I once had a colleague, a sex therapist, challenge me for explaining to him that in my work with clients we address the underlying issues that lead someone to cope maladaptively via sexual acting out. He didn't understand how exactly underlying issues could cause someone to act out sexually in maladaptive ways. I explained that adverse childhood experiences (ACE) including trauma and neglect, attachment failure, and hame can impact a person to where they cope in various ways. One way is through sex or sexual experiences that the person describes as causing distress in multiple areas of their life. Other ways include: abusing substances, food, spending, gaming, (for some, all of the above); or the opposite, deprivation/avoidance strategies.
There is an assumption that sex addiction is about sex and nothing more; that to say it can be "addictive" is just an excuse. But sex addiction is not about sex and it is a complex disorder worth understanding. As Dr. Carnes identified in his landmark research years ago, of the individuals with sex addiction, over 70% came from families with histories of multiple addictions including sex addiction and substance abuse. Individuals with sex addiction also came from families that were rigid, disengaged, and void of intimacy; families where there was various forms of abuse be it sexual, physical, emotional or neglect. Along with this, every person with problematic sexual behavior including sexual addiction that comes to Namasté Center for Healing describes or presents with difficulty regulating their emotions. Their window of tolerance is nearly non-existent.
Sex addiction is a disorder of intimacy, attachment, trauma, and a brain disease. In an article in which I was a lead author, titled Sex Addiction is NOT a Myth when Neuroscience Keeps The Score (2017, Beauregard, J., Christiansen, C., Katehakis, A.). We explore the myths related to sex addiction as well as the evidence based practices that as Certified Sex Addiction Therapists we implement with our clients to ensure we address the underlying issues while avoiding judgment surrounding sex itself.
Sex in and of itself is not "bad" or "wrong"; however, people often show up to therapy with preconceived notions (oftentimes from their upbringings) about sex which adds to their already significant levels of shame. In our work together, we assist both men and women in understanding the underlying issues that caused them to cope via sexual acting out instead of judging intimacy and sex as being the problem. We also work with our clients to understand healthy sex and sexuality, stressing the importance of having healthy intimacy in their relationships. Our couples program strongly encourages working together once addicts and partners are stable to ensure they have healthy intimacy and healthy sex.
For partners of sex addicts, including porn addicts, we explain that their loved one (spouse, partner) is a different person compared to the "addict" that they live with. Similar to a drug addict, they have become addicted to a behavior (sex) which has caused the person they love to disappear (and what seems like a crazy person to cause havoc in their lives).
Treatment entails exploring the deeper issues that led a person to replicate adverse childhood experiences via sexual acting out. For instance, every person I have worked with that has had exhibitionistic behavior (i.e., sending nude pics to multiple partners as part of acting out, strippers, escorts, men who expose themselves in public) has reported a history of being bullied (hazed, abused, harrassed in some way) as a child. Their victimization, being involuntarily exploited during their upbringing by parents, siblings, peers, etc. impacted them in such a way that as an adult, they replicate their trauma via voluntarily exploiting themselves, in an attempt to master or triumph over their trauma. This is one of many examples of childhood trauma being replicated in maladaptive sexual acting out as an adult. Treatment entails identifying the origin of trauma, helping a person resolve it via shame reduction techniques, family of origin and IFS work, and EMDR trauma therapy,
Treatment also entails teaching people healthy coping skills to soothe their emotional dysregulation from the underlying issues (primary component), learn how to identify and address cycle behavior, including cognitive distortions and maladaptive beliefs, as well as learn interventions for being resilient in recovery and in all of their relationships. While our evidence based treatment approach, Carnes Task Based Model, is a key component of our program, two other primary models we use to address much of people's underlying issues entails Internal Family Systems Model (IFS) Model and EMDR Trauma Therapy. Along with these primary modalities, we weave in mindfulness based tools and DBT for teaching self regulation, as well as Gottman Therapy, Nagoski, Perel, and Ogden to explore intimacy, relationships and sexuality.
It is important to remember that sex addiction is not about sex; it is a complex set of out of control behaviors that a person, with the accurate type of treatment, guidance, and support can heal from. Knowing this is often key in taking the first step in one's recovery.
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