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Emotionally focused therapy for couples recovering from sexual addiction
Abstract
Sexual addiction is described as a pathological relationship with sexual behaviors. Similar to addictions to substances, sexual addiction is commonly associated with dependency, tolerance, and withdrawal. The treatment of sexual addiction within the romantic couple relationship is significantly absent from existing literature. The presence of sexual addiction in a romantic relationship can result in lack of trust, feelings of shame, anger or betrayal, and ultimately the deterioration of the relationship. Emotionally focused therapy (EFT) is a couples therapy modality in which both partners are validated and helped by the therapist to develop a secure attachment to one another. This theoretical treatment model addresses recovery from a sexual addiction within the couple relationship through the incorporation of empirically validated addictions literature and EFT techniques. Both partners simultaneously participate in the modified steps of EFT treatment to address underlying needs of each partner. The therapist facilitates the couple's expression of emotions and interaction cycles. The goal of this theoretical model is for the couple to develop a secure attachment to one another and to improve resilient coping within the relationship in order to reduce or eliminate the sexually addictive behaviors.
... Cohn, 2014;Coleman, 1987), sex addiction (i.e. Bird, 2007;Carnes, 1991;Ayres & Haddock, 2009;Ford et al., 2012;Love et al., 2016;Young, 2008), internet infidelity (i.e. Hertlein & Piercy, 2008;Hertlein, 2011;Schneider et al., 2012), hypersexuality (i.e. ...
... Included within a CBT model umbrella is acceptance and commitment therapy (ACT; Crosby & Twohig, 2016;Twohig & Crosby, 2010), along with a CBT-based experiential group therapy (Klontz et al., 2005). Other treatment models for PPU that have been initially explored include structural family therapy (Ford et al., 2012), motivational interviewing (Del Giudice & Kutinsky, 2007), dissociative states therapy (Southern, 2008), and emotion focused therapy (Love et al., 2016). In one study, mindfulness-based relapse prevention successfully reduced problematic pornography use (Holas et al., 2021). ...
... Applied to PPU treatment, some scholars suggest that relationship therapy could be more effective in treating PPU than individual therapy (Bird, 2007;Love et al., 2016). Additionally, Zitzman and Butler (2005) propose with some empirical backing that conjoint therapy is an essential component in treating PPU in relationships due to its ability to provide relationship and individual healing for both partners as PPU often exhibits relational problems as part of the motivation behind treatment seeking. ...
There are common elements of change across all models of treatment that make them effective. Using the common factors of change framework, this article reviews and organizes the current treatment literature regarding problematic pornography use (PPU). PPU continues to be a common presenting problem, particularly in relationship therapy, as pornography use gains further political attention and accessibility. Despite the recent addition of Compulsive Sexual Behavior Disorder in the ICD-11, literature focused on effective treatment for PPU continues to be sparse. While common factors for PPU treatment are still in the initial stages of identification and research, this article will highlight the factors that have been initially investigated in the process of treating individuals and couples struggling with PPU. Clinical and research implications will then be discussed continuing to incorporate a common factors framework as our field strives to discover how to facilitate change in treating PPU within family and couple relationships.
... In sexual addiction, fantasizing about sex, planning to act out, and actual sexual acting out in the real world are all driven because the sexually addicted individual uses these behaviors to self-soothe. The urge to act out (e.g., engage in exhibitionism) may be the only response that the sex addict is aware of when he or she would be expected to be having dysphoric feelings related to his or her life situation (Adams & Robinson, 2001;Goodman, 1997Goodman, , 2001Love, Moore, & Stanish, 2016;Orford, 2001;Schneider & Irons, 2001). Feelings of boredom, sadness, loneliness, rejection, etc. can all potentially be self-soothed by (or serve as a trigger for) sexual acting out. ...
... In other cases, particularly those in which acting out has been rehearsed during fantasy or planning to act out, an opportunity that fits the rehearsed fantasy or plan sets the stage for the sex addict moving seamlessly into acting out the fantasy or plan. Yet, later, when faced with aversive consequences, the affected person may be unable to explain rationally why they engaged in such risky behavior (Adams & Robinson, 2001;Goodman, 1997Goodman, , 2001Love et al., 2016;Orford, 2001;Schneider & Irons, 2001). Feelings or opportunities that increase the likelihood of acting out are sometimes described as triggers as indicated above (e.g., Love et al., 2016). ...
... Yet, later, when faced with aversive consequences, the affected person may be unable to explain rationally why they engaged in such risky behavior (Adams & Robinson, 2001;Goodman, 1997Goodman, , 2001Love et al., 2016;Orford, 2001;Schneider & Irons, 2001). Feelings or opportunities that increase the likelihood of acting out are sometimes described as triggers as indicated above (e.g., Love et al., 2016). ...
Data from 2,607 female participants in an anonymous computerized study were entered by the participants themselves: 276 (10.6%) had exposed themselves in public, 134 (5.1%) reported having urges to expose themselves in public, 153 (5.9%) had engaged in some sort of sex with underage males, and 100 (2.4%) reported they had sexual intercourse with underage males. As predicted by conditioning, modeling, and critical period learning theories, exposure to nudity within the nuclear family and partnered early sexual experimentation involving breast or genital exposure significantly increased the likelihood of participants exposing themselves in public and having such urges.
... A Systematic Literature Review (SLR) is a way for reviewing all the data and results from research about a particular question in a standardized and systematic way in order to minimize bias. Only literature that meets the criteria set by the researchers is included in the systematic review [16] . ...
... In order for a literature review to be considered as 'systematic,' it must meet specific criteria; that the review is based on clearly formulated questions, identifies relevant studies and appraises their quality, and summarizes the evidence by use of explicit and systematic approaches that differs from traditional reviews and commentaries. As shown in Tables 1,2,3,and 4, the authors were able to show the methods used in finding the research articles their systematic literature review incorporates as well as, which articles were selected for this study, which articles were excluded from this study, and the reasons why these articles were included or excluded [16] . [4] N=2 questionnaires, group process case study: Selwyn, Liam Young Schema q u e s t i o n n a i r e (YSQ) Study reviews the link between sexually compulsive behaviors and the enactments of paraphilias, found they are both responses to negative affected states to the past. ...
... Provides support and suggestions to clinicians treating survivors in a variety of clinical settings. Argues for a trauma informed practiced rather than trauma based Levenson, J. (2016) [5] N = 6 7 9 Males Adverse Childhood Experiences (ACE) scale, Substance Abuse Scale Descriptive Statistics from scales given Sex offenders have higher rates of adverse childhood experiences (ACE) than males in the general population [16] N=57 [8] N=68 Editorial/Commentary 'Sex addiction' faces resistance and scrutiny due to outdated information, cultural/ historical misconceptions, and current research based upon morality. ...
... Emotion-focused therapy is a therapeutic method that has shown to help individuals correct inappropriate and stressful relationships, leading to engagement in emotions and attachments in individuals under treatment (Love, 2016;Mosadegh et al., 2023). Emotions are inextricably linked with cognitions. ...
... In other words, emotion-focused therapy was as impactful as short-term psychodynamic therapy. This finding aligns with the prior results (Davanloo, 2001(Davanloo, , 2013Gilbert, 2014;Jarareh & Taleh-Pasand, 2011;Kashefi et al., 2023;Love, 2016;Mobassem et al., 2012;Parisuz et al., 2019;Rostami et al., 2018;Salimi & Sodani, 2023;Sarafraz & Moradi, 2022;Spengler et al., 2022;Ziapour et al., 2023). It can be concluded that emotionfocused therapy is one of the most effective psychological theories that aids in treating sexual dysfunction and improving the quality of sexual life. ...
