Saturday, October 29, 2011

Help for the Partners of Sex Addicts

HELP FOR THE PARTNERS OF

SEX ADDICTS

Frequently Asked Questions

(FAQ's)

byDorothy C. Hayden, LCSW

dhayden@nyc.rr.com

What is sex addiction?

Sex addiction is an obsessive relationship to sexual thoughts, fantasies or activities that an individual continues to engage in despite adverse consequences. These thoughts, fantasies or activities occupy a disproportionate amount of "psychic space", resulting in an imbalance in the person's overall functioning in important areas of life, such as work and marriage. Distress, shame and guilt about the behaviors erode the addict's already weak self-esteem.

Sexual addiction can be conceptualized as an intimacy disorder manifested as a compulsive cycle of preoccupation, ritualization, sexual behavior, and despair. Central to the disorder is the inability of the individual to adequately bond and attach in intimate relationships. The syndrome is rooted in early attachment failure with primary caregivers. It is a maladaptive a way to compensate for this early attachment failure. Addiction is a symbolic enactment of deeply entrenched unconscious dysfunctional relationships with self and others.

While the definition of sex addiction is the same as that of other addictions, sexual compulsion is set apart from other addictions in that sex involves our innermost unconscious wishes, needs, fantasies, fears and conflicts.

Like other addictions, it is relapse prone.

While there currently is no diagnosis of sex addiction in the DSM-IV, clinicians in the sex addiction field have developed general criteria for diagnosing sex addiction. If an individual meets three or more of these criteria, he/she could be considered a sex addict:

1. Recurrent failure to resist sexual impulses in order to engage in compulsive sexual behaviors.

2. Frequently engaging in those behaviors to a greater extent, or over a longer period of time than intended.

3. Persistent desire or unsuccessful efforts to stop or control those behaviors.

4. Preoccupation with sexual behavior or preparatory activities. (rituals)

5. Frequent engaging in the behavior when expected to fulfill occupational, academic, domestic or social obligations.

6. Continuation of the behavior despite recurrent social, financial, psychological, or marital problems that is caused by the behavior.

7. Giving up or limiting social, occupational or recreational activities due to the behavior.

8. Distress, anxiety, restlessness or irritability if unable to engage in the behavior.

9. Distress, anxiety, restlessness or irritability after he/she does engage in the behavior.

How do I know if my partner is a sex addict?

Sometimes, it's difficult to know whether someone close to you has an addiction. The addict might hide the addictive behavior or you might not know the warning signs or symptoms.

Here are some of the signs and symptoms:

* Staying up late to watch television or surf the Web .

* Looking at pornographic material such as magazines, books, videos and clothing catalogs .

* Frequently isolating themselves from spouses or partners, and doesn't inform

them of their whereabouts .

* Are controlling during sexual activity or have frequent mood swings before or

after sex .

* Are demanding about sex, especially regarding time and place .

* Gets angry if someone shows concern about a problem with pornography

* Offers no appropriate communication during sex

* Lacks intimacy before, during and after sex, and offers little or no genuine intimacy in the relationship

* Does not want to socialize with others, especially peers who might intimidate them

* Fails to account for increasing number of toll 800 or 900 calls

* Frequently rents pornographic videotapes

* Seems to be preoccupied in public with everything around them

* Has tried to switch to other forms of pornography to show a lack of dependency on one kind; concoct rules to cut down but doesn't adhere to them

* Feels depressed

* Is increasingly dishonest

* Hides pornography at work or home

* Lacks close friends of the same sex

* Frequently uses sexual humor

* Always has a good reason for looking at pornography (Psych Central.com).

Why can't he/she control his/her sexual behavior?

It's important for you to know that your partner is not volitionally involved in these behaviors so you can begin to understand and, perhaps, forgive. Most addicts would stop if they could.

It's been said that of all the addictions, sex is the most difficult to manage. This syndrome is a complex mixture of biological, psychological, cultural, and family-of-origin issues, the combination of which creates impulses and urges that are virtually impossible to resist. Despite the fact that acting them out produces considerable long-term negative consequences, the addict simply cannot resist his/her impulses. Individuals who are highly disciplined, accomplished and able to direct the force of their will in other areas of life fall prey to sexual compulsion. More importantly, people who love and cherish their partners can still be enslaved by these irresistible urges.

