Sex Addiction: What You Need to Know

Rick Isenberg, M.D. and Medical Director for Psychological Counseling Services, discusses sex addiction and what we need to know in this Triune Therapy audio interview.

[su_button url=”” target=”blank” style=”flat” background=”#003a54″ size=”7″ wide=”yes”]LISTEN TO THE INTERVIEW HERE[/su_button]

More on Rick Isenberg, MD HERE.

Scoreboard Champions Vs. Heart Champions


Scoreboard Champions vs. Heart Champions


“Phony plays for a while but genuine plays for a lifetime”
Ed Wade- former Phillies GM


It was a spring Friday in late April, 2001. It was a day I don’t think I will ever forget! My son Jimmy was a senior and playing his last home game against rival Seton Catholic. They played Seton a few weeks before and Seton got the best of it, winning 3 to 1. Jimmy was the losing pitcher.

I remember telling Jimmy during his last week of practice to take time to take it all in and to appreciate the grind that he had put himself through to get to this point in his high school baseball life. There were a lot of guys who had a lot more talent than he did. He wasn’t the fastest runner, strongest hitter, nor could he throw the ball harder than anyone else.

He was what I call a grinder. A grinder is someone who is not that great in talent but is willing to do the extra work. Jimmy would work relentlessly toward improving his game. He did most of his work on this home field and in the batting cage I had built in our backyard. When he wasn’t pitching, he played first base.

I hit him thousands of grounders at first base. Once we counted after his playing career was over. The count totaled over a quarter of million from age 10 through his senior year. I had bought and accumulated 500 baseballs and we would go out every day in the heat of the summer or the cold of winter and each time I would hit all 500 at him. We did it almost every day. I remember working late—until 8:30pm or 9pm. I would come home, get the baskets of baseballs, head for the field and hit grounders under the lights. There were dings and bruises from balls that took bad hops. Jimmy never backed off and as long as he didn’t, I kept hitting them. Jimmy told me that it was hardest when he would take one off his shins because of a bad hop on a cold day in Arizona when the winter temperature would hover in the high 30’s. There were other times when it was so hot that he nearly would faint under the Arizona sun. We would store the balls in those plastic U.S. Mail contaiNers. Sometimes, I would take a couple of baskets of balls to second base and with a fungo bat would hit the balls on one hop to first. He would practice “picking” one hop balls. He got to be really good at it. He would constantly work on his footwork at first base. I would try to hit fly balls and get them as high as I could hit them with a fungo. Problem was I wasn’t good at it and he would get pissed at me. Somewhere I found this square tennis racquet type mechanism with really strong and tough strings. It was designed to hit fly balls. So I would use it and Jimmy would practice going from first base to running into the outfield foul territory catching the ball with his back to the infield. We did this countless times. He got pretty good.

Today, Jimmy would say that he was over the top in his work ethic about baseball. Between the years of 10 and 21- Jimmy was always on a baseball team and would work between 4 and 7 hours a day on baseball except for 2 weeks around Christmas. He would begin each team as an average middle of the pack player but worked his way to the front of the pack and at times was considered his team’s most valuable player. His work ethic was relentless.

So on this day, I reminisced about all the practice times we had on this field. Just him and me. Though there was a lot of grit and grind, it was a lot of fun.

Since Jim had pitched the game before, he was playing first base. High school games are 7 innings. At top of the 7th, Seton Catholic had the bases loaded with no one out and a 5-3 lead. Jim came into the game as a reliever and struck out the sides. Then at the bottom of the inning, he hit a walk off grand slam home run to win the game and experience a regional championship. I stood back away from all the hoopla. What I will never forget is when he rounded third base, he knew where I was standing and looked for me and made eye contact. That was my special moment with Jim. The rest of the celebration was about him, his team and the feeling of being a champion at last. They went on and won the state championship that year.

Since that experience of being a champion, Jimmy has had many other experiences of being hero and a champion on the field. He also has had more than his share of moments of being the heel. I have been forced to consider the difference between being a scoreboard champion and a champion from the heart.

There seems to be an obsession with being #1 in the endeavor of sports. During college football games, it is common to see cameras pan the crowd and students flash the “we’re #1 sign” even when their team is being annihilated on the field. It becomes so important to identify with the champion on the scoreboard. So much is made up about the heroes on the scoreboard. If he/she is champion there then it is expected that those individuals will be champion elsewhere. But, often the disparity of performance away from the sport is great.

In my work to treat addiction, I find this disparity in performance as well. There are those whose performance is stellar and outstanding on the scoreboard of their professional life. Yet, the disparity of behavior away from their performance at work sabotages their life with out of control addiction.

Scoreboard champions know about winning and losing. There is conditioning and training about performance focus and how to rebound from disappointment and defeat. There is so much preparation that goes into becoming a scoreboard champion.

For many winning and losing becomes a life or death struggle. No matter what it takes it is important to stretch and strive and somehow win. Frequently, athletes adopt a hate mentality toward their opponent, in order to propel them to greater accomplishment on the field of endeavor. Unbelievable stories are told about players who compete with broken bones, damaged bodies and mangled mental conditions. These athletes are lionized with emphasis that to be a real champion you have to compete that way. The inference suggests that real champions ignore human limitations. That’s what makes them champions. Drivenness becomes unparalleled. There is no boundary to what a champion is willing to do to be number one.

I have heard stories about golfers who work on their game as much as 15-20hrs a day! There are stories of runners who run through the pain of a broken bone in their foot. Scott Jurek, in his book Eat and Run, reported during one ultra marathon race through Death Valley at one point after becoming so sick from running that he was uncontrollably throwing up. He had his support team place him inside a coffin of ice prepared for him on the roadside! Then, he revived himself and completed and won the ultra marathon race! These are the examples of extreme lore that defines a scoreboard champion. Corporations across America revel in the legend of leaders who tote the folklore of grit and grind and doing whatever it takes to be a champion in their field of endeavor.

In truth, scoreboard champions learn to depend on this kind of adrenaline to perform. It’s no wonder the line gets blurred around performance enhancement drugs when champions are so monomaniacal about winning and avoiding losing. It becomes their identity. As a result, life becomes imbalanced. Other aspects of life are neglected. Relationship skills, spirituality, community values and sensitivity to anything other than personal ambition often suffer.

Of course, it is not only true of champions of sport. This frenzied feeding of need to be a scoreboard champion is fraught through our society. The stories are replete of personal careers, families, major corporations and entire nations all destroyed by excessive greed driven by obsessed ambition to be number one.

Addiction is positioned as a centerpiece in this dynamic. Addicts become like little kids who cannot get enough sugar. You never get enough of what you really don’t want. Eventually, in a downward death spiral, addiction gets lost in the illusional pursuit of one more hit, one more time that never ends.

In the beginning you just want success, however, it is defined. But in the end, the scoreboard mentality overwhelms and rather than you chasing the brass ring, the tables are turned and it begins to chase you through addiction. Like a pack of wolves chasing someone through the woods and keeps nipping at the heels, the addict keeps trying to reach for that hit one more time, while trying to keep the pack of wolves at bay. The focus becomes “I’m so close—yet so far away”. “I want to climb the hill just one more time”. It’s never sustainable. Even for those who become scoreboard champions. It only lasts but for a brief fleeting moment. As a therapist, many who come to see me are left with the wreck and ruin of addictive devastation.

Recovery weaves a different fabric that looks beyond winning and losing. Recovery focuses on the cultivation of becoming a heart champion. Heart champions are a different breed! They are spawned from a different ilk. There is so much more than the score at the end of the game. Self definition comes from a deeper source. It’s about the preparation, the sacrifice, the sweat and engagement of uncertainty. Whether you win or lose on the scoreboard, a champion’s life is determined within before the game is ever played and independent of the score on the board at the end of the game. It has to do with connecting in congruency with values of the heart that supersede wins and losses on the scoreboard. A heart champion is more concerned about being true to one’s heart and not just winning or losing in life.

It’s not like heart champions condition themselves to lose. Rather, it’s like they are carved from a deeper place down deep inside. A heart champion knows that losing is a part of the ebb and flow of life. She determines to never let an outcome define who she is. Instead, definition is determined by the vision of destiny from within which supersedes any result. What is a priority is knowing that she is connected to herself, embracing all of herself-the good, bad and the ugly. She understands that life is a tapestry weaving together the bitter and the sweet, success and failure, triumph and tragedy. Positive results are fine and desired, but foundationally, a heart champion already has determined that they are “an unrepeatable miracle of the universe” and that no victory will add to it and no defeat will take away from it. it is already etched in the stone of destiny.
Cultivating this concept in recovery demands that we face our addictive failures and our mistakes. It demands that we go into training that teaches us how to manage our shame around our losses and mistaken destructive behaviors.

Heart champions live to connect to the present moment of struggle that comes with a commitment to improve and excel. They learn to cooperate rather than remain focused on competing with their teammates. For them competition is only a training ground for the greater cooperative effort to create a better community, whether that community be a team, a family, a neighborhood or a nation. Heart champions are required for all those who seek healing from an addiction. Addiction breaks the heart and the will of those who suffer. The only path for those who heal is one that requires cooperation within a community who shares equal brokenness and who demand accountability toward change in behavior. This dynamic always creates a heart champion.

Heart champions are able to appreciate all aspects and those who are related to the game. They develop a great appreciation for all team members, not just the star performers. While it is true that you don’t win on the scoreboard without basically talented players, it is also true that you will never be a heart champion without recognizing the value of a bench player mentality.

A bench player mentality is developed when you recognize that those who sit on the bench and do not play carry a very important energy to the enlargement of community. I like to refer to the aggregate collection of people as a community. So, for me, a baseball team is a baseball community.

Kids on the bench make an important addition or subtraction to a baseball community. If a player sulks or allows himself to get distracted from the game, which is easy to do, when you know you’re not going to play, he will drain energy from the focus needed for those who are trying to excel on the field.

But, it goes the other way, too. If guys who are on the field are dismissive of those who don’t play and cop a condescending attitude toward bench players that too will severely damage the results on the field. I have seen this happen many times.
Heart champions embrace the value of all the roles in a baseball community and learn to participate in all the roles. When they are benched, they become cheerleaders for those who play. Whether playing or not, they help gather the equipment before and after the game. They join in preparing the field and picking up the trash. For heart champions, these tasks are as important as playing the game itself.

It’s been my observation, that a “bench player mentality” is necessary for addiction recovery. To translate from what has been described about baseball, recovery requires an addict to do what is needed when others are not looking or even aware. Its one thing to show up at a meeting and engage and say what is expected. Yet, another to follow through in private moments of mundane living, doing what needs to be done to remain sober. Working the 12 steps, calling community members for support and shifting from an attitude of entitlement to one of humility are the common stuff of long term sobriety. These ordinary, every day steps will only occur when an addict shifts from the limelight of wanting to be center stage to the “bench player mentality” of taking up less space so that others in relationship can take up more. Addicts who learn the principles of this life style change are more likely to establish long term sobriety.

Recovery demands heart champions. For the most part, scoreboard champions flame out and addicts relapse into their addiction. In recovery from addiction, one with a scoreboard mentality become more concerned with the number of days of sobriety versus the depth of honesty and integrity going on presently in their life. An addict in recovery with a heart champion mentality is more concerned with being the best client for recovery versus egotistically wanting the touted best therapist. They are more concerned with learning how to be their own guru rather than finding a sponsor who will be their ultimate master guide.

There is nothing wrong with being a scoreboard champion in any sport. But, if one strives and achieves becoming a champion on the scoreboard but fails to incorporate the components of being a heart champion, the game of achievement and endeavor has misled the player and the community at large becomes shortchanged. Phony gets accelerated and genuine is minimized in deference to being #1 no matter what.


Article by Ken Wells, LPC

Rule Breakers


Rule Breakers



“Learn and obey the rules very well, so you will know how to break them properly—“  The Dalai Lama


Danny Almonte was the talk of the Bronx during the summer of 2001. With his high leg kick and a fastball that reached a top speed of 76 MPH (the equivalent for that distance of a 103 MPH major league fastball), Danny became a summer sensation.  His imposing frame won him the nickname of “Little Unit”- a reference to Randy “Big Unit” Johnson. He pitched a perfect game in the World Series, the first since 1979. He led his team to a 3rd place finish in the Little League World Series. His team was referred  as the “Baby Bombers”because they played in the shadows of Yankee Stadium. They quickly became the feel good story of the 2001 Little League World Series. During a Yankees game after the Series they were honored by Mayor Rudy Giuliani with the key to the city.

However, rumors about Almonte’s age swirled during the World Series and were quickly confirmed that he was 2 years too old to legally play Little League. It was soon learned that his father Felipe had falsified his records so that he could play. ESPN called Felipe Almonte “the worst stereotype of the Little League parent sprung to life”

Parents want to mean so well yet contribute to problematic dilemmas for their kids around sports. Rule breaking is an age old practice that most often originates with mom and dad in so many subtle and overt ways. Parents want their kid to shine so bright on the field. They will do almost anything to get their child in the spotlight.

During my boyhood days of Little League, I never witnessed a fight between players while playing the game. However, I did watch three different fights between parents and my coach. Coach Bernie Nale was fair to the players and stubborn and cantankerous with parents who did not like how he played their kid. During the three times it got intense between coach and parent, Bernie called each dad out for a fight. Parents and coaches can be idiots when they lose their perspective about the game. It’s from this viewpoint that Little League baseball can lose its focus and purpose in a kid’s life.

I’ve watched a lot of parents attempt to fulfill their unlived lives through their children. One dad would try to give last minute hitting advice every time his kid was in the on deck circle. His son was a senior in high school when this happened. Other parents have gotten into a major argument with the coach for playing their kid in the wrong position. It was argued that the coach was screwing up their son’s opportunity for a college scholarship. The boy was 10 years old, playing Little League.

I have been guilty in my own way. In that I was given very little support toward any direction as a kid, I vowed that I would always be there to support my kids no matter what. I sacrificed to provide a batting cage with lights in the backyard and the best fitness training, hitting/pitching mentors that I could find. My boys knew that we did not have a lot of money. The message they got in strong non verbal language was “be a good baseball player”. I emphasized that they be the best at whatever they chose to do. But the underlying theme was loud and clear about baseball. It was out of balance and an unfair emphasis. I have learned that messages like this contribute to a kid’s distorted view about life and what is really priority. Parents who try to live out their dreams through their kids cultivate a rule breaking mentality by overemphasizing the need to succeed through their self sacrifice and promoting the sport and the kid to take up way too much space. When mom and dad sacrifice disproportionately so the kid can succeed it fuels and entitled mentality. The link to rule breaking is short and occurs frequently. It is birthed from a conditioned mentality that expresses “I want what I want when I want it”

Most addicts I treat come to therapy with holes in their soul created by unmet developmental needs that were designed to be met by their parents. Those needs were not to be a good baseball player or particularly good at anything. The need was to know that they mattered to their parents. Providing food, shelter, clothing, education and tools to be a good baseball player or anything else might say they are loved but not necessarily that a kid matters. Parents have a hard time equating and understanding this. Kids need their parents to crawl inside their head and just understand them—know what makes them tick inside. The psychological term is called attunement. Essentially, they need a mom and dad to participate with them on their terms, their agenda in sufficient amounts of time. It is crucial to understand a child’s agenda of importance without superimposing yours. Kids need ongoing information from their parents about how to cope with friends, cliques, bullies, romance, sex, failure and success and a hundred other situations. They need mom and dad to role model how to fight fair and address an array of situations that involve conflict. When it does not happen it is traumatic to every kid.

Developmentally, when these needs are not met, kids become like Swiss cheese with holes in it. They try to fill up the holes by finding out what is important to mom and dad and accomplishing that. This occurs subconsciously. It could be showing off when they are little, being “the princess” or “little man” of the house, being successful in school, being obedient to a fault or being successful in Little League baseball. What subtely happens is the kid becomes a “doing” and learns to forsake simply “being”. It can become grotesque like an emphasis on year around sports just to keep up with whoever is getting better. Kids learn that they can never do or be enough. Naturally, most kids burn out which means they can’t get enough from outside accomplishment to fill up the inside hole. In the long run it’s a setup for addiction and a sad saga that uproots the beauty of each child’s destiny.  It’s a setup for dysfunctional behavior and many times contributes to addiction. From this dynamic people get locked into a conundrum of never getting enough of what they really don’t want. They become like a little kid who cannot get enough sugar. Usually, a person will develop a cocktail of experience which often include addictive behavior in an attempt to fill the hole.

This never ending thirst for more gives birth to grandiosity and sets the foundation for rule breaking which is an ultimate downfall to those who suffer from addiction. There is a story told about this subtle snag of grandiosity in the book The Spirituality of Imperfection written by Ernest Kurtz and Katherine Ketchum. The story goes that a past president of Hazelden Foundation, a leading treatment resource for alcohol and drug addiction, was approached by a young researcher asking “Why is it that even intelligent alcoholics can get so trapped in denial of their alcoholism? Is it because of grandiosity—they think that they can do anything to their bodies and survive, they think that they are ‘too smart’ to be alcoholic? Or is it because of self-loathing—they despise themselves and feel they deserve to die, if they are alcoholics? The past president sighed and replied- “The alcoholic’s problem is not that he thinks he is very special. Nor is the alcoholic’s problem that he thinks he is a worm. The alcoholic’s problem is that he is convinced “I am a very special worm!”

Parents can fuel this mentality through Little League sports. Unfulfilled dreams can become grandiose expectations for children, particularly when the child demonstrates special talent to throw or hit a baseball or whatever. Parents conclude that their child deserves special consideration in family or at school because of their talent. When the parent concludes that their child is being treated unfair by not getting to play enough or not allowed to play a certain position, then mom or dad raises hell with the coach. A threat is made. “Either my son will play a certain amount or a certain position or we will pull him off the team and go play elsewhere” is a common retaliation. All too often if the child is good enough, then concessions are made. Suddenly the child is awakened to the experience of special privilege. He notices that I can demand what I want and get it because I have special talent and am an exception to the rules. Sports is not the only contributing factor to this grandiose attitude but it can provides common fuel to this “special worm” mentality.

Usher in the days of college and the world of sports. The university will often bend the rules and make exceptions just to get a prized athlete to play at their school. I say play at their school versus attend the university for education because the truth of the matter is many universities don’t care except for the image of looking like they do. The bottom line is profit and polishing the image so that nothing tarnishes the profit making machine of college sports.

The mentality of rule breaking gets reinforced when the university creates special favors for the athlete, counting on the athlete’s performance to generate money for the university or help the school to present a certain national image. Athletic programs want to tout graduation rates but little is considered regarding the program’s contribution to a rule breaker’s mentality.

The Dalai Lama’s mantra of “Learn and obey the rules very well, so you will know how to break them properly” is commonly distorted by athletic departments by embracing “learn the rules very well. so you will know how avoid getting caught when you break them”.

Professional organizations escalate the rule breaker’s mentality. They fuel the challenge by giving the athlete anything they want, as long as the athlete performed to a certain level of excellence. Usually this meant building a championship team. Historically, it meant doing whatever it takes including breaking the rules. So you have the Vodafone McClaren Mercedes racing team fined a record $100 million for cheating. You have Lance Armstrong and other world class bicyclists being stripped of their accomplishments because of their use of performance enhancing drugs. There is the New England Patriots fined thousands of dollars for spying on opponents practice sessions. And of course, there is the steroid scandal in baseball where many great players who have now retired are deprived from Hall of Fame status because they were found guilty or highly suspicioned to have used performance enhancing drugs (P.E.D’S)  

Back in the day, everybody knew that PED’S were being used even when major league officials cried innocent. The owners loved that those suspicioned were hitting home runs at a record pace and that a rare home run race between Mark McGuire and Sammy Sosa took the nation by storm. The stadiums were being filled and the owners absolutely loved the revenue the drug users were providing. League officials reveled in the firestorm of excitement and enthusiasm. Everybody on the professional side absolutely lost themselves in greed and gluttony of increased revenue.

The fans were not innocent either. As long as home runs were hit, records were being broken and their home team was in the thick of a pennant race, no one cared to think about how big the players were becoming or the way in which these amazing statistics were being compiled.

More was just better! Until, Jose Canseco wrote his bombshell book, Juiced: Wild Times, Rampant ‘Roids, Smash Hits, and How Baseball Got Big in February 2006. In this book he told on himself and a ton of others who broke the rules with steroid use. At first, most people wrote off his statements and accused Canseco of acting out sour grapes about baseball. But, today the detractors are silent and the offending players have become the scapegoat for the league and our society.

The prima donna mentality shows up when treating addiction frequently. Deprivation spawns entitlement. Addicts can be deprived of financial power, emotional fulfillment, or relational validation which will fuel addictive entitlement. The combination makes it justifiable in an addict’s brain to binge one more time and then again and again. The arrogance that has been so characteristic in the cheating scandals of major professional sports is distinctive to the classic attitude presentation in an addict’s life.

I remember one time when a very prominent and renowned politician scheduled a session to see me. He had a long history of alcohol abuse and had been acting out sexually. His family was destroyed by his behavior and his marriage was in disarray.  Because of his notoriety, we decided to allow him to enter the back door and walk directly to my office without me being there to avoid recognition. So Mr. Celebrity Politician walked into my office and chose to sit in the chair that I usually sit. He later told me that he surmised that this particular chair was the “power position” in the room and he was determined to have the power. When I walked in I quickly noted that he was in my chair so I sat on the floor. We had not met and Mr. Celebrity bellowed “Well, Well, Well, Ken Wells -who in the hell is Ken Wells?”—glaring down at me over his reading glasses. So I responded by calling him by name “Mr. Celebrity who in the hell do you want me to be? We can play this game of intimidation whereby we waste our time. But, you are the one who came to treat addiction to alcohol and sex. You decide what you want to happen—“ From that moment on, he got up out of the chair and sat in one that represented him giving up his power (in his mind) and I remained on the floor. He had to shift from his arrogant attitude of entitlement to one that demonstrated openness to being coachable. This celebrity politician did some valuable therapy throughout the week as a result.

Coaches can also add to the mix with regard to the development of rule breakers. I remember my son playing for a coach in college where the rules were that athletes could not chew tobacco on the campus and particularly during their sporting venue. The coach made the announcement only pausing to spit from the chew that was in his mouth. It was an obvious mixed message.

Two other memories from my kid’s baseball days come to mind. One memory is when my oldest son Jimmy played for this one team during the off season. During this particular game, his team fell behind 10- 0 after the first 3 innings. Jimmy’s team was hand picked by his coach and suppose to be really good. The coach was embarrassed that his team was getting shellacked. As a parent I stood behind the screen down the first base line as the head coach and the pitching coach had this intense discussion going on. Head coach said, “that’s it, I’m pulling the kids off the field and forfeiting the rest of the game”. Pitching coach said, “No you are not going to do that! I won’t let you embarrass those kids like that! Head Coach, “ But, it’s over, we can’t come back and we can never catch up!” It went back and forth like this for several minutes while the game went on. Finally, the head coach gave in and conceded to the pitching coach. So what happened is that my son hit his first home run of the season making it 10-1 after 4 innings. The team came to life and scored 8 more unanswered runs, finally losing the game 10- 9.  Had it not been for a spectacular defensive play in the field, Jim’s team actually would have won the game. So after the game I’m thinking “Now this is going to be fun to see what the coach has to say to the kids”. So he gathers the kids around for a closing after game chat. I’m thinking “this is an opportunity for the coach to tell on himself, make a profound leadership statement- like, “you guys have taught me a lesson to never give up or something like that”. Of course, the kids never knew about the argument between the head coach and the pitching coach. So the coach clears his throat and says, “let this be a lesson to you, you gave up in the first 3 innings but you showed yourself that it is always a mistake to give up—You almost came back to win the game. I knew you could do it. You just have to believe in yourself.” He missed a valued opportunity to be vulnerable and empower the kids by telling on himself about being a rule breaker regarding belief in his own team. His shortsightedness short circuited inspiration.

At another time, my youngest son Sam was playing on a summer league baseball team. During the course of the game his coach became annoyed about the umpire’s calls of balls and strikes. The tipping point came when the umpire made a controversial call that Sam’s coach disagreed. He ran out to the umpires to protest. As arguments go, the coach ramped up and things got pretty heated. The coach just wouldn’t back off after the umpire gave him plenty of opportunity. So the umpire threw the coach out of the game. Here’s where things went awry. The coach stepped back, folded his arms across his chest and announced, “No, I’m not leaving—you guys are leaving because I am firing you both!” With that said the umpires gathered their equipment and left. The coach appointed his assistant coaches to finish the game as umpires. He made a complete ass of himself in front of the kids and parents. After the game he gathered the kids in the outfield to go over the usual debriefing. I thought to myself that this will be interesting to see how the coach handles making an ass of himself. During the short talk the coach made a few statements about players who played well and mistakes that were made but not a single word about the umpires. As we walked away it was clear that the coach missed a golden opportunity toward leadership. It would have been a teachable moment had he apologized to the kids and parents for his behavior toward the umpires. He could have demonstrated that even if you are the coach it’s not ok to act like an idiot but when you do, the sensible thing to do is to apologize. He could have shared that he would make sure amends were made to the umpires and pay them double for their embarrassment. Instead, the kids walked away with the lesson that it is ok to break the rules if you’re the one in charge.

Mixed messages are common components for those who grow up in families with dysfunction fraught with addiction. Rigid rules are codified, making it impossible for new information to be received and processed. “Don’t talk”, “my way or the highway”, “children are to be seen and not heard” and a host of other catchword rules dominate and oppress family members and contribute to a foundation which ultimately fuel a rule breaking mentality. These rigid rules fuel a shame bound system which ultimately thwarts and destroys a child’s destiny. It creates a distorted worldview that those who have the power are ones who get to break the rules. Kids learn to be rigid and resistant to change. They learn to hide their mistakes in fear of being ridiculed if they them. Healthy systems in family and community promote resilience toward interpreting life experience. It promotes ongoing dialogue around differences and long term commitment to resolve conflict. Healthy families and communities encourage individuals to claim their place and space in relationship to others. They promote accountability without attacking personal worth. These communities become like tough, flexible leather with a greater capacity to absorb stress from change. They are communities that teach the rules clearly so with a sense of responsibility members of the community system will responsibly understand the flexibility of community guidelines and as the Dalai Lama suggests “so that you will know how to break them properly”.

When an athlete fully blooms into a rule breaker, parents often wonder what went wrong. When it comes to baseball and steroids or other broken rules, society laments that baseball has lost its values. Everyone passes the buck as if it were a hot potato. The truth lies in that we are all complicit in creating the mentality of rule breaking. It comes from an attitude of entitlement. Owners pout and threaten to move their franchises if the community doesn’t build a new stadium for costs upward toward a billion dollars. Ball players contend that if it takes cheating with performance enhancement drugs to get an edge then that is what they are mandated to do. Fans feel victimized but enjoy the success of those who cheat until they get caught. Fans have never asserted themselves in opposition to cheating by boycotting the game. No one wants to take ownership for the creation of the rule breaker. Yet, the rule breaker is a product of society’s system and we are all a part of the system.  

Rule breakers are groomed at every level in our communities. I have learned by working with families that when a principle of responsibility is confronted with a young person, any time I pushed against the parents, if they remained solid and constant with me as I worked with their son or daughter, the results were always positive and transformative for the child. However, if the parent was protective and defensive in behalf of the child and let the child off the hook from consequences for their behavior, we always lost our impact and influence with the child. They learned that they could get by breaking the rules.

Culture and community have glaring examples of rule breakers that contribute to the rule breaking mentality which fuels addictive living. Role modeling rule breaking occurs at every level of society. Politicians break the rules. Ministers, coaches, teachers, policemen, doctors and lawyers have all been guilty of feeling entitled to break the rules. The impact on the worldwide community is astounding.

There is a distinct correlation between the prevalent attitude of breaking the rules in our society and the presence of breaking the rules in an addict’s life. Breaking the power of addiction and entitled living will require that community and addict alike recognize limitations and surrender to living within the common rules of community. Only then will the Dalai Lama’s statement be lived out — “Learn and obey the rules very well, so you will know how to break them properly—”


Article by Ken Wells

Overview and Presentations of Sexual Addiction

In the human experience, sexual expression takes a myriad of forms, limited only by the bounds of imagination. As the field of human sexuality progresses, more and more sexual behaviours have been catalogued and acknowledged as normal variants. As myriad as the range of sexual behaviours are the various manifestations of sexual addiction. Addiction, with its obsession, compulsion, tolerance, cravings and withdrawal, may distort any form of human sexual and romantic expression, and turn what is potentially joyful and intimate into something compulsive and problematic.

Much work has been done to understand the various manifestations of sexual addiction. It is apparent that certain behaviours present in clusters that may accompany specific forms of psychopathology. In this chapter, we review the various common presentations of the disorder, considering first those medical and psychological disorders that present similarly and must be ruled out before making the diagnosis of sexual addiction.

Differential Diagnosis of Sexual Addiction

In the field of mental health, despite our reliance on the Diagnostic and Statistical Manual (DSM) (American Psychiatric Association, 2013), not everything that quacks like a duck is truly a duck. We learn from our colleagues in medicine that a practitioner must always consider a differential diagnosis before making and acting upon a diagnosis. We have come to understand that when presented with depression, for instance, we must rule out hypothyroidism, syphilis, Lyme disease, post-concussion syndrome and drug effects, among many other disorders. So it is, too, with patients presenting with problematic, compulsive sexual behaviour. Especially in light of the shame, discrimination and contempt showered by our society on men and women with sexual addiction, we as clinicians must be discerning in our application of the label. Not all that quacks like a sexual addict is a sexual addict.

Definition of Sexual Addiction

In keeping with the nomenclature applied to substance use disorders and gambling disorder, Carnes has proposed ten criteria for the diagnosis of sexual addiction, which include elements of obsession, compulsion, risk-taking, tolerance, withdrawal, cravings, unsuccessful efforts to stop and social impairment. It is important to recognize that there are conditions that present with only some of the diagnostic criteria that must be separated from the rubric of sexual addiction, and other medical and psychological disorders that largely mimic sexual addiction and must be excluded before a diagnosis is made. We next explore these ‘rule out’ conditions.

Medical Conditions that May Mimic Sexual Addiction

Hypersexual behaviour has been associated with a range of neurological and psychiatric disorders. Before making a diagnosis of sexual addiction, consideration must be given to these medical disorders that are associated with sexual behaviour that is compulsive, inappropriate, uncharacteristic or excessive: Traumatic Brain Injury, Stroke and Neurosurgical Injury, Dementia, Autism Spectrum Disorder, Parkinson’s Disease, Bipolar Disorder, and Substance Abuse. The diagnosis of sexual addiction should not be made when these disorders are present without extensive consideration.

Non-Pathological Behaviours

In this discussion of conditions subject to misdiagnosis as sexual addiction, it is important to emphasize that the concept of healthy sexuality may include sexual behaviours that are frequent or different from the norms of the prevailing culture (such as homosexuality, BDSM, polyamory, etc). The clinician would do a disservice by reflexively labelling such behaviour as addictive. Such behaviors would not qualify as addictions unless all the criteria of obsession, compulsion, risk-taking, tolerance, withdrawal, cravings, unsuccessful efforts to stop and social impairment are present.

The Clinical Presentations of Sexual Addiction

In recent years, multiple typologies have been proposed for sexual addiction.

The most extensive characterization of the phenotypes of sexual addiction has been performed using latent profile analysis of a large database of patient self-reported data obtained through use of the Sexual Dependency Inventory (SDI-4.0).

As described by Carnes, close to two hundred different sexual behaviours have been catalogued as part of the development of the SDI. Using the statistical technique of factor analysis, these behaviours are found to cluster in distinct types, each with characteristic acting-out behavioural patterns. In the derivation of the SDI-4.0, 20 behavioural clusters were identified. It is common for sexual addicts to endorse behaviours in multiple categories. Details are provided in the book chapter.

These behavioral clusters include:

  • Fantasy Sex
  • Pornography Use
  • Phone Sex
  • Use of Inanimate Objects
  • Anonymous Sex
  • Conquest and Seduction
  • Group Sex
  • Relationship Addiction
  • Humiliation & Domination
  • Pain-Exchange Sex
  • Paying for Sex
  • Power Exchange Sex
  • Intrusive Sex
  • Voyeurism & Covert Intrusions
  • Exhibitionism
  • Exploitation of Trust
  • Sexual Exploitation of Children
  • Production of Pornography
  • Compulsive Sexuality with Drug Use


Sexual addiction presents in a myriad of ways with recognizable clusters of behaviour. The clinician facing a client with problematic, compulsive or excessive sexual behaviours must be mindful of the medical and psychological conditions which resemble sexual addiction and must be differentiated, with appropriate specific treatment provided. Multicultural sensitivity is necessary, especially when working with sexual minorities.

By Ralph Earle (PhD, ABPP) and Rick Isenberg (MD, CSAT)

Weaving Together a Solid Recovery Foundation (3 of 3)


Weaving Together a Solid Recovery Foundation (3 of 3)


Step 3-“Made a decision to turn our will and our lives over to the care of God as we understood God”

Acceptance of what has happened is the first step to overcoming the consequences of any misfortune.” William James

“I am an addict!” No harder words are ever spoken than those uttered by one who attends h/her first 12 step meeting. Accepting the limitation of addiction and identifying secretive destructive behavior is agonizingly painful and full of discomfort in the beginning stage of recovery. It demands the rigorous honesty cultivated in Step 1. It calls for the humility of Step 2 to ask for help from a higher power.

Step 3 is a Catch 22 dilemma. Figuring it out can be like trying to nail jelly to a tree. This step in the recovery foundation bids for irony and metaphor. It leans into the concept of to win you must lose. Winning sobriety means to surrender all forms of dishonesty, minimization and displacement of responsibility. It means to be in control you must let go. Let go of control of what people think, secrets kept and serial addictive behaviors repeated. It means to totally surrender to a Higher Power in the midst of fear, uncertainty and ambiguity.

It reminds of the story of the tourist visiting the Grand Canyon while leaning over the railing to see the bottom of the canyon, lost his balance and fell-grabbing a lone branch sticking out of the side of the canyon, holding on for dear life. He looks down to a 300 foot drop and cries out “God help me!” to which he hears a deep voice that says “Ok, let go!” He waits a few seconds and then calls out “Is there anyone else up there!” Step 3 challenges the addict to release h/her grip and let go to the promise of program and Higher Power. It is not a one-time surrender but a daily release moment by moment. The requirement is to do what seems innately against addict nature-give up control in order gain peace and to resurrect control again.

In order to know God, Step 3 proposes that you embrace what you don’t know. Through Step 3 we work with and accept the uncertainties of life. We surrender to the reality that there are no absolute certainties, assurances in life and we abandon all demands for perfection. We embrace the spiritual paradox that “when I am weak then am I strong.”

We are challenged to detach from things and possessions. Attachment to positions, power and places has become a problem that stunts spirituality because at some point they own us. Adding to your collection and hoard of things crowds out the spiritual.

Rather, we embrace our failures and our success, our dark side as well as our light and we gain autonomy by not insisting on our own rights. We learn to pay attention to what we hold on to and soberly accept what has happened. Somehow we allow our Higher Power to transform the Catch 22 of addiction from lose-lose to win-win profoundly letting go and accepting what we cannot control.

Ken Wells is a PCS staff therapist, lecturer, and author of The Clarification Packet.  He facilitates Men’s Leadership Weekends held throughout the year. He can be reached at for additional information.

Weaving Together a Solid Recovery Foundation (1 of 3)


Weaving Together a Solid Recovery Foundation (1 of 3)


“There is no greater agony than bearing an untold story”—Maya Angelou

Recovery in addiction is likened to getting an out of control train running down the tracked stopped. Getting addictive living re-calibrated and re-establishing life balance is a delicate and difficult task. The 12 step program has been invaluable to those who suffer from powerlessness and unmanagability. Courageously telling the story of out of control living is both a beginning and ending point. Our stories are the most powerful source for healing in our lives. T.S. Eliot said it well,

“We shall not cease from exploration

And the end of all our exploring

Will be to arrive where we started

And know the place for the first time-

Admitting our unmanageability and cultivating a pattern of “telling on myself” is a necessary ingredient for a strong recovery foundation. Our story is not static as in “once said and done”. Rather, we knead through our story as a baker would knead through dough in the making of bread. We work the different aspects of story by incorporating its insights and truths into congruent living which is an ongoing lifetime process. In the midst of failure of control, addictive thinking frequently will lower the expectation of sobriety in order to diminish the standards so that they can create an illusory sense of perfection. “Finally, I am sober!” “Finally, I measure up!” Rather, than embrace the possibility of finding meaningfulness in the failure. We find ourselves unraveling with a driven all or nothing mindset. We cannot stand the pace that striving to be perfect imposes.  It is indeed in the process of failing and getting up again that spirituality is essential.

Step one augments that we fail forward. In a very paradoxical way our very brokenness allows us to become whole. Our embrace of this process is paralyzed with dishonesty and denial about our crazy mixed up behavior.

It is very difficult to see our own crazy making ways. We cannot see ourselves without a mirror. Twelve step groups have way of expressing it when they refer “You cannot kiss your own ear”. This challenge brings us back to our story. Stories are the mirror for you and others to see self and uncover behavioral blind spots. This is what makes storytelling and group processing so powerful.

For an addict there is no life balance. It is only pedal to the metal chaos. Step one asks us to embrace our powerless unmanageability.  It is the beginning of weaving a life tapestry by boldly exposing the ups and downs, the bitter and sweet, the failure and success, the out of control heartache with courage and vulnerability. Relief from the agony of the untold story is waiting for all who embrace their pain.

Ken Wells is a PCS staff therapist, lecturer, and author of The Clarification Packet.  He facilitates Men’s Leadership Weekends held throughout the year. He can be reached at for additional information.

Weaving Together a Recovery Foundation (2 of 3)


Weaving Together a Recovery Foundation (2 of 3)


Step 2- “Came to believe that a Power greater than ourselves could restore us to sanity.”

“There is a crack in everything that is made-and not the least of all- in each of us”-Ralph Waldo Emerson

In truth, when it comes to recovery, spirituality is never quite what you expect. At the end of the day, spirituality influences the way we open up to life’s experiences. It helps to work through the dishonesty and denial of unmanagability in step 1 by leading to accept imperfection as imperfection. It transforms the ordinary and yet in a strange way is found in the common place of life. The least likely spaces and faces are utilized to reveal truth that comes from the spiritual in life.

When we deny our individual imperfection with defensiveness and minimization, we disown our spiritual nature which is rooted in common shared brokenness. Minus embracing humanity’s broken condition, we become stuck in destructive behavior without compassion.

Yet, when I embrace my own weakness, I am invited to cultivate compassion toward myself and others. This is the essential root of healing in relationships. Pema Chodron stated “compassion is not a relationship between the healer and the wounded. It’s a relationship between equals.  Only when we know our own darkness well can we be present with the darkness of others. Compassion becomes real when we recognize our shared humanity.”

In developing compassion for my own weakness, I develop compassion for the weakness of others. Spirituality is a journey of becoming one with every sinner. So the victim of destructive addictive behavior is one with the perpetrator because we are all one in common shared weakness. Essentially we all offend and that common thread creates spirituality.

In this sense, spirituality becomes a necessary ingredient for accountability. If we all offend, not just the addict, then it stands to reason that holding each other accountable is necessary to create safety in community. It becomes the glue that holds the parts of recovery together.

Spirituality is found in the wound of human failure. Entangled in the powerful shackle of shame that wraps itself around the spirit like an infectious worm. Defeat and desolation from addictive act become compost for cultivating humility, a cardinal component of spirituality. It is by fertilizing Step 2 and nourishing spirit that later in Step 9, we make amends from the compassion for others spawned from Step 2. Spirituality is the ingredient that forms an antibiotic to conceit and arrogance. It combats self-sufficiency, self-centeredness and the pride that denies need which is the root of all our struggles. In a strange turn of events, the Step 2 process takes the broken condition of addiction and connects it to every other human tribulation. We are all one. Through this epiphany, we look to a Power greater to address the limiting crack common to us all.

Ken Wells is a PCS staff therapist, lecturer, and author of The Clarification Packet. He facilitates Men’s Leadership Weekends held throughout the year.  He can be reached at for additional information.


Spirituality: Sobriety’s Peaceful Paradox


Spirituality: Sobriety’s Peaceful Paradox


Addiction is an invite to become spiritual. In the midst of chaos, denial and deception, there is this beckoning toward truth. The word spiritual is a conundrum. It is a paradox- an “unsettling contradiction”. Some describe spirituality as “trying to nail jelly to a tree”. Others suggest that it is about vulnerability. It can feel like being emotionally naked in front of another. It is about a certain kind of brokenness. Its truth can have a certain coldness and rawness to it. It can be bittersweet. Often, it is presented as sweet peace wrapped in discomfort, even in the presence of being exposed.

Ernst Kurtz, in the Spirituality of Imperfection, indicates that to be spiritual is not about religion and not about therapy. If not, then what the heck is it? He cites that it comes from the “wound” in life. Spirituality comes from our “torn-to-pieces-hood”. It’s in the pus of human failure and repeated destructive behavior. It can be likened to stretching out a tender and sore muscle that begs you to leave it alone. That which we would least like to embrace is the place we are invited to stand. Spirituality demands that I lean into the painful wound. Carl Jung is credited with “the only way out is through the pain”. It’s a contradiction that brings me/you to life as “being” and less about “doing”.

Addiction is painful. It hurts me and others in a profound way. It leaves human carnage in its path. Yet, in the presence of shattered living, spirituality utilizes the pain of addiction as a catalyst to bring us closer to what is real no matter how hard I try to deny it. It demands that I lean into the pain in order to heal. It means I have to scrub the wound. It all sounds so contradictory. I want to do the opposite. Yet, spirituality demands that I embrace the pain of betrayal, the agony of disclosure and the annoyance and inconvenience of consequences. This can include but not limited to incarceration, losses of all types, and the painful tedium of ongoing assessments. It demands the engagement of mistrust of others toward you because of your destructive behavior. It requires that I surrender to the reality that each day I am a beginner in spirit lest I settle into resentment, bitterness and defensiveness toward those who don’t trust me.

Spirituality silently and irrepressibly tells us that we are not in control. Its message can be sweet but only if we embrace what feels bitter.

To myself I will say … “Nah, Nah,Nah”— “I want something better”- “enough is enough!” “I will ignore surrender and force my way to a better place!”- From this space, spirituality takes on a different face. It can even bite back or so it seems. It is not a separate entity trying to break individual stubbornness. Rather, it is the other side of who we are that confronts the resistance and refusal to recognize the limitations of the wounded-ness that comes with addiction.

Spirituality is not about having the answer. It is not fenced in by words. It’s about “am-ness”. Kurtz expressed “it is about a way that we “be”. It’s about emptying (kenosis) from all that we do to embrace simply what we may be. It stirs groundlessness and ongoing uncertainty. It is reality whether we choose isolation and destruction or positive life giving experience. To use a worn out phrase, “it is what it is”.

Metaphors, images and stories become the language of spiritual awareness. For this reason, nothing is more powerful in healing than the story of human brokenness. As the poet T.S. Eliot described “we shall not cease from exploration and the end of all our exploring will be to arrive where we started and know the place for the first time”. We share our stories of brokenness again and again so that spiritually we shall know the place for the first time.

Ken Wells is a PCS staff therapist, lecturer, and author of The Clarification Packet. He facilitates Men’s Leadership Weekends held throughout the year. He can be reached at for additional information.

© Psychological Counseling Services