Objective: The present study aimed to compare the effectiveness of emotion-focused therapy and short-term psychodynamic therapy on sexual dysfunction and the quality of sexual life in women attending counseling and psychotherapy centers in Isfahan. Methods: The research design was a quasi-experimental pre-test, post-test, and follow-up. The population included all women in Isfahan province suffering from sexual dysfunction in 2023. Sixty individuals were selected through purposive sampling and randomly assigned into three groups: twenty in the first experimental group, twenty in the second experimental group, and twenty in the control group. The first experimental group underwent emotion-focused psychological intervention based on the therapeutic protocol by Gilbert (2014) in fifteen 60-minute sessions, and the second experimental group received short-term psychodynamic psychological intervention based on the therapeutic protocol (Davanloo, 2013) in twelve 60-minute sessions held weekly, followed by a one-month follow-up. The control group was placed on a two-month waiting list for the most effective intervention. Data collection for analysis was conducted using the Rosen et al. (2000) Women's Sexual Dysfunction Questionnaire and the Simonds et al. (2005) Women's Sexual Life Quality Questionnaire. Data analysis was performed using mixed ANOVA with SPSS version 25. Findings: The findings indicated that both treatments were effective in reducing sexual dysfunction in women (F = 73.08, p < .001) and improving the quality of sexual life (F = 18.02, p < .001). However, there was a significant difference between the effectiveness of the two therapeutic methods in reducing sexual dysfunction and increasing the quality of sexual life in women (p < .001). Conclusion: It can be concluded that both emotion-focused and short-term psychodynamic therapies are effective in reducing sexual dysfunction and improving the quality of sexual life in women. Both treatments can be used to reduce psychological issues in women attending counseling centers.
... This approach believes that marital disturbances accompany a pervasive state of negative affect and attachment injuries and continue as such. EFT can be an effective and efficient treatment for resolving sexual differences between couples, also helping reduce sexual addiction and improve this disorder (Love, 2016). The results of studies conducted in this area indicate that EFT increases satisfaction, intimacy, and marital compatibility (Akhavan Bitaghsir, 2017;Zanganeh Motlag, 2017); enhances self-esteem and sexual performance (Asadpour, 2017;Badihi, 2016); improves distress tolerance and communication patterns of couples (Faghih, 2018;Javidi, 2013), and reduces marital boredom (Sayadi, 2017). ...
... It can also be said that a significant portion of the spousal relationship is rooted in emotional, emotional, and sexual issues. When a partner perceives their injured emotions and needs differently, this leads to a change in how they respond to their partner, which may involve engagement in relationships outside the marital framework to meet their own needs; therefore, it is not unexpected that with increased experiences arising from secure attachment to their spouse, their commitment to each other and ultimately to the marriage bond increases; thus, in the current study during the process of EFCT, the therapist, while recognizing emotions and the correct way of expressing them to the women and understanding between the couple, helped to improve and significantly increase communication and marital commitment, and reduce their inclination towards extramarital relationships (Love, 2016;Sayadi, 2017). In fact, the inability to express these emotions timely and appropriately initially leads to emotional withdrawal and the loss of intimacy, and ultimately to emotional divorce and dysfunction in their sexual performance. ...
Objective: The current study aimed to examine the effectiveness of Emotion-Focused Couple Therapy (EFCT) on intimacy, marital adjustment, and forgiveness among couples with a history of extramarital affairs. Methods: The research design was a quasi-experimental pretest-posttest with a control group. The study population included all women in Tehran who were affected by their husbands' extramarital relationships in 2022. A sample of 30 women affected by such relationships and visiting counseling centers in District 2 of Tehran was selected through convenience sampling and randomly assigned to either the experimental or control group in equal numbers. The research instruments included the Thompson and Walker (1983) Intimacy Scale, the Spanier (1976) Marital Adjustment Questionnaire, and the Rye et al. (2001) Forgiveness Questionnaire. The experimental group received EFCT in eight 60-minute sessions over a month; the control group was placed on a waiting list. Data were analyzed using repeated measures analysis of variance with the aid of SPSS version 23 software. Findings: The findings indicated that EFCT significantly improved intimacy (p < 0.01), marital adjustment (p < 0.01), and marital forgiveness (p < 0.01). Conclusion: It can be concluded that Emotion-Focused Couple Therapy effectively enhances intimacy, adjustment, and forgiveness in couples with a history of extramarital affairs.
... Such incidents lead to deterioration of attachment between partners and can prevent its restoration. Advocates of Emotionally Focused Therapy for Couples posit that couple therapy should be introduced to restore safe attachment between the person experiencing CSBs and their partner (individual therapy is also advised before the partner is included) [96]. Such therapy should provide circumstances for the transparent sharing of emotions and can help heal attachment injuries caused by CSBs and help rebuild a safe bond in the couple [94]. ...
... Such therapy should provide circumstances for the transparent sharing of emotions and can help heal attachment injuries caused by CSBs and help rebuild a safe bond in the couple [94]. The openness about the problem facilitates the recovery process [96]. The externalizing of the problem of addiction could lead to a shift in the recovery approach of the couple to mutually supportive teamwork in fighting against a problem. ...
Purpose of Review
The objective of this review was to (1) outline the current empirical evidence on the impact of social factors on the development and maintenance of CSBs (compulsive sexual behaviors), (2) identify research gaps in this field, and (3) suggest potential future avenues for studying CSBs within a social framework.
Recent Findings
The evidence highlights insecure attachment as a risk factor for the development of CSBs, indicating a potentially more significant role of attachment anxiety. Higher perceived social support was associated with lower CSB severity; however, the small effect size suggests a supportive role. Loneliness may serve as a risk factor for CSBs across populations. Minority stressors were positively related to CSB severity, while therapy addressing those stressors effectively diminished CSB symptoms. Empirical findings imply complex bidirectional influences between the social bonds’ quality and CSBD/PPU (compulsive sexual behavior disorder/problematic pornography use). Moreover, interpersonal aspects and mutual support are crucial elements in individual, couple, and group treatment for CSBs.
Summary
Empirical evidence highlights the significance of social factors like loneliness, perceived social support, attachment anxiety, avoidance, and romantic bond quality in CSBD/PPU. Social factors should be considered in clinical practice as they may be involved in the development and maintenance of CSBs. Addressing them in therapy may facilitate the treatment process. However, methodological differences across studies make drawing definitive conclusions impossible. More longitudinal data from multicentered projects using standardized methodologies to clarify causality of the relationships are needed.
... In regard to the interpersonal impairments, although addiction broadly is often associated with interpersonal problems (Hassel, Nordfjaern, & Hagen, 2013), this may be particularly true for individuals with CSB, given that they may have established unrealistic or unhealthy expectations of sexual relationships (Fong, 2006). Previous research suggests that CSB is not only linked to intimate partner difficulties, but also strained relationships with friends and other family members (Black, Kehrberg, Flumerfelt, & Schlosser, 1997;Love, Moore, & Stanish, 2016;Spenhoff et al., 2013). It is possible that this may be particularly true for individuals with co-occurring CSB and SUD, given that SUDs are also linked to interpersonal difficulties (Hassel et al., 2013). ...
Background and Aims
Many individuals with substance use disorders (SUDs) present with co-occurring mental health disorders and other addictions, including behavioral addictions (BAs). Though several studies have investigated the relationship between SUDs and BAs, less research has focused specifically on compulsive sexual behaviour (CSB). Given that poly-addiction can hinder treatment outcomes, it is necessary to better understand the impact of co-occurring CSB and SUD. Therefore, the current study aimed to 1) determine the rate of CSB in a sample seeking treatment for SUDs, 2) identify demographic and clinical correlates of co-occurring CSB, and 3) to determine if co-occurring CSB impacts treatment outcomes for SUD.
Methods
Participants were 793 adults (71.1% men) ranging in age from 18–77 ( M = 38.73) at an inpatient treatment facility for SUDs who were assessed for CSB upon admission into treatment. Participants completed a battery of questionnaires upon admission and at discharge to assess psychological and addiction symptoms.
Results
Rates of CSB were 24%. Younger age and being single were associated with greater CSB. Mental distress and addiction symptoms were higher in participants with CSB. Predictors of CSB severity included greater symptoms of traumatic stress and interpersonal dysfunction. Rates of treatment completion were similar between participants with and without CSB.
Discussion and Conclusions
These results highlight several clinical and demographic correlates of CSB amongst individuals in treatment for SUD. However, CSB was not associated with poorer treatment outcomes. Further identifying characteristics associated with CSB can help clinicians identify individuals who may be at higher risk.
