Presents

Sexual Addiction
Department of National Defence
Veterans Affairs Canada
October 20. 2005
Bellwood Health Services Inc.
www.bellwood.ca
Penny Lawson. ICADC. ICCS. CSAT
Manager. Family Services and Special Programs
Acting Out Behaviours Acting Out Behaviours
1. Fantasy Sex 18
2. Voyeurism 18
3. Exhibitionism 15
4. Seductive Role Sex 21
5. Intrusive Sex 17
6. Anonymous Sex 18
7. Trading Sex 12
8. Paying Ior Sex 15
9. Pain Exchange 16
10. Exploitive Sex 13
Adapted from on`t Call It Love: Recovery Irom Sexual Addiction (Patrick Carnes, Ph..:1991)
evel 1 Behaviours evel 1 Behaviours
Culturally acceptable or tolerated publicly,
these behaviours can be devastating when
engaged in compulsively. These healthy Iorms
can easily become selI deIeating and
victimizing in the addiction cycle.
xamples xamples
asturbation
Consenting sexual relationships
Pornography
evel 2 Behaviours evel 2 Behaviours
These behaviours are suIIiciently intrusive and
illegal, but are generally thought oI as nuisance
behaviours by the general public and the iustice
system. The common characteristic is that there
are direct and indirect victims resulting Irom these
behaviours.
xamples xamples
Voyeurism
Exhibitionism
Obscene Phone Calls
Indecent Liberties
evel 3 Behaviours evel 3 Behaviours
This represents those behaviours with the greatest
and most signiIicant boundary violation, and oIten
produce the most severe consequences in social
work and legal systems. There is little
understanding oI those who engage compulsively
at this level, yet addiction exists here, too.
xamples xamples
Rape
Incest
Child olesting
The paraphiliac Iocus oI Pedophilia
involves sexual activity with a
prepubescent child (generally age 13
years or younger). $4:rce: D$ '
%e 2 paragrap8 following ti8 de8.ription
detail -ehavi4:rs of perpetrator8 in
.ontra8t to te diagno8ti. .riteria.
iagnostic Criteria For 302.2 iagnostic Criteria For 302.2
Pedophilia Pedophilia
A. Over a period oI at least 6 months, recurrent,
intense sexually arousing Iantasies, sexual urges, or
behaviours involving sexual activity with a
prepubescent child or children (generally age 13
years or younger).
B. The Iantasies, sexual urges, or behaviours cause
clinically signiIicant distress or impairment in
social, occupational, or other important areas oI
Iunctioning.
$our.e. D$ IJ
iagnostic Criteria For 302.2 iagnostic Criteria For 302.2
Pedophilia Pedophilia (Cont'd) (Cont'd)
C. The person is at least age 16 years and at
least 5 years older than the child or children
in Criterion A.
$our.e. D$ IJ
iagnostic Criteria For 302.2 iagnostic Criteria For 302.2
Pedophilia Pedophilia (Cont'd) (Cont'd)
Sexually Attracted to ales
Sexually Attracted to Females
Sexually Attracted to Both
Specify if: Specify if:
Limited to Incest
Specify if: Specify if:
Exclusive Type (attracted only to children)
Nonexclusive Type
Specify type: Specify type:
$our.e. D$ IJ
Arousal Template Arousal Template
Body Types
Body Parts
Partner Characteristics
Sensations
Feelings
Adapted from Facing the Shadow: Starting Sexual and Relationship Recovery (Patrick Carnes, Ph..:2001)
Arousal Template Arousal Template (Cont'd) (Cont'd)
Situations and Places
Obiects
Processes
Behaviours
Courtship Stages and BelieIs
Adapted from Facing the Shadow: Starting Sexual and Relationship Recovery (Patrick Carnes, Ph..:2001)
The Biology of Attraction and The Biology of Attraction and
Attachment Attachment
ProIoundly inIluences all 3 neurochemical
pleasure planes:
Arousal
Satiation
Fantasy
Adapted from on`t Call It Love: Recovery Irom Sexual Addiction (Patrick Carnes, Ph..:1991)
The Biology of Attraction and The Biology of Attraction and
Attachment Attachment (Cont'd) (Cont'd)
Androgens
Endorphins
opamine
Norepinephrine
Seratonin
Vasopressin
Oxytocin
10 Signs of Sexual Addiction 10 Signs of Sexual Addiction
1. A pattern oI out-oI-control behaviour
2. Severe consequences due to sexual
behaviour
3. Inability to stop despite adverse
consequences
4. Persistent pursuit oI selI-destructive or high-
risk behaviour
Adapted from on`t Call It Love: Recovery Irom Sexual Addiction (Patrick Carnes, Ph..:1991)
10 Signs of Sexual Addiction 10 Signs of Sexual Addiction (Cont'd) (Cont'd)
5. Ongoing desire or eIIort to limit sexual
