"So you don't have a ritual?" I asked.
"No," he said.
"Well, where do you cruise?"
"No, always downtown."
I continued with a barrage of questions.
"Do you cruise at a specific time of day? Do you wear particular clothing? How do you carry your money? Do you drink coffee or alcohol, or smoke? Do you listen to music? What kind of woman do you look for: tall, short, large-breasted, dark skin, blonde hair?"
His answer painted a very specific ritual that came as a surprise to him as he unraveled the specifics.
"I cruise downtown, between midnight and 5 a.m. I have a cooler in my trunk where I have a bottle of vodka on ice. I have a plastic cup I got from some car wash. I place two ice cubes in the cup and sip on the vodka as I cruise. I listen to heavy metal and get my money from a specific ATM. I fold the bills in the shape of a triangle and place it in my left pocket. I wear spandex pants and dark sunglasses. It makes me feel aroused."
Intricate rituals are the norm for sex addicts. Understanding and flushing out all of the ritualized components are crucial if an addict is to move toward healthy sexual expression; each of the components is a potential trigger of cue that could send the addict back to his behaviors. The client could see a cup from the same car wash. He could hear a song he plays while cruising. Going downtown for work, he could drive by his favorite corner, or he could smell vodka.
For the acting-in, or deprivation, side of the cycle, rituals give way to distancing strategies, which can include picking a fight, making oneself unattractive, criticizing or shaming one's partner, staying busy, staying up late, medical or physical excuses such as "I have a headache; it's that time of the month," and so on. All of these strategies serve to elicit the same result: avoidance of sexual contact.
Acting in or acting out is often not the most powerful aspect of the cycle. It is sometimes the shortest part of the cycle, whereas the majority of the time and energy goes into the planning for and ritualization of the behavior. No matter where the addict seeks his most intense high, the results are always the same: feelings of shame, guilt, remorse, and despair that prompt the addict to tell himself, "I will never do this again." However, the guilt, shame and remorse drive him back into the only coping mechanism he knows: acting out. Thus the cycle continues until the addict's life becomes unmanageable or, as they say in twelve-step meetings, he "hits a bottom."
Hitting a bottom is a very personal experience -- what you think may be a bottom for a person may not be nearly the level of pain and consequence he or she can tolerate. This is sometimes the saddest part of my work -- when a client sits before me and facts what I perceive as horrendous consequences: losing a job, partner filing for divorce and selling their home, losing visitation rights with children. Still, addicts are prisoner to the cycle.
No matter how one acts out or in, the issues and results are the same: a cycle of disruptive behaviors that becomes unmanageable and can include serious and often life-threatening consequences.