... Though a systems approach to addiction has long been advocated for and shown to be efficacious (Carr, 2014;Copello et al., 2005;Kaufman & Kaufmann, 1979;Keller, 1974;Kourgiantakis & Ashcroft, 2018;McCrady et al., 2018;Navarra & Gottman, 2013;O'Farrell et al., 2017;Rowe, 2012;Slesnick & Zhang, 2016), structural barriers to its reimbursement from insurance agencies (Dopp et al., 2022) as well as family member's reluctance to engage in therapy they deem "not their problem" (Bacon, 2019;Ventura & Bagley, 2017) are commonly cited as limiting factors to its application in practice. Relational therapy is also inconsistently employed; for example, family therapy is predominantly used in prevention or early intervention with adolescent substance use (e.g., Das et al., 2016;Hogue et al., 2021;Stockings et al., 2016) and couples therapy is predominantly used with adults who are struggling with addiction (e.g., Mutschler et al., 2022;Schumm & Renno, 2022;Wesley, 2015), that are primarily process or behavioral addictions such as gambling (Lee et al., 2020), sex (Love et al., 2016), or pornography use (Ford et al., 2012;Zitzman & Butler, 2005). Regarding substance use disorders, a historical analysis of clinical trials (Miller & Wilbourne, 2002) concluded that treatment modalities including a social component are the most efficacious. ...
Addiction remains one of the most prominent public health concerns to date that presents unique challenges that may require intervention methods that transcend individualized disease model conceptualizations. Addiction is perpetuated beyond the contributions of the individual in the form of economic, social, and cultural factors. Indeed, evidence suggests that the disease model of addiction is a systemic variable contributing to addiction epidemics; therefore, using a systemic perspective in addiction intervention is efficacious. The systemic approach affords clinicians the understanding of how relationships not only contribute to addictive patterns, but also can serve to combat them. The potential for both positive outcomes as well as adaptive addiction healthcare innovations remains high in relational therapy paradigms. What follows is the current conceptualization of addiction and recovery, a brief history of addiction in relational therapy, reviews of efficacious addiction treatment methodologies in relational therapy, and suggestions for filling research gaps with respect to relational therapy to addiction treatment.
... In conclusion, self-healing training improved psychological well-being and increase marital satisfaction in the experimental group. This finding is consistent with the research results of Masoumi et al. (2017) on the effectiveness of marital relationship enrichment program on marital satisfaction and reducing marital violence; Love et al. (2016) on the effectiveness of mindfulness on marital satisfaction of women affected by domestic violence; on the effectiveness of self-healing training on self-compassion, body image concern, and recovery process in patients with skin cancer; Zarean & Latifi (2020) on the effectiveness of self-healing (the healing codes) training on psychological capital and distress tolerance in women with addicted husbands; Zarean & Latifi (2021) on the effects of self-healing intervention on quality of life and mother-child interaction among female breadwinners. ...
A total of 30 volunteers were selected based on the inclusion and exclusion criteria using convenience sampling. They were then randomized into the experiment (n = 15) and control (n = 15) groups. The participants responded to Ryff’s Scales of Psychological Well-Being (SPWB) and ENRICH Marital Satisfaction Scale in three stages of pretest, post-test, and follow-up. The experimental group underwent fourteen sessions (90-minute sessions per week) of schema therapy. The repeated measures ANOVA and SPSS-26 were used to analyze the data. Self-healing training improved the elements of psychological well-being and marital satisfaction (p < 0.01).
... Emotional couple therapy is more effective than other approaches due to its structured nature and has a step-by-step treatment plan for couples, and it is much less likely to recur (Wiebe et al, 2017). Exciting oriented couple therapy has a positive and meaningful relationship in increase of satisfaction, marital intimacy and compatibility, increase of self-confidence and sexual function (Love et al, 2016). Couple therapy increases marital compatibility and is useful for couples (Marín et al, 2014). ...
Objective: The aim of this study was to evaluate the effectiveness of couple therapy on improving marital adjustment, emotional divorce and reducing extramarital affairs of couples in Behshahr. The method of this research was quasi-experimental in two groups (experimental and control) with pre-test and post-test. The statistical population included all couples who referred to Behshahr social emergency were 373 people. According to Morgan's table, 60 people were selected for pre-test or screening by multi-stage cluster sampling method and completed standard spinner (couple) compatibility questionnaires Spinner (1976), Guttman (1955) emotional divorce and justification of extramarital affairs Glass (1988). After conducting the questionnaires, 30 couples who had the lowest score at the same time were selected and randomly assigned to the experimental and control groups (15 people in each group). The experimental group received emotion-centered couple therapy in groups for 10 sessions of 90 minutes, twice a week for two and a half months. Data were analyzed by multivariate analysis of covariance and SPSS software. The results of data analysis show that there is a significant difference between the post-test scores of the experimental and control groups in at least one of the dependent variables (marital adjustment, emotional divorce and extramarital relationships) (F (3, 23) = 65.950, wilks .lambda = 0.109 The results also showed that emotion-based couple therapy is suitable for improving marital adjustment, emotional divorce and reducing couples' extramarital affairs and can be used as an effective intervention method. Introduction Family is a focal point which has to be a healthy and constructive environment for its members and meet their physical and mental needs, but marital relationships is more important than marriage and family. By entering to the era of modernity, social changes happen including industrialization, Expansion of urbanization and increasing of the nuclear family, a variation in culture and family and some of the relationship aspects based on gender, marital relationships and also a new collection of expectations among men and women(Bani Fateme et al,2019). The context of marriage is one of the most important areas in which the function and effect of intimacy and developed social relations is manifested. The purpose of marriage is to eliminate the needs of couples and if their needs are not eliminated and man and woman do not find a positive solution to meet their needs, stress, failure, repression, frustration and
... The research findings also indicated the effect of EFCT on the subscales of marital satisfaction, including personality issues, conflict resolution, sexual relations, and parenting. The findings of this study are in line with those of Fletcher, 22 Love, Moore & Stanish, 31 Greenberg, Warwar and Malcolm, 32 and Priest. 21 These findings can be explained by referring to the fact that in EFCT, the main focus is on the role of emotions in permanent patterns of incompatibility of disturbed couples. ...
Background: Marital relationship has been described as the most important and fundamental human relationship because it provides the basic structure for forming a family relationship and life satisfaction. Also, one of the factors which play an important role in the marital satisfaction of couples is positive feelings towards the spouse, which include both positive emotions. This study aimed to investigate the effect of emotion-focused couple therapy on marital satisfaction and positive feelings towards the spouse. Methods: This semi-experimental method with a pre-and post-test design was conducted on a sample group of 14. The statistical population of the present study includes all married women who in 2018 were referred to counseling centers and neighborhoods in the 10th district of Tehran city. The sampling method in this research is a purposeful sampling. Thus, the questionnaires of enriching and nurturing relationship issues‚ communicating and happiness(ENRICH) and positive feeling questionnaire (PFQ) were completed by married women referring to counseling centers and shelters in the 10th district of Tehran. After scoring the questionnaire, select 14 people who are allowed to score or below average in ENRICH and PFQ. A Paired t-test was used to significantly evaluate the differences between the means in the pre-test and post-test stages. Statistical analysis was conducted using IBM SPSS-24. The significance level was set at 0.05 for all tests. Results: The results of the paired t-test showed that there was no significant difference between the mean scores of the subjects in the pre-test and post-test stages in the variables of marital relationship, relationship with relatives, and friends and spiritual beliefs (Pvalue<0.05), but in there were significant differences in the variables of personality issues, conflict resolution, sexual relations, marriage and children and the total score of marital satisfaction and positive feelings towards the spouse. Conclusions: Emotion-focused couple therapy is effective in marital satisfaction and positive feelings Spouse, hence; family counselors and family therapists can use the results of the present study for therapeutic interventions based on emotion-focused couple therapy to increase marital satisfaction and positive feelings in couples.
... Although there are no clear criteria for diagnosing problems associated with pornography use, 78 a number of people regularly seek therapeutic services related to its consumption. 79,80 Furthermore, sexual desire and frequency are both oft cited presenting problems by those seeking clinical support. 81,82 To best address the needs of such individuals and couples, it is critical for counselors and therapists to understand the complexities of how these aspects of sexual dynamics influence each other. ...
Background:
While links between pornography use and couple relational well-being have been the subject of multiple research studies, less attention has been paid to the associations between pornography use and specific sexual behavior within the relationship.
Aim:
This study aimed to explore associations between each partner's pornography use, sexual desire, sexual satisfaction, and intercourse/non-intercourse sexual behavior. The confounding and moderating role of religiosity was also explored.
Methods:
A dyadic sample of 240 heterosexual couples was used. Measurement assessed pornography use, sexual desire, sexual satisfaction, and sexual behavior.
Outcomes:
Sexual satisfaction as well as intercourse and non-intercourse sexual behaviors were examined.
Results:
Results suggested consistent gendered differences where female pornography use was directly associated with higher reports of female sexual desire, whereas male pornography use was directly associated with more male but less female partner desire and lower overall male sexual satisfaction. Male pornography use was also indirectly associated with sexual satisfaction for both partners and non-intercourse behaviors within the relationship through sexual desire. Overall, religiosity had little impact on the results of the study.
Clinical Translation:
The complex associations between pornography use, sexual desire, and sexual behaviors suggested by our results highlight the importance of comprehensive and systemic assessment and education around sexuality when working with individuals and couples.
Strengths & Limitations:
The main strength of this study is the use of dyadic data. The main limitation is the cross-sectional nature of the data
Conclusion:
The associations between pornography use and a variety of outcomes are highly nuanced. This study provides an important step forward in more fully accounting for the complications of pornography use in a relationship.
Aim: The aim of this study was to evaluate the effectiveness of teaching emotion management strategies based on Emotional Focus Therapy approach on improving marital satisfaction. Methods: The present study is a quasiexperimental study. The statistical population of this study consisted of all couples who referred to counseling centers in Saadatabad region in Tehran during the year 2021. For sampling, all couples interviewed were selected through convenient sampling and had referred to Amin Pajooh and Binesh Counseling Centers. After conducting an interview based on marital self-disclosure, 47 couples were identified as conflicted, all of whom volunteered to attend treatment sessions. Among them, 32 couples were randomly assigned to the experimental group (16 couples) and the control group (16 couples). To test the hypothesis, analysis of covariance was done using SPSS-22 software. Findings: According to table 4-11, the proportion of F covariance analysis for family functioning (P=0/001 and F=26/2) and for marital satisfaction (P=0/001 and F=37/3) were obtained. The results of the study showed that there was a significant difference in marital satisfaction during pre-test, post-test and follow-up. Eta squared size shows that 31% of intra-group changes can be explained by receiving training in emotion management strategies on marital satisfaction. Conclusion: According to the findings, it can be said that emotion management strategies have an effect on marital satisfaction. As a result, this training can be used in couple therapy interventions.
The aim of the present study was to investigate the effectiveness of training of emotionally focused approach and choice theory on couples’ marital satisfaction and burnout. The research method was quasi-experimental with pretest-posttest design with control group. The study population consisted of married couples with marital problems referred to Hamadan Counseling Center in 1398 and among them 30 couples were selected by convenience sampling and randomly divided into three equal groups. These groups received training 8 sessions (each session 90 minutes) of emotionally-focused approach and choice theory respectively. Subjects completed Enriche's Marital Satisfaction scale (1998) and Paines' Marital burnout scale in the pre-test and post-test. Multivariate analysis of covariance and post hoc tests were used to analyze the data. The results showed that both methods of emotionally focused approach and choice theory were effective on increasing marital satisfaction and reducing marital burnout in couples (p <0.05). The results of post hoc test showed that there was no significant difference between the effectiveness of these two methods on marital satisfaction and marital burnout (p> 0.05). According to the effectiveness of the two approaches of choice theory and emotion-based approach, these approaches can be used for psychological interventions of couples.
This study aimed to investigate the effectiveness of the combined approach of acceptance and commitment therapy (ACT) and mindfulness-based cognitive therapy (MBCT) on improving intimacy and reducing Post-traumatic stress disorder (PTSD) caused by extramarital relations (EMR). This was a quasi-experimental research with a control group. The subjects were selected through multistage cluster sampling. Twenty - nine couples who were dealing with infidelity at the time of the research were selected and filled the PTSD scale and intimacy survey. Based on the results, it can be concluded that CCT is effective in improving intimacy and reduced PTSD caused by EMR.
This study aimed to compare the effectiveness of two approaches of acceptance and commitment therapy (ACT) and mindfulness-based cognitive therapy (MBCT) with Emotionally Focused Therapy for Couples (EFT) on improving intimacy and reducing Post-traumatic stress disorder (PTSD) caused by extramarital relations (EMR). This was a quasi-experimental research with a control group. The research population included all couples dealing with infidelity, who referred to a counseling center in Mashhad, Iran, during August-September 2018. The subjects were selected through multistage cluster sampling. Twenty - nine couples who were dealing with infidelity at the time of the research were selected and filled the PTSD scale and intimacy survey. Participants ranged in age from 18 to 45 years. Also, the mean duration of relationships was 2 years. Out of these 40 couples, 30 couples who had symptoms of PTSD and had other conditions and willingness to enter present study, were selected through purposeful sampling as the sample of present study and randomly assigned 10 couples in the CCT group (ACT and MBCT), 10 couples in the EFT group and 10 couples were placed in the control group. Of the 30 couples selected, 2 couples (1 couple from the CCT group and 1 couple from the EFT group) resigned after the evaluation session. Finally, 28 couples remained (9 couples in the EFT group and 9 couples in the CCT group and 10 couples in the control group). Besides the PTSD questionnaire, a clinical interview was used to diagnose PTSD. Data analysis was carried out using the analysis of Covariance (ANCOVA). According to the results, there was a difference between the effectiveness of CCT and EFT on improved intimacy and reduced PTSD caused by EMR. Based on the results, it can be concluded that CCT is more effective than EFT in improving intimacy and reduced PTSD caused by EMR.
Aim and Background: Marital commitment is an important factor in marital life’s consistency. The aim of the present study was to investigate the effectiveness of integrative emotion-focused therapy (EFT) on marital commitment of student couples. Methods and Materials: This semi-experimental study was carried out with pre- and post- test design and control group. The statistical population included all student couples in Farhangian University of Tehran, Iran, who referred to the counseling center of the university in 2017, (50 couples, 100 individuals). Of them, 32 couples were selected by convenience sampling and randomly assigned into two groups of experimental (n = 16 couples) and control (n = 16 couples). Participants in both groups completed Dimensions of Commitment Inventory (DCI). The EFT approach was conducted for experimental group in 10 sessions, each lasting 2 hours. Data were analyzed using multivariate analysis of covariance (MANCOVA) via SPSS software. Findings: Using MANCOVA, it was demonstrated that by controlling the effect of pre-test scores, the mean of total score of commitment and its components including personal, moral, and structural parameters in experimental group in post-test was significantly more than that of control group (P < 0.001). Conclusions: This study showed that regarding the effectiveness of EFT on student couples’ commitment, family counselors and psychotherapists can use this approach to improve couples’ interactions. Keywords: Marital commitment, Couples, Emotion-focused therapy.
Journal: Journal of Research in Behavioural Sciences
URL:
http://rbs.mui.ac.ir/index.php/jrbs/article/view/2184
Emotion focused couple Therapy and therapyIntegrative behavioral couple therapy are Integrative treatments that has a focused on the negative cycles of interaction caused from deep emotional vulnerability. The current research administrated aim to Comparison of the Effectiveness of Approaches TherapyEmotionally focused couple therapy and TherapyIntegrative behavioral couple therapy in forgiveness in Couples with marital conflict. The statistical population of the study included all couples referring to Ahvaz city Mehrvaran Psychological Clinic. The research sample was selected using purposeful sampling method, which included 6 couples (12 persons) from the Couples referred to the clinic, which according to the marital adjustment questionnaire score were distributed among the distracted couples. Non-congruent multiple baseline experimental single case study was used as the method of the present study. The emotion focused couple Therapy and TherapyIntegrative behavioral couple therapy Protocol was carried out Two to four stages of the base line of intervention, 16 session treatment of 60 minutes and 2 month follow-up by using the Marital offence-specific Forgiveness Scale(Paleari, Fincham,Regalia,2009) evaluated. Data analyzed with visuals inspection, improvement percentage and reliable change index (RCI) strategies. Results showed that emotion focused couple Therapy efficacy more than TherapyIntegrative behavioral couple therapy on the Forgiveness variables. The rate of improvement of the conflicting couples's emotion focused group in the Forgiveness variable in the post-treatment and follow-up stage was 47.14 and 48.94 and in the Integrative Behavioral group in the post-treatment and follow-up stages of 35.40 and 35.92 percent. The explanation of the findings suggests that emotion focused couple Therapy efficacy more than TherapyIntegrative behavioral couple therapy in Magnitude, Universally and stability of changes.
Key words: Conflict, Forgiveness, emotion focused, Integrative Behavioral.
Journal: Family Counseling and Psychotherapy
URL:
http://fcp.uok.ac.ir/article_61018.html
Background: research indicated emotional-based couple group therapy and schema group therapy have improved life satisfaction, but whether emotional-based couple group therapy and schema group therapy are effective on this variable and which one is more effective? Aims: The aim of the current study was to compare the effectiveness of group schema therapy and group emotional-based couple therapy on couples' life satisfaction and maladaptive schemas. Method: The present study was a quasi-experimental design containing two experimental groups and one control group. Among couples who referred to counseling centers in the city of Mashhad, 50 couples with marital problems were screened by interview. Then, among them, 24 couples were randomly assigned into the groups. Eight emotional-based couple therapy(Johnson, 2012) sessions and 11 schema therapy(Young, 1999) sessions were held. Data were collected by using Diener, Emmons, Larsen, and Griffin satisfaction with life scale (1984) and Young's maladaptive schemas questionnaire (1991). To analyze the data, SPSS software and multivariate analysis of covariance were used. Results: The results of the present study showed that schema therapy was effective in the improvement of life satisfaction and the reduction of maladaptive schemas in couples. Emotional-based couple therapy was also effective in reducing maladaptive schemas and increasing life satisfaction (p<0/001). Conclusions: The results showed the positive effects of schema therapy and couple therapy on couples' maladaptive schemas and life satisfaction, and also these two methods were equally effective.
Background and Objective: Infertility is known as an important stressor threatening the personal, marital, familial, and social stability in all culturesaround the world. The present study aimed to investigate the effectiveness of emotionally focused couple therapy on marital commitment and couple burnout among infertile couples.
Materials and Methods: This quasi-experimental study was conducted on 30 infertile couples referring to the private centers of infertility in Qom, Iran, from September 2015 to September 2016, using pretest-postest design with a control group. The study population was selected through purposive sampling technique, and then randomly assigned into the experimental (n=15 couples) and control experimental (n=15 couples) groups. All participants filled out the Dimensions of Commitment Inventory and Couple Burnout Measure. In addition, the couples in the experimental group attended 10 emotionally focused couple therapy sessions performed twice a week. The data were analyzed using the multivariate analysis of covariance and univariate analysis of covariance.
Results: The results of the multivariate analysis of covariance showed that emotionally focused couple therapy significantly increased the posttest mean scores of marital commitment and its subscales (i.e., personal commitment, moral commitment, and structural commitment) in the experimental group (P
Misuse of alcohol and drugs is widespread in modern society with the associated emotional and physical tolls on individuals, couples, and families. Yet, many therapists do not assess nor address substance misuse when clients do not identify it as a presenting problem. This article presents an overview of the literature on key aspects of couples and substance use and makes important clinical recommendations for mental health professionals who work with couples that struggle with substance use.
Several theorists and researchers have noted that group therapy is a viable treatment option for sexual addiction. There has been little effort, however, to explain the theoretical rationale of group therapy and show how group therapy works to treat sexual addiction. Long-term group therapy provides a laboratory in which clients can enter into relationship to (a) help manage addictive behaviors, (b) explore the dynamics of their addictive process, and (c) develop intimate bonds with others. We present a model for long-term group therapy of sexual addiction that we have used in private practice, and conclude by giving an excerpt from a group therapy session.
Since the advent of the Internet, the sex industry has profited from an unprecedented proximity to the home environment. Consequently, couples, families, and individuals of all ages are being impacted by pornography in new ways. Examining the systemic impact of Internet pornography, however, is relatively uncharted territory and the body of systemically-focused research is limited. A review of the research that does exist was undertaken and many negative trends were revealed. While much remains unknown about the impact of Internet pornography on marriages and families, the available data provide an informed starting point for policy makers, educators, clinicians, and researchers.
This article introduces a description of a group of nonparaphilic hypersexual behavior disorders, the paraphilia-related disorders (PRDs). The rationale for the definition and characterization of these behaviors is described and empirical literature supporting the concept of PRDs is reviewed. The common paraphilia-related disorders include compulsive masturbation, protracted promiscuity, pornography dependence, cybersex dependence, telephone sex dependence, severe sexual desire incompatibility and paraphiliarelated disorder not otherwise specified. The comorbid associations and clinical characteristics supporting the evidence that PRDs are indeed related to paraphilic disorders are described. The case is made that the classification of nonparaphilic hypersexual disorders as "paraphilia-related disorders" avoids the confusing use of characterizations such as "addiction" or "compulsivity" when applied to a broad range of sexual appetitive behavior disorders.
Hypersexual behavior can have a devastating impact on attachments between partners in committed couple relationships. An array of emotions is activated by these attachment ruptures, including feelings of betrayal, confusion, frustration, hopelessness, and abandonment. Repairing these ruptures can be a delicate and challenging part of helping couples restore trust and forgiveness in their relationships. This article describes the process of using Emotionally Focused Therapy for couples as an intervention to facilitate the process of repairing the damage caused by hypersexual behavior.
Most clinicians and researchers would agree that a condition ex- ists in which a person's driven sexual behavior causes either sub- jective distress or functional impairment. However, questions re- main about how this condition should be designated. This article considers the designations that are most often employed—sexual compulsivity, sexual impulsivity, and sexual addiction—and con- cludes that sexual addiction is the most suitable. Arguments against the concept of sexual addiction are then reviewed and addressed. Finally, the implications of the proposed terminology for treatment are explored. Most clinicians and researchers would agree that a condition exists in which a person's driven sexual behavior causes either subjective distress or func- tional impairment. However, questions remain about whether this condition should be called sexual compulsivity, sexual impulsivity, or sexual addic- tion. The focal point of these questions is how this condition should be designated and classified in future editions of the Diagnostic and Statistical Manual of Psychiatric Disorders (DSM). The influence of the DSM reaches far beyond clinical diagnosis to mental health research, third party payments for treatment, legal decisions, societal morality, and public policy. Conse- quently, the significance of whether the second word in a disorder's name is compulsivity, impulsivity, or addiction is much more than just semantic. For example, different groups of mental health professionals are likely to regard one term or another as an indication that the condition so designated be- longs within their turf. Psychiatrists and many psychologists may thus favor "compulsivity," while counselors at 12-step-oriented facilities might prefer "addiction." Meanwhile, law enforcement personnel and prosecutors may
This study sought to determine recovery-related outcomes for 59 patients who experienced the Homewood Addiction Division's 28-day residential program for sexual dependency.' Preliminary analyses of variables related to patient demographics, clinical profiles, recovery data, and patient evaluations of the program were undertaken in an attempt to identify possible factors underlying abstinence and relapse. It is hoped that the findings of this study, which reflect the experiences of a small, residential sexual dependency program offered within a much larger multi-addiction program, will be of value to other clinicians and facilities in the field.
Differentiates codependence (CDC) from contradependence (CNC) behavior and defines both in an interpersonal context. CDC is a pattern of painful dependence on compulsive behaviors and on approval from others to find safety, self-worth, and identity. Behaviors include martyrdom, fusion, intrusion, perfection, and addiction. CNC is a behavioral tendency to separate oneself from others to prevent being emotionally hurt. CNC behaviors include defensiveness, self-sufficiency, isolation, and acting out. An interpersonal model is proposed to address gender issues, diagnosis, and treatment from an emotional health perspective. The model assumes movements either incrementally or in major shifts to alternative transactional strategies for meeting love and safety needs. Individuals can meet their own needs without guilt and can connect without sacrificing their integrity. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
This article describes emotionally focused couple therapy and the contribution of this model to the field of couple therapy.
A focus on emotional processing in the present moment, on process factors and on a genuine empathic connection with both clients
is at the heart of this model. The creation of new patterns of emotional responses results in the creation of key new interactional
responses. EFT is empirically validated on several levels: on the level of treatment outcome, and on the levels of the relational
theory in which it is based and key moments and factors in the change process.
The potential adverse consequences, personal distress, shame and guilt presented by patients who suffer from sexual addiction require a more in-depth understanding of the phenomenology and psychobiology of this disorder. Methods: A bibliographic review was conducted using MEDLINE and EBSCO databases with the following keywords: "sexual addiction," "hypersexuality," "compulsive sexual behavior," "behavioural addiction," "treatment," and "addiction." Results: Several conceptualizations of excessive nonparaphilic sexual disorder have been proposed based on the models of, respectively, obsessive compulsive disorder, impulse control disorder, out of control excessive sexual disorder, and addictive disorder. Despite the lack of robust scientific data, a number of clinical elements, such as the frequent preoccupation with this type of behavior, the time spent in sexual activities, the continuation of this behavior despite its negative consequences, the repeated and unsuccessful efforts made to reduce the behavior, are in favor of an addictive disorder. In addition there is a high comorbidity between excessive sexual behavior and other addictive behaviors. Conclusion: The phenomenology of excessive nonparaphilic sexual disorder favors its conceptualization as an addictive behavior, rather than an obsessive-compulsive, or an impulse control disorder. Moreover, the criteria that are quite close to those of addictive disorders were recently proposed for the future DSM-V in order to improve the characterization of this condition. Finally, controlled studies are warranted in order to establish clear guidelines for treatment of sexual addiction.
Married men labeled as sexual addicts seek help after being discovered to have had broken monogamy rules for sexual behavior through their use of masturbation, pornography, cybersex, commercial sex involvement, paraphilic pursuits, or affairs. This study analyzed the sexual patterns and dynamics of 30 men who presented to 1 clinician between 2005 and 2009. Their important differences were captured by a 6-category spectrum: (a) no sexual excess beyond breaking the spouse's restrictive rules (n = 2), (b) discovery of husband's longstanding sexual secrets (n = 5), (c) new discovery of the joys of commercial sex (n = 4), (d) the bizarre or paraphilic (n = 7), (e) alternate concept of normal masculinity (n = 5), and (f) spiraling psychological deterioration (n = 7). Only the men with a spiraling psychological deterioration-about 25% of the sample with sexual issues-could reasonably be described as having a sexual addiction. This group experienced significant psychological failures before the onset of their deterioration. Another 25% were adequately defined as paraphilic. Half of the sample was not adequately described using addiction, compulsivity, impulsivity, and relationship incapacity models. The authors discuss the implications of these findings for DSM-5 and treatment.
This article reviews the current evidence base for the diagnosis, assessment, and treatment of hypersexual conditions. Controversy concerning this diagnosis is discussed. Terminology and diagnostic criteria, as well as psychological, psychopharmacological, and other treatment approaches, are presented.
Hypersexual Disorder is proposed as a new psychiatric disorder for consideration in the Sexual Disorders section for DSM-V. Historical precedents describing hypersexual behaviors as well as the antecedent representations and proposals for inclusion of such a condition in the previous DSM manuals are reviewed. Epidemiological as well as clinical evidence is presented suggesting that non-paraphilic "excesses" of sexual behavior (i.e., hypersexual behaviors and disorders) can be accompanied by both clinically significant personal distress and social and medical morbidity. The research literature describing comorbid Axis I and Axis II psychiatric disorders and a purported relationship between Axis I disorders and Hypersexual Disorder is discussed. Based on an extensive review of the literature, Hypersexual Disorder is conceptualized as primarily a nonparaphilic sexual desire disorder with an impulsivity component. Specific polythetic diagnostic criteria, as well as behavioral specifiers, are proposed, intended to integrate empirically based contributions from various putative pathophysiological perspectives, including dysregulation of sexual arousal and desire, sexual impulsivity, sexual addiction, and sexual compulsivity.
Sexual addiction has received increasing attention in the past decade. We review existing literature on (a) competing conceptualizations of this syndrome as constituting an addictive, obsessive-compulsive, or impulse control disorder; (b) symptomatology and progression; (c) etiological models; and (d) treatment approaches. Based on this review, we conclude by identifying questions requiring resolution via empirical investigation.
The study compared the effect of couples-based versus individual-based therapy for men who entered outpatient substance abuse treatment on the psychosocial functioning of children in their homes. Men were randomly assigned to (a) behavioral couples therapy (BCT), (b) individual-based treatment (IBT), or (c) couples-based psychoeducational attention control treatment (PACT). For both children of alcohol--(N = 71) and drug-abusing men (N = 64), parents' ratings of children's psychosocial functioning was higher for children whose fathers participated in BCT at posttreatment and at 6- and 12-month follow-up than for children whose fathers participated in IBT or PACT. BCT resulted in greater improvements in parents' dyadic adjustment and fathers' substance use. Thus, couples-based intervention that addresses both issues may have greater benefits for children in these homes.
The goal of this study was to use task analysis to verify that the attachment injury resolution model described in this article discriminates resolved from nonresolved couples. Twenty-four couples with an attachment injury received, on average, 13 sessions of emotionally focused therapy (EFT). At the end of treatment, 15 of the 24 couples were identified as resolved. Segments of best sessions for all couples were transcribed and rated on 2 process measures. Resolved couples were found to be significantly more affiliative and achieved deeper levels of experiencing than nonresolved couples. They also showed significant improvements in dyadic satisfaction and forgiveness than nonresolved couples. The results support the attachment injury resolution model and suggest that resolution during EFT is beneficial to couples.
Compulsive sexual behavior (CSB) is a condition characterized by loss of control over sexual behavior and repeated negative consequences, including unsafe sex. Selective serotonin reuptake inhibitors have been found to reduce CSB symptomatology in open-label trials. The objective of this study was to conduct a preliminary double-blind, placebo-controlled evaluation of the efficacy, acceptability, and tolerability of citalopram in the treatment of CSB.
Twenty-eight men who have sex with men who met the threshold for CSB on the basis of existing validated measures participated in a 12-week, double-blind trial of citalopram 20 to 60 mg/day to evaluate its effects on CSB symptoms. The primary efficacy measure was the Yale-Brown Obsessive Compulsive Scale-Compulsive Sexual Behavior. The study was conducted from June 2002 to April 2004.
Significant treatment effects were obtained for sexual desire/drive (p < .05) and frequency of masturbation (p < .01) and pornography use (p < .05). Both groups reduced sexual risk, but did not differ significantly.
This study provides partial support for the effectiveness of citalopram for reducing symptoms of CSB in this population. Larger-scale trials are recommended to determine the public health benefits of this treatment.
The investigators proposed that transgression-related interpersonal motivations result from 3 psychological parameters: forbearance (abstinence from avoidance and revenge motivations, and maintenance of benevolence), trend forgiveness (reductions in avoidance and revenge, and increases in benevolence), and temporary forgiveness (transient reductions in avoidance and revenge, and transient increases in benevolence). In 2 studies, the investigators examined this 3-parameter model. Initial ratings of transgression severity and empathy were directly related to forbearance but not trend forgiveness. Initial responsibility attributions were inversely related to forbearance but directly related to trend forgiveness. When people experienced high empathy and low responsibility attributions, they also tended to experience temporary forgiveness. The distinctiveness of each of these 3 parameters underscores the importance of studying forgiveness temporally.
Impulsive-compulsive sexual behavior is a little studied clinical phenomenon which affects similar to 5% to 6% of the population. In the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition-Text Revision, it is classified as an impulse control disorder not otherwise specified or a sexual disorder not otherwise specified. It may be placed in a possible new category in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition called substance and behavioral addictions. This clinical entity is reviewed and the merit of classifying it as an addiction is assessed. Information is presented regarding its diagnostic criteria, epidemiology, types of behavior it can involve, relationship to hypersexuality, comorbidities, treatment, and etiology. The data regarding this disorder and its overlap with chemical addiction is limited. If the two disorders are to be grouped together, further data are needed.
This book is a revision and updating of the 1996 book titled Emotionally Focused Marital Theory. It is intended to serve as the basic therapeutic manual for Emotionally Focused Couple Therapy (EFT). As in the first edition, there is also one chapter on Emotionally Focused Family Therapy (EFFT).
