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Sexual Addiction

Brenda Schaeffer
Abstract
The power of sexual love is unequaled in
human experience. Sex is not addiction; addiction is not sex. But these two experiences
can come together and result in sexual addiction or compulsivity. This article defines
sex addiction, summarizes the history and
research that supports the idea of sex addiction, identifies 20 characteristics of sex addiction, discusses patterns and treatment issues, and summarizes how transactional analysis has been used in therapy with individuals
with sexual addiction. The article includes
case examples to clarify how sex addiction
affects individuals and their partners.
______
W hat Is Sexual Addiction?
Sexual addiction is an excessive sexual behavior that, if left unattended, eventually causes
severe distress and despair for the individual
and/or his or her partner. It occurs when a person uses one or more sexual behaviors as a
fix and in ways that result in negative consequences that may be relational, emotional,
physical, financial, legal, occupational, social,
and spiritual in nature. A physical and emotional dependency on the biochemical or moodaltering chemical experience of arousal, satiation, and fantasy then occurs (Sunderwirth &
Milkman, 1991). There is marked tolerance and
continued involvement in spite of negative consequences. As with other addictions, it becomes
a habit that has gone unconscious, a compulsive ritual that is no longer a choice, and a psychological and biological attachment to the object that provides the pleasure.
W ith sex addiction, withdrawal symptoms
occur when the sexual object is removed and
preoccupation with it begins to interfere with
everyday life. There are mood changes related
to sexual activity or recovering from sexual activity. Since we have three distinct and separate
primal drives that contribute to mating lust,
attraction, and attachment the sexual object
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may or may not be a love or romance partner


(Fisher, 1998, 2004, pp. 77-94). Often there is
exploitation or using someone for the fix.
There exists a high level of denial or rationalization around the out-of-control or self-gratifying sexual behaviors. Denial causes the addict
to distort reality, ignore the problem, blame
others, and give numerous justifications for his
or her behavior. A history of negative consequences is the best indicator that a problem
exists, and for this reason, the diagnosis of sex
addiction is primarily behavioral.
History and Research
In the mid-1970s, an Alcoholics Anonymous
(AA) member in Boston identified his out-ofcontrol sexual behavior as parallel to his alcoholic behaviors and referred to it as sexual addiction. As a result, the first sexual addiction
12-step group was started. In 1974, Solomon
and Corbits (as cited in Schneider, 1994, p.
25) opponent-process theory stated that every
event in life that exerts a potent effect on mood
also triggers a biochemical process in opposition to it. The use, crash, and relief-by-useagain cycle was easily observed in those using
sex as a drug.
In 1978, Orford (as cited in Schneider, 1994,
p. 26) used the term hypersexuality to refer
to patients who sought help for sexual behaviors similar to behaviors that accompany addiction to alcohol and drugs. In 1979, M urphy (as
cited in Schneider, 1994, pp. 24-25) showed
that the level of endorphins in the blood of
hamsters increased dramatically after several
ejaculations, and the location of the endorphin
receptor sites are the same sites occupied by
opiates. Research was giving credence to the
fact that those with out-of-control sexual behaviors were not mere deviants but people suffering an illness and not receiving adequate
treatment (Schneider, 1994).
The sexual addiction movement gained momentum with the publication of Carness (1983/
2001) Out of the Shadows, which was based on
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his work with alcoholics, drug addicts, and


