Shame

1. Shame Out of the Shadows: Understanding Sexual Addiction Patrick Carnes, Ph.d Presented by: Dr. Tory Clark

2. What is Addiction? Gabor Mate “What is addiction, really? It is a sign, a signal, a symptom of distress. It is a language that tells us about a plight that must be understood.” ~ Alice Miller

3. The Addictive System

4. Belief System • Made up of messages about a person’s value, relationships, needs & sexuality. Within it, are our options (answers, solutions, ways of behaving, etc.). • Our belief system is the filter through which we conduct the main task of our lives: making choices. • Our model of the world and on the basis of that model we: • Plan & make decisions • Interpret other people’s actions • Make meaning out of life experiences • Solve problems • Pattern our relationships • Develop our careers • Establish priorities

5. Core Beliefs • What do you think are some of the core beliefs that someone struggling with sex addiction may have? • Addicts struggle with core beliefs about themselves which affect how they perceive reality • Self Image: “I am basically a bad, unworthy person.” • Abandonment • Relationships: “No one would love me as I am.” • Unconditional love • Needs: “My needs are never going to be met if I have to depend on others.” • Trust & dependency – not there. Comfort? • Sexuality: “Sex is my most important need.” • Confusion b/t nurturing and sex • Primary source of comfort, yet…

6. Impaired Thinking • Out of the belief system- the set of interacting faulty beliefs- come distorted views of reality. • Defense mechanisms? • Denial • Minimization • Rationalization • Cut off- gone are the feedback loops which serve as vital correctives to a faulty belief system.

7. Unmanageability • “Addiction surfaces in the addict’s inability to manage his or her life.” –Carnes • Struggle to manage two lives: “normal” and “addictive”…eventually, unmanageable. • Red flags: the workplace, family, isolation • Closed off from the real world- now the addictive cycle is free to work • The belief system lays the foundation for the impaired thinking which supports the addictive cycle (back to the cycle slide)

8. Mental Disorder • DSM-IV-TR (2000) : “The symptoms cause clinically significant distress or impairment in social, occupational or other important areas of functioning” • DSM 5 (2013): "A mental disorder is a syndrome characterized by clinically significant disturbance in an individual's cognition, emotion regulation, or behavior that reflects a dysfunction in the psychological, biological, or developmental processes underlying mental functioning. Mental disorders are usually associated with significant distress in social, occupational, or other important activities. An expectable or culturally approved response to a common stressor or loss, such as the death of a loved one, is not a mental disorder. Socially deviant behavior (e.g., political, religious, or sexual) and conflicts that are primarily between the individual and society are not mental disorders unless the deviance or conflict results from a dysfunction in the individual, as described above."

9. Attachment Theory “Addicts, whether they're using drugs, alcohol, food, love, or sex to soothe themselves, are typically chronically dysregulated. They're seeking relief from underlying issues like depression or anxiety and can't get it. Because they didn't get the appropriate input and modeling for how to seek and receive comfort from the adults in their lives, they turn to substances or behaviors that will give them temporary relief from their own internal dysregulation. Over time, the habituated use of sex or obsessive love, become patterned behaviors that are difficult to stop.” -Alexandra Katehakis, MFT

10. Pay attention to Brandon’s: • Cycle • Core beliefs • Belief system, impaired thinking, and unmanageability • Preoccupation, ritualization, sexual compulsivity, despair • His interior world, exterior world and family and friends