Not Getting Clean: It’s A Killer

  • May 3, 2013 12:15 pm

In his recent book Clean, author David Sheff writes about addiction treatment and why it fails to help so many addicts. The idea for the book came out of his struggles helping his son with his addiction, which led to further research on the state of addiction treatment in the U.S. In a recent article on Time.com, he started his article by stating that:

“Every year in the U.S., 120,000 people die of addiction. That’s 350 a day.”

He goes on to write that “A growing body of evidence has proved that addiction isn’t a choice subject to willpower but a brain disease that’s chronic, progressive and often fatal.” He then writes that in spite of this, there are a shocking number of treatment programs which do not use techniques that are based on research on effectiveness. He writes that it is crucial that people need to find and utilize these programs which “use therapies that have proved effective in clinical trials, including cognitive-behavioral therapy designed to train addicts to recognize and interrupt the cues that trigger the relapse mechanism; motivational interviewing, a therapy approach widely used to treat many psychological disorders that helps addicts engage in treatment; contingency management, which essentially rewards addicts for clean time; and psychopharmacology.” These treatment programs can also include “alternative” therapies that have been proven effective, such as meditation, acupuncture, and animal-assisted therapy.

Importantly, he goes on to say that “most researchers agree that no single therapy is appropriate for every addict. Often they’re used in concert. An effective treatment regimen may include AA, but only for those patients who are open to it.”

One of the most important points that he makes is about how unregulated rehabilitation is, and how widely the programs vary.  He writes:

Currently there’s a chasm between these and other evidence-based treatments (EBTs) and rehab programs. Every day addicts fall into it, and many never make it out. Most people in need find themselves in the same frustrating position I was in when I was desperate and overwhelmed, shopping for programs and doing the best I could to navigate an unnavigable system that’s also largely unregulated. In many states, anyone can open a rehab program — no licenses or accreditation are required.

This is slowly changing. More people are being educated about the fact that addiction is a disease and therefore requires treatments based on the medical model. The more consumers are educated and demand EBT, the more the billion-dollar rehab industry will adapt and offer it. That is, the industry will adapt or it will die and be replaced. In the meantime, those who need treatment must do the best they can to find programs that offer EBT. The place to start is by receiving an assessment from a psychologist or psychiatrist who is trained in addiction medicine. … A competent doctor can determine the severity of addiction and the presence or lack of co-occurring psychological disorders and prescribe the next step. It may include a brief intervention, therapy, psychopharmacology, an inpatient or outpatient program that offers quality care or a combination of these things.

Sheff’s points are crucial and a matter of life or death for many. For some addiction programs, even “certifications” are simply designed by people who had theories rather than based on research and/or outcome studies. His plea for standard of care for addiction is critical – for the health and well-being, and even life or death, of so many.

Samantha Smithstein, PsyD

(Re)Defining Justice

  • April 13, 2013 10:48 am

Restorative Justice is a process to involve, to the extent possible, those who have a stake in a specific offense and to collectively identify and address harms, needs, and obligations, in order to heal and put things as right as possible.”

– Howard Zehr, 1990

Restorative (or Reparative) Justice is based on the Native American principle that criminal behaviors are offenses against human relationships and that after these behaviors are committed, there are both dangers and opportunities:

  • The danger is that everyone emerges further alienated, more damaged, disrespected, disempowered, feeling less safe and less cooperative.
  • The opportunity is that injustice is recognized, equality is restored and the future is clarified. So that participants are safer, more respectful, and more empowered and cooperative with each other and society.

Restorative justice is a process designed to try to “make things as right as possible” for everyone involved.  That includes: repairing what has been broken, making society safer, attending to needs related to the behavior, and making amends.

Traditional criminal justice seeks answers to three questions: What laws have been broken? Who did it? and What do the offender(s) deserve? Restorative justice instead asks: Who has been harmed? What are their needs? Whose obligations are these?

Restorative Justice can take place in a diversity of settings, including neighborhood courts, schools, therapy groups, and nations. The 12-step community has also attempted to address the need for restoration through steps 8 and 9: making a list of the persons harmed and making direct amends to such people whenever possible. Making amends is different from an apology – one is simply an acknowledgement and expression of regret, whereas the other attempts to create restoration. Sometimes people also talk about “living” amends, which has to do with choosing to live differently so as to not create more harm.

