The development of better coping skills in dealing with the vicissitudes of daily living is the psychological underpinning of Step 10. 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.

Experts from the Society for the Advancement of Sexual Health estimate that three to five percent of the population have compulsive sexual behavior, also known as hypersexual disorder. About 90% of those with the disorder are middle-aged men, but it appears to be increasing among females, teenagers, and senior citizens. The number of sex therapists that provide treatment increased from 100 to 1500 in the past ten years.

"It used to be 40- and 50-year-old men seeking treatment," said Tami VerHeist, vice president of the International Institute for Trauma and Addiction Professionals. "Today grandfathers are getting caught with pornography on their computers by their grandkids, and grandkids are sexting at 12."

The usual explanation for the increases in the number of sex addicts is the increased availability of pornography. Newsweek is reporting that every day 40 million people visit the 4.2 million websites that offer free pornography on a 24/7 basis. The theory is the more people watch pornography and send each other provocative images of themselves, the more they want the real thing.

Whether sexual addiction is similar to drug and alcohol dependency and whether it causes changes in the chemistry of the brain is a controversial question. Many people in the therapeutic community, including Robert Weiss, founder of the Sexual Recovery Institute in Los Angeles, believe hypersexual disorder is a brain disease that should be considered a medical condition.

"It’s about chasing that emotional high: losing yourself in image after image, prostitute after prostitute, affair after affair," he said. "They end up losing relationships, getting diseases, and losing their jobs."

Others believe there is no such thing as sex addiction, and that it is not an epidemic.

Psychologist and author Dr. David Ley believes sex addiction is modern mythology.

"The sex addiction concept is a belief system, not a diagnosis," he told Newsweek. "It is not a medically supported concept. The science is abysmal. The thing that drives me crazy is it that over the past year or two, they have started trying to use brain science to explain it. They are now talking about morphological changes that supposedly happen in the brain when somebody watches pornography or has too much sex."

Several celebrities, including Tiger Woods and Charlie Sheen, are reputed to be sex addicts. There are many treatment programs available for the condition.

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.

Step 9 implies a readiness to accept 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.

The quality of interpersonal 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.

By Dorothy Hayden, LCSW
www.sextreatment.com

Humility is a word much discussed in 12-Step meetings. The posture of humility allows a person to quell ceaseless self-preoccupation and opens 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 inter-dependent 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.

"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." (From the book "Twelve Steps and Twelve Traditions" (Alcoholics Anonymous Worldwide))

Having a humble approach, along with the admission of powerlessness, leads to a softening of childish demands for immediate gratification.

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, contribute to the sex addict’s here-and-now problems in living.

Dorothy Hayden, LCSW has been specializing in treating sex addiction and chemical dependency for 15 years. She has training in sex addiction therapy, psychoanalysis, hypnosis and cognitive behavioral therapy. The full text of her writings on sex addiction can be found at www.sextreatment.com.

Sexual addiction is generally regarded in one of two ways—the first theory is that it is addiction, like that of drugs or alcohol, where a state of euphoria or a “high” is experienced; the other is that it is a type of obsessive-compulsive disorder. However it is defined, sex addiction is considered a progressive illness, meaning that the addictive behavior intensifies the longer it goes untreated. Experts believe an estimated three to six percent of Americans are battling some form of sexual compulsion.

Signs and symptoms of a sexual addict may start innocently enough with excessive masturbation, obsessive use of pornography, or partaking in sex phone services. As the disorder develops, the severity of the symptoms increases. Addicts may compulsively date, engage in unsafe sex, and may have multiple or extra-marital affairs. These acts may not only harm the individual’s health, but can negatively impact their relationships with loved ones.

In the most severe cases, a sex addict will engage in illegal acts such as voyeurism, prostitution, molestation, or even rape. Although not all sex addicts become sex offenders and vice versa, it is estimated that 55 percent of convicted sex offenders have a sexual addiction. Interestingly, a person with sexual addiction generally doesn’t receive pleasure or satisfaction from the sexual act. Instead, they often use sex as an escape from other problems such as stress, depression, or anxiety. Many sex addicts have experienced some form of sexual or verbal abuse in their lives that has contributed to their compulsion.

Even though research on sexual addiction is growing, there are skeptics who claim the condition is not a “real” addiction. Many critics believe sexual compulsion is a narcissistic act and a byproduct of society—nothing more. The Diagnostic and Statistical Manual of Mental Disorders (DSM) has yet to include the diagnosis in its compendium of mental disorders although it does include a miscellaneous diagnosis for sexual disorders.

Treatment for sexual addiction may prove tricky at first because many individuals with this disorder feel embarrassed and shameful, making it difficult for them to acknowledge that they have a problem. Once an individual admits they have an addiction, their recovery follows a similar plan to those of other addictive and behavioral treatments. Patients are encouraged to become involved in group therapy, a 12-step program, and one-on-one therapy sessions with a psychologist or psychiatrist. Medication may also be prescribed. The goal behind the therapy is for the patient to learn how to control their compulsive behavior while maintaining a healthy sexual lifestyle.

Overcoming any type of addiction is highly challenging and sexual addiction is no exception. Under the guidance of a physician or clinical therapist and by having the willingness to change, any individual dealing with this addiction can be treated.

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 Step 5, 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. Isolation, fear, and mistrust of others begin to crumble as the interpersonal immersion in a caring community begins.

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. I understand the despair, remorse, and regret that follows an episode of acting out (when Dr. Jeckyll returns) as the realization that one has betrayed one’s own values and moral injunctions.

By Dorothy Hayden, LCSW
www.sextreatment.com

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. Step 3 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.