1. Sexual Addiction in the Family: Pathways to Domestic Violence
Jennifer Thibodeau, MSW, RSW, CSAT (C)
Steven Thibodeau, PhD, RSW, CSAT (C)
Jackie Thibodeau, BHSc, RPC (C)
website:

2. What is Sexual Addiction?
“Sexual addiction is operationally defined as a pathological relationship with a mood-altering experience. Sexual addicts no longer have the ability to say no or choose; they are unable to control their cycle of thinking, feeling, and acting when it comes to their sexual behaviors” (Carnes, 2001)

3. Criteria for Sex Addiction Patrick Carnes
Loss of control
Severe consequences due to sexual behavior
Inability to stop despite adverse consequences
Persistent pursuit of self destructive or high-risk behavior
Ongoing desire or effort to limit sexual behavior
Sexual obsession and fantasy as primary coping strategy

4. Increasing amounts of sexual experience because the currently level of activity is no longer sufficient
Severe mood changes around sexual activity
Inordinate amounts of time spent in obtaining sex, being sexual, or recovering from sexual experiences
Neglect of important social, occupational, or recreational activities because of sexual behavior

5. Ten Types of Sex Addicts
A total of 10 “types” of sexually compulsive behaviors emerged in the sex addicts surveyed by P. Carnes, Ph.D.

6. Fantasy Sex Sexually charged fantasies, relationships, and situations.
Arousal depends on sexual possibility.

7. Seductive Role Sex Seduction of partners.
Arousal is based on conquest and diminishes rapidly after initial contact.

8. Voyeuristic Sex Visual arousal.
The use of visual stimulation to escape into obsessive trance.

9. Exhibitionistic Sex
Attracting attention to body or sexual parts of the body.
Sexual arousal stems from reaction of viewer whether shock or interest.

10. Paying for Sex Purchasing of sexual services.
Arousal is connected to payment for sex, and with time the arousal actually becomes connected to the money itself.

11. Trading Sex Selling or bartering sex for power.
Arousal is based on gaining control of others by using sex as leverage.

12. Intrusive Sex Boundary violation without discovery.
Sexual arousal occurs by violating boundaries with no repercussions.

13. Anonymous Sex High-risk sex with unknown persons.
Arousal involves no seduction or cost and is immediate.

14. Pain Exchange Sex
Being humiliated or hurt as part of sexual arousal; or sadistic hurting or degrading another sexually, or both.

15. Exploitive Sex Exploitation of the vulnerable.
Arousal patterns are based on target “types” of vulnerability.

16. Sexual Addiction
Due to the wide availability of unmonitored internet use by adolescents there is a predicted tsunami of sexually addicted people ( Carnes 2010)

17. Truths Highly addictive Changes the Brain
Destroys emotional, physical and
spiritual health
Negative impact in relationships
Distorts healthy sexuality
Promotes objectification
Decreases empathy and sensitivity to others
Connected to illegal activities

18. Prevalence of Domestic Violence
One woman in six is physically or sexually abused by her husband, ex-husband or live in partner (Lawson, 1992)
Rape is a significant or major form of abuse in 54% of violent marriages (AMA, 1992)
Of women over the age of 30 who have been raped, 58% were raped within the context of an abusive relationship
Domestic violence can, and in many cases does, lead to permanent physical and emotional injury and even mortality.

19. The relationship between domestic violence and sexual addiction
Addictive sexual disorders are frequently associated with domestic (sexual)violence …
… many of the same factors that predispose an individual to the development of an addictive or compulsive sexual disorder can also predispose one to being a participant in a violent sexual relationship (Irons, 1996)

20. While Carnes (1990) advises us that sexual addiction represents the antithesis of love … it is also important to note that sexual violence is often a significant feature of addictive sexual disorders.
Addicts are experts in the use of force or pressure to advance their sexual agenda. Overtly or covertly, force, manipulation and coercion are often present.
Sexual performance may lose it s novelty and intensity ~ the use of threats of violence or infidelity may begin to dissolve into actual infliction of physical or emotional plain. Some will resort to direct use of physical trauma while engaging in sexual actively

21. Cycle of Violence passed from generation to generation
We have been taught that sexual abuse in childhood or adolescence is often sustained and then repressed or split off during growth and development … only to affect relationships decades later.
Children may witness the expression of violence between parents and infer that this is a normative pattern between partners.
A confusing mixture of shame, pain, fear, guilt, excitement, and stimulation may be imprinted that is unconsciously and often indirectly expressed in a relationship decades later.
In adult life, the use of physical force or the threat of violence may represent a learned behavior, that is now being used to assert power and control over their partner.

22. The Addictive Cycle Belief System Unmanageability Impaired Thinking
Preoccupation
Guilt
Shame
Despair
Ritualization
Compulsive Behavior
© 2008

23. Cycle of Sexual Violence in Relationships (Irons, 1996)
Physical Altercations
Isolated and vulnerable
Efforts to reconcile difference
Sexual activity as a mood-altering behaviour
Such efforts are short lived
Physical altercations between partners may leave one or both feeling isolated and vulnerable
In an effort to reconcile differences, the partners may use sexual activity as a mood altering behaviour that intensifies physical comfort
These period of de-escalation from anger and tension are all too often short lived. Another episode of fighting and violence occurs, and the cycle of violence continues.

