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ОглавлениеNot All Forms of Addiction Are Created Equal: What You Need to Know about Sex Addiction
Addiction is a pernicious, crippling, lifelong condition. Addiction is deadly and has an arsenal of means with which to kill. The actor Philip Seymour Hoffman was found dead in early 2014 in his apartment with a needle in his arm—the result of a heroin overdose. It would be more accurate to say that he committed suicide. He had relapsed about a year earlier after twenty-three years in recovery. One of the many problems with addiction is that when you relapse, you don’t start over as a first-time user. You start where you left off.
According to the American Society of Addiction Medicine (ASAM), addiction is characterized by “an inability to consistently abstain, impairment in behavior control, craving, diminished recognition of significant problems with one’s behaviors and interpersonal relationships, and a dysfunctional emotional response.” The “inability to consistently abstain” is a concept that sometimes confuses loved ones and family members close to the addict. They wonder, “How is it possible for the addict to abstain if addiction means that’s something they can’t do?” The confusion is understandable. On their own, addicts lack the ability to consistently abstain without help. Most would stop their compulsive behaviors on their own if they could. It’s just that most can’t do it alone.
An addict’s inability to consistently abstain or practice behavioral control manifests in many ways. He may make promises to himself that he won’t engage in a particular behavior again or he may tell himself that after a certain date in the future he’ll quit. Of course, these promises are rarely kept.
The craving for the addictive substance or behavior grows over time and the addict needs more to get the same effect. If he’s an alcoholic, he will require more alcohol to get the same level of intoxication. In sex addiction, the addict may increase the time spent engaged in a particular sexual behavior over time, or engage in increasingly risky behaviors to get the same level of intensity or “high.” “Acting out” is a commonly used expression to describe the addict’s compulsive behaviors.
Because of an inability to recognize the extent of the problems related to their behavior, addicts usually experience serious life consequences. They have chronic feelings of low self-worth and shame due to the secret double lives they lead. They often suffer from underperforming at work due to preoccupation with the substance or behavior, or a “hangover” effect from having recently acted out or binged. They may even lose their jobs because of poor performance or violating company policies. Addicts suffer financially because of work-related issues or spending large sums of money on the addictive substance or behavior. Some addicts manage to avoid financial or career consequences—but their close, intimate relationships are almost always negatively impacted.
There are two primary forms of addiction: substance addiction and process addiction. Substance addiction includes alcohol, prescription medications, and/or illegal drugs. Process addiction is different from substance addiction because it involves a set of behaviors rather than the ingestion of a substance. Examples of process addictions include gambling, food disorders, and sex addiction. In many ways, process addiction (especially food disorders and sex addiction) is more challenging to overcome because it involves normal, healthy activities, when done in moderation. In alcohol and other drug addiction treatment, abstinence is defined as simply stopping the consumption of the substance in question. However, it’s not realistic to abstain from food or to choose not to be sexual for the remainder of one’s life.
Addiction is considered a lifelong, chronic issue similar to medical conditions that require sustained and continuous behavior modification. There is general consensus among mental health and other professionals who work in the field that addiction is never “cured.” However, addiction can be well managed with guidance and support, usually in the form of counseling, psychotherapy, twelve-step groups, and—in more serious cases—inpatient treatment.
Today’s misconceptions about sex addiction are sadly similar to how people thought of alcoholics in the 1930s and 1940s. At that time, the common view was that if you were a “real” alcoholic you would be homeless and lying in a gutter somewhere. We now know that many high-functioning people can lead what appears to be a normal life while active in their addiction—whether to alcohol, other drugs, gambling, or sex.
The addict’s recovery process and the ways in which sex addiction impacts partners are different from other forms of addiction. Five major factors distinguish sex addiction discovery and recovery:
1. Sexual betrayal is experienced as a personal assault by the partner. If the addict in your life abuses alcohol and other drugs you may be frustrated and angry about his behavior. You may even be hurt by the thought that he seems to care more about alcohol than he does about you. On the other hand, if the addict spends hours a day looking at pornography, frequenting adult bookstores, having affairs, or hiring prostitutes for sex, the level of betrayal and hurt experienced is multiplied exponentially.
