Denial in Sex Addiction: Delusion, Distortion and Dissociation

Denial in sex addiction is a form of distorted thinking. In fact it is a masterpiece of distorted thinking. Breaking through denial marks the beginning of addiction treatment. This is just as true for sexual addiction and behavioral addictions generally as it is for chemical dependency.

Without treatment, the set of ideas, rationalizations and beliefs that constitute a system of denial become more and more entrenched and tend to spread, becoming a world view which supports a deceptive and disordered way of life.

Even for a practicing sex addict, there are moments of clear-headedness when he or she suspects that they are engaging in a problematic or pathological pattern of behavior. But that awareness does not hold up. Why? Because denial is distorted thinking in the context of a semi-dissociated (i.e. “checked out”) state. Continue reading

What is a Certified Sex Addiction Therapist (CSAT)? Frequently Asked Questions

Mature students studying in libraryWhat is involved in becoming a certified sex addiction therapist or counselor?

First, an important point to remember is that only those therapists who are already licensed or otherwise credentialed in their particular counseling field (e.g. psychologists, clinical social workers, marriage counselors, pastoral counselors) are eligible to enroll in the CSAT training.

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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

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 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

Why do Therapists Tell You to “Sit with Your Feelings”?

This is one of those therapy clichés that never worked for me.  Since it refers to negative feelings, it always sounded unreasonable to ask people to sit there feeling angry or sad and not try to do something to feel better.  And yet it is routinely said to our sex addict patients and to patients in general.

If we are going to tell someone to sit with their feelings I think we owe it to them to tell them what this means and why it might help.  Sometimes it’s good to escape from your feelings and sometimes it’s better to delve more deeply into them.

When to escape your feelings

Feeling bad feelings is not helpful in and of itself.  In fact it may be stressful and if it continues could potentially take a toll on your functioning, your sex addiction treatment, your relationships and your heath.

If feeling miserable has become a way of life and you have allowed being unhappy to become part of your identity then there is probably something that needs to change. The same is true for feeling resentful or rebellious all the time.  Negative feelings are not productive if you let them become part of the definition of who you are. In these cases escape means getting help.

On an everyday level feelings are just feelings.  They come and they go and it doesn’t do any good to get alarmed by them or to get down on yourself about them.  By and large you can escape the minor irritations and disappointments that occur by just getting involved with something else or waiting until they pass.  You didn’t get to the phone in time, you burned the toast.  Oh well, you say, and you get on with your day.  Managing the ebb and flow of feelings is part of having good adaptive skills.

If you are saddened by the suffering in the world it may motivate you to become active in a cause.  But if you cannot escape the feelings of despondency and the preoccupation that feeds them you will be harming yourself. You will not be helping others by leading a miserable or unfulfilling life.

When to become more deeply aware of your feelings

One way to think of addictions like drugs,  gambling or sex is that they serve the function of numbing negative feelings.  All addictions start out as ways to avoid or eliminate pain and unpleasant emotions.

When someone is in sex addiction treatment, one of the treatment strategies is to get them to be willing to become aware of the feelings (like fear, resentment, self-loathing) that they are trying to medicate through the addiction.  We do this by getting them to give up the addictive drug or behavior and connecting the dots that will allow them to understand and let go of the feelings.  To do this they need to feel the feeling however painful.

Apart from working through ghosts of the past, this process also allows you to see that feelings won’t kill you and that you can in fact do quite well without medicating them in your usual way.

But there are other good reasons outside of the therapy situation, to allow yourself to fully feel whatever it is that you are feeling.

Knowing what you feel right now, good or bad, is part of knowing who you are at this moment.  It is the most basic way to be mindful, and mindful presence is what allows you to be fully yourself in the moment.

Being honest with yourself is better for you.  Trying to suppress what you really feel involves effort and stress.  Allowing yourself to just experience what you feel whether or not you express it or do anything about it is actually physically more healthful.

Being “in denial” about what you feel is harmful in another way.  Denial is a kind of self delusion and the delusion doesn’t just stop with denying your feelings; it tends to spread to other areas of life and it means that you don’t fully live in reality.

Last but not least, feeling negative feelings allows us to connect not only with ourselves but with other people.  We can connect romantically or intellectually but it is connecting on the level of our deepest feelings that allows us to truly know and be known.  Furthermore it is the basis of empathy.  The closer we get to our feelings the more we are on solid ground as far as our relation to our partner and all of those we care about.

