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“Sex Help with Carol the Coach”

April 20, 2015

Dr. Patrick Carnes

Carol: Tonight, I am thrilled to be talking with the guru, the founder, the master of sexual addiction. This is a man who has put his whole life into sexual addiction recovery. You’ve heard me talk about him before. There’s no doubt about it that he has influenced me. I took the training to become a certified sex addiction therapist (CSAT) through his institute. Dr. Patrick Carnes is a nationally known speaker and writes on sex addiction and recovery issues. He’s the founder of the International Institute for Trauma and Addiction Professionals, and he’s the founder of Gentle Path Press, probably the most phenomenal publishing company regarding sexual addiction. The folks there are stellar, and I just so appreciate being associated with this group of people.

Tonight we are going to be talking about how sexual addiction has changed in the last thirty to forty years and what he’s most excited about in terms of treatment, recovery, brain science, and all the things that are contributing to healthy recovery for sex addicts and their partners. We are also going to be talking about the need for more research to prove to others that sexual addiction is a real disorder/addiction and needs to be in the Diagnostic and Statistical Manual, which is the “bible” of mental health conditions.

You are going to be learning about the American Foundation of Addiction Research (AFAR), which is a group of people devoted to providing research on sexual addiction. All the proceeds from this book are going to AFAR because this research is so very important. It is important in substantiating the work we’re doing, important in helping sex addicts and their partners get healthy, and important in helping other people understand that this is a real disorder.

I was telling my group tonight as we were ending, “Now guys, if you’re not doing anything, you might just listen to my interview with Dr. Patrick Carnes.” I was so excited, and they laughed because, I’m telling you, these guys are from different places and go to different treatment centers and of course attend Twelve Step meetings in other cities, other states, and other countries. But when people find out that they’re from Indianapolis, they go, “Oh my gosh, do you know Carol the Coach?” That is the beauty of media and radio. But here in my own backyard … like Rodney Dangerfield … “I get no respect.” That is not really true, as I work with the greatest guys (and women) who are forever indebted to me and any CSAT who spends time unraveling their shame and pain.

What I know to be true is that there used to be so many stigmas when talking about this kind of stuff. People are hungry for the information. They want to get help. I had a young man call me today. He’s not able to drive. He had difficulty speaking, and he was talking about chronic masturbation. He said, “I cannot stop and I don’t know what to do.” Of course I said, “Get yourself to a Twelve Step meeting.” That’s when I found out he couldn’t drive. I said, “There are telephone meetings day and night that you can be a part of.” But I do want him to do some face-to-face meetings. I can tell that this man is incredibly lonely and is probably using chronic masturbation as a way of medicating the loneliness. I said what I would initially do is find a qualified certified sex addiction therapist. This man was from another state. He had actually Googled me and the show and listened to a few podcasts, and he was really interested in figuring out how he might be able to get help.

What I know to be true about sexual addiction is that whether you had trauma that contributed to the sexual addiction or you have trauma now as a result of the sexual addiction, it is imperative that you work on a recovery program that activates behavioral patterns that are healthy; that you work through the grief, the loneliness, the sadness, the anger, the rage; and that you connect to other people who are going through the same thing. That’s why we really believe in certified sex addiction therapists, because this is a niche. It’s not a “one treatment takes care of all the issues.” There are people who really do have expertise in trauma, people who have expertise in trauma reenactment, people who have expertise in Twelve Step programs, and people who have expertise in ministry and recovery. You need to assess what it is you need, but you need to go to the experts. That’s what this show is all about, and that’s what a certified sex addiction therapist can provide you. Go to www.sexhelp.com, click on “find a therapist,” put in your zip code, and find the closest CSAT or look for somebody who works through Skype or coaching.

I started my group therapy as a result of talking with Dr. Carnes. He has said that if you were going to offer good clinical skills, then you should offer a group to enhance the individual clinical work that you provided to them. Group therapy is a different type of experience than a Twelve Step meeting, because the clients in the group are working on therapeutic issues and resolving them. There is cross talk. The group members help each other work through issues. I do something in my groups called “Mt. Vesuvius.” That is where the men go through an anger exercise where they get to rage at their perpetrator or their neglectful mother or father. They use each other as a container for safety, because when you’re going to do this kind of work, you have to have safety and support. There has to be safety and there has to be containment, and that’s so important for any kind of trauma work. So the group provides that opportunity.

