Healing starts here
We specialize in treating sexual addiction, pornography addiction, hypo-active sexual desire disorder, other sexual and relationship issues (low/high libido), as well as various forms of trauma, relationship conflict, substance abuse, financial disorders, food addictions/aversions, neuro-diverse issues, and workaholism.
Our promise to all of our clients is to walk the recovery path alongside them, offering kindness, compassion, safety, and evidence based support so that they can heal. We whole-heartedly believe that all people are capable of recovering their mental, physical, sexual, financial, and spiritual health and we have the necessary evidence based approaches and methods to help them do so.
Treatment for Sex/Porn Addiction
It is important to distinguish between certain sexual behavior including sex addiction. For instance, just because someone has an affair, has one or more fetish, engages in BDSM, is LGBTQ, or enjoys cross-dressing, does not mean they engage in problematic sexual behavior or that they are a sex addict. Blindly judging someone as such in our opinion, is unethical.
We are sex positive thus avoid labeling individuals with various lifestyles as acting in ways that are problematic or as being a "sex addict" without doing a thorough clinical interview that entails an exhaustive sexual history and the validated and largest broadband measure of it's kind, the SDI 4.0.
We are also aware that some individuals may have chronic mental illness, health-related issues, or other mental disorders that cause their symptomatology to appear similar to sexual addiction; therefore a thorough clinical interview along with the proper assessments, assists us in determining that they in fact may not have that at all. Again, our job is to accurately diagnosis the issue and treat it accordingly.
Many men and women seek our services in order to recovery from compulsive sexual acting out, chronic infidelity, or sex or pornography addiction. There is now ample research that indicates sex and pornography can be addictive. People who have sexual addiction (also referred to as hypersexuality, hypersexual disorder, or sexual compulsion, out of control sexual behavior-OCSB) do not engage in isolated sex acts, such as a one-time affair. They are often preoccupied and obsessed with partaking in various secretive sexual behavior, for instance, getting lost in the fantasy world of viewing pornography and compulsive masturbation (instead of fulfilling other obligations), compulsively paying for sex on-line or in person, sex chatting with multiple strangers, and/or having multiple affairs that includes unprotected sex, to name a few. Many report experiencing shame, despair, and guilt after they sexual act out, as well as fear and confusion surrounding the web of lies they’ve created to mask their risky lifestyle.
We have found that individuals that come to us with an issue on the intimacy disorder spectrum oftentimes have other addictions or aversions. Our team continually assesses for all addictions and aversions, as well as the underlying issues that are causing problematic behavior, in order to adequately treat all symptomatology.
Contemporary Sex Addiction
This term entails the "GenText" generation: 26 years old or younger and shaped by early and chronic exposure to sexually explicit content on the internet. This exposure is distinct from "classic" cases of abuse; however, it may constitute a "trauma" of which the severity can be determined by the age of first exposure. Estimates of the average age of first exposure to internet pornography range between 10 and 14 years of age; however, it is now highly probable that the age is declining as a result of the widespread uses of internet devices. First exposure tends to be accidental. While teens and adults may be more intentional about seeking pornography after exposure, the rapid features of addiction tends to be a common response among all age groups (Riemersma, J. Sytsma, M. 2013. A New Generation of Sexual Addiction. Sexual Addiction & Compulsivity, 20:306-322). Click here for article.
In the last few years, we have also seen a rise in youth and “millennials” (18-26) who enter treatment describing an addiction to pornography but not quite having actual sexual addiction. We attribute this in large part to the accessibility of pornography on the internet and the use of porn beginning as early as 8 years of age for some. We acknowledge that there is a difference in this population and are mindful in our treatment approach. For more information on youth and millennials with pornography addiction who don’t have sexual addiction, visit Your Brain On Porn.
- We know that there are underlying reasons why an individual copes via sexual acting out or in; for instance, unresolved trauma (any incident deemed as shameful may cause trauma), attachment issues, adverse childhood experiences, and/or inability to regulate difficult emotions. In order to identify the underlying issues and hone in on specific symptomatology, we provide our patients with a thorough intake assessment that lasts between 3-5 sessions. This entails a clinical interview (typically the first two sessions) and the assignment and review of the largest, validated broadband measure of problematic sexual behavior, the Sexual Dependency Inventory 4.0 (SDI 4.0). This assessment allows us to accurately identify a variety of potentially problematic symptoms related to sex/porn addiction, hypo-active sexual desire disorder, sexual binge purge behaviors, sexual offending behavior, paraphilias, substance abuse, financial issues, preoccupation, entitlement, eroticized rage, attachment issues, and one's motivation to get help/change. We typically recommend other assessments measures along with the SDI 4.0 to accurately identify other mental health issues (depression, anxiety, PTSD), neuro-diverse issues (Autism Spectrum Disorder), as well as other forms of coping. Our goal is to rule out as well as seek to understand noteworthy symptoms.
