12 step

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.

Journey Through the Twelve Steps: Step Twelve

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This year, we have a monthly series discussing ways to engage and work each of the Twelve Steps.  Stemming from the Alcoholics Anonymous tradition, the Twelve Steps have made their way into the treatment of many addictive behaviors.  My specific focus will be on sex and love addiction, particularly in Christian women.  If you’re interested in finding an in-person, online, or phone meeting for sex and love addiction, check out Sex Addicts Anonymous or Sex and Love Addicts Anonymous.  Before you read this post, check out my introduction to the Twelve Steps to learn about support and resources.

Step Twelve:  Having had a spiritual awakening as a result of these steps, we tried to carry this message to other addicts, and to practice these principles in all areas of our lives.

Through the work you’ve done in recovering from addiction, it has become clear that addiction is an intimacy disorder.  When you are cut off relationally from others, inauthentic with yourself and the people around you, and living a double life, you are unable to be intimate with anyone.  In sex and love addiction, disordered intimacy is obvious as you seek addictive behaviors that provide relief from loneliness.  Building relationships with others working the 12 Step program and seeking to help them helps create a network of positive, healthy relationships to carry you through your recovery. 

As you meet individuals in the beginning of their recovery, you’ll be reminded of your desperation in the early days.  By helping them, you’re “paying it forward” from how you’ve been helped.  Passing along this work to others is inspiring and encouraging.  As an addict who has completed the steps, you are uniquely positioned to help others.  You’ve experienced what they’ve been through, and you can communicate that they are not alone.

You’ll also be ready to take the insights you’ve gained from your recovery journey and apply them to all areas of your life, including career and family.  Bringing authenticity and openness to all areas of your life allows you integrate your life in a way that is vastly different from your previous double life. 

How to Work Step Twelve

Reflect on how you’ve changed since Step One.

How have you become humble as a result of your 12 Step work?  Have you learned to admit your faults and failings?  What insights have you had about your character weaknesses, and how have they changed the way you live?  In what ways have you become more forgiving and less resentful, or more apologetic and quick to ask for forgiveness?  How have your relationships changed as a result of the 12 Step work you’ve been doing?

Reflect on some of the work you completed in early steps, looking through old journals or remembering stories you’ve told at meetings.  Look for evidence of change in your character.  Be grateful for how different you are today than when you started. 

Volunteer at a meeting.

You’ve likely seen other group members take roles to help out, whether that involves bringing coffee or snacks, setting up or tearing down chairs, or even leading a meeting.  12 Step groups are intentionally designed without a leader, which means there are many tasks that require volunteers.  Ask the trusted servant at your meeting how you might be able to volunteer to help in the upcoming months.  Often committing to be a regular attendee of the meetings helps to serve the community by creating consistency for newcomers.

Tell your story.

What do you remember from your first Twelve Step meeting?  My guess is it has something to do with the stories of others.  If you haven’t already shared your first step with your 12 Step group, consider doing so as a service to other group members.  This will allow others to relate to your story.  You can also share your story in a one-on-one setting with a new member of the group or sponsee.

Write a list of gifts you have to offer.

Through your recovery process, you may have become aware of talents or abilities that were masked by your addictive behaviors.  Your sponsor or other trusted individuals may also be aware of positive traits you have to offer.  Ask your sponsor or support people to tell you some gifts they think you bring to the recovery community.  Write these affirmations down and review them often.  Seek to fill roles within the community that allow these gifts to be used for the good of others.

Sponsor a new member of your group.

At this point, you have the opportunity to turn around and share the insights you’ve learned with a new sponsee.  Your insights can help someone else who is struggling with the same questions or doubts in their own journey.  But not only will you be helping them: you’ll find that your relationship with your sponsee will often help your own recovery as well. 

A few cautions before you start: consider the cost of sponsoring another addict prior to taking on this role.  Talk to your sponsor and ask if they’ll serve as a mentor for you with your first few sponsees.  It is recommended that you have at least one full year of sobriety under your belt before you sponsor someone, as sponsoring challenges your sobriety in new and unexpected ways.  When choosing a sponsee, limit yourself to one person at first, and make sure to choose someone who doesn’t remind you of former acting out partners or trigger addictive thoughts in you.

Attend a retreat or conference.