sexual offenders. His research found that 97%
of those who use sex compulsively suffered
emotional neglect, 81% experienced sexual
abuse, and 72% experienced physical abuse as
children and teens (Carnes, 1991, pp. 31-32).
Carnes (1983/2001) identified three levels to
illustrate the wide range of behaviors associated with sex addiction. Level One behaviors are
common, generally sanctioned by society, easily tolerated, and often minimized. They include, but are not limited to, masturbation, affairs, pornography, use of escorts and prostitutes, anonymous sex, sexual seduction, and
cybersex. Level Two behaviors, often considered a nuisance by the legal system, involve the
victimization of someone; exhibitionism, voyeurism, unwanted solicitation, spousal sexual
abuse, sexual predation by people in power,
and stalking fall into this category. Level Three
behaviors involve a more serious crossing of
sexual boundaries and victimize the most vulnerable; these behaviors include rape, incest,
sexual violence, molestation, sexual bondage,
child sexual abuse, and child pornography. Although any of these behaviors can be used excessively or compulsively, involvement in any
of them does not necessarily mean a person is
addicted to sex.
Further research reinforced the idea that sex
could be a chemical and process addiction.
Sunderwirth and Sunderwirth (1991) divided
addictions into three broad categories: arousal,
satiation, and fantasy. It was noted that sexual
behavior can cross all three neuropathways,
which may account for why this addiction is so
prevalent and resistant to treatment. And Goodman (1989) stated that any behavior that is
used to produce gratification or to escape internal discomfort can be engaged in compulsively
and can become an addiction. Three elements
of addiction loss of control (powerlessness),
continuation despite adverse consequences, and
preoccupation or obsession qualify uncontrolled sexual behavior as an addiction.
According to Shaffer (1994), excessive sexual behavior can be the result of addictive behavior, obsessive compulsive disorder (OCD),
a combination of both, or other social, psychological, or biological influences. A primary
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psychodynamic difference between addicts and


OCD sufferers, says Shaffer, is that addicts escape their discomfort by acting out through excess behavior patterns, while OCD patients
avoid the conscious experience of psychic pain
through repetitive intemperate activity (pp.
15-16).
Many professionals recognized that there
was a serious problem in the area of sex addiction, but there was little consensus on how to
treat the problem. In 1988, the National Association of Sexual Addiction Problems was established to bring together professionals interested in research, education, and viable treatment for those suffering with it. Today, it is
known as SASH, or the Society for the Advancement of Sexual Health. Sexual addiction is one
of five addiction categories certified by the
American Academy of Health Care Providers.
It is conservatively estimated that 3-6% of
the U.S. population suffers from sexual addiction (Society for the Advancement of Sexual
Health, 2008, 3). The youngest person I have
referred to inpatient treatment for sexual addiction was 15 years old, and excessive use of sex
on the Internet is on the rise among adolescents.
In addition, 40% of extreme cybersex users are
women (Cooper, Delmonico, & Burg, 2000).
Issues and Treatment
Treatment for sexual addiction now occurs in
both in- and outpatient treatment programs and
with professionals who are specifically trained
to work with this population. W hile the United
States has the most programs available, there is
growing awareness of the need to expand the
network of professionals working with recovering sex addicts worldwide. W hen sex addiction
is present and not dealt with, there is usually
therapeutic failure.
Focused treatment includes a sexual addiction assessment, a psychological assessment, an
assessment for medication, an in- or outpatient
behavioral recovery program, a Sex Anonymous (SA) or Sex Addicts Anonymous (SAA)
12-step or other support group, education, spiritual healing, and psychodynamic work. W hen
the client is in a relationship, greatest success
rates are achieved when the partner is also in
treatment and in a support group, such as CoTransactional Analysis Journal

SEXUAL ADDICTION

Sex Addicts Anonymous (CoSA). The therapeutic challenge of recovery is that three healing processes need to occur concurrently sex
addict recovery, sex addict partner recovery,
and couple recovery and each has unique
treatment issues.
The majority of sex addicts seek help after
they have been intervened on or have had serious consequences. The challenge is to remove
the shame associated with this problem so a
person concerned about his or her sexual behaviors will be free to seek help. Although sex
addiction may be a symptom of a deeper problem, recognizing behavioral signs is helpful in
preventing a sex addiction or in obtaining help
to stop if there is one.
Twenty Signs of Sexual Addiction
1. Use of sex to fix, escape, or cope
2. Negative consequences due to sexual behavior
3. Mood changes around sexual activity
4. Inability to stop even with negative consequences
5. Planning, obtaining, recovering from sexual activity is time consuming
6. Risk of losing a relationship or job
7. Guilt and shame because of behavior
8. Pursuit of high-risk or destructive behaviors
9. A predictable cycle
10. Tolerance or need for more to get the
same high
11. Being at odds with family or spiritual
values
12. Denying, rationalizing, or justifying behavior
13. Sexual cravings
14. Preoccupation
15. Living a double or secret life
16. Using sex to feel or not feel past trauma
17. Sexualizing others
18. Violating the trust of others
19. Inappropriate sexual behaviors
20. Using or abusing others for sexual gratification
(Goodman, 1989; Carnes, 1991, pp. 31-32)
Use of Sex to Fix, Escape, or Cope
The use of sex can be a way to escape probVol. 39, No. 2, April 2009

