patrick carnes

Surrender to the Process: Task 3 in Carnes’ 30 Task Model for Addiction Recovery

A common struggle for addicts entering recovery is the tug-of-war of their desires: wanting to stop acting out while still feeling a pull toward addictive behaviors.  Early in recovery, there’s often an expectation from yourself or from a spouse or loved one to change instantaneously.  And at the beginning, that can feel possible: after discovery or disclosure of addiction, you might have an immediate sense of disgust or distaste for the addiction that fuels sobriety. But with time, that initial emotional response subsides, and the addiction can easily come back when the underlying roots of the problem are still hidden.

One of these underlying roots is a sense of control: a belief that you can force yourself to stop your addictive behaviors, you are in control of your own recovery, and you can pick and choose what you do to get better.  Notice, however, that one of the hallmarks of addiction is repeated attempts to stop without success.  Often early attempts to stop are half-hearted, done in isolation, or not informed by recovery principles. 

The momentary willingness that comes after disclosure or discovery will not turn into long-term sobriety unless there is a recognition that past attempts to control don’t work.  Unless there is a true surrender of control, change will not last.

Surrender to the Process vs. Attempts to Control

What is Surrender?

Surrender is a recognition of the reality that you do not have the power to get better from your addiction on your own or by manipulating or controlling your recovery.  This ties into 12 Step work and breaking through denial as you recognize your own powerlessness and unmanageability.

Surrender acknowledges that the attempts you’ve made to change have been futile.  Often, this is because they are done by yourself without the support or accountability of others.  Or because you approach recovery in a piecemeal fashion, only choosing to do some things and leaving behind necessary tasks for your recovery that stir up discomfort.  Or you may be still on the fence about recovery in general.

What is Control?

Control happens when we believe that we are not powerless and that we can do the work of recovery on our own.  This often leads to white-knuckling, a term that refers to forcing yourself to stop acting out behaviors by sheer willpower.  The term “dry drunk” refers to someone who may not be acting out in their addiction, but hasn’t addressed the underlying root causes of the addiction to create lasting, holistic life change because they are still seeking control. 

Control can be obvious, as in some of the examples above, but it can also show up in subtle ways.  When you are only doing some of the work of recovery and ignoring putting into practice that which makes you feel uncomfortable, you are exercising your own control.  Control shows up in comparing yourself to others in recovery, seeing yourself as better or more capable than them.  Thoughts like “if I just do better, then it will all be fine,” are denial statements that foster this sense of control, but then lead to feelings of lethargy, depression, or self-hatred when you cannot follow through on change.  Another indicator is a lack of willingness to rely on others for support or help through the process, meaning you aren’t attending meetings, don’t have a sponsor, and have no accountability with other group members.

Characteristics of Surrender

Surrender requires you to be uncomfortable.  When you’re surrendering to the process of recovery, you will feel discomfort with some of what you are tasked to do.  You might not like some of the early restrictions or accountability you need to put in place, like an internet blocker, location tracking app, or daily accountability with a sponsor.  But remember that picking and choosing what you feel comfortable with in recovery is a setup for slips and relapse.

Surrender releases anxiety to experience peace.  When you are attempting to stay in control, you put incredible pressure on yourself to change on your own, followed by devastating shame when you inevitably fail.  If you choose to surrender to the process, you can experience the peace of knowing that you aren’t alone and help is available. 

Surrender requires that you say no.  You will need to learn what your limits are in recovery.   We like to think that we can do everything we want and resist temptation to act out in addiction, but this isn’t true. One of the ways denial perpetuates addiction is to tell you that you should “test your strength” or “test your resolve” by putting yourself in risky situations. But this is another form of ritual and preparation for acting out.  You need to identify appropriate boundaries and restrictions early on to set yourself up for success.  Addicts are notoriously bad at boundaries – that’s part of the addiction – so surrendering to boundaries that others help you identify or that have been tenets of the 12 Step recovery process are necessary. 

The Spiritual Nature of Surrender

If we can’t do recovery on our own, then what does that mean? Who can do it for us?

Surrender is a spiritual discipline.  Recognizing the role of God in this process is essential.  In 12 Step, incorporating God or your Higher Power involves recognizing something bigger than yourself that is guiding you toward health, because your self isn’t cutting it.  Step Two and Step Three of the 12 Step program dig into this exploration in more detail. 

Surrender to God or a Higher Power can be a tricky endeavor for those whose views of God are complicated, who have difficulty trusting in God, or who don’t believe God has the power to create change.  These roadblocks are worth working out in the context of your 12 Step group or with your sponsor.  At the bare minimum, believing that there is something outside of yourself that will guide you through recovery, even if it is as simple as the 12 Step process or your work with a sponsor, gives you a good place to start.