Changing up the structure of the standard group meeting and receiving inspiration and motivation from time away can help you re-focus on your recovery and learn new tools to help yourself or your sponsees.  You may also find yourself motivated to speak or offer your story at a conference.  Look for listings of yearly events (like those for SAA or SLAA) and invite a friend from your recovery program to attend with you.

Be conscious of when recovery begins to feel “boring.”

Boredom in your recovery can be a trigger to fall back into the temporary thrill of acting out.  When you notice feeling bored or apathetic in your recovery work, explore what’s leading to the boredom.  Identify dissatisfaction in your life or avoidance of a thorny issue that’s uncomfortable to think about.  Talk with your sponsor about next steps you might take to address these areas.

Another great way to combat boredom is walking through the steps again, perhaps trying out a new sponsor who may have some additional insight.  If you’re struggling with more than one addiction, it is helpful to go through the Twelve Steps with the other addiction and see what new insights you can gain.

Carry your new authenticity into all areas of your life, including sexuality.

Is there a major life change that you’ve been putting off, like in your career?  Is it difficult to apply your insights from recovery into more mundane, daily tasks?  Consider how you might use what you’ve learned in recovery to influence the areas of your life that seem unrelated.  You’ll be surprised to find how applicable these skills are in new contexts.

During this time, you might consider what non-addictive sexuality looks like.  Resources like a couples counselor or an individual counselor trained in treating addiction can help you in this process.  In particular for sex and love addicts, re-integrating healthy sexuality involves a slower journey, learning to embody your masculinity or femininity without necessarily expressing it through sex.  Resources like A Couple’s Guide to Intimacy* or Erotic Intelligence* can be helpful tools to explore this area. 

The End of the Road?

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At this point in your Twelve Step journey, you’ve walked through incredibly difficult steps that have proven to be ultimately rewarding.  But moving through the Twelve Steps is meant to be an ongoing process.  You have not “arrived” when you reach Step Twelve.  Instead, you are called to start back at Step One and examine new areas of your life and well-being that you may not have been aware of when you first began your journey.  Continually working through these steps can lead to significant life change.  You will gain new perspective as you explore your story in new ways.

Pause for a moment now and recognize moments of happiness and joy you have in your life as a result of recovery.  As you acknowledge and express gratitude for these gains, you’ll be motivated to continue.  Make a list of all the accomplishments you’ve made while working through the Twelve Steps, and plan a celebration with your sponsor or trusted individuals to celebrate all the hard work you’ve done to get here!

Step Eleven: Journey Through the Twelve Steps

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This year, we have a monthly series discussing ways to engage and work each of the Twelve Steps.  Stemming from the Alcoholics Anonymous tradition, the Twelve Steps have made their way into the treatment of many addictive behaviors.  My specific focus will be on sex and love addiction, particularly in Christian women.  If you’re interested in finding an in-person, online, or phone meeting for sex and love addiction, check out Sex Addicts Anonymous or Sex and Love Addicts Anonymous.  Before you read this post, check out my introduction to the Twelve Steps to learn about support and resources.

Step Eleven: We sought through prayer and meditation to improve our conscious contact with God as we understood him, praying only for knowledge of His will for us and the power to carry that out. 

Step Eleven builds on the Tenth Step work of taking a daily inventory of your life, as it integrates your relationship with God into that inventory.  The spiritual growth you’ve experienced through the 12 steps has helped you come to depend on God as your source of life, rather than turning to your addiction to feel satisfied.

This step differs from previous spiritual steps by shifting your relationship with God beyond just intense dependence on Him in establishing sobriety into acknowledging God as the guiding force in all areas of your life.  It requires a deepening of your faith and relationship with God in a way that extends beyond empty religious actions.  You will need to find spiritual practices that work to help you build regular conscious contact with God.

How to Work Step Eleven

Create a sacred space.

Where have you had your best experiences with God?  Maybe it’s while you’re out on a walk in the woods, or when you’re wrapped up in a blanket sipping a cup of tea or coffee.  Is there a place in your home where you feel most connected to God?  Is your church a haven to you?  Designate a place that represents closeness in your relationship with God and visit it often.

Sacred space can be created in any physical location.  You might imagine a place in your mind where you feel peace or calm.  You can make a space sacred by lighting a candle, turning on soothing music, or practicing a breathing or meditation exercise.  Whatever you do, seek to set aside the stress of your daily life and enter into a space where you can experience God. 

