In a highly anticipated interview with Oprah Winfrey, famed cyclist Lance Armstrong has finally come clean about the allegations of doping that have haunted him for much of his unparalleled career. Armstrong, who in August 2012 was stripped of his record seven Tour de France victories and banned from competitive cycling due to mounting evidence of performance-enhancing drug use, is just one in a long line of athletes—most notably baseball players—who have either confessed to using performance enhancers or whose images have been tarnished by credible allegations of doping.

It’s no secret that many athletes will go to any length for a competitive edge, but performance-enhancing drugs carry numerous health risks, including baldness, impotence, infertility, addiction, psychiatric issues, hypertension, liver problems, and numerous other issues.

In a world where athletes who use performance-enhancing drugs always seem to get caught, often with disastrous consequences for their careers, what would compel an athlete to risk not only his or her health but livelihood as well?

Perfectionism and Pressure to Perform
Competitive sports can be cutthroat. Fans, coaches, and sponsors have high expectations for athletes, and hold in high regard records and never-been-done-before, seemingly superhuman feats. These expectations are frequently unrealistic, but can place considerable pressure on athletes. People in the upper echelons of athletics are often perfectionists to begin with; after all, it’s not easy to make it to the top. These perfectionist tendencies can make performance-enhancing drugs seem not only justified, but necessary.

Particularly when the competition uses performance-enhancing drugs, a dedicated athlete might feel like he or she has no choice. If the competition has an unfair advantage, taking drugs may seem less like cheating and more like leveling the playing field.

Peer Pressure
Particularly as more and more athletes admit to the use of performance-enhancing drugs, it can seem like sport is full of doping. Athletes may experience peer pressure from friends, teammates, and coaches, who may suggest that they can’t keep up with their competitors if they don’t use drugs. Peer pressure can also come in indirect ways. When athletes are criticized by peers, they might feel like their only hope for improvement can come in a vial or pill. Coaches, teammates, and even physicians or trainers may be complicit in doping.

Financial Issues
Not all athletes are wealthy. Particularly among Olympic athletes, financial gain often comes in the form of sponsorships, not from the sport or league. Many athletes spend years paying coaches, trainers, and gyms, and may get deep in debt covering the costs of developing into one of the best at what they do. Athletes are much more likely to get cushy sponsorship deals and contracts when they break records or win competitions. Particularly when an athlete knows or believes that other successful people in his or her field are using performance-enhancing drugs, they might seem like the most attractive or likely way to get out of debt and into financial security.

Secrecy
Although many athletes are regularly drug-tested, dopers try to stay one step ahead of the science. Many athletes have devised novel ways to avoid being caught, and in a high-stakes world, it’s easy to believe you can outsmart the testing mechanisms. Indeed, many athletes have managed to do just that for years, so the risk might seem worth it to an athlete under immense pressure.

References:

1. Oprah: Lance Armstrong confesses. (2013, January 16). ESPN. Retrieved from http://espn.go.com/sports/endurance/story/_/id/8845599/oprah-winfrey-confirms-lance-armstrong-admitted-doping
2. Performance-enhancing drugs: Know the risks. (2012, December 12). Mayo Clinic. Retrieved from http://www.mayoclinic.com/health/performance-enhancing-drugs/HQ01105
3. Shermer, M. (2008, March 31). The doping dilemma. Scientific American. Retrieved from http://www.scientificamerican.com/article.cfm?id=the-doping-dilemma
4. Shermer, M. (2009, September 07). Why athletes dope. The Huffington Post. Retrieved from http://www.huffingtonpost.com/michael-shermer/why-athletes-dope_b_278861.html

According to comScore, which measures Internet traffic, 66% of Internet-using men between the ages of 18 and 34 look at online pornography at least once a month. Does it really matter if you watch pornography? Does it really impact marriages and relationships? Two-thirds of divorce lawyers say the Internet has played a significant role in divorces within the past year, with excessive interest in online pornography contributing to more than half of such cases. That does not even speak to the impact pornography has on physical and emotional intimacy in relationships.

Consider these five reasons pornography can hurt your love relationship:

1. Men who view pornography can experience “sexual anorexia”! What? Indeed, the results of a study in Italy that surveyed 28,000 porn users seem to corroborate the notion that too much porn has a negative impact on sexual performance. Apparently, men become so accustomed to the unrealistic images they see in pornography that they can no longer get erections. Many men don’t realize their brain’s sensitivity is declining toward “normal” sex because web-based erotica delivers endless dopamine hits—making erection and climax possible where normal encounters would not. When they try to have actual intercourse and cannot, they understandably panic. The brain changes that cause porn-induced erectile dysfunction arise from actual, physical addiction processes (among them, numbing of the pleasure response of the brain).
2. With porn, partners are always willing and ready for sex! Where sexual drive varies in individuals, porn creates the unrealistic illusion that your partner should always be ready, willing, and able. Imagine the pressure this puts on your partner. It leaves no room for emotional connection, real-life circumstances, and the fun of pursuing each other in ways that are meaningful to each other rather than with only one objective in mind. If your partner has had a tough day at work, fought traffic, made dinner, taken care of the kids, done laundry, and prepared the family for the next day but then felt too tired for sex and consequently got replaced by porn, is this going to build intimacy or destroy it?
3. Porn creates scenarios that just aren’t real! Here are some conclusions from a study by the surgeon general: The values expressed in pornography clash with the family concept, and potentially undermine the traditional values that favor marriage, family, and children. Pornographic scripts dwell on sexual engagements of parties who have just met, who are in no way attached or committed to each other, and who will part shortly, never to meet again. Sexual gratification in pornography is not a function of emotional attachment, of kindness, of caring, and especially not of continuance of the relationship, as such continuance would translate into responsibilities, curtailments, and costs. Now what if I told you that study was conducted in 1986? Consider how much more widespread pornography is today with the Internet, social media, etc. Porn sets up couples and families to fail because as one becomes more immersed in the false “reality,” true reality suffers and is shamed.
4. Real-life partners can’t compete with embellished pornography! Porn creates an environment in which everyone is beautiful or handsome. Body parts are perfect, accentuated, and responsive in extreme satisfaction. How can anyone’s spouse or partner compete with that? If someone is indulging in hours of pornography, how can it not affect his or her reality when looking at a spouse or partner? The partner will begin to feel inadequate, judged, and compared, and might shut down or withdraw. This only leads to more disconnect on both parts and, for the one viewing porn, can start the path to even more sexual dysfunction.
5. It is not only the partner who can’t live up to the porn standards! So you view pornography, watch how “perfect” things are, how every encounter is desired and accepted, every act brings mutual satisfaction, and the performance never fails, never disappoints. How can anyone live up to that? The truth is, you can’t—and you are not supposed to. In a true relationship, you accept each other for who you are, you make it special for each other, and there is understanding and compassion, not fear and judgment. Pornography is NOT reality, and forcing oneself to watch unrealistic situations over and over and then expecting yourself to perform the same way is setting yourself and your partner up for disappointment.

