Boundaries and Sexual Addiction Part 3: The Very Challenging Work of Treatment

How does the well-trained sexual addiction therapist address the challenge of boundary failure in the life of a person who struggles with sexual addiction?

It is not enough to describe the condition. It is not enough to understand how internal boundary failures contribute to repeated failures to respect the boundaries of others. Just advising someone to change, does not work.

The challenge is to help people who struggle with sexual addiction to change the way they think. the way they feel, and the way they act. This is a complex challenge indeed, but can be accomplished with a qualified therapist and a structured recovery plan.

Addiction and the Brain

Three fundamental processes — thinking, feeling, and acting —serve as the conscious components human health. Each must be addressed in treatment. We can ‘t change our blood type. We can change the way we think, feel, act. But it is not easy.

As we explored in an earlier post, the boundary failures common in sexual addiction begin as an internal challenge. The person who struggles with sexual addiction experiences a failure of Mind/Body integration that sets up a cycle of internal boundary violations whereby the person experiences self-criticism, self-shaming, self-neglect, and self-harm while possibly denying these thoughts and feelings altogether.

This internal experience is externalized in relationships with others. Healing comes when the person who struggles with sexual addiction invites another into their split world and discloses all secrets and allows themselves to become open, honest, and transparent.

Acting out sexually is a desperate attempt to find relief in patterns of secret behavior.

Experts in neurobiology use the term “neuroplacticity” to point to the way our brains conform to our behavior. “Neurons the fire together, wire together.” The biological operations of the brain are the same for everyone, but each person’s experience is different from any other.

What we call “Mind” is the culminating coherency of a highly complex Brain-Body-Social system by which human beings adapt together with others to their environment.

The brain’s vast network of neurons (brain cells) operate through electro-chemical signals that fire in response to stimuli that come from both inside an outside the body. Other people (and events), as well as one’s own internal brain function, contribute directly to the ever-on-going shaping of the brain’s landscape of functions.

A simple example: The brain receives an internal signal when you experience hunger. The brain receives an external signal when you suddenly see a hungry tiger who looks to you for its next meal.

Traumatic events deliver a shock to the system. If big enough, it can change your brain dramatically. What began as an external event, (a tiger on the prowl) becomes an internal condition. This is Post Traumatic Stress Disorder.

When the brain senses risk, it releases neurochemicals that activate the “Fight-Flight” response. It includes:

  • Increased Heartrate
  • Focused Vision
  • Tensing Muscles
  • Sensitive Hearing

The body is on high-alert. When a person has PTSD, the body goes into high alert when there may be no danger present. Something as triggered the Fight-Flight response.

So, if by some good fortune you survive the tiger, simply driving by a zoo may cause a panic attack as your brain associates zoos with animals, and animals with tigers, and tigers that one, life-threatening experience.

These associations are not conscious. PTSD is an example of how an external event, can change your brain.

Addressing Sexual Addiction

How we interact with others also changes our brain. An association with a kind, affirming partner becomes a relationship of healing intimacy. It changes the brain. Gathering regularly with a group of friends, or with a facilitated therapy group or 12 Step group in which participants share experiences and learn from one another, is also healing. It changes the brain.

Addiction is a brain response to specific behavior. It sets up a specific way of interacting with the external world. When I persist in a specific behavior, I signal to my brain: This behavior is important. Neurons line up to reinforce the behavior. My behavior changes my brain.

When I feel a certain way in response to something, I signal to my brain: This feeling is important. Again, the neurons fall in line. My feelings change my brain.

When I think a certain way and process information using a familiar pattern, I signal to my brain: this thought is important. Neuropathways reinforce ways of thinking. My thinking changes my brain.

Treatment of people struggling with sexual addition involves addressing how a person thinks, what a person feels, and provides the social support needed to reinforce limits on unhealthy behavior and to encourage new behavior. Similarly, treatment of partners who have experienced the trauma of betrayal requires therapeutic interventions to treat the relational trauma.

It is not enough to address how a person may act out sexually. It is not enough to address just the choices a person makes that leads to negative consequences.

The sexual behavior is only the tip of the iceberg. Beneath the surface, are unconscious feelings, thoughts, and behaviors that an untrained eye might never associate with feeding the addiction process.

Not even the client is consciously aware of the brain functions that undermine their ability to function in healthy ways. This is because trauma memory is not conscious. It resides in another part of the brain where emotions exist as preverbal, unconscious memory, insofar as memory is the encoding of prior experiences.

Sexual addiction treatment is a highly complex and challenging treatment. It requires not only understanding the psycho-dynamic processes at work, it requires understanding how to respond and guide people who struggle with sexual addiction — and their partners — into a whole new way of being in the world.

It includes being present in a way that allows the client and the therapist to co-regulate emotional experience. The therapist remains aware of body signals in his or herself that inform the emotional process of the client. This gives the therapist access to preverbal, unarticulated emotional content of the client that the client may be partially or even wholly unaware.

In a sense the client “piggybacks” on the emotional health of the therapist which allows a new emotional foundation to form. A kind of unconscious, closed-system loop is broken. This allows new patterns of thought, feeling, and actions to emerge in the process of recovery.

This represents a near total transformation of the person from the inside out. While the essential person is honored, a new person emerges. Over time, as healing continues, the client is able to embrace the world and everything in it with healthy relationship to self and others based in integrity, trust, commitment, and transparency that reflects love of self and others in its highest form that leads to new-found joy and an embrace of all life has to offer.