Understanding Spousal Betrayal and Narcissism/Addiction as Survival

1. 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.

2. Working with Betrayed Spouses

3. 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.

4. 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 ...

5. 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

6. 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.

7. Recovery boundary problems: Addicts • Expecting understanding, forgiveness and sometimes sex- right 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.

8. 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)

9. We call this theemotional roller-coaster - think PTSD Average time till this ride slows? = 9 to18 months if ...

10. 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 

11. 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

12. 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 ...)

13. 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

14. 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”

15. In order to get “out of the doghouse” you first have to get in it! And this ain’t it.

16. 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

17. Narcissism, Addiction and Detachment as Emotional Survival

18. 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

19. 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. • They end-up feeling like victims of their own stressful lives and therefore entitled to act out - In their minds, they deserve it.

20. “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” Alice Miller: The Drama of the Gifted Child

21. Sexual Addiction Cycle Ritual Acting Out Shortest part Fantasy CONTROL RELEASE SHAME Despair Numbing Shame/Blame/Guilt Any strong emotions generate and stimulate our dependency needs Fossum/Mason/Carnes/Weiss et al.

22. Sadness Nurturing / Understanding Feelings Needs Inform Joy Mirroring Anger Echoing / Support

23. What are the Survival Needs of Infants? • Food and Water = Nutrition • Dry and Warm = Shelter • Holding, Mirroring and Stimulation = Love

24. 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)

25. So how long would any of us survive today without ... - Food/Nutrition - Shelter - Love • We Need “Love” to Survive Throughout the life-cycle

26. 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 learnedas 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.

27. How does the self become shamed? • Primary Narcissism

28. So Who is the Problem? • Not Mom • Not Dad • My Needs are the Problem . . . • The Self is Shamed :(

29. 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.

30. 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

31. 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.

32. Maladaptive or Survival Based Coping Skills Provide • Self soothing • Calm • Distraction • StimulationIn 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)

33. 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

34. At-A-Boy!

35. “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 far-reaching consequences for his well-being.” Alice Miller: The Drama of the Gifted Child

36. Treatment

37. Elements Behavioral HealthSexual 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

38. 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)

39. Elements Behavioral HealthAssessment & Treatment Options - • The Sexual Recovery Institute (SRI) - Los Angeles- 2-weeks 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

40. 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

41. Regarding TreatmentThe 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

42. 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

43. SexualSobriety 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

44. 12-step Groups for Sexual Addicts and Partners • Partner Support • S-Anon • Alanon • COSA • CODA • RCA - Couples • Sex Addict Support • SAA • SA • SCA • SLAA-Women • SRA

45. Sexual Addiction Information • The Sexual Recovery Institutewww.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

46. 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.