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.


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 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 bookRelationships in Recovery: A Guide for Sex Addicts who are Starting Over.

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

Intimacy Disorder and the Healing Power of Confrontation

Sex addicts seem to be good at looking out for themselves, but in reality the opposite is the case.  They are most often crippled when it comes to relating in a confident and genuine way.  Instead of speaking their truth, sex addicts rely on avoidance, aggression, placating and manipulation.

I believe this is part of the codependence that is at the root of all addiction.  Sex addicts predictably approach other people with insecurity and mistrust.  They have early life experiences that leave them alienated: expecting little from others and fearing abandonment, abuse or neglect.  Being open and genuine in interpersonal intimacy is felt as stressful and potentially dangerous.  This is an intimacy disorder.

Aggression vs. assertion

Self assertion, including healthy confrontation, is actually the opposite of aggression in all the important ways.  What is the difference?

Assertion involves saying and doing things that will give you the best chance of getting what you need but not at someone else’s expense.

Aggression involves saying and doing things designed to get what you need at someone else’s expense.

If you are assertive you are clear about what you need and want but in a way that is respectful of the fact that the other person may or may not go along with what you want.  You have a right to ask for anything, but the other person has a right to say no.

In aggression, you try to push, bully, manipulate or frighten.  You make the other person do what you want but you create a negative experience which is harmful to them.  You get what you want but you damage the relationship.

Avoidance, placating and manipulation

Addicts are often so lacking in the confidence that they cannot tolerate being vulnerable to potential rejection or open to negotiation.  They seek instead to control the situation as a way to stay safe.  They may completely avoid talking about anything that goes on inside them.  Often they have a very elaborate “façade” by which they appear to be what they think the situation demands.

Other times addicts simply bury their own strong needs and feelings by just going along with whatever their partner wants.  Placating is a way of staying in control by dodging any situation which the partner might not like.  This works for the addict because although they resent playing this “childlike” role, they have an outlet, a secret life of acting out that allows them to gratify themselves unhindered and without risk.

Manipulation is another form of control that allows the addict to dodge real communication and avoids negotiation and compromise.  It can be aggressive, as when the addict “guilt trips” their partner or it can be underhanded, as when the addict pits someone else against their partner to achieve an outcome or dishonest, as when the addict flat out denies what their partner is experiencing and tries to distort their reality.

In any of the above examples, the addict is avoiding any real confrontation because (a) it is not something they feel they know how to do very well and (b) it is frightening to be transparent with their feelings and needs.  But intimacy in a relationship demands that both people be willing and able to be clear and open about what they want, how they feel, and how things affect them.  No one can do this all the time and no one can be expected to do it flawlessly.  But if one or both of the partners cannot put their needs out on the table they have placed a drastic limit on where the relationship can go.  Learning healthy confrontation can go a long way toward resolving intimacy disorder.

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

When Love Addicts Fall for Sex Addicts

As a therapist I have noticed that partners of sex addicts frequently have characteristics of love addicts.  This is not always the case of course.

Partners of sex addicts may be innocent bystanders.  But I think there are some reasons to suggest an affinity between love addicts and sex addicts.

There are underlying similarities between sex addicts and love addicts in terms of brain chemistry, intimacy issues, abandonment fear and co-dependentence.  Both tend to have early childhood trauma and attachment issues.

However, I think it is the separate, distinct characteristics of each that attract them to each other.

Here are my thoughts on how this pairing might come about and what function  it might serve for the addict and the partner

The allure of the sex addict

What sex addicts do is to behave in certain predictable ways that turn out to be an engraved invitation for the love addict.

  • Superficial intensity

Love addicts have the fantasy of being desired and rescued.  As Pia Mellody puts it

“When these individuals get old enough, they begin to form a fantasy in their head of somebody rescuing them from being so alone, of making them matter. The fantasy usually takes the form of being rescued by – it is like Cinderella — a knight in shining armor or a wonder woman, who will take care of them and help them come out of their dilemma of being too alone and worthless and not knowing what to do.”

Sex addicts are themselves very insecure and narcissistic.  They want to be seen as the hero even if it is a façade.  The love addict would like to be permanently swept away.  But intensity is not the same as intimacy; it is a fantasy that cannot be sustained.

  • Dishonesty

Sex addicts can appear to offer unconditional love and acceptance because they lack the ability to be who they really are in a relationship.  The sex addict is often comfortable with saying what the love addict wants to hear since he or she is invested in a whole other, secret sexual life.