Another way to cultivate this space involves creating sacred objects associated with a milestone in your recovery or spiritual journey.  For many, the surrender chip they received at their first 12 Step meeting serves this purpose.  If you’ve gone through a particular trial and experienced the closeness of God, choose an object that reminds you of that experience.

Keep a prayer journal.

You may have picked up journaling as a habit during your recovery work.  Use this new practice to engage spiritually.  Write down prayers that you have and review them regularly to see the ways in which God has answered them. 

Be curious about the ways in which God may be answering your prayers in a way you wouldn’t expect.  As an example, you may have hit rock bottom in your addiction, which led to a way out.  God could be using difficulties in your life circumstances to grow you closer in relationship to Him or others.

Connect with God in the morning.

What is the first thing that comes to mind in the mornings for you?  Is it the stress of the day ahead, the dream you had the night before, or wishing you could just drift back off to sleep?  Starting your day in dependence on God can set the course for how the rest of the day will go.

Ask God to be with you during the day.  Pray through the events of the day and any challenges you anticipate coming up in the next several hours.  Use a few minutes to read Scripture using apps like First 5 or Read Scripture.

Pray throughout your day.

Paul exhorts in 1 Thessalonians 5:17 to pray without ceasing.  This might seem impractical if you’re splitting focus between work, family, or other tasks.  But you can use this simple Scripture to remind you to talk to God throughout your day as if he were a friend sitting beside you.  The Serenity Prayer can be a helpful, short prayer to memorize and repeat to yourself throughout your day to remind you to focus on God. 

End your day with God using nightly examen.

In discussing Step Ten, examen of consciousness was introduced as a way of reviewing your past day to identify where God was present or where you felt distant from him.  This helps to identify where God was at work in the daily, mundane experiences of your life, reminding you that God doesn’t just work through monumental events.

Taking the examen a step further involves asking God to point out areas where we’ve made mistakes, need to apologize, or could love others more fully.  Allow God to guide these reflections and reveal to you the areas where you can be focusing your attention in the days to follow.

Practice meditation.

Meditation is a popular topic right now, and there are several different ways to meditate.  Scripture meditation involves reflecting on a passage of scripture and allowing God to speak to you through it.  Reading meditations, as mentioned in the Step Ten, involve engaging with recovery literature to help remind you why you’re in recovery. 

Another form of meditation involves setting aside distractions like TV or phones and allowing yourself to connect to your breath in the present moment.  There are several different guided meditations and apps you can use to help in this process. Know that this will be difficult at first, especially if you are prone to anxiety.  The more you practice, the easier it will become. 

Meet regularly with a spiritual mentor or director.

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While walking through the earlier steps, you may have identified a spiritual guide, such as a pastor, church member, or spiritual director, to help you through the Twelve Step process.  Now you have an opportunity to ask that individual to help you in your journey to transform all areas of your life.  You can ask that guide to hold you accountable to the changes you want to implement.

Sometimes it can be hard to see God at work in your own life, but others around you may be able to shed more light on His role.  Your spiritual mentor can observe your life and offer you reflections and encouragements, as well as pointing out blocks that are getting in the way of connecting with God.

Step Nine: Journey Through the Twelve Steps

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This year, we have a monthly series discussing ways to engage and work each of the Twelve Steps.  Stemming from the Alcoholics Anonymous tradition, the Twelve Steps have made their way into the treatment of many addictive behaviors.  My specific focus will be on sex and love addiction, particularly in Christian women.  If you’re interested in finding an in-person, online, or phone meeting for sex and love addiction, check out Sex Addicts Anonymous or Sex and Love Addicts Anonymous.  Before you read this post, check out my introduction to the Twelve Steps to learn about support and resources.

Step Nine: Made direct amends to such people wherever possible, except when to do so would injure them or others.

Step Nine is a logical follow-up to Step Eight, where you are asked to list individuals who you have harmed through your addiction and character flaws.  In order to carry out Step Nine, you need the foundation of all eight of the preceding steps.  Step Nine involves bringing others in to the process in a way that they haven’t been involved before, and thus can be particularly shame-inducing.  You will need your support individuals, God, your 12 Step group, and the recovery you’ve completed so far to help guide you through this process.

Step Nine involves acknowledging that your actions have consequences.  Apologies are not the only necessary step to reconciliation: you must also follow those up with actions.  The goal of this step is to foster empathy and restitution, rather than to check a box or move on.