From a biological standpoint, research has shown that certain formations in the right temporal lobe make certain individuals more prone to sexual arousability from birth. Whether or not such an individual becomes sexually compulsive or perverse then depends on the child's home environment.

Research has also shown that the inability to control sexual impulses is associated with neurochemical imbalances in the norepinephrine, serotonin and dopamine systems. The use of certain anti-depressants (SSRI's) has thus shown to be very effective in treating the impulse control problems of many sexual compulsives.

Biological predisposition contributes and combines with psychological factors. One of the reasons the "erotic haze" is so compulsory is that it is an unconscious but maladaptive way to repair earlier disturbed, anxiety-laden relationships. It shores up an inadequate sense of self which results from these early-life interpersonal abandonments, intrusions and misattunements.

This combination of biological and psychological factors results in an "affective disorder" in the sex addict. Feeling of depression, anxiety, boredom and emptiness are quickly alleviated by immersing oneself in an imaginary world that provides novelty, excitement, mystery and intense pleasure. Sex addiction is better than Prosac. It heals, it soothes, it contains, it provides a "safe place" free from the demands of actual performance, and it gives an illusory sense of belonging. The sense of empowerment in the illicit sex act rectifies "holes in the soul" and lifts the addict from feelings of inadequacy, insufficiency, depression and emptiness into a state of instant euphoria.

Relinquishing this very special (but delusional) mental and physical state can result in a sense of withdrawal which may include mood swings, inability to concentrate and irritability. These symptoms usually disappear in therapy as the sense of self is solidified and he finds more creative ways to deal with uncomfortable feelings.

What are the effects of cybersex addiction on the relationship?

Effects of sex addiction on the sex addict's partner can be numerous, encompassing a wide range of emotions and reactive behaviors. The sexual codependent's experience is similar to, but not thoroughly identical to, a codependent person in a relationship with a substance abuser. A codependent partner of a drug addict or alcohol, for example, may manage to understand and even sympathize with her partner's alcohol problem due to the lesser social condemnation.

But a compulsive addiction that involves engaging in sexual activities on the computer or outside of the home inflicts a psychic injury of ultimate betrayal. Sexuality goes to the heart of who we are.

Arguable, one purpose and outcome of cybersex is to detach and disconnect sexual experience from real relationships in life. Cybersex's primary stimulus to autoerotic behavior produces profound disconnection of the sexual experience from relationship context and meaning. Compulsive viewing of pornography, for instance, in no way supports or fosters intimate, attachment-linked sexual gratification, anchored in emotional connection, intimate responsiveness and relationship fidelity.

Cybersex addiction reinforces a non-intimate, non-relational, and non-demanding sexual experience -- a detached, disconnected physical arousal geared to the self-engrossed preoccupation typical of addictive sexual behavior. Cybersex entrenches emotional, psychological and spiritual/existential disconnection of sexuality from relationship context. Entrance into the "erotic haze" that encompasses the sex addict induces sexual arousal, climax and resolution without real relationship attentiveness, responsiveness, or commitment the key dimensions of a loving attachment.

The behavior directly undermines trust in the couple's relationship. Thus, the sexual dynamics depicted in cybersex are inherently detrimental and destructive to secure attachment that is essential to a sense of trust in the relationship.

It is also reasonably anticipated that a husband's deception and lying the existence of a "secret world" apart from the primary relationship is an overlapping, yet also separate detrimental influence upon relationship trust.

For some women, this lack of trust in their husband's word leads to uncertainty about the "substance" of the man they married, uncertainty about his true identity and a change in their perception of his identity that of seeing him as fundamentally untrustworthy and of disreputable character. Thus, their internal model of their husband changes.

Others may feel that the husband is unable to fulfill marital expectations of emotional intimacy and companionship. They talk about not trusting that their husband would fulfill the role of being someone who could provide emotional support. They feel unable to turn to their husbands for this emotional support for different reasons: fearing she would trigger a relapse; feeling rejected because of his involvement in computer sex; sensing her husband's inability to provide emotional support; being shamed by a husband's angry or dismissive response from her attempts to reach out for support and companionship; or resolving that her husband was emotionally preoccupied with his own struggle with addiction.