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

Intimacy After Sex Addiction Treatment: 5 Frequently Asked Questions

If you are in a relationship with someone who has been in sex addiction treatment you will have a lot of legitimate confusion and uncertainty.   Here are some of the questions I have heard most frequently.

Has he told me everything?

There is a serious chance that a sex addict who is in pretty good recovery may be holding back, some big or little fact about his sex addiction history.  As much as we would like for sex addicts in treatment to disclose everything that is relevant, there may be some information that they feel they simply cannot reveal, or at least not yet.  There is bound to be some residual shame about their addictive behavior and some fear that a particular fact would be a “deal breaker” for you.  If you can be non-judgmental and supportive, the addict will eventually feel safer telling everything.  But if you want to know it all, you should let the addict know that the whole truth is important to you.

Can I trust him not to cheat on me?

If having extra-curricular affairs was one of the addict’s sexually addictive behaviors, and assuming he has committed to avoiding this behavior then you probably can assume that he will not go out and start another affair.  But there is a caveat.  Addicts in recovery often find miniature ways of acting out their old behaviors.  He may flirt excessively, he may contact an old girlfriend online or he may have work relationships with women that are “just friends.”  These are things that are not a good idea for a recovering addict as they are ways of sneaking around the rules to get a “hit,” not to mention they will drive you crazy.  Someone he trusts needs to point this out to the sex addict when it happens because he will be unlikely to see it on his own.

Will he enjoy sex with me?

Your sex life may be perfectly fine.  However, for some addicts it is difficult to adjust to sex with a partner once they have stopped using sex as a “drug”.  The addict may even become sexually avoidant to some degree.  Sex with a partner can initially seem uninteresting to an addict who is used to the adrenaline rush of acting out.  And the addict may have insecurities about whether he or she will be sexually adequate, insecurities which were always there but which were submerged in the addiction.  The addict may be tempted to bring some addictive fantasies into your sex life, familiar thoughts and behaviors and role-playing that the addict found arousing in the past. This can be totally OK (if it’s comfortable for you both) but it can also be slippery territory for the addict; it is a judgment call and it’s important to talk about it together.

What are the signs of relapse?

The signs of possible relapse are many, but one of the most obvious is the addict’s letting go of his or her commitment to their recovery and continued growth.  Lessening of the total devotion to sex addiction treatment may be expected, but if the addict becomes too cavalier about being “cured” he may be at risk.  Another problem area is that of other addictions, which may surface and lead back to the sexual addiction.  Addicts may drink more, get too wrapped up in work or engage in other activities addictively.   If the addict begins using another substance or behavior as a drug this can lead back to sexual acting out.

Will we be able to feel intimate?

Regaining trust and intimacy is a long process.  It is necessary to be very patient and supportive with one another and not to panic.  Sex addiction is often called an “intimacy disorder” and this means that sex addicts have to gradually learn how to express things like nurturance and devotion.  Over the long haul, sex addiction treatment involves learning  how to be honest with a partner and how to feel safe being who you are, with all your imperfections and fears.  This level of honesty will ultimately lead to a closer, safer bond for both of you.  The addict (and you) will come to feel that you are going to be OK even if the relationship should end and that it is necessary to stop hiding and lying even if it means you risk everything.  I like the saying that your love should be unconditional, meaning you don’t have to sit in judgment, but that whether you choose to stay in the relationship is conditional.

Partners Need to Know the Secrets and Lies of Sex Addiction

People generally do not want to disclose their sex addiction to their intimate partner.  And yet in sex addiction treatment we believe that couples cannot begin the process of recovery as long as the addict is still keeping secrets or telling lies.  Hence the saying in treatment circles:

Tell it all, tell it soon!

This is not to say that we cannot have a private inner life or that we have to tell our spouse or partner everything we think or do.  But telling the truth about sex addiction is an essential part of recovery.  It is essential for the addict, for the partner and for the relationship.

When disclosure is not necessary

Disclosing the full extent of a sex addiction is not generally advised when the couple are planning to divorce or separate.  Couples in the process of separation and divorce are dealing with a lot of emotional and real life upheaval.  The disclosure of the details of sexual betrayal may be detrimental to the process of separating.  It can fan the fires of resentment and conflict around settlement and custody issues.  Often a partial disclosure has taken place which is part of the reason for the divorce.  Disclosure can add to the traumatization of the partner who already feels betrayed, without serving any useful purpose.

