(Death, Heaven, Purgatory, Hell)
Rite of Christian Initiation for Adults
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Treating Sexual and Pornographic Addictions
Mark B. Kastelman
Sex and
porn addictions require therapists with special training in these areas for
patients to have a good chance of recovery. These illnesses are very difficult
to treat, with relapses the norm. There are no training programs in traditional
medical schools, graduate schools of psychology or social work that deal with
this kind of addictive problem. And while this will undoubtedly change in the
next few years, anyone now seeking professional help will need to check very
carefully the background experience of any therapists that they might choose to
treat them.
What you are looking for is a "sex addiction therapist" from any of the mental
health healing disciplines who has a good track record in treating this problem
and personal values that are reasonably congruent with the patient's values.
Suggestions will be given shortly on how to find such a therapist.
In addition to having a competent, qualified sex addiction therapist, the
patient will also need to attend regularly - (90% of the time) for two years or
longer - weekly meetings of Sexaholics Anonymous (or other similar 12-step
support group). These groups (free of charge) meet in nearly every fair sized
city in America and their address and location can be found in the business
pages of the phone book or by contacting Alcoholics Anonymous, who can give
directions to the caller on location and time of meetings of the sexaholic
group. It will be at these meetings that patients can inquire of fellow members
or attendees the names of competent therapists they are individually meeting
with and have found helpful and competent in receiving their own treatment.
Another source of referrals is to call the National Council of Sexual Addiction
& Compulsivity, who have a register of most therapists in the U.S. doing
treatment in this area: 770-989-9754.
In my experience of 25 years in treating approximately 350 of these patients I
find, if married, nearly universally the wives are traumatized by the husbands
lies, deceptions, and-out-of-bounds sex behavior, and need treatment, too. If
the wife decides to stay in the marriage for a while longer, I engage her in
joint treatment with her husband. I have found that if I successfully heal the
husband of his addiction but have an angry, hostile, wounded wife who can never
trust or forgive her husband even though she remains in the marriage, it greatly
increases the risk of relapse in the husband as he attempts unsuccessfully to
placate and deal with major marital turmoil. The wife's wounding has to be
addressed as well as have both parties participate in marital therapy. Thus I
nearly always attempt to have the wife join with the husband in our therapy
sessions. This usually predicts a successful outcome if both stay in the healing
program. This program works and is successful if both parties stay with it.
Sometimes the husband will find himself with years of sobriety and feel he's all
"cured" and doesn't need to still attend his group meetings or therapy sessions
anymore. Why waste time and money when he's doing so well? This can be very
risky. And it greatly increases the chances for relapse. What I do when patients
start experiencing long-term sobriety is gradually lengthen the time interval
between therapy sessions. So eventually we may be meeting once every month, or
six to eight weeks or longer.
The specifics of treatment by the therapist will not be presented in detail here
other than to mention that we do marital therapy, put the couple in marital
communication workshops (such as Marriage Enrichment), do a lot of work with
relapse prevention, identify the triggers to acting out and develop strategies
to protect them from the triggers, fortify them to deal with the "wave," and
help them reduce and eliminate masturbation to
pornography,
since this increases the power of their addictive illness over them and is the
royal road to acquiring new sexual addictions or paraphilias which might be
acted out. We also strongly emphasize a "no secrets" rule, and how vital this is
to healing.
We treat concomitantly any other addictions which they might have. All have to
be treated together, otherwise the patient just shifts back and forth between
addictions with no real long-term healing. We teach them the three-second rule
to manage and control intrusive thoughts and imagery. We give them a lot of
reading to do in the sex addiction area (like the Carnes' books, and the "white
book," created by S.A. and filled with successful recovery biographies, plus
monographs on many other related topics). We want them to be "world experts" on
the nature of sex addiction, its genesis, its course, and helpful treatment
procedures.
We also find it most important that they have hope and assured knowledge that
the illness is treatable and they can get their free agency back again and have
rational control over their previously driven irrational behavior. They see how
this is possible as they attend S.A. and see and hear the testimonies of other
people who now have long-term sobriety. These were people who were in much worse
shape than they when entering treatment.
We deal with spiritual issues in therapy when this is appropriate to the unique
circumstances and values of the client. We also deal with deep woundedness
arising out of early life traumas which now make them vulnerable to seeking out
quick-fix sexual acting out as a solution, which really doesn't work in the
long-term. I also give a lot of verbal praise and genuine appreciation in
response to even their smallest gains and good behavior. I never criticize or
put them down when there are relapses. I just say, "This is exactly why we meet
in therapy - to strengthen you and develop new strategies to deal with
temptation. Now if this situation were to occur again, what might be a more
powerful way to deal with it? To resist it? To remain sober? …etc.,"
Male teenage patients can be quite challenging. Many deny that it is a problem
and consistently lie about the details of their involvement with it. Their
motivation to change may be nonexistent. They are usually brought in for
treatment by an angry and/or sorrowful parent and often tend to be uncooperative
and passive/aggressive in dealing with the problem. It may be helpful to
consider family therapy and be therapeutically confrontive in dealing with the
issues that arise. Fairly drastic limitations on home computer/Internet use may
be necessary. If 17 or older, I put them into a regular S.A. group with,
possibly, the father also attending to be a support to the son and be someone he
can talk with about the various issues as they arise.
Mark B. Kastelman
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