lems, reduce stress, and/or fix inner brokenness. A major problem underlying sex addiction is emotional loneliness caused by a fear of
intimacy. Karens story illustrates how she began to medicate her loneliness with sex starting
in childhood.
I was miserably lonely as a child. By the
age of 8 I thought Id found love from an
older man in return for sexual favors. At
age 13 my world fell apart when I realized
I had been sexually abused. But I now had
a potent tool for gaining attention sex. I
realized that whatever had happened to me
in the past, whatever it was that I was lacking, whatever it was I was searching for,
the high of sex seemed to fix it. Sex began
to shape my life, define who I was, and it
kept me in a looking-for-love limbo until,
at the age of 39, my brokenness led me into treatment.
Negative Consequences Due to Sexual
Behavior
A person using sex addictively often fails to
recognize or minimizes the negative consequences that sexual acting out can bring (Schaeffer,
1987/2009, p. 135). These include:
Depression, low self-esteem
Scandal, date rape, violence
Feeling objectified
Lust substituting for love
Sex as a power play
Confusion about healthy sexual intimacy
Emotional stress and illness
Sex as a consumer product, prostitution
Relationship problems, divorce
Loss of productivity
Exploitation
Spiritual emptiness
Inability to focus
Use of other addictive substances
Feelings of betrayal
Increase in HIV and other sexually transmitted diseases, unplanned pregnancies
Isolation
Emotional, physical, and sexual abuse
Loss of innocence and self-respect
Sexual harassment
Avoidance of real needs
Loss of the sacredness of sexuality
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Loss of trust and feelings of safety


Therapeutic failure if not identified
Suicidal ideation
M ood Changes Related to Sexual Activities
W hen sex is used as a drug, there are mood
alterations in the brain. A study that included
brain scans completed by Dr. Mark Laaser and
Richard Blankenship at the Amen clinic (as
cited in Amen, 2007, p. 125) showed that 67%
of sex addicts had problems in the thinking part
of the brain, and 50% had problems in the brain
area that becomes fixated on negative thoughts
and behaviors. The study also showed a high
association between the mood and anxiety parts
of the brain that contribute to emotional extremes.
Inability to Stop Even with Negative
Consequences
If you ask a recovering sex addict if he or she
has ever tried to stop, the answer is usually,
Yes, and hundreds of times. Sex has crossed
the line into an addiction when the brain says,
Give me more of that feel good experience
and I do not care how you do it or what happens to you. Dons story illustrates this:
I was willing to give up everything, including my marriage and health, for sex. I
would say, Just one more time. One became a hundred times. I felt powerless.
The first step was going online to find
prostitute ads. That led to scheduling a
time to meet. The secrecy and naughtiness
accelerated the excitement I felt. I would
push thoughts of my wife aside. I did not
consider the possibility that having anonymous sex could bring me a sexually transmitted disease or that I was desecrating my
marriage. I was drowning and I needed
saving. As odd as it sounds, the saving
grace was my wife discovering my secret
life and learning I had a sexually transmitted disease.
Planning, Obtaining, and Recovering from
Sexual Activities Is Time Consuming
As sexual urges intensify, more time is spent
increasing the addicts relationship with sex.
Yes, sexual addiction any addiction is a relationship. This relationship becomes more
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important than anything else. W hen involved in