If you are looking for a group therapy experience, when you scroll down looking for a CSAT in your area, see who provides groups, because they’re very helpful. Of course, we know that Twelve Step meetings are helpful as well. You’ve heard me talk before about Recovery Nation and some of the online recovery groups. They’re wonderful too, especially for people who really have difficulty with the Twelve Step program. And yet there is no substitute for face-to-face therapy, both individually and in group. It can contribute to the growth and spiritual transformation that is necessary in recovery. It’s not about conforming; it’s about transforming, and that’s so important. When I work with my group, the group teaches me as much as I teach them.

Tonight we will be talking with Dr. Carnes about what recovery tools he thinks are the most important. Of course, so many sex addicts struggle with long-term recovery. And we know that if they work on the Recovery Start Kit and utilize in all the recovery tools, they’re going to be much more likely to maintain successful recovery—and that’s what it’s all about.

What do you do to work on yourself? I am a big believer in setting aside daily time to work on reflection, contemplation, and change. Not only do I get up in the morning and exercise, but I listen to podcasts that provide inspiration and education. I spend time reading. I have a solid fellowship of people in my life who support me and who hold me accountable, no matter what my issues are, and that’s what you need too. There is hope, strength, and recovery out there, and there are lots of opportunities to learn more about recovery through your bibliotherapy, through this show, and through the introspection that comes with therapy.

If you just don’t think you can do it by yourself, it may be time to consider a residential treatment program where you can get specialized treatment, attend workshops, and participate in intensives. Dr. Carnes works at Gentle Path through The Meadows. Gentle Path uses Dr. Carnes’s task-centered approach for long-term sexual addiction recovery. He is a senior fellow at The Meadows.

The Meadows is located in Wickenburg, Arizona, and is one of the finest treatment centers in the world. It allows you to work on all types of addictions. One thing we know about sexual addiction is that there is a higher probability that if you are suffering from sexual addiction, then you likely have at least one other type of compulsion or addiction to address. That’s what we’re finding more and more. You’ve heard me talk about the fact that when I wanted to educate addiction hospitals about sexual addiction, they did not want me to talk about sexual addiction. They were scared to touch it because they feared it would interfere with their not-for-profit status. I’m always really amazed that there can be such fear around sexuality. We’ve got a lot of things to work on in today’s world, and this certainly is one of them. With the Internet being the new crack cocaine of sex addiction, we have to stay on top of it. Again, I am thrilled to be interviewing Dr. Patrick Carnes tonight.

This is a field that has gone through so many changes, and it’s important for us to recognize and honor the changes that it has been through. People didn’t believe in sex addiction and thought it was a moral issue. I’m pleased to tell you that the field has made so much progress. Dr. Carnes had to go through so much to get the word out, and he was stigmatized as a result, kind of blackballed. People thought it was just boys being boys. They didn’t get the compulsivity and the obsessiveness behind this. Now, people are clamoring to figure out how they can learn the skills needed to recover from this serious illness.

Do you feel like you can get the help you need? That is so important, and that’s what this show is all about: to remind you that, yes, you can. You can get the help as long as you reach out and request it. I think it is very difficult to make that first call, and when you do, what you’re going to need to know is that somebody cares and has the expertise to direct you to the right place.

If you’re a partner, I know that it’s really tough for you too, because what we know to be true is while the addicts carry the shame, oftentimes their partners carry the pain. They wonder was it something they did or did not do. They don’t know whether to stay or to leave. They don’t know if it will get better. They don’t know if they will ever be able to trust their partner! I oftentimes work with partners to create connection with other Twelve Step groups, S-Anon, COSA, even an Indianapolis group that has started to provide support on a smaller level, because they really know how imperative it is to be able to talk out their issues and not reinvent the wheel or brainstorm with each other. We’re always working with partners.

You’ve heard me say in the past that there are basically two reasons for addiction. One is trauma-based or neglect, abuse, that kind of thing; and the other has to do with a kind of obsessive compulsive behavior that occurs as a result of habitual patterns of behavior. We call it “ritualization.” We call it a kind of sexual addiction cycle that can actually keep you stuck in the cycle of your addiction.