This works for the love addict who needs to feel completed in a relationship.  The love addict does not see through the sex addict’s perfect love but merely projects their own fantasy onto it.  They feel safe.

  • Seductiveness

Sex addicts are seductive.  They can manipulate the love addict into feeling that they are perfect, the fairy princess.   The love addict needs to feel perfect in order to feel safe.  If I am perfect you will never leave me.

  • Lack of intention or commitment

Sex addicts substitute the intensity, superficiality and seductiveness for any real investment in the relationship or in the future.  Lacking intimacy skills they don’t confront the partner about anything, don’t negotiate, and often avoid talking about their needs and wants altogether.

The love addict cannot tolerate the requirements of real intimacy either such as being open to confrontation, being willing to admit to being imperfect or wrong, or allowing the addict to be imperfect.  Since the sex addict lacks the ability to be real and work on a relationship, the basic unavailability of the sex addict a good fit. 

As Patrick Carnes has said:

“Love addicts consciously want intimacy, but can’t tolerate healthy closeness, so they must unconsciously choose a partner who cannot be intimate in a healthy way.”

The love addict partner is unconsciously drawn toward a relationship in which there is intense romanticism (at first) but which cannot lead to a stable grown-up relationship.  In the long run, the love addict will be subjected to disappointment, deception and episodes of abandonment by the person they love.  Yet they will often continue to be “hooked” on the fantasy.

Intimacy Disorder: An Addictive Relationship Self-Test

Intimacy disorder and addiction are most often two aspects of the same problem.  While it is true that any addiction can cause relationships to deteriorate, it is also true that sex addicts tend to end up in unhealthy and unsatisfying relationships.

Even sex addicts in good recovery may have many residual problems in approaching intimacy and relationships.  See also my article “Intimacy 101”.

What I am calling addictive relationships are relationships that are usually part of a pattern of negativity, turmoil and alienation.  The majority of the addicts I’ve worked with have grown up in families where their parents were not consistently loving, contented or appropriate with each other or their children.  Often they had addictions of their own.  This dysfunctional model may be all the addict has ever known.

Below is a self-test designed to get you thinking about the intimacy disorder aspect of sex or love addiction.  It is not scientific but it is based on my experience working with addicts.  It is adapted from my recent book Relationships in Recovery: A Guide for Sex Addicts who are Starting Over.

  1. My relationships typically start with intense sexual attraction and rapid involvement.
  2. I find it easy to start relationships, but they always get complicated.
  3. I sometimes stay in a relationship because I am afraid of being on my own.
  4. I sometimes placate or manipulate my partner to avoid confronting things.
  5. I find it easy to get into thinking that my partner is to blame.
  6. My partner and I don’t talk about our feelings about the relationship.
  7. Either I feel superior to my partner, or I feel my partner is superior to me.
  8. I am dishonest with my partner at times to avoid upsetting him/her.
  9. When I am in a relationship, my partner and I don’t socialize with friends as a couple very much.
  10. I feel that having a good relationship is hopeless.

You will see that some of these items are characteristic of dysfunctional relationships in general.  But sex addicts will have experienced at least half of them when they have attempted to sustain an intimate bond with a partner.

The intimacy avoidance characteristic of sex and love addicts means that they can’t get close; they are afraid of intimate, honest relating and expect it to bring pain and shame.  They also can’t let go.  They often put up with a bad situation due to their fear of feeling abandoned and inadequate.  Thus addictive relationships are characterized by ambivalence and feeling stuck and hopeless.

The fears, insecurities and low self worth that characterize addicts predictably lead to relationships that are intimacy avoidant.  Addicts growing up did not experience intimate bonds as supportive, validating or safe.

In recovery from sex addiction the addict who is ready to try for a healthier kind of relating will have to do three things:

  • Examine his/her relationship history in detail
  • Come to understand their past relationship style and how it supported the addiction
  • Write a plan for the future which puts rules and boundaries in place for healthier relating

In addition, the recovery from intimacy disorder will involve making an attempt to envision and outline the kind of relationship the sex addict wants for the future.  This vision may be totally new to the addict.  It will involve:

  • Living together in integrity and harmony
  • Giving and providing safety and support
  • Sharing all the parts of oneself including intellectual, social and sexual life
  • Being able to commit and developing a capacity for devotion
  • Willingness to be hurt as part of healthy vulnerability
  • Putting energy into the relationship but being willing to be alone if things don’t work out

In emerging from an intimacy disorder the good news is that relationships can be the most meaningful and enjoyable aspect of your life.  You can continue to grow as you enjoy the fruits of recovery.

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.

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.