Transcript Document

Lauren Bierman, MC, LAC, NCC,
CSAT Candidate
Sex Addiction: Defined
“A pathological relationship with a
mood altering experience”
© Patrick Carnes, PhD,
“Sex Addiction” is an umbrella term
for a number of compulsive behaviors
Sex Addiction
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It is not all about SEX
• At the core of it, sexual compulsivity is an
intimacy and/or attachment disorder
▫ False sense of “connecting” which in
actuality disconnects from the self and
others
▫ Compensating for a feeling of inadequacy
▫ Fear of true intimacy and attachment to a
primary partner
• Attempting to get non-sexual needs met
through sexual behaviors
“I thought that sex was love and love was sex”
“It was the only coping skill that was always there
for me, even if only in my head”
“It filled the deep hole in me, momentarily, and
then after acting out I felt even worse.
“I had sex to escape my shame, then I felt shame
because I had sex, then I again had sex to escape
my shame” (vicious cycle)
The Making of a Sex Addict
10 Criteria for
Sexual Addiction
Compulsive Behavior
A pattern of out of control behavior over
time.
© Patrick Carnes, PhD/
Loss of Control
Clear behavior in which you do more than you
intend or want.
© Patrick Carnes, PhD,
Efforts to Stop
Repeated, specific attempts to stop the behavior,
which fail.
© Patrick Carnes, PhD,
Loss of Time
Significant amounts of time lost doing and/or
recovering from the behavior.
© Patrick Carnes, PhD
Preoccupation
Obsessing about or because of the behavior.
© Patrick Carnes, PhD
Inability to Fulfill Obligations
The behavior interferes with work, school,
family, friends, hobbies, and spirituality.
© Patrick Carnes, PhD
Continuation Despite
Consequences
Failure to stop the behavior even though you
have problems because of it (social, legal,
emotional, financial, and physical).
© Patrick Carnes, PhD
Escalation
Need to make behavior more intense, more
frequent, or more risky.
© Patrick Carnes, PhD
Losses
Losing, limiting, or sacrificing valued parts of life
such as hobbies, family, relationships, and work.
© Patrick Carnes, PhD
Withdrawal
Stopping behavior causes considerable distress,
anxiety, restlessness, irritability, or physical
discomfort.
© Patrick Carnes, PhD
Case Example:
“Ted”
• Ted is a 55-year-old, white male who is a lawyer by
profession and has two adult children and has been
married to his spouse for 22 years. Ted started to engage in
pornography and masturbation at the age of 12 and this
has been a constant for him throughout his life up to 7
days a week, for hours at a time. At the age of 25 he
started to use cybersex with online services and also went
to massage parlors. He hid this from his soon to be wife
when they started dating and promised himself that he
would stop once they were married. They did wed and had
two children and he still continued to act out and had now
escalated into actually seeing escorts for sex. His job was
impacted due to not being able to concentrate and
eventually his partner realized he was using company funds
for his sexual acting out.
Addiction Cycle and
Template
The Addictive Cycle
Belief
System
Unmanageability
Impaired Thinking
Addictive
Cycle
Preoccupation
Shame
Despair
Guilt
Ritualization
Compulsive
Behavior
© 2008
Arousal Template
One’s psychosexual history that establish
patterns and connections which have
formed neurochemical and emotional
templates related to sexuality.
What contributes to the Arousal
Template?
• Biology: Some of our desired parameters are
simply given by genetic encoding.
• Family: Parental interaction with child and the
parents with each other has a profound effect.
• Early sexual experiences: Child abuse can have a
profound effect on the template. Adults who were
trauma victims often repeat their abuse because
the abuse has become eroticized.
• Sexual history: Personal experiences that shape
one’s sexual beliefs and behaviors.
• Sexual Addiction History: Acting out behaviors
that become obsessive.
Components of the Arousal Templates
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Feelings
Personality types
Objects
Processes
Patterns or situations
Body types
Characteristics
Vulnerability
Stages of courtship
The 10 Types of
Sex Addiction
Origins of the Ten Types
In the original research conducted for Don’t
Call It Love (1992), a series of 114 sexual
behaviors was statistically analyzed.
A total of 10 “types” of sexually compulsive
behavior emerged in the sex addicts surveyed by
Patrick Carnes, Ph.D.
© Patrick Carnes, PhD/
Fantasy Sex
• Sexually charged fantasies, relationships, and
situations
• Arousal depends on sexual possibility.
© Patrick Carnes, PhD/
Seductive Role Sex
• Seduction of partners.
• Arousal is based on conquest and diminishes
rapidly after initial contact.
© Patrick Carnes, PhD/
Voyeuristic Sex
• Visual arousal.
• The use of visual stimulation to escape into
obsessive trance.
© Patrick Carnes, PhD/
Exhibitionistic Sex
• Attracting attention to body or sexual parts of
the body.
• Sexual arousal stems from reaction of viewer
whether shock or interest.
© Patrick Carnes, PhD/
Paying for Sex
• Purchasing of sexual services.
• Arousal is connected to payment for sex, and
with time, the arousal actually becomes
connected to the money itself.
© Patrick Carnes, PhD/
Trading Sex
• Selling or bartering sex for power.
• Arousal is based on gaining control of others by
using sex as leverage.
© Patrick Carnes, PhD/
Intrusive Sex
• Boundary violation without discovery.
• Sexual arousal occurs by violating boundaries
with no repercussions.
© Patrick Carnes, PhD/
Anonymous Sex
• High-risk sex with unknown persons.
• Arousal involves no seduction or cost and is
immediate.
© Patrick Carnes, PhD/
Pain Exchange Sex
• Being humiliated or hurt as part of sexual
arousal; or sadistic hurting or degrading
another sexually, or both.