So what I’m going to ask you to do is to think about your recovery. What are you doing that’s working in your life? What is making a difference? Is it the reading you’re doing? I recommend the workbook Facing the Shadow from Gentle Path Press to every person I work with. Why is that? Because it’s the workbook that deals with the ABCs of sexual addiction, and the more you look at the problems that it has caused in your life—the consequences—the more you understand that maybe it’s not just Internet porn. Maybe there is some fantasy; there is some seduction; there is that risk taking that is imperative to the illness itself. You can interrupt that at different points. Dr. Carnes talks about a “fire drill.” Have a fire drill ready so that when you begin to feel urges and cravings, you know how to interrupt that pattern immediately. This might entail writing a letter reminding yourself how much healthier you are, because you no longer utilize pornography, prostitution, exhibitionism, that kind of thing. When you’ve got those things on hand, as well as your fellowship list so that you can call anybody for support at any time, you’re much more likely to make successful choices. Some people have found that certain medications make a big difference in their urges and cravings, so they combine pharmacology with utilizing those healthy outside behaviors like exercise and relationship building and church. Addicts may go to additional Twelve Step meetings when they feel more at risk to slip or relapse.

Other times you may be a partner and say, “You know what? I need to go to a partner trauma workshop so that I can work with a group of people who really know how I feel and can give me the support I need to make the necessary changes in my life. Maybe I need a separation. Maybe I need a full disclosure. Maybe I am tired of information leaking out over and over and over again, which leaves me feeling re-traumatized.”

One of the things I do with addicts is that I ask them to have empathy for what’s going on in the lives of their partner. It’s not all about them; it’s also about how is this affecting your wife or your husband? How is this affecting the kids? How is it affecting your work? And although you need to have somebody who really is there for you and who understands and won’t stigmatize or shame or guilt you, they also need to help you rebuild the lives of the people whose lives you have shattered.

I am so pleased to announce that we have Dr. Carnes on the phone.

Carol: I’m very glad to have you on the show, because I’ve got some important things to check out with you, and of course I wanted to talk to you first and foremost about AFAR. Can you tell our listening audience why AFAR is such an important organization and what it’s doing for the field of sexual addiction?

Dr. Carnes: There is no other organization that really takes into account all the addictions. There are things around some of the chemical addictions, but there isn’t anything that also takes into account what we call a “process addiction,” like compulsive eating or compulsive sex or some of the things that don’t involve chemicals. AFAR is committed to fostering research across all the various types of addiction.

Carol: So in some ways this differentiates process addictions from chemical addictions and will help people to understand through research that this is just as devastating and compulsive as a chemical addiction.

Dr. Carnes: Well, in fact from a neurobiological and medical point of view, this is something that has been in the works for a long time. People have understood that the reward centers of the brain can be accessed in many ways besides chemicals. With both food and sex, for example, they actually are in some ways harder wired in the brain, because they are connected with survival. The reality is that both in food and sex, we can now see this in brain scans documenting that the same parts of the brain are affected as cocaine or other chemicals would affect them. In some ways, like for example in the case of sex, the brain will categorize something as sexual for both men and women 20 percent faster than anything else that it is presented with. So the reality is that physicians are saying and writing about that, and they’re saying of course sex can be addictive. Of course, now it is delivered in ways that we never knew before, because the Internet has really opened technology to flooding the brain and the reward centers of the brain in ways that the human race has never faced before. So we have a greater challenge than we know.

About six or seven years ago, there was an article in Pediatrics talking about the fact that two-thirds of our junior high students are doing sexual things while they do their homework, and 34 percent will go on to have a lifelong problem. That period in an adolescent’s life between the ages of twelve and sixteen is very powerful in terms of forming addictions. Like if you smoke at the age of thirteen or fourteen or if you drink alcohol at the age of thirteen or fourteen, it can be a real problem. One of the things that we are starting to understand is those kids—and roughly that’s about six million U.S. teenagers at this point in time—40 percent of those kids who are having the problem started when they were actually ten. The fact of the matter is that there are parents out there who literally do not know what their kids are doing or that a kid would even be having a problem.

