Men and women gather in a circle. Rules of conduct are recited; experiences are shared. Healing begins.
This is the road to recovery for sex addicts in Tucson--a private journey away from the public eye.
Meetings for members of Sexaholics Anonymous and Sexual Addicts Anonymous are closed--in stark contrast to a myriad of open Alcoholics Anonymous meetings. Ray, the local contact for Sexaholics Anonymous, explains the difference: "Meetings are not open because of the social stigma associated with being a sex addict. Society tries to avoid anyone who is a sex addict."
Ray, a "sober" sex addict for the past 15 years and a sober alcoholic for 20 years, says alcoholics faced the same shame years ago. He cites the opening of the Betty Ford center as one reason alcoholism is more accepted today.
"It's acceptable to be known as a drug addict or alcoholic--even fashionable for some celebrities, but the same is not true for sex addicts," he says. "We hope in the future society will come to understand and accept addicts as people who have an illness that can be controlled."
The road to sobrietyJOHN, BILL AND MAX BEGIN their journey. They settle into their chairs at a Sexual Compulsives Anonymous meeting in Reno, Nev. Although there is no SCA group in Tucson, a peek into this gathering shows the format at similar 12-step meetings held here.
It's Saturday, 5 p.m., in the Sunday school room behind a local church. The three men gather around two TV tray-sized tables spread with literature about sexual addiction. They occupy chairs suited to their size, although most of the furniture stacked against the walls is intended for children not yet old enough to giggle when they hear the word "sex."
Whimsical religious posters decorate the rooms. There's a cartoon illustration of Jesus gazing softly over a group of doting children, and another of youth engaged in various wholesome activities. Framed pictures of "The Last Supper" and a Madonna with child image hang slightly askew on the wall.
This is where recovery begins.
John, with a Diet Pepsi and a bag of Sun Chips at the foot of his chair, recites Sexual Compulsives Anonymous' statement of purpose: "To stop having compulsive sex ... To stay sexually sober ... To define sexual sobriety for ourselves."
Then come first-name introductions.
"Hi, my name is John, and I'm a sexual compulsive."
"Hi, my name is Bill, and I'm a sexual compulsive."
Max reads the 12 steps to recovery. Bill, looking at ease in a basic Hawaiian shirt and khaki shorts, reads the 12 traditions.
Then, John takes a deep breath and dives into his personal history.
"I was raised in a boundary-less home," he says. "There were no boundaries of conduct whatsoever. My mother was an exhibitionist. My father was a voyeur. There was no privacy. You couldn't go to the bathroom or take a shower without somebody walking in on you. If you ever closed and locked a door, you were asked why."
John attributes his obsession with sex to his upbringing. Conversations in his childhood home were highly sexualized. There were frequent sexual innuendos and discussions about sex, which led John to believe there was nothing inherently private about sexuality.
John's first hunch that something was wrong came when he was 5 years old, and he described to a neighbor friend why a dog had an erection. His description was elaborate, graphic and accurate. The friend's parents were upset and offended; they told John's parents that John had a dirty mouth.
John's parents said it was the neighbors who had a problem, not their family.
When he was young, masturbation was part of John's nightly ritual. Still, he didn't think it was strange when his mom would come back into his room after he'd gone to bed. She never behaved as if she disapproved of what John was doing or that there was anything improper about her catching him. John realizes now that this behavior was bizarre and bordered on incestuous.
"I mean, what mom doesn't know to leave a teenage son alone when she puts him to bed?" he asks the group. "I noticed all the things that were different that happened in other people's houses than what happened in my house. But if I admitted that my parents were wrong and bad, I'd have to admit that I was wrong or bad."
The addictionTHE NAME PATRICK CARNES is well-recognized by most therapists and counselors working in the realm of sexual mental health. Dr. Carnes is the clinical director for sexual disorder services at The Meadows in Wickenburg, Ariz. His book Out of the Shadows: Understanding Sexual Addiction is regarded by therapists as the quintessential resource on the subject.
"When a parent is sexual with a child, the child concludes at a fundamental level that in order to have a relationship, one has to be sexual," Carnes says in Shadows. "When a child's exploration of sexuality goes beyond discovery to routine self-comforting ... there is potential for addiction. ... When children's primary source of comfort is sex, and yet they are told by those whose judgments count the most that to be sexual is perverse, the conclusions they make about themselves are clear. They are unlikable. They need to hide that central part of themselves which others will despise."