This is the reality of the impact pornography has on your loved one and your love life. There is the argument that moderation is the key, but too many studies show that it typically does not stay at moderation—it escalates, requires more intensity to meet sexual gratification, begins to have a negative impact on sexual experience with your partner, and eventually causes a disconnect in relationships that is difficult to overcome.

Sure, it is easy to brush it off and say it won’t happen to you, but before coming to that conclusion, take an honest look at what pornography has already done in your life, in your partner’s life, in the area of hiding the habit, shame on you and your partner … if you want a truly honest response, have an open mind to what your partner thinks of your viewing of pornography. Based on real studies, real facts, real impacts on relationships, what are you going to do? It is never too late to get help through counseling, support groups, and accountability to begin the path of personal and relational healing.

I was recently told a statistic that didn’t really surprise me, but was kind of an eye-opener nonetheless: Married individuals daydream about being single at least once a day. Well, I’d argue that single people dream about being in a relationship once in a while, too. The point is that the grass is always greener.

The other point is that there is some truth to the statistic, and people should be aware of what is happening biologically. The chemicals in our brains when we meet someone, start dating and “fall in love” are akin to being on a cocaine high. Dr. Helen Fisher, author of Why We Love: The Nature and Chemistry of Romantic Love, coined this the “lust” and “romance” phases of love­—when things are exciting, albeit chaotic. This is not a sustainable way of living. Most people want to fall in love so they can settle down. A friend once said to me, “But isn’t doing your laundry on a Saturday with your partner what it’s all about?” Yes, a long-term relationship is comfortable, secure, stable, and, well, biologically speaking, perfect for raising children. You wouldn’t want to raise kids in a chaotic state of mind, would you?

Now, this final phase of love, which Dr. Fisher calls “the attachment phase,” is not that exciting, perhaps, but it really isn’t supposed to be. I think a lot of people get disillusioned by messages in the media, romance in films, and passionate sex in movies. It seems that if you want something exciting, you have to keep jumping from one relationship to another. And, trust me, many people do. Although many use the term serial monogamy, this can be a sign of a love addiction—people finding themselves addicted to the rush of romance.

Love addiction also has a flip side to it: It might cause you to stay in an abusive relationship. Love addicts often are afraid of being alone, and don’t like their own company. Love addiction can take over and cause people to make bad choices, fail to see red flags, and continue down a path with someone despite the obvious. Many love addicts have more than one partner.

We all have the tendency to be love addicts because, in the end, we all want love and connections with people, for that is how we grow, but a true love addiction is compulsive and obsessive in nature. A love addict may feel that true love will solve everything. A love addict may consume his or her mind with all things relationship-oriented. A love addict may fantasize about someone who is unavailable, believe he or she just can’t find the right one, or, once the early passion fades, fear he or she is no longer “in love.” Some may jump from one relationship to another in search of that excitement, while others stay in their current situation despite feelings of dissatisfaction, fantasies about leaving, or affairs both emotional and physical, and are prone to blame their partner(s) instead of addressing the matters at hand.

So how do we start to address a possible love addiction? Here are some guidelines I’ve come up with, for starters:

1. Stop blaming the other person. If you are in a relationship, take a close look at what is going on. Are you being fair? Are you being honest? Are you being clingy? A love addict may expect the other person to treat him or her special, make everything, and fix things for him or her. If you are single, stop blaming the ex, take a break from dating, stop interacting with the ex, get into therapy, and talk to someone.
2. Accept your feelings of sadness, fear, anxiety, and loneliness on a daily basis. These are common feelings that everyone feels, but a love addict may try to fight them by finding a relationship. Recognize that you will feel these feelings and it is OK.
3. Take responsibility for your life. This means your happiness and your successes. Take charge of your life, make healthy choices, and spend time doing the things you love.
4. Learn to accept yourself. Accepting your partner, if in a relationship, is key, too. In the end, without acceptance we are continuously searching, and that is at the root of any addiction.

Many mental health professionals consider the three “A’s”—addiction, affairs, and abuse—sufficient reason to leave a partner. This blog addresses lower-level offenses related to the first two. While most couples can overcome low-level indiscretions in any area of the three “A’s,” when multiple indiscretions occur or the degree of severity is greater, it may be time to throw in the proverbial towel. As couples grapple with why one partner cheated or entered the depths of alcoholism or drug addiction, they need to evaluate the patterns of relating they have become used to, the interpersonal dynamics they engage in, the dances they dance, and the issues they may have brought into the relationship. One theme that consistently emerges is the degree to which couples are honest with each other. How much do they divulge? How important is it to tell the truth? Do you really need to tell your partner everything?

In Alcoholics Anonymous, we hear people say, “We are as sick as our secrets.” Family addiction therapists are fond of saying that there are no family secrets. By this, they mean that even when we believe that other family members don’t know a certain secret, that secret still has an impact on everyone in the family. If individual members don’t know the specifics of the secret, they are still impacted by it and sense or experience it unconsciously—and that can affect the whole family. I work with patients who learned in their twenties or later in life that they were adopted, that their parents were once married to an abusive spouse, or that they have a sibling they never knew, among other revelations.

I’ve also become aware of the extent to which sober and recovering clients keep things from their partners. Even in relatively healthy relationships, there appears to be a fair amount of small-scale concealment and deception, though the extent of the infractions often is debatable. Several clients I see—coincidentally or not, all men—have reported engaging in exercise cheating. What’s that, you ask? Exercise cheating, essentially, is exercising and not telling your partner, or not revealing how much or what type of exercise one engages in.

Even I have been guilty of cheating on my wife. A few years back, as I was setting up my new Philadelphia office, I decided to buy a painting by an artist that my wife and I liked. My wife studies art history, and I thought she would appreciate that I was acquiring a painting by a Temple University master’s graduate. And while $650 is no small chunk of change for this sort of thing, I thought it was a great investment for my new office. I thought I would surprise her with the purchase. Instead, she was angry. “You art cheated!” she cried as soon as she saw it. She was genuinely annoyed that I had not consulted with her on a purchase of this magnitude. Whether I was right or wrong in purchasing something of that cost for my office was not the issue. What is important is my partner’s perceived betrayal and need for dialogue, negotiation, and consultation.

