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.

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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.

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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.

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Sexual Recovery Institute Founding Director Will Educate Professionals about Sex and Porn Addiction

May 20th, 2010

LOS ANGELES–(BUSINESS WIRE)–The Sexual Recovery Institute, the leading outpatient recovery center for sexual addiction and intimacy disorders in the United States, has announced that founding director Robert Weiss has been chosen as a faculty member for the first annual West Coast Symposium on Addictive Disorders (WCSAD). The symposium, hosted by C4 Recovery Solutions in partnership with RecoveryView.com, will be held at the La Quinta Resort & Club in La Quinta, CA from June 3-5, 2010.

Dedicated to continuing education and networking in the field of addiction, the event is expected to draw hundreds of regional, national, and international participants, lecturers and faculty. The WCSAD combines workshops and seminars on timely industry topics with an unmatched showcase of the industry’s products and services.

Weiss, who will host a workshop titled “Untangling the Web: A Clinical Understanding of Sex and Porn Addiction,” will offer realistic healing strategies for anyone experiencing the devastating impact of Internet pornography and sex addiction on intimacy, relationships, career, health and self-respect.

“I am extremely honored to be participating in this first-ever event,” remarked Weiss. “C4 Recovery Solutions continues to show leadership in the area of addiction treatment and recovery, and the West Coast professional community will greatly benefit from the symposium. I truly look forward to being part of the team, while helping build and grow C4’s presence throughout the Western region.”

Reservations for WCSAD can be made online at http://www.wcsad.com/.

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Understanding Sex Addiction: Experts Release Series of Informational Web-Videos for Sex Addicts and Their Spouses

May 4th, 2010

LOS ANGELES–(BUSINESS WIRE)–The Sexual Recovery Institute (SRI), founded by Robert Weiss in 1995 and known throughout the U.S. as the leading outpatient sexual addiction (SA) recovery center, has released a series of informational videos intended to reach consumers seeking help and direction toward healing from sex addiction.

The videos, created in response to increased public curiosity and discourse about sexual addiction, clearly define the many characteristics of a sex addict and behaviors associated with sex addiction, while offering resources and treatment advice to addicts, professionals, and loved ones.

“Having provided sex addicts and their families with therapy and treatment for over 25 years, I know the importance of having non-shaming, educational and supportive resources available to those seeking help and understanding,” remarked Robert Weiss, LCSW, CSAT-S, founding director of SRI. “These videos are just another medium for us to reach those who want to understand sex addiction, its implications, and treatment and recovery options.”

To view SRI’s informational web-videos, click here: http://vimeo.com/RobWeissMSW .

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Dealing with Shame and Guilt As a Result of Addiction pt. III

April 30th, 2010

Because of the differences between shame and guilt (who I am versus what I did), people respond to each emotion differently.

Guilt, because it emphasizes what someone did wrong, tends to elicit more constructive responses, particularly responses that seek to mend the damage done.  Guilt is tied to beliefs about what is wrong, moral and immoral.  When we violate one of these moral guidelines, it causes us to feel guilty over our actions and seek to fix what we have done.  As a result, guilt is an important tool in maintaining standards of right and wrong in individuals and society as a whole.  As such, guilt can often be used as a tool to overcome conflict.

Shame, on the other hand, emphasizes what is wrong with us.  It has a much more inward focus, and as such, leads shameful parties to feel poorly about themselves, rather than simply the actions they have taken.  The result is often an inward turning behavior – avoiding others, hiding your face, etc. Therefore, shame can be problematic, as it is often less constructive than guilt.  In fact, shame can lead to withdrawal from social situations and a subsequent defensive, aggressive, and retaliatory behavior, which only exacerbates conflict, rather than alleviating it.

Shame can also lead to other types of behavior, many of which serve little or no constructive role.  People cope with shame in many ways.  However, few get at the actual source of the emotion.  The following is a list of common shame-driven behaviors:

1. Attacking or striking out at other people.  In an attempt to feel better about their shame, people will often strike out at others in the hope that they will be lifted up by bringing others down.  While this behavior may produce short-term relief from shame, in the long term shame is only strengthened and nothing is done to get at the root of the problem.