Restorative Justice, or making amends, doesn’t require forgiveness. Forgiveness is a step that the victim(s) may or may not be able or willing to choose. Instead, Restorative Justice seeks to restore and heal, so that everyone may move forward less broken, and more whole.

Samantha Smithstein, Psy.D.

Is Sexual Addiction a Real Addiction?

  • March 16, 2013 8:31 am

By M. Deborah Corley, PhD, LMFT, LCDC, LSOTP, CSAT, CMAT
Co-owner/founder of Santé Center for Healing (www.santecenter.com)

The acceptability of a vast range of sexual behaviors in the United States reflects our changing society in which every form of expression of sexual behavior is available to anyone with access to the Internet. But even those who do not use the Internet for viewing sexual materials, engaging in sexual conversations, or arranging meetings for sexual purposes, anyone who has access to mainstream media has been exposed to explicit coverage of sexual behaviors in the news or in prime time television and movies. Strip clubs have moved from the backroom into multimillion dollar establishments and are available in every state in the union. However, engaging in one or several of these types of behaviors does not make someone a sex addict. Sexual addiction like any addiction – it is not so much about the type or amount of behavior, but about the impact the behavior has on someone’s life. For people who are finding it hard to control their sexual impulses, many fear they are sex addicts but are not sure if it is a real addiction or what to do about it.

Although it was in 1980 that a very famous researcher and clinician from Johns Hopkin University, Dr. John Money, proposed that sex addiction existed, it was later in the early 1980’s that Dr. Patrick Carnes really began the conversation about whether sex addiction was a disorder or not. Sex addiction has been used synonymously with sexual compulsivity, sexual dependency, and excessive sexual desire and hypersexual disorder and the discussions about the definition have been ongoing for the past thirty years. In the past year, the American Society of Addiction Medicine (ASAM) took the lead in the debate about whether sexual addiction is really an addiction. ASAM set about to define addiction with a focus on what happens in the brain for an addict and they included what mental health professionals refer to as process or behavioral addictions like sex, gambling, and Internet use.

ASAM defines addiction as a primary, chronic disease of brain reward, motivation, memory and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social and spiritual manifestations. This is reflected in an individual pathologically pursuing reward and/or relief by substance use and other behaviors. Addiction is characterized by an inability to consistently abstain, impairment in behavioral control, and craving, diminished recognition of significant problems with one’s behaviors and interpersonal relationships, and a dysfunctional emotional response. Without treatment or engagement in recovery activities, addiction is progressive and can result in disability or premature death. (ASAM, 2012)

The criteria most recently proposed for the DSM-V (Diagnostic and Statistical Manual, sort of the psychiatrist’s encyclopedia of mental health disorders) contains aspects of the criteria mental health professionals have been using for some time now in addiction treatment center sand private practices all over the United States. Basically, criteria requires the behavior must be occurring over a period of at least six months – so it is not about just an affair or two, or two weeks of looking at pornography on the Internet. There is a persistent and pervasive pattern of behavior in which a person is not able to control their sexual fantasies, urges, and/or behaviors despite negative consequences to self or others. The person spends excessive amounts of time seeking or engaging or recovering from the sexual activity and generally uses the behavior as away to cope with anxiety, depression, or emotionally distressing situations. And the behavior can’t be the result of drug use or another medical condition like a brain injury. (APA, 2010)

Most people report that the behavior started in adolescence. Women sex and love addicts report more sexual abuse as children than do men but more men have the disorder than women.In a recent study of women sex and love addicts, exposure to pornography as a child was the greatest predictor of sexual addiction, even more than sexual abuse. The most common behaviors reported in studies of sexual addicts includes masturbation with the use of pornography, followed by sex with a consenting adult, and then cybersex activities on the Internet.

Studies done in the recent past have identified how both women and men put themselves and others in harm’s way. Women sex addicts also tend to stay in relationships after they become abusive as compared to other women. Women sex and love addicts report higher numbers of unplanned pregnancies, terminated pregnancies, depression, suicide attempts, and infertility problems than do non-addicted women. Both women and men report an average of 15 different sex partners in a year, unprotected sexual encounters, and higher rates of sexually transmitted infections than non-addict groups so in many ways sex addiction is also a public health problem. Other behaviors often reported by sex addicts that have caused a variety of negative consequences includes use of prostitutes, multiple affairs, viewing pornography on Internet at work, having sex with employees, and heterosexual men having sex with other men.