The addict's use of cybersex causes self doubt and lowered self esteem in the spouse. These women feel they aren't pretty enough or skinny enough, or whatever. In any event, the feel that they are not what their husbands want. Some feel that if they were more sexually desirable, he wouldn't have this problem. Sometimes, in a frantic effort to compete with unreal women on the internet or with prostitutes, they go to extremes with cosmetic surgery, breast implantation, excessive exercise - in the mistaken belief that if she can lure him back sexually and her husband would stop being interested in pornography and the marriage could be redeemed.

Some spouses feel that her husband's use of internet pornography is a direct attack on her self-worth. They start doubting themselves. They doubt their self-worth. They start doubting the things that used to make them feel special and meaningful. Because if she had any meaning, why was he doing what he's doing?

The wife is often stunned, confused, and in extreme pain upon discovery

of the sexual/cybersex addiction. Anger and resentment can be overwhelming. For many

partners, the addict's betrayal can precipitate trauma that resembles post-traumatic stress disorder.

A wife can believe that sex is the most important way to express love, so her partner's sexual acting out can leave her feeling deeply inadequate and unlovable.

Within the union, the partner's low self-esteem can contribute to anxiety

and fear of being abandoned. Often she will set aside her moral values and tolerates

participating in sexual behaviors with her partner which are unacceptable or even repugnant to her. She feels too unworthy to have solid sexual boundaries. She mistakenly believes that she can stop his acting out if she satisfies his (insatiable and unrealistic) sexual needs.

A surprisingly common effect reported by many partners - after the shock of discovery -

is the feeling of losing one's mind. Obsessing about the details of the sex addict's

betrayal, repeatedly confronting her partner with "evidence" of infidelity and being told she's "crazy" or "just jealous" results in a loss of focus and an inability to concentrate. Fear and anger aggravate the condition. Furthermore, there is an element of intense shame for both addict and sexual codependent attached to sexual addiction, especially if his interests involve an object, cross-dressing, dominance and submission or children. She isolates herself from friends, family and community due to her shame, which provides fertile ground for depression. In some situations, the partner is brought to a point of absolute despair.

Some maladaptive strategic responses the sexual codependent may engage in as a means of coping include excessive alcohol consumption, food binges, excessive house cleaning, and overtime career activity; acts that can serve as distractions from her distrust, pain and hostility. Distractions, of course, provide only a temporary and false "relief" and often create more problems than they solve.

When the partner's anger and resentment are suppressed over a period of time, they

eventually explode in a volcano of rage, blame, and furious criticism of the sex addict.

The explosion of frustrated emotions can open a door to enormous guilt and remorse, so the partner may forgive the addict's offenses and not stand clear in setting boundaries for herself. The result is an unfortunate snare for the couple, in which the partner unwittingly enables the sex addict to carry on with his unacceptable pattern of sexual acting out.

The converse is true regarding the emotional influences on the wife. She may turn inward, withdraw, stay silent and distant. This can include withdrawing from any sexual activity with the addict. These stonewalling behaviors can ignite strong feelings of shame and rejection in the sex addict. In a way, the partner succeeds in punishing the sex addict through these behaviors. But the price of this punishment may be a return to his active addiction as a way to deal with conflict at home.

A tremendously debilitating effect on the partner is to assume all responsibility for the

addict's sexual acting out, and even for all of the problems in the relationship. The

sex addict may exploit this to his advantage, perpetuating self-doubt within the partner.

For example, the partner may confront her spouse with evidence of a transgression, like a credit card charge to a hotel, but the sex addict is skillful and experienced in deception. He will boldly challenge the partner's credibility, suggesting she see a "shrink" for being so paranoid and suspicious of him. He can persuasively feign righteous indignation, causing his partner to distrust her own instincts and perceptions, even in the face of tangible evidence.

The self doubt can plague the partner, aggravating her confusion and contributing to the feeling of "losing my mind". Not wanting to continue to feel "crazy", she may retreat into denial, the basic and most fundamental defense mechanism for both partner and addict. When in denial, she will believe the addict's lies, however far-fetched they may be. She will accept the unacceptable. Whichever lies the sex addict offers to cover up his addiction, she is compelled to "not rock the boat" in order to assuage her abandonment fears.

What are the characteristics of a sexual codependent?

