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Tuesday, February 26, 2013

Healthy Recovery

***
The room is crowded, with all members of the group in attendance. The energy seems low, perhaps due to the tender issues being explored. The usual banter is absent, replaced by a somber mood. 

It is Mark's turn to share with the group. His assignment was the exploration or visual representation of his addiction. He has made a collage and, as he unrolls the large butcher-block paper, I am immediately struck by the sparse images spread before us. 

"This is my addiction," Mark says with little enthusiasm.
"Tells us about it," I say.

He begins with a litany of meandering thoughts, like blood leaking from a loose tourniquet that fails to arrest the bloodbath that has occurred. Making little eye contact, Mark limply points to the pasted images: "This picture of my tornado damage represents the damaged caused by my addiction; this money represents the money I have spent on my addiction."

The group's feedback is equally benign: "It sounds like you worked hard on this. Good job. Thanks for sharing."
"Okay, Tim," I say to the last group member to give feedback. "Now tell him what you really think."

Tim looks at me with fear in his eyes, as if to say, "Let me skate through this: I am not in the mood for a challenge."
"Are you willing to be real with Mark instead of sugarcoating it?" I ask.

Tim looks up at Mark, making brief eye contact and then quickly lowers his head like a racer guilty of a false start. Taking a deep breath, he looks straight into Mark's eyes, this time holding contact.

"I just can't buy this, man," he says, gesturing toward the collage. "I mean, for me, my addiction was dark, dangerous, ruthless. I mean, ready to destroy. I think you are holding back," Tim continues, courageously positioning himself in a vulnerable emotional exchange.

"Why do you think Mark would hold back?" I ask Tim.
"Well, I know for me it was the shame. I couldn't show this stuff to anyone."
"What was it like when you finally did?"
"I felt really good, you know, a relief," Tim continues, seeming to have found his stride. "I really want to get to know you, man; that's why we're here. I'm not here to judge you. I've been there." 
"How does that feel, Mark, to hear that from Tim?"
"It feels good," he says, still walled off.
"Mark," I say, pushing his comfort zone. "I want you to respond with what is really going on for you."

Taking a deep breath as if garnering strength, he looks up at Tim: "I guess this is all new to me. I don't know; thanks for what you said."
"Mark, I want you to dig deeper. How does this feel?" I ask.
"It's different, you know, scary for me. I'm afraid if I show who I was in my addiction, you are all going to run away, and I can't say I'd blame you."

This maybe be the first authentic moment Mark has had in a very long time. This is the beginning of authentic connection. A pivotal turning point in his recovery, being real and intimate is a courageous step toward healthy sexual connection on all levels.

Saturday, February 23, 2013

Healthy Recovery


The outermost region represents acquaintance, such as the clerk in the coffee shop. You are friendly with him or her but share little about your internal emotional world: "How is it going? Can you believe this weather? How about that game last night?" This emotional level allows for an amiable hello or passing exchange of niceties. the level of emotional risk is low, the exchange pleasant.

The next circle represents a first-level friendship.

This may be a new relationship you are building and perhaps assessing to determine if appropriate to be a long-term relationship based on shared interests, hobbies or beliefs. You enjoy the relationship but realize your emotional connection is limited.

The second-level friendship is developed and nurtured through deep trust and emotional connection. These are the confidants who have established mutual respect and are committed to the continual growth of the relationship. These friendships are very similar to an intimate relationship minus the sexual connection.

An intimate relationship reflects the emotional connection of a second level-friendship but includes the physical component. These are committed relationships between potential or lifetime partners. these relationships are nurtured at the deepest levels.

The circle and its levels can be adjusted for individual needs. For example, your levels of friendship my be more defined; an added level or levels may feel more appropriate within your internal construct. The levels are also fluid; a person who is an acquaintance may progress into second-level friend, or someone with whom you have a more intimate relationship may shift to an outer level. Life circumstances -- such as a move, a shift in job responsibilities, an illness, or the birth of a child -- may dictate a change in connection to another person.

I invite the sex addict to access each relationship and where it falls within this continuum. You may realize that one level is deprived, whereas other levels are overflowing. As in all aspects of  recovery, the goal is balance. Hopefully, this exercise will assist the conscious assessment of your connections to others and in the enrichment of their development.

Relational closeness may feel overwhelming to the recovering addict because the threat of emotional exposure is no longer masked by sex. Learning to be present, authentic, and honest is part of the learning curve in developing healthy relationships.

