What Distinguishes Sex Addiction From a Naturally High Sex Drive?

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How To Be Relational

Marie Woods, LMFT, CSAT
Primary Therapist, Gentle Path at the Meadows When addressing an intimacy disorder such as sex addiction, one of the biggest struggles patients face is the ability to be relational. In fact, addressing these issues is at the very core of our program at Gentle Path at the Meadows. The answer to many of our patient questions in treatment are answered with strategies for being relational. For sex addicts, and many others as well, this concept can seem foreign, so we often use the following key points as a guideline for learning and practicing the art of being relational.

Sharing Thoughts and Feelings Appropriately

First, being relational requires sharing thoughts, feelings, needs, and wants appropriately. For many sex addicts, this is a huge hurdle. Perhaps they learned through various life experiences that their thoughts and feelings weren’t valuable, so they have learned to keep them to themselves, making it difficult for others to get to know them and form relationships with them. Others may have learned that in order for their thoughts and feelings to be heard, they had to be loud or rage, possibly causing people to avoid being in a relationship with them. One of the first steps to practicing healthy relational skills is learning how to share thoughts and feelings in an appropriate way. This includes speaking calmly, respectfully, and from the “I” position.

Letting Go of Resentment

The second step in practicing these skills is letting go of outcome and resentments when we share. It can be easy to assume that once we share our thoughts and feelings, others will listen, understand, or even agree, but this is not always the case. Often the most difficult part of sharing our thoughts and feelings is doing so without an underlying agenda to manipulate or control. It is important to remember that the point in sharing thoughts and feelings is to practice intimacy, being known. When we share, it is important to let go of how the information is received and know that we have done our part.

Negotiation

What often comes next is negotiation. If we have been brave enough to share our thoughts and feelings we may find ourselves in a conversation with others that requires negotiation. Perhaps they disagree or have a different perspective. Sometimes the discussion can simply be left at that, and other times, within a relationship for example, there might need to be a negotiation where both people feel heard and respected in the ongoing relationship. This will likely require several rounds of the first two steps followed by the next step.

Setting Boundaries

Following negotiation is the concept of setting boundaries in regards to what is and is not acceptable in the relationship moving forward. This really helps set the stage for building deeper connection with the other person after having successfully navigated through a difficult moment. Despite how hard this can be, it often helps develop trust and respect between individuals thus a framework for a healthy relationship.

Developing Balanced Relationships

The idea behind this equation is not to over simplify the concept of being relational, but rather to provide a basic framework to embark on this process. The ability to be relational is at the very core of what sex addicts struggle with. The steps above can seem terrifying, and thus sex addicts may resort to other less intimate coping skills that leave them isolated and lonely. The goal of practicing the relational skills mentioned above is to develop a balanced, equal relationship between individuals which is critical for deep rooted ongoing recovery. It is through these relationships versus withdrawal and isolation that sex addicts experience some of the most meaningful insights and healing.

Q&A with Lauren Bierman

Lauren Bierman, LPC, CSAT, recently took on the roll of developing and running Gentle Path at The Meadow’s Intensive Outpatient program for sex addicts. She is a Licensed Professional Counselor and Certified Sex Addiction Therapist who has worked with both individuals and families on issues related to substance abuse, depression, anxiety, personality disorders, intimacy disorders, and sexual addiction. We asked her to share some insights on sex addiction and explain her approach to her work at Gentle Path.

As a therapist, you have experience treating patients with a wide range of addictions and behavioral issues. Why did you eventually decide to focus on sex addiction?

As I started my journey in undergraduate and graduate programs towards becoming a counselor I knew that I wanted to work with addictions; but, I had little exposure to sex addiction at that time. When I started my clinical internship with The Meadows in 2010, I rotated from population to population trying to get a good foundation of how to treat all types of presenting issues. It was not until I did my rotation in the Sex Addiction primary group that I realized that I had a passion for treating individuals who were struggling with intimacy disorders such as Sexual Addiction and Love Addiction.

