Why Some Sex Addicts Keep Relapsing in Recovery

Let’s assume you are already clear on the fact that you are a sex addict.  You have consulted with experts and ruled out other causes of hypersexual behavior such as medication reactions (as with some Parkinson’s drugs) and other psychological, physical or neurological disorders. Are there any wrong reasons to get help?  Yes and no.  The initial motivation for getting into sex addiction treatment is often as a means to some other end rather than as a way to become healthier. Yet in the process of recovery the motivation moves from outside of you to inside of you; from extrinsic to intrinsic.  This is when you become truly engaged in recovery.  And this process of embracing recovery even in the absence of any outside pressures to do so is what makes it possible to enjoy solid, long term sexual sobriety.

What drives people into recovery vs. what keeps them there

There are a number of  situations that lead people to reach out for help and then stall out. 

  • Getting in trouble

This could be anything from getting arrested for indecent exposure to losing your job after being discovered using pornography at work to getting in trouble for sexual harassment.  You may get into treatment because you are required to as a result of getting in trouble. But if that remains your only reason to change you will not get too far.  You may stay committed to your addictive behavior and simply “white knuckle” your sobriety in order to meet society’s requirements.  Chances are you will correct your legal or employment situation but you will  still lack the recovery skills to stay away from sexual acting out. It is extremely hard to “embrace” recovery while you are feeling forced into it.

  • Pressure from a partner

This is by far the most common reason propelling people to seek help initially.  It’s not a bad reason, but if all you want is to get your wife back or placate your husband you will not only have a poor prognosis in recovery, you will also probably find that your partner continues to be mistrustful.  And with good reason. Partners can regain trust in a sex addict but only if they see the addict as genuinely involved in their own individual growth.  Furthermore, if you only want to get things “back the way they were” (before you were found out) then the chances are you will continue unhealthy patterns in your relationship that provided the excuse for your addictive sexual behavior.

  • Social pressures

You may find that your sexual behavior is inconsistent with the belief system of your church or community.  You want the good opinion of people you need to impress. You seek to appear to yourself and others as though you care about changing. Wanting to behave in accordance with principles is a good things except when it involves placing the locus of control outside of yourself.  You are seeing your worth as determined by what others think and not what actually works for you in your life.  This is a position of low self esteem and if it does not change in the course of treatment you may remain stuck.

  • Self image

You may be  stuck in your addiction even though you are active in treatment and support groups.  Your addiction doesn’t square with how you want to think of yourself, and yet you don’t want to give it up.  In this case you are only partially engaged in the recovery process.  You can say “I’m trying really hard but I just can’t get sexually sober.”  This allows you to let yourself off the hook while you continue to have frequent relapses.  You can go to meetings that offer you fellowship and sympathy but you don’t have to change. The way out of this involves building in serious contingency plans for “upping” your program like going into a residential program and going back into therapy in the event that you are stalled out.

The right reasons

The journey of recovery involves establishing abstinence from the behavior, working through the issues that caused the problems, building a sense of commitment, connectedness and strength, and finding a new way of living based on honesty and integrity. If recovery doesn’t start to become valuable to you for its own sake then you are likely going to stall out half way through.  You have found a way to keep one foot in denial.  Find Dr. Hatch on Facebook at Sex Addictions Counseling or Twitter @SAResource

Sexually Addictive Behaviors Connect to Early Memories

In sex addiction treatment we describe the addicts addictive sexual behaviors as “acting out” behaviors.  What does this mean?  In general when we talk about acting out it means doing something that indirectly expresses a fantasy or feeling. Often this acting out is done without awareness of the real fantasy or feeling underneath.  For example, if I lash out when I feel hurt it means that I am acting out my hurt instead of being able to talk about it.

  • The sex addict’s arousal template

You will hear recovery people talk about the sex addict’s “arousal template.”  This refers to a particular addict’s preferred sexual acting out behavior scenario.  These vary widely from person to person.  Many different sexual behaviors can be addictive for different people.  The preferred behavior may involve other people or not.  It may involve voyeurism, paying for sex, anonymous sex, serial affairs, sexual massage parlors, cybersex, exhibitionism, fetishes, and so on.