The good news is that sexual addiction can be treated. There are several screening tests that can be used to help identify people that meet the criteria for sexual addiction (see list at end of article.) People in the early stages of the disorder have had success by attending 12-step meetings for sex addicts or group therapy specifically for sexual addiction. (Individual therapy can be very helpful however, group therapy lets an addict be with peers who are dealing with the same issues and thereby has access to others who can be supportive as well as hold the addict accountable for his or her actions.) When people have combined other addictive behavior like alcohol or other drug use with sexual addiction or have had the disorder for a long time and have a long history of secret keeping or trying without success to stop, more intense therapy is often needed like that offered in intensive outpatient programs or in a residential setting where a safe environment helps the addict have enough time in therapy, support, and accountability to learn other ways to manage emotional distress and life’s challenges.

Some behaviors that have severe negative consequences include illegal behaviors. Sexual offenses are beyond the scope of this article, but the addiction model has also been found useful for those who have engaged in sexual offending behaviors. Family therapy is an important component to any addiction treatment. Family members, especially spouses/partners have been betrayed by the addict through his/her behavior. Support of a family member can be significant in an addict’s path to recovery. Yet being supportive when a person has been betrayed is difficult, so everyone in the addict’s immediate support system needs a chance to heal and learn to respond in a healthy way to the addict’s behaviors. Therapy and mutual help groups are also beneficial for family members.

Sexual addiction is a complicated disorder that deserves additional research to clarify
who is most at risk and the most effective treatments. This will take time. As we learn more, it is
important to see that people who suffer from this disorder get the help that is needed. If you have questions about sexual addiction, the Pathways Institute would be happy to answer them for you. Additionally, SASH (Society for the Advancement of Sexual Health) is a national organization devoted to helping sexual addicts and their families find help (www.sash.net). For other assessment, treatment information, referrals, or copies of recent research articles, you can contact www.santecenter.com.

Screening tests:
Sexual Compulsivity Scale (Kalichman & Rompe, 1995. Available at www.santecenter.com)
W-Sexual Addict Screening Test (www.sexhelp.com) (for women)
Hypersexual Behavior Inventory (RReid@mednet.ucla.edu)
Internet Sex Screening Test (Delmonico@duq.edu)

M. Deborah Corley, PhD, LMFT, LCDC, LSOTP, CSAT, CMAT is co-founder and co-owner of Santé Center for Healing, a residential treatment center for addictions near Denton, Texas. She serves as clinical consultant to the Santé treatment team. She won the 2008 Merit Award from Society of the Advancement for Sexual Health (SASH), the 1999 Carnes Award for outstanding achievement in the field of sex addiction and was the co-recipient with Dr. Schneider of the Clinician’s Most Valuable Article Award by the American Foundation for Addiction Research in 2003 for their work on disclosure. She is the past president of the Board for SASH and a clinical member of the American Association of Marriage and Family Therapists. Licensed both as an addiction treatment specialist and marriage and family therapist, Deb has over 30 years of experience working with and conducting research on addictive disorders and high risk families. As an international speaker in the US and Canada, her focus on treatment of addictions, trauma resolution, disclosure, interpersonal neurobiology and meeting attachment needs is well received. In addition to Disclosing Secrets and Surviving Disclosure, she is co-author of Making Advances: A Comprehensive Guide to Treatment of Female Sex and Love Addicts.