Practical Steps for Task 3

Ask for help.

The easiest way to recognize surrender in someone is their willingness to no longer tackle the addiction on their own, but to actively seek out help from others.  This can come in the form of joining a 12 Step group, therapy group, support group, or going to counseling.  Take it a step further by connecting with a sponsor or other group members for contact outside of the group.  Recognize that asking for help requires vulnerability and openness: you need to share the realities of your addiction openly with someone rather than offering partial information.

Identify your Higher Power.

This can be the God of the Bible if you are a Christian believer, or can have a foundation from your religious background.  If you chafe at the idea of religion, you may choose the 12 Step group, people who have gone before you in recovery, recovery itself, or a particular value you hold like love or compassion.  Again, seek to identify something bigger than yourself and have conversations with others in the program to open yourself up to faith and be curious about this process. 

Name denial-based roadblocks.

Denial in your thoughts can be a major factor that keeps you in control and prevents you from offering full surrender.  When you look at the subtle types of control listed above, do you identify with any of them?  Make a list of the denial statements that are most common to you that fuel these attempts to control.  They can include thoughts like, “I don’t need to do that,” “I’m not as bad as so-and-so,” or “other people might need 12 Step, but I don’t.” 

Now consider: what have you tried before in terms of your recovery?  How successful was it?  Is your denial telling you the truth or not?  Look also at what beliefs might be causing you to resist placing trust in your Higher Power or in the support of others.

Grieve the losses associated with surrender.

Surrendering addiction is hard, often because it can feel like you’re giving up the only coping mechanism you have available when stress or other painful emotions arise.  There are aspects of addiction that were appealing or pleasurable to you, and you will need to let go of them.  It also may require you to let go of the belief that you are in control or that you are capable of stopping on your own.  Surrender is a process of letting go.

Remind yourself of your commitment.

When you choose to surrender, it is not a one-and-done moment.  Surrender is a daily practice.  Repeatedly remember your commitment to surrender through a daily reminder, as with a spiritual practice like prayer, journaling, or meditation.  You might choose a mantra or repeated phrase like, “I can’t, but God can,” or “I choose to surrender to the process of recovery.”  Use the Serenity Prayer: “God, grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference.”  Regularly reinforce this commitment through the support of a church or religious community.

Invite others to help with boundary-setting.

As mentioned earlier, a lack of understanding and implementation of healthy boundaries is a characteristic of addiction.  Recovery requires going back to basics with boundaries.  Sit down with your sponsor and talk about your limits and what you should say no to in early recovery, even if you don’t want to.  Get specific and honest here about what you truly need.  Your sponsor will help you explore which triggers are in your control and those you can’t control to help you adapt your boundaries accordingly.  Talk to others in your group with similar acting out behaviors about what boundaries they found effective in early recovery and choose to adopt some of theirs if they strike a chord in you.  Read stories of those who have been successful in recovery, many of which can be found in the foundational text of your 12 Step fellowship, and imitate some of the changes they made if they are relevant to you.

Understanding the Nature of Addiction: Task 2 in Carnes' 30 Task Model of Addiction Recovery

At this point, you’ve been propelled into recovery through a crisis of decision.  You may have faced a rock bottom moment, like an STD or a spouse’s discovery of your behaviors, that led you to begin to break through denial and admit that you have a problem outside of your control.

But when you begin your journey of recovery from addiction, chances are you are unfamiliar with the specifics of the illness with which you are dealing.  Even though you have plenty of experience living out addiction, you probably don’t know much about the underlying causes of what you’re going through. 

Task 2: Understand the Nature of the Illness

In this task, you will learn more about sex and love addiction, including common symptoms, information about how addiction forms, and patterns it follows.  If you are facing sex and love addiction, there are several different manifestations of addiction that you will come to understand through Patrick Carnes’ ten types of behavior, a categorization system created to describe the significance of varied areas of sexual acting out behavior.

Learning about the mechanics of addiction can answer many of your “why” questions, like “why is it so hard to stop?” or “why do I keep coming back to this?”  As you explore addiction, you’ll learn about neurochemistry and how process addictions (those that involve a behavior rather than a substance like drugs or alcohol) work in the brain.

You may also find connections between your personal history and your present-day addiction.  Abuse and neglect are common factors in many addicts’ histories.  Sexual development is often disrupted, leading to a faulty understanding of healthy sexuality.  Even without an obvious history of abuse or neglect, you may uncover messages communicated to you about yourself, your body, or sex. Critical life events that had an impact, like an unexpected death or illness in the family, or your family’s culture and structure may have inadvertently contributed to your addiction.