24. Progression of sexual violence
Light bondage: indirect pressure to submit to unwanted sexual activity
More overt coercion: may include an insistence on sexual performance
Blatantly Violent sex: Sex may deteriorate into hostility, repressive bondage, human degradation, intense combat, aggravated assault, rape
Light bondage~ coercion may at first be exerted through the use of guilt, derogatory comments about sexual appetite and interest, threats to go elsewhere to meet sexual needs.
More Overt coercion: the prospect of another argument or possible physical injury may lead one partner into a pattern of unwanted, sex, somatic complaints, resentment and victimization . At this juncture many women will be at risk of developing an averse sexual disorder.
Blatantly violently sex: Sex may deteriorate into hostility, repressive bondage, human degradation, and intense combat, aggravated assault
Other practices a partner may be forced to engage in are:
Being forced to dress or play roles the partner requests I( cross dressing , using objectionable articles of clothing) ,
To accept sex toys in the sexual activity
To exhibit one’s body publically
To engage in sex with a third parity
To participate in unsafe sexual activity
To risk unwanted pregnancy
to have sex in public places
To be submit to crude, degrading or abusive sex talk during sexual activity

25. It is important to recognize the degree of exploitation of power, and the use of control and aggression by the addict, so that legitimate issues of domestic violence and sexual assault can be named and explored therapeutically at the appropriate juncture.
Therapist must be able to develop appropriate clinical pathways ~ this involves a readiness for the clinician to inquire about domestic violence when there are signs, even if the client is seeking assistance only for an addiction
We must inquire about domestic violence whenever doing bio-psychosocial history, a family history, or a sexual history.
We need to acquire knowledge at a provincial, regional and local level of resources that are available

26. [Sex Addict] I look back now and know that my wife was the perfect partner for me to be able to have this other life. She always wanted to believe in me. I controlled her with anger. She had been raised by a raging father, and then her stepfather sexually abused her. All I had to do was raise my voice and ask, ‘How can you doubt me after all I do for you? You should be grateful.” I’d see the shift in her eyes and she would crumble. Then I’d switch to telling her everything was okay, telling her I really loved her, and acting like I forgave her for her suspicions.

27. Therapeutic Strategies
It is common that when an addict is confronted with his exploitation of power and control, and victimization of another, he will commonly express denial
He will rationalize, minimize or vigorously reject the conclusion.
There may be negative transference to the therapist
Addict may be experiencing profound shame, despair, fear of consequences ~ and may attempt the addict to withdraw from therapy or accuse the therapist of wrongfully re-directing the focus of therapy.

28. The addict will try to reframe the behaviour, from that of perpetrated violence, to that of an alternative and fully consensual sexual life style.
In order to protect himself the addict may mount an aggressive defence (shame bound offenses)
He will go to his partner to assume that she does not see the behaviours as battery or assault.
If she admits that it was assault, the addict will encourage the partner to admit to sharing responsibility for events leading to the offense.
ARGUMENT: choices were consensual, both derived excitement, pleasure, shame through the process ~ practices could have ended at any point if the partner had only voiced an objection.

29. Opening Pandora's Box (Iron)
The risk of escalating violence is a concern as others (partners and other family members) learn of the abusive behaviour
The partner (victim) may not be aware the violence is being addressed in therapy and may not be able to defend against the increased risk of and lowered threshold for abuse
The partner (victim) may have lowered defences at this point in the belief that treatment of the addiction will end the violent behaviour.
Informing the partner that these issues are being uncovered and explored in treatment, they at least have the opportunity to seek help and support for themselves and family.
We need to be clear that therapy can and does make a difference.
Early identification of the cycle of violence may limit its spiral into serious physical and emotional trauma

30. The role of therapist with the abused partner
While the addict (perpetrator) may ask the therapist to be a bystander and do nothing, …. the partner (victim) asks the therapist to ‘share the burden’; demanding action, engagement and remembering (Herman)
We must not shirk our responsibility of confronting the perpetrator (Richard Irons).
It may bring the professional to the point where they are ethically or legally bound to report the violence to authorities ~ which may break the therapeutic alliance with the client

31. The lives of partners
[partner] My life has been riddled with the horror of addiction. My father committed suicide when I was only a year old. My mother had just left him due to his ‘womanizing’. Today we know it as sex addiction. I began believing early that if I could just keep the peace, protect my cousins, stop the depression, everyone would be happy, and then I would be safe. My idea of an attractive man was my uncle, a hard-drinking, raging handsome woman-chaser. I used sex addicts in much the same way they used me to re-create our family history.

32. Partners of Sex Addicts
… often grew up in families where addiction to alcohol, drugs, food, and work were present (Schneider & Schneider, 1996)
…were more likely to have experienced sexual, physical, or emotional abuse as a child (Crawford, 1996)
… have difficulty bonding emotionally and experienced rigid responses to change in their families of origin (Wildmon-White and Scott Young, 2002)
Specific clinical steps that may be used to address the women’s issues:
Validate that their feelings are real
Take adequate time to establish rapport because these women have had their perceptions denied and have often been told they are crazy
Process abuse, abandonment and other early childhood trauma issues
Help the women to learn to identify safe individuals so that trust can be re-established.
Help the women learn to establish physical and emotional boundaries
Help the women confront the unmanageability of their own life due to the to obsessions with monitoring their husband’s behaviour.
Following these steps could lead to more positive treatment outcomes when working with women married to sexual addicts.