B3. 勝過性沉溺的掙扎 Sexual Addiction Cause and Symptoms; Healing and Recovery 性癮 - 成因, 症狀, 治療, 与复健 Copyright © 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 Tel (510) Fax (510)

Gender Differences in Sexual Addiction Predominantly more males than females 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 visually-oriented: Response to visual cues Men are more Goal-Task oriented: Quick fixes; Immediate gratification Men are more Goal-Task oriented: Quick fixes; Immediate gratification Reversal of “Love” with “Sex” Intimacy as always sexual 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 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 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

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. 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 31% of men surveyed said they had visited sex sites and –37% of year olds gave that response

Percentage of Those Seeking Sexual Fulfillment on the Internet ( Zogby International) Of interest to Focus on the Family was the fact that 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 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 Dysfunctional-Abusive family –Rigidity & perfectionism: Can’t fail –Enmeshment between family members Can’t talk about emotions Can’t talk about emotions –Denial of feelings –Re-labeling-Minimizing your feelings by adults Ineffective, non-satisfying social relationships Ineffective, non-satisfying social relationships

Proximal Causes of Sexual Addiction Premature Sexual-Genital Familiarization Over-exposure to adult pornographic materials “My dad’s Playboy magazine” “My dad’s Playboy magazine” “My uncle’s books under his bed or mattress” “My uncle’s books under his bed or mattress” “One day I found a stash of magazine in my neighbor’s trash” “One day I found a stash of magazine in my neighbor’s trash” “I watched HBO after my parents went to sleep” “I watched HBO after my parents went to sleep” “I watched mom having sex with her boyfriend” “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) Molestation-Fondling: Culture specific (Sexual curiosity of adults in Asian ethnic groups) Men’s sexual curiosity over self: Projected on children Men’s sexual curiosity over self: Projected on children Men exposed self to children: To satisfy “something” about themselves Men exposed self to children: To satisfy “something” about themselves Servant-Maid: “Bathing a toddler” Servant-Maid: “Bathing a toddler” Sexual arousal as a way to soothe a child Sexual arousal as a way to soothe a child

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

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

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

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

Unhealthy Signs (Mild-Moderate) Husband demands wife to be in a certain physical position for intercourse 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”) 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 Husband is distracted by flash backs of pornographic images while love-making

Unhealthy Signs (Moderate-Serious) Masturbation after marriage (Decreased desires) Masturbation after marriage (Decreased desires) –Sexual “Anorexia” “Indifference” Very few or no male friendships Very few or no male friendships Gets enraged easily or numb emotionally 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 Rigidity & inflexibility Telling half-truths and white lies to cover-up Telling half-truths and white lies to cover-up

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

10 Types of Sex Addicts (After Patrick Carnes, Ph.D.) 1. Fantasy Sex 2. Seductive Role Sex (dress) 3. Voyeuristic Sex 4. Intrusive Sex (obscene calls) 5. Exhibitionism 6. Sex Trading 7. Anonymous Sex 8. Paying For Sex (Prostitution) 9. Pain Exchange 10. Exploitive Sex

Some Theories Explaining Addiction Dynamic To Follow

The Physical Intimacy-Orgasmic Cycle Copyright © Melvin W. Wong, Ph.D 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.) 1. Craving to get emotionally intimate with others 2. Mental-Emotional-Visual Triggers 3. Repression of Pain with Immediate Sexual Longing 4. Fantasy Development-Planning Begins (Thrilling) 5. The Hunt (The Intrigue)

The Addiction (After Patrick Carnes, Ph.D. & Steven Arterburn, M.S.) 6. The Connection (“Rush” Altered state of awareness) 7. The Act (Under-Control: Impulsivity: Binge) 8. The Fulfillment (Orgasm: Feeling Dissociation) 9. The Let-Down (Self-Blame: Numbness) 10. The Vow (Over-Control: Compulsivity: Rigidity) 11. The Cycle Returns again (Deprivation Sets-In)

Developing Intimacy Through Effective Communication Copyright © Melvin Wong, Ph.D. All Rights Reserved Small Talk & Clichés Exchange of Facts Exchange of Judgments Exchange Feelings Commitments Sex Increases Trust, Intimacy Vulnerability Courtship begins The Final Stage of Intimacy Achieved! Friendship Acquaintance s

The Physical Intimacy-Orgasmic Cycle (Copyright © Melvin Wong, Ph.D. 2000) “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 (Applies to Heterosexuals and Homosexuals)

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

From Over-Control, Under- Control to Recovery Binge-Purge Cycles Binge-Purge Cycles –Impulsiveness vs. Compulsiveness Over-Control: The Victimizer Over-Control: The Victimizer –Power Position: “A Mouse Click Away!” Under-Control: The Victim 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 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? 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) Interpersonal: Healthy-Bonds (Safe People) –Experiential not only rational Non-sexual intimacy –Spiritual: Paradigm shift: Enlightenment Intrapersonal: Mourn loss, Spiritual renewal 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) 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 Control: Try More Alienation Alienation Secret Keeping Secret Keeping Hides Full Story Hides Full Story “No one is Hurt” “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

Getting Help Sex and Love Addicts Anonymous (SLAA) P O Box 119, New Town Branch, Boston MA Sex Addicts Anonymous (SAA) P O Box 3038 Minneapolis, MN Sexual Compulsives Anonymous (SCA) P O Box 1585, Old Chelsea Station, NY, NY National Council on Sexual Addictions, Inc P O Box 20249, Wickenberg, AZ Sexaholics Anonymous (SA) P O Box 300 Simi Valley, CA

Self-Help Group Resources SA: Sexaholics Anonymous (615) SLAA: Sex Love Addicts Anonymous EA: Emotions Anonymous (510) CODA: CoDependents Anonymous (415)