Even within these categories the behavior may be done in a particular stereotyped way by a particular addict.  And too, the arousal template may be exhibited in the type of pornography scenarios that the addict prefers.  The behavior may be perfectly legal, like viewing pornography or going to strip clubs or it may be illicit, such as child porn or sexual exploitation of the vulnerable.  Whatever it is, it may be done addictively or not.  If it is done addictively it will be done to excess, with escalating intensity, with negative consequences, and with an inability to quit.

  • The arousal template as an X-ray of early trauma

Where does this arousal template come from?  In sex addiction theory it is believed to be based in stressful experiences in childhood.   Any traumatic childhood experiences including an inadequate bond with caregivers can deprive a child of necessary supports and lead to problems in development that lead to any number of addictions as adults.

In childhood any highly charged experience has the potential to become sexualized in the course of development whether it started out as a sexual experience or not.  Take for example a patient who is raised by deaf parents who later becomes an exhibitionistic sex addict.  He grew up never being sure of getting his parents attention because they could not hear him.  He had to be looked at in order for them to know that he needed something, and in order to connect at all.  This produces intense feelings of anxiety and frustration in the child who in adolescence begins compulsively exposing himself to the young girls on the block.  This escalates into various exhibitionistic behaviors in adulthood.

In the above example, it becomes very clear that the sex addict’s addictive sexual behavior is related to early experience.  In the same way we can look at a given addict’s preferred acting out behavior and use it as an X-ray of early experiences that were intense or stressful, or that were violating or frightening.

Of course many other factors come into play in the creation of an addiction in any given person and their life experience.  There are genetic factors, temperamental factors, and family dysfunction which can all increase or decrease the risk of future addiction.

Some experiences are extremely powerful but occur too early to be remembered in words.  These experiences are stored in the brain and body but are not able to be dredged up into conscious memories.  Sometimes we can reconstruct experiences based on what we know of a person’s history and what we can deduce they may have gone through as a young child.

In any case the more strongly the person’s arousal template is connected to a childhood trauma, the more addictive they are likely to become in their sexual behavior.

  • Treatment and the arousal template

Early experiences can shape sexual behavior in ways that are an obvious reenactment of traumatic experiences.   The addict may repeat his or her victimization or may reverse the situation and take the role of the perpetrator.  It is said that repeating trauma in this way “deepens the trauma wound”.

Sex addicts do not know why they are compelled to do a particular thing.  They only know that doing that thing is their most exciting “high”.  In treatment addicts are forced to abstain from their sexually addictive behavior which allows them to begin to see what their emotional landscape looks like without their sexual drug.  This in turn opens the way to connecting with the feelings and experiences that played such a formative role in their early life.  Understanding these feelings and experiencing them instead of acting them out allows the addict to escape from the endless cycle of re-enactment of sexually addictive behavior and to learn healthy coping mechanisms for dealing with emotional stress.

Talking about Sexually Addictive Behavior: Inside a Sex Addicts Anonymous Meeting

Would you like to sit in on a Sex Addicts Anonymous (SAA) meeting?  Would you like to hear what real addicts sound like talking about sexually addictive behavior?

What follows is a fictionalized account of an average SAA meeting.  All the names are fake.

The Intro

The room is small and comfortable.  People are saying hello and chatting casually; there is already a sense of common ground.

The meeting starts with the serenity prayer followed by a reading of the guidelines for the meeting: there will be no “cross talk,” meaning you  listen to what people say but you don’t respond or comment.

Next certain readings are read aloud by members who volunteer.  These are short sections taken from the SAA literature that describe the program and the 12 steps.  “SAA is open to men and women of any religious affiliation or of none….”  The readings promise a new way of living “if you want what we have and are willing to go to any lengths to get it…”  Then it’s time for sharing.

Tom W.

Tom is the leader for tonight, meaning he talks for a somewhat longer time and chooses a topic for that meeting.  He is a tall handsome entrepreneur in his 40’s.  He had been in the program on and off for over 15 years.  Tom recounts his early history of verbal and physical abuse by his mother.  As a child he struggled with learning disabilities.  His father was a sex addict who kept a separate house for women he was seeing.

Tom has used pornography, gone to prostitutes, and had extramarital affairs.  He has been a compulsive seducer.  He says of the women he has dated: “I wanted to take them prisoner.”

