Can sex addiction counseling possibly keep up with the permutations of sex providers?
I have seen it said in many places that pornography is what kept the internet going in the early days of the world wide web, which was all of 10 to 15 years ago, and now that there is widely available broadband access, porn and the issue of sex addiction to online pornography has become a much more frequent issue in counselor's practices. It seems like no matter what your preference is, you can find a website which caters it, and mainstream TV is now running salacious psuedo-documentaries about the impact of the internet on prostitution. In other words, it is every where.
But online porn is not the only kind of sex addiction that there is.
Sex addiction counseling will need to explore specific details in areas such as compulsive masturbation, use of prostitutes, sexual massage, phone sex, affairs, anonymous sexual encounters and the various types of sexual behaviors prevalent in sexual addiction.
According to Robert Weiss, LCSW, CAS, sexual addiction is fairly prevalent in the adult USA population with perhaps 8% of adult men and 3% of adult women involved.
A helpful way to integrate a clinical understanding of sexually addictive behavior is to utilize a common definition of Criteria for an Addictive Disorder:
* Frequent engaging in the behavior to a greater extent or over a longer period than intended
* Persistent desire for the behavior or one or more unsuccessful efforts to reduce or control the behavior
* Much time spent in activities necessary for the behavior, engaging in the behavior or recovering from its effects
* Frequent engaging in the behavior when expected to fulfill social, occupational, academic or domestic obligations
* Continuation of the behavior despite knowledge of having a persistent or recurrent social, financial, psychological or physical problem caused or exacerbated by the behavior
Sexual addiction and compulsivity can be defined as sexual behaviors which involve "escalating patterns of sexual behavior with increasingly harmful consequences." Those consequences which often are indicators of the disorder appear in the full biopsychosocial spectrum.
These consequences might include:
* Social Loss of marriage/primary relationship, friendships, social networks due to sexual preoccupation and behavior
* Emotional Depression or anxiety are common due to the shame, secrecy and lowered self-esteem of sexual addicts
* Physical Injury due to frequency and type of behaviors; sexually transmitted diseases are common
* Legal Arrests for sexual crimes (voyeurism, lewd conduct, etc.), loss of professional stature or licenser for sexual misconduct or sexual harassment
* Financial Costs of pornographic materials, use of prostitutes, phone/computer sex lines; Loss of productivity, creativity and employment
Like alcoholics, drug addicts and compulsive gamblers, sexual addicts employ typical defenses such as denial, rationalization and justification in order to be able to continue to engage in their behaviors, while blaming others for the resulting problems. Diagnosis and subsequent treatment can be skewed by a patient's minimization or outright denial of the type, amount or consequences of their sexual activity. Misdiagnosis can also occur due to the commitcant mood disorder symptoms that the shame and stress of living a double life can facilitate.
What works in sex addiction counseling?
Again according to Robert Weiss, LCSW, CAS.,
"One extremely important tool utilized toward these goals is addiction-focused group therapy. A long-standing fundamental to sexual offender treatment, group therapy for sexual addicts is an invaluable resource for integrating the tools of honesty, self examination and commitment into the recovery process."
"Sexual addicts in group work are offered the safe, facilitated space to be able to confront their denial and rationalizations while more realistically redefining shameful self states."
The feeling of shame can happen for us appropriately or inappropriately, and if recognizing and changing the feeling of shame is not taught in the group, relapse can be used as a tool to change the shame feeling to something else, perhaps anger or resentment, which can be powerful impulses to behavior.
Appropriate shame points inward to some unfinished or unacknowledged 'work' for the client to do.
For example, I may feel shame after yelling at my kids in a cruel way, and that shame is pointing in to a part of me that I have not acknowledged yet, call him part of my shadow, which makes it ok to abuse my power under the guise of "parenting".
Feeling shame in those circumstances can be helpful for me learning something about myself.
Shame that says I am a bad person, however, flawed beyond redemption is like a computer virus. It will crash the main frame, and I need to change out of it, because it is an inappropriate expression of the emotion, and so powerful and painful that even relapse is a lesser evil.
Group work needs to speak to the speed of the central nervous system, and how fast thoughts about relapse happen (perhaps in 1/45th second) and group work needs to include effective education about the physiology of stress and stess management, brain fitness, and nutrition.
Group work should include information about Paul Ekman's work on facial expressions, and how we respond to those.
Contempt and attraction non-verbal signals inspire very powerful physiological responses in us very rapidly, faster than I can create the words of the serenity prayer for example.
I think recovery happens in those 1/45th seconds when I can recognize a feeling and make a choice about changing or maintaining it.
Mindfullness training is very useful in that regard, and Heartmath is a very useful mindfullness tool that actually activates the higher perceptual centers in the brain.
I can learn Heartmath rather quickly on my computer, and then implement it heart beat by heart beat
Group work, and the feedback from other group members is vitally important for group members to learn about the purpose of the emotion shame, and how to utilize it to move into an addiction free life.
Appropriate shame teaches. We all experience it.
Group provides an invaluable resource toward building appropriately boundaried social support toward recovery.
The other primary resource for sexual recovery is the 12 step support group. Functional meetings of at least one of the following programs can be found in any major metropolitan area and some in more rural areas as well: Sexaholics Anonymous, Sexual Compulsives Anonymous, Sex and Love Addicts Anonymous, and Sex Addicts Anonymous.
All provide the basic principles of honesty, integrity and spirituality long successful within Alcoholics Anonymous, while making that process applicable to the specific needs of the sexual recovery population."
The key to any 12 Step program is doing the Steps and sponsorship.
While attending the meetings is important, the key to ongoing sobriety is thinking about the steps a lot, mulling them over.
After all, Step 4 in AA pertains to a "fearless and thorough moral inventory".
In the beginning addicts are not very familiar with thorough and ongoing moral inventory, done at least daily, nor are they familiar with at least daily prayer and meditation, which might happen much more frequently than one time per day.
In fact, I like to use Heartmath frequently.
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