References:
Corley, M. D., & Delmonico, D. (2011). Closing the gap: Results from the women’s sexuality
survey on female sex and love addicts. Presentation at Society for the Advancement of
Sexual Health Conference, LaJolla, CA.
Corley, M. D. & Hook, J. N. (2012). Women, female sex and love addicts, and use of the
Internet. Sexual Addiction and Compulsivity, 19, 53-76.
Corley, M.D. & Schneider, J.P. (2012). Disclosing secrets: An addicts guide to when, to whom,
and how to much to reveal. Tucson, AZ: Recovery Resources Press. Available at
www.amazon.com.
Langstrom, N. & Hanson, R. (2006). High rates of sexual behavior in the general population:
Correlates and predictors. Archives of Sexual Behavior, 35, 37-52.
Reid, R., Carpenter, B. & Lloyd, T. (2009). Assessing psychological symptom patterns of
patients seeking help for hypersexual behavior. Sexual and Relationship Therapy, 24, 47-
63.
Reid, R. et al. (2012). Report of findings in a DSM-5 trial for hypersexual disorder. Journal of
Sexual Medicine,
Reid, R., Garos, S., & Carpenter, B. N. (2011). Reliability, validity, and psychometric
development of the hypersexual behavior inventory in an outpatient sample of men.
Journal of Sexual Addiction and Compulsivity, 18(1), 30-51.
Schneider, J. P. & Corley, M. D. (2012). Surviving disclosure: A part

This is your brain on dope(amine)

  • January 25, 2013 11:32 am

Dopamine is a neurotransmitter responsible for movement, pleasure, motivation, and cognitive processes, such as learning. For the purposes of understanding its role in addiction, let’s concentrate on pleasure and motivation.

Whenever we do something that propagates the advancement of our species, dopamine is released in order to motivate repetition of the action. When we sleep, eat, and have sex dopamine is released in our brain and the message is, “That was great, do it again!” We also release dopamine whenever we find something pleasurable. Be it 18th century poetry, heroin, or Radiohead, our brain will release dopamine to encode the stimulus as something that brings us pleasure.

Dopamine not only serves to categorize the good things we encounter in life, it also programs our pre-frontal cortex (the part of the brain involved in judgement and decision making) to alert us when the pleasurable stimulus is available. If your brain cells could talk, it might sound something like, “OMG! There’s a flyer on that lamppost for a Radiohead concert. Go look at it!” In other words, we become hyperaware of opportunities for engaging in behaviors that bring us pleasure. In fact, a study on people with alcoholism found they were more likely to spot alcoholic beverages in a busy photograph than people who don’t have problems with alcohol.

When we consume substances, it makes us feel good because our brains release dopamine, but drugs elicit a higher amount of dopamine release than is necessary. This is part of what causes experiences of euphoria and feeling high. Sometimes the amount of dopamine released is so great, the chemicals in our brain become unbalanced and we may experience hangover or withdrawal. In time, our brain regains chemical equilibrium. However, if one abuses substances, the brain may develop a tolerance (meaning the person needs to use greater amounts to get high) or dependence on the substance as a source of dopamine. If one becomes dependent on a drug, it may take some time for the brain to regain equilibrium and the person may experience extreme physical discomfort and emotional distress when they aren’t using. The period of re-calibration depends on the amount, type, and frequency of the drug used. For this reason, it’s always a good idea to be under medical supervision and receive support from friends, family, and a mental health professional if you’re dependent on a drug and want to stop or decrease your use.

The mechanism of tolerance is also evident in impulse control disorders, such as sex addiction, kleptomania, and compulsive gambling. Although it doesn’t appear that persons with an impulse control disorder undergo the same intensity of withdrawal that persons addicted to substances experience, there can certainly be a period of re-calibration of dopamine receptors during which a person feels irritable and agitated after stopping a behavior.

Based on the information presented here, we can conclude that we are all hard-wired to potentially become addicts and you may be asking yourself, “If this is true, why do some people become addicted and others don’t?” This is a really good question and the answer is “We don’t really know.” We can predict the likelihood of someone becoming an addict based on factors such as first age of substance use and family history of addiction, and we know that a lack of social support and coping strategies (especially when coupled with mental illness) can also lead to addiction, but there is no conclusive answer to date.

The best ways to prevent addiction are to educate yourself about the substances you use (or to abstain from substance use altogether) and to be mindful about the choices you make. If you have a mental illness, ensuring that you are getting appropriate treatment and maintaining social support are good preventative measures.

Jennifer Fernandez, PhD

We Admitted We Were Powerless

  • December 3, 2012 4:13 pm

The very first step of every 12-Step program begins with these words – an admission of powerlessness. For many people, that very first step makes participation in a 12-Step program very difficult and with good reason: powerlessness is an uncomfortable feeling and not one that most people seek out or admit to.

