Tag Archives: Sex Addiction

What the Heck Is Sex and Relationship Rehab?

Part 1
by Robert Weiss LCSW, CSAT-S

(The following post is the first of three taken from Robert Weiss’s article, What the Heck Is Sex and Relationship Rehab?)

It seems like every time I turn on my television, open a newspaper, or go online, I’m hit with yet another story about a secret, problematic pattern of sexual misbehavior and/or multiple infidelities acted out by a major politician, sports star, actor, religious leader, teacher, coach or whomever. Sometimes these men and women might well qualify as sex addicts; other times not. When their behavior does meet the definition of sexual addiction, they sometimes, either on their own or at their lawyer’s behest, enter a sexual addiction treatment facility. The general public is usually unimpressed with this, seeing it as a cop-out, primarily because most people understand neither sex addiction nor the addiction treatment process.

Yes, most people know about drug and alcohol rehab. If they haven’t been to one themselves, they’re familiar with someone who has had to face those demons in a residential setting. At worst, most people understand that you “go to rehab” because you need a time out from drugs and alcohol. At least that’s what it looks like if you watch ABC’s Nashville any episode, any week. But sex rehab? That’s a joke, right? Nope. No joke. Sexual addiction (also known as hypersexuality) is a very real thing with consequences that are every bit as devastating as those of heroin, cocaine or alcohol addiction. And sex addiction treatment is equally as real and as serious.

In many respects, sex rehab mirrors drug and alcohol rehab, relying on the same basic structure and techniques. The main differences between sex addiction recovery and substance abuse recovery are the level of intimacy in the work being done, the subject itself, the fact that the majority of clients have had significant early life trauma, and the way in which “sobriety” is defined. Whereas lasting abstinence from mood-altering chemicals is the goal in nearly all forms of chemical dependency treatment, sexual sobriety involves an ongoing commitment to behavior change but not long-term abstinence. In sexual addiction recovery, the goal is learning to engage in and be satisfied with non-compulsive, non-compartmentalized, relationship-focused sexuality — not to abstain from sex. This is much like an eating disorder, where the person with an eating problem still needs to eat. Essentially, recovering sex addicts and their treatment team must determine what sexual behaviors are healthy and acceptable, and which are destroying their relationships, career, family and life. Addicts then commit to engaging in only the identified healthy sexual behaviors, eschewing the problematic ones and calling it a “slip” or “relapse” if one of those problem behaviors is repeated.

Of course, the definition of “problematic sexual behavior” varies from person to person based on the individual’s life circumstances (married/single, gay/straight, religious background, community standards, etc.) Thus, the definition of sexual sobriety also varies from person to person. But in all cases, sexual sobriety is defined as the elimination of sexual behaviors and patterns that diminish the addict’s life functioning, sense of self and relationships. It is important to note that the patterns of sexual behavior to be eliminated never involve trying to change one’s sexual identity, sexual orientation, or fetish/kink arousal patterns — none of which are considered sexual addiction, per se.

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Can Women be Sex Addicts?

 

Can Women be Sex Addicts?

Guest Post By Robert Weiss LCSW, CSAT-S

Robert Weiss is Founding Director of The Sexual Recovery Institute and Director of Sexual Disorders Services at The Ranch Treatment Center and Promises Treatment Centers. These centers serve individuals seeking sexual addiction treatment and porn addiction help.

From what the media tells us, sexual addiction is a strictly male problem or least that is all we seem to hear. Men cheating on their wives, men seeing prostitutes, men going to strip clubs, massage parlors and of course, male politicians sexting online. Does this mean that there are no female sex addicts? If there are women out there who are acting out with sex, where are they and why don’t we hear more about them?

The news media gives endless examples of famous husbands who betray their wives in ways that often result in public humiliation for them both (Clinton, Sanford, Tiger, Weiner, etc.). But what about women who ‘act out’ with sex and romance? While we know that women act out additively with food, drugs, alcohol, gambling spending and caretaking, the truth is that there is little to no research on female sex and relationship addiction. What we do know today is that approximately 8-12% of those seeking sexual addiction treatment are women (which interestingly more or less mirrors the numbers of men entering eating disorders treatment), but it is highly likely that many women struggle with compulsive and impulsive sexual and relationship disorders. A woman is less likely than a man to seek help for her problem sexual behavior for a variety of reasons – mostly related to shame.

