Sexual Addiction Cause and Symptoms; Healing and Recovery 性癮-成因,症狀,治療,与复健 Copyright © 1997-2000 Melvin W. Wong, Ph.D. All Rights Reserved Melvin W. Wong, Ph.D. 黃偉康博士 Licensed Clinical Psychologist ChristianMentalHealth.com 220 Montgomery St., Suite 1098, San Francisco, CA 94104 1357 Mowry Avenue, Fremont, CA 94538 Tel (510) 794-8898 Fax (510) 475-1473 Sexual Addiction Cause and Symptoms; Healing and Recovery An Advance Understanding of the psychological aspects in the Development & the treatment of sexual addictions Goals 1. To encourage participants & human-services leaders to increase the understanding of the effects of sexual-physical trauma in the development of addictions. 2. To increase the psychological sophistication of mental health professionals and clergy in more effective counseling and therapy. Abstract Upon the dawning of the new millennium, in this technological age, many experts are acknowledging that the biggest addiction of our times apart from alcohol, narcotics, food, and relationships is in the area of sex. Can sex be addictive? How can this addiction be treated? Sex is only a medium through which the addict finds a level of satisfaction he or she could not get through other more healthy media. The sex addict has a preference for sexual gratification early on in life that is preventable. There is generally a deprivation that was created unintentionally by caregivers or parents that found its satisfaction through sexual climax. A neglected or abused child may become less able to tell a safe adult from an unsafe one, therefore making himself or herself more vulnerable to sexual violation. There are others because of the social isolation that set them apart from the usual gratifying experiences of human relationships prefer solitude. These people may stumble upon pornography as a way to satisfy themselves. When this happens, there is a obvious basic cause of sexual addiction in emotional deprivation which gives rise to a craving for satisfaction. This is the cycle of deprivation and satiation characteristic in sexual addiction. Treatment for the sex addict is a complex one since there are many factors that govern the addiction. Individual psychotherapy is necessary as a start with medication evaluation and the determination if hospitalization, or group home is required in the case of serious situations. Most cases in the outpatient settings are not imminently life-threatening in nature and can lend themselves to the typical counseling treatment paradigm. SA or SLAA groups will often be helpful in the course of treatment. The spouse of the addict will need to be included in this counseling process so unhealthy patterns will not continue. Stress vs. Trauma & Post-Traumatic Stress Disorder (PTSD). The Biology of Trauma: Understanding the mechanisms of pain & the cycle of activation vs. deactivation. Control vs. Dyscontrol cycles. Childhood vs. Adult Trauma:Characteristics of Childhood Traumatic Experiences. Trauma & Dissociations: Trauma & Pseudo-Dissociation. Attachment-Detachment cycles & Trauma Re-Enactment. Abusive Family Environment: Sexual vs. Physical vs. Verbal Abuses. Abuse & Addiction. Trauma-Abuse & Shame. Compulsion & Dependency. 10 Types of Sex Addicts. Understanding Trauma Bonding & Trauma Re-Enactment. Common therapeutic strategies for overcoming Compulsion & Addictions.

Gender Differences in Sexual Addiction Predominantly more males than females It is true that this is a “Men’s Problem” of the millennium Men are more visually-oriented: Response to visual cues Men are more Goal-Task oriented: Quick fixes; Immediate gratification Reversal of “Love” with “Sex” Intimacy as always sexual

Percentage of Those Seeking Sexual Fulfillment on the Internet (Zogby International) Focus on the Family recently conducted a survey with Zogby International Indicating that 1 out of 5 American adults may have looked for sex on the Internet 20.8% of respondents to a March 8-10, 2000 survey admitted they had visited a sexually-oriented Web site

31% of men surveyed said they had visited sex sites and Percentage of Those Seeking Sexual Fulfillment on the Internet (Zogby International) The percentage of those viewing sex sites was higher among males and young adults. 31% of men surveyed said they had visited sex sites and 37% of 18-24 year olds gave that response

17.8% of those who claim to be "born again" Christians Percentage of Those Seeking Sexual Fulfillment on the Internet (Zogby International) Of interest to Focus on the Family was the fact that 17.8% of those who claim to be "born again" Christians and 18% of those who are married have also viewed sex sites. In a follow-up question, nearly two-thirds of American adults thought it wasn't likely that sexual fulfillment could be found online

Root Causes of General Addictions Dysfunctional-Abusive family Rigidity & perfectionism: Can’t fail Enmeshment between family members Can’t talk about emotions Denial of feelings Re-labeling-Minimizing your feelings by adults Ineffective, non-satisfying social relationships

Abuse & Addictions Chemical Dependency 42% Eating Disorder 36% Compulsive Work 27% Compulsive Spending 26% Gambling 5% Sexual Addiction ?