Firstly, let's consider what codependency is. Codependency is an overworked and overused word and definitions can be confusing. At core, it revolves around a deep fear of losing the approval and presence of the "other". This underlying fear can result in manipulative behaviors that overfocus on maintaining another person's presence and approval. Control, obsequiousness, anger, caretaking, and being over-responsible are among the behaviors that can be the manifestations of codependent behavior. Because of dysfunctional family-of-origin issues, codependents learn to react rather than respond to others, take responsibility for others, worry about others, and depend on others to make them feel useful or alive.

Codependence also refers to the way events from childhood unconsciously produces attitudes and behaviors that propel people into destructive relationships in the present. The self worth of the codependent comes from external sources. They need other people to give them feelings of self-worth. Codependence is a particular relationship with one's self in which the person doesn't trust his or her own experiences. Lacking the inner boundaries necessary to be aware of and express their true wants, feelings, goals and opinions, they are "other-validating". Having only a reflected sense of self, they constantly seek affirmation and validation from other people because they are unable to endorse and validate from within. "Self-validating" people are able to do this. Co-dependents often focus on an addict's sobriety as a way to achieve a precarious sense of self- consolidation. Sadly, their behavior often perpetuates the loved one's addiction.

Codependent people believe they can't survive without their partners and will do anything they can do to stay in the relationship, however painful. The fear of losing their partners and being abandoned (once again) overpowers her ability to make decisions in her own best interests. The thought of addressing the partner's addiction can be terrifying: they may be frightened of igniting the partner's anger which can result in feeling emotionally flooded by (childhood) fears of loss.

The sexual co-dependent suffers from additional symptoms: driven by the potential loss of the relationship, which she sees as identical with her very identity, some women engage in sexual activities with their partners that they find distasteful or even morally repugnant all in an effort to keep him home and happy. However, this type of fantasy-based acting out may not be based on her real sexual needs and desires and opens the way to turning his partner into yet another object. Certain kinds of sexual acting out can turn sex into another fix for him. The partner senses this, making her sense of sexual betrayal even more poignant.

In couples where one partner is ciphering off his erotic energies from the primary relationship, there are invariably problems with the couple's own sexual expressiveness. He becomes sexually demanding. She expresses her resentment about this by not being sexually responsive. He may lose erotic interest in her, as she never lives up to the thrill of fantasy-based sexual enactments. The sense of having a person-related, intimate sexual encounter may diminish. Erotic expression between the couple can easily dry up, leaving the sexual co-addict feeling even more diminished as a woman and as a person.

Sexual co-dependents have an inordinate need to get the information straight. "Detectiving" is a common activity: checking his computer, looking up names and numbers, or desperately looking for scraps of paper with numbers written on them. One client even invited a prostitute her spouse had frequented into her home because she wanted to know the details. The need-to-know provides the partner with a way to check up on her own reality ("Am I crazy or is this really happening?") and provides her with a sense of much-needed (although illusory) sense of mastery over an out-of-control situation. Especially in light of the addict's continual denial, the co-addict has a need to provide "evidence" to ensure her soundness of mind -- a ploy that rarely works and is exceedingly exhausting.

The final distinction between sexual co-addicts and other co-dependents is the shame associated with this "secret". Sex as an addiction is rarely discussed in "polite society" and there is a huge social stamina associated with it. Sexually addicted clients often tell me that they'd rather be alcoholics or drug addicts. The stigmatization of this compulsion almost ensures that the sexual co-dependent will want to hide or to provide a good "front" to deal with feelings of shame and despair. She may become socially isolated because she can't discuss the situation with friends. Depression easily enters into an emotional environment of isolation and shame. Keeping secrets about important dimensions of life ensure that the issues underlying them will not be healed.

What's involved in therapy for someone who is the partner of a sex addict?

There is hope. The pain the sexual co-dependent experiences is normal. Learning a partner is sexually addicted can be devastating and debilitating. The betrayal triggers a myriad of strong emotions. Feelings of anguish, despair, rage, hopelessness and shame may overtake her. She may feel alone in unchartered territory, wondering "Where do I go from here?"

It's important to know that the situation is not unique. There are many, many people who share this exact dilemma. Sexual codependents who attend either "S-Anon" or "COSA", 12-step programs for partners of sex addicts, often feel extraordinary relief. To break the shame and isolation, it's important to know others are going through the same thing. More seasoned members of the group, who have been grabbling with these issues for years, can be a beacon of hope for the newcomer who begins to discover how to cope with the situation and attain some measure of serenity, whether the sex addict is acting out or not.