Many hypothesize that cheating behavior is related to vestiges of evolutionary differences among men and women. While this theory would be a gross generalization in today’s society, it suggests that it was more adaptive in an evolutionary way for men to cheat than for women to cheat. Assuming evolution prioritizes any behavior designed to propagate one’s genes, men may benefit from spreading their genes in a quantity-focused way. Women, meanwhile, have long gestation and nursing periods which may temporarily move them to be more devoted and committed to their offspring. Thus, they benefit from finding a better quality mate. In other words, women are biologically, or at least evolutionarily, better at taking care of their young, especially in early developmental stages. Most people agree, and research appears to back this up, that most men think about sex more frequently than women do. While both men and women want to find a quality mate, men may be more inclined to seek quantity than women are.

According to this evolutionary perspective, neither men nor women want their mates to cheat because a mate who cheats may have more offspring, which in turn means that mate is less likely to care for the original partner’s offspring and more likely to leave and care for his or her new offspring. It is in a man’s evolutionarily best interest not to alert his partner to the fact he is cheating. Any behavior—sexual or not—that results in producing healthy offspring is powerfully reinforced to the extent that it aids in propagating an individual’s genes. So, infidelity and hiding that infidelity through the processes of natural selection and evolution can become more prevalent over time.

A fair question would be whether cheating sexually is related at all to other types of cheating. Just because a partner doesn’t tell a mate where he or she is going and what he or she is doing doesn’t mean that an affair is happening, and it doesn’t mean that a tendency toward nonmonogamous behavior is the cause of disingenuous behavior in the context of the couple. In fact, the point of this article is to lessen the impact of minor violations of the honesty contract. Putting small indiscretions of dishonesty in an evolutionary context may allow couples to see this behavior as resulting from the natural instincts of the animals we are. What is important, though, is that as humans we have the capacity to dialogue. This is precisely what can keep our natural tendencies in check. Speaking honestly to our partners about our needs and wants, while often challenging, is the hallmark of a healthy relationship.

Smoking gun example: A client once described an interaction he had with his wife after she busted him for smoking pot in the garage. She smelled the smoke even as he vehemently denied he had been smoking marijuana. When she found his metal pipe, still warm, he stuck to his story. “The lie just came out,” he explained later. “I was so used to it.” He eventually was able to talk about why he lied and why he has often felt the need to cover things up. It had nothing to do with infidelity, but was instead linked to his history of struggling to feel good about himself, to be able to ask for help with his emotions feelings and thoughts and to find purpose and meaning in his life. Beginning to discuss these issues with his wife and therapist helped him think more carefully about his tendency to lie and cover his tracks. He became better at advocating for himself and negotiating with his partner in a more healthy way.

Honesty is important in recovery from any mental health issue, whether it be depression, anxiety, or stress, but it is especially important in recovery from addiction and substance use because of the strong tendencies to hide, deny, and minimize one’s behaviors. Seeing an addiction psychologist or other specialist is an important first step in understanding one’s self. It is in this therapeutic relationship that a quick foundation can be set for the basis of an honest dialogue with one’s partner, friends, and family. Rebuilding relationships with those we love and who love us is essential to recovery from addiction. Understanding ourselves and the reasons we might cheat and lie can enable us to pause just long enough to ask ourselves whether we really want to go ahead with the behavior or if we might be able to rely on those close to us to help us through the difficult times. Honest communication with the people in our lives is the only way we can become and stay sober or make meaningful and lasting changes in our lives.

A biography of Marilyn Monroe by Lois Banner, professor of history and gender studies at the USC Dornsife College of Letters, Arts, and Sciences, reveals a complicated woman determined to be the best at everything. Published around the fiftieth anniversary of Marilyn Monroe’s death (August 5, 1962), Marilyn: The Passion and Paradox also reveals Marilyn Monroe’s troubled psyche and tragic childhood, including her childhood experience with sexual abuse, which led to a life-long struggle with sexual addiction. In an act that continues to strike us for its bravery—especially in a society like ours that is obsessed with objectifying women—Marilyn Monroe acknowledged and spoke publicly about her struggle with the consequences of childhood sexual abuse.

Banner builds on Monroe’s own statements to create a picture of a woman battling sex addiction and seeing herself as an object to be possessed by men and women. In one particular interview she gave to the British press, she stated “I sometimes felt I was hooked on sex. I could not stop having sex with almost every man I met.” Her persona as America’s “sex symbol” speaks loudly to America’s twisted relationship to sexuality, which takes tragic self-objectification and makes it something desirable rather than identifying it as a defense to trauma that causes suffering and requires treatment.

Aside from celebrities having affairs and sometimes excusing this behavior under the guise of “sexual addiction,” our society does not talk about the topic, and therefore we do not fully understand sexual addictions. The first thing to note is, oddly enough, sex addiction is never about sex. It is about a repetition of trauma and a craving for intimacy. Sex becomes the tool a person uses in order to find love and acceptance. Of course, the aim is never satisfied because the intimacy created through frequent sexual encounters is never really intimate or loving.

Sex addiction is a byproduct of trauma coupled with loneliness, pain, and the need to be loved and accepted. It is a substitute for these needs, a counterfeit way to meet real desires. However, it always fails to meet those needs and desires and subsequently creates a greater need for more sex in order to mask what one is truly missing. In Marilyn Monroe’s case, this craving for affection probably developed early on in life as she was moved around from foster parent to foster parent. In addition, having been sexually abused by men as a child, she would likely have equated sex with attention, and attention with love.

Studies show a high correlation between childhood abuse and sex addiction in adulthood. “Sixty percent of sexual addicts were abused by someone in their childhood” (Book, 1997, p 52). If your caretakers failed to protect you, or worse, inflicted the pain, you end up repeating what you know; you are attracted to the kinds of people who will fail to protect you or cause you harm. Having been sexually abused early on in life, a child grows up emotionally starved for love and mistakenly comes to equate love with sex. To bear the pain, one begins creating a fantasy where love means sex. And so, slowly, sex becomes a tool to satisfy any kind of need, whether that be loneliness, fear, anxiety, or shame. Worse, contemporary society constantly sexualizes us, especially young women, by teaching them how to become an object for someone else’s pleasure, not a participating subject. From the TV shows that we watch to the magazines that we read, we learn about sex as a performance and, for women in particular, we are taught that our bodies are a tool to be used in order to attract people. This further prevents survivors from seeking out treatment, as our society rewards unhealthy behavior and seldom teaches us how to view sexuality in a healthy way.

Sexual addiction has many different forms: compulsive masturbation, sex with people who are prostituted, anonymous and often unsafe sex with multiple partners, multiple affairs outside a committed relationship, habitual exhibitionism, habitual voyeurism, inappropriate sexual touching, repeated sexual abuse of children, abstaining from having sex altogether, or episodes of rape (Book, 1997). Addictions are quick fixes in order not to experience pain. Adult survivors of childhood sexual abuse often find it hard to trust another, to create real intimacy, to overcome feelings of shame and rejection, and to be present in intimate relationships. Sex, then, becomes a way to create a fantasy world, to tell oneself that you are sharing with another, that you are intimate and therefore present in the relationship. But, since sex addicts don’t necessarily enjoy sex with other people, and the need for intimacy is never fulfilled, one is then compelled to act out sexually—hence the addiction.

