Nature, Nurture or Both?

familyhistorysexaddictIOP_225pxlsWe talk a lot in treatment about compulsive behaviors functioning as self-soothing mechanisms. In the 5-Day Intensive Outpatient Program, we construct a genogram of each participant’s family history. Invariably, someone will say “Yeah, whatever. I don’t want to waste time blaming my parents for my being a sex addict.”

It’s always tough at this juncture. As clinicians, we want clients to accept responsibility for choices made. Yet we also want to present some explanations (not justifications and not excuses!) for how these coping mechanisms might have come into being: What emotionally dysregulating material is present, and how does sexually compulsive behavior obliterate those intolerable feelings?

Recent findings in epigenetics are fascinating to those of us working in the addiction field. [Read more…]

10 Reasons to Learn Sex Addiction-Induced Trauma Model from Dr. Minwalla

MInwalla_SAITM_Berkeley_Sept24-27_optJPEG 2I’m very excited that Dr. Omar Minwalla is coming to the Bay Area in September (9/24 – 9/27) to train sex addiction professionals how to work from the Sex Addiction-Induced Trauma Model. I believe this training will produce a shift in how I work with my clients. (Plus, I totally want to geek-out with my peers about finer points of skillful sex addiction treatment!)

My 10 Reasons to Learn the Sex Addiction-Induced (SAI) Trauma Model from Dr. Minwalla:

1. I had an extremely difficult partner case last year. My consultation with Dr. Minwalla produced a big shift in this client’s treatment and her resilience.

2. The SAI Trauma Model extends beyond “how to treat the partner.” I’d like to better understand how that all fits together clinically.

3. Dr. Minwalla’s work declared that partners’ reactions to discovery were symptoms of trauma. Why not learn directly from the man who pioneered this thinking?

4. Traditional sex-addiction treatment protocol sometimes bristles against my sensibilities and politics. I’d like to supplement my case conceptualization with other well-considered viewpoints.
[Read more…]

Porn & Erectile Dysfunction (Video)

Image Courtesy Esther Gibbons

Men in their 20s and 30s are reporting “copulatory impotence,” which is the inability to maintain an erection with an in-person sexual partner. These men report they still objectively find their partner attractive, but need to fantasize porn-like scenarios to get or maintain an erection.

The abundance of Viagra and Cialis commercials portrays erectile dysfunction as a normal, common phenomenon. Not, however, for men under 40! It’s the porn!

[Read more…]

Excellent NYT article on Betrayal

Image Courtesy James Niland

Image Courtesy James Niland

Here’s a excellent article about the effects of betrayal from the New York Times. It’s a very elegant articulation of the depth and breadth of disorientation experienced by partners of sex addicts.

AB1775: Affected Client Speaks Out



Here’s an example of why AB1775 is a terrible and ill-conceived law. If you’re not worried about the erosion of client confidentiality, then you’re not paying attention.


Visit to sign the petition and learn more.

To Whom It May Concern,

I am the client directly affected by AB1775. I’m terrified to write this letter, but hope maybe I can express the grave mistake and consequences of AB1775.

I was born in the early 1980s and hit my pre-teen years when the Internet was becoming a sensation. Before the internet, I discovered porn like most others at that time: through magazines hidden under my father’s bed and garbled cable-tv channels. For whatever reason—biological, environmental or both—I developed a compulsive need to view pornography as a means of soothing my unpleasant feelings.

Around 11 or 12 years old, when the new computer came home, it took almost no time for my brother and I to discover Internet chat rooms where people exchanged pornography. [Read more…]