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Counseling for Sexual Addictions
By Bonnie Mucklow, LPC, with
Westside Behavioral Care, Inc.
Is sexual addiction REALLY a bad behavior; or is it a set of behaviors
symptomatic of a psychological disease? Why do we hear and read more about
sexual addiction? How can I know and understand what sexual addiction is? How is
sexual addiction treated?
Sexual addictions are defined as a set of behaviors described as a
BioPsychoSocial Disease. Just as is true with the use of other drugs, alcohol,
work or shopping, sexual addictions distract us from painful emotions. These
painful emotions are based in our biology, our brain chemistry.
The set of behaviors defining sexual addiction create intensely negative,
distorted thoughts and feelings. Avoiding relationships with friends and family
and creating destructive, manipulative relationships with others completes the
social disease.
Sexual addicts engage in repetitive patterns of sexual behavior such as affairs,
compulsive use of pornography, internet cybersex or risk-taking sexual
behaviors. The behaviors are repetitive and compulsive, causing a loss of
control over sexual choices. They often interfere with work, family, social, and
emotional functioning. They increase in intensity and frequency despite negative
consequences.
Sexual addiction treatment starts with defining and diagnosing the problem.
Sexual addictions are frequently secretive behaviors causing a great deal of
shame and guilt, which may be hidden from others for years at a time. By the
time the problem comes to the attention of others, the behaviors are compulsive.
Help begins with being honest about the behavior and how it is harming the
individual and his or her relationships. Honest and open talk may begin with a
counselor, minister, doctor or friend; however, a trained counselor will address
the problem systematically and at a deep level so that a solution can be made.
In counseling, the first step of talking about, describing and defining the
sexual behaviors and their consequences to health, emotions and relationships
may occur over several outpatient interviews.
What is the nature of the sexual behavior? Who has it hurt? What have been the
consequences?
Outpatient therapists will also complete an assessment for co-occurring
disorders through the interview. Sexual addictions are sometimes co-occurring
disorders with alcohol and drug addiction, personality disorders, mood and
anxiety disorders. Referrals for psychiatric consultation play an important part
in addressing co-occurring disorders.
Social scientists suggest that huge cultural changes such as Internet access to
a wide variety of pornography and internet websites has increased the risk and
frequency of sexual addiction. Success has been shown with the use of cognitive
behavioral therapies, monitoring sexual behaviors and self-help support groups.
Cognitive Therapy is a research-based treatment proven effective initially for
depression, but also proven effective for a number of different psychiatric
disorders. The basic concept behind this theory is that it’s not the things that
happen to us that cause us to be depressed, anxious or angry but rather that our
negative, unrealistic and biased thinking causes us to be depressed or anxious
or angry about the situation.
Cognitive therapy looks at different components of a problem (external
stressors, biology, behavior and thinking) but focuses on thinking as the most
important element to target for change. The other components are not ignored and
are important, but because thought is the most important contributor to emotion,
thinking is the primary target for change. Therapy teaches individuals to
identify their automatic thoughts. They learn about thinking errors called
cognitive distortions. Individuals learn to challenge their troubling thoughts
and replace them with more adaptive, realistic, helpful thoughts.
Reading and written assignments are important practices in the therapy process.
Behaviors are discussed in therapy and analyzed for how to substitute
ineffective behavior with new, more positive behavior. For example, if a person
formerly “cruised” a certain neighborhood looking to engage in high risk sexual
behaviors, new driving routes are designed. Individuals may also develop a
different structure for where and how they spend their time.
Self-help groups are based on the twelve steps of Alcoholics Anonymous and
adapted to sexual addictions. It’s useful to meet with and receive support from
other persons also learning to change their addictions. Finally, sexual
addiction, like drug and alcohol addictions, require long-term monitoring and
management. Individuals make lifestyle changes. Lifestyle changes require the
slow test of time in order to maintain the change.
Internet Resources for Recovery from Sexual Addiction
http://www.christians-in-recovery.com
http://www.sca-recovery.org
http://www.saa-recovery.org
http://www.sexaddict.com
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