behaviour
6. Sexual obsession and Iantasy as a primary
coping strategy
7. Increasing amounts oI sexual experience
(oIten increasing the level oI risk, danger, and
Iear) because the current level oI activity is no
longer suIIicient
Adapted from on`t Call It Love: Recovery Irom Sexual Addiction (Patrick Carnes, Ph..:1991)
8. Severe mood changes around sexual activity
9. Inordinate amounts oI time spent in obtaining
sex, being sexual, or recovering Irom sexual
experience
10. Neglect oI important social, occupational, or
recreational activities
Adapted from on`t Call It Love: Recovery Irom Sexual Addiction (Patrick Carnes, Ph..:1991)
10 Signs of Sexual Addiction 10 Signs of Sexual Addiction (Cont'd) (Cont'd)
Statistics Statistics
98 million unique individuals visited the
top 5 Iree pornography sites
Estimated 100,000 commercial
porn sites 40 new sites
added per day
E-Porn $1billion industry
70 oI all e-porn traIIic
occurs during 9-5 workday(except lunch)
Cybersex Cybersex
Engrossing
Exciting
Interactive
Inexpensive
Isolating
Secretive
ComIorting
Brain altering
Cybersex Cybersex
Arousal template altering
Low risk (physically)
Increases rationalizations
Types of C Types of Cybersex ybersex
Private vs. Commercial
View and Print Photography
Chat Rooms
Live Video Feeds
Newsgroups/essage Boards/Clubs
Personal E ail
Web Cams
mages mages
Live
orphed
Virtual
Client Characteristics
To Watch For:
Excessive sexual humour
Seductive behaviour and charm
oralizing about sexual issues
Judgmental religiosity
Inappropriate dress
Patterns oI short term relationships
Not accountable Ior money or time
Living in extremes
Spouse, partner, or someone else is, or Ieels, a
victim
elusion around the impact oI sexual behaviour
aior secrets around sex
Emotionally unavailable
Super achiever/under achiever
Compulsively busy
Physical problems around sex
Client Characteristics
To Watch For: (Cont'd)
ynamics of Multiple Addictions ynamics of Multiple Addictions
Switching Suspending compulsive behaviour
and dependence but initiating new
behaviour and dependence
Alternating Predictable pattern oI moving Irom
one addiction to another
Masking One addiction serves as a mask or
excuse Ior the other
Fusing ore than one addiction must be
present Ior the other to work
4/e 4/e Dvnamic Dvnamic
#itualizing One addiction is part oI the
ritualizing Ior another
Intensifying utual existence oI addictive
behaviour increases intensity oI
experience
Numbing Shame about one addiction is
ameliorated by the numbing oI another
Dis-inhibiting One addiction serves to lower
inhibitions Ior other addictive
behaviour
ynamics of Multiple Addictions
4/e 4/e Dvnamic Dvnamic
The Sexual Curve The Sexual Curve
Sexual
Anorexia
ess
Sexual
Addiction
More
Hypoactive
Sexual esire
Hyperactive
Sexual esire
Adapted from on`t Call It Love: Recovery Irom Sexual Addiction (Patrick Carnes, Ph..:1991)
15 Signs of Sexual Anorexia 15 Signs of Sexual Anorexia
1. A dread oI sexual pleasure
2. A morbid and persistent Iear oI sexual contact
3. Obsession and hyper-vigilance around sexual
matters
4. Avoidance oI anything connected with
sex
5. Preoccupation with others being sexual
6. istortions oI body appearance
$exual Anorexia. Over.oming $exual $elf-atred (Patri. Carne8 P.D.. 1997)
15 Signs of Sexual Anorexia 15 Signs of Sexual Anorexia (Cont'd) (Cont'd)
7. Extreme loathing oI body Iunctions
8. Obsessional selI-doubt about sexual adequacy
9. Rigid, iudgmental attitudes about sexual
behaviour
10. Excessive Iear and preoccupation with
sexually transmitted diseases
11. Obsessive concern or worry about the sexual
intentions oI others
$exual Anorexia. Over.oming $exual $elf-atred (Patri. Carne8 P.D.. 1997)
12. Shame and selI-loathing over sexual
experiences
13. epression about sexual adequacy and
Iunctioning
14. Intimacy avoidance because oI sexual Iear
15. SelI-destructive behaviour to limit, stop, or
avoid sex
15 Signs of Sexual Anorexia (Cont'd)
$exual Anorexia. Over.oming $exual $elf-atred (Patri. Carne8 P.D.. 1997)
iagnostic Criteria For 302.79 iagnostic Criteria For 302.79
Sexual Aversion isorder Sexual Aversion isorder
A. Persistent or recurrent extreme aversion to,
and avoidance oI, all (or almost all) genital
sexual contact with a sexual partner.
