1. health and fitness
2. addiction

Understanding Spousal Betrayal
and Narcissism/Addiction as
Survival
Robert Weiss LCSW, CSAT-S
Director of Sexual Disorder Programs:
Elements Behavioral Health
Promises, The Ranch & The Sexual Recovery Institute (SRI
Note: This presentation will demonstrate methods utilized to
access online sexual experiences. Explicit images will not
be shown, however please carefully consider if learning such
information might prove harmful to your personal health or
recovery.
Working with Betrayed
Spouses
Diagnose this client
•
Acts out in angry, vengeful, acts superficially supportive of
treatment while actually undermining it.
•
Often shifts from idealizing her spouse, therapist and
treatment - to devaluing and dismissing them. Can be
demanding and boundary-less.
•
Expresses feeling “out of control.” Engages in compulsive
behaviors such as ‘detective work’ and stalking in order to
somehow gain a sense of control.
•
Often seems to be on a mood ‘roller coaster’, it can hard
to tell what mood will predominate, why and when.
•
Mistrustful, suspicious, at times can rage and be verbally
abusive. Can ‘act out’ by overeating, spending and other
compulsive behaviors.
•
Inconsistent and uncommitted to looking at her part or her
issues - tends to externalize and blame.
Which one is he/she?
• An Axis II Diagnosis -Borderline.
• “Extremely codependent”. Someone who lost his/her ‘fragile
self’ to him.
• A client who suffering from a profound life-trauma and grief
reaction without meaningful support or direction.
• A client (similar to folle a deux) who has been living with a
crazy person so long- they have become ‘crazy’ themselves.
•
It might take a while before you know ...
How has he failed her?
His affair and hiding the truth has produced direct
consequences for her and their child
He doesn’t get honest- she has to drag the truth out
of him.
His immediate need to be understood and forgiven is
his priority - this is not empathic
How Active Sex Addicts Treat Spouses
•
In order to tolerate their own ambiguity and lies they devalue and
diminish their partners.
•
They externalize and blame their unmet needs on the spouse. thereby feeling entitled to act out.
•
They deny their spouses reality - leaving the spouse doubting
themselves
•
When caught, they’re terrified of abandonment - and will use
seduction, ‘regret’, lies, blame or manipulation to try to keep the
relationship.
•
Their needs, wants and desires often come before relationship and
family
•
The don’t understand what broken trust means as they think of it in
limited terms.
Recovery boundary problems: Addicts
Expecting understanding, forgiveness and sometimes sexright away (90 days or less)
Expecting the spouse to be more understanding, less angry
and hurt
Expecting the spouse to ‘get over it’ -intolerance of their
feelings and moods
Expecting validation from the spouse for doing basic
recovery-work.
Demanding forgiveness/sex in exchange for disclosure,
information and/or ‘good behavior’
Continuing to lie, keep secrets, act out etc.
The emotional state of a betrayed spouse
•
The spouses are experiencing a form of trauma
• Everything about the past, present and future are in
question
• Afraid of further loss and abandonment
• Ashamed, self hating, self doubting
• Anxious - easily triggered to previous levels of trauma
• Emotionally unpredictable and feel out-of-control
• Worried about the future -parenting, finances, separation
• Some have intrusive thoughts and images (PTSD)
We call this the
emotional roller-coaster - think
PTSD
Average time till this ride slows?
= 9 to18 months if ...
Recovery boundary problems - Spouses
Expecting the Addict to be 100% emotionally available to meet my
needs now (because he/she owes me).
Expecting all of the addicts’ prior emotional issues (distancing,
crabbiness, narcissism ) to go away right away
Not allowing the addict to have a learning curve for better
communication, emotional availability, empathy etc.
Questioning erections, inner thoughts, looks and fantasy
Dismissing addict’s needs for solitude, reflection, healthy self care
(meetings, therapy groups etc)
Physical or Verbal abuse - this is unacceptable
Worried that somehow they can ‘trigger the addict into acting out
Abdicating their own responsibility for relationship healing & growth,
thereby holding the addict solely responsible for the relationship
What are the clinical needs of this spouse?
•
Direction regarding self-care, health issues, talking to family
etc.
•
Education about addiction, disclosure, family dynamics,
support.
•
Holding and Validation of her reality and her feelings
•
Disclosure and clarity regarding their unknown history
•
Social support by professionals (peers and family where
useful)
•
Structure toward moving forward
•
Hope
Relationship recovery steps for the addict
• A committed recovery plan fully shared with the spouse
• Telling the truth and telling it faster (48-hour rule)!
• Staying in touch and not leaving spouses outside the loop of
your commitments, schedule, feelings
•
•
•
Being transparent and non-defensive
Being unafraid of the truth
Having disclosure in treatment where appropriate (let’s briefly
discuss disclosure ...)
What helps spouses feel safe?