the planning, obtaining, and even recovering
from the sexual behavior, there is an illusion of
security. Referring to his addiction, one person
told me that although my sexual acting out
consumes 1% of my life, it is occupying 50%
of my brain. I corrected his statement and told
him that because it was a secret life that his
partner was not aware of, it was in his brain
100% percent of the time, hovering over him
like a dark cloud.
Risking Losing a Relationship or Job
W hat seems most crazy to outsiders is that
sex-addicted individuals are willing to throw all
good sense out the window and risk losing a
career, a reputation, and a person they love to
satisfy their sexual urges. However, when
someone is in the throes of an addiction, the
possibility of such losses are put out of sight
and out of mind so an urge can be fed. As Don
expressed it, W hat was so unbelievable to me
is that I was with a person I deeply loved, and
yet I was seeking sexual experiences with others knowing I was risking losing her.
Guilt and Shame Because of Sexual
Behavior
I distinguish between shame, guilt, regret,
and remorse. Shame is a debilitating feeling. It
goes deep into a persons core and is experienced as a disintegration of self, a sense of total
vulnerability and loss of power at that moment.
W hen shamed, people are not able to separate
who they are from what they have done.
Guilt is something people feel when their
behavior is identified as terribly wrong. The
terribly wrong may be an A- in school, or it may
be reaching out for a hug and being pushed
aside. After a while, the person does not need
others to inflict guilt and shame on him or her
because he or she does it to himself or herself.
W hen people use sex as a remedy and begin to
move away from values that they hold dear,
they experience intense guilt and shame. These
feelings then push them into denial or rationalization; sex addicts simply cannot admit to a
problem for fear others will view them in a
negative way, thus bringing on even more guilt
and shame.
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As healing occurs, such individuals own the


out-of-control behavior and feel regret or remorse for their actions. Guilt and shame are
generated from the outside when sex addicts
imagine how others may view them. Regret and
remorse come from inside when they dislike
their behavior because it goes against their
goodness and harms self and others. Taking responsibility for negative actions becomes easier
as these individuals mature in their recovery,
increase their self-esteem, and develop compassion for their human frailties.
Pursuing High-risk or Self-destructive
Behaviors
Sex addicts often blot out the risk they are
taking as they step into dangerous territory.
They are into the thrill, freedom, and power
they feel using their sexuality in dark ways. For
some, the high is in the secret life, the risk taking, and living on the edge of being found out.
The thrill thrives on fear and arousal. Sex addicts may need to be found out in order to both
stop the behavior and embarrass themselves
into getting help. One client, a CEO and father,
became swept away with the exhilaration of living on the edge. He took risks as he stepped
into dangerous neighborhoods to find street
prostitutes while avoiding the police. He hit
bottom when he was caught, ticketed, and publicly exposed.
A Predictable Cycle
Carnes (1983/2001) identified a predictable
cycle that sex addicts go through. Most are unaware of the cycle until they stop and look back
at their behavior. It is essential to understand
the subtleties and unique ways individuals experience each step.
1. Preoccupation creation of a trance-like
state similar to the limerent state one feels when
newly in love. The persons mood begins to alter as he or she fixates on his or her excitementrousing behavior. Such individuals imagine
spending hours searching for sex on the Internet, or they fixate on meeting someone at a
pick-up bar.
2. Ritualization the persons predictable
routine, which intensifies the trance and adds
arousal and excitement. Stepping into the
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ritual, the person does not have to waste time


thinking about what comes next; it is automatic.
Putting on specific make-up and/or a favorite
provocative outfit, or turning on the computer
before entering the cyberworld of pornography
or to meet someone, lets the addict know he or
she has just stepped into the game. There is a
chemical outpouring that then propels the addict into the next step: acting out.
3. Compulsive sexual behavior the sexual
behavior that is the end goal of the first two
stages. At this point a sex addict cannot stop.
The chemical and mental build-up, the intensity
of the drive, demands getting to the end product to experience relief. But shortly after
reaching the goal, there is a letdown.
4. Despair the feeling of hopelessness,
powerlessness, and emptiness that follows; the
crash. This crash is biological as well as psychological. A person cannot sustain the drug
high and the behavior did not fix anything.
Realizing that they have not been able to stop
the behavior, addicts may experience shame,
start the cycle again to get away from the pain,
concoct a story that justifies the behavior, turn
to another addiction, make another self-promise
to stop, or become suicidal.
The first two stages are not always taken seriously by a person using them. Those who are
not addicted can stop at this point. The person
addicted to sex progresses to the next two stages. Each time the cycle is repeated, it becomes
more intense and neurologically ingrained.
Tolerance or Need for M ore to Get the Same
High
The term for needing increasing amounts of
a substance or experience to get the same high
is tolerance. As the behaviors escalate, so do
the consequences. One client was court ordered
to get help and was not allowed to see his wife
or child. His demands for sex went from playful spankings to painfully humiliating acts that
did not stop even when his child was crying to
be nursed and his wife pleaded with him to
stop. She nearly died, and it was as if I did not
care, he reported.
At Odds with Family or Spiritual Values
Teds story speaks to how the misuse of sex
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can put a person at odds with his or her core


