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

3 Gateways to Intimacy: Things You Can Practice Doing Now

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

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

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

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

Building intimacy skills

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

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

Nurturance

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

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

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

Mutual process

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

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

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

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

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

Shared experiences

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

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

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

Fake it ‘til you make it

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

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

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

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 

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

Signs of a Porn or Sex Addiction Relapse

When a client who is trying to avoid a sex addiction relapse has had a slip I can often tell before they say anything about it.

At first I wasn’t sure what it was that I was seeing; whether it was just intuition or whether they were actually doing something different.  And with some clients I could tell right away and with others I couldn’t.  So what was the difference?

Signs of a relapse

When I see clients who have had a slip since the last time I saw them I can sometimes spot the following signs:

A difference of style.  The addict who is coming in laden with the knowledge that he has had a slip will likely be thinking about the fact that they have to discuss it with me.  This often results in their seeming to be superficially jocular or casual.  They seem to be tap dancing, probably because they feel embarrassed or ashamed about having let themselves and me down.

A difference in cognition.  To a greater or lesser extent, a sex addict who has had a slip or a relapse will be suffering from the aftereffects of their drug.  In order to go into the slip in the first place, the addict will have had to let go of part of their rational thinking, the part that has to do with weighing consequences, and thinking logically about the decision they are about to make.  This suspension of higher order thinking, being in the “bubble” as it is called, may have residual effects on their apparent ability to think clearly and communicate clearly.

Lack of focus.  The addict who has had a slip may seem scattered in the aftermath.  They are not completely able to integrate what they know they have done to endanger their recovery and part of them doesn’t want to think about it or about anything else.  They may deflect or divert the conversation and go off on tangents.  They may even be questioning their interest in recovery, their need to change or the appropriateness of the program.

When are these signs missing?

Why is it sometimes easier for me as a therapist to spot a client who has relapsed than it might be for other people in their life, even their partner?  And when are they able to fool me as well?

I think the answer has to do with the level of commitment to recovery that the addict has achieved.  Most of my clients are trying to be honest with me.  When they have something to say that they would previously have lied through their teeth about, they have an automatic high level of cognitive dissonance about it which causes some visible distress symptoms.

Likewise when the addict is still somewhat on the fence about whether and how much of their sexual acting out they really want to give up, then they will be better able to lie to themselves and therefore their deception will be more impenetrable.

It follows that the more someone has become committed to recovery the more difficult it will be for them to conceal the truth from someone they are close to.  When an addict has not really given up the need for secrecy as a way of life, they will more readily adopt a false persona that may be hard to see through.

An addict who has lied to his wife for years and then gotten into recovery may be better able to slip into old deceitful habits with her than with a new person such as a therapist.  The addict may have been doing well in recovery so far but when it comes to intimate relationships, recovery is more than just avoiding sex  addiction relapse. Relationship recovery and the building of honesty and trust is a long term process that involves revamping the entire basis of the relationship.

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

Is Sex Addiction Treatment Anti Sex?

Those who think that sex addiction treatment is anti-sex are not paying attention.  Some people who say they are “sex positive” claim that sex addiction therapists shame or judge their clients for their sexual behavior.  They go on to conclude that we are “sex negative” and wish to limit people’s sexual choices.

This is a big topic but I want to try to clarify some points about sex addiction treatment and its underlying assumptions.

Sex addiction is largely a self-defined problem

Sex addiction treatment does not label people as having a problem with their sexual behavior.  Rather we try to help people make that determination for themselves.  We do not assume that they are having too much sex or that their unusual sexual activities are unhealthy.

The idea the sex addiction therapists want everybody to have “missionary position” sex with an opposite sex partner in a committed relationship is a complete misrepresentation.  I had a client who got aroused by being choked during sex.  This is unorthodox, maybe even dangerous, and I don’t go out of my way to recommend it, but it wasn’t a problem for her because I thought there was something wrong with it.  Rather she herself decided it was a problem in her life.