Feelings of isolation and loneliness are common in addiction, as you don’t know many others who have felt the ways you have in addiction. Getting connected to other addicts, hearing their stories, and recognizing the patterns of your own addiction that match up with theirs can help you feel less alone.

Practical Steps for Task 2

Read!

Gather information about your addiction by reading and researching more about it.  While the Diagnostic and Statistical Manual of Mental Disorders 5th Edition (DSM-5) does not utilize sex and love addiction as a diagnosis, you can compare your experience with the DSM-5 criteria for substance use disorders, as in alcohol use disorder.  Learning from books, listening to podcasts, or reading articles from trusted sources can all help you see stories of addiction that mesh with your experience.  It can also explain some of the symptoms you’ve experienced but not fully understood.

Here are a few books I would offer as a starting place for reading and learning more:

Similarly, here are a few informational articles I’ve put together about sex and love addiction:

Review and personalize the cycle of addiction.

In several of the materials listed above, you can find information about the cycle of addiction.  Review the steps involved with a particular focus on preoccupation/fantasy, ritual, acting out behaviors, and despair.  See if you can identify how each of these steps manifests for you.

What were the first triggers that got you thinking of your compulsive sexual behaviors?  What was on your mind while you were fantasizing or preparing to act out?  What behaviors prepare you to act out?  What form did the acting out take?  How did you feel afterward?

If you have multiple different forms of compulsive sexual behavior from which you are seeking healing (eg. pornography use and engaging in affairs), create a separate cycle for each of those forms of acting out.

Identify the function of your fantasies.

As you focus on the fantasy component of the cycle, ask yourself: how does your fantasy work to propel your addiction forward?  What types of situations or scenarios do you fantasize about?  What need are they meeting?  Don’t limit this exploration to sexual fantasies, but include non-sexual fantasies, such as a career you’ve dreamed about, for similar themes.

Often fantasies reveal an underlying need that has gone unmet in the past or is currently unmet by your lifestyle.  If your initial thought about your need is for “more sex,” identify what sex represents to you and why you feel you need more of it, as that might get you closer to a core need. 

If you’re still having trouble getting to the deeper need, connect with a therapist or trusted mentor, like a sponsor, to help you uncover any underlying desires that might be at play. 

Learn about sexual anorexia and the binge-purge cycle.

Often addiction can go unnoticed because it is coupled with sexual anorexia, forming a cycle of bouts of sexual behaviors followed by avoidance and fear of sex.  Sexual anorexia is, simply put, “an aversion to being sexual” (Carnes, Facing the Shadow).  Sexual anorexia involves intentionally depriving yourself of sexuality in order to avoid the discomfort or pain that it brings up, often due to past abuse or negative messaging about sex.

Addicts can be both addicted and anorexic at the same time.  For example, an addict who uses pornography daily but avoids sex with his spouse is exercising both sexual addiction and anorexia.  It can also appear in a binge-purge pattern of use, where an addict binges by acting out frequently over a short period of time, followed by a long stretch in which they avoid sexual behaviors or thoughts.

If you relate to this description of sexual anorexia, Patrick Carnes has written an in-depth book on this issue entitled Sexual Anorexia: Overcoming Sexual Self-Hatred which may be worth a read to help you understand. 

Review and list the consequences of addiction you’ve experienced.

As you read, you’re likely to learn about impacts of sexual behaviors of which you weren’t aware previously.  Perhaps you had some problems in your life that you didn’t realize were connected to addiction, but you’re noticing their connections after learning about the symptoms.  Facing the Shadow has some helpful exercises related to exploring these consequences more deeply.

Identify common factors with others in recovery.

While one of the most important first steps in breaking through denial is joining a group and finding accountability with other recovering addicts, you can also understand the illness of your addiction more fully as you listen to the stories of others and identify stories that line up with your own.  Though you may have vastly different manifestations of acting out or consequences to your behavior, look for the common factors you share.  These factors might have nothing to do with addiction on the surface but might include such historical information as a rigid family upbringing or a lack of adequate education on healthy sexuality.

Create a timeline of your sexual history.

Consider your own sexual development.  What were some of the key sexual experiences you had throughout your life?  Break this timeline down into time periods, such as childhood, early adolescence, late adolescence, young adulthood, middle adulthood, etc.  Your timeline may include abuse or harmful experiences, but it can also include more positive or neutral moments as well.  You can use defining events (eg. going to college, getting married, losing a job) as timeline markers, particularly if they had a significant influence on the progression of the addiction.