Proximal Causes of Sexual Addiction Premature Sexual-Genital Familiarization Over-exposure to adult pornographic materials “My dad’s Playboy magazine” “My uncle’s books under his bed or mattress” “One day I found a stash of magazine in my neighbor’s trash” “I watched HBO after my parents went to sleep” “I watched mom having sex with her boyfriend”

Immediate Causes of Sexual Addiction Child was a victim of sexual violation Molestation-Fondling: Culture specific (Sexual curiosity of adults in Asian ethnic groups) Men’s sexual curiosity over self: Projected on children Men exposed self to children: To satisfy “something” about themselves Servant-Maid: “Bathing a toddler” Sexual arousal as a way to soothe a child

Direct Causes: Biology & Psychology Behavioral: Stimulus-Response Cycle Boredom: Social-Interpersonal Isolation Excitation: Immediate Gratification Stimulus-Response: Emotional Reminders Habit-Forming Behaviors Cigarettes smoking Rage: Temper Tantrums Relaxation Cycles Physiological Arousal & Rest States

Why Sexual Addiction? Needs for Arousal Life is Boring Gambling Sex Stimulant Drugs High-Risk Behaviors

Life is Not Satisfying-Unhappy Why Sexual Addiction? Needs for Satiation Life is Not Satisfying-Unhappy Sex Over-Eating (Bulimia-Binging) Depressant Drugs (Marijuana) Narcotic Drugs (Anesthetic effect) Alcohol

Reality is too Hard: Need a Quick Escape Why Sexual Addiction? Needs for Fantasy Reality is too Hard: Need a Quick Escape Voyeuristic Sex: Intelligent fantasy & Routine Psychedelic Drugs: LSD Marijuana Mystic/Artistic Preoccupation

Unhealthy Signs (Mild-Moderate) Husband demands wife to be in a certain physical position for intercourse Re-enactment (replay) of pornographic materials Have X-Rated (XXX) video on for sex Husband demands wife to wear a certain kind of lingerie (“To seduce-tease him”) He buys specific pieces of underwear, stockings Husband is distracted by flash backs of pornographic images while love-making

Unhealthy Signs (Moderate-Serious) Masturbation after marriage (Decreased desires) Sexual “Anorexia” “Indifference” Very few or no male friendships Gets enraged easily or numb emotionally Polarized emotional expression vs. full-range Happy to sad vs. anger to numbness Numbness to dissociated vs. euphoria to numbness Rigidity & inflexibility Telling half-truths and white lies to cover-up

Unhealthy Signs (Serious) Compulsive (Uncontrolled)“Cyperporn” use Chat Room visits online at work or after bedtime Rendezvous-meetings via chat room & email Sex for hire experiences: Strip joints, Prostitutes Compulsive (Ritualistic) “Tele-Porn” use Astoundingly high phone bills Unexplained hotel bills, condoms, wigs & underwear found in storage or trunk or car Financial-legal problems: Bankruptcy

10 Types of Sex Addicts (After Patrick Carnes, Ph.D.) Fantasy Sex Seductive Role Sex (dress) Voyeuristic Sex Intrusive Sex (obscene calls) Exhibitionism Sex Trading Anonymous Sex Paying For Sex (Prostitution) Pain Exchange Exploitive Sex

Some Theories Explaining Addiction Dynamic To Follow

The Physical Intimacy-Orgasmic Cycle Copyright © Melvin W. Wong, Ph. D The Physical Intimacy-Orgasmic Cycle Copyright © Melvin W. Wong, Ph.D. 1997-200 All Rights Reserved “Intimacy Always Feels Good!” “Emotional Intimacy Leads to Physical Intimacy!” “Physical Intimacy Can Lead to Orgasm!” “Orgasm Always Feels Good!” “Orgasmic Feeling is Intimacy?” Physical Intimacy is an Antidote for Loneliness, Low-Self Worth, Boredom, Aggression, Anger, Despair, Abandonment “H.A.L.T. Defeated”

The Addiction (After Patrick Carnes, Ph.D. & Steven Arterburn, M.S.) Craving to get emotionally intimate with others Mental-Emotional-Visual Triggers Repression of Pain with Immediate Sexual Longing Fantasy Development-Planning Begins (Thrilling) The Hunt (The Intrigue)

The Addiction (After Patrick Carnes, Ph.D. & Steven Arterburn, M.S.) The Connection (“Rush” Altered state of awareness) The Act (Under-Control: Impulsivity: Binge) The Fulfillment (Orgasm: Feeling Dissociation) The Let-Down (Self-Blame: Numbness) The Vow (Over-Control: Compulsivity: Rigidity) The Cycle Returns again (Deprivation Sets-In)

“Acting-Out Cycle” Copyright © Melvin Wong, Ph.D. 2000 Compulsivity Impulsivity Abuser-Victim Blame-Shame