© Patrick Carnes, PhD/
Exploitive Sex
• Exploitation of the vulnerable.
• Arousal patterns are based on target “types” of
vulnerability.
© Patrick Carnes, PhD/
Other behaviors that have been added
through more recent research:
Broken Down:
Added:
• Paying for Sex▫ Power
▫ Commercial
• Exploitive Sex
▫ Trust
▫ Force
▫ Child
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Pornography
Drug Interaction
Internet Sex
Paraphilia
Masturbation
© Patrick Carnes, PhD/
Does it lead to
powerlessness?
Does it lead to
preoccupation?
Case Example: “Sheila”
• Sheila is a 32-year-old, female, of Native American
decent. She is recently separated and has a small child.
Sheila’s husband left her due to her drug use and
severe rage issues. Sheila was molested by a
neighborhood boy when she was 12-15. Since the
separation from her husband, she has been inviting
men over to her place via the internet and will
exchange sexual acts for drugs. Sheila will often post
pictures on the internet of herself naked or in
vulnerable positions to men. Before the men come
over, she will fantasize about how this next one will be
“the one” for her and will sweep her off her feet.
When they arrive, Sheila will suggest that the men to
do almost anything sexually to her including humiliating
and degrading behaviors.
Love Addiction
and
Love Avoidance
LOVE AVOIDANT CYCLE
LOVE ADDICTION CYCLE
Greatest fear is that of intimacy with an
underlying fear of abandonment
Greatest fear is that of abandonment with an
underlying fear of intimacy
Trauma Issues
Trauma Issues
My sense of value comes from taking care of needy people.
My job relationally is to take care of needy people.
If I don’t, I feel guilty.
To be relational (intimate) is to suffocate (die).
I am worthless in relationship to my partner.
I need to be taken care of as I can’t survive alone.
If I don’t get close enough relationally, I’ll die.
Returns to fantasy
or moves on to
new relationship
Enters
relationship out of
duty not love
Is responsive to the
avoidant’s seductiveness
and enters the
relationship in a haze of
fantasy
Enters behind wall
of seduction
(impedes
intimacy)
Denies partners walls
and importance of life
outside relationship
Obsesses &
Medicates
Emotional
withdrawal
from fantasy
Pain
Anger
Fear
Shame
Rage
Panic
May return to the relationship
out of guilt or own fears of
abandonment, or moves on to
connect with new partner
Experiences an event
that shatters the
denial
© Pia Mellody
Becomes overwhelmed
by the neediness of the
partner and moves from
wall of seduction to wall
of anger or resentment
Creates intensity
outside of
primary
relationship
Abandons the
relationship in some
way- creates distance
from the partner
Cybersex
What is Cybersex?
• Accessing online pornography and audio, video,
and text stories.
• Real time with a fantasy partner.
• Other cybersex venues (social networking sites,
and portable devices such as Blackberries and
iPhones).
• Multimedia software.
Internet Pornography Statistics
• A total of 4.2 million websites contain
pornography. That is 12 percent of the total
number of websites. There are 100,000
websites that offer pornography and 1 in 7
youths report being solicited for sex on the
internet.
• Average age of first exposure to internet
pornography is 11-years-old.
http://internet-filter-review.toptenreviews.com/internet-pornography-statistics-pg4.html
Why Sex on the Net?
The Three A’s
• Accessibility
• Anonymity
• Affordability
Al Cooper, PhD
Ten Criteria for Problematic
Online Sexual Behavior
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Preoccupation with sex on the Internet.
Frequently engaging in sex on the Internet more often or
for longer periods of time than intended.
Repeated unsuccessful efforts to control, cut back on, or
stop engaging in sex on the Internet
Restlessness or irritability when attempting to limit or
stop engaging in sex on the Internet.
Committing illegal sexual acts online (ex: sending or
downloading child pornography).
Ten Criteria cont.
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Jeopardizing or losing a significant relationship, job, or
educational or career opportunity because of online
sexual behavior.
Incurring significant financial consequences as a result
of engaging in online sexual behavior.
Using sex on the Internet as a way of escaping from
problems or relieving feelings such as helplessness,
guilt, anxiety, or depression.
Returning to sex on the Internet day after day in search
of a more intense or higher-risk sexual experience.
Lying to family members, therapists, or others to
conceal involvement with sex on the Internet.
How does SA impact the
Family?
• Dishonesty and secrets throughout relationships
or the entire family system
• Overwhelming sense of betrayal
• “Shattered” world
• Covert/ Overt Sexual Energy/ Behaviors
• Risk of disease and consequences (STI’s,
divorce, violence, loss of job, or jail time, etc.)
• Financial loss
• Passed down through generations
Treatment Plan
Building a new
relationship with self
Building a new
relationship with sex
Treatment tools:
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Individual Therapy
Group Therapy
Twelve Step Meeting
Sponsor
Steps One through
Nine
Family Participation
Family Recovery
Couples Recovery
Exercise/Nutrition
Intervention and Plan
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Break through denial
Understand the nature of the illness
Become willing to surrender to the process
Limit damage from behavior
Establish sobriety
Ensure physical integrity
Participate in a culture of support- 12 Steps
Shame reduction work
Grief work
Acknowledge cycles of abuse
Commit to recovery for each family member
For the Addict
• Out of the Shadows- Dr. Patrick Carnes
• Facing Love Addiction- Pia Mellody
• Don’t Call it Love- Dr. Patrick Carnes
• In the Shadows of the Net- Dr. Patrick Carnes
• Ready to Heal- Kelly McDaniel
• Women, Sex, and Addiction- Dr. Charlotte Davis Kasl
For the Family
• Deceived- Dr. Claudia Black
• Mending a Shattered Heart- Dr. Stefanie Carnes
• A House Interrupted- Maurita Corcoran