[fat_widget_sex_left]Most people who experience sex addiction do not understand why they are acting out sexually or why they have constant thoughts of either having sex with someone or masturbating. Sometimes they associate these thoughts with being in love, when love is far from the relationship. Each new sexual encounter brings relief and the promise of a new beginning. It also brings an unconscious desire to understand the pain of childhood sexual abuse. Yet as each encounter ends, and the need is not satisfied, the person feels more helpless, more alone, more ashamed. Slowly, a preoccupation with a new sexual encounter develops, and its promise for a new beginning gives rise to fantasies of intimacy, love, and affection. Perhaps the worst pain inflicted by childhood sexual abuse, which can be easily seen in the powerful and disruptive negative thoughts of someone who is addicted to sex, is the person’s lack of self-esteem, the idea of being damaged. Thus, rather than experiencing sex as a self-affirming, pleasurable activity, it is a source of pain, shame, and suffering.

Sexual addiction is a symptom of a bigger problem, and treating the symptom does not solve the problem. Underneath the symptom, one finds a codependent, wounded soul. As a young girl, Marilyn Monroe was treated as a sexual object and like many adult survivors, she became addicted to sex, suffering in silence. In treating sexual addiction, one needs to move beyond the symptoms and work with the survivor on issues regarding shame, self-esteem, and trauma. Yet therapy also needs to go a step further: In analyzing our culture’s view of women, sexuality, and relationships, we can begin to understand how ideology contributes to negative views of sexuality and women. Perhaps the greatest task for both the client and the therapist is to explore what it means to be a subject rather than an object in a relationship—to begin creating spaces where both women and men value each other and celebrate sexuality, not as a means to an end, but rather as a ground for pleasure.

By slowly peeling away the layers, Banner’s book reveals the complexity of a human being. Through Marilyn Monroe’s tragic story, we are reminded of the painful scars created by childhood sexual abuse that, when left untreated, continue to bleed throughout one’s life.

References

1. Banner, L. (2012). Marilyn: The passion and the paradox. New York: Bloomsbury Publishing.
2. Book, P. (1997). Sex & love addiction, treatment & recovery. New York: Lucerne Publishing.

People who drink coffee usually crave it first think in the morning. Similarly, individuals who enjoy a glass of wine or a cocktail after a long day of work may have physiological cravings during peak happy hour times. And according to a new study conducted by Lydia A. Shrier of Harvard Medical School’s Department of Pediatrics and the Division of Adolescent/Young Adult Medicine at Boston’s Children Hospital, young adults who crave marijuana also do so at specific times of the day. Persistent cravings are associated with high levels of relapse, regardless of the substance. People who crave sweets, alcohol, cocaine, or other substances tend to report that obsessions of cravings for their substance are what preceded their most recent relapse. Some reports suggest that the majority of individuals who receive treatment for drug addiction have cravings when they abstain. This is a primary symptom of withdrawal in drug and alcohol addiction and can lead to eventual relapse. To better understand what causes or increases cravings, Shrier gathered information from 41 young adult marijuana users over a period of 2 weeks.

The participants were cued six times a day, and they recorded where they were, who they were with, their level of desire to use, the availability of marijuana, and mood. Shrier discovered that even though the participants had all been selected because of their current drug use, just over half of them reported any desire or craving for marijuana during the study period. Of those who did, location, companionship, and time were critical triggers. For instance, the participants had more cravings when they were with friends than when they were with parents. Additionally, cravings were more common in the evening than in the morning. The participants in this study may have been engaging in more social activities in the evening and more academic or job-related activities in the morning. This would explain the increase in reported cravings during evening hours, a time that is often viewed as more social. Shrier said, “The association between times of day and increased desire suggests that intervention strategies recommending alternative activities be focused on vulnerable times.” She believes that marijuana use may decrease if individuals are able to reduce their desire for marijuana, especially in situations when cravings are strongest.

Reference:
Shrier, L. A., Walls, C. E., Kendall, A. D. , Blood, E. A. (2012). The context of desire to use marijuana: Momentary assessment of young people who frequently use marijuana. Psychology of Addictive Behaviors. Advance online publication. doi: 10.1037/a0029197

Related articles:
Identifying and Treating Addiction and Substance Abuse Problems
How to Control My Drinking: Techniques to Help You “Stop at the Buzz…”
Gambling—An Addiction for More Than Just Adults: One Teenager’s Story

In my practice as an addiction psychologist, it’s probably the most common question I encounter; when it comes right down to it, it’s what most people who are struggling with alcohol really want to know:

“How can I control my drinking or drug use?”

Only a small minority of people come to my practice with the expressed agenda of stopping their drinking altogether. Most seeking psychotherapy for alcohol dependence, misuse, or abuse have experienced some consequences due to their drinking and would like to minimize or stop those consequences but do not want to give up their drinking entirely.

For some drinkers, controlled drinking or moderate drinking is an option, and for a small portion of the population, about 5%, controlled drinking is nearly impossible. While many people believe “once an alcoholic, always an alcoholic,” many people diagnosed with alcoholism can learn to control their drinking and become social drinkers again. That said, if you have been diagnosed with alcohol dependence, most addiction psychologists, psychiatrists, physicians, social workers, and addiction counselors would strongly recommend abstinence. This is always a very personal decision that should be made with careful consideration of the risks and benefits of drinking versus abstinence.

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If one has never exhibited signs of alcoholism, then controlled drinking, a technique or approach that is a form of harm reduction, is a reasonable yet delicate first step. If one wants to pursue this approach, it is best not to go it alone. Talking to an addiction psychologist or other addiction professional can guide you through some generally recommended techniques.

Notice Feelings and Set Limits

Most addiction therapists will recommend two basic procedures that may differ in numerous ways but have the same central premise. The first is that you cut back your use of alcohol in whatever way you decide and that you then pay attention to what thoughts and feelings emerge. The idea here is that alcohol serves to mediate feelings by numbing, dulling, or blocking them entirely, and when you reduce your use or even stop drinking, your feelings will come back. As this happens, it is often recommended that you keep a journal or that you talk to your friends, family, partner, or therapist about these thoughts and feelings.