values. He was a spiritual teacher who sexually
preyed on the many needy women in his circle.
He used spiritual deceit to justify his behavior:
Love has no limits; I am healing not hurting. So immersed was he in the rush he experienced, he failed to see the damage he was doing
to his students until one of them reported him.
Denying, Rationalizing, Defending, or
M inimizing Sexual Behaviors
For many reasons perpetuating a life script,
soothing oneself, getting a high, filling loneliness or boredom, relieving depression, having
a private fantasy world, reducing stress, feeling
alive, coping with pain a person will do anything to keep his or her addiction alive. Such
individuals will openly deny that a problem exists, minimize the consequences of their acting
out, and become angry or defensive when you
get close to the truth or challenge their behavior. They will even make the problem about
you. As the behavior escalates, they often withdraw or become irritable. They carry on an internal dialogue that goes something like this:
Everyone is doing it; its no big deal.
I deserve it.
No one is really getting hurt.
Oral sex is safe.
A chat room is just a game.
Sex is my most important need.
M y partner is not satisfying me.
A cyber relationship wont get me into
trouble.
Guys need a sexual outlet.
I am lonely and it helps me feel good.
I was used and now it is my turn.
If the men enjoy my seduction, it is harmless.
Strong Sexual Cravings
Funk and W agnalls (Funk, 1955) describe
craving as a natural or morbid yearning or
appetite; intense longing (p. 314). Craving has
an element of urgency to it, an impulse so great
that if the craving is not fed, something awful
will happen. Some sex addicts describe craving
as a physical ache or compelling need experienced in their body. W hy does a craving go
from natural to morbid, from a natural sex drive
to sex addiction? There are many reasons:
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1.
2.
3.
4.
5.
6.

Genetics
Physical and emotional stress
Hormones
Changes in the brain because of drug
use
Nutritional imbalances
Psychological and physical trauma

Preoccupation
For many, the preoccupation with sex, often
under the influence of alcohol or other drugs,
can lead to self-disgust and suicidal thinking.
Such was the case for 15-year-old Tess, the
youngest client I have referred to inpatient
treatment for sexual addiction. She said it
clearly: Sex is like a drug. I think about it all
the time. I think about it I get really excited
I have sex and then I hate myself.
Living a Double or Secret Life
Sexual addiction can be considered a dissociative disorder. W hen there is public shaming
of a well-know political person, the response is
often, How could he/she be so ignorant? In
working with recovering couples, the partners
question is, How can he say he loves me if he
has this other life? The answer to both questions is that the acting-out person has two
selves: the addict self and the healthy self, and
the person has the ability to keep them separate.
The addicts secret life is supported by lying
to self and others. Although telling a lie is uncomfortable, the addict believes it is the lesser
of two evils, fearing that telling the truth will
make matters worse. Truth telling will mean
having to stop the behavior, face withdrawal,
take off the image mask, hurt a partner, and
feel shame and guilt. The person not only obsesses about obtaining the drug but about how
to keep the secret (Corley with Schneider,
2002, pp. 43-47).
Using Sex to Feel or Not Feel Past Trauma
W hen we experience fear that accompanies
trauma, our bodies instinctively react with a
fight, flight, or freeze response. It may not be
safe to fight or leave and so we freeze and store
fearful memories in our bodies. Sex is often an
attempt to release such energy or to replay an
earlier trauma. Bonded with the traumatic event
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or person who abused them, sex addicts will unconsciously reenact the earlier trauma through
the following:
Feeling sexual when frightened
Looking for danger
Bonding with abusers
Seeking high-risk sex
Using sex to escape
Doing to others what was done to them
Obsessing over the abuser
Anticipating being hurt
For recovery to occur, a person must get to
the fear trapped in his or her body and release
it. Many sex addicts use sex as a means to feel
because they have trouble feeling or to block
feelings that might trigger a past trauma and
flood them. A traumatized person needs to
learn that it is safe to have emotions and sensations. W hen a recovering addict learns how to
live an emotional life in the present with ease,
it is easier to tolerate any triggers from the past
and to reframe them (van der Kolk, 2006, p. 5).
Sexualizing Others
In many societies, people are groomed to explore and brag about sexual encounters, to line
up which men and women are the sexiest, and
to learn the skills of seduction. W hen individuals use sex compulsively, they become victims
of their own preoccupation with these skills.
Everyone they are introduced to, every anonymous person they encounter or observe, becomes a sexual object. More than noticing or
appreciating an attractive person, the other person is scrutinized for possibilities. The trancelike state of the search, the hunt, the suspense,
the potential conquest all are addictive in
themselves. Going to a large gathering or logging on to chat rooms is ripe with possibilities.
Sexual arousal intensifies and the mood is altered simply in the anticipation or fantasy. Androgens pulse through the body as the heart
quickens, the pupils dilate, and the body becomes aroused.
Violating the Trust of Others
Sex addiction often creates a breech of trust
that is so deep that a partner wonders if he or
she can ever trust the person again. Some even
consider suicide. W hen the compulsive or adVol. 39, No. 2, April 2009