2. Sexual betrayal creates serious health risks for partners. If a sex addict has unprotected sex with anyone other than his partner and hides this information from her, the consequences may be deadly. The risk is compounded by the fact that she isn’t aware that she may have been exposed to a sexually transmitted infection and/or disease.
3. Abstinence from sex is not the goal. For most forms of addiction, the simple (but not necessarily easy) solution is to abstain from the substance or the behavior. Defining abstinence in sex addiction is more complex because sex is a pleasurable and evolutionarily desirable behavior fundamental to human existence.
4. Slips and relapses are often more common in sex addiction recovery. This is difficult for partners to accept, and rightfully so. But the truth is that, for a variety of reasons, people who attempt to replace compulsive sexual behavior with healthy sex generally aren’t able to simply make a decision to stop all unhealthy sexual patterns and never repeat them. The addict’s sobriety plan may change over time depending on his particular set of behaviors and issues. There can be several—or even many—setbacks along the way. Depending on the behaviors involved, these “slips” may be deal-breakers for partners.
5. Need for more intensive accountability. If your partner is drinking or using other drugs, it’s hard not to notice even if he’s a master at avoiding detection. The odors and/or unusual behaviors of people when they’re using substances are difficult to miss. However, it’s entirely possible for someone to engage in sexual behaviors either alone or with another person during the lunch hour, on the way home from work, while running errands on the weekend, or at home in the middle of the night, without any evidence or clues. This is one of the reasons why formal therapeutic disclosure followed by a polygraph exam has become common in sex addiction recovery. For people who haven’t had experience with a sexually compulsive partner, these accountability measures may sound extreme. However, it’s not unusual for a recovering drug addict to be required to pass a sobriety test (such as urinalysis, breathalyzer, or a hair follicle test) in order to have visitation with children, for example. The polygraph is the equivalent of the drug test as an accountability tool to repair the damage done in relationships impacted by compulsive sexual behavior.
Partners who have recently discovered that their spouse has been acting out sexually sometimes say, “He says he’s a sex addict, but I think it’s an excuse. He’s just trying to avoid responsibility by claiming it’s an addiction.” The idea is that somehow the “sex addict” label lets him off the hook, renders him not responsible in some way, or gives him license to get away with something. I want to assure you that nothing could be further from the truth.
Sex addiction is real. The risks taken by sex addicts that endanger their health, safety, livelihood, and relationships are staggering. Addicts look for anonymous sexual partners through websites, chat rooms, and phone apps; they meet people they don’t know in risky or even dangerous places, and have unprotected sex with people whose sexual history is completely unknown. They may literally risk their lives for the next sexual encounter.
Partners sometimes believe that when the sex addict is acting out he is sneaking around like an adolescent whose parents are out of town, having casual hookups or engaging in other behaviors that he experiences as merely fun and harmless. Addicts often minimize their behaviors or say that what they did “meant nothing” in an attempt to avoid consequences or manage their shame. Addiction is not casual, fun, or harmless. The level of preoccupation, desperation, unmanageability, and shame experienced by sex addicts is so painful that they create distinct “compartments” to manage their dark, secret life.
No one would willingly choose to be an addict—especially a sex addict. It is difficult enough for most people to talk about healthy sexuality, much less to admit to out-of-control sexual behavior. Taking on the sex addict label—with all the work it entails—requires a considerable commitment of time, energy, and dedication. In addition to counseling and twelve-step meetings, the addict may be asked to write a formal disclosure to present to his partner, followed by a polygraph exam.
Given all that’s involved in taking on the sex addict label, it’s clearly not an excuse for bad behavior or a way to avoid responsibility. Quite the contrary. A person who identifies as a sex addict and makes a decision to get help to stop his behaviors is making a long-term—often lifelong—commitment to treatment and recovery.
BASICS OF FIRST-YEAR SEX ADDICTION RECOVERY
As a partner, you need to have an understanding of the addiction recovery process in order to develop realistic expectations and to make informed, reasonable requests of the addict as necessary. Otherwise, you will experience needless frustration because your expectations of your partner are unrealistic, or worse, you may expect and ask for too little. Being uninformed and/or not making requests of the addict for trust-building behaviors is harmful not only to you but it may also inadvertently delay the recovery process for the sex addict.
