Archives for Diagnosis
Therapists, particularly those treating sex addiction and in the addiction field generally, are familiar with therapy-interfering behaviors. Frequent lateness or failing to show up for appointments, fomenting conflict with the therapist, and many other forms of direct and indirect ways of undermining the process. As with problem behaviors generally, these are maladaptive attempts to solve a problem. I first encountered an analysis of therapy-interfering behaviors in the work of Dr. Marsha M. Linehan. Dr. Linehan was a pioneer in the treatment of the maladaptive behaviors that characterize borderline personality disorder such as chronic suicidality, chemical and behavioral addictions, and other self-destructive behaviors. Sex addiction therapists, no less than those treating any other maladaptive behavior, do well to make the problem of therapy-interfering behaviors a priority. Dr. Linehan proposed a hierarchy of target behaviors:
It seems to be axiomatic that going around harboring feelings of anger is hazardous to your well-being. See for example this extensive list of quotable quotations about the perils of anger and how to handle it. Americans seem to be angrier and more pessimistic than they used to be. But according to a new NBC online poll poorer, non-Hispanic white people are the angriest. They are also the most pessimistic about the prospects for getting ahead in America. The report states: "Very rich Americans earning household incomes above $150,000 were the least angry income bracket. The poorest Americans earning less than $15,000 were the most angry."
In the world of science denial, the attempt to deny the existence of sex and porn addiction occupies a special place. Although a large and growing body of science demonstrates the reality of porn and sex addiction, the barrage of assaults continues in the form of weaponized research and ideological demonization. Even among many who accept the reality of behavioral addictions generally, such as food, shopping, exercise and gambling, the idea of sex and porn addiction is seen as a bridge too far. What are the motivations for such powerful reactions?
I have heard this story of treatment failure from many couples who come in to see me about sex addiction. One partner was discovered to have sexually addictive behavior(s) such as porn addiction, voyeurism, hook-ups, paying for sex etc. After an initial upheaval the couple found help for the addict. The addict went into a program which may have included residential or intensive outpatient treatment, individual therapy, couple counseling, or some combination of these. At some point the addict felt that he or she had seen the light and was able to refrain from the compulsive behavior for a period of months or years. Then seemingly out of the blue, the addict starts secretly acting out again.
Most sex addicts, no matter what their behaviors consist in (prostitutes, anonymous sex, serial seductions, pornography etc.) will tend to sexualize other people they look at. You might say that sex addicts view the world through sex colored glasses. But this does not mean that they are voyeurs. Voyeurism is a distinct category of behavior that characterizes certain sex addicts. And although most people who identify as sex addicts have more than one type of behavior, research by Patrick Carnes and others found that there were 10 distinguishable types or clusters of addictive behavior of which voyeurism was one.
Basically you can’t get close to a narcissist. A relationship with a narcissist will be a problem, and the more narcissistic they are the more it becomes impossible. Sex addicts and addicts generally are often described as narcissistic, but many non-addicts are narcissists as well. Trying to have a relationship with a true narcissist can be an extremely tortuous and confusing experience.
It is not unusual for sex addicts to ask “How did I get this way? I had such an ordinary childhood.” Nobody survives childhood unwounded. And many kinds of stressful or frightening experiences can become sexualized along the way, leading to problems later on. And yet whether or not there is lasting damage depends on a myriad of factors such as the age of the child, their temperament, the presence or absence of support outside and inside the family, birth order, and the particular traits of the caregivers and many others.
Self destructive behavior is often hard to fathom. A person who habitually cuts him/herself, a person who has risky sex with a stranger in a park at night, a person who eats to the point of being sick; such behaviors make no sense to the average person. Such behavior can be seen psychologically as an escape, a coping strategy, a survival skill, or a way to restore emotional equilibrium.
Is internet porn addiction related to internet addiction? I don’t know of any data specifically on this point. My colleague Maria Robinson believes that porn addiction is “above all, an internet addiction”. She argues that addiction to internet porn has different properties from addiction to other sexual behaviors.