Recently, I was working with a couple who were struggling due to the husband’s pornography addiction. The husband talked about no longer finding his wife appealing. The wife was hurt and unhappy about this disclosure, but also quite perplexed because her husband historically found her attractive. Previously, their sexual relationship had been fulfilling. This couple was experiencing one of the unfortunate outcomes from pornography addiction.

In 2013, Dr. Valerie Voon at Cambridge University, conducted a neurological study of men who were reportedly addicted to pornography. The research showed that subjects addicted to pornography and subjects addicted to drugs showed the same changes in the reward center of the brain. Both groups of addicted individuals engaged in addictive behavior due to increased dopamine levels in order to get “high.” In other words, the drug addicts increased substance use to get high and the pornography addict increased pornography consumption to get high. Both groups needed to increase use of their “substance” in order to get “high”. This is due to the dopamine receptor cites being flooded and eventually becoming less sensitive to the dopamine, thus needing more dopamine to achieve the same euphoric effect.

In addition to Dr. Voon’s research, Norman Doidge discussed the research in the article, Brain scans of porn addicts: what’s wrong with this picture. He described a trend that professionals were seeing in the mid-1990’s. A commonly noted scenario was an adult male who is in a happy relationship, gets curious and starts looking at pornography on the internet. This person is initially bored with the sites, then finds sites that fascinate him and eventually starts to crave looking at them.

This pornography scenario illustrates the general addictive cycle.   For the 5% to 7% of the population with a predisposition to addiction, once they start using a substance, they build what is called tolerance which means they need more of their drug of choice to get “high”.

While conducting her research, Dr. Voon noticed some interesting differences with pornography addiction. She reports that while these addicts craved pornography, some didn’t like it. Even though the addict was viewing sexual acts, they were less attracted to their partner. The addict also started to have different sexual desires.

Dr. Voon’s research debunks a common misconception that viewing pornography will somehow increase all couples drive for sexual contact. The research indicates a different finding. The addicted person that views pornography is more likely to become disinterested in their partner. In addition to the decrease in sex drive toward their partner, the addict’s sexual taste can change. The specific change depends upon what they are viewing.

Dr. Voon’s research provides couples who are struggling due to pornography addiction with some clarity and answers regarding changes in taste and interest.

There is hope in these situations. The struggling couple mentioned above was able to heal their relationship. The addict was able to abstain from looking pornography which enabled them to decrease desire to get high and to adjust sexual tastes and desires. The partner was better able to understand the addictive process, make necessary changes and realize that the situation wasn’t about them. If you are struggling with the negative impact of pornography, there is hope for you as well.

When I first came in to get help for my addiction, I was scared. I was afraid of revealing the half of me that was hidden all of these years. Without the addiction, I wouldn’t know who I was anymore. I have my wife to thank for encouraging me to get help. I broke her heart which made me feel like I had no where else to turn. I needed professional help.

At the start of treatment, trying to learn everything was so foreign, I almost didn’t want to understand. But I knew that if a stayed and listened that some of the information would eventually get through and make sense.

I have been in treatment for three months. I have begun to see the problems with my addiction and how it has affected my relationship. I now understand that the addiction made me an insanely obsessed person. I’m not saying that I am better, in fact, far from it. But now I can identify when something is wrong and what I need to do to resist triggers and feel better. It is still awkward as hell bringing up some of the urges and thoughts I have in my head. What I know now, is that despite recovery feeling a bit foreign, that it helps. It take’s the burden off me. The doctor’s visits, the SA meetings and working the 12 steps all help. The doctor helps me implement strategies for prevention. The SA groups help me know that I am not alone in this struggle and that others have been through similar experiences.

 Common Alcohol Dependence Questions Answered

Here are some answers to common alcohol dependence questions.  It is important to understand that these answers are not meant to provide specific medical advice, but to provide information to better understand the health consequences of alcohol abuse and alcohol dependence.  Please consult your physician or other health care provider if you or a loved one has an alcohol problem.

What Is Alcoholism?  Alcoholism, also know as alcohol dependence, is a disease that includes the following four symptoms.

1.  Craving – A strong need, or urge, to drink.
2.  Loss of Control – Not being able to stop drinking once drinking has begun.
3.  Physical Dependence – Withdrawal symptoms, such as nausea, sweating, shakiness, and anxiety after stopping drinking.
4.  Tolerance – The need to drink greater amounts of alcohol to get “high.”