The truth is that most of us don’t make meaningful changes without engaging in behaviors and activities outside our comfort zone. While it’s not your job as a partner to provide the addict with growth opportunities, you’ll be doing yourself and your relationship a disservice by not making requests for repair and rehabilitation of trust. In Chapters Three, Six, and Seven, you’ll learn about common boundaries made by partners and how to make effective requests of the sex addict in your life.
Following are the primary components of a good first-year sexual recovery plan. These are the typical recommendations Certified Sex Addiction Therapists (CSATs) make, and may not represent the treatment approach of other mental health treatment providers or recovery programs.
• Assessment by a mental health professional with specialized training in treating compulsive sexual behavior. The International Institute for Trauma and Addiction Professionals (IITAP) and the Society for the Advancement of Sexual Health (SASH) are good resources for locating a certified sex addiction therapist or a therapist with specialized training and experience (see Appendix for more information). Mental health professionals without knowledge or training about compulsive sexual behavior sometimes don’t know how to assess the problem, and they can overlook or minimize it. Most sex addicts minimize the extent of their problematic behaviors. On the other hand, some people who are deeply troubled by their sexual behaviors and those who experience intense shame about normal sexual feelings or behaviors may label themselves as sex addicts when it’s simply not the case. That’s why assessment is so important.
• Participation in regular (preferably weekly) individual and group psychotherapy, along with attending twelve-step meetings, and working with a twelve-step sponsor. Sponsors are mentors in twelve-step programs who serve as guides in the recovery process. (The Appendix includes a list of twelve-step organizations.)
• Therapists and/or sponsors often recommend that addicts new to the recovery process abstain from all sexual behaviors for the first three months of treatment and attend ninety twelve-step meetings in ninety days—sometimes referred to as “ninety in ninety.” Although “ninety in ninety” may seem extreme at first glance, when compared to the amount of time many sex addicts spend thinking about, planning, preparing for, and engaging in their sexual behaviors, seven hours a week spent in twelve-step meetings is usually a fraction of the time spent on acting-out behaviors.
• Daily written recovery work and reading of recovery literature.
• Creation of a sex plan or Three Circle Plan. This plan outlines the behaviors the addict will abstain from, as well as healthy behaviors that will replace those that are destructive and unhealthy. The behaviors in a sex addict’s abstinence plan often change over time. (For more information about the Sex Addicts Anonymous Three Circle Plan, visit their website at www.saa-recovery.org.)
• If the sex addict is in a long-term relationship, the partner or therapist may ask him to prepare a formal therapeutic disclosure. The formal disclosure is a document describing the type and extent of his sexual behaviors outside his primary relationship. Graphic details aren’t included, but the number of partners, how long the relationship or behavior lasted, and how much money was spent, are typical items included in a disclosure. If he agrees, the sex addict will complete a written disclosure to present to his partner in a therapy session, followed by a polygraph exam. It is sometimes recommended that the sex addict complete the First Step in his twelve-step community before presenting a disclosure to his partner.
Most partners find it helpful to get more information about sex addiction and the recovery process from trusted sources. (See the Appendix for a list of recommended reading.)
One of the most painful aspects of sex addiction recovery for partners is that the sex addict will likely not be able to put an end to all acting-out behaviors immediately after getting caught, attending his first twelve-step meeting, or beginning therapy. When addicts break their abstinence plan, it’s called a slip or a relapse. In an ideal world, addicts would choose sobriety, commit to a recovery path, and remain abstinent from their destructive sexual behaviors for life. Unfortunately, this is rarely the case. More often than not, sex addicts in early recovery struggle to maintain an abstinence plan.
There are differing views about slips and relapses in sex addiction recovery. Most therapists who treat sex addiction agree that a slip is a single—usually unplanned—acting-out incident. Relapse is a process that begins before the actual acting-out behaviors. It may start with a reduction in participation in recovery activities (twelve-step meetings, therapy, etc.), the addict thinking he doesn’t need recovery, that his problems aren’t as bad as others, or harboring secret plans to engage in what are commonly called the “middle circle” behaviors of the Three Circle Plan. Middle circle behaviors are activities that aren’t a violation of the abstinence plan, but they have the potential to lead to acting out. Some examples of middle circle behaviors are unstructured alone time, using a computer in isolated circumstances, and traveling out of town for business without one’s partner.
