The rapid mushrooming of individual 12-step programs throughout the nation and the world in the past 50 years has given millions of people suffering from addiction back their lives, their families, their self-respect and their pride.

The methods of the 12- step programs have been borrowed and modified for many kinds of addictions including treatment for sex addiction. Central to sexual recovery is the notion of “people helping people” so that those farther along in the program serve as models and guides to people just starting out. Stories of sexual recovery by group members provide real-world inspiration to newcomers and peers.

I recommend involvement in a 12-Step Program in conjunction with individual psychotherapy as a starting point in therapy for sex addiction.

How Fellowship Heals

Sex addicts need to find positive activities and healthy relationships as substitutions for their sexual acting out. For those who choose it, 12-step meetings do this in abundance. The groups are comprised of many individuals who care, who have similar stories and do not tire of hearing new ones. Because of this compassionate support, members in the group may be able to gently confront the addict with his maladaptive behaviors. Specifically, sex addicts begin to see that they share in common several defense mechanisms that keep the addiction in place.

Defenses are the ego’s way of protecting one’s self from anxiety. Sex addicts use similar defenses which, in the group, are identified as “stinking thinking”.

Denial, in which a person convinces himself that unpleasant emotions are nonexistent. Denial also enables the sex addict to blot out the negative consequences of sexual activities so he can comfortably engage in compulsive sexual behaviors.
Rationalization, in which a person finds logical reasons to justify undesirable behavior.
Magical thinking, an error in thinking in which an addict believes he can recover without help or intervention. Of course, magical thinking is the fuel of sex addiction which occurs in the context of fantasy. Beliefs that come from magical thinking include:
“This beautiful woman really desires me.”
“I have magical power if many women desire me.
”My sexual needs can be met immediately, without my having to put in any effort.”
Sex addicts have in common a reduced capacity for impulse-control. In the 12 Step program, the influence of other, healthier individuals is gradually internalized, becoming part of the self-governing and self-regulating functions of a more mature self. The group itself, as a consistent, caring object also may be internalized. Over time, the psychological wounds of growing up in a dysfunctional family can be repaired through the acquisition of a new family that provides the empathic soothing and caring that was missing in early childhood.

Sex addiction groups have regularly scheduled meetings with a predictable format, repetitive slogans and messages. The structured format of the meetings, together with continual, consistent attendance, provide a certain regulating structure which can also aid the addict in repairing deficits in self-regulation and self-care.

Learning to Talk About Feelings as Part of Sexual Recovery

A mark of the addictive experience is feeling overwhelmed when faced with negative emotions. Some addicts are unable to describe their inner sensations and feelings for which language seems inadequate. A 12-step meeting offers a series of lessons that help find language to represent the self. The basic format of the meeting is that people gather to speak of themselves and listen to others. This provides a powerful experience in modeling how to use language to express feelings and experience, as well as reduce feelings of shame. In this way, what was once felt to be unutterable is formulated into words which then defuse overwhelming negative feelings.

Without the influence of the 12-step group, an addict’s central control is limited to his own way of thinking. There is a certain type of control within the addictive personality which can have its source only outside of the addictive personality – the reality-based, growth-enhancing principles advocated by a closely knit group. A peer group can change an individual against self-centered, gratification-oriented impulses. Instead, an involuntary feeling of belongingness and allegiance to such a group takes hold.

The linchpin upon which the 12-step process is based is that an addict finally, unembarrassed, acknowledges the need for participation in a caring community. The group exists without ulterior motives, and accepts the individual totally for who he is. A sex addict cannot thrive normally as a solitary structure; instead, it is essential that the self’s survival and value participate in a social structure or community. The development of a true self is always participating with others in its realization and progress.

Once this is acknowledged, the individual can move past childish, impulse-ridden desires for self-gratification and immediate gratification and can assume his place as a responsible, mature person in the world.

The passage from infantile narcissism to emotional maturity and full humanity is ultimately accomplished by consistent immersion in working the 12 steps.

How the Steps Heal in Sexual Recovery

Step 1: We admitted we were powerless over sex – that our lives had become unmanageable.

The admission of powerlessness over the one’s addiction is the first defeat of infantile egoism (an immature view of self as the center of the universe.) This is a first step in the assumption of responsibility and mature, healthy living.

In the process of accepting Step 1, the sex addict becomes conviced that he can no longer engage in his addiction. The reality that he has lost control of his own behavior and becomes powerless in the face of overwhelming sexual desire becomes an inarguable truth. It is now a basic fact of his existence. Denial breaks down as the addict increasingly sees that to give way to the impulse to “pick up” has far-reaching and devastating consequences. The addict comes to terms with the essential paradox: you have to lose to win.