Reflect back on the messages you received about sex growing up.  Were you given adequate sexual information?  Was anything left out?  How were sex or sexual matters discussed in your household?  Some of the messages about sex you received may be indirect.  Perhaps your parents never had a conversation with you about the birds and the bees, but you picked up your knowledge of sex from peers or porn.  Maybe TV shows, cultural norms, or images depicted in pornography had an influence on your view of sex. 

Include how you came to understand your masculinity or femininity.  Often we receive messages from similar sources (parents, media, peers) about what it means to be a man or a woman, which can teach faulty messages that contribute to addiction.  Addiction itself can also teach distorted messages about men and women.  Abuse is another factor that can impact this messaging, so be aware of any influences from that arena. 

Share this timeline with someone else.

In the same vein as sharing with a sponsor or trusted friend about your addiction, as mentioned in task 1, once you’ve compiled this timeline of sexual behaviors, go over it together with a sponsor, mentor, therapist, or trusted friend.  Opening up to someone who you trust to be able to receive and listen to your story without judgment is a necessary part of recovery.  Ask for feedback or themes that they notice of which you might not be aware.

This is great preparation for sharing your First Step with a sponsor or in the context of a 12 Step meeting.  Understanding your personal history and how it applies to your story of addiction can lead to significant insight into how your addiction functions.

Breaking Through Denial: Task 1 in Carnes' 30 Task Model for Addiction Recovery

What do you do after you realize you have a problem with sex and love addiction?  Maybe you’ve been found out by a spouse or significant other, and you know you need to get help.  Perhaps you’ve had legal or financial consequences that put you in a position to make some serious changes.  You may have even begun therapy with a counselor to address your addictive behaviors.  But what does treatment for sex and love addiction look like?

The 30 Task Model

Dr. Patrick Carnes, the pioneer in research and literature on sex addiction, designed his treatment model centered around 30 essential tasks to recovery.  These 30 tasks are broken into three sections: early recovery tasks, long-term recovery tasks (internal and external), and relational/family recovery.  He explores the first seven of these tasks in his workbook Facing the Shadow, while the next set of tasks is outlined in the follow-up books The Recovery Zone 1 & 2.

While all thirty of these tasks need to be addressed during the 3-5 year period of recovery from addiction, they aren’t necessarily completed in order.  You may find yourself working on spirituality (task #30) while you’re in the early stages of learning more about addiction (task #2) and establishing sobriety (task #5).  Or you may find that, several years into your recovery, you need to break through denial (task #1) about a new area of addiction that has replaced your sexual acting out (task #8).  Or while you’re working on your marriage relationship (task #27), you’re also grieving the losses your addiction has created in your marriage (task #12).

The 30 tasks don’t directly correlate with the 12 Steps, they share much of the same DNA.  For example, task #3 (surrender to the process) is very similar to what you’d find in Step 2 and Step 3.  In fact, task #7 (participate in a culture of support) is implemented through involvement in support groups and 12 Step programs.

The 30 Task Model can give you a roadmap to follow in treatment for sex and love addiction.  They can also be a helpful reference point when you’re in the middle of recovery and looking for what’s next or when you find yourself getting off track.  I’ve used them in sessions with clients as a means to define our goals together and as a self-assessment to identify potential areas for continued growth. 

In this series, we’ll take an in-depth look at each of the 30 tasks in Carnes’ model and explore some of his recommended activities (as well as a few of my own) for addressing this task or returning to it later in recovery.  Kavod Psychotherapy created a reference diagram briefly describing each of these 30 tasks.  More information on the tasks can be found in Facing the Shadow, The Recovery Zone series, or the Recovery Start Kit, all created by Dr. Patrick Carnes. 

Task 1: Break Through Denial

The essential starting point for any addict in recovery is the shift in thinking from “I don’t have a problem” or “this isn’t a big deal” into facing the reality of the presence of addiction and its destructive power in your life.

To put the label of “addiction” on your behaviors can be challenging, as we often associate addiction with moral failure or flaws.  Denial allows you to avoid a sense of shame or guilt about these behaviors.  Labeling behaviors as addiction also compels you to change, while denial can justify or minimize the impact of your behaviors.

Often the first call to break through denial comes when a loved one, like a spouse, finds out about your compulsive sexual behaviors.  This often begins the process of therapy and support.  Sometimes you’ve experienced a sense of guilt or being unable to stop that you’ve been aware of, but there isn’t any motivation to make a change until you hit that crisis point. 

Practical Steps for Task 1

Take an addiction-related assessment.

When you begin working with a Certified Sex Addiction Therapist (CSAT), they’ll typically encourage you to take one of a few different types of assessment to compare your symptoms and behaviors to a norm.