Relapses almost always involve deception because the addict, either consciously or unconsciously, knows he’s headed down a dangerous path. Once he’s acted out, he will rationalize continuing the behaviors even for a short time since he’s already violated his abstinence plan. Sadly, addicts sometimes consciously choose to act out prior to a particular milestone of abstinence (sixty or ninety days, for example) because they tell themselves that the disappointment over “failing” after sixty or ninety days would feel worse to them and their partner after reaching the milestone. This is a clear and painful example of the cunning and baffling nature of addictive thinking.
Individuals with sobriety in other twelve-step programs like Alcoholics Anonymous (AA) or Narcotics Anonymous (NA) sometimes criticize the sex addiction recovery community for being too tolerant of slips and relapses. The idea is that in AA or other twelve-step programs, people get sober from the beginning of their time in the program. This is simply not the case. Substance addicts may slip or relapse multiple times over many years before getting a foothold in solid, long-term recovery—sometimes referred to as “rehearsing” sobriety. The story of Bill W., founder of AA, is probably the best, and most well known, example of the reality that sobriety is not a simple onetime choice of abstinence.
Because abstinence in sex addiction recovery isn’t as black and white as in alcohol and other drug addiction, it is not uncommon for the definition of abstinence to change, especially in the first year. For example, addicts often complete ninety days of celibacy from all sexual activity in early recovery. During this time, masturbation is considered acting out. However, after the ninety days of abstinence is complete, masturbation may no longer be considered a slip. This is one among many reasons why abstinence in sex addiction is more complicated than other addictions.
Sex addiction, like all other forms of addiction, involves a considerable amount of isolation and secretiveness on the part of the addict. The isolation inherent in addiction results in frequent deception and lying to partners, family, friends, and employers. As a partner of a sex addict, you need to know that, because of the nature of deception and secrecy that goes hand in hand with addiction, your trust in your reality has likely been seriously impacted.
You may have been told:
• “You’re crazy.”
• “Why are you so upset? I only did it once.”
• “You’re overreacting.”
• “All men _______ (look at pornography, go to strip clubs, etc.).”
• “You’re wrong. You don’t know what you’re talking about.”
These attempts to convince you that you’re crazy, stupid, or just plain wrong are what we call gaslighting. The term comes from a 1944 movie called Gaslight and, as mentioned before, it denotes a form of mental abuse where the victim is lied to—or the truth is otherwise distorted—for the purpose of causing the victim to doubt her own reality, memory, or perceptions. Gaslighting creates the fog of addiction, and perfectly describes what happens to partners of sex addicts when the addict is still acting out and attempting to cover up his behaviors.
Having been in a relationship with an active addict, your reality has been manipulated. You may not trust your intuition or perceptions. Some addicts are so deceptive, and their lives so Jekyll and Hyde, their partners wonder if they are sociopaths. Of course, it’s possible that your partner is a sociopath—but it’s unlikely. Many addicts manifest sociopathic characteristics when they’re acting out. They use every means available to deceive and cover up the truth of their secret life. The addiction becomes more important than anything else for them, and the level of deception inherent in addiction takes a serious toll on partners.
Some well-meaning but misinformed therapists have encouraged the partner of a sex addict to participate in the acting-out behaviors of the addict even when those behaviors are outside the partner’s value system or just aren’t something the partner wants to do. These harmful experiences happen too often and delay the addict and partner from getting the help they need. I highly recommend you seek out a professional who is trained in the field of sex addiction treatment and recovery. Don’t be afraid to ask detailed questions about the therapist’s training, experience, approach to treatment, and any concerns you have.
Because of the level of shame and stigma inherent in sex addiction, you may find it difficult to talk to family or friends about what’s going on with you and your partner. It is wise to carefully consider with whom you share information. Because sex addiction is not widely understood, the input and advice you receive may cause more harm than good. Be especially aware of people who immediately tell you to leave or say things like, “I can’t believe you’re still with him,” or “I didn’t think you would put up with behavior like that.” This kind of advice and feedback is not supportive and actually harmful. You may choose to leave, but you likely have a huge investment of time in the relationship, and perhaps children to consider. Your best course of action is to find a therapist, join a support group or twelve-step community, educate yourself about your situation, and practice the very best self-care you can.
