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

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

Sex Addicts are Codependents Too

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

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

-are sexually compulsive outside of the relationship

-are intimacy avoidant

-use coping skills which create distance

-lead a double life

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

-fearful of abandonment

-enmeshed and preoccupied with their partner

-emotionally constricted or volatile

-subject to self-doubt and insecurity.   

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

Origins of codependence

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

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

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

In what way are sex addicts codependent?

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

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

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

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

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

I think of the disease of codependence as a tree. 

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

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

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

Not Sure if You’re a Sex Addict?

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

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

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

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

Sex addiction may not be the “primary” addiction

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

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

Addictions may be fused with other addictions

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

Sexual acting out may not be continuous

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

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

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

The person who can sexually “act out” in moderation

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

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

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.

 

3 Gateways to Intimacy: Things You Can Practice Doing Now

Intimacy is the ability to be real with a significant other, the ability to be known for who we really are.  And being seen in this way requires that we are secure enough to take a risk and be vulnerable.

Sex addiction has been described as an “intimacy disability.”  Addictive behaviors are ways to deal with stress and negative emotions; ways that do not depend on other people for soothing or emotional support.  Addicts feel mistrustful about being open with their needs and have a deep rooted belief that no one who really knew them could love them.

In recovery, addicts learn to reconnect with themselves and with their inner feelings without running away.  And they learn to reconnect with other people with more trust and less fear of rejection.

But addiction treatment does not automatically resolve all the addict’s fears about being known and about sharing all of themselves with a partner.  Becoming intimacy-“abled” is a much longer process than that of simply kicking an addiction.

Building intimacy skills

It is all very well to tell people to stop judging, to set appropriate boundaries or to “speak your truth in the moment.”  But these can seem pretty abstract and hard to put into practice.

Here are some specific kinds of behavior that the addict can focus on and some ideas about why they may help promote intimacy.

Nurturance

Nurturance involves giving someone what they need.  But in a relationship with a partner it also implies that the nurturer gives something (reassurance, food, listening, back rubs etc.) willingly and without resentment.  You don’t have to be a saint to nurture someone, and you can even do it because you are convinced that it is part of what you should do as a partner.  But real nurturance does mean that you give some attention to what the other person is feeling and that you are sincerely motivated to be kind to them.

Why does being nurturing foster intimacy?  Because it promotes empathy and an understanding of what your partner is like inside.  If done in the right spirit, nurturing makes us more able to be caring.  And taking care of someone is a way for them to feel our love and for our love to become deeper.

Also nurturing another person has the potential to bolster our own self esteem, even if that is not the original motivation.  When we give freely in this way it means that we are “full,” that we are not always worrying about our own need for self enhancement.

Mutual process

How do you relate to a partner when dealing with something specific in your life together?  It could be anything: an analysis of a movie you saw, a decision about buying furniture, or a discussion of one another’s plans and fears.

Addicts are all-or-nothing people: either we do it my way or we do it your way.  Instead of engaging in a constructive back and forth the addict will simply try to convince you of their own point of view.  If you are right they are wrong.

Approaching a question or topic as something to be decided together by a back and forth of ideas is new behavior for many recovering addicts.  But even if it is hard to believe that your partner could be right about anything, you can still practice listening and responding to what the other person says.

This is not the same as arguing your point and trying to convince the other person.  The point is to take a breath and allow the other person’s ideas to stimulate your thinking.

It is obvious how mutual process supports intimacy.  The “we” is greater than each of you alone.  In mutual processing you are building something together.

Shared experiences

It has been said that “love is not gazing into each other’s eyes, but it is gazing together at something else.”  When you can share and experience with someone you are automatically providing fertile ground for intimacy.

People who share intense experiences like being in combat in the armed services know that there is an automatic intimacy of a sort just from having gone through the same thing.  When we share something we re-affirm our common humanity because, to a great extent we have the same reactions to things.  This is especially true for powerful experiences like joy and triumph.

But sharing a joke or a sunset or a silly cat video can help feed intimacy.  This does not require any particular skill; simply that you make sure that you include times when you share experiences in your daily life together.

