Subtle Signs of Self Hate: Recovering Sex Addicts Find New Outlets

There is a common saying among sex addiction therapists that “sex addiction is not about sex, it’s about pain.”    Sex addicts use one or more sexually addictive behaviors such as internet pornography, frequent visits to prostitutes or sexual massage parlors, compulsive sexual hook-ups or serial affairs and so on as a drug of choice to escape stressful or unpleasant feelings.

Sex addicts, like most other kinds of addicts have long-standing doubts about their worth as people.  They have early life histories that have left them fearful of intimate relating.  They are afraid to be open or vulnerable.  They protect themselves from situations in which they feel insecure by retreating into their addictive behavior, their fantasy life of sexual acting out in which they are soothed, gratified and safe.

Addicts may continue to experience low self worth even as they are becoming stronger in their recovery.  It takes a long time to understand and work through the feelings of low self worth and even longer to become confident and comfortable in their own skin. 

Substitute ways of acting out in recovery

Recovering sex addicts who are reliably free of their sexual acting out behavior may exhibit certain behaviors which get in the way of their work, their ability to relate to other people and their intimate relationships.  They are finding new ways to “act out” their feelings and fears now that they can no longer use their drug of choice.

In their work life and social life addicts often exhibit their need to escape their deep self doubt in one or more predictable ways, such a

Conflicts at work.  Addicts may have trouble getting along with others and may be irritable in ways that they never were before.  This is due to the absence of their ability to soothe themselves with their sexual behavior.   

Compulsive overwork or workaholism.  Addicts may pour themselves into their work as a way to escape having to deal with people or relationships.  Work can take up all the space that is left over in which the recovering addict feels ill at ease.

Comparing, competing and contempt.  These are the narcissistic behaviors.  They are an attempt to avoid self doubt and self hate by constantly judging others and trying to be one up.

Need to please.  In the absence of an inner sense of worth and validity, many sex addicts become pleasers.  They feel safe and soothed when they have the approval of others.  This takes the place of a skill they have not yet mastered, that of speaking their truth and being clear about their needs and feelings.

In close relationships addicts will engage in behaviors that tend to put distance between them and their intimate partner.  In this way they escape the demands of intimacy which they feel inadequate to meet.  They do this even as they exhibit codependent behaviors like the need to fix and control.  They will

Subtle or passive aggressive hostility.  This can take many forms such as sarcasm, contempt, sighing, groaning, and eye rolling.  This behavior expresses feelings indirectly which the addict feels incapable of expressing directly. 

Provoke conflict.  Recovering addicts often feel dissatisfied and irritable.  They may project blame onto their partner for this and they may escape intimacy by creating a rift. This can come in cycles, almost like an abuse cycle of lashing out, remorse, reconciliation and repeat.

Flirt or engage in other mini-sexual behaviors.  As discussed in my previous post about subtle forms of betrayal, sex addicts in recovery may use behaviors like flirting, ogling or talking about other people sexually, or reaching out to old girlfriends or boyfriends online as a substitute for their earlier sexually addictive behavior.  This is a way to give themselves a small bit of their drug, a mini “fix.”

Avoid sex.  Sex addicts may take a long time to get comfortable with a sex life with their partner.   Even if they enjoy it, their whole inner sexual landscape has been revamped in recovery and they may have new fears about sexual intimacy such as sudden attacks of performance anxiety or other fearfulness such as jealousy.

Overcoming all of these insecurities and learning to feel and express feelings takes time and patience for both the addict and those around them.  Sex addicts in recovery are building a sense of self and acquiring a set of interpersonal skills that they never had before.  They will get there if they and their spouse or partner or trusted friends are honest about what is going on.


Is Healthy Masturbation Part of Sex Addiction Counseling?

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

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

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

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

Risks of masturbation during recovery

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

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

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

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

Adding masturbation back into the program

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

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

How masturbation can be useful in sex addiction counseling

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

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

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

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

Is 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

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

Too Good-Looking, Too Smart, or Too Rich (to give up Sexually Addictive Behaviors)

There is an old recovery saying that you can’t get sober if you are too smart, too rich or too good-looking.   Clinicians working with clients who have sexually addictive behaviors know that these attributes can sometimes present challenges.

I’m not saying that looks brains and money lead to sexually addictive behaviors but I can see some of the ways they might operate to prevent the addict getting better.


There is no longer any doubt that success (fame, money adoration) can cause what is known as “acquired situational narcissism.”  Narcissism is a false sense of self worth which can be bolstered and encouraged by massive amounts of positive feedback from others.  This feedback promotes narcissistic self-centeredness, lack of empathy for others and over-entitlement. (See also my blog Narcissism, Sex, Power and Herman Cain.)

Any sex addict can adopt a narcissistic defense system but the process is magnified if the person is rich, beautiful, etc.  The greater the narcissistic self-importance the greater the sense of being exempt from the ordinary rules that govern behavior.

