Saturday
Mar312012

PATHOS Screening for Sex Addiction

Here's another article I wrote for therapists in a local journal:

 

Many of us who work with alcoholics or addicts are familiar with the CAGE screening for alcoholism:

C: Have you ever felt you should CUT DOWN on your drinking?

A: Have people ANNOYED you by criticizing your drinking?

G: Have you ever felt bad or GUILTY about your drinking?

E: EYE OPENER: Have you ever had a drink first thing in the morning to steady your nerves or to get rid of a hangover?

In addition to the AUDIT and T-ACE screenings the CAGE test can be a quick way for us to find out if our clients might have a problematic dependency upon alcohol requiring further assessment.

What do we do, however, if our clients present with possible symptoms of a process addiction like sex addiction?  Patrick Carnes has developed a simple and useful screening for sex addiction.  If your clients are presenting with the following symptoms, it is likely that they require further assessment for the possilility of sexual compulsivity:

P: PREOCCUPIED – Do you find yourself preoccupied with sexual thoughts?

A: ASHAMED – Do you hide some of your sexual behavior from others?

T: TREATMENT – Have you ever sought help for sexual behavior you didn’t like?

H: HURT OTHERS – Has anyone been hurt emotionally because of your sexual behavior?

O: OUT OF CONTROL – Do you feel controlled by your sexual desire?

S: SAD – When you have sex, do you feel depressed afterwards?

If you have clients presenting with these symptoms it is important to take the symptoms seriously.  Many sex addicts will not voluntarily disclose about their addiction, even to their therapist, until they are discovered by a partner or spouse.  When this happens, the consequences can be devastating for the individual, his or her relationships, and his or her community.  My hope is that you can use this simple assessment to bring healing to your clients before they experience the devastating consequences that result from sex addiction.

Saturday
Mar102012

Female Partners of Sex Addicts: It's Not Her Fault!

Here is an article I recently wrote for therapists in a local journal:

Sex is everywhere in our culture.  From billboards, to iPhones, to gossip with friends, we as a society are becoming sexualized at increasingly younger ages.  Most of us are able to navigate these sexualized waters with few problems.  However, there is a growing percentage of Americans that cannot.  Whether through childhood trauma, abuse, or an inability to cope with emotions or intimate relationships, these individuals become ensnared in the shameful web of sex addiction.

Our society is beginning to recognize sex addiction as a legitimate diagnosis. In much the same way that an individual can become addicted to alcohol or other chemicals, he or she can similarly become addicted to the dopaminergic high of chemicals released during sexual activity.

There are many resources available for sex addicts: 12-step fellowships, individual and group therapy, and residential treatment to name a few.  But what about resources for partners of sex addicts? In the rush to provide effective treatment to addicts, what healing is available for their partners? Why is there such a plethora of good books and 12-step programs for sex addicts and such a dearth of books and resources for partners? We turn our focus to treating the addict and too easily neglect the traumatized partner. Worse yet, we attempt to find answers for the addict’s behavior in the behavior of his/her partner.

We are trained to think systemically, and it is tempting to do so in families impacted by sex addiction. We attempt to find elements of the partner’s behavior that might have contributed to the addictive system. However, in doing so, we forget the profound compartmentalization, deception, well-hidden shadow side, and even psychological manipulation that a sex addict utilizes in order to preserve his addiction. Most partners report that they had no idea the nature or extent of their husband or partner’s sexual behaviors outside the relationship.

I am not suggesting that there are not components of the partner’s behavior that could be seen as "co-dependent" or otherwise leading the partner into a relationship with an addict. In some cases, these behaviors could be part of the picture.  What I am saying is that we cannot afford to perpetuate gender-based violence where we attribute the unfaithfulness of a sex addict to some defect in his partner. Certainly partners can be men as well as women, gay as well as straight. However, since it is male sex addicts and female partners that typically present for treatment, I believe there is an extra historical and socio-political dimension that occurs when the sex addict is a man and the partner is a woman.

History is replete with examples of men being excused for sexual behaviors outside their committed relationships, with the responsibility of such behaviors being placed on some inadequacy in his partner. If only she were more available sexually, if only she hadn’t put on weight after having children, if only she were __________. As Judith Herman (1997, p.116) writes in Trauma and Recovery, "The search for characteristics of women that contribute to their own victimization is futile . . . It is sometimes forgotten that men’s violence is men’s behavior. As such, it is not surprising that the more fruitful efforts to explain this behavior have focused on male characteristics. What is surprising is the enormous effort to explain male behavior by examining characteristics of women." Herman writes more globally about violence towards women, but I believe her point also applies to the trauma a partner experiences as a result of discovering her husband or partner’s sex addiction. We need to look at the characteristics of the addict, not the partner, to understand the partner and family so they can heal.

As a therapist I'm passionate about helping men achieve sobriety from sex addiction, their partners heal from the incredible shattering that sex addiction brings to their lives, and their relationships to be birthed again with intimacy, honesty, and integrity.  Furthermore, as a man I am passionate about empowering women who have experienced the traumatic betrayal of sex addiction to heal and to know that their partner's sex addiction has many traceable roots, none of which are her fault.

 

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