One of the things that AFAR is trying to do is mobilize the recovery community as well as the research community and public health people to become aware that we have a major problem. Addiction is our number one public health problem. In chemicals alone, there is over $500 billion a year in medical expenses connected with the chemical addictions. When you fold in the eating disorders and compulsive overeating—for example, with a third of our adults having obesity, which leads to diabetes and cardiovascular problems, etc.—then you fold in sex addiction and you start getting to sexually transmitted diseases and AIDS. In fact, a recent statistic shows that the leading cause of throat cancer—which used to be either alcohol or nicotine—the leading cause of throat cancer now is HPV, the virus that is transmitted by oral sex in adolescents, and it’s reduced the age of onset from the early fifties to the mid-thirties. It’s stunning to see that we have major consequences, major things that are happening in our culture, and people are oblivious to it. It’s AFAR’s mission to help people understand that we as a nation have a huge addiction problem. We are one of the most expensive medical systems in the world, and we are not one of the healthiest nations in the world.

Carol: That makes total sense. So, in some ways, it’s going to have to hit a physical realm for people to grasp how this addiction is affecting our kids, our families, and certainly adults. Tell me, what is the greatest change you’ve seen in the past forty years in your work with sexual addiction? Actually, has it been forty or is it fifty years now? Wasn’t it in the mid-80s that you first started this work?

Dr. Carnes: I actually started … the book that kind of started it all for me in my career was Out of the Shadows. I actually wrote the majority of that in 1972.

Carol: Did you really?

Dr. Carnes: We did not publish it until 1983, because at that time we were still learning. To talk about any non-chemical addiction was a real problem, so what we did in 1985 is we started off really researching. We followed 1,000 families for seven years, and what we found is we were able to document that there was a process, probably an age-old process, in that sex addiction comes from certain kinds of families; it usually involved things with childhood abuse, sexual abuse, physical abuse, emotional abuse. We knew that it was very stress and trauma related. We also knew that early sexual experiences could have a tremendous effect on it and that it traveled with other addictions. So we had kind of a pathway. If you’d ask me the biggest change that has happened in my career, I thought by 1991 that we had a map of how all this happened and we did. At that time, we had a really good picture and really good numbers about how sex addiction occurred.

Carol: Before the Internet, right?

Dr. Carnes: It was before the Internet. We started getting people … I was getting patients who didn’t fit that pattern. What did happen is they got on the Internet, and as we have since learned from a number of different sources, there are now people who struggle with the problem who never would have had it if not for the Internet. Reality is that, first of all, I had people tell me that and one of my clues was it happened so fast. I remember having a minister tell me that he discovered the Internet in his church when he was working alone one day on a holiday, and he quickly went through his family savings and he embezzled from the church, and he said it happened so fast. That’s what cocaine addicts would tell me about how fast it happened. Then we started getting people who not only would tell that story, but they would tell me—and this was in the later 90s—that they had had that problem ever since they had been on the Internet as kids. Now they’re in their twenties and they’re telling us they had gotten into trouble for something that they’ve done, and now we started seeing the history of that. Now I would say today, anybody who treats sex addiction, sooner or later most of them … it’s very rare now that we see a sex addict who doesn’t also have some issue also with the Internet because the Internet is such an easy form for access. It’s really changed things. I thought to be truthful, and I think you’ve heard me say this, Carol; I thought that we had the answers in the 90s and that we had done all this research and found what the path was. Well, that path was accurate until that time. The path is now different and there are many different ways that people can get there.

Carol: I so agree with you. Certainly, we’re now learning how to be neuroscientists and brain scientists, because we have to do brain work to help people recover. You and I both know how much we’re learning about that every single day.

Dr. Carnes: In fact, one of the things that I think is important, obviously as the basis for recovery, and is that the Twelve Steps have a formula that worked, and now we’re starting to make sense of why. For example, one of the ways the brain changes has to do with the brain’s need to feel safe. In other words, if there is a commonality of story, all of those things that go into a Twelve Step program from a neuroscience point of view, make lots of sense now, but nobody had that idea in the 1930s and nobody thought about applying it to things other than alcohol. But the reality is that system worked. The truth is whether you’re in recovery or not in recovery, I think that brain consciousness now is something that everybody has to start learning about. It’s not just that professionals need to become aware of the way the brain changes, but all of us need to become good consumers of information about how to take care of our brain, how to feed it better, how to stimulate it, how to keep it going.

Carol: And how to rest it.

