Oftentimes people who are new to sexual recovery and struggling to establish and/or maintain sexual sobriety hear “inpatient sexual addiction treatment” as a suggested option. However, most of them have no idea what this really means. What happens in sex rehab? How does it work? How long does it last?
In most respects, inpatient sexual addiction treatment mirrors inpatient drug and alcohol treatment – utilizing the same basic structure and approach. The primary differences are the subject matter being addressed – compulsive sexuality rather than abuse of a substance or substances – and the way in which sobriety (and therefore long-term success) is defined.
Typically, with alcohol and drug addiction the goal is permanent abstinence, but with sexual addiction sobriety is handled differently. Essentially, instead of permanently abstaining from all sexual activity, recovering sex addicts learn to be sexual in non-compulsive, non-problematic, life-affirming ways. This is similar to the treatment of eating disorders – another area in which long-term abstinence is not feasible.
That said, most sex rehabs do require total abstinence during the inpatient stay, which usually lasts anywhere from 30 to 90 days. This brief period of total sexual abstinence, including abstinence from masturbation, is suggested because most struggling sex addicts have lost touch with reality when it comes to their sexual activity, and they simply have no idea which of their behaviors are and are not healthy versus problematic. This required timeout from all sexual activity gives recovering sex addicts a chance to develop some clarity about which of their sexual behaviors are addictive and which are not.
The most common misperception about inpatient sexual addiction treatment is that sex addicts, after completing an inpatient program, will have their problem completely under control, never to struggle with it again. This is absolutely not the case. Sex addicts are not cured by sex rehab. In fact, there is no cure for sexual addiction (or any other addiction, for that matter). Instead, the primary goals of inpatient sexual addiction treatment are to establish a modicum of sexual sobriety and to prepare the addict for the longer-term (lifelong) process of recovery to come.
Typically, inpatient sexual addiction treatment accomplishes the following:
- Temporarily separating the addict from his or her active sexual addiction
- Helping the addict create his or her highly individualized version of sexual sobriety by determining which sexual behaviors are (and are not) problematic for that individual
- Helping the addict uncover and understand the consequences of his or her addiction (the harm done to self and others)
- Uncovering and debunking the addict’s denial – the rationalizations and outright lies that he or she uses to justify his or her addictive behaviors
- Helping the addict to identify his or her triggers toward addiction – the people, places, feelings and experiences that cause the addict to desire emotional escape through sexual fantasy and/or activity
- Creating a “sexual recovery toolkit” that the addict can use whenever he or she is triggered to act out sexually
- Starting the addict on the road to long-term (lifelong) recovery from sexual addiction, a process that likely includes ongoing individual and/or group therapy, along with participation in 12-step sexual recovery support groups
Another common misperception about inpatient sexual addiction treatment is that therapeutic work will focus on the identification and resolution of the addict’s childhood trauma. This is not the case. Uncovering and addressing childhood trauma is certainly an aspect of sexual addiction treatment, but it’s just one among many, and it’s not usually a priority. After all, helping sex addicts understand their childhood issues doesn’t exactly provide them with the concrete tools they will need if they are going to cope with life on life’s terms without returning to the obsessive use of sexual fantasy and behaviors as a way to self-sooth and self-medicate.
Instead of looking at the past, sexual addiction treatment generally focuses on the present – the here and now – utilizing the highly directive methodology of Cognitive Behavior Therapy (CBT). With this approach, addicts are able to look at the people, places, feelings and experiences that trigger and reinforce their sexually addictive thoughts, desires and behaviors, and then they identify ways to short-circuit the addictive cycle. Essentially, they learn to recognize that they’ve been triggered, and to act in ways that counteract rather than reinforce their desire to act out sexually. So instead of wallowing in sexual fantasy, which ultimately leads to problematic sexual behaviors, sex addicts learn to engage in healthier behaviors like calling a supportive friend in recovery, going to a 12-step meeting, exercising, reading a book, meditating, helping others, enjoying a hobby, etc. (Longer term issues are generally dealt with, if the addict so chooses, a year or so down the line, in outpatient therapy.)
It is important to state, once again, that inpatient sexual addiction treatment does not offer a cure for sexual addiction. Instead, it interrupts long-established patterns of sexual acting out, and it provides a safe, structured setting in which sex addicts can build awareness of their addictive problem along with coping skills they can turn to instead of their addiction. In truth, with or without the benefit of inpatient treatment, sex addicts must battle their issue on an ongoing, lifelong basis. Their desire to act out sexually does not go away. It lessens, certainly, and they learn to respond in non-addictive ways when triggered, but the desire to engage in their addiction does not disappear entirely, no matter how good the treatment center or how motivated the addict.