B. The disturbance causes marked distress or
interpersonal diIIiculty.
C. The sexual dysIunction is not better
accounted Ior by another Axis I disorder
(except another Sexual ysIunction).
$our.e. D$ IJ
LiIelong Type
Acquired Type
Specify Type: Specify Type:
eneralized Type
Situational Type
Specify Type: Specify Type:
ue to Psychological Factors
ue to Combined Factors
Specify: Specify:
$our.e. D$ IJ
iagnostic Criteria For 302.79 iagnostic Criteria For 302.79
Sexual Aversion isorder Sexual Aversion isorder
The Making of a Sex Addict
ddicts in FamiIy 87%
Rigid & Disengaged
FamiIy Systems 68%
EmotionaI
97%
8 Trauma Factors
FAM FAM
CataIytic Environment
MuItipIe
ddictions 83%
ChemicaI 42%
Eating Disorders 38%
CompuIsive Working 28%
CompuIsive Spending 26%
CompuIsive GambIing 5%
ddiction
Interaction
Disorders
Impaired:
SexuaIity
Work
PhysicaI Body
LifestyIe
Love/Bond
SpirituaIity
Disengaged
FamiIy
System 87%
Rigid
FamiIy
System 77%
SexuaI
81%
PhysicaI
72%
ddictive
System
SexuaI
ddiction
buse/EarIy Trauma
CataIytic Stress
Trauma Bonds: Trauma Bonds:
When Humans Bond With Those When Humans Bond With Those
Who Hurt Them Who Hurt Them
Copyright: Patrick J. Carnes, Ph, C.A.S. 1990
Trauma #eactions: Psychological and/or
psychological alarm reactions
Irom unresolved trauma
experiences.
Trauma Pleasure: Seeking/Iinding pleasure in the
presence oI extreme danger,
violence, risk, or shame.
Trauma Blocking: EIIorts to numb, block out,
overwhelm residual Ieelings due
to trauma.
Trauma Bonds: Trauma Bonds:
When Humans Bond With Those When Humans Bond With Those
Who Hurt Them Who Hurt Them (Cont'd) (Cont'd)
Copyright: Patrick J. Carnes, Ph, C.A.S. 1990
Trauma Splitting: Ignoring traumatic realities by
splitting oII experience and
not integrating into personality
or daily liIe.
Trauma Abstinence: Compulsive deprivation
which occurs especially
around moments oI success,
high stress, shame or anxiety.
Trauma Bonds: Trauma Bonds:
When Humans Bond With Those When Humans Bond With Those
Who Hurt Them Who Hurt Them (Cont'd) (Cont'd)
Copyright: Patrick J. Carnes, Ph, C.A.S. 1990
Trauma #epetition: Repeating behaviours and/or
seeking situations or persons who
recreate the trauma experience.
Trauma Bonds: ysIunctional attachments that
occur in the presence oI danger,
shame or exploitation.
Trauma Shame: ProIound sense oI
unworthiness and selI hatred
rooted in traumatic experience.