Often as a result of abuse, individuals grow up with unhealthy ideas about sex. When they later are forced to live in a world that frowns on sexuality as they understand it, they try to hide their desires and proclivities. Feeling something's wrong or different with their sex drive, the compulsive person begins to feel isolated. Isolation drives them further into secrecy and further into the addiction itself, as they find relief in the endorphins that accompany sexual arousal.
Sexual addiction may be compared to alcoholism. Both involve an abnormal and compulsive relationship to a mood-altering, generally mood-enhancing, chemical.
But there is a difference between the two addictions.
"Sexual addiction is more fundamental and core to the person than a drug addiction," says Dr. Paul Simpson, a Tucson psychologist, author and national speaker with more than 20 years experience intervening in destructive sexual behaviors.
"If you are addicted to cocaine, the substance is outside of you. You can remove yourself. With sex, you can't put it in a box outside of you. The dynamic you are addicted to is within you," he says.
This creates differences in the treatment and recovery of the two addictions.
"If I am recovering from alcoholism, I can say I will never drink. In recovery (for sexual addiction) you can't say I am giving up sex for the rest of my life. The goal is not complete abstinence but balancing and cultivating healthy sexuality," says Simpson.
A secret lifeBILL REALIZED AT A young age that he had homosexual tendencies. In applying for a volunteer organization in his early 20s, Bill was asked if he'd ever had homosexual thoughts. He admitted that he had. Although Bill received a position with the organization, it wasn't long before a homophobe read his report and decided he wasn't the type of person the organization wanted.
After he was fired, Bill told his wife-to-be about the situation, along with the promise that he loved her. She accepted him. They got married and had children.
More than 30 years later, a concerned individual told Bill's wife that she should be tested for AIDS, as Bill had been having numerous affairs with men.
His wife was devastated. Bill was, too. "I thought I was bisexual, but if I was married, that it should go away," says Bill. "For 1 1/2 years, I was monogamous. At the time I was married, I was a virgin with women, although I'd been having sex with men since I was 16.
"I realized that getting married wasn't like having a live-in prostitute. I was resentful, which can grow into an addiction. For the next 30 years of my marriage, I always had a secret male lover. I had 15 serious relationships and many other sexual encounters in places like bath houses."
Looking for answers, Bill suspects his homosexual-hypersexual nature may have come from having an emotionally distant father.
"I felt an intimacy and a closeness with these guys that I never felt with my dad."
Bill also felt more sexually free with men--behaving in ways he didn't feel were appropriate to act with this wife. He connected spiritually and mentally with her, but the sex was not satisfying.
"That may be categorized and probably over-simplified by the Madonna-whore complex," says Bill. "When people exhibit this symptom, they really love their wife, and they see the wife as almost a Madonna-type figure who is the mother of their children. It's therefore hard to think of down-and-dirty sex (with her)."
Degrees of addictionCARNES OUTLINES THREE levels of sexual addiction that most addicts and therapists use for classification. Bill's addiction falls into the Level 1 category, as does John's compulsory masturbation. Level 1 contains all behaviors that are regarded by most as normal or tolerable: masturbation, repetitive promiscuous and emotionless sex between consenting adults, frequenting of strip clubs, prostitution and pornography addiction.
Many individuals who indulge in these activities may not have a problem. People can only decide for themselves whether their compulsory activities threaten their emotional, mental and physical health and their families' well-being. Addicts also set boundaries for themselves, and when they cross those boundaries, it's called acting out. For Bill, acting out equates to compulsive and anonymous sex.
Level 2 addiction includes actions that involve a victim, for which legal sanctions may be enforced, such as exhibitionism, voyeurism or making indecent phone calls.
Level 3 encompasses those criminal behaviors that have grave consequences for the victims and severe legal consequences for the addicts. Incest, child molestation and rape fall into this category.
In the early '90s, when his children were away for college and his wife was out of town, Bill would go to the video store and rent six pornographic tapes. He would masturbate until he felt satiated. He'd feel awful. But that didn't stop him from renting more the next time she left.
The Internet also provided Bill with pathways of pornographic discovery that he'd never imagined existed.
"Dr. Carnes says, which I was skeptical of at first, that sex addiction is progressive," says Bill. "For me, the Internet is progressive. When I put the Internet in at home, first it was pictures of naked men that I had to see to get aroused, then pictures of naked men with erections, then sex, then S and M, then bondage. Afterwards I would feel just awful. That's one of the real insidious things about the Internet."
Web of sexTHE INTERNET IS the crack cocaine of sexual addiction," says Dr. Simpson. "It is really intense for folks."
Simpson refers to statistics in Patrick Carnes' In the Shadows of the Net to illustrate the intensity: In January 1999, there were 20,000 unique visitors to the top five paid porn sites. During the same period, there were one million new visitors per month on the top five free sites.
