SRI Blog

Hypersexuality – the diagnosis

September 7th, 2010

By: Robert Weiss, LCSW, CSAT-S

Once considered fodder for daytime talk shows and grocery store literature, today Sexual Addiction is increasingly acknowledged by the psychotherapeutic mainstream and the general public as a legitimate disorder with specific assessment criteria and a defined method of treatment.

One sign of this growing acknowledgement is the proposed DSM V diagnosis of Hypersexuality Disorder currently being investigated by the American Psychiatric Association for possible inclusion in the 2012 Diagnostic and Statistical Manual of Mental Disorders.  Driven primarily by the endless variety and accessibility of online sexual content and sexual contact, today sexually addicted clients and their troubled spouses are showing up in increasing numbers at the doorsteps of addiction counselors seeking concrete direction, behavioral containment and support.

Initially most sex addicts’ presenting concerns are related to wives or partners threatening abandonment unless help is sought, though many seek treatment when suffering from the financial, medical, emotional, career and legal difficulties that follow in the wake of Hypersexual Disorder. While the diagnosis itself is not defined by any specific sexual act or orientation, hypersexuality, as in gambling addition or eating disorders, is organized around the feelings, activities and consequences surrounding sexual behavior.

Here are the primary diagnostic criteria for the proposed Hypersexuality Disorder diagnosis for the upcoming 2012 DSM V.

A. Over a period of at least 6 months, recurrent and intense sexual fantasies, sexual urges, or sexual behaviors in association with 3 or more of the following 5 criteria:

1. Time consumed by sexual fantasies, urges or behaviors repetitively interferes with other important (non-sexual) goals, activities and obligations.

2. Repetitively engaging in sexual fantasies, urges or behaviors in response to dysphoric mood states (e.g., anxiety, depression, boredom, irritability).

3. Repetitively engaging in sexual fantasies, urges or behaviors in response to stressful life events.

4. Repetitive but unsuccessful efforts to control or significantly reduce these sexual fantasies, urges or behaviors. 5. Repetitively engaging in sexual behaviors while disregarding the risk for physical or emotional harm to self or others.

B. There is clinically significant personal distress or impairment in social, occupational or other important areas of functioning associated with the frequency and intensity of these sexual fantasies, urges or behaviors.

C. These sexual fantasies, urges or behaviors are not due to the direct physiological effect of an exogenous substance (e.g., a drug of abuse or a medication).

Specify if: Masturbation Pornography, Sexual Behavior with Consenting Adults, Cybersex, Telephone Sex, Strip Clubs, Other.

Stay tuned to SRI’s blog for more news and information regarding Hypersexuality….as it’s sure to be a hot topic in the behavioral healthcare and medical industries leading up to the publication of the DSM V.

What is Codependence?

September 1st, 2010

These patterns and characteristics are offered as a tool to aid in self-evaluation. They may be particularly helpful to newcomers as they begin to understand codependence and may aid those who have been in recovery, in determining what traits still need attention and transformation.

Denial Patterns:

  • I have difficulty identifying what I am feeling.
  • I minimize, alter or deny how I truly feel.
  • I perceive myself as completely unselfish and dedicated to the well-being of others.

Low Self-Esteem Patterns:

  • I have difficulty making decisions.
  • I judge everything I think, say or do harshly, as never “good enough.”
  • I am embarrassed to receive recognition and praise or gifts.
  • I do not ask others to meet my needs or desires.
  • I value others’ approval of my thinking, feelings and behaviors of my own.
  • I do not perceive myself as a lovable or worthwhile person.

Compliance Patterns:

  • I compromise my own values and integrity to avoid rejection or others’ anger.
  • I am very sensitive to how others are feeling and feel the same.
  • I am extremely loyal, remaining in harmful situations too long.
  • I value others’ opinions and feelings more than my own and am often afraid to express differing opinions and feelings of my own.
  • I put aside my own interests and hobbies in order to do what others want.
  • I accept sex when I want love.

Control Patterns:

  • I believe most other people are incapable of taking care of themselves.
  • I attempt to convince others of what they “should” think and how they “truly” feel.
  • I become resentful when others will not let me help them.
  • I freely offer others advice and directions without being asked.
  • I lavish gifts and favors on those I care about.
  • I use sex to gain approval and acceptance.
  • I have to be “needed” in order to have a relationship with others.

