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Sex Addiction and Addiction Interaction

Remember the carnival game “Whac-a-Mole”?  Moles would pop up through a hole and the object of the game was to force individual moles back into their hole with a mallet.  The goal is to make them disappear as fast as possible when they rear their heads.  Addiction interaction is like the “Whac-a-mole” game. 

I had my chemical addiction credentials for over a decade before receiving my Certified Sex Addiction Therapist (CSAT) credentials.  For years I noticed the phenomenon as one would get sober from alcohol or drugs, other behaviors might begin to creep in as problematic or new focus in an unhealthy, unbalanced, way. I would see clients cease drinking and begin shopping to excess, or beyond one’s means. Men would stop drinking, but with new renewed clarity and focus, begin work to excess. This work drive would become a detriment to family obligations and life balance.  Even more, I would notice within marriages where addiction had been present, one spouse would shop to excess and the other spouse would feel like they were obligated to keep up with the debt forcing unhealthy work escalations in response.

  Sometimes comfort eating would replace the numbing of alcohol.  Often with sex addiction sobriety, we see this interaction begin to take place.  Often, increased food or sugar consumption begins in an attempt to mood regulate.  Food companies have long known about the “trifecta sweet spot” of the right amounts of sugar, salt, and fat to release optimal dopamine hits in the brain. 

In August 2012 the American for Society for Addiction Medicine released a new document defining addiction from a 4-year study involving more than 80 experts in neurology and addiction. They defined addictions as a chronic neurological disorder involving many brain functions most notably an imbalance in the so-called reward circuitry.  This fundamental impairment in the experience of pleasure literally compels the addict to chase the chemical highs produced by substances like drugs and alcohol and obsessive behaviors like sex, food and gambling.  The new definition leaves no doubt that all addictions whether to alcohol, heroin or sex are fundamentally the same. 

So what does this mean for the addict and treatment?  Sometimes people have more than one active addiction.  Sometimes they stop one behavior and another problematic behavior does surface in a compulsive way.  Effective treatment must include assessment and treatment for all active addictions and one must be vigilant for other addictive risks.

CSAT’s are uniquely trained to understand, assess and treat the addiction interaction.  Addiction interaction is like switching tracks, so to speak, to continue to avoid uncomfortable feelings.   These addictive risks include, alcohol, drugs, spending, debting, sex, shopping, e-trading, video gaming, gambling, impression management, even problematic feelings, and codependent relationships. 

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The Case of Anthony Wiener (Part 2): Why Does His Wife Stay?

As I listened to CNN cover the aspects of the Anthony Wiener story, two questions stuck with me from the various reports:

1.    Is Sexting Cheating?

2.    Why does his wife stay?

This post will explore the second question: “Why does his wife stay?”

(See the previous post: The Case of Anthony Wiener – Part 1 for “Is Sexting Cheating?”)

Anthony Weiner’s wife, Huma Abedin, has come out in public statements maintaining that she forgives her husband and chooses to stay by his side.  csmonitorThere is much discussion about the shocking reports that he is doing his sexting thing ….AGAIN. There are questions about why his wife would stay.  She is an intelligent woman who has gone on record to say she forgives him and he is a good man.

Why does she stay?  While I can only speculate about the Weiner-Abedin marriage, or go on reports in the press which report that she forgives him and can’t leave because of their 19-month old child, I can make comment on the couples I see in my practice. 

Why would a woman want to stay with a man who betrays in this way?  Should someone stay in a marriage when this type of betrayal is involved?  There are no easy answers, especially when a child is involved. 

I think of three different cases for consideration.


When people exhibit type of behavior exhibited by Mr. Weiner, there are negative consequences, and when it is repeated, we must consider the possibility of addiction.  If this is the case, healing is possible for people who struggle in this way.  Properly diagnosed and treated, people can change, and change can be sustained.  One of the hallmarks of living a changed life is humility.  Addictive behavior is a very selfish act.  Those acting in humility have the capacity to understand their that actions have an effect and impact on others around them. They show remorse.  If there is addiction, there is a recovery plan.  While there are no guarantees, when one is working a recovery plan there is hope for sustained long-term change.


What if the offending spouse begins a recovery plan and the person has trouble sustaining that recovery process?  This presents a dilemma for the other spouse to consider.  At first, recovery can be a shaky proposition.  “Slips” require an increase in treatment plan and / or the recovery process to create a sustained recovery.  Should a spouse stay now?  The health of a marital system is sustained by the ability to hold healthy boundaries.  If one’s boundaries continue to be crossed, we have to begin to question, Why would one stay?  Only the person whose boundaries are continued to be crossed can make a determination of when enough is enough! By setting boundaries we teach others how to treat us. 

