It's Not About the Sex: Moving from Isolation to Intimacy after Sexual Addiction

By Andrew Susskind

Ending compulsive sexual behavior is just the beginning.

Drawing on personal and professional experience, psychotherapist Andrew Susskind examines issues such as shame, grief, narcissism, and codependency to demonstrate how people use out-of-control sexual behavior to cope with brokenheartedness and trauma. He offers strategies to cultivate sustainable sexual sobriety, sharing his own healing narrative, as well as those of others who’ve chosen to bare their truths. No one is ever too hurt or isolated to achieve reliable relationships and emotional intimacy. This is a guidebook for every person seeking long-term healing from sex addiction.

• Language: English
• Publisher: Central Recovery Press
• Release date: Jun 11, 2019
• ISBN: 9781949481075

Book preview

Introduction

Sexual addiction is commonplace in our culture. But so is the desire to heal. Twenty-five years ago, clients came to me with the sole purpose of stopping their self-destructive sexual behaviors. Today it’s a different story: not only do they want to put an end to the cravings, they want to live better lives as well, with greater intimacy. The root cause of their suffering tends to be brokenheartedness. I have found that out-of-control sexual behavior is really about pain, and the remedy is reliable relationships.

It takes hitting bottom for many people to seek help, but even after therapy they’re often vulnerable to relapse because they remain haunted by their past. On the outside, life looks stable. Yet on the inside there’s a constant fear of backsliding. This is part of the sex addiction paradox: recovering addicts can appear high functioning while they deal with lingering pain, longing for meaningful connection.

While your compulsive sexual behavior likely began as a way to temporarily feel good, it eventually stopped working—and that’s when you realized you had a serious problem. If you’re sexually sober, but still feel stuck and dissatisfied, this book will help you establish sustainable ways to connect with others. It takes courage to ask for help, and perseverance to get unstuck, so I’ve provided steps in each chapter to guide you toward dependable relationships and emotional vitality.

There has never been a book fully devoted to life after sex addiction, and readers can find inspiration here in the stories of real people who’ve been in their shoes. These brave individuals fought through the compulsive urges, developing deeper relationships once the sexual acting out stopped. They’ve been in recovery for a long time, but the guidance they share goes well beyond their experiences at meetings or working the Twelve Steps. Now they live happy, imperfect lives, no longer defining themselves by past transgressions, instead pursuing meaningful contact with others.

As a psychotherapist, coach, and recovering sex addict who has been in twelve-step recovery for more than twenty-five years, I’ve witnessed hundreds of clients—and even some colleagues and friends—struggle with problematic sexual behavior and its consequences. They too have come to realize that sexual compulsivity is not about sex; it’s about deep-rooted challenges with intimacy. I wrote this book for those moving beyond out-of-control sexual behavior and for the people helping them to heal from it.

Sex addiction thrives on isolation, shame, and secrecy. To diminish the stigma, this book contains the latest approaches the mental health field has to offer. It’s been thirty-five years since Dr. Patrick Carnes released his groundbreaking book, Out of the Shadows, and this book builds upon that foundation. Drawing on Somatic Psychology, you’ll gain perspective on what’s going on in your nervous system and understand somatic awareness, a method to calm your body and mind. Learning about Interpersonal Neurobiology, you’ll see your tendencies toward fantasy and obsession through a new lens. With the help of Positive Psychology, you’ll establish greater purpose in sobriety. All of which can lead to satisfying, intimate relationships.

Each chapter plants the seeds of purposeful connection. The goal is to move from intimacy avoidance to reliable relationships, from loss to gratitude, narcissism to generosity, shame to self-compassion, and codependency to clear boundaries. This book offers helpful step-by-step strategies to examine issues that hold readers back, such as unresolved grief, persistent perfectionism, and relentless fantasy, to name just a few.

Think of It’s Not About the Sex as your gentle companion. It’s meant to remind sex addicts that healing from the agonizing pain and isolation of compulsive sex requires daily practice and a new lifestyle. For sustainable recovery to take form, you’ll need to say goodbye to your old ways and develop self-acceptance, empathy, and boundaries. It doesn’t really matter if your pain is the cause or the effect of compulsive sex; it’s time to move forward with purpose and direction. If you’re up for this challenge, sexual compulsivity will finally be a part of your past.

In June 2018, the World Health Organization (WHO) announced the landmark decision to include compulsive sexual behavior disorder in the International Classification of Diseases (ICD-11). This is the first time in history sexual compulsivity has been recognized and validated as a mental health problem worthy of a diagnostic code. For decades there had been efforts to include sexual addiction as a diagnosis, to no avail.

Here’s the dilemma. Does compulsive sexual behavior truly fit into the medical model of illnesses? Or is out-of-control sexual behavior an intimacy impediment caused by past trauma and brokenheartedness? I believe there can be a biological predisposition for compulsive behaviors, but trauma and childhood pain also play a significant role. In other words, whether it’s nature or nurture we don’t know for sure, but this recognition by the WHO will prompt more research and options for treatment, bringing hope to those still suffering.