Psychotherapy is also extremely important. Be sure to find a therapist conversant with these issues. What should happen in your therapy?

Treatment for sexual codependence can become a process of continued growth, self-realization and self-transformation. Working through feelings of victimization can lead to a new sense of resiliency. Going through this process can be an avenue to discovering meaning and to building stronger self-esteem. Challenges faced can elevate one to a higher level of well-being. A sense of serenity and peace from the appreciation of having worked through this process may occur.

Lessons not learned in the family-of-origin can be now be learned and worked through: appropriate self-esteem, setting functional boundaries, awareness of, acknowledgment of and expression of one's personal reality without undo fear of retaliation, and taking better care of one's adult needs and wants while allowing other adults to take care of theirs are all potential gains to be made in therapy and recovery.

Internal and external boundaries will be strengthened. Strong external boundaries will ensure that you will not again put yourself into a victim role. A sense of having internal boundaries will open up new avenues of healthy intimacy as you will know who you are and be able to hear who another is. At the heart of healthy intimacy is the ability to share your real self with another and be available when someone else shares his real self with you.

The sexual co-depenent may find she no longer needs to bend herself into a pretzel to accommodate others. Rejection or disapproval may be unpleasant, but not devastating. Compromising personal integrity in order to get external approval and validation will cease. With increased self-knowledge comes the ability to Self-validate while still being in a relationship. Self esteem will be generated by her behaviors rather than the approval or validation from others.

The choice to stay in or leave the relationship is an individual one. With therapy comes the knowledge that a fulfilling life can be crafted whether alone or in a partnership. People involved in a therapeutic process have the potential of reclaiming a sense of dignity and renewed sense of purpose even if the spouse remains active.

Finally, time and energy spent on preoccupation and control of the addict can be used to attend to emotional support for the children, to recommit to and obtain increased satisfaction from work, to meet new people, and to develop new recreational activities.

How can I possibly forgive him?

Despite the fact that it may seem impossible, forgiveness is a critical part of recovery for the partner of a sex addict. To forgive is not to forget. Forgiving means being able to remember the past without experiencing the pain all over again. It is remembering -- but attaching different feelings about the events, and it is a willingness to allow the pain to have decreased relevance over time. Understanding the pain, compulsion and despair that the sex addict has undergone from sexual compulsion can open avenues to compassion.

To forgive is important primarily for oneself, not for the person one forgives. The opposite of forgiveness is resentment. When we resent, we experience the pain and anger all over again. Serenity and resentment cannot coexist.

The process of forgiveness begins with acknowledging that a wrong has been done to you. You have to recognize that you have strong feelings about what happened and you need to feel and process those feelings. You are entitled to be angry or hurt. Ideally, you can share those feelings with the person who has hurt you in couples counseling. If that is not possible, then you can share the feelings with your therapist or support group. After that, you can choose whether to stay in a relationship with that person. In either case, forgiveness does not imply permission to continue hurtful behaviors. As part of your own treatment, you need to decide which behaviors you can accept in your relationships and which you cannot.

The primary goal of forgiveness is to heal yourself. In a partnership affected by sexual addiction, forgiveness is aided by evidence of the partner's changed behavior and commitment to treatment. These are also elements in rebuilding trust. For many couples, forgiving and learning to trust again go hand in hand. Both take time, making amends, continued treatment and steady, continual, trustworthy behavior on the part of the addict.

After the acting out has stopped, it's critical to not use his past behavior as a "hook" to punish or manipulate him. When a desire for revenge exists, you have not forgiven, and you see him in one dimension ("Bastard"). The capacity to see him as a whole person (he's not just a sex addict, he's many things) will help you move forward. Couples therapy will help you move toward a sense of tolerance of his vulnerabilities, acceptance of the past and a renewed interest in him as a multidimensional person with on-going issues.

My partner refuses to go for treatment, or even to identify that he has problem. To stay in this relationship is to accept the unacceptable. Nevertheless, I've been unable to leave him. Why do I stay in a relationship that causes me such emotional anguish?

There may be realistic reasons why women stay in relationships despite repeated betrayals and lost of trust, mutual concern and physical compatibility. Children and finances have traditionally been two of them, although increasingly these reasons are becoming less relevant.

