Treatment for sexual addiction can occur in an inpatient or outpatient setting. Like treatment for alcohol and other drug (AOD) addiction, treatment for sexual addiction is usually made up of individual and group counseling, education about addiction, and self-help participation. When choosing between inpatient and outpatient programs, there are pros and cons to consider. The highly structured environment of inpatient treatment makes it more difficult to relapse in early recovery. Yet, an outpatient program is less confining and the addict lives in a real world environment while practicing the skills s/he is learning in treatment.
The overriding immediate goal for treatment of sexual addiction is the elimination of the sexual acting out behavior. Compulsive, problematic sexual behaviors are identified and abstinence is then individually defined. Sex addicts, with help, identify, and contract with accountability partner(s), (e.g., counselor, 12 step group, clergy,) to abstain from bottom line problem sexual behaviors.
"Abstinence" in alcohol and other drug addiction treatment is easily defined. "Abstinence" in sexual addiction requires more consideration. Although complete sexual abstinence is not usually a long term goal for recovery from sexual addiction, treatment providers and programs may encourage people in early recovery to completely abstain from all sexual behavior for a period of time. A variety of abstinence skills is taught to the struggling recovering addict in early recovery.
One of the first therapeutic goals besides abstinence is to gain insight into the effects of the acting on various aspects of the addict's life. Addicts are helped to see the damage that their addictions have caused others. Insight into the negative affects of the addiction helps to disable the denial system. Denial allows addicts to continue with the destructive sexual behavior and to reduce the emotional distress associated with continuing that behavior. Disabling the denial system reduces the probability of relapse.
Like recovery from other addictions, treatment will also focus on identifying triggers for "relapse" and putting a relapse prevention plan of action in place. The negative feelings associated with the addiction, such as shame, guilt, self-loathing, will be addressed. This may occur in a group setting where other recovering addicts provide support, challenges to defense mechanisms, and assistance in reducing the shame.
Grief and loss issues related to negative consequences from the addiction will typically be addressed. Recovering sex addicts like other addicts are encouraged to identify the roles that the sexual acting out has played in their lives and to replace those roles with healthy living skills or alternatives. New living skills are modeled, encouraged, and practice is reinforced. Couples' and/or family therapy are often provided to improve communication and problem solving, and to resolve hurtful feelings such as the betrayal that the non-addicted spouse usually feels.
Recovering sexual addicts are encouraged to develop an adequate support network and to practice reaching out to others for meeting any dependency needs. This is especially important since social isolation and withdrawal have often been a characteristic of sexual addiction. Participation in 12 step group or other recovery groups is usually encouraged.
Multiple addictions are often present in sexual addiction. Common co-occurring disorders with sex addiction include mental health problems, such as depression, anxiety, eating disorders, compulsive spending. Treatment usually addresses the co-occurring illnesses simultaneously. Support group participation, such as AA/NA, is also encouraged for other addictions.
Individualized treatment plans are developed to address the components of sexual addiction. Treatment objectives typically include relapse prevention, identification and resolution of intrapersonal and interpersonal issues that could impact a recovering person's likelihood of sustained recovery, and replacement of the target behavior with healthy living skills. People in treatment for sexual addiction often work on unresolved family of origin issues, including early childhood trauma or abuse, intimacy difficulties, reduction of deeply ingrained shame, improvement in self-esteem, and development of feelings managment skills.
Sexual addiction is treatable and recovery is possible. There are resources available for sexual addiction recovery. For local resources, call the national treatment or local substance abuse facilities and ask for a referral.
Dr. Peggy L. Ferguson, Ph.D., LADC, LMFT, is a Licensed Marriage/Family Therapist and Licensed Alcohol/Drug Counselor with over twenty years in practice. Peggy is a private practitioner, writer, consultant, and trainer. Peggy’s website offers a wide range of educational resources for additional help (“Links” page), and an “Ask Peggy” column where you can ask specific questions about the topics listed and make suggestions about other topics to be covered. There is a “Recommended Readings” page and “Articles” pages that are constantly being expanded. This article is one in a series of numerous articles on Sexual Addiction. Check them out at peggyferguson.com.
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