Here’s an illustration that opened my eyes to the distinctions between the terms sexual addiction and sexual compulsivity. My friend Tom, who is in his sixties, disclosed to me that after being molested as a teenager, he became sexually promiscuous in his twenties. He felt profoundly alone at the time, not knowing where to get help. In retrospect, Tom wouldn’t have identified as a sex addict because it implies disease and illness, but he would’ve admitted to being sexually compulsive at the time. Ultimately, what counts is getting support. The twelve-step rooms work well for a lot of people. But there are those who never make it there.

Dr. Carnes, the original pioneer of this field, set the foundation for millions of people to get help for sexual addiction. Yet with as much as we’ve learned, I believe we still have a long way to go. In this book I chose to steer away from anything that pathologizes sexual behavior or describes it as a disease. The WHO classification is bittersweet because it finally legitimizes compulsive sexual behavior, yet identifying it as an illness ignores the roles childhood experience and trauma play. For the purposes of this book, I use several terms interchangeably: sex addiction, compulsive sex, out-of-control sexual behaviors, and self-destructive sexual behaviors. I welcome you to consider what fits you and what doesn’t, based on your particular background or ongoing challenges.

Chapter One

Now What? Life after Sex Addiction

I don’t need anyone else to distract me from myself anymore, like I always thought I would.

—Charlotte Eriksson

If you are recovering from sexual addiction or sexual compulsion, you know how bad things got and how much better you feel now. But you hope this isn’t as good as it gets. The decision to end this self-destructive behavior has opened the door to great possibilities, but it’s not easy to achieve a balanced, connected, and meaningful life in recovery. The quest for sexual and emotional sobriety is an incredible growth opportunity. Yet how do you enter this new way of life? Initially, it took an internal shift—a conscious choice to move forward without self-sabotage—to decide once and for all that it was time to live your life more fully. This is similar to the first step of the twelve-step program: admitting compulsive sex is truly unmanageable. Finally, it was time to do something about your behavior.

Harm Reduction

Let’s first acknowledge how sexual compulsion differs from substance abuse. I strongly believe that certain addictive, compulsive tendencies, such as sex, food, money, and work, require a harm-reduction approach. Wearing a condom instead of having unprotected sex is an example of harm reduction. Refraining from all sexual contact for an indefinite period of time is an example of the abstinence approach. Although both may be useful at times, rigid rules lead to dogmatic shaming and cause unnecessary pain, often resulting in relapse. Harm-reduction offers a variety of safer options rather than claiming there is only one way to get sexually sober.

The same principle applies to IV drug use. Needle-exchange programs are controversial yet effective examples of harm reduction. Providing clean syringes to drug abusers can save their lives, as the spread of disease is decreased. The drug user stays healthier longer, giving them more time to access the help they need. Similarly, the goal of sexual recovery is not to take a lifelong vow of celibacy. Most of you aren’t monks—you’re human beings who want real love and fulfilling sex.

As you heal from out-of-control sexual behaviors, over time you can introduce safer, healthier forms of sex and intimacy into your life. Temporary periods of abstinence from sexual contact may be necessary, but in the long run it’s more realistic and productive to gradually integrate sex and love into your life. This book is meant to give you perspective on that hopeful journey, as well as practical strategies toward sustainable recovery.

Unfortunately, some of you are still silently suffering. In spite of your efforts, powerful emotions remain constricted while you long for a deeper connection with yourself and others. In recovery you hoped things would be different, but there’s still an undercurrent of dissatisfaction. In this book, you’ll hear from people in long-term recovery who’ve built bigger, better lives.

Let’s look at what sexual sobriety means. Most twelve-step programs focusing on sex addiction suggest writing a recovery plan to clarify your sexual boundaries. A sponsor—someone who has worked the steps and has something that you admire and want for yourself—typically reviews the plan. This is how you set the parameters for your sexual sobriety.

A suggested sexual recovery plan might include three primary areas: bottom-line sexual behaviors or dangerous choices that you wish to abstain from completely; gray-area behaviors, which include risky actions that may lead to bottom-line behaviors but are not in themselves considered self-destructive; and top-line behaviors, which refer to life-affirming choices, such as quality time with loved ones and fun outdoor activities. Setting these boundaries is an example of harm reduction. These three categories are borrowed from the language of Sex and Love Addicts Anonymous (SLAA).

If you engage in bottom-line or gray-area behaviors, it’s a sign that you’re not entirely sexually or emotionally sober. For example, you may no longer contact escorts, but still obsessively spend time looking at call girl websites and masturbating to these images. This reduces harm, but is still compulsive sexual behavior. Yet the twelve-step program teaches you that it’s about progress, not perfection. And because of the shame associated with sexual recovery, this philosophy holds even more weight.

