Archives for Addictions

Addictions

Pornography: Shame-Based Clients vs. Addicted Clients


Just Because a Client Says He’s Porn Addicted…

As digital technologies become more ubiquitous and porn usage becomes more prevalent and socially acceptable, clinicians, especially certified sex addiction therapists (CSATs), have seen a corresponding increase in the number (and variety) of people seeking help with shameful and/or compulsive porn use and related life problems. Importantly, there are multiple and often very different populations seeking such assistance. For instance, some clients seek treatment because they are addicted, while others seek treatment...
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Addictions




Can Therapists “Officially” Diagnose Sexual Addiction?

A Hopeful Outlook

In the April 2016 edition of Addiction, Dr. Richard B. Krueger of Columbia University and the New York State Psychiatric Institute provided a short commentary on the ways in which psychotherapeutic clinicians, if and when it’s appropriate, can make a DSM-5 and/or an ICD-10-CM diagnosis of sexual addiction. This is important primarily as it relates to insurance companies, who don’t especially like to pay for the treatment of any issue...
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Addictions

Is Addiction an Intimacy Disorder?

In his popular 2015 TED talk, “Everything You Think You Know about Addiction is Wrong,” journalist Johann Hari discusses research into the underlying causes of and effective treatments for addiction, ultimately concluding, “The opposite of addiction is not sobriety, it’s connection.” While Hari is not a scientist and he tends to overgeneralize in his presentation, making it relatively easy to nitpick, his belief that addiction is linked to early-life and adult struggles with emotional intimacy is, in my opinion, right on target. In fact, any therapist who has worked with addicts on a relatively routine basis will recognize the addictive pattern he describes.
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Addictions

Problematic Porn Use: Quantity vs. Consequences

A new study by Mateusz Gola, Karol Lewczuk, and Maciej Skorko, published in The Journal of Sexual Medicine, looks at the factors that drive people into treatment for problematic porn use. In particular, Gola and his team wanted to determine if frequency of porn use or consequences related to porn use are more important. Unsurprisingly, as sex addiction treatment specialists like myself and Dr. Patrick Carnes have been stating and writing for more than a decade, when diagnosing and treating porn addicts the amount of porn a person uses is considerably less relevant than his or her porn-related consequences. In fact, Dr. Carnes and I have consistently defined porn addiction based on the following three factors:
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Addictions

Lesbian Women, Love Addiction, and “The Urge to Merge” – An Interview with Dr. Lauren Costine

Ten years ago the first edition of Cruise Control: Understanding Sex Addiction in Gay Men was published in response to what I viewed as a meaningful missing puzzle piece for gay men to learn and grow. At that time there were few if any self-help books specific to gay men. Thus, gay men had to interpret their challenges and experiences through the written lens of heterosexual life and culture. Although...
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Addictions

Child Porn Offenders and the Sentencing Process Part One: Recidivism and Escalation

In previous postings to this site, I have written about the differences between sexual addiction and sexual offending, the various types of sexual offenders, the treatment of sexual offenders, and therapist reporting requirements when dealing with sexual offenders. However, I have for the most part left a crucial aspect of this therapeutic relationship unaddressed – advocating for (or against) sexual offenders (in particular, child porn offenders) in the sentencing process.
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Addictions

Recovery from Cybersex Addiction: Part One – Initial Action Steps

For the last five years (at least), Jerry, a handsome 36-year-old office manager, has put the search for sex ahead of all else – even though he’s not having any in-person sexual encounters. Instead, he looks at and masturbates to hardcore pornography for several hours each weeknight and all day on the weekends, and occasionally he engages in mutual masturbation with strangers via webcam. Until a few years ago he tried to also date in real life, usually going out with nice women who were interested in a long-term relationship. He says that he really liked one of them, but that he was never really present with her and she eventually broke things off. He admits that on their dates he was usually more focused on going home and going online than on her. As it turns out, she broke up with him because she thought he was cheating on her (and in a way he was). That was three years ago, and Jerry has not been on a date since. He has tried several times to quit using porn, and sometimes he manages to do so for a day or two. But before long he feels depressed and lonely and he goes back online as a way to escape the pain. Recently, he’s started using his office computer to access porn during work hours – a situation that he knows will not end well. And yet he continues.
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Addictions

Does Your Client Have a Problem With Love Addiction?

It’s March. Valentine’s Day is a distant memory and wedding season looms. Essentially, this is the time when psychotherapy clients often want to review and discuss their romantic relationships. For clients who struggle with problematic behavioral choices related to love, attachment and intimacy, in particular love addiction (also known as romance addiction and relationship addiction), this can be a very difficult undertaking. These individuals see friends and loved ones finding relationship success, while they take one manic spin after another on the relationship merry-go-round – desperately hoping to find that one special person who can make them feel complete and worthwhile and loved for longer than a few days or weeks at a time.
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Addictions

Resolutions for Change: What are the Chances for Success?

Making Resolutions... The season for overindulgence is finally past. Now is the winter of our discontent with all of that intemperance, and our desire to make commensurate life changes. This year I will stop overeating and bingeing on junk food, and I will lose at least 20 pounds. This year I will cut down on my drinking. This year I will limit myself to $50 per week at the casino. This year I will stop smoking pot and taking other drugs.
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