Emblematic of this problem is our cultural reference for the man who is generating a lot of sexual contacts “stud”, whereas a woman engaging in the same types of activity is referenced as “slut” or “nympho”. This kind of prejudice leaves those women with sexual and romantic behavior problems more highly subject to shame and prejudice – and therefore less likely to get help.  Even the woman whose sexual and romantic behaviors are causing her profound problems  (health, family, relationship, career, etc.) is not likely to identify as having a sexual problem, she is more likely to use terms like, “I have relationship issues” or “I tend to pick the wrong partners”. Because women more often see and experience sexuality in more relational terms then do men – even when a woman is having sex in the same ways and frequency as a male sex addict often won’t identify as having herself as having this problem.

While the primary etiology of male sexual addiction is mostly based in early emotional neglect, covert parental incest and early attachment deficits – female sex addicts report much greater incidences of profound, overt childhood abuse, physical neglect and trauma – often sexual, which leads to sex addiction and intimacy issues in later life. Some of these women unconsciously live out their early abuse by becoming sex workers (i.e. prostitutes, strippers, involved in porn, sensual massage, etc.), attempting to give themselves a sense of ‘control’ over early out of control experiences. As their adult lives are dominated by exchanging sex for money and the feelings of control and power that sexual behavior offers them, these women have little access to outside support or role models toward change and self-examination.

Not all women who are sex and relationship addicts are prostitutes however, many are housewives, single women and even teens, who utilize sex and romantic intensity as a means of self-stability and comfort, despite the various risks and dangers associated with addictive sexual relationships. In terms of risk taking and out-of-control behavior, female sex addicts are very similar to male sex addicts.

Mary S. presented for treatment in an acute crisis when her husband Jeff learned about her having multiple affairs and was threatened to leave unless she got help. Mary is 38 years old with two children ages 4 and 7. In addition to the affairs and anonymous sexual liaisons both before and throughout her marriage, Mary also disclosed “losing myself on a daily basis” to 30-40 minutes of porn use with masturbation, “to help calm me down or as a way to get to sleep” for nearly all her adult life.  She simply reported this as “what I do to relax” but she also keeps this secret from her husband.

Though Mary had a highly physically and emotionally abusive home environment, she had not previously sought out treatment or therapy nor did she relate her problem adult sexual and romantic history to early childhood abuse. She told her therapist that she had always believed that “by marrying the right guy, I could just put the past behind me, when Jeff came along – I thought I was safe” Just after her first child was born, Mary began sexual/romantic affairs with both a neighbor and separately, a co-worker, believing then that her marriage had become boring and she needed these other experiences to feel “more alive”.  In addition to the stated ongoing sexual and romantic liaisons over the past several years, Mary has been signing onto Craigslist in search of other lovers and casual sex whenever she or her husband are out of town for work. Despite her sexual acting out history – Mary was highly motivated to make her marriage work and keep her family together.

Today there are a few precious resources for female sex and love addicts include the recent book, “Waiting to Heal” by Kelly McDaniel MFT,  “Women, Sex and Addiction” by Charlotte Kasl. SLAA, Sex and Love addicts Anonymous is a 12-step sex addiction recovery program that encourages female participation and offers many gender separate meetings. The Ranch, a residential treatment center in Nunnelly Tennessee offers private, gender separate residential treatment for female sex addicts.

The most important step a female sex and love addict can take toward recovery is to openly and honestly bond with healthy adult women, not for sex – but for recreation, friendship and mutual support. Sharing their sexual past in detail (non-graphic) with other women helps to reduce shame and non-sexual bonding with supportive women helps alleviate the need to use men sexually for self-soothing and self-stability.

Below are is an abbreviated list of 20 key “questions” adapted from the Sex and Love Addicts literature that might help a woman self-determine if she has this type of problem. More about SLAA can be found at:  http://www.slaafws.org/

Am I a Female Sex and Love Addict?

1.) Do you feel that your life is becoming or is unmanageable because of your sexual and/or romantic behavior or your excessive dependency needs?

2.) Do you find yourself unable to stop seeing a specific person even though you know that seeing this person is destructive to you?

3.) Do you feel that you don’t want anyone to know about your sexual or romantic activities? Do you feel you need to hide these activities from others – friends, family, co-workers, counselors, etc.?

4.) Do you get “high” from sex and/or romance and then crash when the act or experience is over?

5.)  Have you had sex at inappropriate times, in inappropriate places, and/or with inappropriate people?

6.) Do you make promises to yourself or rules for yourself concerning your sexual or romantic behavior that you find you cannot follow?

7.) Have you had or do you have sex with someone you don’t (didn’t) want to have sex with?