Partner's Progression
enial oI problem
Realization
Challenge to partner
etective behaviours begin
Hyper-vigilance
Anger and resentments
Increasing ambivalence about the relationship
Problem seen as partner`s addiction
Sadness and resentment
Adapted from Rhonda ilrad: Co-Addiction Recovery
Partner's Progression (Cont'd)
Seeking Iull disclosure:
P To make sense oI the past
P To validate suspicions
P To gain sense oI control
P To assess risk oI std exposure
P To assess partners relationship commitment
Enter 12 step program and therapy
Reduce detective behaviours
Focus on own issues
Adapted from Rhonda ilrad: Co-Addiction Recovery
Surviving Withdrawal Surviving Withdrawal
Fatigue
Tenseness, nervousness
Insomnia
Headaches
Shakes
High sexual arousal
Low sexual arousal
Body aches
Surviving Withdrawal Surviving Withdrawal (Cont'd) (Cont'd)
Increased Iood appetite
enital sensitivity
Itchy skin
Chills, sweats
Nausea
Rapid heartbeat
Shortness oI breath
The Course Of Recovery Over Time
Pre-recovery
Year One Year Two Year Three Year Four Year Five
DeveIoping Stage
Up to two years
Cross-decision Stage
1 day to three months
Shock Stage
8 months
Grief Stage
4 - 8 months
Growth Stage
Two years & continuing
Repair Stage
Eighteen to thirty-six months
Recovery Tasks
1. Break through denial
2. Understand the nature oI the illness
3. Surrender to the process
4. Limit damage Irom behaviour
5. Establish sobriety
6. Ensure physical integrity
7. Participate in a culture oI support
8. Reduce shame
Recovery Tasks (Cont'd)
9. rieve losses
10. Understand multiple addictions and sobriety
11. Acknowledge cycles oI abuse
12. Bring closure and resolution to addictive shame
13. Restore Iinancial viability
14. Restore meaningIul work
15. Create liIestyle balance
16. Build supportive personal relationships
Recovery Tasks (Cont'd)
17. Establish healthy exercise and nutrition patterns
18. Restructure relationship with selI
19. Resolve original conIlicts - wounds
20. Restore healthy sexuality
21. Involve Iamily members in therapy
22. Alter dysIunctional Iamily relationships
23. Commit to recovery Ior each Iamily member
24. Resolve issues with children
Recovery Tasks (Cont'd)
25. Resolve issues with extended Iamily
26. Work through diIIerentiation
27. Recommit/commit to primary relationship
28. Commit to coupleship
29. Succeed in primary intimacy
30. evelop a spiritual liIe
eveloping Healthy Sexuality eveloping Healthy Sexuality
earning Self Nurturance
esign Nurturance Plan
and mplement
Gain A Sense of Self-
Respect
evelop a Sensuous
dentity
Cultivate Sensual Attunement,
Complete 5 Sensory
Exercises and Journaling
Gain A Positive Self-
Perception That ncludes
Embracing our Sexual
Self
Create A Self mage Begin 12 Step nvolvement
Explore Core Beliefs,
Complete Sexual History n-
ventory, Apply Affirmations
Create Sexual Safety and
Empowerment
evelop Self efinition Establish Sexual Boundaries
evelop Sexual
communication skills, efine
dentify Ego States, Explore
Addiction
nteraction
Create Sexual Safety and
Empowerment
TSK PERFORMBLES LIFE COMPETENCY
earning Self Nurturance
Establish Sexual Comfort Assess Sexual Trauma,
Confront Body mage ssues
Capacity to be at Ease
About our Sexuality
Gain Sexual Knowledge Overcome Negative Family of
Origin ssues, Address Cultural
Religious & Gender Specific
Beliefs Related to Sexuality,
Begin Trauma Resolution
Gain Knowledge of Both
the Negative and Positive
Aspects of Sexual Self
evelop Appropriate
Relationships
evelop Solid 12 Step
Community, Participate in
Appropriate Hobbies & nterests
Separate Erotic From
Relationship Attraction
Create Sexual Safety and
Empowerment
Establish A Partnership Enhance Communication Skills
earn & Apply Conflict
Resolution Skills, Attend RCA
Maintain an
nterdependent Equal
Relationship That is
ntimate and Erotic
TSK PERFORMBLES LIFE COMPETENCY
eveloping Healthy Sexuality (Cont'd)
Gain Comfort Through
Non-genital Sexuality
Participate in Non-genital
Exercises, evelop
Communication skills
Self Satisfying Expression
of Erotic Pleasures Without
the Use of the Genitals
Healthy Expression of
Genital Sexuality
Apply New Sexual Techniques
Address ssues of Control
and Power
Free Expression of Erotic
esires With the Use of the
Genitals
Spiritual Connectedness evelop Sexual/Spiritual Model
for Self and Partner
The Value of One's ife is
Enhanced by Sexual
Expression
Expression of Passion Share Story with 12 Step
Community, ntegrate passion
in all Aspects of ife, efini-
tions of Boundaries
Well efined Sense of Self
Who Can Express eeply
Held Feelings and esires
TSK PERFORMBLES LIFE COMPETENCY
eveloping Healthy Sexuality (Cont'd)
PHYSICAL MNTAL
SOCIAL
Balanced iving Balanced iving
SPI#ITUAL
Presents
Sexual Addiction
Department of National Defence
Veterans Affairs Canada
October 20. 2005
Bellwood Health Services Inc.
www.bellwood.ca
Penny Lawson. ICADC. ICCS. CSAT
Manager. Family Services and Special Programs