Thaddeus shared some of his own story of struggle and vulnerability, explaining he had been a Vicar for 30 years before training to be a Psychotherapist/Psychosexual therapist and subsequently integrating accreditation in CBT into his portfolio and establishing the Marylebone Centre for Psychological Therapies, London (www.marylebonecentre.co.uk). He said that when inducted into a Parish the Bishop would place a document into his hands with the words ‘receive this cure of souls which is both yours and mine’. The word psychotherapy means the ‘cure of souls’. Thaddeus combines ministry and psychotherapy within the space of the therapeutic relationship to aid transformation in clients. Religion’s aim is not to make some-one more religious, but more human.
The focus of the Talk for this evening would be on sex addiction in men although the Marylebone Centre does work with women and couples of all combinations. Research suggests women seek relationships in sexual encounters whilst men seek sex. An interesting point raised here, and briefly discussed, was: ‘is having a high libido ok or was it a form of sex addiction’? St. Paul mentioned ‘the good that I would, I do not and the evil that I would not, I do’ and St. Augustine, who struggled with sex addiction, felt ‘the enemy had my power of willing in his clutches, and from it had forged a chain to bind me’. Both seem to indicate a sense of powerlessness, regret and shame’. Richard von Kraft-Ebing (1886) said that ‘pathological sexuality is a dreadful scourge for its victim, for he is in constant danger of …losing his honour, his freedom and even his life’. Whilst Carnes, 1991, talks about ‘severe consequences such as, the inability to stop, persistent pursuit of the addictive substance sex as the primary coping strategy and neglect of other important activities’. The Talk was enhanced through the use of music, humour, case studies, guidelines and anecdotes. The Centre’s work is underpinned by consistent formal evaluation and support for the client using the Four Criteria which helps illustrate their experience:
- The behaviour feels out of control; 2. It brings with it harmful
consequences but is continued in spite of these harmful consequences.
- People try to stop but cannot successfully stay stopped and 4.The behaviour has function: to relieve or anaesthetize unbearable affect states.
The last one was, Thaddeus felt, the most relevant and said, he tended to divide sex into three states: intimate, recreational and compulsive which indicates a possible continuum from the one side offering a shared loving pleasure and exploration of sex and sexuality with another and to the other side where lay the potentially harmful aspects of sex addiction with broken relationships with self and others, trauma and shame. Here he discussed Aetiology (cause or origin) in Narcissistic Damage and Psychoanalytic Parallels.
In many clients’ formative years, there appears to be a significant lack of nurture, love and acceptance resulting in neglect or sometimes abuse, sexual or psychological. Such a lack of appropriate care often creates serious damage and trauma just at a time when children, aged 4 – 9 or 7 – 11 have the beginnings of sexual awareness with the feelings and, of course, curiosity. This a natural developmental stage requiring understanding and acceptance by the parents and if this is not supported but damaged then attachment issues and paraphilia, distorted internalised sexual understanding, can create lifelong issues. Often the child is in a catch 22 situation. If the parent(s) has narcistic tendencies, it makes it impossible for the child to tell them – for fear of not being believed but punished further and at the same time they do not want it to continue – they cannot win and the inner belief of no-one caring, nor are they are worth caring for is reinforced. Goodman (1998) said damage was caused through an ‘enduring affect, cognitive, behavioural and relational patterns, laid down in the family of origin that are maladaptive, inflexible and/or cause significant impairment or subjective distress’ together with ‘the mother’s inability to administer life experiences that are phase adequate for the child’. Goodman was the only writer Thaddeus found who had tried to answer the question ‘why sex addiction?’ Goodman uses the term ‘mother’, but we might use ‘primary care giver(s)’. Quoting Khan, 1963, Thaddeus explained ‘pathogenic trauma’ where the lack of good enough care given creates small traumas, one on top of another, which slowly undermine the child’s sense of a healthy self-worth and so addiction can be an escape from the burden of this deep hurt.
Addiction affects the brain and its functions, particularly in the limbic system. Neuroscience of addiction and recovery shows that the neuroplasticity of the brain is altered by experiences such as watching porn, particularly when young, which often leads to physical and psychological problems. Neurons that fire together wire together. In sex addiction, every time dopamine is released the reward neuro-transmitter consolidates the connection often meaning more extreme material is needed to gain orgasm and release. The cycle then keeps repeating, often leading to psychologically damaged health, erectile dis-function and relationship issues.
