex Addict’s Difficult Adjustment

Sex addicts tend to be perfectionists.  And this is especially true in their attitude toward sex.  They are known for their all-or-nothing thinking, the tendency to view the world in terms of extremes.  In their sex life with a partner, sex addicts in recovery tend to carry with them an extreme and basically intolerant set of expectations. Just as an aside, there have been a slew of blogs and research survey findings that suggest that we are all having our sexual expectations distorted by the increasing pornification of our culture.  Some in the “feminist porn” movement and elsewhere have attempted to fight the idealized images and expectations shown in mainstream porn and in the “ambient porn” of movies, games, magazines and TV.  See also my journal article the findings of the APA task force on the sexualization of girls in our society.

The over importance of sex and orgasm

Sex addicts have as a core belief that sex is their most important need.  Thus sex addicts place an undue emphasis on sexual arousal and gratification.    Even before the advent of internet porn, sex addicts have always tended to be in a hurry to get to the sex act and to achieve the perfect orgasm.  If this didn’t happen all was lost. Having permission to have “bad sex”, i.e. sex that doesn’t match some perfect ideal, is a way to counteract the desperate need that sex addicts feel.  It can help relieve the pressure and can allow for times when the partners feel less energetic, more sensual etc.  It takes the focus off of “getting my needs met” and places it more on just having a sexual, physical experience with someone you are close to.

Fantasy standards of desirability

Because sex addicts are used to engaging in sex that is excessively loaded with fantasy content, (sex with strangers, cybersex, escorts, strip clubs, and of course pornography) they usually have perfectionistic (fantasy ridden) ideas about how women’s and men’s bodies should look.  This then results in the feeling that any sex with someone who doesn’t measure up to a fantasy standard of beauty or prowess is no good.  Hence the saying that to an addict “sex with a real woman is just bad porn.”

Unrealistic expectations about sexual behavior

Sex in the context of a relationship may seem boring to a sex addict.  In a real situation the addict has to deal with all kinds of awkward, messy and most importantly unpredictable elements.  These will almost certainly burst the addict’s fantasy bubble. In addition, sex addicts are used to fantasy scenarios that may involve all kinds of erotic behavior that their partner may not wish to engage in. We are asking the recovering sex or porn addict to adjust to what they may see as “plain vanilla” sex.

Paradoxically, sex in real life may also be more unpredictable and less boring.  Sex addicts are used to controlling the sexual experience from beginning to end.  In sex addiction, the addict has a preferred scenario or arousal template. This can evolve and escalate into more extreme behaviors, but the addict knows what he or she is going to get.  Real, relational sex is not so predictable.  This means things may end up unusually exciting and passionate or they may end up less so.

Expectations of hyper-arousal and porn induced ED

In addictive sexual acting out, the addict seeks a very extreme form of arousal and often seeks to prolong it.  This level of extreme or hyper-arousal is unlikely to exist in any everyday situation.  Furthermore there is beginning to be evidence that porn addiction in particular can lead men to experience erectile dysfunction when they attempt to have sex with a real person.  This porn induced ED, as it is called, is reversible when the addict abstains from porn use for a period of time.

The use of ED drugs like Viagra is becoming increasingly prevalent, even among younger men and men who don’t need it.  Addicts in particular may have exaggerated ideas about what they need to be able to do to “perform” sexually and may be very anxious in trying to have healthy sex with a partner.  It is normal for men to have a physical response to what is going on around them and sexual “performance” can vary for any number of reasons.  It is unfair, inaccurate and inhumane to see these fluctuations as a sign of something wrong or bad.  In recovery there is often a period of insecurity about sex but this is not a signal to panic and reach for ED drugs.

Sex can be a good thing no matter how it turns out

Sex addicts are so zeroed in on sex as central to life that they don’t realize that it is only one aspect, not the be-all and end-all.  Sex addicts find it hard to fathom the idea that, for many people, sex is great but has its proper place among many other great things in life.  In relationships sex is no doubt very important but it is a source of bonding as well as excitement and gratification.  The behavior of the partners and the level of arousal will exist in a broader spectrum or array of experience.