Is Alcoholism A Disease?

Yes, alcoholism is a disease.  The craving an alcoholic feels for alcohol can be as strong as the need for food or water.  An alcoholic will continue to drink despite serious family, health or legal problems.

Like many other diseases, alcoholism is chronic, meaning that it lasts a person’s lifetime.  It usually follows a predictable course, and it has symptoms.  The risk for developing alcoholism is influenced both by a person’s genes and by his or her lifestyle.

Is Alcoholism Inherited?

Research shows that the risk for developing alcoholism does indeed run in families.  The genes a person inherits partially explain this pattern, but lifestyle is also a factor.  But remember; risk is not destiny.  Just because alcoholism tends to run in families doesn’t mean that a child of an alcoholic parent will automatically become an alcoholic too.  Some people develop alcoholism even though no one in their family has a drinking problem.

Can Alcoholism Be Cured?

No, alcoholism cannot be cured at this time.  Even if an alcoholic hasn’t been drinking for a long time, he or she can still suffer a relapse.  Not drinking is the safest course for most people with alcoholism.

Can Alcoholism Be Treated?

Yes, alcoholism can be treated.  Alcoholism treatment programs use both counseling and medications to help a person stop drinking.

Treatment has helped many people stop drinking and rebuild their lives.

Which Medications Treat Alcoholism?

Three oral medications – Antabuse, Depade and Campral – are currently approved to treat alcohol dependence.  In addiction, there is a long acting injectable medication called Vivitrol.  Although medications are available to help treat alcoholism, there is no “magic bullet.”  In other words, no single medication is available that works in every case or with every person.

Does Alcohol Treatment Work?

Alcoholism treatment works for many people.  But like other chronic illnesses, such as diabetes, high blood pressure, and asthma, there are varying levels of success when it comes to treatment.  Some people stop drinking and remain sober.  Others have long periods of sobriety with bouts of relapse.  An still others cannot stop drinking for any length of time.  With treatment, one thing is clear however, the longer a person abstains from alcohol, the more likely he or she will be able to stay sober.

Do You Have To Be An Alcoholic To Experience Problems?

No.  Alcoholism is only one type of an alcohol problem.  Alcohol abuse can be just as harmful.  A person can abuse alcohol without actually being an alcoholic – this is, he or she may drink too much and too often but still not be dependent on alcohol.  Some of the problems linked to alcohol abuse include not being able to meet work, school, or family responsibilities; drunk – driving arrests and car crashes; and drinking-related medical conditions.  Under some circumstances, even social or moderate drinking is dangerous – for example, when driving, during pregnancy, or when taking certain medications.

Are Specific Groups Of People More Likely To Have Problems?

Alcohol abuse and alcoholism cut across gender, race, and nationality.  In the United States, 17.6 million people – about 1 in every 12 adults – abuse alcohol or are alcohol dependent.  In general, more men than women are alcohol dependent or have alcohol problems.  And alcohol problems are highest among young adults ages 18-29.  We also know that people who start drinking at an early age – for example 14 or younger – are at much higher risk of developing alcohol problems at some point in their lives compared to someone who starts drinking at age 21 or after.

How Can You Tell If Someone Has A Problem?

Answering the following questions can help you find out if you or a loved one has a drinking problem:  Have you ever felt you should cut down on your drinking?  Have people annoyed you by criticizing your drinking?  Have you ever felt bad or guilty about your drinking?  Have you ever had a drink first thing in the morning to steady your nerves or to get rid of a hangover?  One “yes” answer suggests a possible alcohol problem.  More than one “yes” answer means it is highly likely that a problem exists.  If you think that you or someone you know might have an alcohol problem, it is important to see a health care provider right away.  They can help you determine if a drinking problem exists and plan the best course of action.

Can A Problem Drinker Simply Cut Down?

It depends.  If that person has been diagnosed as an alcoholic the answer is “no.”  Alcoholics who try to cut down on drinking rarely succeed.  Cutting out alcohol – that is, abstaining – is usually the best course of recovery.  People who are not alcohol dependent but who have experienced alcohol-related problems may be able to limit the amount they drink.  If they can’t stay within those limits, they need to stop drinking altogether.

If An Alcoholic Is Unwilling to Get Help, What Can You Do About It?