How people decide sexual behavior is a problem

The criteria for whether or not someone has a sexual addiction or problem sexual behavior rely on the person’s own report of what is going on in their life.  Among these criteria are the ideas that the behavior has negative consequences in the person’s life.  These include such things as the following.

  • The pattern of sexual behavior is such that it gets in the way of their having or maintaining a kind of relationship that they want.  Often a spouse or partner insists that their behavior is out of control and intolerable.  And often the prospect of losing a loved one makes it clear to the client that they want to change their sexual behavior.  Other times the person’s sexual behavior prevents their being able to establish an intimate relationship with anyone.
  • The behavior causes them significant problems in their life such as getting fired for using pornography at work, getting hurt or arrested due to behaviors like indecent exposure, spending their paycheck on strip clubs and prostitutes or bringing sexually transmitted diseases home to their family.
  • Sometimes the consequences of the behavior have to do with internal discomfort, the feeling “I don’t want to be like this the rest of my life.”  In this case the negative consequence is the fact that the person can no longer ignore the extent to which their sexual compulsiveness or sexual preoccupation goes against their own value system.  I have heard people say “I don’t want to be that old guy sitting home alone watching internet porn for hours” or “I don’t want to keep spending all my time looking into neighbors’ windows hoping to see someone nude.”

In other words, sex addiction therapists don’t go out looking for addicts and trying to convince people that they have a problem.  This just doesn’t happen.  Addicts come to us in pain, often in crisis.

What happens in sex addiction treatment?

An initial period in which the addict abstains from all sex provides a way for the addict’s head to clear; it is not intended as a way of life.  Much as it is impossible to do counseling with someone who is high on drugs or alcohol, it is also hard to deal with a sex addict who is high on his/her drug of choice.  Sex addiction treatment proceeds to:

  • Help the addict define and understand the behavior that is of concern
  • Help the addict understand the origins of the behavior i.e. what drives it and its roots in early life experiences
  • Understand the role of other addictions such as drugs, alcohol, gambling or work as they interact with or support the sexual behavior.
  • Help the addict see that he/she is not alone; connecting with other addicts reduces shame and allows for an honest an open dialogue.

When we do sex addiction treatment in this way we are helping clients develop their own definition of sexual recovery and giving them the tools to get there.

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

Do Happily Married Men Go to Prostitutes?

I’ll go out on a limb and say that a married man who visits prostitutes repeatedly is probably not the happiest kid in the sandbox.  Although the wives of such men may feel the behavior reflects on their desirability, my experience tells me that such a pattern of behavior doesn’t have anything to do with the wife’s attractiveness.  It says something about the man who, most often loves and feels committed to his partner.

Paying for sex on a regular basis is not the norm, even for single men.  And it can be a sexually addictive behavior, in which case it has to do with the man’s emotional problems including his problems dealing with relationships.

Who are these men who pay for sex?

An article published earlier this year called What Kind of Men go to Prostitutes?  reviewed some of the recent research and survey data on men who visit prostitutes.  The studies indicate that between 1 and 3 percent of men in the U.S. have gone to a prostitute in any given year and about 14 % of men have paid for sex at some point in their lives.

The studies also indicate that men who hire prostitutes are only slightly more likely to be single than married.  And furthermore they do not appear to differ much from the general population of men.  The men’s reasons for having hired prostitutes were seen as predictable: wanting more sex, being unhappily married, being insecure about dating, wanting the excitement of risk, and wanting power and control.

An outcome study of men who attended a “John School”, a criminal diversion program for men who are arrested for paying for sex, reported that:

“Johns report a variety of reasons for why they purchase sex including the feeling that buying sex is an addiction. Interviews with “Johns” revealed that 83 percent of participants identified buying sex as an addiction (my italics) (Durchslag & Goswami, 2008).  Additionally, research suggests that men who participate in the commercial sex industry often view women as commodities and feel a sense of entitlement to sex. Interviews revealed that men who did not have a regular sexual partner also legitimized purchasing sex (Monto, 2000).”