The term “surrender” permeates step work. There are two facets of surrender in the first step. The first and surely the most significant is formation of deep conviction that one is powerless over one’s sexual addiction.

Another aspect of Step 1 is that the addict is surrendering his sense of uniqueness. As one admits powerlessness, one no longer expects the world to conform to one’s own egocentric beliefs. The first step is a step toward “living life on life’s terms”. It is making a decision that to spend one’s life being driven by the desire for pleasure and power ultimately give way to suffering. Relinquishing pleasure and power hunger is the beginning of movement toward meaning, connection, mastery and freedom.

Step 2: Came to believe that a power greater than ourselves could restore us to sanity.

In this step, the addict develops an openness to the possibility that a higher power exists. An egoistic perception is replaced by a wider, more inclusive version of reality. From a psychological perspective, immature levels of personality structure are egoistic in nature. All things seem related to one’s self, a condition that prevents the individual from seeing others for who they really are. Others are seen as extensions of oneself, making it impossible for the individual to have anything but a self-centered point of view.

The realization and acceptance of some higher power need not be religious or even spiritual. The power merely needs to be seen as a force greater than one’s egoistic pursuits, putting in motion the abandonment of a grandiose posture. One no longer expects the world to conform to the self’s own needs and wants. Rather, one learns to live “Life on Life’s Terms” and learns the power of acceptance as the avenue to serenity and peace of mind.

Step 3: Made a decision to turn our will and our lives over to the care of God as we understood Him.

This step suggests that ”surrender” once again be considered. When left to their own devices, addicts tend to make decisions based only on their ego-centric and self-gratifying motives. The step suggests a less self-driven, less self-serving way of being in the world.

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, meaning that the addict learns he can achieve control by letting go of control. Prior to recovery, the addict focused intensely on control issues (e.g., controlling use of the drug, controlling the amount of damage caused by using, controlling other people’s perceptions through lying and secrets, and controlling emotional distance to minimize vulnerability in intimate relationships.

Step 3 encourages a manner of taking positive actions towards a goal but surrendering the results to whatever powers may be. The person is productive, but allows events to unfold without futile attempts to control outcomes.

This approach to living greatly increases the spaces on one’s life to feel contentment and serenity.

Step 4: Made a searching and fearless moral inventory of ourselves.

This step suggest making a review of one’s life in as a meticulous and forthright a way as possible, listing the action and choices that have caused guilt and shame in oneself and harm to others. The process of emotional development involves a degree of self-knowledge and self-awareness. This step is an opportunity for the sexual addict to see repetitive thought processes and behaviors that inhibit the process of growth. When one sees the contribution that these “character defects” have made in one’s own misery, the process of projection onto other people (blame) and external events (victimhood) for unwanted inner states is reduced. The focus in Step 4 is on the issues with 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 personalities of an addict become compartmentalized, the person “dissociates” and, in a manner similar to multiple personality disorder, becomes two distinctive personalities. 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 sets in.

Step 5: Admitted to ourselves, God, and another human being the exact nature of our wrongs.

The words “sex addict” and “secrecy” go hand in hand. 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 would be despised. A diminishing sense of self esteem contributes to a sense of isolation and alienation. With the 5th Step, the secret is out. The person is unburdened.

The process of complete self-disclosure in the presence of another recovering addict doesn’t judge or condemn is extremely healing. One can let down one’s defensive armor and enjoy a sense of ease with the world. Revealing the content of his inventory to another defuses feelings of guilt and shame. Once paralyzing feelings of isolation, fear, and mistrust of others begin to crumble as the interpersonal immersion in a caring community evolves.

Step 6: Became willing to have these defects removed.

From a psychological standpoint, an attitude of “willingness” is essential to the process of growth. It puts the person in a less egocentric stance. It also conveys a breaking down of rigid defense mechanisms that may have worked as a barrier of protection in the past to survive a frightening, unstable childhood. The strategies, or defenses, used in the past in order to emotionally survive have outlived their usefulness. It is these outmoded strategies for handling life that actually create negative consequences and problems in daily living.

Step 7: Humbly asked Him to remove these shortcomings.

Humility is a word much discussed in 12-step meetings. Have a modest view of one’s importance in the grand scheme of things is very freeing. The posture of humility allows a person to quell excessive self-preoccupation and instead, opens him/her up to having a sense of awe in the moment-to-moment awareness of life, nature, God and fellow human beings.

Gaining humility also suggests a turning-point in personality development from the illusion of self-sufficiency to having an interdependent view of relating to others, one that is reciprocal and enriching. Step 7 is the beginning of understanding that building character and remaining close to essential values are more important than chasing the high of sex addiction.