I quickly learned how rampant this addiction is in the general population and in those who seek treatment for other co-occurring disorders. I have also always had an interest in working with couples and it helped me see how much sex addiction therapy is needed in working within that dynamic.

Working with people struggling with intimacy disorders challenged me to become skilled at confronting overt and covert behaviors, working with personality issues such as narcissism, and helping people tolerate the emotional pain that can lie so deep within coupleship and families.

Over the years, working with great mentors, learning about Dr. Carnes work, and getting trained in the CSAT model just continued to grow my passion for this field and for the community of clinicians who work in it.

You are now in charge of Gentle Path’s new Intensive Outpatient Program. Why did we start this program? What can recovering addicts and their family members expect from it?

Individuals who come from an inpatient treatment center will likely always need some type of transition to help facilitate re-acclimating into the real world. Inpatient treatment is meant to create a safety bubble to help deter triggers and opportunities for acting out. We all know that unfortunately this is not the way the world works once they step off of campus. Maintaining long-term recovery can be especially challenging for sex addicts, due to the accessibility of opportunities to act out in almost any environment.

The Gentle Path Intensive Outpatient Program was built to allow for a smoother transition from treatment to day-to-day life, and to allow people to continue working on accountability and using the relapse prevention tools they learned about in treatment. The program allows them to practice healthy autonomy and to have a safety net of their support group.

Recovering addicts and family members can expect continued structure in their process groups, 12-step meetings, therapeutic activities, and peer support. On top of that, we also offer individual and couple's therapy to help the patient continue to delve deeper into their struggles. We are able to customize their treatment plan based on individual patients’ needs and help them to achieve goals that they want. The Phoenix valley has an abundant recovery community where patients can practice making connections and living in accordance with their recovery plan.

You also played an integral role in founding Gentle Path’s Family Week program. Can you tell us why family involvement is important to a sex addict’s recovery process?

The education that Family Week provides for the family system is extremely important. There is a large amount of misinformation out there about sex addiction and there are many stigmas and labels that come with it. This can keep families stuck in unhealthy shame and isolation.

Working with the partner of the addict and other family members is crucial to long-term success for the recovering addict. Sex addiction is the most "personal" addiction in that it can be so damaging to the partner's self-esteem, view of the world, and trust. And, not only does the spouse or partner suffer, but also many adult children, parents, and siblings of the addict are also negatively impacted; their experience with the addict often has affected their relationships with themselves and others.

I look at treatment through the lens of Family Systems Theory, which says you cannot treat the individual without treating the whole system and vice versa.

For example, when the addict is getting help, growing, and becoming healthier but the spouse who has not been therapeutically supported is still in the pain and anguish of the trauma, it can really hinder the addict’s recovery process and keep the couple stuck in a revolving circle of dysfunction.

By that same token, partners and family members can be light years ahead in their own recovery, but if the addict continues their inappropriate behavior they can stunt the development and healing that the family members have worked so hard to achieve.

Family can also unintentionally impact the addict’s recovery by enabling, rationalizing, or encouraging their dysfunctional behavior if they do not know a healthier way to interact with them. One of the hardest tasks in family week is for families to set healthy boundaries around the addictive behaviors.

Some family members, due to no fault of their own, have no idea how to communicate healthy boundaries or reinforce them long-term. This is such an imperative step in all addiction recovery to create the safety that all relationships need in order to be able to communicate effectively.

What is your hope for the future of sexual addiction treatment?

I have many hopes for the future of sex addiction. But, most important, is that we continue education about the disease and decrease the shame and stigma around it. As a clinician, you can't work day in and day out at an inpatient level of care and not believe that this is a debilitating brain disease that leads to extreme consequences─ for some, even death.

I hope that our therapeutic community will wrap their arms around the issue and continue to advocate for those who are suffering and those who have been impacted. There are so many individuals out there who are too afraid to ask for help in fear of being judged and labeled. Hopefully, in the future they will be able to come out of the shadows and seek treatment.

