Chronic Sex Addiction Relapse: Letting Go Once and For All

Sometimes I feel as bewildered and frustrated as my sex addiction clients when they periodically slip up and engage in their addictive behavior, even as they seem to be making progress in their recovery.  (See also the excellent article by Dr. Patrick Carnes entitled “The Perfect Storm: Assessing for Sex Addiction”)

What is it that makes some recovering sex addicts continue to relapse frequently?  Why are some sex addicts seemingly unable to cut the cord?  I believe that beyond the question of “hitting bottom”, the process of letting go of an addiction is similar to the loss of a relationship and that some addicts get stuck at various stages of the grieving that loss.

Addiction as a relationship

The idea of an addiction as a relationship has been around for a long time.  Sex addiction, like addiction generally, has been defined as a primary relationship with a mood altering experience.  That experience may be a chemical such as a drug or alcohol or it may be an activity such as gambling or sex.  Whatever the chemical or activity, there is some evidence that the brain mechanisms involved in the addiction are all similar.

But beyond brain chemistry, brain alteration and changes in mood (excitement, euphoria, soothing), addictive activity is also something that develops like a relationship.  And the activity as well as everything leading up to it and surrounding it becomes like a friend or even a loved one.

This affection for our addictive activity is not entirely illogical.  For most addicts, their “drug” is something that they have relied on to regulate their emotions, escape stress, and even maintain their ability to function.  A porn addict I know once said “Miss January (his name for his addiction) is always there for me.”  It has served the addict well in some sense.  Yet it also has destructive potential and usually goes against the addict’s own value system.  Hence it is a relationship that needs to end.

In sex addiction treatment a commonly used exercise is that of having the client write a good bye letter, a “Dear John” letter, to his or her addiction.  In this letter the addict “breaks up” with his addiction, often acknowledging that the addiction was important, fun and will be missed.  This exercise underlines for the addict the fact that he or she is letting go of something important.  Whether it is giving up porn, prostitutes, compulsive hook-ups, or fetishes it is going to amount to a real loss.

Grieving the loss

All grief is about the struggle or process involved in coming to acceptance of a loss.  Loss is stressful.  In fact one definition of stress is “a loss or the threat of a loss”.  And so the loss of an addiction is stressful, challenging and potentially even traumatic.

Most sex addicts have a history of childhood relational trauma.  The drug, the “relationship” with a fantasy became a way to endure stress and to substitute something for what was missing in reality.  In dysfunctional families intimacy is fraught with danger and self doubt.  The addictive fantasy involved in much sexual acting out is one of being able to be gratified in a way that feels safe.

Getting stuck in the grief process and relapse

It is possible to get stuck at any point in the process of letting go.  Even once past the denial phase and even after acknowledging the need to let go of the behavior, there may be predictable stages of anger, bargaining, and depression.  A good example is the addict who knows that porn blocking software would hugely improve his chances of getting free of porn addiction but who either rebels against getting it installed, finds excuses, or finds ways around the filters.  I have seen clients use their GPS or their children’s devices when other outlets are blocked.  This addict is stuck in anger and possibly old rebellion against authority.  He or she is saying “you can’t make me.”

Bargaining can go on for a long time too.  The addict makes a deal with their treatment program that says basically “If I get XYZ then I will be able to let go of my addiction”.  This can mean that the addict is going to support group meetings, going to therapy, and reading all the right books but is not willing to experience change.  He is waiting for it to feel right to stop being an addict.  Or he is waiting for a “sign” or for a new relationship to save him etc.  The unpleasant reality is that in giving up the addiction there is nothing that will immediately take its place.  No way to avoid experiencing some sense of loss.

Some addicts go along way down the road to recovery but still can’t give up their addictive behavior completely.  They find that the loss of the addiction brings on depression.  They endlessly analyze why they have relapsed this time.  They feel they cannot tolerate stress or loneliness.  But there is no way to eliminate all of life’s stresses and challenges.  Eventually they begin to realize that they can experience unpleasant feelings without reaching for a drug.    This is the point in a sex addict’s recovery when he or she has turned a corner and is finally done with acting out.  They know it and you can see it.  They will come to acceptance and begin to be solid in their sobriety.

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

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.

 

Is Healthy Masturbation Part of Sex Addiction Counseling?