***

Thursday, February 21, 2013

Bruce's Lecture

Three year old Ben stands at the gate and cries. Barely able to see over the top of the wooden child gate locked in place, he can see his working in the backyard. His anxious cries become louder as he shakes and pulls on the gate. Ben's mother ignores him. He throws this body down on the wooden floor. Ben kicks at the gate and cries, gasping for air. His mother throws down the towel she had been using to tend her flower bed and sighs. By the time she reaches the doorway and is towering over him. Ben has stopped crying. Her stare is stern as she narrows her eyes and purses her lips. "You are a selfish, selfish boy!" she says. The words pierce Ben's heart like arrows. "A selfish boy," she repeats. Ben lies on the floor looking up at his mother. He sees the displeasure in her eyes as she leaves him behind.

His cries turn to whimpers. Defeated, he makes his way over to the couch, lying face down. Unable to articulate his pain, he deliberately drools on the expensive fabric.

"If I can't have her, I will destroy her couch," he thinks. Ben cannot put his revenge into so many words, but his actions speak for his three-year-old feelings.

Of all the instinctual drives of childhood, I believe the one most often left unidentified (perhaps because it is so obvious) is the obsession for the familiar. Children have an instinctual need to belong to a life sustaining family system, but this survival trait has a design flaw. Children continue to obsess for the familiar, even when the familiar harms rather than nurtures. Even if parenting becomes abusive, children choose to fit and adjust rather than protest and risk ostracism. They are hardwired to believe that abandonment must be avoided, no matter the cost. Ben will passively and aggressively express his anger at his mother, disguising it enough so that she will not leave him totally unprotected.

Monday, February 18, 2013

Bruce's Lecture

Sexualized Anger

Healthy sexual desire is nourished by love, connectivity, and intimacy. However, when we have been traumatized into compulsive sexuality, love, connectivity, and intimacy are replaced by shame. As we have already discussed, sexualized anger is the reaction to the shame that trauma fosters. Let's consider the model below: (Note: I'll transcribe it)

Sexualized Anger

Etiology of Sexualized Anger

Born precious and valuable

Shame Core
I am worthless.
I am unloveable.

Abuse                        Abandonment

Results in Feeling...
  • One down
  • Disempowered
  • Fear
  • Vulnerable 

The other diagram...

Sexualized Anger

Etiology of Sexualized Anger

 Born precious and valuable

Shame Core
I am worthless.
I am unloveable.

BIG arrow pointing UP for (anger rising)...

Results in Feeling...
  • Feeling in control
  • Nero Chemical release
  • Temporary relief
  • Return to shame
We were all born with inherent worth and value. But when we grow up in abusive and abandoning environments; are we told we are worthless; and are physically, sexually, verbally, emotionally, and intellectually abused by our caregivers, we are compelled to believe we are worthless and not deserving. In order to survive these painful beliefs and feelings, we mask them with anger. Anger masks our shame so that we do not have to recognize the ego-annihilating pain that lies behind it. When new clients come into my office to share their histories, I listen first for the shame and, second, for their reaction to the shame, the mask of anger.*

* Not all anger is dysfunction. Healthy anger gives us strength to protect ourselves from physical and emotional harm. Anger becomes dysfunctional when we mistake the harm we are doing to ourselves, or when another's behavior triggers our own sense of worthlessness, making us vulnerable to attack from outside. The anger we feel toward that outside person is the projection of the shame we feel at our own worthlessness. 

Friday, February 15, 2013

Bruce's Lecture

Beth is thirty-five and very thin, weighing only about 100 pounds; her face is hollow and pale. Her legs are drawn tightly against here chest in a fetal position. She is unwilling to make eye contact with me as she tells me her story.

She was sexually abused by her father and raped several times in her adult life. She was married and had a daughter, whom her husband abused sexually. He admitted this abuse to the authorities. Beth and her husband were separated and, yet, after a while, she let him back in the house. He told her that the problem was hers and that, if she weren't so depressed, things would work out. Beth eventually entered treatment, but she was so rooted in her denial about her husband's behavior that she left her child alone with him in the house.

As she sits across from me in the fetal position, she finally makes eye contact. She has piercing eyes. She says, "What I need to know, Maureen, is can I trust him?"

I look at her, cup my hands around my mouth, and say as loudly as I can, "NO!" And then I say loudly, spacing out each word with staccato emphasis: "He is a perpetrator!" I am trying to shock her back to reality, to break through her denial. If Beth is unable to break through, she will be unable to heal.

Trauma is a profound experience that affects all aspects of our lives. In his book Waking the Tiger, Peter Levine describes trauma's and the possibilities it solicits:

----------
Trauma is a fact of life. It does not, however, have to be a life sentence. Not only can trauma be healed but also, with appropriate guidance and support, it can be transformative. "Trauma has the potential to be one of the most significant forces for psychological, social, and spiritual awakening and evolution. How we handle trauma (as individuals, communities, ans societies) greatly influences the quality of our lives. It ultimately affects how or even whether we survive as a species."

Tuesday, February 12, 2013

Healthy Recovery

Stages of Relationships

The fear of being discovered as defective makes sex addicts fear intimacy. The closer they move to their partners, the more vulnerable they feel. This increasing vulnerability scares sex addicts into aggressive and defensive postures.