- Our patients in our Sexual Recovery Program (both individuals with addiction and their partners) attend weekly individual therapy and weekly group (partners attend our bi-weekly group) along with other programming depending on our clinical recommendation.
- Some of our patients attend our intensive outpatient program which includes attending our program 4-5 times per week and doing homework on site in between individual or group therapy sessions.
- We offer a FREE Mindfulness Based Alternative 12-Step Group on Tuesday nights that Refuge Recovery facilitates from 6-8 p.m. Individuals with all addictions are welcome to attend this non-gender specific group.
- We will offer our fall FREE weekly meditation class. Dates/Times TBD.
- Our patients actively work out of evidenced based Task-Focused Workbooks created by Dr. Patrick Carnes, Ph.D., who is the pioneer of sex addiction treatment in the United States.
- Candice is a Consultant and Trainer with Dr. Carnes' Institute, IITAP. She and her clinical team has trained directly with Dr. Patrick Carnes, Dr. Stefanie Carnes, Dr. Ken Adams, Rob Weiss, Debra Kaplan, Alexandria Katehakis, all of which are internationally recognized experts on trauma and sex, porn, trauma, and multiple addiction recovery. We whole-heartedly subscribe to Carnes’ Task Based Model for treating intimacy disorders because we have seen that it actually works!
- We also encourage our patients to do supplemental reading on complex trauma when applicable, brain resiliency, shame resiliency, as well as books on healthy sexuality, healthy communication, healthy intimacy, and attachment.
Our clients are assigned daily homework from the various Task Based workbooks we use for addict/partner recovery. When appropriate, we incorporate supplemental assignments and literature that allow individuals to expedite their recovery process outside their weekly individual therapy and group sessions.
Couples therapy can be a delicate journey, one that we ensure couples are ready to partake in. We treat couples for a variety of issues related to intimacy: intimate betrayal, libido/sexual issues, parenting, and high conflict relationships. As Gottman Leaders, we provide couples with essential tools for improving their communication and intimacy.
Our couples recovery program entails:
- Couples therapy and Individual Therapy: This allows each person the necessary stability and support on their own, along with working together in couples therapy to heal their relationship.
- Stability: If the relationship is unstable, we ask that couples begin working on their own issues in individual therapy first, each with one of our expert clinicians. This allows each person to achieve the internal stability necessary before we begin to work on the relationship dynamics. At intake, we assist couples in determining the best fit for their relationship.
- Addiction Issues: If there is an addiction present, we wait to start couples therapy until each person gains the necessary internal stability and support for couples therapy.
- Theory/Model/Approach to Couples: As Gottman Leaders, we weave in key aspects of Gottman Therapy, along with Attachment Theory, and models within Sex Therapy along with Carnes’ Task Based Approach (if there are sex/love/relationship addiction issues) to assist couples in learning healthy communication, trust, boundaries, improve sexual and non-sexual intimacy, explore desire, eroticism, connection, and more.
- Intimate Connections Class: Our monthly Intimate Connections class gives couples a wonderful opportunity to learn and practice valuable skills to improve their sex lives. Note: Individuals in our sexual recovery program must be stable and have solid recovery time in order to fully benefit from all that this class offers.
- Gottman Couples Class: This class is for couples wanting to learn how to improve communication, manage conflict in a healthy way, and improve connection, affection and intimacy. Our next 8-week class will be offered in late summer, early fall.
- An Open Mind: We are open-minded, LGBTQ friendly, and supportive of a variety of couples issues, values and beliefs, as long as there is not a violation of anyone’s human rights (i.e., domestic abuse, risk to children, family). We acknowledge that every relationship is unique and couples have their own value systems (i.e., some couples may enjoy polyamory, BDSM, Kink, Fetishism, Furry-Phenom). We do our best to meet couples where they are at in their relationship.
Couples intensives are for couples wanting to quickly immerse themselves in the intimacy recovery process. We offer intensives for one couple and up to three couples at a time. We provide intensives during our disclosure process for couples healing from sex/pornography addiction or infidelity issues. Couples Intensives are also requested by couples who have been living with addiction issues and/or aversions who have a desire to dive deeply into their recovery process (this is often separate from the disclosure intensive). An intensive ranges from 3 to 10 hours and can be 1 day to spread out over a 2 day period. For couples uncertain of whether or not they want to remain in the relationship, we ask that they inform their therapists at the inception of the intensive so that specific goals surrounding the uncertainty will be addressed.
