Many sex addicts try therapy first. Although it may be appropriate for some sexual problems, conventional forms of psychotherapy alone don’t address sexual addiction effectively. It has long been understood that addictions in general- drugs, alcohol, gambling and so on- are different and require “treatment.”
Treatment vs. therapy
What’s the difference? In the simplest terms, therapy is more about insight into why you do certain things and feel certain ways; treatment is more about “follow these instructions and complete these tasks and you’ll end up in a better place.” Treatment often takes place in programs and most of them use a range of inter-disciplinary of interventions.
But both treatment and therapy can take place in any setting from an outpatient therapist’s office to a residential treatment program. Certified sex addiction therapists practice “treatment” in their private practices. So when I refer to “therapy” I’m talking about the traditional kinds of therapy that do not deal specifically with sex addiction.
Here are some reasons to try treatment first
Treatment emphasizes action, therapy promotes awareness
Sex addicts who are just beginning to get help are still very much in the grip of delusional thinking. This is not a metaphor. They are in fact deluded and their thought processes are distorted in the service of their addiction.
So the goal of the initial treatment process is to break through their delusion and denial with certain exercises and inventories, as well as certain rigid rules governing their behavior so that they can begin to come out of the fog of distorted thinking that goes with their addiction. Until this happens, psychotherapy in the usual sense will be hindered.
Treatment in any setting, a clinic, an intensive outpatient program or a residential rehab center is able to surround addicts with a very high level of round-the-clock support and accountability that can get them over the hump and into a period of abstinence so that their head can clear.
Treatment is about feeling worse, therapy is about feeling better
This is an oversimplification of course, because the ultimate goal of all treatment and therapy is make people more aware, more fulfilled and happier.
But sex addicts in their addicted state are out of touch with their feelings. Their addiction to sex as a drug exists largely to escape emotional pain that they have been unable to address. As long as the drug is available, the addict will opt for the emotional anesthesia.
Therapy involves getting in touch with the feelings left over from old wounds in order to expel the residual fear and pain. But until they have a period of abstinence, sex addicts can’t stay away from their drug long enough to stick it out. They may even use therapy as an excuse: “well I tried, but it didn’t work.”
Treatment does not assume that addicts can reflect on and report their feelings. On the contrary, it assumes that initially addicts are very disconnected from themselves and everyone else.
Treatment requires willingness, therapy requires readiness
Treatment, therapy and participation in a fellowship such as a 12-step support group are the three pillars of successful sex addiction recovery. But in the beginning, sex addicts are not necessarily ready to participate in the therapeutic relationship. A one-on-one relationship may be too intimate and too full of conflict.
Treatment does not require that you believe in the process or that you care about self awareness. It only requires that you are willing to give it a shot and it involves a safe and supportive group process. (This is true for 12-step work as well.)
The decision to agree to participate in treatment for an addiction means that the addict is willing to take a leap of faith. The addict says in effect “I don’t understand this and I don’t even think it will help me, but this is what people believe works and I’m willing to try it.”
And this willingness to follow the program carries with it the momentum of engaging in the concrete task work. Taking the leap of faith gives the addict the initial sobriety that leads to the readiness for self-exploration in therapy and for a long term habit of growth and change.
What is your experience with therapy and treatment?
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Last reviewed: 5 Dec 2012