Disclosing to a partner is often partial and disorganized

Partial disclosure, or disclosing in “stages,” is the norm although it is not considered a good idea.  The addict feels the pressure to come clean but wants to hold back some facts about the sex addiction, usually those that are most damaging or shameful.  The addict who has been partially found out is in a crisis state and is most often very afraid of abandonment by a partner.  The feeling is that if the spouse or partner knew everything they would surely leave.  This is not necessarily a true or rational idea.

However, full disclosure sets the stage not only for the addict to begin a new way of living but for the relationship to begin on a new basis of honesty and trust.  Every time another little piece of information about the addict’s past behavior trickles out it makes the partner feel like it is just more than they can take.  This is because the partner feels the dishonesty may have no end.

The commitment to truthfulness going forward

Holding on to secrets is a sign that the addict is not in very good recovery.  “Rigorous honesty” is considered to be at the heart of the 12-step model of addiction recovery.  There is a level of self hate and shame in the addict who feels he cannot be honest.  He is continuing to act on the core belief that if someone really knew him they could never love him.  It is a way to hang onto control but it is unfair.

Dishonesty about who we are sexually is a way to keep ourselves apart from our partner.  It is a fatal barrier to true intimacy, which involves allowing ourselves to be known.  It also gives the addict unequal power.

To the partner, the fact that they do not know what is going on or has gone on means that not only do they not know their addict partner very well but they do not have a view of their life that is based in reality.  Partners cannot find contentment and happiness if their reality is being manipulated by someone else.

What not to disclose

The optimal way to disclose the facts of a sex addiction to a partner is thought to be through a “planned disclosure.”  This is one where the couple prepare separately with their counselors and carry out the disclosure in the presence of a treating professional.

As part of the preparation, the partner or spouse will decide what it is they want to hear.  This is very important.  The addict may want to tell more than the partner wants to know.  The addict will have to take direction from the partner as to what to disclose.  For example, the partner may or may not want to know how many times the addict did a certain thing, or with whom, or what the details of the act were.

Planned full disclosure may be the ideal, but people are human and it is often not that neat.  We need to accept that both people may be afraid and mistrustful.  The addict may try to get away with holding onto a few key pieces of information our of fear, and the partner may resort to spying on the addict’s email in order to deal with the crazy-making feelings of mistrust.

But even if it is not perfect, the disclosure must take place for the relationship to survive and thrive.

Sex Addiction Treatment and Forgotten Childhood Trauma

Many people in sex addiction treatment or recovery programs can remember and talk about their history of abuse or trauma.  But sometimes recovering addicts have all the outward symptoms of having had traumatic childhood experiences but they don’t remember being traumatized or mistreated in any way.

Sometimes  people in sex addiction treatment feel certain that “something must have happened to me” and though they rack their brains they cannot remember anything that they can label as abusive or traumatic.

We who work with sex addicts assume that there is always going to be a history of  some problems in relationships with caregivers which lead to  an insecure, avoidant or disorganized attachment style later in life.  This problem with close relationships relates directly to  sexually addictive behavior and is why we think of sex addiction as an intimacy disorder.

Often addicts will go in for EMDR (eye movement desensitization and reprocessing) or somatic techniques in an attempt to connect with forgotten memories, and many claim this helps.  And sometimes the abuse happened before the child learned to talk, which means that there is no way to remember it in words.

But just as often the traumatic events are there but are simply not recognized as such by the addict.

Why people can’t see their traumatic childhood

First and foremost, many people have a mistaken notion about what constitutes childhood trauma.  Infants and children need consistent nurturing, closeness, touch, connection and love in order to develop as strong, stable normal adults.  The absence of this kind of closeness and support does not allow the child to develop normally.  So people in sex addiction treatment need to look at the kind of relationship they had with their caregivers and at what was missing in that relationship.

Many addicts were not held enough as infants, were not soothed enough or were left alone or with strangers.  These things are traumatic to the developing child.  As children many addicts experienced abandonment, were sent away, or were devalued or rejected by their caregivers in some way.  All of these things constitute abuse and lead to problems later on.

Most people whether they are sex addicts or not tend to idealize their family and their early life, or at least to minimize the hurt or deprivation they suffered.  Growing up we need to see our parents in a positive light; it is part of what helps us get through childhood.  We want to trust and look up to our parents and it is very threatening for a child to think anything bad about their parents.  This leads to a tendency to idealize our childhood even in the face of evidence of stressful and traumatic experiences.

Add to this the fact that most of us resist seeing ourselves as “damaged.”  If we are survivors, we have come through a lot and we want to see ourselves as basically OK.  This makes it all the harder to understand our early life.