Tom has been sexually sober for a few years.  He describes his current stormy relationship.  He knows he is attracted to angry women who remind him of his mother. Tom can flash a dazzling smile but in meetings he is mostly in pain, often tearful when he talks about his struggles.

Tom suggests a topic of relationships.

Joe S.

Joe is a middle-America looking guy in his early 60’s. He has a small mustache, glasses and a paunch.  Joe is married with children and he is active in his church.   Joe is a professional man who lost his job and retired from his career a few years ago after being caught with pornography at work.  His wife has stuck it out even though he has had relapses every so often.

Joe says that when he first got into recovery he felt like: “Quit porn? You gotta be kidding!”  Tonight I see Joe avoiding talking about his marriage.  He talks about seeing his grandchildren that week, about singing in the church choir, and about how life is basically good.  He cannot find anything to complain about in his childhood.

Joe admits, in vague general terms, that he does not have sex with his wife.  He wants to dodge this issue.  He tries to be a glass-half-full kind of guy but it comes off a little forced.  What he does not say out loud is that he is still in love with porn.

Dave T.

Dave is a short and pudgy guy in his 30’s.  He has some kind of job but also gets aid for psychological problems.  He has been acting out continuously by going to strip clubs multiple times per week.   He uses up all his money on strip clubs and he seems to have little if any other life.

Tonight Dave talks about wanting to date one of the strippers he goes to see.  He has tried to strike up an acquaintance with her but nothing came of it.  He doesn’t see that dating a stripper is part of the same fantasy life as his addiction.  He is unable to get abstinent for more than a few days.

Ian A.

Ian is a 30 year-old gay man.  He is fit and pleasant looking in a boyish way.  Ian was physically and emotionally abused by his mother and step-mother and sexually abused by his father.  Ian was a voyeur and an exhibitionist until he got into recovery.  He says that had he kept on acting out he would probably be in prison today.

Ian is very bright and is dedicated to his own recovery.   He quit college and took a low level job until he can get his life on track.

Ian recently decided to break a long-standing habit of showering at the gym.  He did so because he realized he had been using the locker room as a surreptitious way to peek an naked men.  Even as he struggles, Ian is articulate and often very funny.  He wants to be a psychologist.

Bob R.

Bob is a 70-something retired doctor.  He was married to the same woman his whole life and during that time secretly carried on dozens of affairs.  When his wife found out and left him he got into the SAA program.

Bob is funny and philosophical.  He pays lip service to wanting to recover from his addiction but is mostly focused on getting his wife back.  Tonight he announces triumphantly that his wife has agreed to try living together again.  He says he is deeply grateful to the program.

Teri B.

Terri is a serious, pretty woman in her 20’s.  She recently graduated from university with a degree in chemistry.  Her history is one of poor family boundaries, sexualization by her father and molestation by an older girl.  Terri in her young life has a history of compulsive masturbation, indiscriminate sex and exhibitionism.

She talks about her relationships with men.  She has typically picked younger men she could dominate.  She then breaks up with them before they can break up with her.  Teri is in good recovery and is looking to start a healthy relationship.  She recently took up with a guy who is several years older than she.  It feels different, but she is cautious.  She says some day she wants to have children and doesn’t want to pass her problems on to them.

The the meeting goes on for an hour and a half.  There is a new member, Jeremy, barely 20, who was in residential rehab after he admitted watching child pornography.  There is Jerry, who cries when he talks about giving his pregnant wife a sexually transmitted disease resulting in damage to their child.  There is Jeff, who is making no headway in his career in internet technology but instead habitually exposes himself in movie theaters.

After the meeting there is “fellowship” (conversation).  What becomes clear is that these people are struggling and suffering but they are doing so with a purpose.  They read a lot they think a lot and they go to meetings a lot.  Mostly what seems to help is that they are together in their struggle.  They witness the gradual changes in one another.  They are not alone.  Find Dr. Hatch on Facebook at Sex Addictions counseling and on Twitter @SAResource.

Icelandic Porn Law Will Strike a Blow for Gender Justice

Will Iceland’s proposed ban on violent internet pornography work?  We have heard the arguments that internet porn content is increasingly violent, depicting more sex with children, more abusive acts toward children, and can lead to violent crime.  We have also heard that it traumatizes kids who view it and that it wreaks havoc with marriages, causes erectile dysfunction in men and body image issues in women, and “hijacks” our sexuality.

