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.

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.

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.

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

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 sex addiction. One surrenders to the reality that they can never act on the impulse to "pick up." "One day at a time" is a truth that becomes an incontrovertible fact as sex addiction recovery progresses.

The second facet is that the sex addict is really surrendering their sense of uniqueness.

By Dorothy Hayden, LCSW
www.sextreatment.com

There are varying focus areas to consider when choosing a 12-Step program for sexual addiction, such as whether the problem is sexual compulsivity or an addiction to love. Other factors that can influence a person’s decision to attend 12-Step group are specific requirements, like behaviors the members will permit or not permit. Some do not allow masturbation or sexual activity outside of marriage, for example, as members strive toward sexual sobriety.

The 12-Step groups that work toward helping people overcome sexual addiction were founded on similar philosophies as the global chapter for people with alcohol addiction, Alcoholics Anonymous, with one core difference: unlike Alcoholics Anonymous, fellowships for sexual addiction do not focus on total abstinence from the sex, but instead a healthy plan of sexual sobriety that brings recovery from the problem behaviors.

One core support group for sexually addictive behaviors is Sex Addicts Anonymous. Members are required only to have “a desire to stop addictive sexual behavior.” Sex Addicts Anonymous members strive toward sexual sobriety, which they explain means abstaining from a specific problematic sexual action. There is no formal definition of abstinence; rather Sex Addicts Anonymous chapters state that it is up to each individual to identify which sexually addictive action or behavior they choose to abstain from.

Sexual Compulsives Anonymous (S.C.A.) groups focus on abstaining from what they call “compulsive sex,” and members embark on a plan for sexual recovery based on a definition of sexual sobriety that is personalized to their own patterns of destructive behavior. Members of S.C.A. try to stop sexual behaviors that destroy their time and deplete their energy, or jeopardize their emotional and physical health.

Another option for the sex addict might be Sex and Love Addicts Anonymous. Sobriety, according to Sex and Love Addicts Anonymous, means striving to stop the habitual “acting out” with sexual actions or behaviors. Referred to as “bottom-line behaviors,” members of the fellowship are permitted to declare the exact sexual behaviors that have created the addiction cycle they are living in and to identify those actions for which they are no longer in control.

Perhaps the most “traditional” of the sex addiction groups is Sexaholics Anonymous, who ask their members to have “a desire to stop lusting” and to strive toward sexual sobriety. This includes self-stimulation (masturbation), and those who are unmarried are not permitted to have sex – behaviors the group deems as addictive and self-destructive. According to Sexaholics Anonymous, reaching sobriety from sexual addiction must also include the person’s thought patterns toward sex, not just their behaviors.

While experts differ on views concerning wither addiction to sex is a disorder, or should be called a disease, the emergence of new 12-Step based programs and treatment facilities across the nation is calling attention to these destructive behaviors, and continues to open the door to recovery for thousands of sex addicts.
 

Tiger Woods’s admission of infidelity has cast a spotlight on treatment for sexual addiction. Though some believe the term is an excuse for men behaving badly, there is a growing acceptance that sexual addiction is a medical condition similar to compulsive gambling and overeating.

The most recent edition of the International Classification of Diseases, written by the World Health Organization, lists “excessive sexual drive” as a diagnosis. Last week, the American Psychiatric Association proposed that “hypersexual disorder” be included in the next edition of the Diagnostic and Statistical Manual of Mental Disorders. The proposal will be debated over the next two years.

Many agree that compulsive sexual behavior is a condition that can require treatment ranging from medication to residential treatment programs. The rise of Internet pornography (much of it free and anonymous) has fueled the problem. Patrick Carnes, a pioneer in the field, believes that 3 to 6 percent of the population suffers from the condition, which he defines as compulsive behavior that interferes with normal living.

“With the advent of the Internet and access to pornography, the number of men coming for help now who have serious problems with porn has increased greatly,” says Dr. Martin P. Kafka, who has treated more than 1,000 people with sexual disorders. “I think this whole thing is very scary for women.”

Kafka, a professor of psychiatry at Harvard Medical School, has discovered that mood disorders such as bipolar disease and depression are often linked with hypersexual behavior. He treats such patients with antidepressants or mood stabilizers and Ritalin if they have attention deficit disorder.

“In society now, we commonly refer to sex as an addiction, and when we do that, we’re destigmatizing it as a completely moral problem,” Kafka says. “We’re saying there’s something else going on here.”

Suki Hanfling, director of the Institute for Sexuality and Intimacy in Belmont, says sex addiction is different from bad behavior. “A person who’s narcissistic may feel, ‘I’m entitled to this, I’m not getting caught, it’s great,’” she says. “But with a sexual addiction, those people often end up hating themselves and feeling a lot of shame and guilt. Usually people feel awful about it, except when they’re doing it.”

Kafka treats paraphilias (sex offenders, some of them sex addicts). But most of his caseload deals with “totally harmless guys” who are simply obsessed with sex.
“These men have what you call normal sexual arousal, except it is excessive and disinhibited,” he says. “They’re mostly self-destructive.”

Jeff, who ran the recent SLAA meeting, says that description fits him. An engineer, he describes a former life out of control, with constant trips to strip bars, “dirty movie houses,” peep shows, prostitutes, and porn sites. Even after he contracted venereal diseases, he didn’t stop. His low point came, he says, when, in a dream-like state he sexually assaulted his sleeping wife.