I am returning to this topic because it is one that comes up repeatedly in sex addiction counseling.  Masturbation to pornographic images or fantasies is not necessarily an unhealthy thing on its own. But for sex addicts the uncontrollable acting out of particular sexual fantasies and the act of masturbating while having specific sexual fantasies are very similar processes.

If the addict’s preferred acting out behavior is visiting prostitutes, going to sexual massage parlors, anonymous sexual hook-ups, cyber sex, porn, serial seduction or more likely some combination of behaviors, the fantasies that accompany masturbation will likely mirror those activities.

Sex addicts have what therapists call an “arousal template,” the sexual scenario that they find most exciting. To the addict it is far more thrilling than any other sexual activity; it should really be called the hyper-arousal template.  It may be any one of a myriad of sexual experiences, remembered or imagined, but that scenario is what they return to when they masturbate.

If not an exact repeat of the behavior, the masturbation fantasy will likely contain the essential elements of the arousal template, such as dominance, submission, multiple partners, the feeling of being intensely desired, or any of an array of specific sexual acts or fetishes.

Risks of masturbation during recovery

A great many sex addiction therapists believe that in the initial phase of recovery when the addict is trying to abstain from compulsive sexual behavior, that sexual activity should be avoided entirely, including masturbation.  Even if masturbation is not part of the addict’s acting out scenario per se, it will most likely bring up fantasies of that activity which in turn could trigger the addict to relapse into the full-on behavior.

A sex addict who compulsively seeks sexual encounters with people he or she recruits from online sources such as personal ads may masturbate while thinking of these hook-up experiences.  But this can bring up urges for more, which in turn may lead to the addict “taking a quick look” at the online ads or photos, and then to actual acting out.

When sex addicts use masturbation to “relieve the tension” in order to (theoretically) avoid their preferred sexually compulsive behavior, they may be perpetuating their problem.

In sex addiction counseling we often discourage using masturbation in this way.  If it is a watered down version of the behavior the addict is trying to quit, it has the potential to simply prolong the process of withdrawal.  The addict is trying to “kick” the habit of a compulsive sexual behavior, one that is secret, alienated and often surrounded with shame.  And reliving that behavior in masturbation fantasies is like methadone maintenance for opiate addiction.  It is not the same as getting sober.

Adding masturbation back into the program

When in the recovery of the sex addict, or in the process of sex addiction counseling, is it appropriate to allow for masturbation?  Using masturbation in recovery depends on:

  • The addict’s ability to masturbate without addictive fantasies.  This is difficult for most sex addicts as they often find it hard to get aroused or to climax with different fantasies or no fantasies at all.
  • The addict’s ability to masturbate to orgasm and avoid “edging.”  Edging is the process of repeatedly bringing oneself to the edge of orgasm, pulling back and starting again as a way to prolong arousal.
  • The addict’s ability to plan to masturbate rather than doing it when a sexual urge arises.  The spur of the moment decision to masturbate may be due to urges or triggers that the addict should pay attention to and deal with in other ways than simply reacting sexually.

How masturbation can be useful in sex addiction counseling

Masturbation can be like a sexual laboratory.  Here are some of the ways in which the addict can use masturbation to explore and learn about himself or herself.

  • Psychological factors surrounding the act of masturbation.  Arousal and orgasm may bring up ideas, voices from the past that have played a role in shaping the addict’s sexuality.
  • Emotions or even “body memories” can crop up when masturbation is done without going off into the trance of addictive fantasies.  These emotions and memories may relate to past traumatic experiences that the addict has never worked through.
  • Some people in sex addiction counseling can experiment with changing their fantasies while masturbating.  They can use masturbation to “stretch the envelope” i.e. to go to fantasies and images that are more in the healthy range for them, like thinking about the person they love.  For some this will be a return to a more normal time in their life.

Some people have become free of sex addiction through years hard work in their sex addiction counseling program and have begun a new way of living.   For these recovered addicts, masturbation is often neither compelling or triggering.  It can then take its place as a normal kind of sexual activity.

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

Is Your Relationship Addictive? Take the Self-Test

Relationships should feel good.  They should be happy and loving most of the time.  Addicts, recovering addicts and partners of addicts often have relationships that are the opposite.