What I find most interesting about the Icelandic government’s proposed legislation http://www.guardian.co.uk/world/2013/feb/16/iceland-online-pornography is that it is built on another argument as well, one that is seldom cited, namely porn promotes gender inequality.

The question of whether such legislation can “work” must be looked at not only in terms of whether it can decrease crime or other objective measures of social wellbeing.  The Icelandic proposals have the potential to go where no one has gone in a liberal western country.  That is to raise consciousness about the eroticizing of domination and the “comodification” of women.  In other words to bring a focus to what the new feminists see as the underlying woman-hating that saturates pornography and the depiction of maleness as brutal.

The British Prime Minister David Cameron had supported legislation last year which would require internet providers to block access to pornography and put in place an “opt-in” system for users.  When this effort failed to get traction Cameron in December of last year came out is support of a proposal which would leave filtering in the hands of parents and would “require” that parents with children at home provide for filtering when the obtain internet service in their home computers. http://www.independent.co.uk/news/uk/politics/filth-and-fury-david-camerons-uturn-on-online-porn-8426765.html

The argument that we should somehow prevent children from seeing pornography is not wrong.  However it misses an important point.  The point that gets the least attention in the whole porn debate is that pornography sanctions an increasingly cruel and degrading representation of a whole class of society—women.  Such stereotyped and prejudicial images of any other sub-group of society would be seen as intolerable and unjust.

 

Do You Have Healthy Boundaries in Your Relationship? Take the Quiz

Boundaries are a necessary part of any intimate relationship and of relationships in general.  They are guiding principles that I have which determine how I behave; what I will do and refrain from doing.  As such they are part of the definition of “me.”  For example setting a boundary that says “I will tell my partner if I have engaged in my addictive sexual behavior or if I have come close to it” defines me as “honest about my sexual behavior.”

Without boundaries I have no solid sense of myself. 

Without a solid foundation to who I am I cannot hope to weather strong emotional upheavals or protect myself from destructive situations.  In this case “me” becomes very vulnerable to what people say and do to me, to the momentary problems that crop up and therefore I cannot regulate my emotions.  I am likely to respond reflexively, unconsciously or on the basis of old “scripts” from my past.  I am a slave to my irrational thoughts and feelings.

Boundaries help keep me emotionally regulated

If I am emotionally dysregulated (meaning that I respond with excessively strong emotions and that I take too long to get back to baseline) then I have diminished self-efficacy.  I will be less effective at getting my needs met in a relationship or in life in general.  I will be vulnerable to the urge to grab hold of anything that offers some way to get back into emotional equilibrium, i.e. my drug of choice.

Boundaries in relationships: the quiz

The lack of boundaries can wreak havoc on relationships.  Boundaries are essential to the ability of the partners to meet their own needs and relate to each other in a calm, open and rational way.  Without boundaries I may become overly combative or overly compliant with my partner. I may allow myself to feel controlled and victimized.  Or I may try to control the other person or “fix” them.

The following will help you look at your own boundaries or lack of them. Granted these items are somewhat arbitrary and there are a lot of different ways to describe the same processes.  See for example David Richo’s Maintaining Personal Boundaries in Relationships (The California Therapist July/August 1990.)  Look at the statements below and check those that apply to you.

  1. I often excuse or try to ignore behavior that is really unacceptable
  2. I go along with what my partner wants to keep the peace
  3. I get obsessed with what my partner is doing wrong
  4. I try to find roundabout ways of getting my partner to change
  5. I feel guilty about claiming my right to privacy and alone time
  6. I do favors I don’t want to do just because I am asked
  7. I don’t know how to avoid drama and blow-ups
  8. I stay in relationships that are probably hopeless
  9. I am afraid of disagreeing or doing something my partner won’t like
  10. My self esteem goes up or down depending on my partner
  11. I try to be perfect and not show vulnerability
  12. I have to feel “needed” in order to be in a relationship

Building better boundaries

If you check any of these statements you may need to think about the need to look at your lack of boundaries and work with someone on building better, healthier boundaries.