In fact, most of us spend a great deal of energy, time, and effort attempting to try to control things and other people in our lives. We work hard to try to create a life of happiness, as we should. However, these efforts often involve trying to gain control over something we don’t have control of, like an addiction. Other times, the efforts involve trying to change or control other people who are in our lives. And understandably, because the people in our lives – their choices and behaviors – affect us; sometimes profoundly.

But when we stop and look at how effective our efforts are to bend others’ actions to our will – when we really examine how well our efforts to control things go – we find that, in fact, we cannot figure out a way to make others be or do what we want. We discover that using all of our efforts to control someone so they don’t cause us pain doesn’t, in fact, protect us. As the program of Alanon says: we don’t cause the behavior of others, we can’t control it, and we can’t “fix” it. Trying to do so simply makes our life feel unmanageable and increases our unhappiness.

Acknowledging that we are powerless is not about acknowledging that we are weak. Instead it acknowledges what is true, and allows us to focus on the things that we can control and the person who we can help: ourselves. Acknowledging the ways we are powerless also allows us to be more accepting of others, and to find a more peaceful way of being in the world and in relationships.

Security is mostly a superstition. It does not exist in nature, nor do the children of men as a whole experience it. Avoiding danger is no safer in the long run than outright exposure. Life is either a daring adventure, or nothing. Helen Keller

Enjoy Your Life

  • September 1, 2012 8:51 am
Sometimes change is simple, even if it’s not easy

Enjoy your life and be happy. Being happy is of the utmost importance. Success in anything is through happiness. More support of nature comes from being happy. Under all circumstances be happy, even if you have to force it a bit to change some long standing habits.

Just think of any negativity that comes at you as a raindrop falling into the ocean of your bliss. You may not always have an ocean of bliss, but think that way anyway and it will help it come. Doubting is not blissful and does not create happiness. Be happy, healthy and let all that love flow through your heart.

— Maharishi Mahesh Yogi

 

To many, this quote by Maharishi Mahesh Yogi may seem trite, or overly simplistic. And indeed, there are times when we need more than this to create happiness—we may to make changes in our lives or our behaviors, we may need insight and/or healing. We may need transformation through meditation, psychotherapy, or relationship before we can apply new ways of thinking effectively.

However, there is a basic truth to the above quote, as evidenced by Cognitive Behavioral Therapy (CBT); a psychotherapeutic approach that addresses dysfunctional emotions, behaviors, and cognitions through a goal-oriented, systemic process. It is also evidenced through programs such as the 12-Step programs, which helps its members transform, in part, through addressing habits of thought. Programs such as this address a basic truth in the same way Maharishi does: habits of thought create an experience in life, and sometimes we have to consciously change those habits in order to create a different experience, one of happiness.

Addiction or Excuse?

  • September 1, 2012 8:47 am
Public shaming is counterproductive and simply wrong.

Whether it’s food, alcohol, or sex, there are a number of people who react strongly to hearing that someone has engaged in self-destructive behaviors because they are an addict by saying, “Don’t use addiction as an excuse for your behavior! Take responsibility!”

This concept of an “addiction excuse” is relatively new, and while it captures the imagination of those who are hurt, angry, or frustrated by the behavior of an addict, or by someone who lacks basic understanding of addiction, it simply doesn’t hold water for people who are addicts or those who work with people who struggle with addiction. People who speak about addiction as a “convenient excuse for bad behavior” or a “way to not take responsibility,” don’t comprehend what addiction is, and what the experience is like for the person who struggles with it.

Addiction is a psychological and physiological disorder. Even for “process addictions” such as those related to eating, sugar, sex, gambling, and stealing, there is strong scientific evidence that the neurological pathways related to dopamine are activated similarly to an addiction to cocaine. So addiction is not something made up by people to explain something away, it is a real condition, with both biological and psychological underpinnings.

For the vast majority of people who suffer from an addiction or impulse control disorder, acknowledging an addiction is one of the most difficult steps they will ever take. Most are in denial for years, believing in the “free will” that addiction naysayers speak about; addicts want to believe they are in control, and can stop any time they want. Many struggle for years to gain that control and feel deep shame when they fail, again and again.