The following are examples of boundaries a spouse might choose to set with their spouse who is struggling with addiction:

·        “After the infidelity in our marriage, if I find out about the betrayal of infidelity again, I may be forced to file for divorce”. 

·        “I will not live in a marriage impacted by addiction without a commitment to therapy and an ongoing recovery process.”

·        “If you continue the offensive behavior without being accountable to your recovery plan, I may be forced to leave.” 

Boundaries are not set to control another – they are set to teach others how we will, or will not tolerate being treated. 


This leads us to a third consideration.  What If one stays in a relationship where there are repeated boundary violations?   If an offending spouse is not working a recovery process when working a recovery process is a condition of the marital contract to continue, and the spouse stays in the relationship, the spouse is in essence saying:   “it is o.k. for you to cross my boundaries.  You can continue your offending behavior and I will stay regardless.” In essence: “I do not mean what I say”.  Often the spouse hangs in hoping that change will happen.  They stay focused on the hope of change rather than the reality of what is. They might believe the relationship will change when it actually is not changing as evidenced by the repeated boundary violations in this way.  A spouse who is betrayed has to be prepared to follow through with the boundaries they set. 

If there are repeated boundary violations in a marriage, I would wonder why one stays.  Sometimes this willingness to tolerate intolerable treatment is a result of a condition called Trauma Bonding. Trauma Bonding, a term developed by Patrick Carnes, is the misuse of fear, excitement, sexual feelings, and sexual physiology to entangle another person. Trauma bonding is an unhealthy emotional attachment.  People who stay in troubled relationships often were in emotionally or physically abusive relationships growing up.  It was their early experience of love growing up.  In Al-Anon this is what is referred to “as the comfortable slipper”.  It feels familiar, even if it is unhealthy and it was our primary experience of love. 

If you find yourself unable to leave a troubled relationship and are trauma bonded, there is help.   You don’t have to tolerate intolerable behaviors, you can learn healthy relationship behaviors, you can attempt to make change in your relationship, or if need be, you can learn how to get strong enough to leave. 

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The Sex Addiction Cycle, The Super Bowl, and The Audi

During the recent Super Bowl Sunday “parade of super commercials” Audi had a commercial depicting a young man going to the Prom.  He was going to the prom alone.   In that determination to go alone he had several family members and friends taunting him with the words “no one goes to the Prom alone”.  Even his grade-school aged sister in the chorus of taunts says:  “Only losers go to the Prom alone.”  His dad offers him the key to the Audi as incentive and courage to go it alone.  The next scene flashes and we see him boisterously walking onto the stage to take the prom queen and whisk her off in the A4.  The final scene portrays the young man and the prom queen screaming in the thrill of going top speed in the A4.  The commercial ends with the slogan “Bravery.  It is what defines us.”

Many of my male clients who struggle with sex addiction share with me a silent shame that began for them in adolescence, or even earlier  in their lives.  Many feel they didn’t have the courage to be who they dreamed or wished themselves to become in assured confidence.  They measured themselves against others constantly feeling inadequate and coming up short in relation to a perceived ideal.  Many have had experiences of abuse and shame that became permanent voices of inadequacy in their heads.   I have heard stories of locker room hazing and ridiculing by their peers.  I have heard stories of well-intended but misguided coaches creating “rituals of manhood” that would be considered abusive.   Overt and covert criticisms of their body, their abilities, and their manhood remain etched.    These experiences have left indelible marks of shame and rage on their virility.  Shame and rage become sublimated to sexual energy or fantasy in attempts to regain what was stripped from them, or put upon them.  This sexualized rage fuels the acting out in attempts to avoid those feelings for years to come.  These messages play over and over in their heads.  Messages remain imprinted in the forms of internalized self-talk and self-concept.

The addiction cycle begins with a faulty belief system.  Often that faulty belief system begins with these messages which were carried from those shameful episodes of childhood and adolescence.  Episodes of adult inadequacy call up those uncomfortable feelings to be avoided at all costs.  The attempts to avoid the feelings stoke the fires of the engine that feed the addiction cycle.   Pornography becomes the modern-day solution to regain virility.  Pornography gives relief to avoid the current uncomfortable feelings and act out the sexualized rage of inadequacy buried long ago.

Many men feel there was something they were missing.  The magic elixir of the Audi Key of courage was elusive to them in adolescence but easily tapped into in fantasy with the novelty of the porn hit.  A swirl of old shame to be avoided and a quick fix of feel-good pain-relief, followed by despair, shame and guilt, are hallmarks for the set-up of the addiction process.  