At one time, alcoholism was seen as a strictly "moral issue", but today it is seen by the medical world as a brain disease. I believe that one day people will also see sex addiction as a much more nuanced and complicated problem.

Partners of Sex Addicts Face The Pain of Discovery

Marie Woods, LMFT, CSAT
Primary Therapist, Gentle Path at the Meadows
When the news of the Ashley Madison leak made headlines last week, one of the first thoughts to cross my mind was, “what about the partner of the Ashley Madison subscriber?”

Being betrayed by a spouse is bad enough, but to find out that it was through a site like AshleyMadison.com, and to think that your identity might be publicly leaked on top of the betrayal sounds almost unbearable.
Inside the rooms of Gentle Path at the Meadows, stories like these are far too common. Partners of sex addicts often tell us that the discovery of the betrayal is one of the most traumatizing aspects of dealing with a sexually addicted spouse. What partners often say is the most painful, however, is the way in which they discovered the acting out behavior.
The Ashley Madison leak serves as a good example of one a particularly painful type of discovery. When something like this makes front page news, the addict may decide to tell their partner what they’ve been up to out of fear. Some might think that this is a good thing; however, for most sex addicts the disclosure is just one small detail of their overall struggle. For partners, it can be a traumatic event.

The Cascade of Disclosures

Because sex addicts rarely come clean with the entire story at first, a cascade of disclosures often follows. So, as though the initial discovery of the betrayal were not painful enough, the partner may go on to learn more and more details as time goes on. Some partners become suspicious after the first discovery and very soon find out more. Other partners may go years without learning the full story. Either way, each time more details are disclosed, more betrayal, hurt, and pain is felt, and the partner is further traumatized. Meanwhile, the addict remains steeped in the shame and guilt that perpetuates their acting out.
In the sex addiction therapy community, we refer to this as “staggered disclosure.” This is when the sex addict tells bits and pieces of the truth over time throughout their active addiction rather than telling the whole truth at once when they are sober. This usually happens when they are questioned or get caught, and they share just enough information to escape the current conflict. This pattern of trickling information often keeps addicts stuck in their guilt, shame, and addiction. Consequently, it also keeps partners stuck in their anger, pain, and trauma, and it leaves both unable to begin healing.

A Certified Sex Addiction Therapist Can Help

During this process, partners often vacillate between wanting to know the truth, but not wanting to continue to be hurt over and over again either, and they are not always sure what to do.
If a partner thinks that they might be dealing with sex addiction, a Certified Sex Addiction Therapist (CSAT) should be one of their first stops. For starters, the CSAT therapist can assess the situation and find out if what is being dealt with is actually sex addiction or not. If it is, then the therapist can be of huge support in walking the couple through a formal disclosure process. This involves a therapist (sometimes two) working with both the addict and their partner to determine what the extent of the addiction is, and the addict’s willingness to share it in an open and honest way. It also involves helping the partner cope with the initial discovery and any new information that may come out of the disclosure. In its later stages, it involves defining the meaning of the relationship and forgiveness moving forward.
It’s important to know that this process takes time, but our experience at Gentle Path at the Meadows shows that couples that choose this route typically save themselves a lot of additional pain during an already excruciating process. Although these are difficult and painful therapeutic issues, having a therapist who specializes in sex addiction to support both the addict and the partner through this is absolutely critical. Soliciting help from a therapist will help minimize any further trauma for a partner. Resources are available, and partners do not have to face this alone. In the midst of some of the most gut wrenching betrayal, partners should know that they deserve compassionate care and support.

What Were They Thinking? Wealth, Power and Sexual Addiction

Earlier this week, news broke that Jared Fogle, the well-known spokesman for Subway, was at the center of an FBI investigation. No details have been confirmed at this time, but many speculate that the investigation is related to the recent arrest of an executive of the Jared Foundation on child pornography charges. (Fogle himself has not been arrested or charged with a crime.)

