Establishing a sobriety definition in the treatment process of sex addiction

Sobriety definition has significantly hindered the efficiency of the treatment process due to the lack of understanding around the importance of when and how to establish what one would identify as sobriety.  If not all behaviors that solicit the dopamine response are eliminated, the neurological system will continue its addiction cycle of dopamine self regulation.  This causes the pathology like relationship between the brain, addiction and the nervous system.  At this often untreated early stage within the treatment process, the addict’s primary way of relating to others is often through self-regulated safety found in treatment relationships where many sex addicts often seduce and use flirtatious like behaviors with others to solicit the dopamine response.  In the “Love Addiction” system often the fantasy projected onto the relationship formed with another in the treatment process is established to increase the intensity of the dopamine/chemical release cycle of self regulation.  Dopamine, vasopressin, oxytocin and other chemicals fuel the erotic desire to attach and ‘matter’ in this toxic system.  We often see this theme within the treatment process which provides individuals no ability to engage in the proposed treatment modalities of addiction.  This self regulating process also includes many other behaviors that interact with this system, many common in the treatment process are increased sugar consumption, food, caffeine intake and other possibilities that one is capable of engaging in within the treatment process.  It is important to acknowledge that establishing these patterns early within the treatment process is integral and need to be incorporated into ones initial sobriety definition so that the treatment modalities used are effective in the treatment of addiction disorder, otherwise the addict will continue to regulate through a behavioral or substance avoidant system.  With all this in mind, I have established a 6 week treatment program with the design of treating men with compulsive sexual behaviors where imbedded in the treatment model is a way to establish what behaviors have been identified that continue to solicit the dopamine response that fuel the addiction cycle within the first week of treatment and a plan is put in place around abstaining and creating boundaries around these behaviors are established to create maximum efficiency for the introduction of the treatment modalities to conceptualize.  For example this would include eliminating masturbation, unhealthy sex with self, boundaries around caffeine and sugar ingestion, elimination of nicotine use and the engagement with individuals for reasons outside a therapeutic relationship as part of the treatment process at initial to early stages.  The treatment for sex addiction uses the “three circles” method to calculate and establish a definition of sobriety of which I utilize within the first week of the treatment process alongside working through the “What is Real” task of recognizing self delusion.  In my experience patients have had more success in affect regulation and establishing healthy outer-regulation and finally inter-regulation tools which allow one to establish true intimacy.  This supports the idea of conceptualizing sex addiction as simply an intimacy disorder as the addict is stuck in the cycle of self-regulating behaviors where there is no ability to regulate other than addiction.  This causes blocks in one achieving true intimacy.  This cycle has the thought process of the addict engaged in the acknowledgement of being a threat to self, preoccupied with distorted thinking as again the neurology is stuck in addictive thought patters.  The distorted thinking often leads to isolation and the ability to only use ones addiction to self regulate.  This self regulation process is addiction or the “acting out” aspect which leads to the shame, despair and life threatening consequences of ones addiction system but more importantly the perpetuation of the self regulating dopamine solicited response system.  In conclusion, it is imperative to eliminate these behaviors as early in the treatment process as possible so that one can have established a sobriety definition and become open and teachable to the proposed treatment modalities.

Mike Quarress CSAT