2. Compulsivity and addiction.  Through compulsive behaviors and addictions, we can anesthetize our feelings of shame and guilt.  Unfortunately, the relief experienced through the disconnectedness is temporary.  Subsequent feelings of remorse and guilt compound our shame and the compulsive behavior and addiction cycle is repeated.

3. Seeking power and perfection.  Others attempt to overcome their shame by preventing the possibility of future shame.  One way in which they do this is by aiming for perfection – a process that inevitably fails and causes more problems.  Another manner in which people cope is by seeking power, which makes them feel more valuable.

4. Diverting blame.  By blaming our faults or problems on others we can avoid guilt and shame.  However, like the previous responses, doing this fails to get at the core problems and as a result, fails to achieve its purpose.

5. Being overly nice or self-sacrificing.  People sometimes compensate for feelings of shame or unworthiness by attempting to be exceptionally nice to others.  By pleasing everyone else, we hope to prove our worth.  However, this inevitably involves covering up our true feelings, which is once again, self-defeating.
6. Withdrawal.  By withdrawing from the real world, we can essentially numb ourselves to the feelings of guilt and shame so that we are no longer upset by these sorts of things.  Again, nothing has been done to address the core issues of the problem.

While each of these actions may provide temporary relief, the long term effects are often negative and deepen feelings of shame and guilt.

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Healing the Addict in Sexual Recovery

April 21st, 2010

The saying, “There is nothing worse than a reformed smoker” applies even more intensely when dealing with sexual addicts. While it is true that early recovery requires a clear and well-defined sexual plan and often may require a period of celibacy, I never cease to be amazed by the degree of judgment, sexual anorexia and fear that can be generated by sex addicts who actually chose to engage in some form of sex in their early part of recovery. Desperate to ‘do it right,’ knowing the stakes are very high, most sex addicts have good reasons to be guarded about their early sexual choices and behaviors. However, what often gets dragged into the sexual decision making process is the perfectionism, shame and self-hatred which drove the addictive behaviors in the first place. While the first few months of sexual recovery necessarily require somewhat rigid boundaries, beyond that it is essential to help addicts negotiate the line between healthy sexual recovery and a healthy nurturing self.

As long as a sex addict is having indiscriminate and addictive sex, he or she can’t see how his own deeper emotional needs often go unmet, especially as continued sexual acting out provides so many reasons for feeling shameful, like a failure and self-hatred. Much of the important work of recovery happens when the painful longing of the addicts’ unmet emotional needs become exposed and accepted for what they are–old, intolerable feelings of loneliness, fear and sadness, which only happens through years of healthy community building, 12-step work and good therapy. In early recovery however, sex addicts often continue to express various forms of control issues and self-hatred, utilizing perfectionism, judgment of self, others and strong black and white views of what makes up healthy sexuality.

One part of the self-love essential to help reverse a lifetime of abuse, neglect and trauma needs to be directed toward the addiction itself. Despite all the negative behaviors, the losses and the harm caused by the addiction, recovering sex addicts need to find ways to love and value the addict within themselves even if the desire to act out remains active. If the desire to sexually act out, indeed the addiction itself can be re-conceived as emotional alarm bells that exist there to inform the addict that he is having some kind of legitimate need (to eat, to get hugs, to rest, to reflect, to grieve , etc.).  Then the addiction can really be seen as an ally, a part of the self to be valued and appreciated, not disparaged. As long as he or she responds to these addictive longings by reaching out, perhaps calling someone in recovery, going to a 12-step meeting, therapy etc, thereby replacing shameful behavior with self-nurturing and healthy attachments, then the call of the addict will have been served and is deserving of appreciation.

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Spouses of Sex Addicts Informational Video

March 31st, 2010

In this brief video, sex addiction expert and founding director of L.A. based Sexual Recovery Institute, Robert Weiss, offers advice and resources for spouses of sex addicts, as well as educational information for treatment, recovery, and support options.

Spouses of Sex Addicts Informational Video from Robert Weiss on Vimeo.

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The Tiger Woods “12-Step”: Which dance will he choose?

March 16th, 2010

Step 1
Become a young sports superstar. Make sure your family teaches you the importance of being loved for performance, rather than who you are. Improve upon your talent but stop growing emotionally.