This news comes on the heels of the release of court documents in which veteran comedian Bill Cosby admitted to giving women sedatives in the pursuit of sex. And, similar shocking revelations have come to light in the past year pertaining to Stephen Collins from the popular 90s TV show 7th Heaven, and to Tiger Woods, who is rumored to have relapsed into his sexual addiction by cheating on girlfriend Olympic gold medalist Lindsay Vonn.

When these stories come to light, the same questions begin to appear on social media sites, in our offices, and around our dinner tables: “What is wrong with these men? How could they do these things? And, why can’t they stop?”

There are, of course, no easy answers to these questions. And, it would be too presumptuous for us to speculate about any of these men without any direct knowledge or understanding of their personal histories. But, here at Gentle Path at The Meadows, we do see some common behavioral patterns that emerge among our patients that have parallels to what we’re seeing in the news.

Entitlement

One of the patterns that we most often see with clients who are caught up in destructive sexual behavior is a struggle with an enormous amount of social or political pressure. Although this pressure in no way serves as an excuse for their behavior, it does often lead them to feel entitled to act out in destructive ways and, frankly, to not experience any negative consequences for it.

Their distorted thinking tells them that they’ve earned the right to do these things because “they work so hard” and “do so much.” On top of that, the constant scrutiny that they are under in the media and in other social arenas often fuels anger and resentment. The more anger, resentment, and pressure that exists, the more entitled they feel and the more destructive their behaviors become.

Over time, without intervention, the behavior will continue to get worse, sometimes leading to acting out that is even more offensive in nature. That’s when legal consequences and news stories often emerge.

Narcissism

Another common pattern we see in clients is the presence of narcissistic personality traits. These traits can include grandiosity, entitlement, exploitation of others, arrogance, repeated law-breaking, impulsivity, lying, aggressiveness, and lack of remorse or empathy.

According to a recent study, these same personality traits are associated with behaviors related to sex trade use, use of drugs with sex, soliciting sex with money or drugs, hurting and exploiting adults sexually and sexually exploiting children. Grandiosity, in particular, seems to have the strongest link to sexual acting out.

These traits are addressed early in treatment at Gentle Path through an exercise related to the first step of the 12-step model: admitting one’s powerlessness in the face of sexual addiction. This first step serves as a powerful challenge to grandiose, narcissistic, and antisocial traits, enabling patients to begin to take an honest stock of the damage caused by their actions and inactions and proceed with greater openness to restorative treatment.

There is Hope

For the bystander, it may seem like “these men will never learn.” But, for those who are willing to acknowledge their problem and do the difficult and painful work of addressing their underlying issues, change is possible. Many men who have been through the program at Gentle Path report to us that they feel free from much of the shame that came with their sexual addiction, and that they have been able to regain their self-respect and restore relationships with their friends and loved ones.

If you or someone know is struggling with a sexual addiction, we’re here for you, 24 hours a day.

Visit us here or call 855-333-6076 to find out how we can help.

Why Sex Addiction Isn't About Sex

Primary Therapist, Gentle Path at the Meadows

When our culture hears about a person with sex addiction, often the automatic assumption is that he (or she) must like a lot of sex. In light of the nature of their behaviors, sex addicts are also often labeled as perverted, creepy, or strange.

These distorted perceptions aren’t just limited to the public, but are often among the core beliefs that sex addicts have about themselves. As patients engage in treatment and begin to understand themselves better, they often begin to realize that their behaviors are not solely about the sex itself, but about some larger constructs.

IT’S ABOUT COPING SKILLS

As a treating therapist, I’m aware from the moment a patient enters my office, that the symptoms associated with sex addiction have less to do with sex, and more to do with limited coping skills for what is often an intense amount of pain. This is not to say that the sexual behaviors are excusable, but it does help us to shift the focus from the stigma of sex addiction and onto its possible underlying causes.