As Patrick Carnes has pointed out in his writing, both sex addicts and their partners often have many similarities in their psychological makeup.  Both addicts and partners of addicts often come from families in which relationships were dysfunctional and appropriate nurturing was unreliable.

This early relational trauma leads to both fear of intimacy and fear of abandonment.  And these can lead couples into patterns of relating where each feeds the other’s unhealthy dynamics such as avoidance, manipulation, lack of openness, fear, and over-control.  See also my post “When Love Addicts Fall for Sex Addicts.”

Mistakes addicts and partners make

  • Mistaking sex for intimacy

Most sex addicts and many partners of sex addicts place an undue emphasis on sex as the most important aspect of the relationship or as the proof of whether the relationship is loving and devoted.  Sex addicts have little experience of healthy intimacy and place an undue emphasis on having their sexual needs met, either inside or outside the relationship.  Partners may allow themselves to see their addict’s powerful sexual attraction as the only or most important aspect of love and intimacy.

  • Lack of Courtship Skills

Addictive relationships often begin with sex.  By building a relationship on sex and romantic passion, addicts and their partners may ignore the process of getting to know each other in a healthy way.  There is nothing wrong with enjoying feeling swept away, but it shouldn’t prevent you from learning about one another as part of a process leading to healthy commitment.  In a more normal courtship, people take it slower and ask more questions about the other person’s situation, their relationship history, their feelings about relationships etc.  And they also do not approach the situation with any ideas about what they might need or want in another person (aside form feeling swept away).

  • Mistaking Intensity for devotion

Many addictive couples have patterns of high intensity and high drama in their relationships.  They may have frequent and even violent conflicts and they make often break up and get back together.  Their interaction may be characterized by jealousy, threat, competition, and fear, all of which are mistakenly interpreted as signs that the relationship is the most important and most deeply committed one in their life.  Nothing could be further from the truth.

  • Mistaking power for trust

People who feel inadequate to the demands of an intimate relationship or who are overly fearful of abandonment may have an excessive need for control in their relationships.  Instead of feeling safe and secure in the knowledge that they can deal with problems that arise, they are closed off and mistrustful.  This leads to a vigilance about what the other person is doing and a lack of openness in communication.  The excessive need for control is based in the person’s own insecurity about their ability to sustain a relationship, their worth as a partner and their partner’s reliability.

An addictive relationship self-test*

The items in the test below are informally compiled based on my clinical experience and reading on this topic.  These problems are not unique to addicts and may be experienced by anyone with impaired intimacy and relationship abilities.  But they are very characteristic of addicts and often of the partners of addicts as well.

  1. Growing up I didn’t see my parents as consistently loving, and contented with each other.
  1. My relationships typically start with an intense sexual attraction and rapid involvement.
  1. I find it easy to start relationships but they always get complicated.
  1. I find it hard to know how to get out of a bad relationship.
  1. I sometimes think I stay in a relationship because I am afraid of being on my own.
  1. I am afraid of my partner’s anger.
  1. I sometimes placate or manipulate my partner to avoid confronting things.
  1. I find it easy to get into thinking that my partner is to blame.
  1. My partner and I don’t talk about our feelings about the relationship.
  1. In my relationships one person is always less devoted than the other.
  1. Either I feel superior to my partner or I feel my partner is superior to me.
  1. I am dishonest with my partner at times to avoid upsetting him/her.
  1. When I am in a relationship my partner and I don’t socialize with friends as a couple very much.
  1. Either I or my partner is always trying to get us into some kind of therapy.
  1. I feel that having a good relationship is hopeless.

*Taken from my book Relationships in Recovery: a Guide for Sex Addicts who are Starting Over

When you look at this list of statements, it should be clear that what I am calling addictive relationships are characterized by things like negativity, turmoil and alienation.  A person who has the emotional development required for healthy intimacy would avoid or even run from such a relationship.  Without a level of openness, security and contentment it is impossible for relationships to succeed and for the partners to flourish.

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

What is Healthy Sex for a Sex Addict?