Acknowledging an addiction, therefore, is an incredibly important first step. No problem can be solved if the problem is not acknowledged. Until someone admits, “I have lost control of this situation and can’t stop myself,” they cannot possibly be open to learning and working on the steps it takes to change their behavior. To the addict, acknowledging an addiction may be the most difficult, shameful, and scary step they take … but is also a crucial first step in saving his or her life. In fact, rather than being about shirking responsibility, acknowledging an addiction is the first step to taking responsibility.

As a society, we must stop shaming them further by telling them that acknowledging their addiction is an “excuse” and that they should “take responsibility for acting badly” and just feel ashamed. Instead, addicts must be supported in their first step and invited to take the many steps— psychological, physiological, spiritual, and emotional—that must take place for them to become well.

It may be that part of what people are reacting to is the overwhelming list of addictions that we hear about these days. People have begun to feel as if it is an overused term, and that there simply can’t be so many people in our society addicted to so many different things. Sadly, this is also not something that is made up. It doesn’t take much work to look around and see the sheer numbers of people who are addicted to food, shopping, electronics, alcohol, drugs, gambling, sex, and the myriad of ways available to us to avoid the profoundly beautiful but sometimes acutely painful process of being human.

Samantha Smithstein, Psy.D.

(Re)defining Infidelity

  • June 23, 2011 7:09 am

in·fi·del·i·ty

n.pl. in·fi·del·i·ties

1. a. Unfaithfulness to a sexual partner, especially a spouse.

b. An act of sexual unfaithfulness.

2. Lack of fidelity or loyalty.

3. Lack of religious belief.

(The American Heritage® Dictionary of the English Language, Fourth Edition copyright ©2000 by Houghton Mifflin Company. Updated in 2009. Published by Houghton Mifflin Company. All rights reserved.)

 

There has always been a “gray zone” when it comes to defining infidelity and monogamy. Certainly, most people would agree that having sex with someone else would constitute infidelity.  But what about a coworker you regularly flirt with?  How about that person at the gym that you frequently fantasize about?  And what about pornography use?

 

With the internet, that “gray zone” has become a lot larger and a lot grayer. While the above examples still exist, there are plethoras of new ways people are connecting sexually.  Old college friends reconnect through Facebook and find themselves re-igniting an old flame through intimate emails.  Avatars in online fantasy worlds kiss, date, and even marry.  Sexting (sending sexually explicit messages or photographs between cell phones), direct message Tweeting (ala Rep.Weiner), cybersex chat rooms, and hot IMs (instant messaging) are just a few of the ways that people are engaged in “virtual” sexual contact with each other.

 

When Rep. Weiner acknowledged his behavior, he stated that while he had engaged in sexual tweeting with several women, he never had the desire to actually meet any of them in person.  What, then, was he after when he engaged in this behavior?  And if he didn’t really want a real relationship with them, what did he want?  And if it was not actual sexual involvement, does this behavior constitute “infidelity?”

 

Part of why it may be difficult to figure out the answer to these questions may be because sex, itself, is difficult to figure out. The origins of desire, lust, and fantasy are often complex and mysterious, and can range from physiological urges, to emotions and needs that have little to do with sex.  Additionally, the answers become further difficult to reach because we often don’t understand the principles that underlie monogamy.  In other words, monogamy is often a reflexive and emotional choice without having a deeper spiritual and/or psychological understanding of the purpose.  If this were understood, it might be easier to see clearly when lines were being crossed – indeed, it might be easier to make the choice not to cross the lines.

 

Among couples today, cybersex and Internet infidelity are leading causes of divorce.  So while it may feel in the “gray zone” and be experienced as “not real” to the person engaging in the behaviors, it is often experienced as a betrayal and very real to their spouse.  It is worthwhile work, then, for us to gain a deeper understanding of what monogamy, fidelity, and faithfulness look like, what they mean, and why they are there, so that we can catch-up our relationships to the high-speed blossoming of the sexual world of the internet.

Samantha Smithstein, Psy.D.

Infidelity in cyberspace: whose doing it & how great is it really?

  • June 20, 2011 6:44 pm

Recently, in order to explore infidelity on the internet, Kholos Wysocki and Childers placed a survey on a website aimed at married people looking for sexual partners outside their marriage. A total of 5,187 adults answered questions about internet use, sexual behaviors, and feelings about sexual behaviors on the internet. The authors were particularly interested in aspects of sexting, infidelity online, and infidelity in real-life.