dictive behavior has been kept a secret and the


behavior surfaces, the partner goes into shock.
Many trauma symptoms appear as the partner
wants to run, numb out, or attack: How can I
ever get over this? How can I ever get back
the safe feeling I had before? W hy am I not
enough? Despair, rage, and grief are experienced as the partner attempts to understand and
not personalize the partners behavior. W here
there is a good basic foundation of love and because trust can only be rebuilt with time, couples who hope to rebuild their relationship are
encouraged not to make a hasty decision to leave
and to commit to the relationship for one year.
W hether trust is restored or not is predicated on
whether or not both do their personal work.
Engaging in Inappropriate Sexual Behaviors
Sometimes a sex addict is hard to identify
because the behavior is covert. Sex addicts use
sex as the theme of most jokes and humor.
They tease with sexual innuendos or make direct comments about anothers sexual anatomy.
They give too many hugs, touch in ways that do
not feel right, and/or invade anothers physical
boundaries by brushing up against them. They
show off body parts and get high on others enjoying them. They are great at double entendres
(words or phrases that have two meanings).
They are quick to pick up a sexual meaning and
point it out. As the disease progresses, the behaviors become more inappropriate and direct.
In a partnership, a person gets the sense that
she or he must do more and more to thrill his or
her partner. The key word here is must in that
it is not a mutually satisfying arrangement, and
the partner begins to feel like a sex object.
Using or Abusing Others for Sexual
Gratification
Gregorys story tells how his first profound
sexual relationship, rather than being a good
one, reinforced early childhood trauma and set
the neural tracks that would be repeated in his
adulthood.
Gregory blurts out in the middle of our
session, I think I am addicted to sex. M y
sexual urges are out of control. I carry this
awful secret inside of me. It is as though I
get possessed and I say and do things I
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regret later. I use women for my own gratification. I cheat and lie. I keep sex separate from my heart.
As I guided him to the roots of the problem, Gregory remembers being 5 years old
and sitting in his mothers lap. He leans in
close to her. I love the way she smells.
She smells like flowers. I love the way she
rubs my hair and scratches the back of my
neck. I like her voice. She tells me I am a
big boy. I know Im not. I am sad but I
cannot be sad because she is sad. I have to
take care of her; Dad is gone away again.
He remembers more. At 17, Gregory
meets the most breathtaking person he has
ever met; she is 25. She introduces him to
sex, but no one can know. W hen he is with
his friend, Gregory feels 5 years old again:
I love the way she smells. I love the way
she rubs my hair and scratches the back of
my neck. I like her voice. She tells me I
am special. This must be what love isthe
touch, the closeness, the anticipation, the
sexual high.
Suddenly his electrifying friend is gone.
She says she fell in love with someone her
own age. He feels abandoned once again
by a woman he thought loved him. In his
pain Gregory affirms a forgotten promise
he made to himself at age 5: I will use
women like they use me. His script is set;
his childhood drama continues. From that
day forward, use he did. Living on the
brink of love became a way of life. Sex became a way of life. No fear, no hurt, and
no heart. On occasion the loneliness and
self-disgust would surface, but he would
quickly soothe it with sex, drugs, and alcohol. Then one day he collapsed into a depression, his payoff. He was so far away
from himself that it scared Greg into
reaching out for help.
Transactional Analysis and the Treatment
of Sex Addiction
Transactional analysis can play a significant
role in the treatment of sexual addiction. W hile
stopping the sexual acting-out behavior, understanding sexual addiction and its insidious nature, and developing a life of personal and
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spiritual integrity are essential components of


