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The 12 Steps as Therapeutic Tasks for Sexual Addiction Recovery: Steps 1, 2 and 3

Just Go to a Meeting!

Sex addicts, like many individuals in early recovery, are often highly resistant to the idea of attending 12-step meetings. And, like all addicts, they often have clever and insightful but typically unproductive reasons for not going.

Some examples include: “That’s where the really sick people go, right, not people like me?” or “I can’t talk openly to a bunch of strangers. What will they think of me?” or “What if someone sees me there and tells someone I know?”

And it’s not like the urban or online sex addict is limited in terms of sex and relationship addiction 12-step meetings, as today numerous groups can be found both in-vivo on and the Internet—each with a slightly different focus and population (SA, SLAA, SCA, SRA, SAA, etc.). Yet for a variety of reasons, mainly fear of the unknown, attending therapy often seems a more palatable option than going to a 12-step recovery meeting. So be it.

Bring the Mountain to…

The addiction therapist, working with a newly recovering but 12-step-averse client can and should bring the themes, wiring, and writing of 12-step recovery into the treatment arena. Once the actual problem has been clearly assessed and client/treatment goals and expectations are aligned, it is very productive to initiate discussions on themes like surrender, feeling out-of-control/powerless, asking for help, turning it over, etc., all related to the behavioral problem itself, while using a cognitive behavioral treatment format.

This work can be achieved either as homework or in the sessions themselves knowing that the individual’s chances of finding and maintaining sexual sobriety may well increase, perhaps significantly, with these themes in place. And should that person later decide to enter 12-step sexual recovery, all the better.

Ideally an addict’s concurrent work in therapy and 12-step recovery reinforce one another. And the social support and shame reduction that occurs in a good “S” meeting mirrors therapeutic goals, further improving the odds of lasting sexual sobriety.

Early Recovery? Step on It!

The 12 steps, as originated in Alcoholics Anonymous (AA) and later adopted by other self-help programs, have long been the foundation of recovery from all types of addiction. Below is a simple attempt to adapt the 12 steps into therapeutic tasks specifically designed to address sexually addictive and impulsive sexual behaviors.

Adapting the Steps for Therapy

STEP ONE: We admitted we were powerless over Sexual Addiction—that our lives had become unmanageable.

Step one asks sex addicts: What is the behavior that is out of control (powerlessness) and what are the consequences of that behavior (unmanageability)? A detailed but not graphic review of these simple themes via a sexual history or similar examination can move a client out of contemplation and into action.

Breaking through denial by simple questioning and reframing of the actual sexual behavior patterns while simultaneously reminding the client of the consequences of those actions (seen and unseen) is the work of early treatment. Until sex addicts have both a clear overview and a detailed understanding of their sexual acting out patterns, with insight (often painful) into how those behaviors have affected their lives, they are not yet on the road to recovery.

A definitive acceptance of these facts helps bring clients into the realization that recovery work—therapy, meetings, journaling, social support, etc.—must become their number one priority.

Related to Step One

  1. Have the client write down and bring to therapy frequent and/or recent concrete but non-graphic examples of their problematic sexual behavior, starting with the precipitating event that brought them to seek help. Then discuss in detail, with each example:
  2. If and when they tried to stop the behavior, and what happened?
  3. What are the consequences of their sexual behaviors (including what they see and what they may miss) including lost time, depression or anxiety after the fact, estrangement from or hurt to loved ones, and any tangible consequences such as arguments with a spouse/partner, reprimands at work, physical danger, health issues, financial issues, legal consequences, etc.
  4. Ask the addict to write down and bring to therapy for discussion a list of things he or she feels are missing in his or her life, perhaps related to the time/secrecy/compartmentalization of his or her addictive behavior patterns, and compare these to the previously discussed experiences of sexual acting out.

STEP TWO: Came to believe that a Power greater than ourselves could restore us to sanity.

Step two asks the sex addict: Were you out of control? Was your sexual behavior working in your life or was it making you crazy … and knowing the answer to that, did you repeat that behavior (insanity)? Sex addicts must also accept that the solution to their problem involves a power beyond their own best thinking. Often, they understand this instinctively, because when left to their own devices they continue to engage in problematic sexual behavior, over and over, despite the negative consequences.

It’s not necessary or useful to engage clients in lengthy discussions of God/religion/spirituality, as the second step is more about an admission that help is needed—the realization that the addict can’t fix this alone—than it is about spirituality or any sort of religious affiliation.