Fake it ‘til you make it

Fake it ‘til you make it is an idea that is often heard in 12-step meetings.  It means that you engage in healthy behavior even before you have fully embraced it.  And the theory is that in time you will come to feel that it is part of who you are.

In relationships it is also important to engage in specific caring behaviors and ways of relating.  Otherwise couples can end up endlessly talking, reading and “working on the relationship” without really getting anywhere.

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

When are Sex Addicts Ready for a Relationship? Here’s a Checklist

Most sex addicts enter sex addiction treatment with a warped sense of what relationships are all about.  The relational trauma in early life that made them addicts also results in their having:

  • No models of healthy relating over time
  • No experience of giving or getting appropriate nurturing
  • No set of relationship skills such as openness and mutuality

Some sex addicts avoid relationships altogether, preferring to limit their intimate contact to porn, prostitutes, hook-ups, cybersex or other sexually addictive behaviors that allow them to avoid the demands of real connection with someone.

Other sex addicts form relationships and marriages while they are secretly active in their addictive behavior.  They too are avoiding intimacy.  They cannot share their deeper feelings with a partner due to fear of being hurt or abandoned.

Mistaken ideas about what relationships are for

Here are some of the superficial ideas that often form the sex addict’s paradigm of what a relationship is for:

  •  A relationship will bring me social recognition and acceptance in a world I want to belong to.
  •  A relationship with a glamorous person will make me proud and confident and make others envy me.
  • A relationship with the right person will provide the perfect balance to my life.
  • A committed relationship with children will make me a normal person with a normal life.
  • We will be considered a “great looking couple.”
  • The right relationship can cure my addictions.

These ideas come out of a sense of inadequacy and reflect the addict’s inability to imagine a healthy bond.  They reveal his or her narcissistic view of a relationship as a useful accessory and a partner as a fantasy.

Recovery lays the groundwork for relationships

In recovery sex addicts have gained enormously in the areas of self-awareness, self control, accountability, honesty, sharing and empathy.  They have learned to connect with themselves and with others.  And they have learned that they are worthy to be loved and that commitment requires vulnerability.  They are less self conscious, more confident and better at communicating.

All of this does not guarantee that the addict is ready for a relationship. Here are some questions that may help clarify whether the addict is ready to try again.

A relationship readiness checklist*

1.      I am more aware of what I am feeling at any given time and I am more able to identify feelings and think and talk about them.

2.      I have taken care of my basic health needs including having an STD test and other routine tests. If I have been prescribed psychotropic or other medication I follow up on appointments and on the use of medication.

3.      My ability to focus on whatever I am doing is improved and I don’t feel anxious and pulled in different directions as much.

4.      I enjoy having “down time” and I don’t feel like I have to do something all the time.

5.      I have learned that I can go to a counselor or other person I trust for help or advice and I can listen to what they say even if I disagree.

6.      I am aware of any problems I have with other addictions and I have done what I needed to do to address them.

7.      I have found ways to keep myself accountable regarding my addiction that rely on people other than a spouse or partner.

8.      I am willing to try out new activities and interests and I am OK if some things I try don’t work for me and others do.

9.      I am willing to experiment with changing my daily ritual.

10.  I have a greater sense of what I want and need and am clearer on what things interest me in life.

11.  I am more interested and confident in my work or other activities.

12.  I am more flexible and more tolerant than I used to be.

13.  I feel like I can stick up for myself when I need to without going overboard.

14.  I am not as self-conscious about initiating a social contact and I can be more comfortable just being myself.

15.  I no longer feel anxious or apprehensive when I am alone.  I would like a partner but I am OK without a partner.

Having achieved these milestones is a minimum requirement for a recovering sex addict who wants to start out with a new relationship.  But the addict will still have some work to do to.  Applying these new found skills in intimate relationship without repeating the mistakes of the past is the next biggest challenge in recovery.  It takes time, practice and a whole lot more self-examination.

*From my book “Relationships in Recovery: A Guide for Sex Addicts who are Starting Over.”

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