The well-known acronym “HALT” captures this eloquently. HALT stands for Hungry, Angry, Lonely, and Tired. These are the types of feelings people will experience as they reduce their alcohol or drug use. It reminds us to halt, or stop, and pay attention to what we need. Somehow, we have to cope with those feelings or risk relapse. If you are hungry, then eat. If you are angry, then tell someone, vent, exercise, pound a pillow, or express your anger in a healthy way. If you are lonely, then surround yourself with friends or start the process of finding new ones if all your friends drink. If you are tired, then sleep. Many people with alcoholism have an inability to take care of themselves, and learning this new skill in recovery is essential even with such basic behaviors as eating and sleeping.

A second basic tenet to alcohol counseling for people who are attempting moderate or control their drinking is to pick an amount of alcohol that they will not exceed and to stick with it. The National Institutes of Health recommend that, to maintain “low-risk drinking,” men consume no more than four drinks per day and no more than 14 per week. For women, the number is no more than three per day and seven per week. My personal belief is that this is fairly generous; a man can drink four beers while at a party on Friday or Saturday night, three or four during the football game on Sunday, three or four at bowling or poker night with the guys, and still have two or three with his partner on another day during the week.

When we can learn to stop at the “buzz,” we are well on our way to having our relationship with alcohol fully in check. For most people, three or four drinks make them feel tipsy or buzzed. Alcohol is a central nervous system depressant, yet the initial effects of alcohol in these amounts are more stimulating and euphoric feeling. People tend not to get into serious trouble from these amounts, but since the initial effects feel good, many people continue to drink past these amounts, assuming more alcohol equates to more good. It does not. It takes time for alcohol to work itself into your system, so people don’t realize how drunk they are getting, and in larger amounts alcohol has a depressing effect. The alcohol you drink today can make you feel depressed days and weeks later, and these small amounts can contribute to depressive feelings over time. Rarely has anyone come into my office with concerns about alcohol abuse because of drinking three or four drinks a few times a week.

Other Useful Techniques

To stick to the above drinking goals, there are other moderate drinking techniques that you can employ, such as avoiding hard alcohol and sticking to beer. Beer has lower ethanol content, and the carbonation can fill you up, so it tends to take longer to drink. Switching from alcohol to nonalcoholic drinks and back can slow you down as well. Holding a drink with lime or lemon may deter others from thinking you are not drinking an alcoholic mixed drink, and they may be less likely to offer you another drink. Remember, you are more aware that you are not drinking your normal amount or that you have reduced your consumption, and others probably aren’t even aware that you made any changes.

One technique to help you be honest with yourself is to take four coins (or as many coins as you are planning to have drinks that night) and place them in your back pocket. Each time you take a drink, move one of the coins into your other pocket. This may be more important if you are planning on drinking larger amounts of alcohol, and many of the people I work with start out reducing their drinks per setting with numbers more like from 10 to five or six, for example, so counting drinks becomes more important. This way, when your coins run out, you can be sure not to exceed the previously determined limit that you imposed on yourself.

Many addiction therapists recommend one drink per hour as another way of limiting oneself. Since alcohol leaves the bloodstream at about .02 blood alcohol content (BAC) per hour, this will most likely keep your BAC at a reasonably safe level. In using this technique, it is recommended that you discuss your upper limit with a certified addiction professional or addiction psychologist.

It goes without saying that it’s important to pay attention to drink equivalents. A typical shot equals one 5-ounce glass of wine, which equals one 12-ounce standard beer. If your favorite bartender is pouring your drinks and he knows you are a big tipper who likes to drink, you might need to have a brief conversation with him. Believe me, bartenders are used to these conversations, and they will not hold it against you. In fact, most bartenders will be very respectful and discreet and will keep an eye out for you thereafter. If your buddies are trying to get you drunk, that’s another story. Watch how much they pour. A Long Island Iced Tea counts for three drinks, not one.

Don’t Try to Drink Away Emotional Pain

While I consider myself to be an open-minded therapist, what would an alcohol blog be without a major caution? Here’s my warning: Don’t drink when you are sad, anxious, lonely, worried, or in any negative feeling state. These are times when you should figure out healthy ways of coping. If you drink during these times, you are at high risk for using your drinking as a crutch.

What happens if you can’t control your alcohol use with these techniques? After trying these techniques and determining your level of success, you should be able to assess whether you can be a social drinker. To the extent that you break any of the rules that you set up as an experiment and exceed these drinking limits with resulting consequences, then it is time to reconsider lowering your upper drinking limits and decreasing the frequency, quantity, intensity (alcohol content), or duration of your alcohol use.

If you are wondering whether you have a drinking problem, please read Do I Really Have a Drinking Problem?

An addiction psychologist or other psychotherapist specializing in addiction can help you answer any questions or develop a plan that, over time, will enable you to understand the role that alcohol plays in your life and make decisions about what, if any, changes you are ready to make. You don’t need to figure this out on your own. It takes courage to seek help for alcohol use. If you are reading this, you are well on your way to understanding yourself better and getting what you want and need in life.

People in their 20s seem to have it all: youth, energy, health, and looks. But they are also still figuring themselves out, and this time of change can bring certain mental health concerns as well. Experts have information on these issues that tend to impact people in their 20s, and provide some solutions for addressing and coping with these problems.

Clinical psychologist Dean Haddock, a marriage, family, and child counselor and the executive director and founder of Community Counseling and Psychological Services, points to a fairly common activity of 20-somethings that can lead to mental health issues if it’s not checked: alcohol and drug use.

“The first problem that leads to many others is alcohol and chemical abuse, which often leads to dependency,” Haddock said in an email. “The mental disorders that follow are often depression, anxiety, and brain injury. Of course, self-esteem and body-image problems often lead to eating disorders.”

Haddock gives three tips to help people in their 20s prevent and get through some common mental health concerns:

1. Know your genetic history of mental disorders. Knowing is half the battle to avoid those disorders in yourself.
2. Be choosey about your friends, as they will influence your decisions. Healthy friends lead to healthier decisions.
3. Self-esteem is often the result of the people who matter to you. If they do not esteem you, then you will not esteem yourself.

Nerina Garcia-Arcement, a clinical psychologist and clinical assistant professor at NYU School of Medicine, suggests that the many life changes people experience in their 20s can cause mental health issues at times.

“Your 20s are filled with life transitions that can be stressful,” Garcia-Arcement said. “This is a time when young adults are solidifying their personalities, developing their independence from family, starting or finishing college, beginning new jobs, developing a career, forming romantic relationships, and learning to manage their existing family relationships and friendships within these context.”

“Individuals in their 20s don’t have a lifetime of experience to draw on when managing multiple life transitions at once,” she added. “When someone experiences these transitions, anxiety and depressive disorders can occur.”

