In sexual addiction treatment
, clinicians help clients carefully self-define the sexual behaviors that do not compromise or destroy their meaningful personal values, life circumstances, and relationships. Clients then commit in a written sexual sobriety contract to only engage in sexual behaviors that are permitted within the bounds of that predetermined pact. As long as the client's behavior remains within his or her concretely and mutually defined boundaries, that individual is sexually sober. (I have written extensively about "boundary plans" in a previous blog
) But how can we help sex addicts deal in healthy ways with the people, places, and things that trigger them to act out? After all, every time they leave the treatment setting the real world awaits-with all the same temptations as ever (and, thanks to the ever-expanding Internet, probably a few new ones).
One of the first tasks any clinician should undertake with a sexually addicted client is helping that individual learn what his or her triggers toward acting out are. For most sex addicts, travel, unstructured free time, and boredom are major triggers, as are uncomfortable feelings like depression, anxiety, fear, and anger. Sometimes driving through a "bad" part of town, watching R-rated movies, or seeing a lingerie catalog can set the addiction in motion. Each sex addict has his or her own unique set of triggers, and it is incredibly important to help the addict identify these danger zones. After all, relapse prevention only really works if you recognize that your boulder (the addiction) has tipped and is about to start rolling down the hill. Stopping the boulder before it gets moving is doable, but once that boulder is tumbling down the hill at 20 mph, the addict is in serious trouble.
Stocking the Toolbox
Below I present six tools sex addicts typically find helpful in terms of keeping the proverbial tipped boulder from rolling. When the addict recognizes that he or she has been triggered, implementing one or more of these tools is often effective. Some of these tools are specific to sexual addiction, others are used effectively by addicts of all types.
Shared items in the recovering person's toolbox include:
This is an acronym for "H
onely, and T
ired." Any of these four conditions can leave an addict more vulnerable than normal to using or acting out. Let's face it, even healthy, non-addicted people get cranky, lash out, and behave in ways they later regret when their judgment is clouded by hunger, anger, loneliness, or exhaustion. The problem in addiction recovery is recognizing and addressing these naturally occurring needs. Typically they've been pushed aside for so long that the addict has lost touch with them, oftentimes misidentifying them as restlessness, irritability, and discontentment. And the addict's natural response to these and all other uncomfortable feelings is to "numb out" by re-engaging with addictive behaviors. However, the feelings misidentified as restlessness, irritability, and discontentment are usually manifestations of something much more basic-the need to eat, sleep, and/or be with other people. Addicts, especially addicts in early recovery, must learn to ask themselves: What is really bothering me? When is the last time I ate? Did I get enough sleep last night? Would a few minutes of fellowship so I don't feel so alone be helpful?
More often than not, a quick nap, a candy bar, or a five minute phone call will greatly diminish the desire to use or act out.
Addicts are constantly triggered. Usually this happens unexpectedly, but sometimes potential dangers can be seen a mile away. Needing to attend a social or business event where alcohol will be served is an obvious danger zone for recovering alcoholics; if people a sex addict is likely to find attractive will be in attendance, then he or she also needs to be wary. The good news is addicts can learn to spot potential triggers before they actually manifest
, allowing the individual to "bookend" these events with before and after phone calls to a sponsor or another supportive person in recovery. During the "before" call, the addict commits to sobriety, and may even discuss his/her plans to avoid relapse in this particular situation. The "after" call provides an opportunity to discuss what happened, what feelings came up, and what the addict might need to do differently next time. (The practice of bookending also helps with the "lonely" portion of HALT.)
The road of recovery is oftentimes rocky. Addicts have used substances and/or behaviors to numb out for such a long time that they've forgotten how to experience emotions-especially uncomfortable ones like anxiety, depression, and fear-in a healthy way. Sometimes, especially early in the recovery process, addicts can become overwhelmed by their feelings and lose sight of what is going right in their lives. A great way for them to combat this "stinking thinking" is with a gratitude list. When an addict feels as if he or she might use or act out, writing a ten-item gratitude list will nearly always halt the addictive cycle. For some individuals, every gratitude list begins the same way: I am grateful to be sober right now
Tools specific to recovering sex addicts
THE THREE-SECOND RULE:
Sex addicts are not in control of the thoughts that pop into their minds. What they can control is what they do with those thoughts once they become aware of them. For instance, after recognizing an unwanted, objectifying thought or sexual fantasy, sex addicts give themselves a maximum of three seconds to turn away from it and focus on something else. Typically, as soon as the addict becomes aware of the triggering thought, he or she "turns it over" to his or her Higher Power, asking for the thought to be removed. This process works, and works well, even for addicts who struggle with the concept of God/Higher Power
. The simple act of doing something
(anything at all) to get rid of the unwanted thought or fantasy nearly always does the trick. Sometimes the three-second rule only helps for a few minutes. During difficult periods, unwanted sexual thoughts may pop into an addict's mind almost constantly. One unwanted fantasy is banished, and moments later another arrives. When this occurs, the three-second rule can be used repeatedly. This can actually be a blessing, as practicing the three-second rule on a regular basis increases its effectiveness.