How to connect with childhood trauma

In addition to understanding the biases described above, it is important to understand that people do not have to remember major horrible events in order to connect with their trauma history.  Very often we already know everything we need to know but we have not looked at it closely enough.

Much of the work of uncovering our traumatic past history involves looking at events that took place and reinterpreting what was going on in light of what we now know as adults.  What seemed like our parents having high standards for us may turn out to have been a way they put us down or conveyed negative expectations about us.  What we saw as encouraging self-reliance or being given a lot of freedom may have been a form of neglect.  And what we took for bonding may have been invasive or inappropriate.

It will be important to go back and look at what were vivid memories or recurring themes in childhood and look at them with fresh eyes, critical eyes.

What I hear over and over is “well, they did the best they could!”  People don’t want to blame their parents or caregivers or seem ungrateful.  But it goes without saying that our parents did the best they could.  That does not help us unravel our own issues.  In sex addiction treatment we need to look at what went wrong as much as, or more than, what went right.  This is the real eye opener.   Find Dr. Hatch on Facebook at Sex Addictions Counseling or Twitter @SAResource

How to Get Your Spouse into Sex Addiction Treatment

As a porn and sex addiction therapist I am often contacted by the spouses looking for sex addiction treatment for their partner.  I will look at the reasons for this and give my views on why the role of the spouse or partner is important in getting treatment for the addiction.

Why partners do the initial reaching out for help

  • The sex addict usually resists treatment for the same reason any addict does—part of them would really like to keep doing what they are doing no matter what the consequences are.  Hence it is easier to let the partner do the leg work of finding help.  At this early crisis stage immediately after disclosure the addict will be inclined to say they want help but will not want to be proactive in seeking out what might actually be an effective intervention.
  • The spouse of partner of the sex addict may be the one who is experiencing more of the distress in the situation.  The addict will surely be feeling shameful and remorseful when the addiction is disclosed, but this is nothing compared to the trauma of the betrayal usually experienced by the partner.  This in turn motivated the partner to go into crisis mode and begin trying to find solutions.
  • The sex addict may resist being the one to reach out for sex addiction treatment because he is too embarrassed to call up and admit to a stranger that he has these problems.  I often hear this discomfort in the voices of addicts who do call me and I hear them groping for a way not to have to state the problem directly.

Why the partner’s role is so important in getting help

Most often a sex addict or porn addict is in the grip of a strong compulsion to “act out” in their addictive behavior, whatever it is; porn, sexual hook-ups, infidelity, prostitutes, online sexual encounters, etc.  They may engage in this behavior frequently or less frequently, but the main point is that they are doing it addictively, meaning they are leading a separate sex life, they cannot stop, it is going to escalate over time, and it will have negative repercussions for their life and relationships.

The untreated sex or porn addict is in a state of denial.  Very often it will take some force from outside to get his attention and to convince him to get some serious treatment.  That force may come in the form of getting in trouble with the law, losing a job, or losing a marriage.  But whatever it is it will exert the necessary pressure on the addict. 

When spouses and partners discover a sex addiction they are in a unique position to use the crisis to force the addict to get help.  Addicts tend to panic at the thought that they will lose their wife and possibly alienate their children.  The spouse needs to recognize that very often they and they alone can lower the boom on the addict and cause an effective intervention.

Spouses should not expect that the therapist, even the most expert therapist, will be able to force treatment on an addict.  In the simplest terms, the therapist has no ammunition compared to the spouse. 

What the spouse needs to do

Spouses and partners seeking sex addiction treatment should be prepared to draw a line in the sand about the need for the addict to get help.  They need to say that they will live with a recovering sex addict but not with a practicing one.  And they need to mean it, in other words they need to be prepared to separate if there is inadequate movement.

Spouses need to be realistic about the kind of help that is required.  Often sex addicts will promise to quit, attend a few 12-step meetings, engage in an online program, install blocking software or get some couple counseling.   Sometimes addicts try to convince their partner that the addiction is really the partner’s fault, which it never is!

These can be ways to diffuse the situation while still having no real motivation to change.   A serious sex addiction requires a serious treatment program, often a one or two week outpatient intensive or a four to six week residential program followed by active12-step participation, and follow up therapy. 

Ultimately the addict will have to become engaged in their own recovery for it to work.  But the initial impetus can often come from the desire to hold on to a partner.  And in the long term, the relationship can get on the right track if both partners are engaged in recovery both separately and as a couple.  Find Dr. Hatch on Facebook at Sex Addictions Counseling or Twitter @SAResource