TREATMENT OF SEX ADDICTION How the 12 steps Heal

How Fellowship Heals Sex addicts need to substitute people for their sexual acting out. For those who choose it, 12-step meetings do this in abundance. The groups offer many individuals who care, who have similar stories and do not tire of hearing new ones. Because of this caring and support, members in the group may be able to gently confront the addict with his maladaptive defenses of denial, rationalization and magical thinking without inflicting new wounds upon the self. The impulse-controlling capacity of these other individuals is gradually internalized and becomes a part of the self-governing structure of the self. The group itself, as a consistent, caring object also may be internalized. Over time, the psychological wounds of growing up in a dysfunctional family can be repaired through the acquisition of a new family that provides the empathic soothing and caring that was missing in early childhood. Sex addiction groups, -- with their regularity and predictability, their repetitive slogans, and their structure, provide a certain order -- a system --even a ritual, which can be used by the addict in the development of internalized self-governing structures.

Learning to Talk about Feelings

A mark of the addictive experience is a sense of overwhelm when faced with intense feelings for which language is inadequate. A 12-step meeting offers a series of lessons in using language to represent the self. The basic format of the meeting is that people gather to speak of themselves and listen to others speak about themselves. This provides a powerful experience in modeling how to use language to express feelings and experience, as well as a reduction in shame. In this way, what was once felt to be unutterable is formulated into words which then de-fuse overwhelming feelings.

There is a certain type of control within the individual personality which can have its source only outside of the personality - the moral principles advocated by a closely knit solitary group - and can only be made effective against self-centered, gratification-oriented impulses by an involuntary feeling of belongingness and allegiance to such a group.

The unembarrassed acknowledgment of the need for participation in a caring community without ulterior motives, one which accepts the individual totally for what he is, is the linchpin upon which the 12-step process is based. The self of a sex addict cannot exist as a solitary structure; its survival and value require participation in a social structure or community. The development of a true self is always participating with others in its realization and fulfillment .This is the beginning of the "unfreezing" of the developmental arrest and becomes an adaptive substitute for the destructive, maladaptive addiction.

But it is only the beginning. The passage from infantile narcissism to emotional maturity and full humanity is ultimately accomplished by consistent immersion in working the 12 steps.

How the Steps Heal Step 1: We admitted we were powerless over alcohol - that our lives had become unmanageable. The admission of powerlessness over the one's addiction is the first defeat of infantile egoism, a first step in the assumption of responsibility.

The conviction that one can no longer engage in one's addiction becomes an inarguable truth. Denial breaks down as the addict increasingly sees that to give way to the impulse to "pick up" has far-reaching and devastating consequences.

The addict comes to terms with the essential paradox: you have to lose to win.

The term "surrender" permeates step work. There are two facets of this concept in the first step. The first "surrender", and surely the most significant, is this deep conviction that one is powerless over one's addiction. One surrenders to the reality that one can never act on the impulse to "pick up", "One Day at a Time". This truth becomes an incontrovertible fact as recovery progresses.

The second facet is that the addict is really surrendering his sense of uniqueness. As one admits powerlessness, one no longer expects the world to conform to one's own egocentric beliefs. The first step is a step toward "living life on life's terms". It is making a decision that one is no longer driven by the desire for pleasure and is willing to be open to accepting and coping with reality. Step 2: Came to believe that a power greater than ourselves could restore us to sanity. An openness to the possibility that a higher power exists necessitates developing boundaries over an egoistic perception of reality. From a psychological developmental perspective, more immature levels of personality structure are egoistic in nature. All things seem related to oneself, a condition that prevents the individual from seeing others for who they really are. Rather, others are seen as extensions of oneself, making it impossible for the individual to have anything but a self-centered point of view. The realization and acceptance of some power (it need not be religious or even spiritual) greater than one's egoistic pursuits puts in motion the abandonment of a grandiose posture. One no longer expects the world to conform to one's own needs and wants. Rather, one learns to live "Life on Life's Terms". Step 3: Made a decision to turn our will and our lives over to the care of God as we understand Him. This step suggests that another "surrender" be considered. It is the surrender of one's own willfulness in the decision-making process. When left to their own devises, individuals make decisions based only on their ego-centric motives and ways of seeing the world. The step suggests a less self-driven version of reality which leads one to consider one's powerlessness over many of the events that occur in one's life.

Step 3 sparks a renewal of trust in living and a loosening of ego-dominated self-sufficiency. Doing the work of this step requires an understanding and acceptance of paradoxical thinking. Prior to recovery, the addict focuses intensely upon control issues. Controlling use of the drug, controlling the amount of damage caused by the using, and controlling emotional distance to minimize vulnerability, held exclusive sway over the addict's consciousness. Step 3 encourages a more passive mode of letting go by surrendering and allowing events to unfold without futile attempts to control outcomes. Step 4: Made a searching and fearless moral inventory of ourselves. This step represents the attempt to review one's life in as a meticulous and forthright way as possible, listing the action and choices that have caused guilt and shame in oneself, and harm to others. The process of emotional development involves a degree of self-knowledge and self-awareness. This step is an opportunity for the addict to see repetitive cognitions and behaviors that inhibit this process of growth.

When one sees the contribution that these "character defects" have made in one's own misery, the process of projection onto other people and external events for unwanted inner states is reduced. The focus is on the self and not the faults of others. The addict can't help but accept responsibility for his life, a crucial step on the movement towards maturity.

