healthmedicinet

Porn Addiction can be notoriously hard to quit.  Relapse is the norm, at least in the initial months of recovery.  Many recovering porn addicts quit for a long period, sometimes by giving up their computers entirely, sometimes with the use of blocking software, only to relapse again.

The harm reduction approach to addiction treatment is conceived as an alternative to total abstinence form the substance or behavior and involves techniques to reduce the risks that go along with addiction.  The early harm reduction techniques originated in 1972 in the Netherlands as an approach to drug addiction.  Early harm reduction, later called “normalization”  involved things like needle exchanges and methadone maintenance for drug addicts.  Recently the term has been used to describe system of care services that are interdisciplinary, empowering, and involving the family and community.

In sex addiction, harm reduction might include charting techniques such as having the addict track the amount of time he or she spends masturbating, risk reducing strategies like getting addicts who visit prostitutes to use condoms and other plans for risk reduction like refraining from using internet porn on work computers.   These would be intended both to raise awareness and to contain the behavior in ways that make it less damaging.

These techniques involve working with the addict toward agreed upon goals that do not involve entirely giving up the addictive sexual behavior.

Can the harm reduction model  work for sex addicts?

The harm reduction model does not necessarily address why you engage in sexually compulsive behavior, but only how you do it.  It does not attempt to get at the root causes of addiction which we now know involve early attachment problems and neurodevelopmental factors.

Current thinking among sex addiction therapists is that addicts will be very prone to relapse if they have not worked through their early childhood trauma issues.  Without this, the thinking goes, the addict will stay stuck in patterns involving poor coping skills, inadequate emotion regulation, low self-concept and intimacy avoidance.  These “survival skills that no longer serve,” as they are called, will in turn lead inevitably to a return to dependence on addictive substances and behaviors.

Harm reduction by definition does not require the addict to go through withdrawal from an addictive behavior.  This in turn means that the addict is continuing to use the behavior as a drug.  As such the sexually addictive behavior keeps in place all the self delusion, denial and secrecy that characterize the sex addict’s functioning.

When addicts in early recovery abstain from all sex it appears to allow their heads to clear, the so-called “neural reset.”  This in turn opens up the possibility of thinking more realistically, exploring the underlying psychodynamics and becoming committed to a different kind of life.  A life without being stoned all the time.

Given that sex and porn addiction are progressive and the behavior tends to escalate over time, addicts who continue to engage in addictive behavior, even under harm reducing parameters, can be expected to follow the typical course of acting out more frequently and in more extreme ways over time.  The very risks that harm reduction attempts to curtail may be the very thing the addict begins to crave more as time goes on.

The harm reduction model is already part of sex addiction treatment

Many of the basic ideas of harm reduction are already present in treatment and 12-step program work for sex addicts.  Outside of an initial period of abstinence, these programs are never geared toward a life devoid of all sex.

The addict with the help of a sponsor or counselor lays out the behaviors that characterize his compulsive sexual acting out.  These are the ones he agrees he needs to abstain from entirely and for good.  This might include internet pornography or any other addictive sexual behavior but might ot include abstinence from sex with a partner or masturbation once recovery is established.

12-step sex addiction recovery involves a great deal of learning and awareness about the harm of the addiction.  Step1 in the 12- steps involves looking at how the addiction has made the addict’s life unmanageable.  The later steps continue the process of looking at the harmful consequences and repairing the damage.

Even with regard to the forbidden “inner circle” or “bottom line” addictive behaviors there is room in sex addiction recovery for a modification of these definitions.  Recovering sex and porn addicts often move behaviors into or out of the forbidden zone as things change.  If certain behaviors are not problematic in the long run then they can be allowed back in and enjoyed in moderation.  Find Dr. Hatch on Facebook at Sex Addictions Counseling or Twitter @SAResource

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And they are apparently too stupid to realize how easy it is to ensure they are called out for their bad behavior.

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    Last reviewed: 20 May 2013