YOUR SELF-CARE IN EARLY DISCOVERY
In the early stages of discovery and disclosure, your world has been turned upside down and—in many ways—shattered. Your brain is trying to assimilate, organize, and comprehend all the incoming data that doesn’t correspond to the way you saw your life, your relationship, or your family pre-discovery. You may spend much of your day asking your sex addict partner for information and details about his acting out or engaging in some form of detective work—combing through credit card or bank statements, phone records, or email accounts. You may have even gone a step further and installed keystroke logger software on a computer or phone, or a GPS tracker on your partner’s vehicle.
It is completely understandable for you to want to use all means to seek safety through gathering information that has been systematically and deceptively withheld from you. If the sex addict in your life seeks professional help from someone knowledgeable about sex addiction treatment and recovery, he will be given the tools and guidance to prepare a formal disclosure to give you all of the information you want and deserve, followed up by a post-disclosure polygraph if you request one.
As understandable as it is for you to seek safety through gathering information, this will not be your greatest strategy for creating safety. Your greatest source of strength and safety comes from your practice of good self-care through the use of effective boundaries—knowing how they work, how to create them, and what to do when they’re broken.
In the next chapter we explore the concept of boundaries and how to recognize a good one when you see it. But first, let’s look at the basics of your self-care plan as you navigate this difficult time.
A simple way to think about the primary components of your self-care is the PIES model:
P Physical
I Intellectual
E Emotional
S Spiritual
Following are examples of how partners practice self-care using this model.
Physical
STI Testing—Even if you don’t believe your partner has had sexual contact with another person, you need to be tested for sexually transmitted infections/diseases. Some partners tell me they don’t see why they should be tested, either because the sex addict has already been tested or because they don’t believe they should have to go through the embarrassment of a visit to the family physician since they didn’t do anything wrong. The reality is that regardless of what your partner has done, you are ultimately responsible for your own physical health and well-being. If you’re uncomfortable going to your regular physician, consider going to one of the many high-quality community clinics that offer anonymous, low-cost STI testing.
Safe Sex Practices—I am always concerned when a partner tells me she’s having unprotected sex with the sex addict after discovery and before the formal disclosure process. Even if you don’t believe your partner has been sexual with anyone else, you owe it to yourself to use safe sex practices each and every time until you have more information about the addict’s behaviors.
Intellectual
Knowledge is power. Partners should read a variety of books about sex addiction or those specifically written for partners of sex addicts. In addition to gathering information, you will save time and valuable resources by going to a sex addiction specialist first. I’ve heard many unfortunate stories of couples going to therapists who weren’t knowledgeable about sex addiction and offered advice like, “Just go to Victoria’s Secret and buy some new lingerie,” or “All men ________ (fill in the blank),” and worse.
Emotional
One of the most difficult realities of dealing with the aftermath of discovery is that the person you used to go to for comfort and reassurance has become the person who feels the least trustworthy to you. The sad truth is that even before discovery, your relationship was not as intimate and close as you may have believed. Addicts who are still acting out or who have recently sought help are generally not emotionally available to provide the kind of support, validation, and empathy you need.
Over time, and with healing, the sex addict will become more present and emotionally available. However, in the beginning, you will benefit from finding other sources of emotional connection. Trusted friends, communities of support, and therapy will be your lifelines as you deal with feelings of isolation and uncertainty about whom you can talk to.
Spiritual
Now, more than ever, you need spiritual support and guidance. Spiritual practice can be as simple as spending time in nature, reading inspirational books, or listening to audio programs that bring you a sense of comfort, hope, and peace. If you belong to a church, synagogue, temple, or mosque, I encourage you to attend regularly if your spiritual home is a place of strength, support, and comfort to you. If your spiritual life has been dormant, this is a great time to explore spiritual practices that resonate with you, or religious communities you’ve been curious about.
Now that you have a good understanding of the sex addiction recovery process and a foundation for your self-care plan, let’s take a look at the basics of boundaries.