*Information from CoDA - a fellowship of men and women whose common purpose is to develop healthy relationships.

Rob Weiss explains voyeurism

August 25th, 2010

Sexual Recovery Institute’s Robert Weiss was recently interviewed for associated contents health and wellness section regarding Voyeurism.  Rob helps explain the signs and symptoms of voyeurism and how to get help.


Click Here
to view the article.

SRI’s launching its new “Lunch Hour” support group

August 12th, 2010

Starting Thursday, August 19th, SRI will begin offering a “lunch hour” support group for spouses and partners of sex addicts from 12 p.m. to 2 p.m.

The sessions will take place on Thursdays from 12 p.m. to 2 p.m. at the Sexual Recovery Institute (SRI), facilitated by treatment specialist, Korina Jochim, M.A., one of the primary SRI staff. They will focus on building social support, understanding triggers, and creating healthy boundaries for partners of addicts.  Korina will also integrate grounding and meditation techniques as a management tool for those suffering from trauma.

The cost of the group is $75 per session with a three-month minimum commitment.  Those registered for the Wednesday group are invited to join SRI’s Saturday psycho-education lectures free of charge.

To register, please contact Korina Jochim directly at 310-360-0041 ext. 202, or korina@sexualrecovery.com.

CLICK HERE to learn more.

Addicts’ Best Advice: Developing Sobriety and Healthy Sexuality

August 3rd, 2010

1. Pick an extended period of celibacy. The top priority for most addicts is to experience a period of celibacy. Celibacy helps the person clear out unmanageability, to feel more alive again, and to reclaim repressed memories of childhood abuse experiences.

2. Be patient with yourself. Gentleness, kindness, and self-care are watchwords. To change after years of compulsion is a huge task, and you’ll make mistakes. As one addict observed, “Don’t make self-love contingent on abstinence.”

3. Accept yourself as a sexual person. Sexuality and sobriety are, as another addict advised, “possible, and not a contradiction in terms.” Sex is not dirty and shameful. You must distinguish between your addiction and your sexuality. Sobriety is about addiction, not about sexuality. Your sexuality is to be embraced, not denied.

4. Work on boundaries. Boundaries give you clarity about your sexual self and help to reduce shame. As guidelines, they serve as a bulwark against denial, obsessive thinking, and relapse.

5. Keep others current. Always keep others in your program informed about happenings in your sexual life. When in doubt or when confronting something new, check it out. Have no secrets, and avoid becoming isolated.

6. Understand that things will change. Your vision of your sexuality will change dramatically with time in recovery. You will need to allow yourself that process.

7. Accept the imperfect. The search for perfection in relationships and sex cause many addicts to discard relationships before they recognized their potential. The search was futile and the losses real.

Women’s Pyschotherapy Group

July 29th, 2010

Come join a confidential psychotherapy group. Accepting women between the ages of 25-50, who are either married, single, divorced or widowed. This group embraces individuals from all diverse backgrounds, cultures and orientations. Learn and develop skills in the following areas:

  • Learn what intimacy is and how to practice within your relationships.
  • Learn about what it takes to develop lasting loving relationships with others.
  • Learn how to practice healthy boundaries with others.
  • Increase self-esteem, self-worth, and self-care.

When: Mondays from 7:30 to 9:00 p.m.

Contact: Elana Clark-Faler, MSW, LCSW (LCS23340)

Location: Beverly Hills, CA

Phone: 310.403.9147

Email: elana@wholenessandhealth.com

Website: www.wholenessandhealth.com

How are female sex addicts different from male sex addicts?

July 27th, 2010

By Sharon O’Hara MFT

Historically speaking, women have always been overlooked or underrepresented in addiction studies, whether the compulsive behavior studied had to do with alcohol, drugs, gambling, or sexual acting out. It has been 70 years since the founding of AA, 60 years since the American Medical Association recognized alcoholism as a disease, and yet it was not until the late 1980s that significant findings regarding very powerful gender differences in the development of alcoholism surfaced in research studies for other diseases, such as heart disease or AIDS, where women have also been underrepresented as research subjects.