From Over-Control, Under-Control to Recovery Binge-Purge Cycles Impulsiveness vs. Compulsiveness Over-Control: The Victimizer Power Position: “A Mouse Click Away!” Under-Control: The Victim Not Responsible for what happened Don’t blame me! I can get away with it Rationalization & Justification: Maintains the addiction

From Over-Control, Under-Control to Recovery Taking Control: The Survivor “I don’t have to dominate to succeed!” “I admit I am powerless over my addiction” Step 1 “I don’t have to be a victim anymore!” “I will take responsibility for myself!” “I will not stay in the ‘blame mode’ of helplessness! How to broker, balance this Power Dilemma? Avoid extremes by identifying feelings accurately Form effective intimate relationships

Healing Compulsions & Addictions Interpersonal: Healthy-Bonds (Safe People) Experiential not only rational Non-sexual intimacy Spiritual: Paradigm shift: Enlightenment Intrapersonal: Mourn loss, Spiritual renewal Rediscover goodness in self (false guilt) Rediscover meaning & significance (Help others) An Element of “A Loving but Firm Structure” (Live-In programs, 12 step groups)

Change and Recovery After a crisis then comes a paradigm shift First Order Change Control: Try More Alienation Secret Keeping Hides Full Story “No one is Hurt” Addiction is a 1st order problem: The harder you try to control, the worse it gets Second Order Change Powerlessness Community Involvement No Secrets Disclose full Story Accepts Self as Hurt

Self-Help Group Resources SA: Sexaholics Anonymous www.sa.org (615)331-6230 SLAA: Sex Love Addicts Anonymous EA: Emotions Anonymous (510) 471-8864 CODA: CoDependents Anonymous (415) 905-6331 www.ChristianMentalHealth.com

Sexual Addiction Cause and Symptoms; Healing and Recovery 性癮-成因,症狀,治療,与复健 Copyright © 1997-2000 Melvin W. Wong, Ph.D. All Rights Reserved Melvin W. Wong, Ph.D. 黃偉康博士 Licensed Clinical Psychologist ChristianMentalHealth.com 220 Montgomery St., Suite 1098, San Francisco, CA 94104 1357 Mowry Avenue, Fremont, CA 94538 Tel (510) 794-8898 Fax (510) 475-1473 Sexual Addiction Cause and Symptoms; Healing and Recovery An Advance Understanding of the psychological aspects in the Development & the treatment of sexual addictions Goals 1. To encourage participants & human-services leaders to increase the understanding of the effects of sexual-physical trauma in the development of addictions. 2. To increase the psychological sophistication of mental health professionals and clergy in more effective counseling and therapy. Abstract Upon the dawning of the new millennium, in this technological age, many experts are acknowledging that the biggest addiction of our times apart from alcohol, narcotics, food, and relationships is in the area of sex. Can sex be addictive? How can this addiction be treated? Sex is only a medium through which the addict finds a level of satisfaction he or she could not get through other more healthy media. The sex addict has a preference for sexual gratification early on in life that is preventable. There is generally a deprivation that was created unintentionally by caregivers or parents that found its satisfaction through sexual climax. A neglected or abused child may become less able to tell a safe adult from an unsafe one, therefore making himself or herself more vulnerable to sexual violation. There are others because of the social isolation that set them apart from the usual gratifying experiences of human relationships prefer solitude. These people may stumble upon pornography as a way to satisfy themselves. When this happens, there is a obvious basic cause of sexual addiction in emotional deprivation which gives rise to a craving for satisfaction. This is the cycle of deprivation and satiation characteristic in sexual addiction. Treatment for the sex addict is a complex one since there are many factors that govern the addiction. Individual psychotherapy is necessary as a start with medication evaluation and the determination if hospitalization, or group home is required in the case of serious situations. Most cases in the outpatient settings are not imminently life-threatening in nature and can lend themselves to the typical counseling treatment paradigm. SA or SLAA groups will often be helpful in the course of treatment. The spouse of the addict will need to be included in this counseling process so unhealthy patterns will not continue. Stress vs. Trauma & Post-Traumatic Stress Disorder (PTSD). The Biology of Trauma: Understanding the mechanisms of pain & the cycle of activation vs. deactivation. Control vs. Dyscontrol cycles. Childhood vs. Adult Trauma:Characteristics of Childhood Traumatic Experiences. Trauma & Dissociations: Trauma & Pseudo-Dissociation. Attachment-Detachment cycles & Trauma Re-Enactment. Abusive Family Environment: Sexual vs. Physical vs. Verbal Abuses. Abuse & Addiction. Trauma-Abuse & Shame. Compulsion & Dependency. 10 Types of Sex Addicts. Understanding Trauma Bonding & Trauma Re-Enactment. Common therapeutic strategies for overcoming Compulsion & Addictions.