Having good boundaries is learned in childhood or is not learned properly.  The process of getting better at setting and keeping healthy boundaries involves looking at your early experiences that may have made us feel unwilling or unable to stick up for ourselves.  For example you may have had a family situation that discouraged or punished you for asking for what you needed or expressing your feelings.  You may have had experiences that left you with abandonment fear and insecurity about whether you can put your needs first.

Why Sex Addiction is an “Intimacy Disorder”

What is an Intimacy Disorder?

Intimacy is the ability to be real with another person.  In its essence, intimacy is the connection between two people who are equals and are genuine and open about what they are feeling in the moment.  In other words the capacity to be intimate involves the ability to take the risk of being known for who you really are.  It is necessarily a willingness to take the risk of getting hurt or rejected.

Addiction and intimacy

Addicts of all kinds, including sex addicts have difficulty being real in their relating to people including a significant other.  They typically have early experiences in their family of origin that failed to produce a secure attachment to their caregivers.  These may take the form of neglect, abuse, abandonment or the absence of an appropriately nurturing caregiver.  Addictions are an adaptation or coping mechanism usually beginning early in life as a way to handle stress and regulate emotion.

Addictive behaviors are a way to adapt that does not depend on another person for comfort or support.  If other people are involved in the addictive behavior, it is because they facilitate or support the addict using a drug or behavior with which to distract, stimulate or soothe themselves.

Addiction is intimacy avoidance

Because of their early life experiences, addicts are afraid of intimacy.  Depending on their early experiences with their caregivers addicts will predictably approach the prospect of being intimate with:

Fear of abandonment

The addict tends to do and say what the other person wants rather than what they really think and feel

Fear of rejection

The addict feels that rejection will be devastating and will reinforce an already insecure self-concept

Fear of engulfment

The addict fears losing their separate identity and becoming totally absorbed into another person

Fear of conflict

The addict fears the other person’s anger and the sense that they cannot stick up for themselves or set boundaries

Addicts prefer to avoid getting close beyond a certain point.  Patrick Carnes states that intimacy is the point in a relationship when there is a deeper attachment and that this requires “profound vulnerability.”  He calls this “the ‘being known fully and staying anyway’ part of relationships.”

Addicts view intimacy as potentially painful.

Addicts often view intimacy as an inherently painful experience.  This may be all they know from experience and all they have ever observed growing up. Many addicts would much prefer physical pain to the emotional pain they might experience in an intimate relationship.  Often they learned early to be careful and self conscious around people.  Addicts will often avoid even close friendships or social situations because they anticipate having to play a role.  And playing a role is much more strenuous than being yourself.

Intimacy requires strength

The strength required for intimacy is a strong sense of self and self worth.  I prefer to use the concept of “self-efficacy” over that of “self-esteem.”  Being intimacy “abled” is not so much having a positive view of yourself as it is having a sense that you should and can act in effective ways to protect yourself and enhance your own life.

This is the strength that neutralizes all the fears that make the addict run from intimacy.  It is not a question of being tough; on the contrary, it is knowing that you may get hurt but that you will not get devastated.

Gaining these skills involves a combination of not only addiction treatment and therapy but assertion training, which involves de-conditioning what is essentially a phobic reaction to being emotionally honest and practice with basic relationship and communication skills.

Learning to be stronger is what allows us to be vulnerable in relationships.  And this vulnerability is a sign of strength.

Do You Need God to Live a Sober and Surrendered Life?

Here are some of my own meandering thoughts and observations.  Most anonymous programsfor treating addictions such as sex addiction and drug addiction seem to begin and end with turning something over to a “higher power.”  They begin with admitting powerlessness over an addiction and end with living an enlightened life in which we accept what we cannot control.

Do you need God to get sober in the first place?

In the beginning you are urged to admit that you cannot kick your addiction on your own, that you are powerless when it comes to your addictive behavior, that you must let go of “self will” and so on.

It is pretty clear to a lot of addicts who get sober that they were not able to kick on their own.  These are the cases where the addiction was so compelling that they finally had to reach out for help.  Does this help have to involve calling on a higher power such as God?

In the beginning every journey involves a leap of faith

So the addict who decides to go to an AA meeting or a Sex Addicts Anonymous meeting and ends up believing that he or she should give the program a try is actually making a leap of faith.  They may not see it that way but in fact they have decided to try to follow a set of instructions, like a 12-step program, even though they may have zero ability to imagine how it will work in their own case.

