Sunday, September 4, 2011

Sex Addicts Are True Addicts, and Addiction Is Often a Trauma Response

Sex addiction has been a hot topic in the last year or two - it seems to be the go-to answer when a man gets caught sleeping around. Tiger Woods was said to be diagnosed with sex addiction, as was David Duchovny, as well as Governor Mark Sanford (SC), former-president Bill Clinton (according to former-president Gerald Ford), former Mets GM and now-fired ESPN baseball analyst Steve Phillips, and nearly anyone else who gets caught having affairs (or in other "unseemly" predicaments).

But sex addiction is not about having affairs or a lot of sex - it's about compulsive sex that often loses its excitement and pleasure. It's about masturbating so much that the penis gets raw, or having unsafe anonymous sex in adult arcades, or risking arrest to expose oneself to passers by, waiting for hours outside a house for brief glimpse of a woman undressing.

And it's about lying to oneself about how out of control one's life has become, about all the money wasted, the jobs lost, the family that left - it's about a huge pile of lies told to others and told to oneself.

Sex addicts - like most other addicts - believe their lies and rationalizations, a trait referred to as sincere delusion. Part of the delusion is often blaming others for his actions:
The addict’s blame of others for all problems is another way to protect his secret life. Fault lies with spouse, children, parents, work associates, or boss. The addict is self-righteous, critical, and judgmental. There is no acceptance of personal responsibility for mistakes, failures, or actions. This appearance of integrity further insulates the addict’s world from reality. The blame dynamic provides further justification for the addict’s behavior.

[Carnes, P., Out of the Shadows, 2009, Kindle Locations 453-456]
As pioneer sex addiction researcher Patrick Carnes has made clear in his many books (Out of the Shadows: Understanding Sex Addiction, 3rd Edition, 2001, is probably the best introduction), sex addiction, like all other addictions (sex, like gambling, is often considered a process addiction rather than a substance addiction), is generally a response to developmental damage in the child, who is neglected, abused, molested, raped, or otherwise exposed to violence and/or sexuality at a young age. The result is a brain that is wired differently, a brain prone to seeking ways to escape, to numb the psychological pain.

Carnes identifies four primary areas in development that get hijacked and become unhealthy core beliefs, leading to addictive behavior.
There are four factors in a child’s development that ultimately become part of the sexual addiction:

1. self-image—how children perceive themselves

2. relationships—how children perceive their relationships with others

3. needs—how children perceive their own needs

4. sexuality—how children perceive their own sexual feelings and needs

These perceptions ultimately become “core beliefs” central to the addictive system. They are conclusions that can govern choices and behaviors during the child’s adult life.

[Carnes, 2009, Out of the Shadows, Kindle Locations 1432-1437]
In the addict, each of these areas develops into an unhealthy core belief. In examining how these beliefs comes about, Carnes offers a series of examples, including a man named Morris. Here is a brief summary of this man's childhood:
First, there is alcoholism in the family. Second, physical and emotional abuse accompany sexual abuse. Third, sexual experience is both humiliating and comforting. And fourth, the reality of the child is denied when the child’s accounts of abuse are not taken seriously. All of these are potent contributors to the addiction, as we shall see. 

By far the most important factor, however, is a sense of having been abandoned. From a child’s point of view, “you can abuse me, humiliate me, exploit me, and even not believe me, but by far the worst is if you don’t even want me.” Fear of abandonment is a constant theme in all addictions, including alcoholism. Within the sexual addiction, it is especially powerful.

[Carnes, 1454-1459]
Abandonment, in some form or another, whether literal, emotional, physical, or otherwise, is a foundational wound for addicts, but especially for sex addicts.
The sexual addiction receives its power from a fundamental concern for survival.

The first core belief of the addict is “I am basically a bad, unworthy person.” Abandonment means being unwanted. The child can only conclude that being unwanted means being unworthy and bad.

[Carnes, Kindle Locations 1467-1469]
Abandonment does take many forms, and aside from the versions mentioned above, attachment psychology recognizes poor attachment as a form of abandonment, especially the absence of "mirroring" for the infant as a way to develop affect regulation (see Allan Schore). Schore refers to this as relational trauma, and the results includes inability to regulate affect (thus the 4th core belief in some form another as shown below), a sense of worthlessness, feeling fundamentally flawed, and a variety of other issues, mostly stemming from the right brain's emotional centers.