In his pioneering research that focused mainly on male sex addicts, Patrick Carnes described in Out of the Shadows how early victimization experiences led to the formation of negative core beliefs (e.g. I am unworthy, I will always be abandoned, sex is my most important need). Highly charged early erotic experiences, often dangerous and/or abusive, coupled with powerful shaming messages, led to a preoccupation with sexualizing all feeling states. In other words sex-addicts-in-the-making, at an early age, learned to block out all painful feelings of inadequacy or loneliness through sexual fantasy, rituals, and an escalation of self-destructive sexual behaviors.

In later research discussed in his book Don’t Call It Love, Patrick Carnes discovered that in general male sex addicts tend to objectify their partners and seem to prefer sexual behavior that involves relatively little emotional involvement. This leads male sex addicts to engage primarily in such activities as voyeuristic sex, buying prostitutes, having anonymous sex, and engaging in exploitative sex. This may be seen as a logical extension of the way that men in our culture are raised to view women and sex.

As the dozens of pop psychology books on male-female relationships can attest, there is no end to the lament that men in our culture have difficulty with bonding and intimacy issues. We live in a culture that prizes competition and autonomy, particularly for men: getting ahead, going for the gold, becoming an individual, gaining mastery of feelings, making sexual notches on one’s belt. Taken to the extreme, these values can easily lead to extreme isolation, objectification of sex partners, an inability to express feelings, and a strong sense of entitlement at the expense of others—all fertile breeding ground for addictive behaviors. (I’ve been wanting to diagnose this phenomenon as “Independency syndrome,” meaning putting too much emphasis on being independent.)

Women sex addicts, on the other hand, tend to use sex for power, for control, and for attention. They score high on measures of fantasy sex, seductive role sex, trading sex, and pain exchange. Unlike the men, female sex addicts do not seem to be following an intensified trend already existing in the general culture. In fact, by acting out sexually, these women seem to be reacting against culturally prescribed norms.

Author Charlotte Kasl has noted that women in our culture are primarily trained to be sexual codependents. In her book, Women, Sex, and Addiction: A Search For Love and Power, she defined such codependency as letting one’s body be used in order to hold onto a relationship, whether or not a woman really wants to have sex. In general, sex addicts tend to use (manipulate) relationships in order to have sex, whereas sexual codependents use (manipulate) sex in order to keep relationships. Neither group has a clue as to true intimacy.

Codependency has become an overused term, tending to brand all helping impulses as pathological. In her ground-breaking work on normal female development, In a Different Voice, Carol Gilligan describes how women create a sense of identity through relationships, through the development of an “ego-in-context-of-relating”. Male developmental theorists from Freud to Erikson have emphasized the need for human beings to become autonomous, basing these models on themselves and then projecting them onto women.

Gilligan points out that normal female development involves an early need for intimacy skills, with autonomy becoming an issue when women are older, perhaps in their 30s or 40s. Men, on the other hand, are encouraged to find their autonomous identities first and then to explore intimacy skills.

This may explain why, so often, we see the phenomenon of women going back to school after the kids are grown to “find themselves,” at just about the point when their husbands may be wanting to get closer, wanting to “settle down.” The point here is that a woman’s need to understand herself in the context of relationship is not by definition pathological. It is only when these normal developmental needs are distorted (usually through early abuse experiences), that desperate, compulsive, and obsessive behavior emerges, culminating in various women-who-love-too-much scenarios.

Sex addiction in women cannot truly be understood without being constantly aware of the interrelationship of addiction and codependency. Often it appears in my outpatient practice that some women sex addicts are actually trying to “fix” their codependency (a self-perceived sense of weakness and vulnerability) by taking the initiative to act out sexually “like a man.” Consider the following examples:

* Kate, a 25-year-old woman, married, with a 3-year-old daughter. She had been incested for 12 years by her father, which she had difficulty seeing as abuse, because “he didn’t use force.” This woman was so hyper-eroticized as a child that she sexualized all relationships, male and female. Her sexual acting out behavior had shifted from replaying abusive scenarios with men (hitchhiking, seeking out dangerous sexual situations) to a compulsive use of female prostitutes. Her primary sexual motive was to be in control, and buying women made her feel powerful.