The same is true for an addict who enters a treatment center or who works with an addiction therapist.  In effect they are putting their faith either in a 12-step fellowship or in a program or clinician that is saying “trust us, we can help you.”

Is a leap of faith the same as belief in God?

All of us take leaps of faith at many points in our lives.  When we embark on a new endeavor or career path, or when we get married.  We do not know what is in store for us and we do what we do because we have some reason to believe that the path will take us where we want to go.  But we don’t really know.

So what kind of faith is involved?  Some people believe that there is a deity, someone watching over them and that whatever happens to them will be for the best.  But other people simply accept that they do not know where the road will lead and that they can live with the results whatever they are.

The willingness to take a leap of faith is often just the intuition that something is a good idea.  Sometimes this takes the form of believing in a mentor or guide such as a therapist or sponsor.  On some gut level we believe that we can trust someone or something and we go along with the program.

Is this a belief in God? Are we then making that person into a “higher power?”  Not necessarily.  I think often what we are doing is trusting our gut level sense of things.  We have no proof, but something gives us a sense of hope and we put our faith in our own judgment.

Is “intuition” the same as God?

One of my favorite quotes pulls these ideas together:

“If you can’t trust that the universe will, in its own way look after you and protect you, like the lilies of the field, it means that you have no trust in yourself…”

Learning to trust your own instincts, learning to believe that you have the gut level ability to make good choices and look after yourself is, I think, a belief in a higher power of sorts.  Sometimes this is experienced by people as being “guided” by a higher power in that it is not a product of conscious thought.

When a new way of looking at something or a creative idea “comes to you” it seems to come out of nowhere.   It often seems like you are listening to something on a whole other level.

My 20-something step-son has a T-shirt that says: “I used to be an atheist until I realized that I was God.”  What has been your experience?

Recovering Alcoholics Often Have Sex and Intimacy Issues

Sex addiction therapists as well as many in the recovery community believe that a sizable proportion of alcoholics are also sex addicts or move into sexual addiction once they are sober from alcohol.

Intimacy disability is at the heart of all addiction

Alcoholics and drug addicts who are abstinent from drug and alcohol use have most often “worked a program” in which they became aware of their own fears and insecurities.  They have probably learned how to be less self-conscious and more authentic in their every day dealings with people.  They have also been exposed to the idea that recovery means “rigorous honesty.”

However, sobriety from chemical dependency does not necessarily mean delving into the hang-ups that the addict has with regard to intimate relationships.  The recovering addict or alcoholic will have learned to trust a higher power and to accept the help and friendship of other people.  And yet they may still be incapable of being trusting and open in an intimate romantic/sexual relationship.

The alcoholic/addict may have had no experience with “healthy” intimate relationships.  Most if not all addicts have childhoods characterized by problems in their bonding with their parents or caregivers.  These may seem very obvious or more subtle, but these attachment issues produce addiction prone people who have a long-standing mistrust and avoidance of intimate bonding.

Alcoholics and addicts may have worked through their general social avoidance, self-consciousness and discomfort for which alcohol was the medication. But they may not be able to carry those skills over to the more threatening and less familiar area of dating and intimacy.  Often they are aware of the fact that in their alcoholism or drug addiction they did not have healthy relationships.  As they often put it they don’t have relationships, they “take hostages.”

Alcoholics and addicts resist looking at their intimacy issues

A lot of alcoholics/sex addicts will tell you that programs like SAA (Sex Addicts Anonymous) are “graduate school” compared to AA and the other chemical dependency support groups.

Sex addiction programs look a lot like drug and alcohol programs and they do have a lot in common.  But quitting drinking or drugs is often experienced as a simpler and easier process for many people than confronting sex addiction.  I have heard more than one AA member complain that when it comes to SAA: “the credits don’t transfer.”

Although recovering alcoholics are very well represented in the ranks of recovering sex addicts, there remain a very large number of recovering alcoholics who resist or pooh-pooh the idea of sex addiction recovery.