If this superiority is constantly reinforced then the addict has a hard time getting a grip on reality.  His attitude is “I’m special, I’m allowed; even my flaws aren’t flaws.”

Masking shame

Most addicts feel some level of guilt or shame about their sexually addictive behavior.  After engaging in a behavior like repeated visits to prostitutes or sexual massage parlors or the wasting of hours on internet porn and masturbation most addicts go through a period of feeling let down.  They have engaged in an out of control behavior that they must keep secret and they soothe the feelings of self-loathing in any way they can.  Often they use other drugs to numb the feelings.

The problem for the rich successful or beautiful person is that they can use these assets as tools with which to numb or mask their negative emotions and restore their facade of self worth.  The more easily the addict can dodge the feelings of self-hate, the more easily they can avoid coming face to face with their own double life.

Normalizing sexually addictive behavior

Normalizing is one of the defenses invoked by most sex addicts but with the brilliant, beautiful or rich addict it is particularly useful in certain cases.  Take the guy who engages in repeated seduction, predatory flirting, workplace harassment or serial affairs.  If he is successful or good-looking he can much more easily excuse his behavior by saying “I can’t help it, women just come on to me—what am I supposed to do?”

In this case the special attributes can function to keep the addict in denial.  Special levels of status or achievement can be seen as justifying behavior which would be reprehensible in mere mortals.  “Beauty is life’s Easy Pass,” as a New Yorker cartoon put it.  Or in the words of Henry Kissinger, “Power is an aphrodisiac.”

Never hitting bottom

For the very good-looking, smart or rich addict can to a great extent use their special advantages to avoid or greatly minimize the adverse consequences of their behavior.  These attributes give them power and that power allows them to maintain the status quo.  They may never have to confront the reality of what is wrong with their way of life let alone what they have done to others.

The very smart, successful or powerful addict will have a hard time accepting the basic fact of his or her powerlessness over the addiction.  The very smart addict is used to relying on his ability to think his way out of a problem.  There is nothing he can’t solve.  Therefore he doesn’t need to rely on others, doesn’t need to take direction or work a program.  He’s got the answers, or so he believes.

Those around the addict face a dilemma

Attractive high-achieving people often do have many strengths.  Their intelligence, attractiveness and resources can be used in a positive way to help them overcome sexually addictive behaviors.  But as a therapist—or even as a friend, colleague or partner it is  important to notice when these traits are being used in the service of self-delusion and be prepared to confront the addict directly about it.

Is it Possible to Recover from Sexual Addiction?

The concept of “recovery”

I have seen many sex addicts recover from an unhappy, lonely, self-destructive pattern of behavior in their sexual addiction and go on to not only rebuild their lives but to reach greater heights than they ever imagined.

Yet there is a tradition in the addiction field of viewing addictions as in some ways similar to “chronic” mental illness and chronic medical conditions like diabetes; conditions that require ongoing care and can be managed successfully over time.  This implies that there is no “cure,” that there may be periods of relapse and that there is no end point to recovery.

Current thinking about sexual addiction has moved beyond the earlier more limited concepts.  See a recent review of the history of the concept of recovery in mental health and addiction.

Recovery from sex addiction

Recovery from sex addiction is considered today to involve much more than abstinence from the sexually addictive behavior.  It involves a long term process of years rather than weeks or months in which the addict will make many positive changes in his/her life and functioning and in which abstinence is merely a first step along the way.

Sex addiction is viewed in the larger context of a problem with intimacy in general, usually relating back to a relational trauma of some sort during childhood.  Treatment involves resolving the underlying trauma issues and building up the life competencies that have been compromised.

Sex life in sexual addiction

The sex life of the practicing sex addict looks very different from that of the addict in recovery.  The sex life characteristic of sexual addiction is:

  • Compulsive in that it involves preoccupations, cravings and urges that defy control
  • Compartmentalized in that a chunk of the sexual life of the addict is separate from the addict’s intimate life i.e. the addict leads a double life
  • Secret in that the behavior characteristic of the addicts sexual addiction does not square with the rest of the addict’s life and the face he presents to the world, and
  • Used as a drug in that the hyper-arousal characteristic of the addictive behavior serves to distract, numb or otherwise escape from negative feelings
  • Does not usually involve a real relationship although the addict may fantasize a relationship with a stripper, a masseuse etc.

Sex life in recovery

In recovery the sex addict will be able to integrate his sex life and his “regular” life instead of keeping them separate.  This implies that the recovering addict will be:

  • Less narrow and rigid in sexual preferences and fantasy scenarios
  • Less compulsive about sex, meaning less preoccupied with seeking sex and less obsessed with sexual cravings
  • More relational and less isolated in sexual activity (e.g. sex with a person vs. porn only)
  • Less selfish, in that he will be less focused on himself and his gratification and more able to focus on a partner and
  • Able to give up the “hyper-arousal” of addictive sex in which sexual excitation is used as a drug

Long term benefits in recovery from sex addiction

Not only can the recovering sex addict have a richer, less destructive sex life, but he or she will throughout the time of recovery make many other changes as well.  If recovery continues to be a process of overcoming past fears and insecurities through active participation in treatment, therapy, support groups or a combination of these, the addict can grow in many ways over a period of 3 to 5 years and beyond.