Here are six of Garcia-Arcement’s tips to help people in their 20s cope with mental health issues more common to that age group:

1. Seek out and form strong support networks.
2. Seek out others who are going through similar experiences and share your feelings, whether you are feeling worried, nervous, scared, sad, confused, or excited.
3. Know that you are not alone in your confusion about your career and relationships.
4. Seek out mentors who have achieved their goals, and ask for advice.
5. If you are feeling stress, sadness, or anxiety, engage in activities that will help you manage those feelings such as yoga, meditation, exercise, hobbies, social activities, relaxation exercises, and deep breathing.
6. If you feel you are not getting the necessary support and feel overwhelmed or depressed, seek out mental health professionals who can help you manage the feelings related to your life transitions.

Stephanie Sarkis, a licensed mental health counselor, said in an email that anxiety and depression are some of the main mental health issues 20-somethings face.

“We have seen an increase in these issues due to the lagging economy and difficulties finding employment,” Sarkis said. “Many people in their 20s have moved back in with their parents, which can trigger feelings of failure and frustration.”

Dr. Maiysha Clairborne, a family physician and wellness and stress management coach, added in an email that eating disorders associated with body dysmorphic disorder and body-image issues are also common for people in their 20s. She has three overall tips for people in this age group:

1. Talk to someone. The worst thing that a person can do when they are feeling depressed, anxious, or alone is to isolate more. Many times when we talk with someone we trust about what’s going on, we come to realize that we are not the only ones experiencing it and then we can get support.
2. Get active. Staying physically active not only helps to keep the body fit but also helps release endorphins and serotonin in the brain, which help keep the mood elevated. Physical activity is also a good release for stress and anxiety.
3. Minimize sugar and junk food. Sugar and processed junk foods can worsen the emotions of stress, anxiety, and depression because they cause erratic changes in your body’s blood sugars. This can disrupt the normal release of hormones in the brain that keep your moods stable.

Scott Carroll, a psychiatrist with dual board certifications in adult and child and adolescent psychiatry, said there are many issues specific to people in their 20s, including problems associated with medication use.

“Many people were on stimulants/meds for their ADHD when they were younger, but they thought it was okay to stop their meds when they were done with school,” Carroll said. “Now they are struggling at work and don’t know why. I’ve also seen young adults stop all kinds of meds like their thyroid meds because they didn’t know why they were even on it, and then they have all kinds of problems.”

Bad habits involving drug and alcohol use can start to become a major substance abuse issue when people are in their 20s, and other mental health issues start coming to the forefront at this time in peoples’ lives. Examples include bipolar disorder and schizophrenia. Also, panic attacks can start for people who have a genetic predisposition and who have higher amounts of stress associated with newfound adulthood.

“The 20s are an important time of social/emotional development,” Carroll said. “Unlike previous generations, identity formation often takes the entire 20s due to the complexity of modern society. It could be said that adolescence lasts until the early 30s in today’s society due to [prolonged] periods of education (grad school, law school, med school, etc.), lack of stable job options, and delays in getting married and starting families.”

Carroll, who is also an assistant professor at the University of New Mexico School of Medicine, suggests that when it comes to serious relationships and marriage, people in their 20s should consider how their choices could eventually affect their mental health and how their brain plays a part in their decision.

“Many 20-somethings are tempted to get married, but it is generally a bad idea because the brain in not done developing until about 25 [years old] … which leaves young adults vulnerable to having their rational mind be overwhelmed by their feelings or stress,” Carroll said. “Relationship choices often dramatically change from the early 20s to the late 20s, so many people find that the person that was perfect at 22 is a disaster at 27.  This can be an incredibly hard transition, to have to break up with your former soul mate that you thought you’d love for life because you’ve changed so much over the last several years.”

Related articles:
Do I Have a Healthy Relationship With Food and My Body?
Social Anxiety Can Be a Hidden Problem in College
How Schools Could Prevent Depression

Romantic love can be all consuming. In the beginning stages of a relationship, one or both partners may be overwhelmed with feelings of affection for the other partner. Couples may want to spend all of their waking hours together and actually crave each other’s presence when apart. These feelings are not uncommon in many budding romances. However, when they persist and lead to unhealthy behaviors, this type of love can become destructive. Much like an addiction to drugs or alcohol, people who experience love addiction pursue their drug at the expense of their friendships, careers, family members, and even self-respect.

In a recent article, Dr. David Sack, a psychiatrist and addiction specialist, explains what love addiction is. He says that people who are in addictive relationships experience limerence, a term introduced by psychologist and author Dorothy Tennov to describe love obsession and dependence. Limerence mimics new romantic love, but unlike true love that constructively develops into reciprocal, mutual affection, limerence is usually destructive. When one partner exhibits limerent behaviors, they may begin to cross emotional and physical boundaries in order to secure the attention and affection they need. Even when the feelings are not returned, the limerent partner may continue to chase after the other partner. Sack says, “Behaviors may become dangerous, such as stalking or unwanted contact, and require outpatient or residential love addiction treatment, professional counseling, and/or 12-step work.”

Limerent relationships are not all bad. Although most end with one partner being rejected and hurt, some actually grow into healthy and mutually loving unions. Individuals who display limerent behavior in one relationship may continue to do so in future relationships, creating a pattern of destruction and disappointment. Sack suggests that individuals who believe they are involved in a limerent relationship, either by their own actions or those of their partner, work with a professional to identify the negative behaviors. Understanding the cause of the limerent patterns will help an individual become aware of why they behave the way they do and give them an opportunity to transform negative patterns into more positive and promising ones.

Source:
Sack, D. (2012, June 28). Limerence and the biochemical roots of love addiction. From the Huffington Post. Retrieved from http://www.huffingtonpost.com/david-sack-md/limerence_b_1627089.html

Related articles:
What to Look for in an Addiction Therapist, Part 1
(Don’t) Keep Coming Back

Did you know that most individuals who have experienced sex addiction and have taken their recovery process very seriously and remain committed to it for life can be some of the healthiest individuals, despite their past challenges?

Relationships in general take a lot of hard work, but many people are not willing to engage in the hard stuff to make their relationships easier down the road. If people do not feel that they have an addiction or struggle with any kind of sexual integrity issue, it is more challenging for them to understand the need to have boundaries around their relationship to protect it from anything that can cause it to weaken.

Here are THREE REASONS individuals need not be afraid to date someone who has recovered from or is in active recovery from a sex addiction:

STRONG BOUNDARIES: Most individuals recovering from sex addiction who have worked hard in a program, such as outpatient therapy, along with being a part of a support group or in-patient program with a solid outpatient support system know the importance of having strong boundaries to first protect themselves from relapse or slipping back into old habits. For example, a person who has abused alcohol needs to stay away from bars and heavy drinking venues to avoid temptation. The same goes for people with sex addiction; they have certain places they cannot visit, movies they cannot watch, and websites to stay clear of, and even conversations with other individuals that may trigger certain thoughts or feelings.