Simpson sites five driving factors that have made Internet sex as the powerful addictive force it is: accessibility, anonymity, affordability, fantasy and isolation.
"Going back 10 to 15 years ago, if you wanted sex-related materials, you had to go out of your house to buy pornography. Or you had to get up out of the house and go to a bar. The Internet changed all of that. From the privacy of your home, you have access to thousands of chat rooms to pursue cybersex.
"There's also great safety in the fact that no one can know who you are. You can take on a whole new identity and be safe," says Simpson.
Affordability also draws in Internet-savy sex addicts. "When you compare what people would pay for sexual massages and prostitution, you have a cost effective means of accessing porn and sexual partners," continues Simpson.
And while on the Net, many whims can be fulfilled. "The Internet really allows a person to unleash their wildest fantasies. Everything under the sun is represented in Internet porn," he says.
Yet another attraction to the Internet is its ability to eliminate the isolation faced by its users. "For those who are isolated or emotionally immature, the Internet provides an avenue where they can shed isolation and social awkwardness and develop relationships and contacts. A person who is socially awkward cannot do this in real life," says Simpson.
John is very familiar with Internet porn obsession.
John's first search on the Internet was for Penthouse. Sometimes, John would rent pornographic films, find out the name of the leading lady and then take her sexy pseudonym to the search engine. He compares his Internet porn addiction to gambling.
"It offers unpredictable returns," says John. "You play the same hand as in gambling ... and you keep playing one more hand. I would delay orgasm because I didn't know what the next image was going to be. It could be better."
John would start surfing the net at 10 p.m. and wouldn't stop until 4 a.m., which left him with two hours of restless sleep before he had to get up for work.
John began attending Sexual Addicts Anonymous meetings, but he found stories of people slipping from sobriety time and time again discouraging, so he stopped going.
John often removed Internet access from his computer, like an alcoholic pouring out the booze, but it was never long before he reinstalled it. He and his wife divorced. Relationships that followed were failures.
Sexual healingARIZONA IS KNOWN for its share of experts in the field of sexual addiction. In addition to Dr. Patrick Carnes in Wickenburg, Dr. Jennifer Schneider of Tucson is a nationally recognized expert in the field of addictive sexual disorders.
"Both of them are pioneers in the field," says Dr. Simpson. "Patrick Carnes is considered the leading pioneer of sexual addiction work. Dr. Schneider's pioneering work has been with partners of sex addicts É and developing models of intervention for spouses and partners of those who are sexually addicted."
Treatment centers are also part of the geography of the Old Pueblo. Cottonwood de Tucson offers treatment for individual and families suffering from addictive diseases, compulsive behavior patters and behavior health disorders.
Nationally recognized Sierra Tucson, just north of town, is dedicated to the prevention, education and treatment of addictions and behavioral disorders. "We're able to deal with multiple issues simultaneously," says Clinical Outreach Supervisor Cheryl Brown.
The Sierra Model® of treatment recognizes that all of us exist as mind, body and spirit. Seeking to heal the whole person, the Sierra Model® integrates medical, psychological, family systems, self-help and 12-step philosophies.
Many sexual addiction recovery programs, Sexual Compulsives Anonymous included, follow the 12-step process common to many addictions. The 12-step path, born to help control alcoholism, is modified only slightly to suit other forms of addiction--replace the word "alcohol" with "sex," and you've got SCA.
SCA, Sexual Addicts Anonymous, Sex and Love Addicts Anonymous and Sexaholics Anonymous all focus less on group therapy and more on helping a person with individual spirituality.
"The SAA program is based strictly on Alcoholics Anonymous' model, which doesn't propose any one religion," says Bill. "You can go in there, and you can be agnostic, Jewish, Hindu or Christian. because all we talk about is a higher power. Whatever we believe is our God is what it is. A person decides in their own mind how they want to become spiritual."
Ray, of Sexaholics Anonymous, agrees spirituality is at the center of the program. "It's about God and examining one's behavior in relation to the higher power so the higher power is at the center of one's life. It's God centered but not affiliated with any faith," he says.
In Step 1, the addicts admit they are powerless over their addiction, that they have lost their ability to control it. Step 2 requires that the addict believes a higher power can restore their sanity, and Step 3, that they give themselves over to God, "as (they) understand him."
Step 4 is the one addicts will tell you is the hardest, which is to make an insightful and bold inventory of oneself as part of the grieving process, which means confronting anger, fear, depression, loneliness and shame. Step 5 says that on top of just coming clean to God and yourself--which you did in the fourth step--you have to share your wrongs with another person, too.