It became clear that this was less a question of sexual orientation than it was a need for sexual dominance in order to handle fears and other painful feelings. And in Kate’s mind, buying sexual favors from women was not as “immoral” as having illicit affairs with men. She did not want to become too dependent on her husband’s affections because of a deep fear of abandonment, but she paradoxically craved intimacy. In other words, Kate became a sex addict in order to hold off her fear of becoming too sexually codependent, which was what her father had trained her to be.

* Marie, a 42-year-old entrepreneur, divorced, no children. Marie came into treatment saying, “every day I want to turn a trick.” She, too, had been sexually abused as a child, and had tried to gain internal mastery of her feelings by becoming a call girl and madam, where she felt more in charge. Even though she had stopped practicing prostitution 7 years ago, Marie could not stop compulsively masturbating to the point of injuring her genitals, and she fantasized about turning tricks constantly. This sexual self-abuse was not her only coping mechanism; she was also a binge-purge bulimic.

* Lila, a 34-year-old woman, married, with two adopted daughters. Lila came into treatment after attending a Family Week for her husband, who was a sex addict who cruised young men in public parks. He was very homophobic and wanted Lila to “cure him” of his attraction to men. He also hoped to “cure her” of her attraction to women, even though he had known throughout their 12-year marriage that she had always been primarily oriented towards lesbianism. After Lila stopped focusing on her husband’s acting out behavior as the cause of all their problems, she realized that she felt equally out of control about her own sexuality, and that she needed treatment for herself.

Many women have found the fellowship of Sex and Love Addicts Anonymous helpful in reducing the shameful feelings that surround the problem of compulsive sexual behavior, which is the first step towards stopping this behavior.  Another 12-Step group that is helpful for women is Love Addicts Anonymous.  Finding other women who struggle with this problem can go a long way towards lessening the shame that tends to surround sexual addiction in women.

A Hero’s Journey: Part 2

July 22nd, 2010

By Gregory Pospisil

When working with groups of sex addicts I often inquire if they’ve ever had any drama in their lives.  The laughter in the room this time isn’t merely a ripple, it comes on as a full-tilt wave as they all smile and nod their heads in recognition.

I ask them the definition of drama (again, it can be defined in one word).

Drama = Conflict.

The “drama” we experience in life, all stems from conflict.  While most of us, especially sex addicts, would do anything in order to avoid conflict …the paradox is…conflict is essential for us to grow.

Facing conflict is necessary in order to develop our human potential.

Take the film, STAR WARS, for example.  If Luke Skywalker had never left his home planet to fight the forces of evil in a galaxy far, far away it would have been a very dull and boring trilogy (Episodes 4-6).  Instead, as an audience, we sat riveted as we watched Luke face conflict after conflict after conflict and in the process slowly emerge into the Jedi Knight that he was meant to be.

In each and every moment of conflict something happened.  Luke was forced to take action.

There’s that word again:  Action.

We are confronted with conflict on a daily basis.  Going back to my earlier example, deciding what to do when finding a wallet on the street presents conflict…of the lower case variety.

Some Conflicts, however, merit a capital C.

While others arrive in ALL CAPS.

If you are reading this, chances are you’re in CONFLICT as a result of your sexual addiction.

And now it is time to take action.

In recovery, you will frequently encounter conflict as you face triggers and want to act out.   What are the actions you are willing to take to sustain your sexual sobriety?

The thought of remaining sexual sober for the rest of your life can be overwhelming.  Take your mind off the future and return to the present.

Remain in the here and the now…one day at a time.  Or better yet…narrow your scope even more and think of recovery as just one action at a time.  Continually ask yourself…“What’s the next best thing I need to do to stay in my recovery”?  And follow your inner voice.

If you’re unsure, check with your sponsor, your therapist, or someone from your recovery network.  Addicts are notorious for not wanting to ask for help.  But the Herculean effort of picking up the phone can be the most important action you ever take.

Let their force be with you.

A Hero’s Journey: Part I

July 20th, 2010

By Gregory Pospisil

The definition of character can be summed up in one word: Action.

Character = Action.

The action we take at any given moment defines our character at that time.

For instance, let’s say you are walking down the street and discover a wallet on the sidewalk. If you pick it up, rummage through it, stuff the cash in your pockets and throw the wallet in the bushes – you’ve just defined your character. If on the other hand, you pick the wallet up and take it to the police department, your definition is now very different.