People recovering from chemical dependency use the same denial mechanisms about sex addiction that they used about drugs or alcohol prior to getting into recovery from chemical dependency.  These denial mechanisms have just changed their content but not their basic form.  They include things like minimizing, rationalizing, intellectualizing, and compartmentalizing.

The role of ego

In all of the above mentioned denial mechanisms, there is an element of ego that has crept back into the alcoholic or addicts thinking.  They can’t imagine what it is to feel safe and contented in an intimate relationship and instead they satisfy themselves with various behaviors such as one night stands, serial seductions, high drama relationships that do not last, or avoidance of intimate relating altogether and so on.

What the recovering addict in denial has failed to see is that other people can and do change and that their sexually addictive tendencies are out of their control.  They have forgotten that step one in 12-step work is admitting powerlessness and admitting that you need help.  The ego has crept in the form of “self-will” about sexuality and relationships.  The addict has forgotten about reaching out and having faith.

Sex Addiction Deniers: What Makes Them So Mad?

The mere idea of “sex addiction” gets a lot of people angry.  I’m talking here about the writers who rail about the “myth” of sexual addiction and who argue that the whole idea of sex addiction is just a cop-out for the addict and a money making scam for the professionals.

The anatomy of a sex addiction denier

I prefer to see these “deniers,” as I call them, as a part of a larger societal pattern and one that is worthy of study in its own right.

Currently the opposition to the concept of sex addiction comes in two main flavors.

1.  Sex addiction is really just normal behavior.

These men and women have a defensive reaction to the whole field of sex addiction treatment as an attempt to restrain normal sexual freedoms.  Sometimes their blogs and online commentary seem to be jokingly, (nervously?) defending behavior around which they have some unacknowledged shame.  The message is “we all do it and you just think it is ‘sick’ because you are so uptight!”  This is an uninformed bias that seems to resist logic.

2.  Sex addiction is really just irresponsible behavior.

This argument comes from all quarters including some in the scientific community.  It minimizes the seriousness of the problem and the suffering it can cause, and the message is often “you so-called addicts are just behaving badly and you need to take responsibility and shape up!”

This second argument sometimes takes the form that “if sex can be an addiction then anything can,” or “if we let people off by calling it a disease then there’s a slippery slope which will lead to nobody ever taking any responsibility for anything.” (OMG!)

Both of these arguments have the net effect of saying that we shouldn’t medicalize the issue of sexually compulsive behavior and therefore that we shouldn’t actually do anything about it.  See the New York Times Op-Ed for an excellent discussion.

We need to understand the deniers, not condemn them

“Deniers” have always existed in relation to almost every unwelcome phenomenon that has emerged throughout history.  Sometimes they have taken a socially acceptable position which conforms to religious or other dogma and have acted accordingly, as in burning heretics or imprisoning the mentally ill.  In other cases they have simply veered off into crazy-sounding conspiracy theories such as that the 9/11 terrorist attacks were really a government plot or that the holocaust never happened.

These are elaborate attempts to explain or deal with something that is experienced as incomprehensible or intolerable.  In this regard they are all defense mechanisms and nowhere more obviously so than in the area of sexual addiction.

Sex addiction deniers are trudging a road well traveled in earlier eras by those who wished to defend themselves against a trend or theory that they found very threatening.  This is especially true in recent history in the evolution of the disease model of mental health. It has been very gradually that the “deadly sins” have been recast as very human psychological afflictions.

Fear and loathing as a developmental phase

Because I believe sex addiction deniers are genuinely reacting to some unconscious fear, I think professionals cannot dismiss them but rather need to understand them.  If we don’t they won’t go away and will keep confusing the public and getting in the way in much the same way that global warming deniers get in the way of protecting the biosphere.

As the superstitions and fears surrounding a social ill begin to dissipate, the issue moves through a predictable sequence in public awareness from demonization to criminalization to medicalization to reintegration.  First the problem, say alcoholism, is a moral failing, then it’s a legal problem, then a medical disease, and finally a larger societal or public health issue.

Leaving aside the issue of illegal sexual behavior, this mans that society’s current approach to sexual addiction is moving beyond demonization and criminalization but has not yet reached medicalization.  This transition to full medicalization will mean the evolution of awareness. This involves dispelling fears, confronting judgmental attitudes, and persuading people to suspend those judgments.  It is up to us to patiently explain.