So, why do they stay? For some women, being in love is tantamount to being in pain. The two are indistinguishable. Obsessing about a man's behavior, allowing it to control her emotions and behavior, realizing that it negatively influences her health and well-being, she finds herself unable to let go. Does she measure the degree of her love by the depth of her torment?

Problems from childhood rear their ugly heads when contemplating why some women masochistically stay in relationships that they find erosive to their sense of security and self-worth. The one characteristic of all dysfunctional families is the inability to talk about feelings and problems. In dysfunctional families, emotions are repressed, major aspects of reality are denied, and roles remain rigid. Children from such families learn not to believe in their own perceptions nor are they able to validate their own feelings. When the family denies a child's psychic reality, it's difficult them to trust their own perceptions as adults.

What comes to mind is a "Joey Bishop" episode from the 50's wherein the wife walks in on him in bed with "a blonde" and Joey and his sexual cohort calmly get up and dressed, the woman walks out the door, and Joey denies that there ever was a woman in the room. The (typically 50's) wife responds by not believing her own perceptions and being apologetic!!

These women become unable to discern when someone or something is not good for them. Situations and people that others would avoid as dangerous, uncomfortable, or unwholesome do not repel them because they have no way of evaluating them in a self-protective manner. They do not trust their feelings and are unable to be guided by an appropriate sense of entitled self-interest. Rather they are drawn to the dangers, intrigues, dramas and chaos that come from living with an addict.

If she comes from emotionally unavailable parents, she was never able to change her parent(s) into the warm, loving caretaker(s) for whom she longed. Subsequently, she unconsciously is drawn to an unstable, unavailable man with whom she can try to change into a loving, stable man who can give her what she lacked as a child. The ruse rarely works, and these women live in the ever-perpetuating pain and suffering that they lived in as children.

Because her emotional needs were not met in childhood, she is terrified of experiencing the kind of emotional neglect and abandonment she felt back then, and she will do almost anything to prevent a relationship from dissolving. Accustomed to lack of love in personal relationships, she is willing to wait, hope, try harder, and give more chances to a partner that has betrayed her many times over. She may try harder to please him sexually, believing that it is her own deficiency that caused his sex addiction in the first place. In her relationship, she is much more in touch with her dream of how it could be rather than with dealing with the reality of what is. She may be addicted to men and to emotional pain. By becoming enmeshed in a situation that is chaotic, uncertain and emotionally painful, she can avoid focusing on her responsibility to herself, as her family of origin did not provide a role model for guiltless self-care. Alternatively, the highs and drama of life with a sex addict may forestall the experience of deep-seated depression. She may have never been attracted to men who were kind, stable, faithful and reliable. Such men may have been experienced as "boring".

I'm incredibly frustrated that he/she won't tell the truth. Even when I present "evidence", he denies his sexual acting out. How can I ever trust a man who so blatantly lies to me?

Sex addiction thrives in secrecy. Addicts will go to any length to protect their double life. Denial, ("Don't Even Know I'm Lying") plays a huge part in any addiction process. The reality of the acting out is protected from the conscious mind. If the addict is unaware of the truth, how can he tell you?

The very thinking process of the addict becomes impaired as he becomes immersed in the denial process, giving way to the minimization of the extent of his behavior. This connects with "rationalization": i.e. "I'm not really cheating" "All guys do this" "I'm not hurting anyone" "I work hard so I deserve some pleasure." This combination of denial, minimization and rationalization makes it extremely difficult for him to know the truth.

More complexing is the phenomenon of "dissociation", or "The Dr. Jekyll and Mr. Hyde" syndrome. Dissociation is a clinical process that characterizes multiple personality disorder. While I'm not saying the sex addicts have MPD, I am suggesting that some of the same characteristics of that disorder are shared. One side of the personality protects the other side from the truth. Some level of dissociation is in every man who has a "double life". Each side of the personality has different values, goals, beliefs and needs that conflict with the other side.

This is why, when the sexual acting out is finished, the addict feels so distressed and shameful. Mr. Hyde does the acting out and Dr. Jekyll experiences the remorse.