Healing Trauma & Betrayal
While our patients come to us as a result of an addiction, aversion, or some sort of betrayal, underlying these issues are often shame and trauma. We recognize that trauma takes on many forms and impacts each person differently. Therefore, we take a holistic approach to healing one's past or current traumas (i.e, intimate betrayal, chronic childhood neglect, shameful experiences, sexual assault, sexual, physical, and/or emotional abuse; workplace violence). Our mind, body, and spirit approach reinforces people's ability to experience life-long resiliency.
We recognize that individuals with trauma often live their trauma on a daily basis. However, more often than not, many enter therapy unaware of how much of an impact their trauma has had on their lives, including their coping skills (i.e., often addictive or aversive behaviors). Therefore, we provide a thorough clinical interview to ensure that we are able to accurately diagnose and treat an individual's specific trauma(s) in the most effective way.
Part of our assessment process may be to use one of two (or both in some cases) on-line assessment measures called the Post Traumatic Stress Index-Revised (PTSI-R) or the Inventory for Partner Attachment Stress Trauma (IPAST); the latter if there has been partner trauma. These tools identify various aspects of coping with trauma and betrayal issues based on one's self report. They are essential in giving our patients a thorough understanding of how trauma has impacted their level of coping, as well as the ways in which they have coped that may be maladaptive. Both are an important roadmap for determining our specific treatment approach, i.e., if a person is notably dissociative, we will work to assist them in containing and feeling safe in their body and surroundings before beginning trauma therapy.
EMDR Trauma Therapy
Many of our patients that come to us with trauma are desperately seeking relief. Therefore we offer EMDR Therapy (Eye Movement Desensitization and Reprocessing), developed by Francine Shapiro, Ph.D. EMDR is a Trauma Psychotherapy that enables people to heal from the symptoms and emotional distress that are the result of disturbing life experiences.
Repeated studies show that by using EMDR people can experience the benefits of psychotherapy that once took years to make a difference. It is widely assumed that severe emotional pain requires a long time to heal. EMDR therapy shows that the mind can in fact heal from psychological trauma much as the body recovers from physical trauma. The brain’s information processing system naturally moves toward mental health. If the system is blocked or imbalanced by the impact of a disturbing event, the emotional wound festers and can causes intense suffering. Using the detailed protocols and procedures learned in EMDR Therapy sessions, our EMDR trained clinicians help patients activate their natural healing processes, increase healthy coping skills, learn how to regulate emotions, reduce urges, triggers, and cravings, and recover from trauma longterm.
Internal Family Systems Model (IFS)
Along with using EMDR trauma therapy, we incorporate Internal Family Systems Model, developed by Richard C. Schwartz. IFS combines systems thinking contends that the mind is made up of relatively discrete subpersonalities, each with its own viewpoint and qualities. Often described as "Parts Work", this model is essential in assisting individuals in understanding their different parts and how they impact their Core Self. It is especially effective in using it when addressing various aspects of trauma particularly which parts learned to cope via being "Firefighters, Managers, or Exiles." Parts are explored and explained in detail as part of our our approach to treating both trauma and addictions.
Healing one’s body is a key component in having 100% recovery from anything. Many individuals who have experienced childhood trauma and/or adult trauma (including sexual abuse, domestic violence, chronic life stress) often experience sleep disturbances as well as have various health issues, including poor eating habits. We believe that healing one's body is an essential part of integrative recovery. Therefore, we collaborate with functional medicine practitioners in our community who have the medical knowledge and ability to provide labs and nutritional resources to help our trauma patients return to physical wholeness via balanced sleep, nutrition, and hormones.
Individual & Group Therapy
We offer individual and group therapy for men and women with trauma, intimate betrayal, sex and pornography addiction, substance abuse, and other intimacy, relationship issues. Research shows that the most effective modalities for healing these various issues entail regular, structured programming that includes individual and group therapy.
We encourage once to twice per week individual therapy due to the extensive nature of our patient's needs, especially in Phase I ("Discovery") of our sexual recovery program in order to gain solid traction in one's recovery. For couples, we encourage weekly to bi-weekly (every other week)90 minutes to 2-hour couples therapy sessions to ensure we address the significant needs of each person. Committed individuals who want to change attend our sexual recovery program weekly for individual and weekly group. Sometimes individuals will attend more frequently, depending on our clinical recommendation and their mental health needs based on ASAM criteria, (individuals transitioning from inpatient treatment enter our intensive outpatient programming which is 4 treatment episodes times per week minimum).
Insurance: We are not an in-network insurance program, however, we provide our patients with monthly statements and proper insurance coding in order for them to submit for reimbursement. Many of our patients report success in receiving some reimbursement for groups, classes, workshops, intensives, individual and couples therapy.