 

The survey posted on the “infidelity” website revealed a wide range of results on sexting and infidelity. For example, they found that women were more likely than men to engage in sexting behaviors, and over two-thirds of the respondents had engaged in sexual behavior online while in a serious relationship. Over three-quarters of them had engaged in infidelity in real-life, and both women and men were just as likely to have engaged in sexual behavior with someone other than their partner while in a serious real-life relationship.

 

Of particular interest was that Kholos Wysocki and Childers found that respondents were more interested in finding real-life partners, both for dating and for sexual encounters, than online-only partners. The authors concluded that while the internet and social networking sites are increasingly used for social and sexual contact, our need for physical contact has not lessened.  They state, “While social networking sites are increasingly being used for social contact, people continue to be more interested in real-life partners, rather than online partners. It seems that, at some point in a relationship, we need the physical, face-to-face contact.”

 

While the authors of this study did not suggest it, one could argue that it’s possible that it may be that not only were people more interested, ultimately, in real-life sexual encounters than online encounters, but perhaps the sexual encounters themselves were simply a stand-in for even deeper yearnings.  In other words: perhaps the extra-marital online sex is a poor substitute for real-life sex, but that real-life sex itself may be a poor substitute for other, deeper needs that aren’t getting met.

Samantha Smithstein, Psy.D.

Sex addiction, sexual abuse, and “men behaving badly”

  • June 2, 2011 8:54 am

Recently, as news of Arnold Schwartzenegger’s extramarital affair (and out of wedlock child) and Dominique Strauss-Kahn’s arrest for hit the news together, there have been a spate of articles about the two of them – men in power behaving badly, men in power being psychopathic, etc. – and with that a re-visiting of the sexual behavior of Tiger Woods, John Edwards, and others.

 

While some of this discussion is educational and even important regarding sex addiction, extramarital affairs, sexual assault, power, and culture (and even heterosexual privilege), other aspects of the discussion seem bafflingly over-generalized and damaging. Should all of these men be lumped together and painted with a broad brush?  And furthermore, should their behavior be attributed to power?

 

From years of working with both individuals who have been convicted of sex offenses and individuals suffering from sex addiction, I can assure you that men in power are not the only men who have extramarital affairs or children out of wedlock – and it is not only men. The current accepted estimate is that approximately half of all married men and women will have an affair at some point during their marriage.  In regards to sexual assault, estimates are that each year in the US there are over 200,000 victims of sexual assault.  Certainly some of this behavior is by men in power – and a position of power or wealth can give an individual more power to perpetrate, and perpetrate without getting caught or punished.  But much of it, obviously, was not – it is estimated that 2/3 of the victims were acquainted with their attacker.

 

Furthermore, there are thousands of men in powerful positions who behave with integrity and grace, and never abuse their positions of power. To equate men in power with egregious sexual behavior is a gross disservice to these men, similar to dismissing all priests as child-molesters simply because of the behavior of some.  Certainly, discussing power in relationship with sexual behavior and dynamics is worthwhile and important, but it would behoove us to do it thoughtfully and with sensitivity, and to attempt to avoid stereotyping and perpetuating harmful myths.

 

To give an “armchair diagnosis” of any of these men is simply an irresponsible – and harmful – guess. Often when people seek help for their sexual behavior (or are mandated to treatment for it) it is because it has wreaked havoc in their lives and they are in danger of losing those they love, or already have.  When asked why they engaged in these behaviors, they often don’t have an answer. The answer turns out to be a complex mixture of: personality, physiology, environment, childhood, psychology, drugs and/or alcohol, neurology, and circumstance.  Again, there is something important about discussing the influence of any and all of these factors in order to thoughtfully discuss issues of importance in our culture and society.

 

But to narrow down behavior to simply one of these factors is a disservice – not only to these men, or men in general, but to all of us. It may be convenient and comfortable to create an “us versus them” scenario when regarding the behavior of others that we don’t like or don’t agree with or even find unacceptable.  But ultimately, prevention and change come from embracing the complexity, attempting to understand in a deeply thoughtful way, and even empathy. Through understanding these men, as complex individuals, we grow to a deeper understanding of humanity and even of ourselves, and move to the possibility of prevention and change – as individuals, as a society, and as the world.

Samantha Smithstein, Psy.D.

Get Adobe Flash player