Sex Addiction Treatment Articles

Narcissism, Porn Use, and Addiction

Thursday, July 10th, 2014

Narcissism, Porn Use, and AddictionProof that Porn Users are Narcissistic

Any clinician who treats sex and porn addicts on a regular basis can tell you that our clients, both male and female, tend to be highly narcissistic – a quality that often makes for a tempestuous therapist-client relationship. Simply put, evidence from the field strongly suggests that sex and porn addicts are nearly always self-centered and self-absorbed, often to an extreme degree, not only sexually but elsewhere in their lives. Of course, it’s nice to have scientific research that backs up what we typically see in our practices, and a recent study, Narcissism & Internet Pornography Use, accepted for publication in the Journal of Sex & Marital Therapy, does exactly that.

With No Formal Diagnosis or Treatment Plans, How Can Sex Addiction Exist?

Wednesday, April 30th, 2014

With No Formal Diagnosis or Treatment Plans, How Can Sex Addiction Exist?After more than twenty years spent treating, speaking about, and writing about sexual addiction, I’ve heard all the arguments (and then some) both in favor of and against utilizing an addiction-focused model of diagnosis and treatment to identify and help individuals who self-report repetitive, problematic patterns of impulsive and/or compulsive sexual behavior. For the most part, those who believe that sexual addiction (also known as sexual compulsivity and hypersexual disorder) is simply a myth tend to offer some combination of the five challenges presented below. I thought it might be both interesting and useful to examine the validity/reality of these concerns here.

Linking Sexual Shame and Addiction

Wednesday, February 26th, 2014

Linking Sexual Shame and Addiction Flawed, Defective, Unworthy of Love and Happiness

It’s no great secret that most alcoholics, drug addicts, and behavioral addicts live with deeply felt feelings of shame. In fact, shame is nearly always part of the underlying matrix of psychological conditions that can typically lead to addiction. In short, shame leads to extreme emotional discomfort and the gnawing belief that one is inherently flawed, defective, and unworthy of love. These feelings can in turn lead to depression, severe anxiety, and lifelong challenges with intimacy and relationships. And all of the above can create a powerful desire to escape and dissociate via the use of addictive substances and/or behaviors. Over time, a pattern of self-medicating life stressors and emotional discomfort in this fashion can easily escalate to full-fledged addiction, with all of the usual negative life consequences.

Effective (and Ineffective) Treatments for Sexual Offenders

Friday, May 3rd, 2013

Are Sex Offenders Treatable?

Last week I wrote about clinician prejudice toward sexual offenders. As part of that writing I introduced the four main categories of sexual offenders:

  1. Violent offenders
  2. Fixated child offenders
  3. Regressed child offenders
  4. Sexually addicted offenders

I also mentioned the some of the most damaging misconceptions that most people, including many psychotherapy professionals, have about sex offenders.

  1. All sex offenders are treatable.
  2. No sex offenders are treatable.
  3. All sex offenders are sociopaths

None of these beliefs is correct. The reality is that most but not all sex offenders can benefit from proper treatment. In fact, the recidivism rate is actually quite low, provided the offender is paired with the most effective form of treatment. It’s all about good assessment and knowing who needs what and when.

Clinician Prejudice Toward Sex Offenders

Wednesday, April 24th, 2013

Perverts and Rapists and Creeps, Oh My!

Clinician Prejudice Toward Sex OffendersA couple of weeks ago my colleague Jenner Bishop posted an open letter on the IITAP (International Institute for Trauma and Addiction Professionals) listserv about clinician prejudice toward sex addicts and sex offenders. Jenner had just come from a “suite meeting” for an office she’d recently rented, at which she’d been bombarded with angry questions from the other therapists about how they were supposed to protect their clients from her “unsupervised” sex addicts and offenders. She had explained that she doesn’t work with violent offenders, and that the offending behaviors of her clients were typically something along the lines of hiring prostitutes and/or looking at illegal pornography – which the other therapists’ clients were probably also doing, even if the therapists weren’t aware of it – but Jenner’s fellow professionals just wouldn’t let it go.

Sex Addiction Treatment: Addressing Hypersexual Behavior in a Rehab Setting

Wednesday, September 12th, 2012

Hardly a day goes by without the national media trotting out the problem sexual misbehavior of some politician, sports star, actor, or religious leader. Oftentimes, within a few days or weeks we hear that same person is “entering treatment” for sexual addiction. This begs the question: What is sexual addiction treatment?