Emotional Sobriety

So what exactly is emotional sobriety? At its core, it’s the capacity to experience the fullness of life—a resilient, resourceful, and buoyant state of well-being when you feel most like yourself. Comfortable in your skin, you feel calm, relaxed, and at peace with who you are.

Speaking with people in recovery, you learn there are many different versions of emotional sobriety:

When do you feel most like yourself?

When you were sexually compulsive, you often felt like you were crawling out of your skin—restless, desperate, and lonely. The good news is there’s hope in becoming aware of your feelings. According to Dr. Tian Dayton, author of Emotional Sobriety: From Relationship Trauma to Resilience and Balance, these are the signs of emotional sobriety:

•  Ability to regulate strong emotions

•  Ability to regulate mood

•  Ability to maintain a perspective on life circumstances

•  Ability to regulate potentially harmful substances or behaviors

•  Ability to live in the present

•  Ability to regulate activity levels

•  Ability to live with deep, intimate connection

•  Resilience—the ability to roll with the punches

Before we take a closer look at the ingredients of emotional sobriety, let’s define self-regulation. You may not be familiar with the term; it’s a fairly new way to describe awareness of your internal state of being, based on your nervous system. The self refers to everything going on inside of you—emotions, moods, thoughts, and sensations. The regulation is how you achieve internal well-being to feel balanced, resilient, and most like yourself.

Dysregulation occurs when upsetting emotions are more powerful than your ability to calm yourself, such as when a partner breaks up with you. Of course this is upsetting, so how do you regulate more effectively? Strategies such as deep breathing, mindfulness, and asking for help will be explored throughout this book.

Ability to Regulate Strong Emotions

Self-regulation can be challenging in the best of times, especially if you’re not sexually and emotionally sober. As you’re working toward sexual sobriety, it’s often difficult to identify what’s going on inside you. As a result, self-regulation may not be possible yet. In this case, ask for support from others. Perhaps mutual regulation with a therapist can be a stepping-stone. When you are sober, your nervous system feels calmer and more grounded, and as a result you feel more like yourself. The good news about regulating your nervous system is that you’ll begin to feel all of your feelings—the pleasant ones, the uncomfortable ones, and those in between.

Stressful or traumatic circumstances throw us all off. But ultimately, the dysregulation itself is not what matters so much as how you deal with it and find your way back to a regulated state. Learning to regulate your nervous system is a lifelong practice that can begin with somatic therapy.

When distressing events from your past were too traumatic to process at the time, the body stored these memories. The information comes out later in life in the way you fight, flee, or freeze during triggering events. Here is where mind-body approaches help you to regulate your nervous system and be aware of what’s happening—what’s known as somatic awareness. Attending a mindfulness class, keeping a journal, and daily meditation will also help in the development of self-regulation skills.

Ability to Regulate Mood

Regulating your mood requires a tracking system. You wake up one morning and realize you don’t want to get out of bed. This is the time for a self-assessment. Is it because you’re still tired? Did you have a fight with your best friend last night? Are you trying to avoid some obligation? Is it difficult to pinpoint why you want to stay under the covers?

Identifying, tracking, and eventually regulating your mood is an ongoing practice of mindfulness and self-compassion that requires a healing team to be fully implemented; ideally, you’ll have a therapist, sponsor, coach, friends, and family involved. You need people who are honest, direct, and offer unconditional love.

Because mood dysregulation may originate from your genetic predisposition or from past trauma, your first action step is to identify when it’s happening and to ask for help from someone you can count on. The mere act of naming it and reaching out to others is healing in itself, because it takes you out of the isolation and shame often associated with moodiness.

Ability to Maintain a Perspective on Life Circumstances

In 1999, I was building my private practice and working part-time for a large managed healthcare company. It was too much for me, and I was on the verge of burnout. But I was fortunate enough to work with a coach who helped open up my outlook. Her optimistic, openhearted perspective was infectious, and over time I developed a new vision. This experience unlocked bigger, more creative possibilities and set the stage for my full-time private practice. As a result, I’ve carried more hope through the years, and I wouldn’t have my fulfilling career if it wasn’t for the seeds we planted together. This type of connection is not easy to find, but keep your eyes open for one loving person you can invite into your corner to bring a constructive perspective not possible on your own.

Building a brighter outlook is the cure for self-centered agonizing as well as a form of relapse prevention. As part of this process, you’ll open up to the many possibilities in front of you, including asking for help and being of service to others.

Ability to Regulate Potentially Harmful Substances or Behaviors

Many of you reading this book likely choose to stay away from destructive behaviors. But emotional sobriety challenges you to take that a step further. In addition to staying away from dangerous activities, be vigilant about substances and actions that may be toxic for you. For instance, some may argue that in the grand scheme of things, sugar, flour, and caffeine aren’t bad. The effects of these items are relatively benign in moderation. Yet these seemingly innocent substances impact your mood, energy, and even your sex drive.

Remain mindful of your exposure to