"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."
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.

Step 8: Made a list of all persons we had harmed, and became willing to make amends to the all.

Achieving the quality of healthy interpersonal relationships is a mark of a person’s stability and ability to live comfortably with himself and others. Here we again come across the word “willingness”, implying a deeper insight into the self is necessary to overcome the unconscious motivation to continually set up repetitive, unsatisfying personal relationships. It is only by letting go of resentment of the (real or imagined) harm done by others. Through relinquishing the victim stance, through acknowledging fully that your sexual addiction has harmed others, through focusing on what the problems have been in YOU, the personality becomes less emotionally vulnerable, less reactive, and more stable.

Step 9: Made direct amends to such people wherever possible, except when to do so would injure them or others.

Step 9 is another deeply liberating step. After amends have been made to individuals harmed, there is no reason for the addict to hide from the world for past deeds. The lethal effect of shame is eradicated. Before recovery, those we were harmed or whom we avoided out of shame had an exaggerated power over us. The step implies a readiness to accept the responsibility of your behavior. It’s the beginning of being an adult as well as being an essential step in the development of a self- and- other orientation to living. You are no longer driven by self-centered needs for self-gratification.

Step 10: Continued to take personal inventory and when we were wrong, promptly admitted it.

In Step 10 the goal is the development of better coping skills in dealing with the vicissitudes of daily living. When thrown off emotional balance by people or new events, the process of taking a quick inventory, admitting to errors in the now and learning to forgive the imperfections of others is a sign of a stable personality. The practice of Step 10 releases one from the need to be right and offers a truly liberating way of operating in the world.

Step 11: Sought through prayer and meditation a conscious contact with God as we understood him, praying only for knowledge of His will and the power to carry it out.

Research has consistently shown the psychological and physical benefits of prayer and meditation. The person in sexual recovery discovers that he is not a victim of his own mind and that he does have power over the state of his inner life. Meditative techniques have a powerful influence in reducing the anxiety that underlies most addictive behaviors. The individual experiences a sense of calm, focus and direction. Psychologically, the 11th Step is a means for even deeper insight into one’s motives and needs.

Recovering people are often confused about what “knowledge of His will” means. Each individual needs to cultivate an image of what life expects from him. It is doubtful that God’s will, or the universe, or karma includes misery in an active addiction. Perhaps God’s will includes living a life that is not entirely self-centered or self-serving. Perhaps God’s will includes living a moral life, consistent with one’s deepest values and beliefs. From a psychological standpoint, working this step represents a conscious contact with the higher self – the real, authentic self that existed before we were exposed to negative conditioning.

Step 12: Having had a spiritual awakening as a result of these steps, we tried to carry this message to alcoholics and to practice these principles in all our affairs.

The altruistic values of concern for others, unconditional love, and genuine, honest relating comprise the core of the sexual recovery process. Successful application of this step defines the essence of emotional maturity. Maturity implies access to having a core, authentic self that has developed adequate coping skills to deal with life. A sense of “agency” of the self that had been lost to the addiction returns. A mature person is the captain of his own ship. He has the ability to tolerate emotional pain with the knowledge that all internal states are transitory. The mature individual has developed healthy inter-personal relationships and a sense of purpose in living. These are the fruits of sex addiction recovery.

In summary, the addictive experience is marked by inter-personal difficulties and problems with isolation, self-esteem, impulse control, short-term gratification, and lack of self-regulation. The problematic dimensions of the addictive experience are addressed through the structure of 12-step meetings. The program, including the steps, provides cognitive strategies, compensatory mechanisms and intra/interpersonal resources to assist the addict in successfully negotiating the vicissitudes of human living and stay sober for good purpose.

Author's Bio: 

Dorothy C. Hayden, LCSW, MBA, CAC is a Manhattan-based analytic therapist who specializes in sex therapy and sex addiction. Having received her MSW from New York University, she studied psychoanalysis at the Post Graduate Center For Mental Health and The Object Relations Institute. After studying hypnotherapy at the Milton Erickson Society for Psychotherapy and Hypnosis, she became a certified NLP practitioner. She is currently studying couples counseling at The Training Institute for Mental Health. She can be reached at ( ). SKYPE sessions are available and Paypal is accepted.Dorothy Hayden, LCSW, has been treating sex addiction for 15 years. With 30 articles and one e-book, "Total Sex Addiction Recovery -- A Guide to Therapy", she is considered a "thought leader" in the field. She has been interviewed by HBO, CNN and "20/20" about cybersex and sex addiction.