the healing process, the element that assures
long-term sexual sobriety is the psychodynamic
life script work a person does. On a psychological level, sex addiction has an explanation.
W hat within a persons psyche or script invites
him or her into the compulsive use of sex?
Case Example: Back to Gregory
Presenting Problem. Depression, fear of intimacy, and using women as sex objects, including a woman he wanted to truly love.
Script Analysis. Gregorys script set the stage
for a sexual addiction. He was the firstborn
child of an alcoholic father and a depressed
mother. His father provided modeling for being
an addict and finding emotionally unavailable
women. He was named by his mother after an
uncle who was described as austere, solitary,
unemotional, and concerned about image (Dont
Feel, Dont Be Close). He grew up in an upwardly mobile family that presented well to the
outside world (a lie). Father was absent for
weeks at a time, and mother relied on Gregory
to care for her emotional needs in his absence.
She would take him into her bed when father
was gone (emotional incest/secondary unhealthy
symbiosis). He both liked her closeness and
smells but knew it was not his place. Sexual
arousal became confused with love (Adams,
2007). It felt like a secret he had to keep (have
a secret life). W hen father returned home,
mother gave him little attention (no one will
love me as I am). Gregory would hear fighting
in their bedroom at night and developed an intense fear that mother would be hurt and he
could not save her (bonding with trauma that
leads to living on the edge).
In doing his script, this story emerged.
Bursting with energy and excitement he
could not contain, Gregory leaves the confines of the yard his parents had told him
never to leave so that he can climb his favorite tree. His mothers piercing screams
get his attention, and terrified, he runs
home. She grabs him and says, W ait till
your father gets home, hell take care of
you! He runs to the security of his closet.
A strange feeling of arousal charges through
his body as he waits in fearful anticipation.
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SEXUAL ADDICTION

I wonder when he will be home.


How bad will it be this time?
M aybe she wont tell him how bad I was.
No, I cant cry.
I cant be afraid.
Gregory enters a world where there is no
pain. He is at the top of the closet, where
he is safe, watching himself. The unmistakable sound of fathers car coming up
the driveway jerks him back to reality.
Footsteps walking toward the closet door
confirm that the time has come. Frozen in
terror, he waits for the punishment due a
bad child. Father takes off his belt, pulls
down Gregorys pants, and wallops him
again and again. Mother peeks in from the
kitchen, and although she winces, she says
nothing. Gregory feels totally alone.
In this painful intimacy, core beliefs and
script decisions are being made and incorporated into Gregorys P 1. These will later reinforce
his sexually addictive behaviors: Love is illusive, I cant count on others to meet my
needs, It is not safe to trust, and I wont let
anyone hurt me. Script injunctions are being
established: Dont Trust, Dont Feel, Dont Be
a Child with Needs, Dont Be Important,
Dont, Dont Be You, Dont Belong, Dont Be
Separate (Goulding & Goulding, 1979, Ch. 2,
9). The stage is being set for primary drivers to
be absorbed in P 2 Be strong, Please others (Kahler with Capers, 1974). Fathers modeling is being incorporated into A 2: The way to
be a man, to deal with women, and to connect
is to be abusive, distant, and controlling (Berne,
1961, pp. 200-210; Steiner, 1974, pp. 42-48).
In this and other trauma, Gregory learns that
a way to feel alive is via high drama, anticipation, and intense arousal, which sexual addiction will later provide. Bonding with a mother
who does not meet his needs but invites him
into a secondary unhealthy symbiotic system in
which he cares for her needs helps him learn to
play the grandiose role that sets him up to find
women who will play the victim role (Phillips,
1975, pp. 6-62). His most familiar game will be
first and- second-degree Rapo. First-degree
Rapo occurs when Gregory is solicitous and
attentive initially but later mentally and emotionally withdraws, although he still demands
Vol. 39, No. 2, April 2009