Steps 6 through 9 begin to address eliminating the addiction and the negative consequences that followed in its wake.
Steps 10 through 12 are maintenance steps. Step 10 requires admitting when you're wrong and continuing to take personal inventory. Step 11 is "(Seeking) through prayer and meditation to improve our conscious contact with God as we understand him, praying only for knowledge of His will for us and the power to carry that out."
Step 12 involves a spiritual awakening and spreading the word.
"What makes the 12-step program so effective is it offers accessibility, anonymity, a way to break out of isolation and to make contact with people struggling with what I am," says Dr. Simpson. "In the 12 steps, you find out that you're not terminally unique, that other people are going through the same struggles. The 12 steps are effective for walking people out from destructive, out of control behaviors to honesty and practical healing."
Members of Sexaholics Anonymous are able to attend several 12-step meetings each week in Tucson.
"We encourage members to attend meetings, work the steps, have a sponsor and read the book (Sexaholics Anonymous). We have a clear definition of sobriety: No sex with yourself and no sex with anyone except your own spouse. If you are not married, that means no sex at all," says Ray. "The program works. Many of us have years of sobriety."
The female factorThe three groups in Tucson--Sexual Addicts Anonymous, Sex and Love Addicts Anonymous and Sexaholics Anonymous--all use the 12-step program. But within Sexaholics Anonymous, Ray says, there are a lot more men than women.
"There's more of a stigma attached to women than men. Men find it easier to admit they have a problem and come to meetings. There's more of an acceptance of men sex addicts than women," says Ray.
Dr. Simpson states if a woman is a sex addict, she's not as easily identified as a man would be. "We are accustomed to viewing men as sexual initiators. The notion that a woman would be sexually aggressive goes contrary to the grain. We aren't conditioned to see it if it's in front of us."
Counselor Sandy Kline, of Tucson's Bethany House, agrees. Kline has worked at the long-term residential treatment facility for women since 1989. With more than 20 years experience working in the field, Kline indicates there is more judgment about women's morality and their ability to raise children.
"It doesn't seem to be socially acceptable. A lot of people just don't accept the reality that women can become sex addicts. With men, it is boys will be boys. It is not really fair," says Kline.
She sites another difference between men and women addicts. "Women are more often filling relationship needs."
These types of addicts often receive help at Sex and Love Addicts Anonymous.
"They feel they need to be in relationships all the time and move from one relationship to another compulsively," says Ray. Adds Klein, "You lose power to chose. It's controlling you. You want to stop but despite your best intensions, you are not able to stop."
The road aheadJOHN AND BILL HAVE ACCEPTED their powerlessness. They admit they can't control their addiction. Bill started attending SAA meetings in 1997, shortly after a therapist friend suggested that his problems were rooted in a sexual addiction, not an alcoholic one like Bill thought.
"I went to the meetings rather skeptically," says Bill. "At first, I didn't think that just getting together in AA-type fashion was going to do any good. Then, all of a sudden, after I'd been going for a while, I started to feel that these were some of the most honest people I'd ever met. Without having to reveal our background, our professions, our last names, we could be totally honest. I began to notice the rapport that went on among the groups, so that's what kept me coming back, that and the fact that I didn't want to continue to have the same kind of problems I'd had that lead to the break-up with my wife."
Bill's been in SAA and SCA for five years now. He says he has a whole new attitude and a more spiritual outlook. He was sober for five years and was at the Step 5 of the 12-step program until he acted out in the beginning of July.
Bill slipped. He had compulsive, anonymous sex. Alcohol played a large part. He's awaiting the results of an HIV/AIDS test.
He felt guilt about his slip, but he has let it go. He plans on attending 12-step meetings indefinitely.
"I'd have become an alcoholic and drunk myself to death," says Bill, "or I'd have committed suicide, if I hadn't been coming to these meetings."
John's struggle is a daily one that he says he will fight to the end. With a grin that spreads from ear to ear under his trimmed and friendly mustache, he declares that the length of time he is able to endure without looking at Internet pornography is increasing--but that is no excuse to relax vigilance.
"Today, I didn't act out," he says. "Yesterday's gone. Tomorrow, I'll ask again for this obsession to go away. I can only live day to day and pray that it goes away. With the way that it's going now, I'm happier than I've ever been in my life."
With 15 years of sobriety under his belt, Ray is "very committed to the program. The program is very successful. People who work the program are able to stay sober for long periods of time. Recovery changes one's total life."
The names of John, Bill and Max were changed to help preserve the men's anonymity.