This can be a challenge.  An alcoholic can’t be forced to get help except under certain circumstances, such as traffic violation or arrest that results in court-ordered treatment.  But you don’t have to wait for someone to “hit rock bottom” to act.  Many alcoholism treatment specialists suggest the following steps to help an alcoholic get treatment.  Stop all “cover ups.”  It is important to stop covering for the alcoholic so that he or she experiences the full consequences of drinking.  Time your intervention.  The best time to talk to a drinker is shortly after an alcohol-related problem – like a serious family argument or an accident.  Be specific.  Tell the family member that you are worried about his or her drinking.  Use examples of how drinking has caused problems.  State the results.  Explain what you will do if he or she doesn’t go for help – not to punish the drinker, but to protect yourself from his or her problems.  Get help.  Gather information in advance about treatment options in your community.  If the person is willing to get help, call immediately for an appointment with a treatment counselor.  Get support.  Remember you are not alone.  Support groups include Al-Anon, which holds regular meetings for spouses and other significant adults, and Alateen, which is geared to children of alcoholics.

You can call the National Drug and Alcohol Treatment Referral Routing Service (Center for Substance Abuse Treatment) at 1-800-662-HELP (4357) for information about treatment programs in your local community and to speak to someone about an alcohol problem.  Many people find support groups a helpful aid to recovery.  Search these topics:

Al-Anon/Alateen

Alcoholics Anonymous (AA)

National Association for Children of Alcoholics (NACOA)

National Clearinghouse for Alcohol and Drug Information (NCADI)

National Institute on Alcohol Abuse and Alcoholism (NIAAA)

 

The World Health Organization (WHO) Acknowledges Compulsive Sexual Behavior Disorder (CSBD)

Over the past twenty-five years, I have observed a wide variety of beliefs and values about human sexuality.  Some people believe in having many sexual partners while others think that having a monogamous relationship is right. Some individuals advocate having multiple sexual experiences as “normal and natural”.  While others indicate that sexual acts or thoughts can become obsessive, compulsive, and out of control. I know of professionals who become very frustrated during discussions about sexuality.  Both sides of the argument seem to have merit depending on how you view the situation.  Human sexuality IS a normal activity; however, for some sex turns into compulsive “acting out.”  At this point, the World Health Organization (WHO) is acknowledging research trends providing important information on this topic.  

On July 2, 2018, The Social Post news reports WHO officially recognized their most current diagnostic manual, ICD-11 which categorized sex addiction as a form of mental illness.  This decision implies that sex addiction needs medical consultation and intervention.

According to Porn Help.org, the ICD-11 describes the condition of Compulsive Sexual Behavior Disorder (CSBD) in the following way:

Compulsive sexual behavior disorder is characterized by a persistent pattern of failure to control intensive, repetitive sexual impulses or urges resulting in repetitive sexual behavior.  Symptoms may include repetitive sexual activities becoming a central focus of the person’s life to the point of neglecting health and personal care or other interests, activities, and responsibilities; numerous unsuccessful efforts to significantly reduce repetitive sexual behavior; and continued repetitive sexual behavior despite adverse consequences or deriving little or no satisfaction from it.  The pattern of failure to control intensive, sexual impulses or urges and resulting repetitive sexual behavior is manifested over an extended period of time (e.g., 6 months or more), and causes marked distress or significant impairment in personal, family, social, educational, occupational, or other important areas of functioning. Distress that is entirely related to moral judgements and disapproval about sexual impulses, urges, or behaviors is not sufficient to meet this requirement.

The ICD-11 does not specifically use the word “addiction,” rather it classifies CSBD as an “impulse control disorder.”  This is due to a person’s inability to control impulses to engage in repetitive sexual behavior.

The Social Post news reports that approximately 2% to 4% of the population experiences this condition.  Some professionals believe this number is higher due to the billions of dollars that are spent on the various areas in the sex industry.

Professionals in the field have been aware for some time that certain clients neglect their relationships, health, family, and work responsibilities, due to these sexual obsessions and compulsions.  Hopefully, for people suffering with this new diagnosis “CSBD” will understand their condition and feel more comfortable seeking treatment.

For more information or consultation, please contact me.

Betrayal Trauma

Have you heard of the term “Betrayal Trauma”?