Here are the other three core beliefs and how they play out:
A second core belief comes from the first core belief about the child being a bad person. Because of personal unworthiness, the child believes, “No one would love me as I am.” Relationships with others become more tenuous the deeper this belief is. Children grow up believing that no one will accept them unconditionally. People will not be there; they cannot be trusted or depended on. If they do want a relationship, it is because they want something—not because they care. There will always be a price to pay. Minimally, there will be something that must be overlooked, ignored, or denied. To be close will mean to lose reality or integrity somehow. So intimacy is avoided.

[Carnes, 1483-1488]

[I]n the lonely search for something or someone to depend on—which has already excluded parents—a child can start to find those things which always comfort, which always feel good, which always are there, and which always do what they promise. For some, alcohol and drugs are the answer. For others it is food. And there is always sex, which usually costs nothing and nobody else can regulate.

This choice stems from the addict’s third core belief that is about needs: “My needs are never going to be met if I have to depend upon others.” In healthy families, children have a deep sense that their parents care for them as opposed to abandoning them.

Healthy parenting includes touching, loving, affirming, and guiding. The child feels cared for even when struggling with rules and limits. Trust in one’s self, as well as trust of others, emerges in that relationship.

When a child’s exploration of sexuality goes beyond discovery to routine self-comforting because of the lack of human care, there is potential for addiction. Sex becomes confused with comforting and nurturing. Moreover, the assumption is made that everyone else feels and acts the same. Therefore, to feel secure means to be sexual.

Consequently, the child’s relationships with people have the potential for being replaced with an addictive relationship with sexuality. Addiction is a relationship—a pathological relationship in which sexual obsession replaces people. And it can start very early. The final core belief of the addict emerges clearly: “Sex is my most important need.”

The kinds of childhood situations described here are further complicated when the children are surrounded by negative rules, messages, and judgments about sex. When addicts and their spouses study their families of origin, they are flooded with memories of events where they were told that being sexual was bad or, worse, that they were bad for being sexual.

When children’s primary source of comfort is sex and yet they are told by those whose judgments count the most that to be sexual is perverse, the conclusions they make about themselves are clear. They are unlikable. They need to hide that central part of themselves, which others will despise. Rather than repressing the sexual behaviors, they hide them or keep them secret. Needing to keep that central part of themselves secret adds to the pain and loneliness—which, in turn, creates a need for comfort, making the sexual fix that much more necessary.

[Carnes, 1494-1512]
In summary, here are the four core beliefs held by most sex addicts in one form or another (and if you substitute something else for sex in the fourth one, like cocaine, heroin, or food, these may apply to all addicts).
  1. I am basically a bad, unworthy person
  2. No one would love me as I am
  3. My needs are never going to be met if I have to depend upon others
  4. Sex is my most important need
These core beliefs were the foundation of the child's life as he grew up (can also be a she) become the axis of the addict's adult life - with each belief adding to the disconnect between the addict's interiority (the "world the addict experiences, with its pain and shame") and the addict's exterior persona or image that is projected to protect his secret and keep his inner life hidden. 

To cope with this disconnect, to cope with the belief that "I am a bad, unworthy person," some addicts feel that any degradation or humiliation that comes their way is justified - it reinforces their sense of failure and inadequacy.

Other addicts develop a grandiose or detached  persona (mask) that they show to the world hide their foundational guilt and shame.
Addicts create a front of “normalcy” to hide their sense of inadequacy. They may even appear grandiose and full of exaggerated self-importance. The front contrasts with actions that appear degrading or self-defeating or both. Others see decisions or behaviors as irrational, unfathomable, or even self-destructive, but not “normal.” 
Close friends and family members become angry and frustrated with the addict’s egocentric quality, especially when there is insensitivity to others. They are troubled at what looks like destructive or curious behavior that does not fit the image the addict projects. 
The belief “No one would love me as I am” also sustains the secret world. Addicts continue to believe that everyone would abandon them if the truth were known. Consequently, they have a constant fear of being vulnerable or dependent on others.