The emotional walls addicts construct cause them to conduct their relationships in extremes. Their containment boundaries fail them, and they spew their emotions like a garden hose. Or their protective boundaries fail them, and they can become emotionally flooded,not allowing themselves to be approached or touched by any emotion or physical contact. Or they may wall themselves up thoroughly from their own authentic emotions and the desire to be physical that they become as silent and untouchable as a tightly shut clam. Boundary practice teaches us to regulate the levels of respect, affection, and sexual intimacy that are appropriate to our relationships.

Note: Not from the book. Book deals with one-on-one relationships: Acquaintance;  first level friendship, second level friendship, intimate relationship.



With implementation of boundaries, the development of healthy relationships can begin. In establishing or assessing relationships, it is helpful to apply the concentric circle model. This concept maybe be difficult or awkward for the recovering sex addict because of his limited ability to relate.

The concentric circles represents levels of relational development or emotional connection: The closer to the center of the circle, the more intimate the relationship.

Monday, February 11, 2013

Bruce's Lecture

Destructive Relationships

The emotional bonds we make under the provocation of traumatic wounds are often dysfunctional, often involving us with people who are dangerous, shaming, or exploitative.  A person believes she or he is in a relationship for something like love or companionship. In truth, her or his inappropriate, abuse partner reminds or her or him of  his or her familiar basis of shame. She or he stays in a dangerous, destructive situations because they subliminally find that the abuse makes them feel right at home. It was dangerous growing up and acting like a wounded child to get loved. It will remain dangerous being an adult wounded child trying to get love. The results are the same. Addicts will get what they still crave from their original abusers: shame from "adult" relationships.

***  

Saturday, February 9, 2013

Bruce's Lecture

"I remember him wrapping his arms around me to start, and then his hands would begin to wander. He would rub my back, the slip his hands under my pajamas, rubbing my butt, and the he would make his way to my genitals."
"What was that like for you, when something that was supposed to be nurturing turned into sexual trauma?"
"It was confusing. I loved my dad, and I wanted to be close to him and make him happy. But something inside of me knew it was wrong, but, at the same time, it felt good. I think the hardest part was feeling frozen, like I had no control."

Lisa's imprinting of sexual abuse has kept her from having healthy sexual relationships. Even the thought of being touched can set off an intense emotional reaction.

"I only like to be touched if I feel in control," Lisa explains. "I don't even like to be around people who are being affectionate."
"Why is that?" I ask.
"Because I feel uncomfortable. I see them as being weak, unable to control themselves."
"So when you are in a relationship, there is no show of public affection?"
"We'll hold hands, but that's about it," she says, shrugging he shoulders.
"What about in private?"
"It's easier in private, as long as I feel I am in control."
"What does that look like, being in control?"
"I have to have my eyes open, lights on, facing the person."
"Are you able to experience pleasure?"
"Sometimes."
"Are you able to orgasm?"
"Never," Lisa says with defiance.

Lisa's level of sexual aversion is extreme. It is a terror traumatically imprinted in her core. When this fear is triggered, it takes her back to the scared, helpless little girl lying frozen in her father's bed.

Thursday, February 7, 2013

Bruce's Lecture

Lisa lies in the vacant king-sized bed while her dad readies himself for sleep. It is Lisa's job to "warm it up" and then "snuggle" with her dad before she scurries off to her own room for the night. Lisa's mother, a nurse who works the late shift, won't be home for at least a few hours. Lisa lies in bed, tightly tucked under the covers. The lights out in the bedroom, Lisa watches the adjoining bathroom as her dad passes by the door, getting ready. As her dad is clad in boxer shorts made of thin cotton fabric, Lisa can see, by the backlight, a view of her father's genitals. Seeing her father this way has become normal for Lisa.

"You know, I never thought of that as being bad or inappropriate," Lisa says.
"Do you think it affected you?"
"I never did until I realized that seeing your father mostly naked is shocking for a kid. I don't think he did it on purpose, but it surely imprinted my sexual development and affected my discomfort with my own body."

Lisa's father's lace of boundaries became more intrusive once he pulled back the covers and joined Lisa in the bed.

Tuesday, February 5, 2013

Bruce's Lecture

Deprivation

Trauma deprivation is rooted in profound shame, and the deprivation the person imposes on him or herself is punishment for being unworthy. The deprivation can be imposed on any part of a person's life, such as money, sex, food, work, or social relations. Such a person seeks to gain power and control by taking no risks that result in exposure or their addiction. This individual is not only afraid, but horrified at the thought of being sexual.

***

Lisa, a woman in her mid-fifties, has been working with me for almost a year. She has been in several relationships but reports that being sexual is "difficult."
"What do you mean by difficult?"
"I dread being sexual," she answers. I find it almost intolerable."