THE ROLE OF TRAUMA IN SEX ADDICTION

For many sex addicts, their problematic sexual behaviors developed early in their lives as a way to deal with significant stressors or trauma. For example, compulsive masturbation often stems from a child’s early learning about how to self-soothe in a chaotic home environment. At its onset, this coping skill was not necessarily problematic. But for sex addicts, the behavior becomes problematic when they do not acquire a more expansive set of coping skills as they continue to develop. This is just one example of the many ways in which engaging in normal and pleasurable sexual behavior may develop into problematic sexual behavior.

It is important to recognize that in our most functional human state we use a variety of coping mechanisms, including positive sexual behavior, to regulate ourselves, and that is not necessarily pathological or problematic. What can become compulsive, and perhaps problematic, is when this is one of our only coping mechanisms to regulate stress and anxiety over time.

FINDING THE ROOT CAUSES

As treatment providers, we work with patients to look at both the sexual behavior itself, and also at what may drive it. Sex addicts often have an immense amount of shame around their sexual behavior, so it’s important to help them understand any connections that may exist between specific sexual behaviors and their pasts.

But, some of their unwanted sexual behaviors are more about activating a part of the brain that allows them to numb out, dissociate, fantasize, or even feel deprived in order to provide some temporary relief from their emotional pain. In these cases, we would want to spend some time focusing on why a patient may choose these ways of responding, and what other coping skills they may need to develop in order to feel better about themselves rather than perpetuate the cycle of toxic shame they experience after engaging in their addictive behaviors.

CREATING LASTING CHANGE

The vast majority of addicts that we work with express an adamant desire to stop engaging in the use of alcohol, drugs, and to stop acting out sexually. Many of them can also identify numerous failed attempts to stop their behavior.

Before we make assumptions about what the behaviors associated with sex addiction mean, it is worth stepping back and considering the bigger picture. Moving towards lasting change with sex addiction means that we must examine both the behaviors themselves and the stories surrounding them. This opens the door for compassion, which is an essential component of the process of healing from sex addiction.

Gentle Path at The Meadows Offers Couples Recovery Workshop

Gentle Path at The Meadows has announced the addition of Couples Recovery Workshop to its services available to patients. Designed by Kenneth M. Adams, PhD, CSAT, with input from over a dozen leading national experts and Gentle Path at The Meadows clinical and executive teams, this program emphasizes hope for couples struggling with sexual addiction to recover trust and intimacy in their relationship.
"This unique program offers couples a one-of-a-kind opportunity to heal from the impact of sex addiction through a series of intensive workshops that track specifically the couple’s needs from disclosure to renewal,” said Adams. “Long overdue, it is my sincere hope that this program becomes an important contribution to the support of couples wanting to rebuild shattered lives."
The Couples Recovery Workshop, based on a developmental model of couple's healing from the impact of sexual addiction, encompasses sound clinical and research-based components of sex addiction, complex partner trauma, and couples treatment. Workshop participants can choose from three specific modules that can be taken together or separately to shape treatment for optimal timing and needs. Modules include:

• Disclosure: From Secrecy to Transparency
• Impact: From Recognition to Amends
• Reconciliation: From Grief to Renewal

Allan Benham, Executive Director for Gentle Path at The Meadows, says, “This workshop is an exciting addition to our sex addiction treatment program. It offers couples a chance to address the impact of sexual addiction on the couple in a supportive, respectful, and caring format.” He adds, “We’re excited about this workshop helping us to more completely serve all of those who are impacted by this disease and working with the providers who send us their suffering couples to work with by providing specific written follow-up plans after each workshop module to guide the couple and their on-going treatment provider.”

Gentle Path at The Meadows is a confidential inpatient treatment center for men 18 and older who battle sexual addiction, relationship addiction, and sexual anorexia. To learn more about Gentle Path at The Meadows’ work, contact an intake coordinator at 855-333-6076