[Carnes, 1568-1574]
A lot of sexual addicts proclaim extreme sexual propriety, or in some circles, "postconventional moral development" - the results of this can be moral self-righteousness around sexual activity, with those who call them on their behavior being dismissed as morally underdeveloped or morally rigid.
Cover-ups, lies, and deceptions are made to conceal personal sexual behavior. The addict’s protestations of high sexual morality are like a smoke screen, obscuring the impact of sexual obsession. Friends and family tend to reject suspicions of sexual compulsivity because of the addict’s “values.” However, as evidence of powerless behavior and unmanageability mounts, these persons are confused because they do not know what to believe. In addition, they do not wish to intervene in something so personal.

[Carnes, 1604-1607]
As this quote shows, people around the addict often dismiss accusations around the addict because they do not match their experience of the addict's professed morality in the sexual realm. Those who are closest to the addict risk becoming co-addicts, according to Carnes:
By definition, the addict replaces normal human relationships with sexual compulsiveness. Loved ones feel the loss, try to deny it, and become angry, feeling despair and sometimes hope. The coaddicts’ efforts to restore the relationship are not only ineffective, they can intensify and deepen the addictive system for the addict. To compound the tragedy, coaddicts will take actions which are self-destructive, degrading, or even profound violations of their own values. Family members, as coaddicts, become part of the problem. Hence, the prefix co-.

[Carnes, 1640-1644]
Finally, I want to conclude with the basic addiction cycle as experienced by sex addicts and defined by Carnes:

For sexual addicts an addictive experience progresses through a four-step cycle that intensifies with each repetition: 

1. Preoccupation—the trance or mood wherein the addicts’ minds are completely engrossed with thoughts of sex. This mental state creates an obsessive search for sexual stimulation. 

2. Ritualization—the addicts’ own special routines that lead up to the sexual behavior. The ritual intensifies the preoccupation, adding arousal and excitement.

3. Compulsive sexual behavior—the actual sexual act, which is the end goal of the preoccupation and ritualization. Sexual addicts are unable to control or stop this behavior. 

4. Despair—the feeling of utter hopelessness addicts have about their behavior and their powerlessness. 

The pain the addicts feel at the end of the cycle can be numbed or obscured by sexual preoccupation that reengages the addiction cycle.

[Carnes, 462-470]
There's also a process called sexual anorexia that can occur after the despair stage, where the shame is so strong that the addict is able to deny himself sex for an extended period of time. This can also backfire in that the addict will say, "I can quit whenever I want." Shame-based deprivation is not the same as being able to quit.

Please keep all of this mind in the coming days as I post some news over at Integral Options Cafe.


Mark said...

I hope all of this is not a preface for "compassionate" defense of the absurd, ongoing parade of sex scandals among Wilber's approved gurus.

A diagnosis of addiction, or an attitude of compassion, doesn't change the fact that they should be held accountable for their actions. In particular, they shouldn't be permitted to teach, especially with LGAT techniques that compromise the students' capacity for maintaining boundaries and critical thought.

If you permit unreconstructed sex addicts to escape legal accountability for their actions, cover up their history, and then rake in money for teaching others about the "sexual shadow," your institution will get the exactly the reputation it deserves.

WH said...

If you have been reading my blogs for any length of time, you will know that I have been the ONLY voice in the integral world demanding that those you refer to not be allowed to teach - ever.

That has not changed and will not change.

My perspective is that no one really GETS, aside from the victims, how truly messed up these men are. A little education can go a long way toward demonstrating that this is not something that gets "fixed" in a couple of sessions with an amateur - you need years of work with someone educated in how to deal with sex addicts.

These people can be some of the slickest and most narcissistic offenders around - many are very bright. They can often talk and manipulate their way out of trouble, as has happened in the integral world.

GD said...

This is very important information William, thank you for sharing. The cycle of addiction is a difficult thing to recognise and those affected suffer in ways that are impossible to imagine. The co-addicted partners also find themselves in an extremely difficult situation, and the solutions are not easily come to at all.

Applied to any type of addiction this posting points to the insight development needed for understanding and acknowledgement to arise. Addressing such material is not often enough encouraged and supported - and those who need the help the most are often vilified by uneducated critics rather than directed to effective remediation.

Thank you for your research and commitment to the psychological well being of the community.

Drake said...

When it comes to the issue of sex addiction, even the psychotherapy community is baffled by various aspects that revolve around such behavior.

With a multitude of high-profile cases of such, did someone advice them to come into rehab so that they receive sympathy and be spares from the harsh criticisms of the public or are they just really sex addicts who need compassion, and professional help? We may have differing opinions but I am sure everyone will agree that accountability for such is imperative.