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On this week’s episode of Sex Rehab, we saw the patients going trough some very tough issues with their withdrawal from their sex “acting out” behaviors. I find the series fascinating because I like to learn about things other people go through. It helps me to better understand myself and the people around me. Even if I don’t think I know anyone personally who has this problem, it’s interesting to find out how similar sex addiction is to drug addiction. It’s all done to numb out emotional pain.
[Photo: © 2009 VH1, all rights reserved]
After last week’s episode of Sex Rehab, Jill Vermeire, the licensed clinical therapist that’s working with Dr. Drew to help the patients, answered a few questions about how withdrawal from sex addiction usually plays out. This isn’t my interview, but it’s a small excerpt of a larger interview. Here’s what Jill had to say about the subject of sex addiction withdrawal:
The episode opens on the patients struggling with withdrawal. Can you talk about how the concept of withdrawal pertains to sex addiction versus drug addiction?
Jill: Sex addiction is a behavior addiction, as opposed to a chemical addiction. With drugs and alcohol, you’re going to see the withdrawal pretty quickly after you remove the drug because the body is chemically and physically dependent on it. With sex addiction, when you remove the drug–whether it’s masturbation, pornography, acting out with other people–it’s not as immediate of an effect, because the brain chemistry isn’t addicted to the chemicals, it’s addicted to the behavior and the emotional and psychological components of it. It takes a little bit longer for withdrawal to set in. Patients can still exist for a while just on what we call “euphoric recall,” and the high of their last acting out, which does produce the chemical oxytocin in the brain. The effects of oxytocin and dopamine and serotonin start to wear off days to weeks after the last major release when they’re related to the addiction. You’re not going to see the withdrawal effects until at least a week after the last acting out or hit.
Besides the fact that they’re talking about it a lot and that you can note the jitteriness of their behavior, how can you be sure that the patients are not masturbating?
Jill: The truth is that we can’t. It’s based really on an honor system, and how committed they are to their recovery. Just like in real life with my real life patients every day in my practice, I check in with them at the beginning of every session about their time sober. It’s really up to them and how much integrity they want to bring to their recovery as to whether they’re honest about what they’ve done. If you create am environment where it’s not shaming, and if they’re able to start to trust you and trust the process, they’re going to be more willing and more likely to be honest and forthcoming with their behaviors and whether they’ve acted out. We also had the night lights in their rooms, so if one of the producers or night people had seen something, we would have heard about it.
I know it probably varies from person to person, but how long do you usually tell them to refrain from masturbating?
Jill: Thirty days.
What’s the philosophy there?
Jill: It’s just a good number. It’s one month, it gets them into their withdrawal, and then you get to start to see what the feelings are underneath the acting out. If chronic masturbation is part of their sex addiction, then it means they’re using it to numb out, check out and avoid feelings. They’re using it to deal with uncomfortable feelings or things they can’t tolerate. When you take away the coping mechanism, you’re going to see what it is they’re trying to medicate. There are plenty of people who can masturbate in a healthy way, and I have plenty of patients who don’t masturbate at all. I have plenty of patients who have acted out sexually, but have never touched themselves. They think that their private parts are gross, you know? This is a spectrum disorder. It’s not black and white, and nobody falls into one specific category. You really have to decide on an individual, case-by-case basis what is included in their addiction, and what needs to be eliminated for a while so you can allow the underlying feelings and issues to come up. It’s the same thing as removing cocaine, alcohol, or any other drug: if you allow them to keep using the drug, you’re never going to see what’s really going on underneath it. It’s not until you take away that coping mechanism that you really see what the underlying issues are.
Be sure to go read the entire interview here. Visit Jill’s web site. Follow Jill on Twitter.