The presence of the word "moral" needs special consideration. When the Dr.Jeckyll/Mr.Hyde split occurs in a sex addict, the person "dissociates" and, in a manner not dissimilar to multiple personality disorder, becomes two people. The addict has his "normal" life and his "secret" life. The Dr.Jeckyll side of the personality has one set of values, goals and beliefs, and the Mr.Hyde side has a completely different set. that one has betrayed one's own values and moral injunctions. Step 5: Admitted to ourselves, God, and another human being the exact nature of our wrongs. The words "sex addict" and "secrecy" are almost synonymous. The addict carries the weight of the knowledge of what occurs in his "secret" world. If he shared the "secret" with another person, he would, in his mind, be condemned to hell. He believes he'd be despised. A diminishing sense of self esteem contributes to a sense of isolation and alienation. With the 5th Step, the secret is out. The ability to know and accept oneself in the presence of complete disclosure to another recovering addict is very freeing. One can let down one's defensive armor and have more of a sense of ease with oneself and the world. The recovering person, in revealing the content of their inventory to another, defuses feelings of guilt and shame. Another significance of this step is the movement from isolation, fear and mistrust of others begins to crumble as the interpersonal immersion in a caring community begins. Step 6: Became willing to have these defects removed. From a psychological standpoint, an attitude of "willingness" is essential to the process of growth. Again, it puts the person in a less ego-centric stance. It also conveys a breaking down of rigid defense mechanisms that may have worked to survive a frightening, unstable childhood but have now outlived their usefulness and, in fact, contributes to the addict's here-and-now problems in living. Step 7: Humbly asked Him to remove these shortcomings. I understand the despair, remorse and regret that follows an episode of acting out (When Dr. Jeckyll returns) as the realization

Humility is a word much- discussed in 12-step meetings. The posture of humility allows a person to quell ceaseless self-preoccupation and opens him/her up to having a sense of awe in the moment-to-moment awareness of life, nature, God and fellow human beings. Humility also suggests a turning-point in personality development from the illusion of self-sufficiency to having an interdependent view of relating to others.

Step 7 is the beginning of understanding that character building and remaining close to essential values is more important than chasing the high.

I quote from the book "Twelve Steps and Twelve Traditions" (Alcoholics Anonymous Worldwide):

"We never thought of making honesty, tolerance and true love of man and God the daily basis of living. We sought to gain a vision of humility as the avenue to true freedom of the human spirit."

Having a humble approach, along with the admission of powerlessness, leads to a softening of childish demands for immediate gratification. Step 8: Made a list of all persons we had harmed, and became willing to make amends to the all. The quality of inter-personal relationships is a mark of a person's stability and ability to live comfortably with one's fellows. Here we again come across the word "willingness", implying a deeper insight into the self as carrying responsibility for repetitive, unsatisfying personal relationships. It is only by letting go of resentment of the real or imagined harms done by others and focusing on what can be changed in oneself that the personality becomes less emotionally vulnerable, less reactive and more stable. Step 9: Made direct amends to such people wherever possible, except when to do so would injure them or others. This is another deeply liberating step. After amends have been made, there are no reasons that one has to hide from the world for past deeds. Those we have harmed and avoided out of shame have an exaggerated power over us. The step implies a readiness to take the consequences of past behavior, which is important in developing new modes of being in the world. It is an essential step in the development of a self and other orientation to living. Step 10: Continued to take personal inventory and when we were wrong, promptly admitted it. The development of better coping skills in dealing with the vicissitudes of daily living is the psychological underpinning of this step. When thrown off emotional balance by people or new events, the process of taking a quick inventory, admitting to errors in the now and forgiving, or at least tolerating, the imperfections of others is a sign of a stable person who has developed a new way of dealing with reality. Practice of Step 10 releases one from the need to be right, a truly liberating way of operating in the world.

Step 11: Sought through prayer and meditation a conscious contact with God as we understood him, praying only for knowledge of His will and the power to carry it out. Research has consistently shown the psychological and physical benefits of prayer and meditation. The person in recovery discovers that he is not a victim of his own mind and that he does have power over the state of his inner life. Meditative techniques have a powerful influence in reducing the anxiety that underlies most addictive behaviors. The individual can generate a sense of calm, focus and direction. Psychologically, the 11th Step is a means for even deeper insight into one's motives and needs.

Recovering people are often befuddled about "knowledge of His will". It would seem to me that it is not God's will, or anybody's will, that the addict return to using. It's probable that God's will includes not living a self-centered, self-serving life. Perhaps God's will includes living a moral life, consistent with one's deepest values and beliefs.

From a psychological standpoint, it is a conscious contact with our higher selves -- the

best part of who we really are. Step 12: Having had a spiritual awakening as a result of these steps, we tried to carry this message to alcoholics and to practice these principles in all our affairs. The inherent values of care for others, unconditional love, and genuine, honest relating is the core of the recovery process, a process that produces a mature personality. Successful application of this step would seem to define the essence of emotional maturity.

Maturity connotes having an authentic self that has been able to develop adequate coping skills; a sense of "agency" of the self that had been lost to the addiction; the ability to tolerate emotional pain with the knowledge that all internal states are transitory; the development of healthy inter-personal relationships, and a sense of purpose in living.

In summary, the addictive experience is marked by inter-personal difficulties and problems with isolation, self-esteem, impulse control, lack of self-regulation among other symptoms. The problematic dimensions of the addictive experience are addressed through the structure of "S" meetings. The program, including the steps, provides cognitive strategies, compensatory mechanisms and intra/interpersonal resources to assist the addict in successfully negotiating the vicissitudes of human living and staying sober for good purpose.

References Sachs, Kenneth S. Treating Alcoholism as a Disorder of the Self: Insights from Alcoholics Anonymous and Masterson Alcoholism Treatment Quarterly, 1544-4538, Volume 21, Issue 2, 2003, Pages 75 85

Hopson, Ronald E. and Beaird-Spiller Beth. Why AA Works :A Psychological Analysis of the Addictive Experience and the Efficacy of Alcoholics Anonymous