Therefore, people who have recovered from sex addiction and have moved toward a healthy outlook in life will more than likely be very respectful and aware of situations that may be uncomfortable for their partner, such as noticing attractive people in the partner’s presence or even while alone or putting themselves in a position that could be cause for concern, such as eating lunch alone with a coworker of the opposite sex.

INTEGRITY: Most people recovering from sex addiction have learned the benefits and the importance of having integrity in their life. It is essential that they share their feelings appropriately and be truthful with themselves and that they avoid anything that would cause even a hint of suspicion by others. One way that you will know that your dating partner is someone who values integrity is to watch him or her. Does this person’s behavior coincide with his or her belief system? Is he open about his life’s journey while using discernment? Does she show consistency in making decisions with integrity in all areas of her life (i.e., financial, family, work), not just in relationships?

SELF-CARE: When people who have struggled with sex addiction have worked hard on their personal recovery, one of the tools they learn is the importance of self-care. What that means is their ability to recognize that they first must take care of themselves in a healthy way before they have anything to offer anyone else. They are good at keeping things in their lives that bring value, and they do not expect someone else to fill all their needs. These individuals will have introduced specific behaviors/patterns in their life that support their recovery and reduce the temptations they will face, such as computer filters, accountability partners, continued self-improvement choices, and consistent activities that not only grow who they are but also have a positive impact on others. Most important, where their recovery plan may change along the way, they never let their guard down to say they have arrived, and they stay in the continuous mode of healthy self-care in some fashion. This not only assists them in being the person of integrity they want to be but also prepares them to be real, genuine, honest, and transparent in future relationships.

As you can see, while some may shy away from the idea of dating an individual who has recovered from sexual addiction, there are numerous reasons this can actually be a very positive experience. Keep in mind, it is not your responsibility to keep this person on track in his or her recovery, and if the person is truly taking care of himself, he will not want or expect you to do this. You actually get the benefits of being with an individual who has come face to face with a very challenging addiction and decided that he or she is worth doing the hard work to overcome it and live a life of integrity. The end result is someone who can share compassion, understanding, and love in a deeper, healthier way in relationships because that person made it a point to have tough love for him- or herself first.

Related articles:
Three Ways to Avoid Sex Addiction Relapse
Sex Addiction: Can Trust Be Restored?

The following is an open letter to my sister Andrea Haber, who died from complications due to alcoholism on 10/31/11.

Dearest Anj:

Just a note to let you know how much I miss you. It’s still so bitterly ironic to me that what killed you is the very disease I’ve devoted my life to battling. But in a way, your alcoholism never gave you a chance.

I’m sorry we never talked about it, although you can’t say I didn’t try. There was a time, a few years back, when you told me you wanted to talk about it, and my heart leapt. But that talk, like so many hoped-for moments, never materialized.

I believe when I first got sober I wrote you a somewhat long-winded, pompous letter about the perils of drinking. I’m sorry again that I preached at you like that. You handled it with grace but I cringe now at the thought of my presumptuous rambling. Newly sober people often think they can save the world with a few well-chosen phrases. I guess I thought there was really something I could do. Naïve, yes, but even at the end, and maybe even now, I often feel the same way.

I miss your letters. They really made me laugh. You were a fabulous writer and I think that you, as with so much else, underestimated yourself. Their absence has created a very loud silence.

I’m sure you’re thinking, “Gee bro, nice cheery letter!” I only wish I could be more cheery. This is an occasion I never wanted— that even with the grim medical news coming from Pittsburgh, I never really saw coming. There’s just no good way to spin the loss of someone so young, so beautiful, so amazing. Part of the tragedy for me is, I don’t think you ever truly understood just how loved you were. Mom told me you were shocked when she said to you, near the end, how much you’d be missed should the worst happen. This too, is another symptom of addiction: the disbelief that we matter to people, the certainty that we’re really “only hurting ourselves.”

Hard to be cheery when feeling so cheated…

Of course, denial is the hallmark of this loathsome affliction. We grew up with rationalizations and minimizations aplenty when it came to Dad’s drinking and the family’s Nixonian “cover up”—i.e., “Don’t talk about it, too embarrassing” (Dad’s favorite) and “It’s not that bad” and “Don’t exaggerate,” all repeated like mantras. Even I, near the end, felt that chances were good you’d come around; see the light, get sober. Your disease made a mockery of my optimism.

So hard to sit on the sidelines and simply try to accept. I’ve struggled lately with, “Did I really do enough?” Should I have gone all out and planned an intervention, John Wayne style? Should I have demanded you listen to me until “the truth” sank in? I already felt like a stick in the mud, the voice of gloom, whenever you called or wrote me and wanted to laugh or kid around; I loved the jokes but was so terribly worried about your well-being. We had a trove of inside jokes, a bulwark against the despair of growing up in that chaos and emotional violence. I cherished the humor but wondered what might be going on underneath. There is a pain we can’t hide from, I have found, no matter how clever or humorous we are. When your doctor handed you that grim prognosis last year, that you either stop drinking or die, I thought “well this is it, she can’t ignore it any longer.” Wrong again, bro!

Of course the cliché is that there’s nothing you can do to get a person to stop; no amount of begging or pleading or coercion will ever do the trick. Maybe briefly, superficially, but it’s an “inside job” (as they say) when it comes to lasting change. We can give someone just about anything, except motivation to do the hard but necessary thing. I kept thinking you’d finally “hit bottom” when the doctors told you your liver was shot…until mom told me this wasn’t the case, that she feared nothing was changing. I backed off a bit because I know how she hounded you. Maybe that was a mistake. Maybe hearing it from me would’ve got you moving.

I cringe when I see the pride and ego in that last sentence. Yes, you should have heard it from ME, your big brother, sober white knight on the West Coast, brandishing a master’s degree in psych., saving souls and fighting the good fight. I wonder if you’re chuckling as you read this.

Perhaps it’s pretentious of me to think I had the slightest idea of what might be good for you. I had no idea what was really going on in your life, and I suppose it was none of my business. Maybe the long, hard climb back to sobriety might have been too difficult; perhaps too many skeletons, whatever they were, had accumulated in the closet for any one person to face.

But saying “There’s nothing I could have done” doesn’t seem to help. Maybe that’s why I’m writing you now; perhaps, in my Jewish neurotic guilt, I struggle towards some kind of absolution. Doubt has always dogged me; so hard to not look over my shoulder in almost every instance. This is no exception. Could I have somehow said more, done more, pushed harder to help you “see the light”? (Am I hearing that chuckle again?)