Dr. Carnes: The brain replaces itself every two years, like our blood supply is replaced every six months. The brain actually reconstitutes itself and it’s very, very plastic. Part of what we have to do is to be aware … one of the things we can do to help our brain consolidate, learn new things, be stimulated, and develop new ways of behaving and thinking, which brings our brain to a new level of functioning. That actually begins … it goes well into what many people would consider elderly. The truth is the brain actually reaches kind of an epitome in the mid-60s. I think there may be listeners who, as they get older, will forget things like they go into a room and forget why you went there, forget names and things that they are familiar with and what have you that they can’t recall. The fact is the brain gets very complex, so the brain is able to handle a lot of variables as you age and sometimes where you’ve been—stuff is forgotten. I think for a lot of people, they worry about maybe their brain is deteriorating, but in fact brains really keep maturing. There are good books out there that can help with that, but for sure what people need to understand is that addiction is a brain disease. In other words, it’s a problem where the brain doesn’t function like it’s supposed to.

When we think of Alzheimer’s, people understand Alzheimer’s and nod their heads and think, “What happens if somebody has Alzheimer’s?” Well, they have trouble with their memory; they have trouble with feelings; they have trouble managing their feelings; they lose contact with reality—that’s a brain disease. It’s also true of what happens with addicts. They start to lose contact with reality; they start making bad decisions; they have a hard time managing their feelings; they have difficulty with being in touch with what is going on around them. The fact of the matter is that addiction is very much a brain problem as opposed to a moral one, which of course many people were judged by. When I started my career … that’s the other thing that I would say was one of the major changes. The change is that one of the reasons we didn’t publish Out of the Shadows for so long was because of just the fear. We were teaching other professionals and talking about it and what have you, but we were aware of what the public reaction would be to the idea of sex addiction. Today it’s a pretty commonly understood concept. Some countries have been notable in pioneering the public’s understanding of that. For example, in Canada in the province of Alberta, they did a public education thing much like you do, Carol—where you’re trying to help the public understand that there is a problem—and they brought in experts and told the story and what have you. It appeared on all their TV channels and health channels and in hospitals and subways, and then they surveyed the average citizen on what they thought about addiction. Then two years later, they did an assessment and what they found is they totally changed the culture’s perception about the nature of addictions. When they were asked, “Now that you understand this, what treatments do you think we need the most help with,” the number one thing they were requesting was more services for sex addiction.

Carol: That is amazing. I had no idea. So would you say that their treatment centers and their workshops and their experts … that is actually more available to the public?

Dr. Carnes: That in fact put the whole system … starting with medical schools and hospitals and delivery systems, and the health care system is very different from ours, so it really required very different thinking in order to understand what it was going to take to build a system that would really deal with addiction as a problem. They took a giant step by educating their public. It’s interesting; the people they brought in were from American institutions and it was headed by a Washington think tank that helped them design the whole process. So they used American technology to help them with their problem, which we haven’t even accessed in our own country.

Carol: Did they ask you to be part of the think tank?

Dr. Carnes: There were numbers of us that were involved in the education, but they were from all kinds of addiction institutions and academic institutions in the U.S. There is a lot of common agreement amongst professionals and people who work both in the addiction community and the brain community about this as a problem.

Actually, Europe has been in some ways further ahead than we are in some of the neuroscience studies. For example, out of Cambridge, we’ve been getting studies of what pornography can do to the brain. One of them, for example, really opened their eyes to the fact that four hours of Internet pornography a week will actually decrease gray matter volume, affect the decision making for brains, and would also affect the bottom of the brain where you have feelings and learning and motivation. All those things were affected. One of the most interesting side effects is that it affected the ability to be sexual with another human being, so for example erectile dysfunction was one of the common side effects. That’s what four hours would do for you. The whole idea was to understand that it was something that seemed so innocent … like it wouldn’t have an impact. The stimulation the brain was receiving was so great that it actually altered how the brain was functioning. I think it was really eye-opening to a lot of people. Now there are studies … there is one from Germany from the great University of Berlin, so that appeared in the Journal of the American Medical Association. In other words, more and more evidence is coming in about the impact of it, and it’s being understood worldwide.

Carol: That is absolutely amazing. When you think that the average male describes that he watches at least four hours of porn a week, you’re saying that decreases the gray matter, which then affects the ability to process feelings and learning and to be motivated, and then physiological, erectile dysfunction, anorexia. I mean, it just trickles down; it ripples out. So we have a whole lot more to do to educate the public about how notorious this situation is.

What are you doing right now, because I know that I was reading in the Guinness interview and you said probably four or five years ago that your proudest book thus far was the recovery stuff. So what are you doing these days? I know you’re running a circuit where you’re really helping to connect people to the Twelve Steps. Tell us a little bit about how you’re doing and what you’re doing.