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

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

Subtle Signs of Self Hate: Recovering Sex Addicts Find New Outlets

There is a common saying among sex addiction therapists that “sex addiction is not about sex, it’s about pain.”    Sex addicts use one or more sexually addictive behaviors such as internet pornography, frequent visits to prostitutes or sexual massage parlors, compulsive sexual hook-ups or serial affairs and so on as a drug of choice to escape stressful or unpleasant feelings.

Sex addicts, like most other kinds of addicts have long-standing doubts about their worth as people.  They have early life histories that have left them fearful of intimate relating.  They are afraid to be open or vulnerable.  They protect themselves from situations in which they feel insecure by retreating into their addictive behavior, their fantasy life of sexual acting out in which they are soothed, gratified and safe.

Addicts may continue to experience low self worth even as they are becoming stronger in their recovery.  It takes a long time to understand and work through the feelings of low self worth and even longer to become confident and comfortable in their own skin. 

Substitute ways of acting out in recovery

Recovering sex addicts who are reliably free of their sexual acting out behavior may exhibit certain behaviors which get in the way of their work, their ability to relate to other people and their intimate relationships.  They are finding new ways to “act out” their feelings and fears now that they can no longer use their drug of choice.

In their work life and social life addicts often exhibit their need to escape their deep self doubt in one or more predictable ways, such a

Conflicts at work.  Addicts may have trouble getting along with others and may be irritable in ways that they never were before.  This is due to the absence of their ability to soothe themselves with their sexual behavior.   

Compulsive overwork or workaholism.  Addicts may pour themselves into their work as a way to escape having to deal with people or relationships.  Work can take up all the space that is left over in which the recovering addict feels ill at ease.

Comparing, competing and contempt.  These are the narcissistic behaviors.  They are an attempt to avoid self doubt and self hate by constantly judging others and trying to be one up.

Need to please.  In the absence of an inner sense of worth and validity, many sex addicts become pleasers.  They feel safe and soothed when they have the approval of others.  This takes the place of a skill they have not yet mastered, that of speaking their truth and being clear about their needs and feelings.

In close relationships addicts will engage in behaviors that tend to put distance between them and their intimate partner.  In this way they escape the demands of intimacy which they feel inadequate to meet.  They do this even as they exhibit codependent behaviors like the need to fix and control.  They will

Subtle or passive aggressive hostility.  This can take many forms such as sarcasm, contempt, sighing, groaning, and eye rolling.  This behavior expresses feelings indirectly which the addict feels incapable of expressing directly. 

Provoke conflict.  Recovering addicts often feel dissatisfied and irritable.  They may project blame onto their partner for this and they may escape intimacy by creating a rift. This can come in cycles, almost like an abuse cycle of lashing out, remorse, reconciliation and repeat.

Flirt or engage in other mini-sexual behaviors.  As discussed in my previous post about subtle forms of betrayal, sex addicts in recovery may use behaviors like flirting, ogling or talking about other people sexually, or reaching out to old girlfriends or boyfriends online as a substitute for their earlier sexually addictive behavior.  This is a way to give themselves a small bit of their drug, a mini “fix.”

Avoid sex.  Sex addicts may take a long time to get comfortable with a sex life with their partner.   Even if they enjoy it, their whole inner sexual landscape has been revamped in recovery and they may have new fears about sexual intimacy such as sudden attacks of performance anxiety or other fearfulness such as jealousy.

Overcoming all of these insecurities and learning to feel and express feelings takes time and patience for both the addict and those around them.  Sex addicts in recovery are building a sense of self and acquiring a set of interpersonal skills that they never had before.  They will get there if they and their spouse or partner or trusted friends are honest about what is going on.