When the addict is acting out, he has feelings of being disconnected from himself and his environment. Clients speak of "the bubble", the "erotic haze", "zoning out", and "feeling apart from myself and watching myself from afar ", of feeling "foggy" or "not feeling like a real person" Losing track of time is common as is feeling outside oneself as both an observer and a participant. Emotions are numbed; the fantasy creates an alternate reality which obscures the truth of "what is".

Once in therapy, a primary issue that arises is a feeling of a fragmented sense of self or being unsure of his identity. Therapy will help him get to the bottom of hidden parts of himself that he may not have fully understood or been able to control until treatment starts to work. Only by getting in touch with hidden parts of himself will the full realization of his talents and strengths be realized and fulfillment in his personal relationships can begin to unfold.

I don't see how our relationship can survive the emotional pain and chaos of his sexual addiction. Have other couples been able to work through these issues? How have they done it?

When at least one member of a couple is sexually addicted, restoring trust and building intimacy can be very difficult. These couples must work as hard on their recovery together as a couple as they do on their individual recoveries.

One of the great challenges to recovery from sexual compulsivity is restoring or building an intimate relationship with a committed partner. Many existing relationships are seriously impaired and often don't survive because of sexual acting out. The partner of the sex addict's ability to trust is obviously damaged. The psychodynamic and behavioral issues underlying sexual addiction contribute to obstacles to overcoming and building intimate and committed relationships.

The good news is that we have seen from our experience that not only is it possible to repair, rebuild, or newly build a committed relationship, but the level of emotional and physical intimacy that comes from working on these issues together is sustaining, gratifying and growth-producing for each member of the couple.

What is effective in the process of healing and building?

To fix a marriage that has been damaged by sexual addiction, the first step

is to discover what's been broken. The process of repair is a journey that both

partners must choose to undertake together, as well as separately. Self inventory is

an inescapable feature of the process. Studies of couples who have achieved success

have shown their willingness to ask themselves certain questions:

How committed am I to this relationship? Do I want to find out what a healthy sexual partnership is? Am I willing to take the risk of being truly vulnerable to my partner? Can I face my own interior issues to develop my own personal growth? A faithful, honest, monogamous sexual relationship with my partner is

this what I really want? Is this my goal?

A strong commitment to the marriage and a desire to learn and experience a healthy

sexual relationship with the spouse are essential for recovery. For clarity, two definitions

are helpful. The sex addict is the partner who has been engaging in compulsive

extramarital activities. The sexual co addict is the sex addict's partner, sometimes

identified as a relationship addict.

Next, the major "breaks" in the damaged marriage need to be identified. The first and

greatest casualty is invariably lost trust. The co- addict has feelings of anger as a result of being betrayed. The addict feels guilt and shame as a result of hurting and betraying the spouse. Re-establishing mutual trust must be actively addressed and worked on in treatment. Forgiveness and opening up to being vulnerable again are necessary ingredients for rebuilding lost trust.

Another "break" in a sex addiction-damaged marriage is the loss of honest communication. The addict has been hiding his acting out with compulsive sexual behaviors, so that deception has become a part of daily married life. The partner of the sex addict, on the other hand, has suspicions, yet avoids confronting the addict and hides her fears.

Self-blame, feeling responsible for the addict's secret sexual behaviors, and even blaming

herself for all of the marriage's problems are some typical reasons for not discussing their issues.

Thus, both partners keep themselves isolated in their emotions. Problems in their own

sexual relationship a central "break" to be fixed - are rooted in certain core beliefs

that they hold. The addict's main core belief is that sex is his most important need. The

partner of the sex addict's main core belief is that sex is the most important sign of love.

Two more "breaks" in the marriage can be traced to communication breakdown and loss

of trust. Neither spouse has effective conflict-resolution skills. Also, both of them have

difficulty setting boundaries on what sexual behaviors they can accept and where they

insist on drawing the line.

Be encouraged because there are a variety of places you can go. First, find a therapist conversant with these issues. Couples report that isolation is their number one enemy. Take the first bold step with your spouse to open up and talk with each other. Acknowledge there are problems and you both want to resolve them. Then look into the self-help available to you. There are 12- step programs for the sex addict and for the sexual codependent.. There are also 12- step programs for couples. All of these groups emulate the Alcoholics Anonymous model, which emphasizes the importance of peer support and identification with others who have gone through what you've gone through.