I can’t tell you how many people in sex addiction programs are baffled about the issue of healthy sex.  They are pretty clear on what they need to not do, but they are at a loss to envision what a healthy sex life would look like for them.  Many addicts have never had the experience of what they see as “normal” sex with anyone. For example, they may have experienced their sexuality only in the two dimensional fantasy world of pornography, or they may have experienced sexual arousal only in very alienated or risky situations with strangers, illicit situations etc.  In other words, for most sex addicts in early to mid recovery strong sexual feelings have never been integrated in any way into their life and relationships.  Therefore, they have trouble seeing how they could ever feel intense sexual interest and gratification in the absence of their “acting out” behaviors.  They know it exists, but for them it is an empty concept.  The problem is further complicated if the addict is married or in a long term relationship in which they have been leading a double life.  Chances are that they have periods of aversion to sex with their partner and/or that they have a sex life with their partner in which they find ways to bring their addictive behaviors into the mix such as being lost in their addictive fantasies during sex, bringing other people into the situation somehow, etc.

What has been written about healthy sex may or may not help enlighten the addict in early sexual recovery.  Dr. Patrick Carnes’ writing is read by many recovering addicts and he has defined 12 dimensions of healthy sexuality which mostly have to do with the overall emotional maturity and relationship skills of the individuals in question.  Such things as the ability to nurture and be nurtured, a clear sense of self and good boundaries, comfort with sex in general, the capacity for genital and non genital sex with a partner and so on.  While these may be a necessary foundation for a sexually healthy person, they don’t help flesh out the concept of the sex life itself.  Likewise, most addicts at some time come across the saying that “intensity is not intimacy”.  Dr. Carnes spells this difference out in terms of ten different domains of functioning, e.g. high drama vs. problem resolution, or fear and arousal vs. passion and vulnerability.  So although a person may be aware that fear or drama are what escalate their arousal, they have no model in their mind for how to achieve that level of arousal any other way.  The awareness is important, but they would like to know where it’s all going.

So when we ask a sex addict to believe that he or she will be able at some point to enjoy the rewards of healthy sex are we able to offer any proof?  Are we simply saying that they should clap their hands to show they believe in Tinkerbell?  Well, in a way, yes.  We already know that the willingness to embark on any journey of recovery involves a leap of faith.  So sex addicts need to take it on faith that they will like what they get when they get there. But they also need to recognize some other realities about a healthy sex life with a committed partner.

First and foremost I think that addicts need to realize that healthy sex in the context of a good relationship may have a high degree of passion, variety and deep gratification, but it will not involve the same kind of hyper-arousal, the blast of instantaneous intensity that comes with acting out situations and fantasies.  The good news is that the need for that kind of “hit” dissipates in the fullness of recovery.  In other words you won’t have what you once had but it won’t matter as much as you think it will.

By the same token, addictive sexual behaviors tend to be the same every time.  The addict controls the script and the outcome, even to the point of building in the risk or fear to heighten the “fuel mix”.  The healthy sexual relationship has more room for the unexpected to happen, so that even though the context is one of comfort and safety, there is the possibility of genuine discovery.

Second, people tend to be unclear on the role of fantasy in their sexual life with a partner.  Although this is an individual matter, generally speaking sexual thoughts and images can and should be part of healthy sex as long as they do not remove you from the present situation.  Any kind of sexual fantasy may enhance your experience with a partner (or in masturbation for that matter) but it should be one that allows you to be more engaged in the real, physical experience at the time rather than less.  Fantasy as a means to check out, numb out or escape is likely to set up a pattern that is not conducive to healthy sex.

Another way to look at this trade off in recovery is to put it in terms of what the AA book entitled Twelve Steps and Twelve Traditions calls “the sacrificial spirit”.  We sacrifice something to get something more worthy.  In this case we sacrifice the need to focus only on ourselves and our own most perfect gratification and we behave in ways that have to do with the overall benefit to our lives and the lives of everyone around us.  As addicts change, they will likely come to see that addictive sex is a drug they want to put down and that it was only their most important need because it was an addiction.

Finally, an inescapable reality of intimate relationships is that they require some attention in order to be maintained.  So in terms of a healthy sex life the addict and their partner need to nurture all aspects of their relationship life, including the sexual.  Planning to have sex, setting up a time to have sex may seem like anathema to sex addicts starting out in relationship recovery because, again, it’s not the impulsive or mindless escape into the “hit” or the oblivion of acting out.  Sure, sometimes sex with a spouse or partner can be spontaneous and free and that’s great.  But taking care to have time to have sex is going to be part of taking care of your relationship, just like expressing affection, problem solving, negotiating, and guarding each others’ solitude.