In my practice, I have seen an increase in the number of individuals experiencing betrayal trauma. Betrayal trauma occurs when a person we are attached to or depend on significantly lets you down or more accurately, betrays your trust. In adult relationships, this person is often a spouse or lover who repeatedly violates the “trust bond”. The betrayed partner may experience verbal, physical, sexual or emotional abuse. This abuse can create uncertainty and ambiguity within the relationship and usually leads to a feeling of instability, like the rug has been ripped out from under you.

Betrayal trauma results when an addict views pornography, goes to a strip club or participates in some other form of “sexual acting out”. When the betrayed partner expects their partner to be faithful, but instead is cheated on, then betrayal trauma can result.

The difficulty in the relationship comes to a head when a partner makes a clear discovery that the addict has betrayed the expected trust. Once the betrayal comes out in the open, the betrayed partner needs help working through the emotional devastation caused by the addicts’ behavior.

In a betrayal situation, the betrayed partner often feels like their life is spinning out of control or that they are going crazy. They often experience symptoms of anxiety. There is a body of research that suggests that partners married to sexually addicted spouses can and often do exhibit anxiety symptoms of Posttraumatic Stress Disorder (PTSD) following infidelity or even perceived unfaithfulness.

Robert Weiss, MSW describes some of the anxiety symptoms that a betrayed partner may experiences including depression, mood shifts, extreme emotional reactions, tearfulness, rage, anger, anxiety, and low self-esteem. They may have difficulty sleeping, waking up, or have nightmares. They may begin to investigative the addict by checking phone texts, phone numbers, computer logs, wallets, credit card bills or phone bills for signs of unfaithfulness.

They may be easily triggered by their partner flirting with others, looking too long at others, or getting off the computer too quickly. They may have difficulty concentrating and completing daily tasks. They may obsess about the betrayal and have problems living in the present. They may exhibit addictive behavior themselves by using drugs, alcohol, gambling or spending. They may also eat too much or too little in response to the stressors.

Even though the betrayed partner exhibits symptoms of PTSD, a diagnosis of PTSD may not be necessary. With time and therapeutic intervention, the partners can recover and experience relief.

One of the best ways to self-soothe and heal from this trauma is to focus on establishing better boundaries. In her book, Moving Beyond Betrayal, Vickie Tidwell Palmer suggests that self-care through the use of boundaries is essential for healing. The boundaries include physical, intellectual, emotional and spiritual areas.

Boundaries are Essential for Healing

Physical – These boundaries include behavior to keep the partner safe such as not allowing for any abusive behavior, getting testing for STD’s, and only having protected sex.

Intellectual – Obtain as much information about the addiction as possible. The knowledge will help you better understand the situation and make better decisions.

Emotional – Seek support from appropriate people such as a knowledgeable addiction therapist, friends, sponsors, and family members who understand what is happening. It is important that you don’t try to go through this trauma alone. Connecting to supportive individuals can be very helpful.

Spiritual – Spiritual practices can provide a sense of hope, comfort, and peace during this difficult time.

In addition to setting boundaries, a final suggestion is to stay positive during the recovery process. Even though a person is thrown into a very difficult situation, they can find comfort in remembering their core values. This can prevent you from blaming yourself for the addict’s actions. Focusing on positive values can also help you avoid becoming bitter.   May your recovery be strong and your journey, be filled with hope.

 

 

As a professional, I am always looking for relevant information about what is happening in the lives of individuals and families.  Internet Pornography by the Numbers; A Significant Threat to Society is a compelling article with statistics about the significant costs of pornography in our world. The authors, Webroot Smarter Cybersecurity indicate that pornography use negatively impacts business productivity by 16.9 Billion dollars annually. However, they suggest that fiscal costs are only part of the story. They believe that the human costs are much more significant.

They quote Patrick F. Fagan Ph.D. psychologist, and former Deputy Assistant Health and Human Services Secretary, who says, “Pornography hurts adults, children, couples, families, and society. Among adolescents, pornography hinders the development of healthy sexuality, and among adults, it distorts sexual attitudes and social realities. In families, pornography use leads to marital dissatisfaction, infidelity, separation and divorce.”

The article sites many general, youth, and family statistics about pornography use. Some of the statistics are quite startling for example, every second approximately 28,258 users are watching pornography on the internet and every second approximately $3,075.64 is being spent on internet pornography. Obviously, a huge amount of time and resources are being directed toward pornography use.  The statistics also target the impact that pornography use is having on adolescents.   The teenagers exposed to high levels of pornography experience loneliness, depression, and lower sexual self-esteem. The statistics also indicate a significant impact on marriages. In 2010, the National Coalition for the Protection of Children & Families reported that 47% of families reported that pornography is a problem in their home. Pornography use increases the infidelity rate by more than 300%.

