Case Study


Case Study

Addicted to Sex: There are no shortcuts in treating SA

By Alexandra Katehakis

March/April 2010


While the subject of Sex Addiction (SA) no longer draws snickers or skepticism, defining it precisely and treating it still puzzles most psychotherapists. Marked by compulsive, out-of-control sexual behaviors that damage every part of a person's life—work, family life, personal well-being, and love—SA makes thinking about, seeking, and getting sex the organizing principle of a person's existence. As much of an addiction as one to drugs, gambling, or alcohol, it can shred the fabric of personal life, create serious legal problems, and ruin physical health. Because sex addiction so often has roots in ­disordered attachment patterns, stemming from childhood abuse or neglect by parents or primary caregivers, many who have sexual addictions experience extreme difficulty forming stable, loving relationships.

As with any other addiction, the primary goal is long-term sobriety, which with these clients means noncompulsive sexual behavior. Treatment is initiated with a contract, often written, between the addict and therapist that lists specific behaviors from which the addict promises to abstain (a temporary period of complete sexual abstinence may also be required) and a 12-step recovery program. Because childhood trauma is so often implicated in SA, leaving many clients with a damaged ability to form relationships, they also need long-term intensive individual and group therapy directed at fundamental attachment issues in addition to the 12-step programs. Doing this kind…

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