You need to break out of the burden of isolation you've placed on yourself due to feelings of guilt and shame. Bringing it into the open and sharingwith other sympathetic couples is invaluable. In couples counseling you'll discuss subjects that impact your relationships in major ways. Some of these are the renewal of trust, how to work on your communication skills for problem solving, and how to really listen to each other without disapproval.

Be open to understanding that you both will do well when you accept the need for

patience. Recovery, after all, is a process. Just as the problems you are experiencing

didn't evolve in ten minutes, keep in mind that healing requires a commitment of time.

Recovering couples stress this, and emphasize that they maintain a positive outlook

because they feel good along the way. They know they are empowering themselves

and learning self esteem.

Couples who have participated in therapy, plus 12 step programs for the addict, the partner of the addict, plus the couples' 12 step groups, have demonstrated a very good success rate.

There is one essential tool you can avail yourself of, and that is seeking treatment with a professional who specializes in sex addiction treatment. Joint professional counseling will enhance your personal recovery. Devoting yourselves to self-discovery together is a choice that will yield excellent results in time.

And remember this once you choose to take the journey, you will begin to experience

many rewards along the road. One of them is an ever increasing personal freedom in your

spirit. You will discover strengths you never knew you were capable of, and courage you

never knew you had. It is possible for you and your spouse to have a loving, intimate, sexual relationship despite having been through the trauma of active sex addiction.

How can couples counseling help us?

Most couples who come for couples therapy after discovery are in a high state of reactivity, with communication being limited to blame/defense. There is a high degree of projection (seeing the things you like least about yourself in your partner) and a small degree of self-focus. The tendency is to react immediately and emotionally, with no time given for reflective thinking. One task of the therapist is to create a safe, non-volatile space by gradually guiding each person to commit to self-focus which reduces blame and defense.

The therapist will do some psychoeducational pieces on sex addiction and co-addiction to normalize each person's feelings and further reduce blame. Nothing can be done about the quality of the marriage unless each person commits to a personal program of recovery: an "S" meeting for the addict, and COSA or S-Anon for the co-addict. The couple can come out of the shadow of shame about living with sex addiction through identifying with others who have gone through similar experiences. Here, finally, they find people they can talk to about what they've been hiding from family and friends. Regular attendance at meetings gives structure and accountability to the life of the sex addict. A co-addict who works on the steps with a trusted sponsor is renewing her commitment to focus on herself and her own issues, renouncing her focus and pre-occupation with the addict.

Sex addicts and sexual codependents usually have never experienced healthy bonding with and nurturing from their parents. This impairs their ability to have successful bonding and separation in subsequent relationships in adult life. The therapist might construct a "genogram" which is a graphic depiction of three generations of each person's family. It shows psychiatric and physical problems throughout the generations such as alcoholism, divorce, hospitalizations,etc. The genogram also reveals the quality of family relationships, indicating where there was enmeshment and where there was distancing. With a clear understanding of family-of-origin issues, the couple can understand themselves and each other and develop awareness of what triggers are coming from the past.

Couples counseling enables the couple to reach a point of mutual interdependence in which both partners have lives outside of the relationship, but also feel committed to it. The partners need each other, but are comfortable with independent lives of their own. Over time, each develops a new sense of "Self"-in relationship.

Couples counseling facilitates reaching this state of mutual interdependence. Both members of the relationship are encouraged to accept mutual responsibility for the dysfunction in the relationship. As long as one partner is blaming the other for all of their couple problems, progress will be slow. Recounting the history of the relationship will be a part of this process. How have each other's addictions and co-addictions affected the relationship? What consequences have been experienced? What strategies have the partners tried to heal themselves that haven't worked? What are the repetitive arguments and fights? What is the nature of the collective shame in the relationship? How does each partner trigger the other's issues?

Each person needs to acknowledge that they will repeat the mistakes of their previous relationships if they don't consider the dysfunctional characteristics each one brings from the past. Exploring psychodynamic wounds in each other will be a part of the process.

Each individual in the couple learns how to exchange instant gratification for the joy of ongoing intimacy. Sexual addict/codependents find that this intimacy and the trust, mutual understanding, and the emotional/spiritual/physical closeness it creates from having done the work can be qualities that few couples ever experience.

Dorothy C. Hayden, LCSW

www.sextreatment.com

dhayden@nyc.rr.com


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