8.) Have you ever thought that there might be more you could do with your life if you were not so driven by sexual and romantic pursuits?

9.) Do you feel desperate about your need for a lover, sexual fix, or future mate?

10.) Have you or do you have sex regardless of the consequences (e.g. the threat of being caught, the risk of contracting herpes, gonorrhea, AIDS, etc.)?

11.) Do you find that you have a pattern of repeating bad relationships?

12.) Do you feel like a lifeless puppet unless there is someone around with whom you can flirt? Do you feel that you’re not “really alive” unless you are with your sexual/romantic partner?

13.) Have you ever threatened your financial stability, career or standing in the community by pursuing a sexual partner?

14.) Have you ever had a serious relationship threatened or destroyed because of outside sexual activity?

15.) Do you feel that life would have no meaning without a love relationship or without sex? Do you feel that you would have no identity if you were not someone’s lover?

16.) Do you find yourself flirting with or sexualizing someone even if that was not your intention?

17.) Does your sexual and/or romantic behavior affect your reputation?

18.) Do you feel uncomfortable about your masturbation because of the frequency with which you masturbate, the fantasies you engage in, the props you use, and/or the places in which you do it?

19.) Are you unable to concentrate on other areas of your life because of thoughts or feelings you are having about another person or about sex?

20.) Do you find yourself obsessing about a specific person or sexual act even though these thoughts bring pain, craving or discomfort?**

**excerpt from © 1985 The Augustine Fellowship, Sex and Love Addicts Anonymous, Fellowship-Wide Services, Inc. All Rights Reserved

Robert Weiss is Founding Director of The Sexual Recovery Institute and Director of Sexual Disorders Services at The Ranch Treatment Center and Promises Treatment Centers. These centers serve individuals seeking sexual addiction treatment and porn addiction help.

Follow Robert on Twitter @RobWeissMSW

 

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“What to do with a client that may have addiction issues” Part 2 – Cognitive Distortions, Stages of Change and ACE Assessments

Cognitive Distortions

As I interview the client, I keep in mind their language, way of talking and their perceptions. I listen for Cognitive Distortions in their conversations. Dr David Burns, author of “Feeling Good” has a list of Cognitive Distortions that comes into service here, as it can identify certain key phrases that reveal the cognitive distortions that are characteristic of an addict . I am sure you have heard these types of cognitive distortions in past interviews

1) They didn’t show up on time, they’re completely unreliable! This is an example of All or Nothing thinking, a cognitive distortion
2) I’ll never get that promotion/ My boss always tries to swindle me out of my commission. This is an example of Over-generalization
3) I forgot to send that email! My boss won’t ever trust me again, then I won’t get that raise, we will loose the house to foreclosure and my wife will leave me. This is an example of Catastrophizing, which is seeing things as dramatically more or less important than they actually are.

Identifying the Stage of Change

My next series of assessment questions include the Annis, Schober & Kelly interview questions, to identify the stage of change the client is in . This series of interview questions are drawn from the Identifying the Stage of Change research by James Prochaska, John Norcross and Carlo DiClemente. There are six questions in this interview and the questions start out very simply:

1. Did you drink during the last 30 days? YES or NO
2. Are you considering quitting or reducing drinking in the next 30 days? YES or NO
3. Did you knowingly attempt at least once, to quit or reduce your drinking during in the past 30 days? YES or NO

At this point in my assessment work, I have to decide whether I can help this person or not. I call the Annis, Schober & Kelly assessment the “knowing when to hold them or knowing when to fold them” assessment. If in completing this assessment, the coaching client does not present that they are in the Preparation Stage or the Contemplation Stage of change, I cannot help them. I have to regretfully say I cannot help them and why.

Adverse Childhood Experiences

The last series of questions are from the ACE survey (Adverse Childhood Experiences) which are highly personal questions . In the executive coaching world these are not questions an executive coach would ever ask, but for a recovery coach, these are important questions. However, I still have to tread very lightly on these queries. I preface the questions with a warning that I will be getting very ‘close’ to the client with the next series of queries, and if he/she chooses not to continue with answering these questions, we can move on.
Some examples are:

1. Did a parent or other adult in the household swear at you, insult you, put you down or humiliate you?
2. Did a parent or other adult in the household push, grab, slap, or throw something at you?
3. Did you often or very often feel that no one in your family looked out for each other, no one feels close to each other, or no one supports each other?

 

The ACE questionnaire is important in identifying behavioral addictions, primarily eating disorders or compulsive sexual behaviors, so I use it specifically for queries that may identify these addictions.

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