Some of these areas of improved functioning are internal, and some have to do with relationships and general levels of functioning.  The addict in good recovery will show improvement in

  • Empathy for others
  • Less narcissistic attitudes
  • Greater feelings of overall comfort
  • Improved self-care
  • A commitment to honesty
  • Greater ability to be responsible and nurturing as a partner and parent

Addicts in recovery can expect to learn many life skills they never had before, such as the ability to set appropriate limits and boundaries, to stick up for themselves, and to set life goals and achieve them.

So where does it end?

These are pretty hefty promises but I have seen them fulfilled.  You might ask “So why do we keep on talking about ‘recovering’ addicts instead of ‘recovered’ addicts?”  Perhaps addicts feel the need to be vigilant about habits that may still be deeply buried in their “lizard” brains.  Perhaps it is just a leftover tradition from the founders of AA.  For the time being we could just think of it as a way to stay connected to a fellowship and a reminder to us to give back.

Why Some Sex Addicts Keep Relapsing in Recovery

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

What drives people into recovery vs. what keeps them there

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

  • Getting in trouble

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

  • Pressure from a partner

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

  • Social pressures

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

  • Self image

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

The right reasons

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

Sexually Addictive Behaviors Connect to Early Memories

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

  • The sex addict’s arousal template

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

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

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

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

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

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

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

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

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

  • Treatment and the arousal template

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

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

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

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

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

The Intro

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

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

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

Tom W.

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

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

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

Tom suggests a topic of relationships.

Joe S.

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

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

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

Dave T.

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

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

Ian A.

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

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

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

Bob R.

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

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

Teri B.

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

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

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

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

How to Survive Sexual Betrayal

Why do most spouses and partners react to the discovery of sexual addiction with such a sense of total devastation?  Sexual betrayal is an emotional blow that can be harder to deal with than anything, even death.

Most therapists who deal with partners of sex addicts now see the partner as experiencing severe trauma and PTSD symptoms, at least in the initial period post-discovery.  This suggests a theoretical framework that can help us understand the partner’s recovery  process as it proceeds.

The usual tools for dealing with hardship seem to fail us

Our usual arsenal of tools for transcending heartbreak and loss seems to break down in the face of the discovery of sexually addictive behavior in a loved one. For example:

We try:

Practicing detachment by reminding ourselves that the betrayal is not about us, and going to support groups and 12-step meetings, letting go of comparing ourselves to the addict’s other sexual interest.  But detachment seems to keep slipping through our fingers and we feel a mix of strong emotions.

We try:

Educating ourselves about the disease by reading and learning about the roots of sex addiction in the early childhood attachment issues, by learning that sexual addiction is not a deliberate attempt to hurt us.  But still feelings of anger and blame seem to hang around forever.

We try:

Meditation, prayer or other spiritual practice to help us realize that we did not cause the problem and we cannot cure it, and to let go of outcomes.  This will work perfectly for some things; the job we didn’t get, the flooding in the basement, but in sex addiction disclosure there is something so totally unacceptable that we want to tighten our grip.

All of the above tools are very important in a partner’s recovery  and should be practiced even when their efficacy seems limited. But why is sexual addiction so much harder to deal with?

Some reasons why sexual betrayal is different

Here are some factors that “up the ante” in sexual betrayal.

  • The personal closeness you have to the person who has been deceiving you, the person you saw as your support system
  • The abandonment  by the most important person in your life (death is easier to accept because it is something that can’t be helped)
  • The blow to your sense of reality

The last of these, the way sexual betrayal messes with your reality, is one of the most powerful factors.  Sexual addiction is often so extreme and so out of character that it calls into question all your assumptions about “normal” life.

Surviving sexual betrayal as a grief process

I tend to think of surviving sexual betrayal as a grief process because I think it is the most useful way to look at it.  I believe that seeing it this way will give you permission to take better care of yourself and to make allowances for your own healing.

  • Grief is a process that follows its own course.  It is also a process that is very different for different people depending on your own personal make up.
  • Sexual betrayal is a loss and therefore must be grieved.  It is a loss of the relationship that you thought you had and produces the same pain and abandonment as other losses.
  • Recovery from sexual betrayal seems to follow the familiar stages of grief.

The initial stage of denial often takes the form of believing the addict’s false promises or trying to set up a quick cure.  In other words, the belief that things could be patched up and go back to “normal” is a form of denial.

The bargaining, anger and depression stages of grief are also clearly identifiable.  For example, self blame, feeling that you somehow failed, is a form of bargaining.  It allows you to hold onto a feeling that you can control the situation.

The grief process is one that must be allowed to occur.  Feelings must be experienced and emotions expelled in order to move through the process.  There is no way to make it pleasant, but it will eventually lead to acceptance and a new and better relationship life.