The Johns as a group also consisted of married and single men.  Were all the married men paying for sex because they were unhappily married?  This is unlikely, because Johns as a group are characterized as unhappier than other men.  And besides, if they have problems with sexual behavior this could account for their unhappy marriage as much as the other way around.

Unfortunately there is not enough known about the demographics of the John population or the prevalence of psychological problems.  These are still very much being debated.

Paying for sex and sex addiction

I feel on firmer ground talking about the kinds of relationship dynamics that are commonly seen in men who show up for sex addiction treatment where paying for sex is one of their compulsive behaviors.

As with sex addicts in general, men who visit prostitutes most often have other sexually addictive behaviors.  These can include compulsive porn use, cybersex, strip clubs, and sometimes offending behaviors like exhibitionism and others.  Going to prostitutes is thus part of an pattern of sexually addictive acting out behaviors.

The fantasy element in sexually addictive behavior

Whatever the specific behavior, sexual acting out is always largely a fantasy.  It takes place outside of the person’s “real life” and it functions as a drug.  While engaging in the sexually addictive behavior, the addict escapes whatever is painful and achieves a totally gratifying experience on his own terms.  This implies that the man has issues that he cannot resolve, or issues he would rather escape than allow his adult self to face head-on.

The avoidance of intimacy in sexually addictive behavior

Paying for sex is exactly the same as any other sexually compulsive behavior in that it is part of a pattern of intimacy avoidance.  What is the addict escaping from when he is avoiding intimacy with a partner?  It is not that the prostitute has so much more to offer than the spouse.

The sex addict experiences intimate bonds as frightening and overwhelming.  Being with a prostitute is safe, limited and controlled interaction.  The addict can relax and feel safe from the dangers of getting hurt, abandoned, rejected or feeling inadequate.   The sex addict feels unlovable and insecure and meets his needs for sexual abandon in a contrived, compartmentalized way.

Sex addicts feel bad about their addictive behavior afterward but they continue to do it.  If a man who is not an addict visits a prostitute he may feel many things but he will not be driven to repeat the experience.

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

Relapses and Slips in Porn and Sex Addiction

It is accepted among those of us who work with porn and sex addiction that there will be relapses or “slips” at some point in the first year or so of recovery.  Internet pornography in particular is notoriously hard to quit.

Sex addiction is  clever and devious.  It wants to find a way to come out and play.  So even when the addict is totally abstinent from his or her “bottom line” behaviors (behaviors that the addict has identified as the ones that need to be out of bounds) the addict may engage in other watered down kinds of behavior to get a “hit.”  For example, the addict who wants to quit internet pornography may find himself watching movies that have a significant amount of sexual content or looking at YouTube or Facebook videos that are suggestive or outright sexual.

But in early recovery addicts are likely to repeat even their bottom line sexually addictive behavior at some point.  So when is this something to be concerned about? When should it be called a slip and when should it be seen as an out-and-out relapse?

When is it just a slip?

What is counted as a slip is doing the addictive behavior (e.g. going to a strip club, watching porn, engaging in cybersex, having a sexual hook-up with a stranger, or getting together with an old affair partner).  It is not doing the things that lead up to the bottom line behavior but it is actually doing something that is what you have decided not to do any more.  (Slips will usually count as sexual acting out and will mean changing your sobriety date.)  What I believe makes it a “slip” rather than a relapse is:

  • You perform the sexually addictive behavior without planning to.  You did not enter the situation consciously intending to do the behavior.  It “just happened” and you may feel a certain shock at finding yourself in the situation.
  • You do the behavior only once.  You realize immediately what you have done and you get out of the situation before you do it again.  You turn off the computer, you hang up the phone, you get rid of the person’s contact information etc.
  • You talk about it with someone like a sponsor, counselor or recovery partner and you describe it in your regular 12-step meeting right away.  You do not attempt to hide it or minimize it.
  • You figure out what you need to learn from the slip. This means that you use the slip to gain a better understanding of the circumstances that can lead up to you slipping.  Do you have to plan your day or evening more carefully? Should you be more aware of slippery situations like business trips?  You will need to anticipate known stressors or other things that constitute your “relapse scenario” as it is called.
  • You may change your recovery plan in response to the slip.  You might decide to put additional behaviors, people or activities, such as browsing singles ads, into your list of bottom line behaviors so that you see them as relevant to your staying abstinent.   You may also consider whether other addictions such as alcohol or drug use have played a role in your slip and consider addressing them more strenuously.  And you may want to consult with a doctor if appropriate when you believe you may have psychological issues or need medication to stay emotionally stable enough.

Avoiding Relapse

If you respond to the incident of sexual acting out in the way described above you will have gone a long way to avoiding a full on relapse in which you continue the acting out behavior.  Often people have a slip and decide that it is a relapse.  They therefore feel “What the heck! I’ve already blown it; I might as well go all the way.”  This is using the slip as an excuse to keep acting out.  But the fact is a slip does not mean that you have blown your program.  It is an opportunity to make your program better and to learn about yourself.  If you use it.

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

Why Sex Addicts Blame Their Partners

For most sex addicts, blaming a spouse or partner for a pattern of sexual acting out behavior is a predictable part of the denial process .  Even when they are devoted in many ways to their spouse and family, addicts may still feel that their behavior is caused by something in their situation.

Like all denial mechanisms, this is partly a matter of wanting to avoid feelings of shame about the behavior, as well as wanting to explain it away.  This “shame dumping” as it is sometimes called can be conscious or unconscious, overt or covert.  It is like saying “I’m really a good guy; I only do what I do because of such-and such.”

Your own problems and addictions are usually hard to spot and/or admit to.  But it is always easier to see what’s wrong with someone else or what’s wrong with your life.

Feeling abandoned by a partner with the birth of a child

It is very common for an underlying sex addiction in men to really begin to take hold following the birth of a child.  The problems with the addict’s intimacy avoidance, their addiction proneness, or their lack of emotional maturity were most likely there before.  Often they were masked by the newness of the relationship.

The birth of a child takes the mother away to some extent and puts the emphasis on someone other than the addict.  The addict may flee the new demands and seek to escape into acting out.  In this case the addict may feel unconsciously that they have been rejected or abandoned by his wife and thus feel justified in acting out behaviors like going to strip clubs, prostitutes or sexual massage parlors.

Self sacrifice and overwork

Self sacrifice and devotion to their partner may paradoxically be a setup for the addict to begin to feel like indulging the urge for a separate secret life of acting out.  Many sex addicts are prone to work too hard and try to be the hero for their spouse or partner.

Later they come to resent it and feel that they are owed something.  Instead of being able to practice the intimacy skills of stating their needs with their spouse and letting go of being the hero, they take refuge in a very self indulgent secret life which they feel they deserve.  You will sometimes hear addicts in recovery say “I had to shoot my white horse.”

Sexual dissatisfaction

Sex addicts often feel that their sexual acting out whether in porn use, serial affairs, or any other sexual behavior is a direct reaction to something that is missing in their marriage.  They may say that the problem is that they “want more sex than my wife” and their reasoning is that if that is the case then they are justified in going outside the marriage or relationship to get sex.  After all it’s his/her fault.  If their partner were meeting their needs then they wouldn’t have to seek sex elsewhere.   But in reality it’s apples and oranges.  What the addict wants is an addictive high, a dopamine rush that is the result of a secret sexual behavior.  This is not just a case of needing more sex.  And it is certainly not the partner’s fault.

Lack of investment in the relationship

Most sex addicts who have partners and who are active in their addictive behaviors are lacking in the ability to be fully invested in their relationship.  Even if they love their partner very much, they have chosen a relationship and a way of relating to a partner that sets the stage for the compartmentalization and deception that go along with sex addiction.  They often feel that they didn’t really want to get married or commit to the partner in the first place.