that his sexual needs be met. His partner feels


lonely or disappointed and he feels guilty.
Second-degree Rapo occurs when he seduces
and commits to a love partner and she later
learns he has a double life. She feels betrayed
and leaves the relationship. He shifts into selfrighteous anger followed by depression (Berne,
1961, pp. 98-115; Steiner, 1974, p. 38).
Treatment. To get out of his depression and
express healthy bonding and sexuality, Gregory
first updated his Adult and Parent ego states via
decontamination of his distorted thinking, education, reading, listening to stories of peers, reviewing his life script, and finding mentors who
would provide structure, nurturing, and wisdom
he could incorporate. Only then was he ready
to do the impasse and redecision work that
would assure long-term success in achieving and
maintaining his therapeutic goals in recovery.
To redo the story just described, for example, Gregory cathected his Child ego state,
went back into the scene, felt the pain, released
it, and this time in his mind confronted his parents. He took back his right to explore, be
heard, have needs, and experience feelings and
have true closeness. This helped to resolve a
second-degree impasse between the Child ego
states of his parents and his Child ego state
(Goulding, 1974). W hile still in the regression,
Gregory was asked to separate his grown-up
self from the child Gregory and with compassion to enter the scene and ask young Gregory
if he was ready to come home with grown-up
Gregory. He was. To affirm autonomy versus
anti-dependence, Gregory was asked to integrate the two parts of him by telling the inner
child how he would care for him today and lead
him to healthy relationships.
Having a strong ego structure, Gregory was
now in a position to do third-degree impasse
work between his addict self and his emerging
healthy self. His third-degree impasse work
was between his Adapted Child (I am bad and
enjoy it) and his Free Child (I am good and deserve to be close and sexual). It was important
to invite Gregorys addict self to transform the
energy in his Adapted Child into healthy adaptation assuring sexual sobriety. This was done
by corrective parenting (Schaeffer, 1989/2005)
with a structuring versus a critical Controlling
161

BRENDA SCHAEFFER

Parent ego state, an unconditionally loving versus an overly permissive Nurturing Parent ego
state, and an updated and well-informed Adult
ego state.
Conclusion
The advantages of using transactional analysis in recovery for sexual addiction are many:
It provides a psychodynamic script explanation
for addictive behaviors, it has methods that
facilitate identifying and reframing beliefs, it
promotes group therapy that is effective in reducing shame, and it offers corrective parenting
tools that can be used indefinitely by the client
to help maintain sexual sobriety. Incorporating
transactional analysis into the recovery treatment program has been key to reclaiming the
personal power given to the acting-out behavior. Each client presented in the previous cases
undertook a detailed life script analysis to identify and then heal the underlying problems. Doing the psychodynamic work contributed to a
high level of sexual sobriety: living a full and
meaningful sexual life with healthy boundaries.
Keeping healthy boundaries contributed to the
rebuilding of trust that had been broken, and,
therefore, many relationships that might have
ended did not.
Brenda Schaeffer has a doctorate in spiritual
psychology and is a licensed psychologist, a certified addiction specialist in sexual addiction, and
author of Is It Love or Is It Addiction?; Loving
Me, Loving You; Balancing Love and Power in
a Codependent World; Loves Way; Love or Addiction?: The Power and Peril of Teen Sex and
Romance; The Healthy Relationship Series, the
Corrective Parenting Chart, Inner Reflections
meditation CD, and several professional articles.
She is a Certified Transactional Analyst (psychotherapy), past executive board member of the
Society for the Advancement of Sexual Health,
associate member of the Association of Enneagram Teachers, and a consultant to Life Works
Treatment Center in the UK. She has a private
practice in Minneapolis that includes training,
speaking, and therapy. She can be reached at
15798 Venture Lane, Suite 101, Eden Prairie,
MN 55344, U.S.A.; brenda@brendaschaeffer.
com ; Web site: www.loveaddiction.com .
162

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