Be mindful of your motives in completing Step Nine.  Often addicts simply want to get their painful feelings off their chest and don’t regard the emotions or responses of others.  If you’re motivated by a desire to vent, relieve your own guilt, or reconnect with someone who has intentionally removed themselves from your life, talk with your sponsor and reconsider.  If you’re rushing into amends, ask yourself if you’re acting out of selfishness or self-serving motives.

How to Work Step Nine

Separate your list of direct and indirect amends.

Identify those individuals with whom it is appropriate to make direct amends with the help of your sponsor.  You may feel a burning desire to make direct amends to someone, but acknowledge when it would actually cause more harm than good to do so.

Pray and ask God to help you experience willingness to move toward amends.

As you work this step, it will feel daunting to tackle making amends with all the individuals on your list.  Pray and ask God for help and support through this process and seek to focus on just one person at a time rather than trying to take on the whole list.

Practice self-care.

This step can be incredibly taxing on the shame-based identity that’s driven your addiction.  Combat the power of that shame by prioritizing self-care and support.  Create a self-care plan for before, during, and after completing amends, and have your sponsor or a support individual from your 12 Step group hold you accountable to that self-care. 

For Direct Amends

Intentionally select who you share amends with first.

Choose who you will break the ice with in making amends first by asking your sponsor who might be the best option for you.  It may be helpful to make amends with the person who you feel the most distress about sharing first, in order to get it out of the way.  Alternatively, it might be worthwhile to make amends with an individual with whom you feel more comfortable first in order to build up your confidence. 

Write a letter outlining the harm you’ve done.

Use the list of specifics you created in Step Eight to draft a letter outlining the harm that you’ve done.  Remember, the purpose of the amends is to take responsibility for your actions rather than to explain or to offer excuses, so focus on “I statements” and limit the details that may come across as defensive.  Limiting details also helps limit the potential for harm.   

Identify ways in your letter in which you can make direct amends in the form of financial restitution, commitments to family obligations or housework, or other forms of restitution.  Ask those with whom you are making amends what they think you could do to make things right.

Practice reading aloud the letter with your support people.

Read the letter several times through with your sponsor, accountability partner, trusted mentor, or therapy group.  This will allow you to become more comfortable with sharing, allow the flow of the letter to feel natural, and receive feedback from others.

Prepare for negative or unexpected responses.

While reading the letter to your support people, anticipate and discuss possible negative responses you might receive from the one you’ve harmed.  Keep in mind that the amends are not causing the pain in the harmed individual: the addiction has already caused the pain.  Remember that the responses of others are not your responsibility and they are able to choose whether they want to reconcile the relationship, but you can only offer your own part in making the amends.

Set up a face-to-face appointment with the harmed individual.

If you are still in contact with the harmed individual, connect with them to set up an appointment time to discuss your amends.  If you or they need to have support individuals involved in the amends process (ie. a sponsor, therapist, pastor, or friend), then make allowances as needed.  Talk with your sponsor about the best way to reach out to individuals with whom you are not in contact.

Indirect Amends

Brainstorm ways you can provide indirect amends.

Perhaps your list of those you’ve harmed includes someone who is deceased.  Or maybe you used pornography or objectified anonymous others sexually.  It could be that re-opening a connection with a former acting out partner would cause more harm than good. 

Talk with your sponsor or 12 Step group about ways to make amends indirectly.  For example, you may be able to offer an anonymous donation or volunteer your time to an organization that fights sex trafficking.  Former acting-out partners can receive a letter of amends rather than a face-to-face meeting.  Writing a letter to a deceased individual may still offer those indirect amends. 

Schedule in your plan to make those amends.

Once you’ve decided the best way to make indirect amends, commit it to your schedule.  For example, if you’ve decided you’ll complete 20 hours of volunteering, sit down and schedule 1 hour a week into your time.  Research organizations to find one that is the best fit for your donation and plan a date to make the donation. 

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Use commitment to recovery as “living amends.”

As mentioned earlier, making amends isn’t just about apologizing.  It’s also about a change in action that indicates a commitment to recovery and change.  Even if you can’t make a direct amends, you can live out the change in your life that would offer reparation for the damage caused to those individuals.  You can continue staying sober, changing your behavior toward others, and improving your current relationships.