Through formulation and situation slides, Thaddeus helps clients understand how they moved from the unmet needs of their family of origin plus perhaps school bullying to using escape mechanisms, i.e. addictive methods or substances as a salve to pain and chaos. Most addicts do not realise there is a process and once they do, are relieved to know they are not crazy and, the process is understandable. In the ‘cycle of addiction’ it is clear feelings and thoughts of anxiety, loneliness, shame and boredom allow the habitual behaviour to trigger without conscious meaning to do so leading on to the acting out after which follows remorse, regret and disappointment with the self. Clients come to understand how their thoughts create feelings and by a behaviour change that there can be reciprocal changes in thoughts and feelings. The client can test how this could be experienced with a period of abstinence. The American Society of Addiction Medicine (www.ASAM.org) report that ‘addiction is a primary, chronic disease of the brain reward, motivation and memory circuity system’. James, 1903 said ‘The greatest discovery of my generation is that a human can alter his life by altering his attitudes of the mind’.
Thaddeus explored how he and his colleagues at the Marylebone Centre successfully offer help to those suffering from this addiction. The use of the 12/24 step programme in three phases together with intense psychotherapeutic support and interventions, art and writing therapy, thought records, group therapy (Yalom & Leszcz, 2005), the empathically held ‘hot seat’, relapse prevention strategies and pragmatic steps and goals help clients understand the cycle of addiction. One of key interventions Thaddeus said helps is in the understanding of trauma. Each client is asked to draw a large egg and then in their own way illustrate within it all the traumas they have experienced to date. Some will be quite obvious to them and others will need gradual uncovering within the therapy and so begins the of understanding of ‘why’. Thaddeus said that he loved group therapy and felt it was so important in the recovery process. Within a group, each is just themselves – not what they are, but who they are. As the macho shields begin to crack the sharing of experience, fear, shame and loss comes to the surface – men cry with and for each other, no judgement here just being – it is powerful!
It is a demanding and hard journey of recovery, but clients can take back their lives if they will work for it. The ‘farewell letter to the Addiction’, good life goals and the ‘snakes and ladders’ experience must make Graduation absolutely life-enhancing with an empowered part of self-esteem and sense of self-worth restored.
The next break-out group discussion was the question ‘The therapeutic relationship – is it essential but is it not enough?’ The response was informed, in part, by modality but the consensus seemed to be it was the cornerstone of the work. The CORE Conditions offer acceptance, respect and empathy and, most importantly, the building of trust where none has probably been for years. The process might be seen as similar to a wheel, with each spoke or intervention equally important, the hub is the client who has to keep the wheel attached to the journey of healing and recovery, and the rim containing the wheel is the therapeutic relationship with its empathic, non-judgemental hope and belief in change.
But what of the Therapist? Risk of secondary trauma is certain, together with the effect of transference and counter transference. To balance this therapists must be aware of their own needs, limitations, contracting and the support of supervision, therapy and the writings of others. Thaddeus himself remembered noticing ‘it was some time before I realised that I was suffering from secondary trauma. Shame is contagious’. Oh, and he said regarding the question about ‘Myth or Reality’ that it is probably a bit of both. There was so much more to this Talk than there is space in this brief review. Thaddeus was described by others as having ‘mastery of his topic’ and is certainly a shining example of a ‘good enough’ therapist who would inspire hope and trust in others.
Thank you Thaddeus, on behalf of everyone, for a memorable evening which left us wanting to know and understand more about this important topic.
Birchard T. 2017, ‘Overcoming Sex Addiction – a self-help guide’ Routledge, Oxon.
Birchard T. & Benfield J eds. 2019 ‘The Routledge International Handbook of Sex
Addiction’ Routledge, Oxon & New York.
Goodman A. 1998 ‘Sexual Addiction: An Integrated Approach’.
James W. 1903 ‘Principles of Psychology’ International Universities Press Inc.
Khan MMR. 1963 ‘The concept of Cumulative Trauma’
Rush B. 1812 ‘Medical Inquiries and Observations upon the diseases of the Mind’.
Von Krafft-Ebing: 1886 ‘Psychopathia Sexualis’
Yalom I.D. & Leszcz M. 2005 ‘Theory & Practice of Group Psychotherapy, 5th Edition’
Basic Books part of the Perseus Book Group, New York.