  1. If the addict struggles with online behavior, assign the addict to purchase and install onto his or her computer, laptop, smart-phone, and other mobile devices “parental control” software with Internet filtering and “accountability partner” capabilities – noting that by using this software they are acknowledging they need help beyond themselves.
  2. Ask the client to write a “job description” for a “power greater than the client” and discuss this description in therapy. What would the client want from a relationship with that power? How could the client learn to trust that power? What would a relationship with that power look like?
  3. Discuss the idea of a “power greater than the client” as an entity of personal strength, nurturance, soothing, and hope—perhaps an emotional place the client can turn to supplant his or her reliance on sexual behavior.

STEP THREE: Made a decision to turn our will and our lives over to the care of God, as we understood God.

Step one explores with sex addicts the depth and consequences of their problem (breaking through denial), and step two tells them what the solution is going to involve (ongoing help). In step three, addicts have to do something about it by turning their will and lives over to the care of God, as they understand God, or don’t understand God.

The fact is, understanding God, per se, is not necessary to successfully engage in the recovery process. Addicts only have to acknowledge that they need and are going to have to accept help—which most often takes the form of supportive individuals willing to aid in their recovery.

  1. Those clients who are willing to attend a 12-step meeting will find many answers there to questions surrounding “surrender” and “higher-power.” Written material is readily available via AA online to help those who are agnostic, atheist, and/or those who have experienced religious abuse to address their “higher power” issues.
  2. Ask the client to identify three people he or she can ask for help when needed about anything. Discuss if the client has no one who knows everything about him or her (sexual acting out included). Role-play “asking for help stopping sexual behavior.”
  3. Consider assigning clients to find an accountability partner. This person can be found in 12-step meetings or it can be a trusted friend, member of the clergy, etc. (It is best this person not be the client’s spouse.) Explain the use of such a partner—someone to call when wanting to act out sexually, someone to help bookend time spent online or out of town, etc. Addicts are well served by learning that a “higher power” can be anything outside of themselves that helps them stay sober.

The above bullet-point lists are of course incomplete, and every client’s path to long-term recovery is different. However, the well worn, trusted concepts integrated into all 12-step recovery programs are extraordinarily useful therapeutic tasks for sex addicts. Remember too that each of the 12-step sexual recovery programs has its own “Big Book” much like the AA Big Book, and all of these can be purchased online without ever having to go to a meeting.

* Due to space constraints, this blog discusses only the first three steps, helping to incorporate useful concepts for early therapeutic addiction treatment. In future blogs I may address the remaining nine steps, examining how they too can be adapted and incorporated into the therapeutic treatment of sexual addiction.

The 12 Steps as Therapeutic Tasks for Sexual Addiction Recovery: Steps 1, 2 and 3

Robert Weiss PhD, MSW

Robert Weiss PhD, MSW, CEO of Seeking Integrity LLC, is a digital-age sex, intimacy, and relationship specialist. Dr. Weiss has spent more than 25 years developing treatment programs, educating clinicians, writing, and providing direct care to those challenged by digital-age infidelity, sexual addiction/compulsivity, and other addictive disorders. He is the author of several highly regarded books on sex and intimacy disorders including Prodependence, Out of the Doghouse, Sex Addiction 101, and Cruise Control, among others. He also podcasts (Sex, Love, & Addiction 101) and hosts a free, weekly interactive sex and intimacy webinar via SexandRelationshipHealing.com. His current projects are: • SexandRelationshipHealing.com, an extensive online resource for recovery from sex and intimacy disorders. • Seeking Integrity Los Angeles, an Integrated Intensive Program for Sex and Intimacy Disorders (Opening in Feb, 2019). For more information or to reach Dr. Weiss, please visit his websites, RobertWeissMSW.com and SexandRelationshipHealing.com, or follow him on Twitter (@RobWeissMSW), LinkedIn (Robert Weiss LCSW), and Facebook (Rob Weiss MSW).


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APA Reference
Weiss PhD, R. (2012). The 12 Steps as Therapeutic Tasks for Sexual Addiction Recovery: Steps 1, 2 and 3. Psych Central. Retrieved on March 26, 2019, from https://blogs.psychcentral.com/sex/2012/05/the-12-steps-as-therapeutic-tasks-for-sexual-addiction-recovery-steps-1-2-and-3/

 

Last updated: 10 May 2012
Last reviewed: By John M. Grohol, Psy.D. on 10 May 2012
Published on PsychCentral.com. All rights reserved.