Lauren Bierman, MC, LAC, NCC,
CSAT Candidate

“A pathological relationship with a mood altering experience”
© Patrick Carnes, PhD,

P o r n o g r a p h y
“Sex Addiction” is an umbrella term for a number of compulsive behaviors
b a i t o n
M a s t u r i n g
P a y f o r s e x r s a i
A f f r s l o
P a r g e s a
M a s s y t a
F a n

• At the core of it, sexual compulsivity is an intimacy and/or attachment disorder
▫ False sense of “connecting” which in actuality disconnects from the self and others
▫ Compensating for a feeling of inadequacy
▫ Fear of true intimacy and attachment to a primary partner
• Attempting to get non-sexual needs met through sexual behaviors

“I thought that sex was love and love was sex”
“It was the only coping skill that was always there for me, even if only in my head”
“It filled the deep hole in me, momentarily, and then after acting out I felt even worse.
“I had sex to escape my shame, then I felt shame because I had sex, then I again had sex to escape my shame” (vicious cycle)

The Making of a Sex Addict

A pattern of out of control behavior over time.
© Patrick Carnes, PhD/

Clear behavior in which you do more than you intend or want.
© Patrick Carnes, PhD,

Repeated, specific attempts to stop the behavior, which fail.
© Patrick Carnes, PhD,

Significant amounts of time lost doing and/or recovering from the behavior.
© Patrick Carnes, PhD

Obsessing about or because of the behavior.
© Patrick Carnes, PhD

The behavior interferes with work, school, family, friends, hobbies, and spirituality.
© Patrick Carnes, PhD

Failure to stop the behavior even though you have problems because of it (social, legal, emotional, financial, and physical).
© Patrick Carnes, PhD

Need to make behavior more intense, more frequent, or more risky.
© Patrick Carnes, PhD

Losing, limiting, or sacrificing valued parts of life such as hobbies, family, relationships, and work.
© Patrick Carnes, PhD

Stopping behavior causes considerable distress, anxiety, restlessness, irritability, or physical discomfort.
© Patrick Carnes, PhD

• Ted is a 55-year-old, white male who is a lawyer by profession and has two adult children and has been married to his spouse for 22 years. Ted started to engage in pornography and masturbation at the age of 12 and this has been a constant for him throughout his life up to 7 days a week, for hours at a time. At the age of 25 he started to use cybersex with online services and also went to massage parlors. He hid this from his soon to be wife when they started dating and promised himself that he would stop once they were married. They did wed and had two children and he still continued to act out and had now escalated into actually seeing escorts for sex. His job was impacted due to not being able to concentrate and eventually his partner realized he was using company funds for his sexual acting out.

Belief
System
Unmanageability Impaired Thinking
Addictive
Cycle
Preoccupation
Shame
Despair Ritualization
Guilt
Compulsive
Behavior
© 2008

One’s psychosexual history that establish patterns and connections which have formed neurochemical and emotional templates related to sexuality.

What contributes to the Arousal
Template?
• Biology: Some of our desired parameters are simply given by genetic encoding.
• Family: Parental interaction with child and the parents with each other has a profound effect.
• Early sexual experiences: Child abuse can have a profound effect on the template. Adults who were trauma victims often repeat their abuse because the abuse has become eroticized.
• Sexual history: Personal experiences that shape one’s sexual beliefs and behaviors.
• Sexual Addiction History: Acting out behaviors that become obsessive.

Components of the Arousal Templates
• Feelings
• Personality types
• Objects
• Processes
• Patterns or situations
• Body types
• Characteristics
• Vulnerability
• Stages of courtship

In the original research conducted for Don’t
Call It Love (1992), a series of 114 sexual behaviors was statistically analyzed.
A total of 10 “types” of sexually compulsive behavior emerged in the sex addicts surveyed by
Patrick Carnes, Ph.D.
© Patrick Carnes, PhD/

• Sexually charged fantasies, relationships, and situations
• Arousal depends on sexual possibility.
© Patrick Carnes, PhD/

• Seduction of partners.
• Arousal is based on conquest and diminishes rapidly after initial contact.
© Patrick Carnes, PhD/

• Visual arousal.
• The use of visual stimulation to escape into obsessive trance.
© Patrick Carnes, PhD/

• Attracting attention to body or sexual parts of the body.
• Sexual arousal stems from reaction of viewer whether shock or interest.
© Patrick Carnes, PhD/

• Purchasing of sexual services.
• Arousal is connected to payment for sex, and with time, the arousal actually becomes connected to the money itself.
© Patrick Carnes, PhD/

• Selling or bartering sex for power.
• Arousal is based on gaining control of others by using sex as leverage.
© Patrick Carnes, PhD/

• Boundary violation without discovery.
• Sexual arousal occurs by violating boundaries with no repercussions.
© Patrick Carnes, PhD/

• High-risk sex with unknown persons.
• Arousal involves no seduction or cost and is immediate.
© Patrick Carnes, PhD/

• Being humiliated or hurt as part of sexual arousal; or sadistic hurting or degrading another sexually, or both.
© Patrick Carnes, PhD/

• Exploitation of the vulnerable.
• Arousal patterns are based on target “types” of vulnerability.
© Patrick Carnes, PhD/