Dr. Carnes: Well, the Twelve Step part is that in the late 80s we put a book out called A Gentle Path through the 12 Steps and it was a way of structuring how you worked, and I kind of started thinking differently in a more psychological and self-aware way about doing Step work. In fact, when I proposed the book to the publisher, they said it was a book that was never going to sell, but they thought that a tape set would, and they would include it as a book to go in one of the tape sets. Six months after it appeared, people were buying the tapes; they were buying the book, so the Gentle Path book is a book that grew in the Twelve Step community. It was used in Debtors Anonymous and Codependents Anonymous and Adult Children of Alcoholics; a wide variety of different fellowships were using it. As I reflect about it over the years, the fact is that once somebody starts this, they realize they probably would qualify for more than one fellowship, and the fact is that as you get further along in the process, you realize in therapy you have to do things that kind of transcend everything. The idea was to help people think about this. If you’re living this way, this discipline across these Twelve Steps, certain principles appear that become very, very important.…

Carol: Like honesty, courage, and those kinds of principles.

Dr. Carnes: So it’s called A Gentle Path through the 12 Principles. We started doing retreats around that and AFAR has been very instrumental in helping people start to think about that. The book has kind of been a springboard to a lot of thought across the fellowships. What I really hope happens with that is that … no disease entity ever got what it needed until people who have the problem stood up and said, “We need to do something.” It’s true of diabetes, cancer, multiple sclerosis, AIDS, and the fact is that people who have the problem and their families needed to stand up and do this.

The fact is that addiction is a problem that still has so much shame attached to it that people who have the problem don’t stand up. Part of that is because there is confusion about really what is anonymity. The truth is that Alcoholics Anonymous would never have gotten off the ground if it wasn’t for the The Saturday Evening Post and Reader’s Digest and other places in which alcoholics spoke out about the power of what can happen in healing and recovery. The fact of the matter is we have this huge problem and we have people of all these different fellowships who have a common bond and can help in this issue. They need to become educated and be able to speak out, and my hope is as they get more familiar with the Principles, they would be people who would then be able to stand along with the research people and AFAR and the various people from both the science and the clinical communities and what have you. It needs to be a recovery-driven thing where recovery people are speaking up. My hope is that the book stimulates that kind of leadership and that kind of speaking out.

Carol: So if people want to attend the Twelve Principles workshops, because I read that you can really join in at any point—you don’t have to start at the beginning or anything—you can contact us and begin at any time?

Dr. Carnes: People are welcome; they can find out about that by going to the AFAR website or www.thetwelveprinciples.com has information about it.

Carol: Got it. I so appreciate your time. I know that I get three very common questions, and one of them is, what recovery tools do you think are the most important to integrate when working on sexual recovery? Of course, my answer is “all of them.” You need a committee of people like a Twelve Step fellowship, and you need recovery tools and resources to utilize to help you manage this addiction. Sex addiction is different from other types of addiction.

Dr. Carnes: I think the vital reason for that is that of all the things you can struggle with, sex has so much shame attached to it in our culture, and the fact is that the recovery can be very difficult. All addictions are difficult. It’s a little bit like what Viktor Frankl talked about with the people who made it through the concentration camps. He said it’s basically the people who are able to make the transformation are those where literally they were transforming suffering into meaning. What I think is that anybody who works with a disease like this, and you have the suffering, it brings you to this place where sooner or later you do the hard work, you face the hard things, because you realize that it matters. It matters to loved ones; it matters to having a different life; it matters to your kids; it just has to matter. That basically is in the realm of spirituality.

Carol: And that goes beyond confirmation; that is in transformation. Is there one Step in the Twelve Step process that you feel is pivotal in recovery?

Dr. Carnes: I think it’s hazardous to name one Step. People do the first Step and they sometimes think that’s all they have to do, and the truth is each Step brings you down into a deeper level. The truth is that the real core, deep places in the Twelve Steps are the realization that making the commitment to being a better human being is an ongoing process. The fact that you’re getting healthier doesn’t mean that you aren’t going to have challenges or further crises or further learnings. I’m going to be seventy-one in a few weeks, and the reality is I’m striving to work as hard on myself as I was going back to the beginning when I started. The reality is that it becomes a lifelong thing that you have to start really realizing. It is something that doesn’t end.