Generally speaking, well-rounded sexual addiction treatment mirrors in many ways the structure and techniques that have proven highly effective in drug and alcohol addiction treatment—focusing on breaking through denial, managing the crisis or crises that drove the person to seek help, social learning, cognitive behavioral therapy, group therapy, relapse prevention, etc. Depending on the individual being treated, the work may center on the person’s immediate life circumstances in an attempt to determine (and find healthy ways to control) the various triggers to his or her sexual acting out. Other addicts, while still needing to learn how to contain their sexual behavior, may have a greater need and ability to work though various forms of past trauma and emotional reactivity—challenges that oftentimes have been lifelong concerns. For all individuals, once sexual sobriety has been established, all useful clinical methods are on the table: art therapy, traditional cognitive behavioral therapy and relapse prevention work, social learning models, equine and experiential work, EMDR, somatic therapies, the support of 12-step meetings, etc.

The Narcissism of Sex Addicts and Some Strategies for Therapists

Wednesday, July 4th, 2012

Guest post by: Linda Hatch PhD, CSAT,

Narcissism Equals Low Self-Esteem

A majority of sex addicts behave in ways that are seen by others as narcissistic. Narcissistic personality traits are often described in terms such as grandiosity, self-centeredness and over-entitlement. This suggests the narcissist has an inflated sense of self-worth. In fact the opposite is true.

Most narcissism is actually a defense system. The narcissist has acquired a façade of superiority and self-sufficiency as a defense against unconscious feelings of inadequacy and unworthiness. This defense is often bolstered by career success or being prominent in the community. This self-image is flimsy and superficial, but it is felt by the narcissist-addict to be his or her true self.

As such, this false self protects the addict from experiencing his or her vast reservoir of unhappiness and insecurity.

What Do You Mean “NO SEX” for 30 Days!?!!

Wednesday, January 25th, 2012

The Therapeutic Use of Abstinence in Relationship and Sexual Addiction Recovery

Try telling a sex addict to stop pursuing and having sex for a month or more and you may quickly find yourself pushed aside for a more enabling (and less directive) therapist, sponsor or friend. Inform a profoundly love addicted (attachment disordered or trauma survivor) woman – the one who lives to seduce – that she can’t wear provocative clothing or makeup for at least 2-3 weeks and you will quickly learn about her level of dedication to recovery and change.

Such is the initial challenge of cognitive-behavioral treatment with sex and love addicts. In truth, a period of abstinence from sexual and romantic behavior, combined with contracted and prescribed boundaries around romance/seduction/dress, can be highly useful clinical tools toward expanding a sex and love addict’s sobriety skill set. This is especially true when working with individuals who’ve spent their whole lives seeing themselves and others as objects.

Why Abstain from Sex and Romance?

Active sex and relationship addicts base their adult self-worth on whether or not they are desirable and typically think, “I have value if I can get x, y or z to desire me sexually.” As such, they objectify themselves and others completely, often viewing their lives and relationships through a lens of conquest, seduction and intensity. This can sadly make the most mundane activities, like finding oneself in an elevator with an attractive stranger or walking past a good-looking person in the grocery aisle, a sexually charged opportunity to pursue people as objects.

Attachment Disorder, Name Thyself! Working with the Love/Romance Addict, Sexual Anorexic, Trauma Survivor and Intimacy Avoidant

Thursday, January 19th, 2012

Chronically distant and emotionally detached partners are often on the hunt for their mirror selves – the one who will draw them in with romantic intensity and then distance themselves when things get too close. Intimacy avoidant individuals unconsciously check out when their relationship starts to feel too close, whether related to an emotional, physical or sexual connection. Examples include:

  • The working husband who rarely returns home in time to see his wife still awake
  • The wife who puts her entire emotional self into childcare, leaving nothing leftover to meet the needs of her neglected spouse
  • The serial dater, consistently bouncing from one intensity-based superficial relationship to the next
  • The “modern” couple, too distracted by smartphones, laptops and video to prioritize an emotional connection

The Love Addict/Avoidance Cycle

Outwardly often an unlikely couple, the consistent (often maternal) and desperate seduction of the relationship/love addict is a forever flame for his or her opposite – the intimacy-phobic avoidant. Their emotional dance is one of endlessly circling one another, but never quite allowing themselves to connect.

Sex Rehab for Weiner? How Sexual Addiction Treatment Works

Tuesday, June 14th, 2011

As reports that “Congressman Anthony Weiner heads to rehab” continue to dominate headlines (and the Twitter-sphere), I am receiving an increasing number of media calls asking to explain exactly how sex addiction treatment works.  While many believe that “Men In Power” heading to rehab is a blatant attempt to “help their image” or somehow excuse their bad behavior, I can promise you that rehab isn’t intended to serve either of those purposes.

Pre- Rehab: Crisis (in this case “Weinergate”)

The initial need for any addiction treatment – whether sex, gambling, food, drug or sex rehab – is most often born out of a crisis. For those attending sexual addiction treatment the crisis tends to be related to their profound betrayal of primary relationships, but problems can also center on health, work, legal or financial issues that have come about due to their sexual behavior problem. Sometimes a crisis is created to get someone to go into rehab and this is called an Intervention.

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