Being respected regarding sex and intimacy
Being ‘allowed’ to be angry, hurt and emotional
Consistency in commitments and agreements
No relationship decisions/pressure for six months
No sexual pressure
Hearing the truth as clearly and quickly as possible
Receiving disclosure -if they wish it and it is appropriate to
the situation
At the heart of the spouses’ concerns
How do I know if this is all there is to know?
(Disclosure)
How will I know if he/she acts out again?
(Honesty as a priority -slips will happen).
How is trust re-established? (Consistent,
reliable behaviors over time)
•
“Broken trust is like a broken plate, you can
glue it back together and make it functional,
but the cracks always remain”
In order to get “out of the doghouse” you first
have to get in it! And this ain’t it.
How is couple trust regained?
•
Trust is restored over time through ...
Reliable and consistent actions. Love is Behavior!
Fearless truth-telling - even when facing disapproval
Keeping commitment to recovery steps
Acting as a full adult contributing family member
Patience, empathy & understanding of the spouses
anger and hurt
Healthy boundaries and self-care
Narcissism,
Addiction and Detachment
as Emotional Survival
The Problem
Fmr. President Bill Clinton
Fmr. Governor Elliot Spitzer
Fmr. Governor Mark Spencer
Fmr. Congressman Christopher Lee
Fmr. Congressman Larry Craig
Fmr. Sports Hero Tiger Woods
Fmr. Chief Dominique Strauss-Kahn
Fmr. Governor Arnold Schwarzenegger
Fmr. Congressman Anthony Weiner
Why do such smart, powerful men make such
stupid, self-destructive sexual decisions?
• The intellect and the emotions run on different
tracks- think about being hungry when busy.
• People under intense pressure with high stress
and poor self-care can “end up” being lead
around by their emotions. No matter how high
their intellect - the emotions always win.
• Some individuals seek positions of status and
power in the hope that the role will bolster a
preexisting internal sense of inadequacy. Without
help, they will not resolve nor soothe this
emptiness by high status or success, but it will
remains an unfulfilled part of them.
“It is thus impossible for this person to
cut the tragic link between admiration
and love. In his compulsion to repeat
he seeks insatiably for admiration, of
which he never gets enough, because
admiration is not the same thing as
love. It is only a substitute gratification
for the primary needs for respect,
understanding and being taken
seriously”
Sexual Addiction Cycle
Ritual
Acting Out
Fantasy
CONTROL
Despair
Shortest part
SHAME
RELEASE
Numbing
Shame/Blame/Guilt
Any strong emotions generate and stimulate our
dependency needs
Fossum/Mason/Carnes/Weiss et al.
Feelings
Inform
Needs
Sadness
Nurturing /
Understanding
Joy
Mirroring
Anger
Echoing / Support
What are the Survival
Needs of Infants?
‣ Food and Water = Nutrition
‣ Dry and Warm = Shelter
‣ Holding, Mirroring and Stimulation = Love
What happens to
the infant if any one of these
three are missing?
‣Absent Food = Death
‣Absent Shelter = Death
‣Absent Love = Death (failure to thrive)
So how long would any of us
survive today without ...
- Food/Nutrition
- Shelter
- Love
We Need “Love” to Survive Throughout the
life-cycle
Learned shame prevents us from fully
experiencing adult intimacy and love
Shame is a feeling of being defective brought
about through early attachment deficits,
unresolved character disorders and trauma.
Shame is learned as essential dependency needs
are denied or subverted and the child turns upon
themselves as the source of their own pain.
Shame is reinforced by secretive behavior and
acting out - drugs, sex, spending etc.
How does the self
become shamed?
Primary Narcissism
So Who is the Problem?
Not Mom
Not Dad
My Needs are the Problem . . .
The Self is Shamed :(
Attachment and Addiction
Early attachment disturbances appear to be a key
root cause of both narcissism and sexual
addiction. Compulsivity and obsession offer some
relief from the pain, rage and fear of the
disrupted, empty self in those who never learned
how to find comfort in healthy relatedness. The
compensating compulsive behaviors eventually
take on a life of their own.
Intensely stimulating activities suppress and
distract from unmet dependency needs (love)
‣ Addictions (substance and behavioral)
‣ Intense Self Focus, Self Blame, Suicidality (shame)
‣ Pathological Care-taking /Co-dependency
‣ Thrill Seeking / High Risk Activities
‣ Dissociation / Fantasy
‣ Rage / Abuse
‣ Passivity / Helplessness and/or Drama
‣ Seduction and Objectification
What does your addict have to say about the
need for relationships and intimacy?
‣ “I hate myself for being so needy”
‣ “I hate my neediness”
‣ “I hate my addict”
My needs are SHAMED and the connection
between my emotions (call to action) and
dependency needs is broken, but I still have
quiet my needs because they are shouting in
me. Acting out appears as a logical, useful sane
solution to this dilemma.