All too often sex addicts have no idea what a good devoted primary relationship should look like and they are unable to bond effectively.  They expect little of the relationship and of their partner and so are free to put their eggs in several baskets.  They may think consciously that their partner is just too busy with work or that their partner will be likely to betray them anyway.  But it is not their partner who can’t make the bond happen it is them.  Their addiction (and intimacy dysfunction) is not an effect, it’s a cause.

Being Sexually Triggered vs. Sexually Aroused

Maybe you have heard recovering sex addicts talk about being “triggered” and wondered how it differs from just being aroused or turned on by some stimulus or other. Being triggered is a common term used in sex addiction recovery. It means something different from simply feeling aroused by something or someone.

A triggering experience can be seeing, hearing or doing something that is a precursor to the addict’s sexual acting out behavior. There are sexual images and sexual stimuli to be seen everywhere but certain kinds of perceptions will be more likely to be associated with a particular person’s preferred sexual behavior.

What triggers do

A trigger sets the stage for a sequence of behavior moving toward acting out. An addict whose preferred sexual scenario involves power and exploiting someone weaker, such as that of rescuing a helpless female may be triggered by seeing an attractive woman who is in a difficult situation.

Sex addicts are not always fully aware of why an experience is triggering. It may seem to be unrelated to their sexual acting out behavior and still make them want to go out and do that behavior. An addict who typically finds sexual partners for anonymous sex through the internet may begin to feel an urge to relapse into that behavior when simply looking at Craig’s List ads for someone to play bridge with. The mere fact of online descriptions or photos of people may be enough. In this case the addict is on thin ice, often not realizing it.

The triggering experience need not be sexual and in fact often it is not. For someone who is compulsive with prostitutes or sexual massage parlors, certain parts of town or certain streets may cause the beginning of a chain reaction known as the addict’s “ritual.” An addict who is an exhibitionist or a voyeur will likely become triggered in any situation in which being seen or seeing others undressed is a possibility, such as finding him or herself in a locker room or changing room with little privacy.

In contrast to ordinary arousal, being triggered may involve the beginning of delusional thinking. The addict sees something and either consciously or unconsciously it touches off an association with the addictive behavior on whatever level. At this point, sexual acting out begins to seem more like a viable option even though the addict wants to avoid it like the plague when he has his wits about him.

Identifying “triggery” feelings as useful information

Although addicts may slip into ritual or delusional thinking without realizing it, there are often ways to catch yourself and not move toward a slip or relapse.

  • Feeling triggered can involve a sudden feeling of hyper-arousal, a dopaminergic “burst”, which is different from normal sexual arousal or attraction. It is more sudden and intense and is thus more compelling. To an addict in good recovery it is a warning. Sometimes the triggering involves the blurring of boundaries with other intense feelings like fear or anger which in turn bring on sexually addictive urges.
  • Another way that the addict may identify a trigger is through noticing and examining their own thought processes. Addicts in recovery get progressively better at seeing the ways in which their thinking can go awry. Even though you may not think there was any triggering event, you may still notice that your mind has for some reason begun to distort reality.
  • You may find yourself feeling that there is no harm in doing a particular behavior or you may begin to look for little ways to get a sexual hit.  At this point the addict can get a handle on things by going back and looking at what may have been a triggering experience.
  • Since the sex addict is locked into a pretty set pattern of sexual acting out behavior, it is sometimes the case that the experience of feeling triggered is one of sudden familiarity.  The excitement, the intrigue, whatever it is, feels like where the addict belongs. This is another kind of signal.  In normal arousal there is always some sense of not knowing where it is going.

But remember, they are your triggers and you must manage them. It is never someone else’s fault if you get triggered! Most recovering addicts get very good at identifying what are triggers for them ahead of time and avoiding them. This takes time and experience and is part of what happens in treatment and 12-step work.

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