Just this morning I advised the mother of a patient that there was nothing she could do to “get” her daughter to stop using and go to meetings. I thought, “Wow she really thinks there’s something she can do!” So easy to sit in one’s cozy office chair and dispense wisdom to the struggling, misguided souls asking for help…

Here’s the hard part (as if there’s an easy part!): You can detach, stop trying, accept another’s addiction, respect their “life choices” and move on. But how to really “move on” when it’s your own flesh and blood? You can stop obsessing, stop letting the person’s disease hold your serenity hostage, attend Al-Anon meetings, seek counseling…but the kind of Zen-transcendent it’s-all-good acceptance I’ve perhaps subtly advocated to others isn’t possible, at least not for me, at this point in time.

Because I can’t stop loving you. Can’t switch off the caring. How could it be otherwise?

Maybe the idea is to make room for both, the love and the acceptance. It’s not either-or (as I’m fond of telling my patients). You can love the person and hate the disease. It’s just hard to stand by and watch a loved one fall to pieces and to try and pretend it’s not happening. It’s like a fatal car accident happening in slow motion right outside your door. I prayed every night for you to find the desire to stop drinking. I struggle to accept it never happened.

I know you meant no harm, Sis, and I never took it personally. I think if you could have stopped, you would have; as I say, the odds were seriously stacked against us from the get-go. I don’t know why I hit the lucky number; I just know it’s a gift that I protect with my life, and I would have given anything to have shared it with you. I tried.

I hope you know that somehow, wherever you are, I was worried but not condemning you. There is so much shame with this thing but I always longed to say to you, How could you not be an alcoholic, with all the crap we had to deal with? Even so, I underestimated the awesome power of this thing, and can only guess at how you suffered beneath the chuckles, the jokes and that wonderful wit of yours. It’s just hard to accept that, in this case at least, love was not enough…so difficult at those times when I think of our private jokes and laugh and want to email you…hard to really accept that my kid sister—my first friend, my loyal ally—is really, undeniably gone…

 Related articles:
The Pendulum of Grieving
Over-Extended: Thoughts on Boundaries in Addictive Families
In Case of Emergency: Seeking Help When a Loved one Struggles with Addiction

I am getting asked more about cybersex and online pornography addiction from therapists. It seems to be a growing problem in their practices. I thought I would address some of the fundamentals regarding how the addiction is sustained by the addict, or what I call the “start-stop relapse cycle.”

Eric is a 46-year-old computer programmer who described how hard it was for him to go “cold turkey” from cybersex during work. “I always go to the same chat room for cybersex. I feel comfortable there, and I typically find a good partner quickly. I always think about cybersex when I feel stressed from work and overwhelmed on the job. I always promise to only do it for a half an hour or hour, but time just slips by. Besides, my drive is stronger than my wife’s, so it won’t hurt, actually it will help our relationship, so I don’t go looking for someone in real life. Afterwards, I realize that I should not do this to my wife and also to my work. My boss will find out one day if I don’t stop doing this in my office. Each time I log off after cybersex, I promise myself that I will never do it again. I hate myself for all the wasted time I spent online and quickly try to catch up on the lost work. I go a few weeks, then the pressure seems to build up inside. I play mind games with myself, telling myself just a little won’t hurt. No one will know what I am doing. Sometimes I actually believe that I am in control. I wear myself down, and the whole process starts all over again and I feel defeated that I will never get rid of these feelings. The temptation is constantly there and relapse is just a click away.”

Relapse is a common struggle for anyone in recovery, but the problem often seems compounded by the need to use the computer while in recovery from cybersexual addiction. The relapse process is especially difficult for the cybersex addict due to the stop-start relapse cycle. The cycle is an internal dialogue that serves to maintain the compulsive behavior.

•    Rationalization – Users will rationalize that cybersex serves as a “treat” from a long, hard day of work often making self-statements such as, “Just a few minutes won’t hurt,” “I can control my net use,” or “I am right here at the computer, what the heck?” The user will try to justify the need to look at a few pictures or chat for a few minutes, but they soon discover that time slips by and the behavior is not so easily contained.

•    Regret – After the cybersexual experience, the users experience a period of deep regret. Once they climax, the addict feels guilt or shame for the behavior such as, “I feel guilty for how this is hurting my wife” or “I can’t believe I wasted all this time,” or “I am a horrible person for what I just did.”

•    Abstinence – The addict views the behavior as a personal failure of willpower and promises never to do it again, and a short period of abstinence follows. During this time, the addict temporarily engages in healthy patterns of behavior, resumes interests in old hobbies, spends more time with his family, exercises, and gets enough rest.

•    Relapse – The addict in recovery feels tempted to return to the computer during stressful or emotionally charged moments. They begin to crave and miss cybersex. They tell themselves that cybersex is the best way to relax and feel good about themselves. Or they begin not to care about the consequences. They remember how good cybersex felt both sexually and emotionally, and they forget how bad they felt afterwards. The rationalization period starts again and the cycle repeats itself.

How does an addict kick the cybersex habit when he or she needs to be on the computer for work? How can the addict stop abusing when relapse is just a mouse click away? Similar to programs that address overeating and food addiction, the addict will need to learn how to make healthy, positive choices about his or her Internet use because complete abstinence isn’t always possible in today’s technological world. There are two basic principles to follow:

Principle One: Learn to moderate legitimate use of the Internet.
Principle Two: Abstain from all contact with sexual material online.

As in food addiction, certain types of food trigger binge behavior. Let’s say chocolate or potato chips will trigger binge behavior but celery sticks will not, so avoidance of those “trigger” foods is a necessary part of recovery. Recovery from food addiction is about relearning how to eat in order to make more informed and healthier food selections, with success being measured through objective goals such as changes in caloric intake and weight loss.

To address cybersexual abuse and addictive behavior, the same basic steps are applied. First, it is important to determine the Internet activities, situations, and emotions that are most likely to trigger net binges. A particular chat room, a certain time of day, or the mood you are in just before you go online may all serve as “triggers” that will lead to inappropriate conduct and abuse. Recovery means relearning how to use the Internet in order to make better choices about time spent online, with success being measured through objective, measurable time management goals and abstinence requirements that are achieved and maintained. Goals should include a reduction in the number of hours you spend online in total, the ability to maintain abstinence from adult online content, and an increase in other offline activities.

Second, the addict must abstain from sexual material online. In this case, it means removing all the bookmarks and favorites leading to these sites, adding filters that prohibit sexual material from getting through the browser, or possibly changing the entire Internet Service Provider (ISP) system to one that is family friendly. These family friendly ISPs stop sexual content from the server end, so there is less chance of relapse. This has been found to be the most effective way to dealing with the addiction.

Related articles:
Super-sizing Sex
The Double Bind of Sex Addiction
Sex Addiction is a Relational Disorder