binge-purge cycle

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.