DDN Magazine July/August 2021 | Page 7

Treatment for sex / love and porn addictions is as challenging for individuals as treatment for any other addiction , and our clinical team engage patients throughout the pre-admission process . Compulsive sexual behaviours can be comorbid with mental health conditions such as depression , anxiety and bipolar affective disorder , and a robust psychiatric assessment assesses for the presence of such comorbidities in this patient group .
Abstinence from sexual behaviours during treatment impacts positively on treatment outcomes . We ask all those joining the treatment community to abstain from all sexualised behaviour including masturbation . The withdrawal experience can be similar to those more commonly recognised with substances – it can be intense and visceral . People do not always anticipate going into withdrawal and therefore need emotional support to understand what they are experiencing . It ’ s common for patients to experience disorientation , headaches , low mood , anxiety , irritability or depression .
LONG-TERM RECOVERY Long-term recovery from sex and love addiction or porn addiction is different from substances or gambling . Sex is a human need the same as eating or sleeping , so abstinence from sex is more complex . A person needs to identify a sense of positive sexuality and be able to move forward with positive relationships , and preparing patients for different types of relationships is key to successful outcomes . Therapists look to realign behavioural reinforcers with meaningful ‘ reality-based ’ relationships and not the ‘ online ’ cybersex virtual reality .
For instance , those addicted to pornography are engaging in ‘ fantasy ’ rather than the reality of physical and emotional intimacy and therefore it is vital to help patients understand how sex might feel different , perhaps even disappointing , within the context of their real-life relationships . Clients can find themselves trying to substitute care , support and nurture for emotional or sexual dependence with sometimes devastating consequences –
‘ Those with an addiction to pornography will access porn content in a continued quest to alter moods ... and with an escalating habit their tolerance and choice of more extreme pornography increases .'
these might include engaging in physically or emotionally abusive and harmful relationships devoid of emotional intimacy .
It ’ s also important to consider that there may be cultural and diversity issues revealed during the therapeutic assessment , for example the subculture of ‘ chemsex ’ in gay communities . A social norm gives
the person a sense of belonging to such a community despite the potential risks , harms and consequences . If there are chemicals involved there can be additional important questions to ask , such as what is the client ’ s relationship with the substances and / or the sexual behaviours ? Understanding from a wider perspective than that which fits with binaries of heteronormative culture is important , and what is normal for one person , might not be for another .
BARRIERS TO WOMEN There is a tendency for more men to seek treatment than women , and more needs to be done to understand the barriers to seeking treatment by women and to find better ways to support women to open up more about sex , love and pornography addictions . As conversations emerge during treatment , therapists find more women open up to their peers about their experiences .
Asking for help with a sex , sex and love , or porn addiction requires a huge amount of courage , and those who make contact with services should be treated with care and respect . Families are often deeply traumatised by their loved ones ’ behaviour and it ’ s important that family support is
OVER THE PAST FIVE YEARS , Clouds House has experienced an increase in people accessing treatment for sex and love or porn addiction as their primary addiction . Historically it ’ s emerged within the context of other addictions . Access to porn anytime , anywhere is problematic and a significant challenge .
given throughout the treatment period and beyond where necessary . Mutual support is vital , sustaining recovery through fellowship meetings such as Sex and Love Addicts Anonymous and Sex Addicts Anonymous , in the same way as with attendance at AA or NA .
This type of behavioural addiction is largely unspoken and misunderstood across health and social care . It needs to be recognised and understood more broadly to improve treatment and enable people to reach out for support . Recognising it can go some way to validating the experiences of those engaging in these behaviours and instil some hope that change is possible .
The sector spent many years trying to get gambling addiction properly recognised in the DSMV to legitimise treatment and lower barriers to accessing support . It is now time for sex , love and porn addiction to also be categorised as a behavioural addiction .
Clouds House and Action on Addiction are part of The Forward Trust . Find out more at https :// www . forwardtrust . org . uk / or https :// www . actiononaddiction . org . uk / addiction-treatment / clouds-house Pamela Walters is clinical director at Clouds House
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