The article provides us with thought provoking statistics and material about pornography that should be considered in business and in our personal lives.

If you would like to learn more please visit:

https://www.webroot.com/us/en/resources/tips-articles/internet-pornography-by-the-numbers

Weekend Seminar Client Relection

Being able to listen and share in a safe environment with other men from similar backgrounds was very revealing and comforting. Having Dr. Chen as the facilitator allowed a level of honesty and self-reflection that I have not felt before in SAA meetings.  Because of Dr. Chen’s intimate knowledge of our emotions, feelings, and past behavior, he was able to ask clarifying and revealing questions that probe for more deep and honest answers.  Dr. Chen always made me feel safe and comfortable.  He also added down time over meals to get to know everyone on a friendly level.  Dr. Chen’s ability to select a group of men that would be able to share openly for a weekend seminar and be able to bond and grow was a gift. The opportunity to have one-on-one time with every man not only helped me to get to know each of them better, but also opened-up a level of honesty that is not always available in group. I can honestly say that without having Dr. Chen as the anchor of my recovery, I would not have as much sobriety as I do today.

Honest Recovery

Sexual Addiction Conference – Assessment and Treatment

Description

The training at this conference will enable professionals to identify 10 criteria for addiction. They will understand the addiction cycle. They will recognize how early trauma and other components enable an addiction to develop. Providers will be able to identify 10 types of compulsive behavior revealed through research.

Who Should Attend

Therapists who work with individuals and couples who are having personal and relationship problems. In some cases, the individual’s and couple’s struggles might be due to underlying sexual addiction issues.

Date: February 28, 2018

Time: 9:00 am until 12:00 noon

Location: Salt Lake City Public Library

Salt Lake City Public Library

210 East 400 South

Salt Lake City, UT 84111

Fees:

Single Registrant: $45

Group Rate (4 or more): $35 each

Registration Link:

www.stevenjchen.com/workshops

Continuing Education Credit: 3 hours

The following organizations have approved CE credit for this course:

The Utah Psychological Association

Utah Association of Social Workers

The course relates to Marriage and Family Therapy work. The training will help MFT providers identify sexual addictive behavior when applicable.

Course Director: Steven J. Chen, Ph.D.

Steven was trained in Clinical Psychology and obtained his Ph.D. in 1992. He has worked at a variety of settings and has more than 25 years’ experience in psychology. Steven has worked with numerous individuals suffering from addiction, including alcohol, sex, and drug dependence. He utilizes a unique intensive outpatient approach, which is highly effective in helping those with addiction as well as spouses and family members. He is a certified sex addiction therapist (CSAT).

For more information about the conference, please see the training section of the website.

 

 

Dear Dr. Chen,

I am very grateful for your guidance and instruction.  For over 50 years, I have dealt with sexual addiction.  I have found it unbeatable despite my most ardent, sincere and determined efforts to control it.  Almost three years ago my life hit rock bottom.  I finally understood my life was uncontrollable and I could not beat the addiction by myself.  Quite by chance I met with Dr. Chen.  I told him my story and he said that I was a sex addict.  He handed me a book about sexaholism and told me to attend a 12-step meeting.  He told me that sex addiction was a disease.  He would work with me to help me manage the disease, but that I would never be cured.  Since that time with Dr. Chen’s help, my personal surrender, and the help of other recovering addicts, I have embarked on a path of spiritual rebirth.  This spiritual rebirth consists of physical, mental and emotional recovery.

I think that recovery has many components.  I cannot be completely successful without religious, social and professional therapy components working together equally.  I am grateful to have found all three components.  Even more grateful that my recovery is happily proceeding with a life connected to God, loved ones, and others.  I have appreciated Dr. Chen’s wisdom, suggestions, and constant reinforcement of me as a person of value throughout the process.

Sincerely,  Grateful

Dear Grateful,

I appreciate your kind words.  It has been a pleasure helping guide you through the recovery process.  As we have discussed on many occasions, recovery is not a destination. Recovery  is a life long undertaking that one must recommit to each day.  The process is not easy.  As you have experienced, there are many challenges.  However, with patience and persistence, the life improvements you experience will be well worth the effort.

All the best,  Dr. Chen