Unlike recovery from substance abuse, sexual sobriety
does not entail ongoing abstinence. Instead, sex addicts define-working in conjunction with a knowledgeable sex addiction therapist or 12-step sponsor-the sexual behaviors that are (and are not) problematic for that individual
. These goals are then utilized to create a three-part written commitment, often called a boundary plan. The inner boundary is the bottom-line definition of sexual sobriety, specifically listing the sexual behaviors the addict wishes to stop. The middle boundary lists specific warning signs and slippery situations that could lead the addict back to his or her inner boundary behaviors. The outer boundary lists healthy activities the addict can engage in as enjoyable and fulfilling alternatives to acting out. Sex addicts often carry printed or digital versions of their boundary plan with them at all times, referring to it in times of crisis. Not only does a boundary plan serve as a reminder of which behaviors are forbidden and/or slippery, it provides addicts with a handy list of alternative activities. For most sex addicts, even a quick glance at an outer boundary item-re-earn the respect and trust of my wife and kids
, for instance-is enough to halt the acting out process.
Admittedly, nearly every addiction you can think of has at least one 12-step program designed to combat it, and for the most part these programs are remarkably similar in format and approach. All are based on the 12 Steps of Alcoholics Anonymous. Many sex addicts, especially those with co-occurring disorders (substance addiction, compulsive gambling, etc.) attend "non-sex" 12-step groups, finding a great deal of comfort and wisdom. But ultimately sex addicts are addicted to SEX, and they desperately need to attend meetings where they can talk openly about their addiction to SEX. In "S" meetings they don't have to worry about being judged for their sexual behaviors, because other people in the room have likely engaged in the same activities-and even if they haven't, they've probably thought about it. Sharing dark secrets and hearing others share dark secrets helps sex addicts to overcome the shame, guilt, and remorse that drives their acting out. Simply put: when a sex addict is triggered, the most powerful tool in the box is talking to another recovering sex addict
, and this occurs most readily before, during, and after meetings. "S" programs include: Sexaholics Anonymous (SA)
; Sex Addicts Anonymous (SAA)
; Sexual Compulsives Anonymous (SCA)
; Sex and Love Addicts Anonymous (SLAA)
; and Sexual Recovery Anonymous (SRA)
. Some meetings are open to anyone who wishes to attend, while others are open only to those who identify as sexually addicted. A few meetings are gender specific. It is best to check ahead by calling the group's local hotline number, which can easily be found online or in the phone book.
What is Most Effective?
Obviously, the half-dozen tools listed above are hardly the full kit. Journaling, written 12-step work, ongoing outreach to others in recovery, 12-step sponsorship, reading recovery literature, changing old routines, prayer and meditation, and just plain "thinking it through" are just a few of the hundreds of tools a sex addict can use to combat his or her addictive patterns. I've chosen the six listed above for two reasons: 1) they are illustrative of the breadth and variety of support available to the sex addict in recovery; and 2) over the years my clients have typically found these to be their most effective options. In closing I would like to repeat a thought from the discussion above: When sex addicts are triggered, the most powerful tool they have is their willingness to let another recovering sex addict know that they are struggling
. Thus, our most basic task with these folks is to help them recognize and accept their need to build a community of support they can turn to when they are vulnerable. If sexual addiction is a maladaptive attempt at self-soothing and connection, then the "cure" surely is reaching out for non-sexual contacts and support when feeling needful.
Robert Weiss LCSW, CSAT-S is the author of three books on sexual addiction
and an expert on the juxtaposition of human sexuality, intimacy, and technology. He is Founding Director of The Sexual Recovery Institute
and Director of Intimacy and Sexual Disorders Services at The Ranch
and Promises Treatment Centers
. He also founded the Stimulants and Sexual Disorders Program at Promises, Malibu. Mr. Weiss is a clinical psychotherapist and educator. He has provided sexual addiction treatment training internationally for psychology professionals, addiction treatment centers, and the US military. A media expert for Time, Newsweek, and the New York Times, Mr. Weiss has been featured on CNN, The Today Show, Oprah, and ESPN among many others. Rob can also be found onFacebook at facebook.com/RobWeissMSW
and Twitter at @RobWeissMSW
Last reviewed: 22 Feb 2013
Weiss LCSW, R. (2013). Basic Sobriety Tools for Sex Addicts. Psych Central.
Retrieved on October 23, 2014, from http://blogs.psychcentral.com/sex/2013/02/basic-sobriety-tools-for-sex-addicts/