The Basic Facts about “Sex Rehab” – Part Two
If you missed The Basic Facts about “Sex Rehab” – Part One you can read it here.
Many people enter inpatient sex addiction treatment expecting that the primary focus of the work will be identifying and resolving their childhood trauma. Certainly this is one aspect of sex rehab, but it’s only one among many, and a minor one at that, since helping patients gain insight into childhood concerns is, at this point, far less important than the immediate issue of stopping the sexual fantasies, urges, and behaviors that are causing problems in the patient’s life. In other words, first things first, and the first thing to do in sex addiction treatment, beyond a thorough bio-psycho-social-sexual assessment, is to identify and stop the problematic sexual behavior. Later, after the addict is stabilized and has established a modicum of sexual sobriety, childhood trauma and other underlying psychological issues can effectively be addressed.
Once the patient has been evaluated, inpatient sex addiction treatment typically focuses on two main issues.
- Separating the addict from his or her problematic sexual and romantic behavior patters
- Breaking through the denial the addict uses to make his or her problematic behaviors acceptable (in the addict’s mind)
The most effective tools for accomplishing these early sobriety tasks are Cognitive Behavioral Therapy (CBT) and Group Therapy. CBT differs significantly from traditional models of talk therapy, which examine how the patient’s past is affecting the present, relying instead on a more directive approach. With CBT the clinician and client look at the people, places, and things in the addict’s life that trigger and reinforce his or her sexually addictive thoughts and behaviors, identifying ways to recognize and interrupt the process. Essentially, CBT teaches sex addicts how to recognize the early stages of their addiction cycle, and how to short-circuit that cycle by thinking about and/or doing something else. In other words, instead of turning to sexual fantasy and behavior as a way to “self-medicate” uncomfortable emotions and dissociate from life stressors, sex addicts learn to engage in other, healthier behaviors such as going to a 12-step meeting, calling a 12-step sponsor or supportive friend in recovery, exercising, engaging in a hobby, cleaning the house, spending time with family, etc.
Recovering sex addicts nearly always require more than just a therapist for support if they wish to permanently eliminate their deeply ingrained sexual behavior patterns. This is where group therapy comes in. Usually, in group, a clinician works with anywhere from six to ten addicts. In these facilitated discussions clients are able to see, often for the first time, that their problem is not unique and they are not alone in their fight against it. This realization goes a long way toward reducing the guilt, shame, and remorse associated with sexual addiction (all of which can be triggers for further compulsive sexual behavior).
Group therapy is also an ideal setting for combatting the rationalizations and justifications – the denial – that is common to all sex addicts. When an addict talks at a group level about the internal lies used to make his or her behavior OK, others are able to help the addict dismantle this intricate web of deceit. These peer-driven confrontations are powerful not only for the addict being confronted, but for the people doing the confronting. Through such interaction, everyone present learns how rationalization and justification sustain sex addiction.
Group therapy has other benefits, too. For starters, this is the beginning of the addict’s social support network. For probably the first time ever, the addict now has people in his or her life who are able to identify with and understand the thoughts and urges he or she is experiencing. This alone is incredibly helpful. More helpful, however, is input on how to recognize and overcome triggers to act out. In other words, clients are able to learn and reinforce with one another what interventions and coping mechanisms are most effective in specific situations based on their own and other members’ actual experiences.
It is important to state very clearly that sex addiction rehab is not a cure for sex addiction. Instead, it is the start of a journey into health. Many feel, after an inpatient stay, that they’ve got things under control. However, once they’re back in the real world they are inevitably confronted with the very same problems and temptations that drove them into treatment in the first place. As such, careful, structured, contracted aftercare is an essential part of inpatient care. Most addicts need continued work with a sexual addiction treatment specialist, often both in individual and group therapy. Those in relationships may also require therapeutic support for spouses/partners.