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The Presents of Presence in Sex Addiction Recovery

Recovery wisdom advises: Never allow yourself to get too hungry, angry, lonely, or tired, (HALT).  On this morning’s 6-mile run, with my run partner out of town and running on less sleep than normal, I was hitting 2 out of 4 of the precautionary directives.  If I let my mind wander to “I have to do 6 miles today” the run seemed like an impossible task.  I wanted to walk.  I wanted to slow down.  My thoughts entered the realm of “stinking thinking” and the dreaded “I can’t do this”.  Ughhh.  I was tired.  I was alone.  I didn’t have my music.  I was becoming bored.  All the tell-tale signs of the wheels falling off the bus were at-risk for coming into play. 

I began to change my focus.  First, I HAVE to do this.  This 6-mile run today is part of a bigger plan to reach my goals for a 15k race in January.  I do not want to let this long run slip by today.  One step at a time I have to keep my focus.  One step at a time I have to keep going.  I began to look just slightly ahead.  I looked at a leaf a few steps ahead – and made it to there.   I looked at a crack in the asphalt just ahead.  I thought to myself, you can make it to “there”!  I looked at my watch.  I could make it another 40 seconds.  See how it feels.  With each successive small goal and re-focusing my mind to just stay present to the small task at-hand, I made it the whole 6-miles. 

Recovery is like that.  If one focuses on the whole plan of sobriety and recovery, it can feel hugely overwhelming. If one says to oneself:   I can’t drink for the rest of my life again, ever.  I have to stay sober and not act out.  I am not sure I can do this.  I have all these meetings to attend.  I have to work steps.  I have to get a sponsor.   I have to make phone calls to peers.  I have to…on and on and on…we’d stop before we ever start.  If you are employed and thought about all you would have to do day-in and day-out for your employment, you might not want to show up!  Heck, if you are married, who would stand at the alter thinking ALL that one has to do to stay joined in a committed relationship for the rest of your life?

Just as I began to focus on the present moment at hand, one increment at a time, recovery needs an adjustment in the same measure. “Half-measures avail us nothing.”  Just as I have a vision of my race in January and a weekly plan to get there, recovery vision is necessary, too.  In the paradoxes of recovery, one must focus one step at a time but be guided by an overall vision and goal. 

In the marriage impacted by sex addiction, sometimes one is not sure how they can continue.  How can the betrayed partner trust again?  How can they stay in if they are so unsure?  One might not know if they can do the “whole run”, but changing the focus to smaller short term goals can help break it down and give information that feeds an overall plan one day at a time.

I finished my run this morning.  Bringing my mind to the present gave me presence of mind.  Just for this week I am on task.  Just until the leaf and the crack in the asphalt, I can do this.  What a gift!

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Rewiring Habits in Sex Addiction

It’s a Beautiful Day in the Neighborhood 

Remember Mr. Rogers?

He began every one of his ½ hour educational shows with the same ritual.  He would come onto the set through the same door chirping out his usual song “It’s a beautiful day in the neighborhood, a beautiful day in the neighborhood, ….”.  All the while, he would go through the same motions of taking off his tweed suit jacket, don his casual work sweater, take off his dress wing-tipped shoes, and put on his casual sneakers.  You knew what was coming.   He started each show the same way.  That ritual set the stage for that day’s show. 

Mr. Rogers was an extraordinary educator.  He knew the importance of structure for children.  Structure helps us make transitions.  Structure helps us make sense of the unknown.  As a marriage and family therapist I help parents develop routines that help children settle, feel safe, and decrease anxiety in the changes that face them as they developmentally move through time. 

As an addiction-credentialed therapist I help individuals and families settle from the chaos of addiction into new rituals to support sobriety.  Addiction is a set of habits “to the bad”, sobriety calls for a set of habits aimed “to the good’.

Good habits to support sobriety include aiming your day towards doing the next right thing at every turn.  Spiritual meditations, prayer, and 12-step meditations can be very helpful to set your brain in the right direction as each day begins. “90-Meetings-in-90-Days” sets the stage for a program of new habits, connects one consistently with a new community aimed in the right direction, and reduces shame by realizing one is not alone in their past deeds or current struggles.  Daily calls to peers are another great habit to support sobriety each day.  Daily check-in with your 12-step sponsor is another important habit for consideration.  Daily habits create a structure which become like threads that weave into a strong tapestry of recovery over time.  Having these elements of recovery in place help for when “the going gets tough” in the passage from addiction to sobriety.  These elements of early sobriety set the foundation for a life-long sobriety plan.

Addiction creates etched pathways that make going to the drug, or process, an automatic in times of high stress.  The job of recovery is to create new habits which circumvent those old etched addictive pathways in the brain.  The goal of recovery is to create new re-wired habits in the brain that keep one safe and stable consistently over time.