Maladaptive or Survival Based
Coping Skills Provide
‣ Self soothing
‣ Calm
‣ Distraction
‣ Stimulation
In the absence of, fear of or limited experience
with, healthier, more integrated relational means
of self stability like intimacy & the ability to
down-regulate under stress (self-soothe)
In Summary ...
‣ Addicts don’t learn about their emotions
‣ Addicts don’t know what they need or how to
get their emotional needs met, they just want
any uncomfortable feelings to go away!
‣ Addicts learn to disavow their needfulness
‣ Most addicts would rather eat dirt than ask for
help (acknowledge need)
This guides treatment
At-A-Boy!
“The child who is used emotionally
by their parent has the chance to
develop his intellectual capacities
undisturbed, but not the world of
his emotions and this will have farreaching consequences for his
well-being.”
Alice Miller: The Drama of the Gifted Child
Treatment
Elements Behavioral Health
Sexual Addiction Assessment & Treatment Options
‣ The Sexual Recovery Institute (SRI) - Los Angeles- 2-weeks
of Outpatient Intensive Treatment (IOP) - Structured,
manualized programming. Clients reside in men’s recovery
residence - Cost $7,950 plus housing.
‣ Also provide Psycho-sexual and Fitness for Duty Assessment,
approx. $6,500 www.sexualrecovery.com
‣ The Ranch in Tennessee - 35 Days of Residential Sexual
Addiction Treatment with Extensive Trauma and Family
Component - cost $24,500 inclusive www.recoveryranch.com
‣ Promises Malibu or West Los Angeles- Primary CD Treatment
with a focus where needed on Sexual Disorders and access to
SRI clinicians or full IOP where needed. www.promises.com
Treatment vs. Therapy
•Behavioral problems REQUIRE behavioral
forms of intervention and treatment
•Structured steps and tasks
•Problem behaviors have to be contained FIRST
before psycho-dynamic therapy and trauma
work begins in earnest
•The attachment maladaptations are the slow
work of long-term therapy, living honestly and
12-step involvement (2-3 years)
Elements Behavioral Health
Assessment & Treatment Options • The Sexual Recovery Institute (SRI) - Los Angeles- 2weeks of Outpatient Intensive Treatment (IOP) Structured, manualized programming. Clients stay at a
men’s recovery residence - cost $7,950 plus housing.
• Also provide Psycho-sexual and Fitness for Duty
Assessment, approx. $6,500 www.sexualrecovery.com
• The Ranch in Tennessee - 35 Days of Residential Sexual
Addiction Treatment with Extensive Trauma and Family
Component - cost $24,500 inclusive
www.recoveryranch.com
• Promises Malibu or West Los Angeles- Primary CD
Treatment with a focus where needed on Sexual Disorders
and access to SRI clinicians or full IOP where needed.
www.promises.com
Initial Sexual Addiction Treatment
Is Cognitive Behavioral
• In Outpatient- we don’t delve deeply into trauma
or transference until 90-days sober at minimum
• In Residential - we can delve into deeper issues
sooner and more directly - but still stay focused
on the primary goal - establishing sobriety and
relapse prevention
Regarding Treatment
The six required treatment steps
when working with Sex Addicts
Do a thorough psycho-sexual history/assessment
Identify the treatment goals of the client and then
align a sexual sobriety contract with those goals.
Hold clients accountable to all their agreements!
Confront denial and teach relapse prevention
Spouse, job & family crisis resolution
Refer to long-term 12-step, therapy or faith-based
group support
What is Sexual Sobriety?
• A mutually agreed upon clear, written and
signed, behavioral contract based on client
goals.
• Sobriety plans don’t change without prior
discussion.
• Similar to how we handle eating disorders
Sexual
Sobriety Contract
List of Behaviors
I Want to Stop
‣A
‣B
‣C
‣D
‣E
‣F
List of Behaviors
I Want to Add
‣A
‣B
‣C
‣D
‣E
‣F
12-step Groups for
Sexual Addicts and Partners
Sex Addict Support
‣SAA
‣SA
‣SCA
‣SLAA-Women
‣SRA
Partner Support
‣ S-Anon
‣ Alanon
‣ COSA
‣ CODA
‣ RCA - Couples
Sexual Addiction Information
‣The Sexual Recovery Institute
www.sexualrecovery.com
‣The Ranch www.recoveryranch.com
‣IITAP - International Institute for Trauma, and
Addiction Professionals www.iitap.com
‣SASH - The Society for the Advancement of
Sexual Health
www.sash.net
‣Esummits www.esummits.com
Understanding Spousal Betrayal
and Narcissism/Addiction as
Survival
Robert Weiss LCSW, CSAT-S
Director of Sexual Disorder Programs:
Elements Behavioral Health
Promises, The Ranch & The Sexual Recovery Institute (SRI
Note: This presentation will demonstrate methods utilized to
access online sexual experiences. Explicit images will not
be shown, however please carefully consider if learning such
information might prove harmful to your personal health or
recovery.