Lisa's reaction is a typical response for a person with sexual aversion. The idea of being sexual can cause marked distress, including headaches, dissociation, nausea, anxiety or panic attacks, flashbacks, intrusive thoughts and body memories. 

Like many people who suffer from sexual aversion, Lisa is an expert in avoiding an act she has come to dread. She is an attractive woman; however, she wears baggy clothing that successfully hides her body. She cannot afford to call attention to her figure or have anyone find her attractive. 

When Lisa does enter a relationship, she maintains an arsenal of strategies that allow her to avoid being sexual: she has a headache, she's too busy, or she initiates physical contact at inappropriate moments, such as before company arrives or she has to leave for work. The planning and execution of the avoidance are just as powerful and consuming as the acting-out behavior, but the goals are the opposite. 

Like the acting-out side of the cycle, aversion is usually based in traumatic wounding. This is true for Lisa.

Monday, February 4, 2013

Bruce's Lecture

When Sally made her first appointment for therapy, she emphatically explained that she was in relationship crisis and needed help. A woman in her early thirties, Sally seemed confident, articulate, and eager to get to work.

"I fell in love with my dance instructor," Sally begins."He is an unbelievable dancer," she continues.
"You said there are problems in the relationship."
"Well, sort of."
"Tell me what is going on."
"Well, the problem is he doesn't know I love him."
"Have you told him?"
"Oh, no! No. No, No!"
"What's the resistance?"
"Well, he doesn't even know I like him. I mean, we are friendly, but we only do things in groups."
"You're dating?" I ask, perplexed.
"No," she says, pausing, "Not yet."

Sally's 'relationship' took place in her head. A fantasy became a 24/7 IV drip. As I explore the nature of Sally's fantasy, I discover a highly developed one.

"I have photos of him on the walls of my bedroom," Sally explains. "I even had him sign them."

The the last year, Sally had been fanning the flames of her addiction into a heated and painful obsession. The fantasy had grown in power to the point at which she started following him. She would drive by his house in order to spy on him. She told me that this escape she was creating in her mind felt as if she were taking a shot of heroin. There was immense pleasure and excitement. There was relief from pain and discomfort.

Despite all this, Sally is not interested in pursuing any real relationship. Her emotional satisfaction takes place in this world of fantasy. By keeping her feelings secret, she can maintain her fantasy for herself. That way, she believes she has power and control. She can have a secret world that operates just as she wants it to.

The roots of Sally's problem lie in how isolated she had been as a child. She spent almost all of her time alone, until fantasy became her only friend. Fantasy replaced the real world. She crawled into these cocoonlike compartments that reduced her distress. Fantasy became her drug of choice.

Individuals who suffer from multiple addictions often find that these addictions interchange or replace one another. The clients deposit their shame into separate addictive compartment, each driven by a different addictive remedy (drugs, alcohol, sex, gambling, gaming, shopping, etc). The dysfunctional purpose of dissociation is to allow the traumatized individual to continue indulging in his addiction in one place, while banking the self-esteem of having stopped it in another.

An example of this is the alcoholic who becomes sober. Once he is in recovery fro alcohol abuse, he starts acting out sexually.* He old sobriety for alcohol and sexual acting-out in two separate compartments and may not talk about the still-active addiction for years. When I treat a person who has revealed multiple addictions, such as sex, eating and gambling, I treat one at a time, giving priority to the addiction most likely to destroy him.


Friday, February 1, 2013

Healthy Recovery

"What's going on? You seemed really reactive in the car," Janet says in a calmer manner.

Her husband just stares back at her, seemingly lost in thought.

"Have you ever been hurt in a car accident?" she asks with more tenderness.

Pausing and seemingly surprised by the question, he says, "Yeah, I have. I took out three windshields with my head."

When Janet's husband shares his story, his body relaxes and his eyes soften. Her serene irritation is replaced with a sense of compassion, warmth, and love.

Through our trauma, we are conditioned to personalize another's response. In reality, it is always about the other person's wounding, experiences, beliefs, and filters. To avoid the victim's stance, it is vital that we learn to ask, to be curious about the other's reality. When we do, we allow for connection, and that is where intimacy exists. We need to notice the response from the other but not lose our own boundary by reacting from our wounding.

Where so many relationships, land, however is in the blame game: "You made me feel frightened, sad, angry, shamed, guilty," and so on.

These unrealistic accusations are the basis for which resentments they harbor, and the walls from which they attack, defend, or retreat. Because the only "self" with whom sex addicts are in contact is the wounded self, they fear that their inadequacies will be discovered if the truth is known. Because they cannot believe in themselves; if their partners knew the truth about them, they would leave them. Dysfunctional reasoning tells them to take what they want before it can be denied them.