“She called the police and had me thrown out, with a restraining order,” Jeff says. He entered a residential treatment program for sex addicts, the couple went into therapy, and he has been attending SLAA meetings for more than 20 years. He and his wife, who have two grown children, reunited, and Jeff says he has been “abstinent’’ from compulsive sex for 12 years.

Those in SLAA use the 12-step model of Alcoholics Anonymous. To be abstinent or sober means that you haven’t violated any of the rules you list on your “bottom line.” In Jeff’s case, that means he doesn’t do anything that would physically or emotionally hurt himself or others, such as having an affair.

Though the majority of sex addicts are men, women also struggle with the issue. Jennie, 50, has been married and divorced twice. By her 40s, she had slept with at least 25 men.
The eldest of five children, she grew up responsible for her siblings. “The one way I knew to get attention was to be sexual,” says Jennie. “From my early teens, I would go out with bad boys and have sex with them.”

As a child, she says, she was sexually abused by someone close to her. In adulthood, every relationship became obsessive. “I would completely lose interest in my friends and everything else; my life revolved completely around the men. I would have sex constantly every time we got together as a way of providing a connection.”

Finally, after having a relationship with a married colleague, Jennie checked into an eight-week residential treatment program. When she returned, she broke it off with her colleague, took a leave from her job, and has been in recovery for three years.

“It means for the first time in my life I like myself,” Jennie says. “It means I have friendships with women who in the past were always my competitors. It means I can have a hug with someone and I know it’s not going to turn sexual.”

She has been going to SLAA meetings for five years and says she will do so for the rest of her life. “If I don’t stay with it, there’s a really good chance I’ll relapse.”

If it’s difficult to be a sex addict, what’s it like to be married to one? One couple was married for more than 20 years when she discovered his affair through an e-mail. He confessed that he had been lost in Internet pornography and was hooking up with other women through chat and dating sites. The couple took out a second mortgage on their home and paid $31,000 for him to enter the Pine Grove residential treatment center in Mississippi, run by Patrick Carnes (the same center that former ESPN analyst Steve Phillips said he attended).

In the residential program, the man met others who had spent fortunes on phone sex and prostitutes. “We were blind to what we were doing,” he says. “We were leading a double life, compartmentalizing it all.”

He attends two SLAA meetings a week, and if he finds himself slipping (“glancing at a bra ad or noticing a woman on the beach for a little longer than is comfortable for me”) he calls his sponsor for guidance.

He says Pine Grove saved his life, with structured days that included psychotherapy, lectures, yoga, art therapy, 12-step meetings, spirituality and grief groups, shame reduction, and exercise.

Thomas Tullos, who was the clinical director at Pine Grove for five years, says sex addicts must establish a healthy relationship with sex—not abstain from it completely. “These are men and women who have, over time, used sexual behavior to medicate their feelings,” says Tullos, who now treats addicts in his private practice in Hattiesburg, Miss.

Neither the husband nor the wife know if their marriage will survive. “It’s a very, very, hard thing for spouses, because sex is such a personal part of your identity,” she says. “It’s impossible not to take personally.”

Still, she has empathy for her husband. “There is no compassion for this on the part of society,” she says. “People don’t realize that if you look at it as a disease, that person is in pain.”

For many people who suffer from sexual compulsivity, sex is often used as a way to feel less lonely, become numb to painful feelings, or avoid boredom. It often isn’t about the pleasure one receives from sexual acts. In fact, about 80 percent of people with sexual compulsivity have been sexually or emotionally abused.

Psychologist Mark Schwartz said that having feelings of being neglected as a child can lead to sexual compulsivity. “When you have abuse in your background, you’re less likely to trust people, (and) you’re more likely to turn to something like sex addiction as a manifestation,” he said.

Early signs of sexual compulsivity can include excessive masturbation, compulsive use of pornography, or taking part in phone sex services. As the disorder progresses, individuals may compulsively date, engage in unsafe sex, and may have multiple or extra-marital affairs. The individual’s health, work, and relationships may suffer, and some people end up divorced, jobless, or ill due to their condition. Some people even engage in illegal activities like voyeurism, exhibitionism, and rape.

There are many different treatment options available for people who suffer from sexual compulsivity, including psychotherapy, trauma treatment groups, and cognitive behavioral therapy. Therapists who specialize in compulsive sexual disorders work with clients and their families to develop new coping strategies and alter behaviors.

Unlike treatment for alcohol and drug addiction, those seeking treatment for sexual compulsivity are not advised to abstain from sex entirely, but instead are encouraged to learn to control their behaviors and positively associate sex with relationships. An effective treatment program involves individual and group therapy, 12-step support, and possibly psychiatric medications, depending on the individual’s needs.

The only requirement for membership is a desire to stop addictive sexual behavior. There are no fees or dues.

Meetings are found in many communities, and if you are shy at first you can attend their online meetings.  If you are not yet ready to admit you have a sex addiction problem, you should look for what is called an “open” meeting, which can be attended by anyone.

Members of SA will tell you that only you can decide if you are a sex addict and if you want help. Rarely do people succeed when they are “forced” to get treatment.

Here are some signs SA says may help you determine if you are a sex addict: