Understanding Spousal Betrayal and Narcissism/Addiction as Survival

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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.
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Working with Betrayed Spouses
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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.

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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 ...

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How has he failed her?

• His affair and hiding the truth has produced
  direct consequences for her and their child
• He doesnt 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

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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, theyre 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 dont understand what broken trust means as
  they think of it in limited terms.

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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.

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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)

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

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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

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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
  (lets briefly discuss disclosure ...)

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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

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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

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In order to get out of the doghouse you first
have to get in it! And this aint it.
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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

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Narcissism, Addiction and Detachment as
Emotional Survival
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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

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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.

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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
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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.
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(No Transcript)
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What are the Survival Needs of Infants?

• Food and Water Nutrition
• Dry and Warm Shelter
• Holding, Mirroring and Stimulation Love

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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)

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So how long would any of us survive today without
...
- Food/Nutrition - Shelter - Love

• We Need Love to Survive Throughout the
  life-cycle

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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 learned as 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.

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How does the self become shamed?

• Primary Narcissism

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So Who is the Problem?

• Not Mom
• Not Dad
• My Needs are the Problem . . .
• The Self is Shamed (

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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.

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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

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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.

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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)

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In Summary ...

• Addicts dont learn about their emotions
• Addicts dont 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
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At-A-Boy!
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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
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Treatment
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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 mens 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

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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)

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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 mens 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

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Initial Sexual Addiction Treatment

• Is Cognitive Behavioral
• In Outpatient- we dont 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

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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

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What is Sexual Sobriety?

• A mutually agreed upon clear, written and
  signed, behavioral contract based on client
  goals.
• Sobriety plans dont change without prior
  discussion.
• Similar to how we handle eating disorders

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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

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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

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Sexual Addiction Information

• The Sexual Recovery Institutewww.sexualrecovery.c
  om
• 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

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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.