Disorders characterized by impulsivity include disorders of impulse control (intermittent explosive disorder, pyromania, kleptomania, pathological gambling and trichotillomania), paraphilias, sexual impulsions and sexual addictions and impulsive aggression personality disorders (borderline, antisocial, histrionic and narcissistic personality disorders). Impulsivity has a substantial impact on both individuals and society. Impulse control, disorders may be conceptualized as a subset of the obsessive-compulsive spectrum. In this article, we examine the genetic and neurobiological aetiology of these disorders and possible treatment options. The link between serotonergic dysfunction and the pathophysiology of impulsivity is discussed, and studies that examine the efficacy of various selective serotonin reuptake inhibitors and other alternatives in the treatment of impulsive disorders such as pathological gambling, sexual addictions and borderline personality disorder are presented.
Sexual addiction is an intimacy disorder that is rooted in impaired early attachment experiences. This impaired bonding causes the developing self to be shrouded in shame. Primary needs and desires become contemptuous to the individual. Affect regulation also is damaged because of negative bonding experiences. This further impairs the capacity to master feelings and successfully guide the process of need fulfillment. Sexual addiction is a compulsive cycle that attempts to compensate, soothe, and regulate the internal struggle. The cycle, in turn, creates more shame and dysregulation of affect. Strategies to reduce shame, regulate affect, and create sexual boundaries necessary for successful treatment of sexual addiction are outlined.
Disclosure as a process of both recovery and healing within committed relationships is advocated by couple and addiction therapists. The traumatic impact for partners of an initial disclosure or discovery of betrayals has been well documented, but less is known about the impact of disclosure for sex addicts. The present study explored the experience of relapse and disclosure among sex addicts. Relapse was a common experience among sex addicts, and the disclosure of relapse had a range of consequences for the addict and the relationship. Voluntary disclosure of relapse (rather than the partner discovering relapses independently) was associated with positive relational outcomes.
This study seeks to understand differences in the interpersonal dynamics of couples living in alcohol-complicated and alcohol-free marital relationships in India. An ex-post facto cross-sectional design was used to compare 150 wives of alcoholics with an equal number of wives of nonalcoholics, who were administered standardized instruments to assess marital adjustment and family interaction pattern. Analyses show that wives of alcoholics have lower levels of marital adjustment and a poorer family interaction pattern across various domains, in consonance with the Western literature on these issues. Covariates analyzed included four variables such as type of family, type of marriage, consanguinity, and wife's occupational status. Implications for de-addiction programs in India are discussed and the need for couple/family-based therapy is emphasised.
Pornography increasingly affects couples’ relationships commensurately with the increasing availability of pornographic material. Relationships can be adversely affected by the addictive influences of pornography, and therefore therapists are likely to encounter this concern with their clients. It is suggested that addiction to pornography can be characterized by withdrawal and tolerance, and can have neurological impacts and negatively influence relationships. However, clinicians sometimes fail to recognize pornography addiction to be equally as troublesome as other addictions. This paper explores the implementation of successful structural therapy treatment of pornography addiction using an actual case study with a married couple.
Bartholomew's (1990) four-category typology of adult attachment styles was compared with Hazan & Shaver's (1987) three-category typology in terms of three substantive issues. First, the same two dimensions were found to underlie both typologies, and the Bartholomew and Hazan & Shaver measures corresponded as predicted. Second, there were no gender differences on Hazan & Shaver's measure, in line with previous studies, but there were gender differences on Bartholomew's measure, especially in her two avoidant categories. More males than females were dismissing avoidants; more females than males were fearful avoidants. Third, a hypothesis advanced by Latty-Mann & Davis (1988) was confirmed. Adult children of alcoholics scored high on both avoidant and anxious-ambivalent scales of Hazan & Shaver's measure, and fell predominantly into Bartholomew's fearful-avoidant category, suggesting that at least some fearful adults are grown-up versions of the `disorganized, disoriented' children identified by Crittenden (1988) and by Main & Solomon (1990). These children are more common in families troubled by parental alcoholism, depression or abuse.
The traditional approach to substance-abuse treatment involves the disease model, as promulgated through Alcoholics Anonymous. In this model, the message for relatives and friends of substance users is that their behavior cannot influence the user to either enter treatment or to reduce their substance use. The main emphasis instead is on helping relatives concentrate on their own lives and cultivating a sense of detachment from the drinker. However, a beginning empirical literature has developed on treatment with the relatives of substance users, which indicates that the relative may be able to affect the behavior of the substance user, although the effect of such treatment on the relative may be less consistent. This article will discuss findings of studies, which are organized according to whether relatives are treated alone or in a marital therapy context. Suggestions for further research in this area and implications for social work are discussed.
This study evaluated processes of conjoint therapy for married couples recovering from husbands' addictive use of pornography. We hypothesized that through conjoint couple therapy clinicians are able to help organize the relationship to sponsor recovery while also promoting essential relationship and individual healing for both spouses. Results demonstrated an increase in (a) marital trust and confidence in the future, (b) mutual softening, (c) the ability to discern key points of intervention sponsoring and supporting recovery, and (d) client-perceived marital enhancement. Conjoint marital therapy is recommended as a useful component in treating compulsive pornography consumption.
Sex addiction is elusive and often undetected in couples' therapy. Although not as obvious as other addictions, its effects can be just as damaging. The meaning of sex addiction and its implications for couples therapy are explored. Specifically, the etiology is broken down into several different aspects: intergenerational factors, cultural distortions, and sex addiction and the couple. Assessment of sex addition is disclosed along with the signs of sex addiction. Eleven general categories are listed as well as the treatment options and different stages of addiction. Case histories are given to illustrate the impact of sex addiction on the couple subsystem. Research and future develops are also discussed along with its limitations.
This phenomenological study aimed at understanding the experiences of women living with intimate partners with substance abuse
problems. Findings show that the five participants’ family-of-origin experiences centrally influenced their degree of awareness
of their responses to their intimate partners’ addictive behaviors. Experiences leading to dawning of awareness include an
escalating toll on self, critical life events, and the catalytic effect of outsiders’ perspective and support. The discovery
of self and care for one’s own well-being precipitated changes in spouse and family relationships. Implications of these findings
for clinical practice and recovery are suggested.
There have been several diagnostic labels for persistent, excessive sexual behaviors, often referred in the popular media as sex addiction. Two related diagnoses, Internet addictive disorder and hypersexual disorder, will appear in the appendix of the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders.However, most clinicians, even those trained in sexual disorders or addiction medicine, have little to no training in treating sexual compulsivity and cybersex addiction. The authors present the historical context, proposed diagnostic criteria, evaluation protocols, comorbid disorders, speculations about the neuroscience, and treatment recommendations.
The present study examines differences in cybersex behavior related to gender and sexual orientation. Data were from 4,492 individuals being treated for sexual addiction, including 3,561 heterosexual men, 164 homosexual men, 131 bisexual men, 429 heterosexual women,18 homosexual women, and 61 bisexual women. Measures included the Sexual Dependency Inventor –Revised (SDI-R; Carnes & Delmonico, 1996) and the Sexual Addiction Screening Test-Revised (SAST-R; Carnes, Green & Carnes, 2010). Similarities and differences across genders and sexual orientations are reported. Multiple regression results demonstrated a general pattern in which isolative sex behaviors predicted more Internet use and relational sex behaviors predicted less use.
When at least one member of a couple is sexually addicted, restoring trust and building intimacy can be very difficult. These couples must work as hard on their recovery together as a couple as they do on their individual recoveries. A number of key characteristics of these relationships can be understood and allowed to inform the work that needs to proceed. Relationships develop very much as individuals do. Margaret Mahler's developmental model is helpful in understanding this process for couples. The 12 steps can be applied to couple recovery in order to facilitate the work of intimacy and trust building.
This study surveyed 248 counselors, members the American Mental Health Counselors Association (AMHCA) or International Association for Addictions and Offender Counselors (IAAOC), divisions of the American Counseling Association, regarding their perceptions of the nature and treatment of sexual addiction/com-pulsivity. Findings indicated that counselors perceived sexual addiction as an obsessional illness, characterized by out-of-control sexual behavior. A combination of individual and group therapy was most often suggested. Strategies most often recommended for treatment of sexual addiction included cognitive restructuring, defining behavioral boundaries, empathy, positive self-talk, and recognizing and avoiding high-risk situations.