Step 2
Find yourself insulated from day-to-day personal growth lessons because you are increasingly surrounded by those more concerned about your athletic performance and earning potential than your growth as a man.

Step 3
Encourage the world to idealize you while getting paid to do so. Polish your image by having your face appear on billboards and ad campaigns all over the world. Then get caught up in the feeling of invincibility that flows from having a lot of money and power. Repeat many times.

Step 4
Isolate yourself further by hanging out with men who are comfortable controlling and manipulating people using power, image and money. Feel special in their presence because they admire your athletic skill- despite the fact that they really don’t know you.

Step 5
Learn to use your emotional deficits to your advantage by hiding behind a manufactured, squeaky-clean and emotionally detached image, while living out a secret double-life of bars, strip clubs and serial infidelity with prostitutes and players. Learn how easy it is to get as much sex and attention you want without having to take the risks that come with intimate friendships and love.

Step 6
Utilize only the best publicists, marketing and PR people to help hide the truth of your personal challenges. Keep your real self under wraps and only reveal yourself when scripted to do so. Come to believe your own hype.

Step 7
Get married and then betray your spouse–often. Break promise after promise made to her and keep a lot of secrets. Spend long periods of time and distance away from home so you can live out your double life and maintain your image. Note that pictures of a loving family life can be used to burnish your image. Make sure to take sleeping pills when on the road and pain pills if injured. Take as many as you need to take in order to keep winning on the course.

Step 8
When the eventual discovery and crisis come about, hide behind the publicity machine and manufactured image that have always worked for you in the past. Try to ignore the problem. When this fails, disappear.

Step 9
Go to treatment and find yourself grieving all that you missed out on as a child. Learn about the life rewards that come only when who you are is more important to you than your performance.

Step 10
Reconcile with your wife in treatment. Admit your wrongs to her and those close to you. Get clean from the inside out. Start feeling hopeful about yourself and your life for the first time in a long time. Begin to connect with your children and realize what really matters in life. Take the time for you that you have let others take from you.

Step 11
Go public with your problem and tell the truth, as you know it. Acknowledge that you will have to go forward living differently. Understand that your words mean little and promises even less. What matters going forward is what YOU DO.  Promise to change, to live differently and admit your sins but put no timeline or agenda on it. Don’t let people’s judgments or opinions matter. Let your spirit and hearts of those who love and know you be your guides.

Step 12 A
Don’t go back to work anytime soon. Follow the advice of the professionals who are working with you. Stay the course of treatment and remain deeply involved. Understand that trust is only regained after a very long time – if ever. Be less focused on what others think of you and focus instead on what makes your life and the lives of those you love full, sincere and healthy.

-OR-

Step 12 B
Return to work before you are ready on the advice of professionals who rely on your income for their financial stability. Worry too much about those whose fortunes rise and fall with your own. Become again seduced by the call of fame and fortune as a restorative function, this myth based on your performance – not who you are. Make promises to wife, loved ones and professionals that this time it will be “different.” (Return to step 8 and repeat).

Written by Robert Weiss, LCSW, CSAT-S

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“Sexual Addiction is a Feminist Victory”

February 9th, 2010

While men often joke that they wouldn’t mind being “sex addicts,” women tend to think sexual addiction is just an excuse for bad behavior.  Clinicians and those who’ve been working in the field for some time now know that it is in fact very serious and not a cop out or something anyone would actually want.

Slate.com recently ran an article claiming “sex addiction is a feminist victory.”  Naturally, women are going to find it difficult to sympathize with their spouses once they catch them cheating–addict or not. When Patrick Carnes popularized the term “sex addict” in the 70s:

“…feminists rejected Carnes’ diagnosis not because they considered “addict” a cop-out for cads, but because they considered the book ’sex-negative,’ recalls Robert Weiss, founding director of the Sexual Recovery Institute in California. “That was an era of sexual permissiveness, when sex therapists were encouraging people to come out and accept all kinds of sexuality.” If men behaved the way Woods or the fictional Del did, ‘there wasn’t a lot of perspective’ in society about it being a problem or an illness, says Weiss. “It was just what guys were being encouraged to do.”"

CLICK HERE to read the full article.

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