SEXUAL RECOVERY, TREATMENT PHASES:
phase i, "Discovery":
During Phase I of our sexual recovery program, individuals and their partners identify and process the shock, denial, anger, grief, and mental and physical symptoms related to the out of control sexual behavior that has damaged the relationship. This is often the crisis management/resolution phase of recovery where both individuals in the relationship need extra support in order to comprehend the array of emotions and physical symptoms that they are experiencing. Many couples request an intake together only to find out that they are not stable enough yet to work in couples therapy and both need the support of their own clinician (often an ASAT or CSAT) and group. Therefore, in Phase I each person works with an assigned therapist and attends weekly group to gain mental and emotional stability prior to incorporating couples therapy.
Phase II, "Recovery":
During Phase II of our sexual recovery program, individuals and their partners start to come to terms with the reality, impact, and magnitude of the out of control sexual behavior that has torn their relationship apart. If both people in the relationship are committed to healing, they are often observed as working diligently on their own recovery via individual therapy and group by incorporating Carnes' Task Based Model (for sex/porn addicts) or the wealth of tools and support provided to partners via Facing Heartbreak (Carnes, S., Lee, M., Rodriguez,A.) including other supplemental resources. EMDR (Eye Movement Desensitization and Reprocessing) therapy and IFS (Internal Family Systems) model is incorporated into the treatment process to explore family of origin, trauma re-enactment and ego/feeling states that potentially impact one's coping. Disclosure is typically done during this phase of treatment when both parties are stable. We also begin to incorporate once per month couples therapy; communication, boundaries, and the dynamics surrounding intimacy are often addressed during this phase.
Phase III, "Intimate Connections":
By Phase III of our sexual recovery program, individuals and their partners have actively participated in Phase I and Phase II via attending individual and group therapy consistently, learning and implementing new tools for healthy coping with the betrayal, and beginning to repair their relationship. During this phase, we incorporate couples therapy into treatment on a weekly to bi-weekly basis in order to ensure couples are improving their communication as well as strengthening the overall health of their relationship. By this time, couples are encouraged to attend our 8-Week Gottman Class as well as our weekly "Art of Ecstasy: From Sexual Disconnect to Sexual Bliss™" webinar series in order to redefine, reclaim, and increase their overall intimate connection. Our founder Candice Christiansen facilitates the Gottman class and webinar series.
We offer affordable groups and classes per week for men, women, and partners who are in our sexual/relationship/multiple addiction-aversion recovery program.
Weekly Men's Sexual/Relationship Recovery Groups: Offered Mondays, Tuesdays and Thursdays for men in Phase 1-2 of our sexual recovery program for sex/porn/love/relationship/multiple addiction issues. These are evidence based therapy groups that use Carnes' proven Task-Based Model for sexual recovery. They explore mens cycle of addiction, core beliefs and thinking errors, sexual and relationship boundaries, emotional regulation techniques, healthy interventions and more.
Bi-Weekly Female Partner Groups: Offered every other Thursday each month for women who've experienced intimate betrayal by their partners or loved ones. These are structured process groups. We offer male partner groups upon request. In January, this group will be weekly!
FREE Refuge Recovery Alternative Group: Free Mindfulness based meeting for men and women recovering from sex, food, relationship, love, substance, financial disorders. Time: 7-8 p.m. This group is for community members only; inpatient programs are not appropriate for this group.
Monthly Intimate Connection Class: Offered the last Tuesday of each month to couples in/out of sexual recovery* who want to learn about healthy sexuality. We incorporate aspects of sex therapy (the 4-D model, aspects of Esther Perel's book Mating in Captivity (2007), Gina Ogden's workbook Exploring Desire And Intimacy (2017), and Emily Nagoski's book Come As You Are (2015) with other work (The Gottmans, Sue Johnson) to assist couples in learning how to achieve healthy sex and intimacy. *Individuals in our sexual recovery program must be stable in their program to attend this class to avoid unnecessary set-backs in their healing process.
coming February 2018: Gottman 8-Week Couples Class
Gottman 8-Week Couples Classes, will start in February and March 2018: Join Candice and Meg as we teach you core Gottman concepts for improving your relationship! We will use the Gottman Couples Kit with reference to Seven Principles For Making a Marriage Work©2015.
Mastering the Trauma Wound Group is currently in process! A New group will start in 2018!
Annie Jacobs, LACMHC facilitates this powerful group via weaving in founder Candice Christiansen's Mastering the Trauma Wound©2016 workbook to assist women and men in gaining lasting mindfulness-based tools for helping them navigate through their trauma and having healthier relationships.
Starting January 2018: Female Partner Empowered Group!
Join Annie and Candice for this weekly group that will help women recovering from a partner's betrayal learn how to own their voices, heal their hearts, and feel empowered again. We will use various work from the leading experts in intimate betrayal recovery to support women on this incredible healing journey! Starts Thursday, January 18, 2018.