Other behaviors that have been added through more recent research:
Broken Down:
• Paying for Sex-
▫ Power
▫ Commercial
• Exploitive Sex
▫ Trust
▫ Force
▫ Child
Added:
• Pornography
• Drug Interaction
• Internet Sex
• Paraphilia
• Masturbation
© Patrick Carnes, PhD/

• Sheila is a 32-year-old, female, of Native American decent. She is recently separated and has a small child.
Sheila’s husband left her due to her drug use and severe rage issues. Sheila was molested by a neighborhood boy when she was 12-15. Since the separation from her husband, she has been inviting men over to her place via the internet and will exchange sexual acts for drugs. Sheila will often post pictures on the internet of herself naked or in vulnerable positions to men. Before the men come over, she will fantasize about how this next one will be
“the one” for her and will sweep her off her feet.
When they arrive, Sheila will suggest that the men to do almost anything sexually to her including humiliating and degrading behaviors.

LOVE ADDICTION CYCLE
Greatest fear is that of abandonment with an underlying fear of intimacy
Trauma Issues
I am worthless in relationship to my partner.
I need to be taken care of as I can’t survive alone.
If I don’t get close enough relationally, I’ll die.
LOVE AVOIDANT CYCLE
Greatest fear is that of intimacy with an underlying fear of abandonment
Trauma Issues
My sense of value comes from taking care of needy people.
My job relationally is to take care of needy people.
If I don’t, I feel guilty.
To be relational (intimate) is to suffocate (die).
Enters relationship out of duty not love
May return to the relationship out of guilt or own fears of abandonment, or moves on to connect with new partner Returns to fantasy or moves on to new relationship
Is responsive to the avoidant’s seductiveness and enters the relationship in a haze of fantasy
Obsesses &
Medicates
Emotional withdrawal from fantasy
Pain
Anger
Fear
Shame
Rage
Panic
Denies partners walls and importance of life outside relationship
Experiences an event that shatters the denial
© Pia Mellody
Enters behind wall of seduction
(impedes intimacy)
Becomes overwhelmed by the neediness of the partner and moves from wall of seduction to wall of anger or resentment
Creates intensity outside of primary relationship
Abandons the relationship in some way- creates distance from the partner

• Accessing online pornography and audio, video, and text stories.
• Real time with a fantasy partner.
• Other cybersex venues (social networking sites, and portable devices such as Blackberries and iPhones).
• Multimedia software.

• A total of 4.2 million websites contain pornography. That is 12 percent of the total number of websites. There are 100,000 websites that offer pornography and 1 in 7 youths report being solicited for sex on the internet.
• Average age of first exposure to internet pornography is 11-years-old . http://internet-filter-review.toptenreviews.com/internet-pornography-statistics-pg4.html

• Accessibility
• Anonymity
• Affordability
Al Cooper, PhD

Ten Criteria for Problematic
Online Sexual Behavior
 Preoccupation with sex on the Internet.
 Frequently engaging in sex on the Internet more often or for longer periods of time than intended.
 Repeated unsuccessful efforts to control, cut back on, or stop engaging in sex on the Internet
 Restlessness or irritability when attempting to limit or stop engaging in sex on the Internet.
 Committing illegal sexual acts online (ex: sending or downloading child pornography).

 Jeopardizing or losing a significant relationship, job, or educational or career opportunity because of online sexual behavior.
 Incurring significant financial consequences as a result of engaging in online sexual behavior.
 Using sex on the Internet as a way of escaping from problems or relieving feelings such as helplessness, guilt, anxiety, or depression.
 Returning to sex on the Internet day after day in search of a more intense or higher-risk sexual experience.
 Lying to family members, therapists, or others to conceal involvement with sex on the Internet.

• Dishonesty and secrets throughout relationships or the entire family system
• Overwhelming sense of betrayal
• “Shattered” world
• Covert/ Overt Sexual Energy/ Behaviors
• Risk of disease and consequences (STI’s, divorce, violence, loss of job, or jail time, etc.)
• Financial loss
• Passed down through generations

Building a new relationship with self
Building a new relationship with sex

 Individual Therapy
 Group Therapy
 Twelve Step Meeting
 Sponsor
 Steps One through
Nine
 Family Participation
 Family Recovery
 Couples Recovery
 Exercise/Nutrition

• Break through denial
• Understand the nature of the illness
• Become willing to surrender to the process
• Limit damage from behavior
• Establish sobriety
• Ensure physical integrity
• Participate in a culture of support- 12 Steps
• Shame reduction work
• Grief work
• Acknowledge cycles of abuse
• Commit to recovery for each family member

For the Addict
• Out of the ShadowsDr. Patrick Carnes
• Facing Love AddictionPia Mellody
• Don’t Call it Love - Dr. Patrick Carnes
• In the Shadows of the Net - Dr. Patrick Carnes
• Ready to Heal - Kelly McDaniel
• Women, Sex, and Addiction - Dr. Charlotte Davis Kasl
For the Family
• Deceived - Dr. Claudia Black
• Mending a Shattered Heart - Dr. Stefanie Carnes
• A House Interrupted - Maurita Corcoran