Case Study
In order to protect client confidentiality, this is a fictional case study. However, it captures many of the common problems that clients bring to sex addiction therapy and explores the way that I work with them.
When Jake entered my therapy room for the first time, it was abundantly clear that he didn’t want to be there. He sat up poker straight in his chair and refused to make eye contact. After some gentle probing on my part, he reluctantly told me that his wife, Sarah, had insisted that he come for therapy. As I tried to find out what he might want from our work together, he appeared at times defiant, professing that he did not need help, while at others defeated, muttering that he was beyond help.
Despite that difficult first session, Jake decided to persevere with therapy, as he realised it was the only way he stood a chance of saving his marriage. Gradually, as he got to know me and trusted that I was not judging him, his story of addiction began to unfold. He explained to me that Sarah had opened a letter from the bank and discovered that they had defaulted on their mortgage repayments. The bank was on the verge of repossessing the house. When Sarah confronted Jake, he pleaded ignorance, but as Sarah uncovered more evidence of their financial situation and his exorbitant spending, he eventually broke down and admitted to her that the money had been spent on strip clubs, prostitutes and gambling. Sarah had gone into deep shock and depression. As Jake gradually revealed all this to me, he too broke down, finally facing the real implications of what he had done. Jake realised that something fundamental needed to change.
I helped Jake to put into place a plan for stopping his addictive behaviours, identifying triggers, challenging unhealthy thought processes, and replacing the acting out with new healthy behaviours. He learnt to look out for the warning signs that he might be about to act out, and to intervene quickly if he found himself thinking about visiting an escort. He put a blocker on his electronic devices that prevented him accessing sex work websites and deleted the numbers of escorts he had previously visited. We identified the situations in which he was most likely to be tempted to act out. These ranged from arguments with Sarah, to stress at work. We put in place new coping strategies for dealing with the difficult emotions that these situations provoked. I also recommended the local Twelve Step support groups, Sex Addicts Anonymous (SAA) and Gamblers Anonymous (GA), which Jake soon began to attend on a weekly basis.
Although the recovery went well in the first few months, Jake would come to some sessions on the verge of acting out. We would try together to identify the emotional triggers. Recognising and naming his emotions was a new process for Jake, and one which he found very uncomfortable. I taught him some mindfulness techniques, which helped him to acknowledge and accept his emotions without acting out. We also discussed how connecting with some of the people he had met in SAA might help to alleviate the feeling. Jake also had to learn how, when he was experiencing difficult emotions in the relationship, he could allow himself to be vulnerable and discuss them with Sarah, rather than running away and seeking solace in sex and gambling.
As our relationship strengthened, I was able to work with Jake to uncover some of the underlying causes of his addictions. I discovered that Jake’s father had suddenly disappeared when he was three. His mother sank into depression and so neither parent was available to help soothe his distress. His older brother had a stash of porn magazines, which Jake discovered when he was 13. Soon, he found that looking at the magazines and masturbating helped to ease his sense of loneliness and insecurity. As Jake grew up and went to work in the City of London, visits to strip clubs and escorts seemed the norm among his colleagues, who also drank heavily. Jake soon found that any difficulty in his professional and private life could be effectively obliterated with a potent mix of sex, alcohol and gambling. When he met Sarah, he vowed to himself that he would stop. He was successful until they had their first argument, at which point he immediately turned back to his old habits in order to soothe himself. This then became his normal way of dealing with any problem in their relationship, particularly after their son, Sam, was born and Sarah no longer seemed to have any time or energy for Jake.
Through our work together, Jake came to realise that he had an underlying belief that he was not good enough (after all, his father left him) and other people were unreliable (neither his mother nor his father were there to ease his pain). After many months of work, Jake decided that, as part of his recovery process, he wanted to reconnect with his mother, from whom he was estranged, understanding that she had done her best under difficult circumstances.
Much of Jake’s concern within therapy was the restoration of his relationship with Sarah. She had entered individual therapy with another therapist and, six months into their work, both of them decided that they were ready for couple's therapy. I referred them to a couple's therapist specialising in treating sex addiction. Even though Sarah had been unaware of the addiction, it had pervaded their relationship from the start. Both of them had to re-learn how to be in relationship with each other without the addiction present, to form a secure bond with each other. The couple's work centred around rebuilding trust, re-establishing sexual intimacy and strengthening their emotional connection.
Eighteen months later, Jake and I still see each other on a weekly basis, and he still attends weekly SAA and GA meetings. He and Sarah have repaired and strengthened their relationship, and Jake is no longer acting out. Sarah is now pregnant with their second child, and Jake and I are exploring how this shift in the family may once again trigger difficult emotions. This time, Jake is armed with the emotional resilience and communication tools that will hopefully allow him to manage the transition without seeking solace in sex and gambling.
If you are able to relate to aspects of Jake's story, you may find that you would benefit from sex addiction therapy. Please do contact me to arrange an initial consultation.
“The first step towards getting somewhere is to decide that you are not going to stay where you are” - Unknown
Treating Sexual Compulsivity
Harley Street, Central London & Online