Results of a survey of 142 married sex addicts and coaddicts suggest that for couples in crisis because of multiple affairs, use of pornography and masturbation in preference to relational sex, visits to prostitutes, arrests for voyeurism or exibitionism, or other compulsive sexual behaviors, survival of the relationship can be enhanced when both members identify themselves as “addict” and “coaddict,” attend individual and joint 12-step meetings and counseling, seek feedback from other couples, and commit to ongoing work on individual problems and on the relationship.
Defines sexual addiction as a disorder of intimacy in which the individual has difficulty consistently combining sexuality and closeness with a desired partner. Sexual addiction is a destructive means of coping with stress as a result of self-hatred, guilt, and passive rage. Treatment is difficult and must be progressive beginning with an end to the deviant behavior, followed by admission, group therapy, and perhaps weekly psychotherapy. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Argues that emotion is not a
within phenomena that falls outside the bounds of systems theory. It is a leading element in the system that organizes interactions between intimates. To leave emotion unaddressed is to miss a crucial part of the context of close relationships. Emotional expression is the main route by which partners and family members define their relationships and influence each other's behavior. It is the music of the attachment dance. The fastest and most direct to create change in relationships may be to change this music and actively evoke the emotions that elicit caring, compassion and contact. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Compulsive sexual behavior (CSB) is characterized by excessive or poorly controlled sexual thoughts, urges, or behaviors, and was first described over 100 years ago. Although there is little consensus about definition or classification, CSB is generally thought to involve both paraphilic (e.g., pedophilia, voyeurism) and nonparaphilic (e.g., compulsive masturbation) forms. CSB has been estimated to affect as much as 5% of the United States population; 80%-90% of those with CSB are male. Onset occurs in the late teens or early twenties, and the disorder is generally chronic or episodic. Psychiatric comorbidity is common, particularly substance use and mood, anxiety, and personality disorders. Developmental, behavioral, neurobiologic, and sociocultural mechanisms probably play a role in the etiology of CSB and its expression. Treatment has not been well delineated, but individual psychotherapy, behavioral therapy, and 12-step programs may be helpful. Serotonin reuptake inhibitors may help some patients regulate their sexual impulses, while anti-androgens may be helpful in sexually aggressive forms of CSB.
(C) Williams & Wilkins 1998. All Rights Reserved.
Among the various types of partner- and family-involved interventions used to treat adults with substance use disorders, Behavioural Couples Therapy (BCT) has garnered the strongest empirical support for its efficacy. During the past thirty years, multiple studies have consistently found married or cohabiting substance-abusing patients who engage in BCT, compared to traditional individual-based counselling or partner-involved attention control treatments, report significantly greater (1) reductions in substance use, (2) levels of relationship satisfaction, and (3) greater improvements in other areas of relationship and family adjustment (e.g. reductions in partner violence, improvements in custodial children's adjustment). In addition to discussing the theoretical rationale for BCT as a treatment of substance abuse, this article describes specific therapeutic techniques used as part of this intervention and summarizes the relevant evaluative empirical literature.
This article identifies and operationalizes the newly defined construct of attachment injury. An attachment injury occurs when one partner violates the expectation that the other will offer comfort and caring in times of danger or distress. This incident becomes therapy. An attachment injury is characterized by an abandonment or by a betrayal of trust during a critical moment of need. The injurious incident defines the relationship as insecure and maintains relationship distress because it is continually used as a standard for the dependability of the offending partner. The concept of an attachment injury is defined here in the context of emotionally focused therapy, an empirically validated, short-term approach to modifying distress in couples. The broad theoretical underpinnings of this concept may be found in attachment theory as applied to adult romantic relationships. Through the delineation of attachment injury events and the ongoing development of a detailed model of resolution, couples therapists will be better able to identify, describe, and effectively treat such injuries and address the therapeutic impasses that are associated with them.
This article has been retracted: please see Elsevier Policy on Article Withdrawal (https://www.elsevier.com/about/our-business/policies/article-withdrawal).
This article has been retracted at the request of the Editor-in-Chief. Following the retraction of Dr. Safarinejad's work by other journals, The Journal of Sexual Medicine has undertaken an extensive re-review of all papers Dr. Safarinejad published with the journal. Following an intensive re-evaluation and close scrutiny of the manuscripts, our expert reviewers raised multiple concerning questions about the methodology, results, and statistical interpretation as presented in this article. Dr. Safarinejad was contacted to provide his original data and offer explanations to address the concerns expressed by the reviewers. Dr Safarinejad chose not to respond. Consequently, we can no longer verify the results or methods as presented and therefore retract the article.
Intensive interviews with women married to alcoholics reveal a taken-for-granted use of the term "codependent" to describe the spouses of alcoholics, despite considerable definitional ambiguity as to what codependency is. Although most of the wives agreed that codependency involves caretaking behavior and exists by virtue of their association with an alcoholic, they disagreed widely as to its impact on the self, its locus as personal or social, its disease status, its longevity, and whether or not it is distinctive to alcohol-complicated marriages. Self-labeling and identification occur through retrospective reinterpretation of their lives with their alcoholic husbands, guided and legitimated by rehabilitation personnel. These reconstructions then serve as self-evidence of codependency. In challenging the notion of codependency as an objective condition, we emphasize the social construction and application of this condition, and, in doing so, suggest that there has been a two-fold process of deviantizing the women's identities and medicalizing this new-found deviance. While this situation perpetuates a traditional view of women as more passive than active, a more serious possibility is its affinity to a historical view of wives of alcoholics as pathological.
Sexual compulsivity is defined as a lack of control over one's sexual behavior. Data were collected on 30 gay and bisexual men in New York City who defined themselves as sexually compulsive and who sought treatment for the problem, in order to determine: 1) whether they differed in psychological profile and sexual behavior from a matched control group of men seeking general psychotherapy; and 2) what the effect is of group psychotherapy for sexual compulsivity on the sexual behavior of group participants. It was found that men who are sexually compulsive differ from controls primarily in terms of the frequency and type of their sexual behavior. They do not display more neurotic symptoms. Further, it was found that group psychotherapy helps participants reduce the frequency of their sexual encounters with different partners. An objective measure of the sense of control one has over his/her sexual behavior is needed for further research on this subject.
Although results from multiple studies conducted over the last two decades indicate that Behavioral Couples Therapy (BCT) is an effective treatment for married or cohabiting alcohol- and drug-abusing patients, both in terms of reduced substance use and improved relationship satisfaction, it is unclear whether BCT or other types of couples-based interventions are used in community-based substance abuse treatment programs. In the present study, program administrators (e.g., executive directors, clinical directors, staff physicians) from 398 randomly selected community-based outpatient substance abuse treatment programs in the U.S. were interviewed regarding use of different family- and couples-based therapies in their programs. According to the program administrators, 27% of the programs provided some type of couples-based treatment. However, less than 5% of the agencies used behaviorally oriented couples therapy and none used BCT specifically. Recommendations for researchers and clinicians to increase the use of BCT in community-based treatment programs are provided.
The present study examined general and romantic attachment and parenting students received in their families of origin among 401 college students who resided with an alcohol-abusing parent prior to age 16 years as compared to those who did not reside with alcohol-abusing parents. Participants completed the Children's Report of Parent Behavior Instrument [Schludermann, E. and Schludermann, S. (1970). Children's Report of Parent Behavior Inventory (CRPBI). Canada: University of Manitoba], Experiences in Close Relationships--Revised [Fraley, R. C., Waller, N. G., and Brennan, K. G. (2000). An item response theory analysis of self-report measures of adult attachment. Journal of Personality and Social Psychology, 78, 350-365], Relationship Scale Questionnaire [Griffin, D. W. and Bartholomew, K. (1994). Models of the self and other: Fundamental dimensions underlying measures of adult attachment. Journal of Personality and Social Psychology, 67, 430-445], and the Children of Alcoholics Screening Test [Jones, J. W. (1983). The Children of Alcoholics Screening Test: Test manual. Chicago: Camelot]. Young adults who met criteria for ACOAs reported more anxious and avoidant behavior in romantic relationships and a more fearful style of general adult attachment. Parenting behavior in one's family of origin predicted anxious behavior in romantic relationships and a fearful overall style of attachment, whereas being an ACOA and parenting in one's family of origin predicted avoidant behavior in romantic relationships.