Take a moment and think about your own character. As sex addicts, doing so can bring intense feelings of shame.

During our Intensive Outpatient Program (IOP), I look out among the participants and ask them how many heroes there are in the room? Invariably, there’s a ripple of nervous laughter before, at most, one or two hands are timidly raised. I proceed to tell them they’re all heroes. As they look at me with puzzled expressions, I explain that we are all heroes and that each of us is on a hero’s journey. In the epic story of our lives we are the lead character front and center. The hero. But that doesn’t mean we are incapable of doing unheroic things.

Looking back at your life’s journey thus far, there may have been times when you’ve been active in your sexual addiction and taken actions of which bring you shame. Indeed, one’s sexual acting history is rarely a mantle one wears proudly. But the wonderful thing is that your character is redefinable. It’s in a constant state of flux.

A hero cannot be content to rest on his laurels. Nor should he be condemned by the events of his past. Remember there are times where all heroes struggle to do the right thing, to resist temptation, and to sacrifice instant gratification for the want of a better tomorrow. It is all a part of the process.

As humbled heroes we must recognize that we are flawed but worthwhile human beings. We are capable of giving and receiving love. We each have the capacity to change.

In recovery from sexual addiction, you have the opportunity to redefine your character by taking actions that are different than the ones you’ve taken before and thereby moving your journey forward in a new direction.

Recovery allows you the opportunity to reclaim your life. To Rebuild. Restructure. Renew.

Recovery is your chance to reinvest in yourself and reap the rewards that you deserve.

All that is required for you to have a better life is… ACTION.

At SRI, we are here to help when you take action and call.

10 Signs Your Partner Might Be a Sex or Porn Addict

July 13th, 2010

By: Korina Jochim, MA, MFTI
Addiction Specialist

As professionals treating sex addicts and their partners, we have observed that certain patterns over time are hallmarks of sexual addiction. We are often struck by the commonality of the stories we hear and in the interest of helping partners recognize some signs that may indicate there is a problem. We have outlined some “red flags” to watch out for below. If your partner consistently demonstrates three or more of these symptoms, he may be a sex and porn addict.

1 ) He pressures you to be sexual very early in your relationship; he also tells you he loves you and is intensely romantic toward you in the “in love” stage.

2)  Your every need is attended to, initially, and this person seems almost too good to be true. After a deeper commitment is made, such as an engagement or marriage, there is a period in which your partner withdraws from or criticizes you constantly.

3 ) He is very possessive of his cell phone and it never leaves his side; if you so much as pick it up, he rages at you. He has multiple phone numbers and email addresses.

4 ) When you ask him to participate more in your relationship and family life, he has a bevy of seemingly logical reasons why he cannot be available(i.e. “Honey, I’m busy working to support our family,” “I’m stressed out about money. With all the pressure that’s on me, can’t you give me a break,” etc.). You don’t feel heard.

5 ) Your sexual life tends toward extremes. He is either hypersexual and coercive (i.e. tries to get you to do things you don’t want to do, such as swinging or involved sexual role playing) or completely disinterested in sex; claiming fatigue or stress.

6 ) After rocky periods of moodiness and “projecting blame” onto you when you attempt to address problems, he is suddenly conciliatory. He might buy flowers and other gifts, help out more around the house, suggest vacations
or even couples’ therapy, but these “flights into health” are short-lived, and you begin to recognize this as a cycle.

7 ) He habitually comes to bed hours after you do, or gets up in the middle of the night for an extended period of time. When questioned, he might admit to Internet surfing, or complain of insomnia.

8 ) Unaccounted-for cash disappears from your accounts; he may insist on having sole domain over your finances.

9 ) If you confront him with suspicions that he is being unfaithful, he tells you that “you’re crazy and controlling.” He often describes former partners this way as well.

10 ) His time is often unaccounted for, and he is frequently unreachable by phone for hours at a time.

If you do suspect an active, untreated addiction, it is important to be direct but caring when voicing your concerns, and ask your partner to seek evaluation or treatment. Also, get clear on your own boundaries; can you stay with your partner if he continues to demonstrate these behaviors? Regardless of whether your partner seeks treatment, you can seek help for yourself. 12-step groups such as CoSA or S-Anon are good places to start for support and resources, or you can seek help from a professional.