Carol: You know I heard you say, and it’s certainly in your tapes, that you have to be able to call on your committee if you’re going to stay in recovery. You can’t do it by yourself. You can’t white-knuckle it. You need that support to create that transformation. So yeah, people can be white knuckling it, but that is not true recovery. Although it does seem that when clients figure out that when suffering has meaning, it becomes exciting. That’s what I want to share with the listeners: that it is about hope, strength, and recovery, and it’s about really giving back at the end once you get it. Dr. Carnes, you have given back and back and back. You’re an amazing individual.

Dr. Carnes: I’ve been thinking about it a lot lately for a variety of reasons, but one thing is that there is a very interesting piece of federal research that was done on the Twelve Steps. And they found that one of the best predictors of success was not that you had sponsors, but the fact that you became a sponsor. I’ve had a chance to think about that, because when I teach I often create gifts for my students, but what I’ve always learned is that sometimes you teach about that which you need to work on yourself. I learn as much, whether it be in an educational setting or a therapy session, in many ways I learn more from the patient or student than the patient or the student does. I think the giving back thing was one of the secrets that Bill W. and Dr. Bob got; really they got that out of a letter that Carl Jung wrote about that in order for them to really make a difference, they had to be able to pass it on. I think in many ways that is one of the secrets—that it isn’t just that you got help, but that you also helped. It’s a basic act of gratitude. That gratitude becomes a way of reframing then what your whole life is about.

Carol: Marci Shimoff, who wrote the book Happy for No Reason, interviewed 20,000 people to find the meaning in life. They found that if you stayed in the moment, if you had gratitude, and if you reframed so that you were always asking yourself, “What did I have to learn and what wisdom have I gained from whatever experience I’ve had?” that it kept you stable and kept you giving back. That book has been instrumental for me. You know I’m a coach, so I really believe in coaching people once they get out of the crisis, stabilize their life, and are searching for that meaning. So I’m glad to hear you say that you feel the same when it comes to reframing and looking at suffering, and realizing that it has a wonderful end game, and that there is transformation in giving back.

Dr. Carnes: The number one resilience skill, I think, that a person can evolve is to keep that focus on your gratitude. It’s a real discipline to do that, but that gratitude list really makes a difference; there’s no doubt about it.

Carol: That’s a perfect place for me to end. I just want to say I am so grateful that you found the number, that you got the right number, and that you came on the show.

Dr. Carnes: We got there.

Carol: Well Dr. Carnes, you are the master of sexual addiction recovery. I remember you telling our class that for so many years you were such a pioneer and that people stigmatized you for it. Truly I hope that you’re seeing full circle that we are a community that loves you, that appreciates you, and our listening audience was clamoring to have me get you on the show, so thank you so much. Lots of gratitude to you for being on the show, and we’re going to give back by creating that ebook and having our listeners buy it so they learn more from our guests, and they can read the transcripts and also donate to AFAR all at the same time.

Dr. Carnes: That will be great. I appreciate it.

Carol: All right, we’ll see you at the next conference.

Dr. Carnes: Okay, thanks Carol.

That was Dr. Patrick Carnes, obviously an incredible mentor. I just can’t speak highly enough about him. When I did coaching, I had people who asked me, “What are you going to do next, Carol?” and I said, “I’m going to learn about sexual addiction and provide services to those people who have sexual addictions and also to people who are in love with sex addicts.” The general population said, “Gosh Carol, why would you do that? Here you’re working on coaching—you’re taking people to their highest potential—what would compel you to want to work in that field?”

It’s what Dr. Carnes said today; there’s a lot of suffering in that field, but out of suffering comes growth, and my clients are the wisest, the strongest, and the most compassionate because they’ve been through so much—so much trauma, so much effort, so much work. And I appreciate all my listeners out there who consistently listen to the show and want to learn more about this disorder and, more important, about that recovery movement that is so imperative to taking your life to the next level. As I end the show, I will tell you, “There will only be one of you at all times, so fearlessly have the courage to be yourself.” Keep working on your recovery and being the best person you can be. Again, thank you to Dr. Patrick Carnes, who founded the Gentle Path program at The Meadows, which is a confidential inpatient treatment center for men eighteen and older who battle sexual addiction, relationship addiction, and sexual anorexia. It was a pleasure to speak to him tonight. We’ll see you next week. As I always say, “Have a good one.”