One is a quick inventory that you can take on your own: The Sexual Addiction Screening Test, or SAST.  This compares responses from a non-addicted population to a population of self-reported sex addicts.  This way, you can see whether or not you fall within range of normal behavior or addictive behavior. 

If your scores from the SAST put you in range of addictive behavior, you may be asked by your therapist to take a Sexual Dependency Inventory (SDI).  This is a much more extensive assessment that helps you clarify the form your addiction takes, as well as various additional measures that identify potential roots for the addiction.  Some of the questions for this particular assessment are found in the Facing the Shadow book in Chapter 3, so you can review those on your own if you choose.

Another alternative is to compare your experience of compulsive sexual behaviors with the criteria for addiction listed in the DSM-5.  While there isn’t yet a diagnostic category for sexual addiction in the DSM, you can use the same criteria as alcohol or drug use disorder and simply replace the substance listed in the criteria with compulsive sexual behaviors.

Write out any problems or consequences you’re experiencing.

Make a list of any problems you’re facing in your life, whether they are obviously addiction-related or not.  Often problems seem unrelated to the addiction, but their solutions can be influenced by the time and energy the addiction takes.

Examine your list to identify which of these are either directly caused by or intensified by your compulsive sexual behaviors.  Include not only physical consequences you may have had as a result of the addiction but also emotional and spiritual consequences.

Make a list of the secrets you are keeping and from whom you are keeping them.

Addiction thrives in secrecy.  One major way to break through denial is to identify where that secrecy is taking place.  This deception can be about major things, like hiding your compulsive sexual behaviors for fear of rejection or pain.  But they can also be about minor things, like finding yourself compulsively lying or hiding aspects of who you are as a person.

Take note of these, as well as from whom you’ve been hiding them.  Notice if there is anyone in your life who knows everything.  If not, be curious about why that is.  If you run into a pattern of presenting a different person in different contexts, explore what might be influencing that behavior. 

Recognize the “stinkin’ thinkin’” of addiction.

Denial exists primarily in our minds as a way of interpreting our behaviors and our thoughts.  It can show up as making excuses, minimizing, justifying, feelings of entitlement, blame-shifting, taking on the victim role, and many others.

Begin to recognize the beliefs you have that allow you to continue on in your addiction.  Utilize resources such as this article to identify different types of beliefs that might show up in your denial.

Sometimes these beliefs are so strong that they’re hard to label as denial.  Understanding delusion and self-deception can help make sense of these thoughts and place them into the correct category.

Tell the whole story to someone.

Once you’ve sorted through how denial functions to protect you from facing the reality of your addiction, now you can work against that denial by sharing your story of addiction with a safe and trusted person.  This person could be your therapist, sponsor, pastor or spiritual mentor, or a close friend who has offered understanding and empathy when you’ve talked about difficult things in the past.  It may be helpful to write a letter or narrative to help you express your thoughts and ensure that you are as honest as possible.

Many 12 Step programs encourage you to share this information in your First Step.  You might share parts of your story with a group during a regular meeting or present your First Step as a whole to the group.  Telling another sex and love addict in recovery can be helpful, particularly in a group setting. They will know how and when to challenge you, as they can relate to the experience in a unique way.

Obviously, it can be challenging to work up the courage to share your First Step with the group in a way that feels supportive and kind to yourself. Get connected to a sponsor or other support individual and share with them first before you do so in a more public form.  In the meantime, listen to others’ First Steps to consider what pieces of your story relate to theirs.

Check your story with others.

The way we perceive the world, especially when it comes to our own actions, isn’t always the way others see it.  If you’re wondering about the impact of your behaviors and you feel able or comfortable to do so, ask others.  Similarly, you can observe when others in your group talk about the impact of their addiction on their loved ones and draw connections to how your loved ones may be feeling.

If you are married or in a significant relationship with another person, you may go through a formal disclosure process at some point.  As part of the disclosure, your loved one will read you an impact letter they’ve written that describes how they have felt as a result of your addiction.  This can be a helpful experience to come back to as a reminder of the reality of the pain caused by your behaviors. 

Repeat.

Keep coming back to these components of breaking through denial at each stage of your recovery.  You might find the stinkin’ thinkin’ re-emerges when you’re about to face a new challenge to your sobriety.  At around 6-8 months of sobriety, you may become overconfident and observe some of these denial patterns coming back in again.

Create and add to a list of beliefs that push you into addiction, denial statements, entitlement, and excuse-making statements so you can continue to recognize those thought patterns when they come up.  The more you are able to recognize and be on guard for this denial, the more likely you will be to catch it and redirect into your recovery.