What does treatment for paired substance use and sex/intimacy issues look like?

In a general way, treatment for paired substance abuse and sex/intimacy issues utilizes the same basic strategies and techniques that work with alcoholism, drug addiction, behavioral addictions, and eating disorders. Early treatment efforts focus on containing your problematic behavior. Safety is our primary concern. After that, we focus on breaking through your denial, managing the crisis or crises that pushed you into recovery, and preventing relapse.

Treatment includes both individual and group therapy – most often a directive, accountability and behavior focused modality like cognitive behavioral therapy paired with social learning, psychoeducation, 12-step or other addiction-focused social support, and alternative methodologies like psychodrama, art and movement therapies, exercise, meditation, and experiential therapies. Our psychiatrist might also suggest that you begin a trial-run of an antianxiety or antidepressant medication, as these can reduce not only anxiety and depression but cravings to engage in problematic behaviors.

What is substance/sex recovery?

If you’re like most people with paired substance and sex/intimacy issues who are new to recovery, you have little to no idea what the term ‘recovery’ means. You may fear that recovery from the sex/intimacy half of your issue will mirror recovery for substance abuse, where permanent abstinence is the goal. You may be thinking, “Do I have to give up sex forever? Because if I do, you can forget about me coming to treatment.”

Fortunately, unlike recovery for alcoholism and drug addiction, sexual recovery is not defined by long-term abstinence. Celibacy is not a long-term solution to sex/intimacy issues. Recognizing this, we define sexual recovery as we define recovery with eating disorders – another area in which long-term abstinence is simply not feasible. Rather than permanently abstaining from all sexual activity, we ask clients to think about recovery as learning to be sexual in non-compulsive, non-problematic, life-affirming ways.

What happens each day in treatment?

As part of treatment, you should expect the following:

  • Full Bio-Psycho-Social and Psychosexual Evaluations
  • Completion of the Sexual Dependency Inventory (Online)
  • Behaviorally Focused Individual and Group Therapy
  • Sexual (and Chemical) Addiction Education
  • Social Learning and Peer Accountability
  • Alternative Therapeutic Modalities (Art Therapy, Psychodrama, Adventure Therapy, etc.)
  • 12-Step Sexual Recovery Focus and Participation
  • Digital Era (Online) Recovery and Participation
  • Prodependent Partner/Family Involvement
  • Shame Resilience Work
  • Self-Care (Exercise, Meditation, Yoga, Massage, Acupuncture, etc.)
  • Aftercare (Relapse Prevention) Planning and Implementation
  • Trauma Identification and Containment
  • Continued Treatment-Group Interaction (Weekly Online Meetings)

Will I be able to contact my work, family, and friends?

Within certain limits, yes. That said, while you are in treatment, it is important that you focus on the task at hand – understanding and overcoming your sex/intimacy issues. If you are too focused on outside communication, your process of healing and recovery will be stunted. Thus, we limit the use of phones and other digital devices to early morning and early evening breaktimes. Moreover, digital devices can only be used in common areas. When clinically appropriate, Seeking Integrity staff may revoke phone and/or computer privileges or end a specific conversation. Porn, hookup apps, and similar behaviors are strictly forbidden. At no point should you or any other client access any material that might be detrimental to your treatment or any other client’s treatment. As part of your treatment, your therapist may arrange specific phone or video conversations between you and your significant other. Such conversations should only take place with therapeutic guidance.

Note: There is a 72-hour moratorium on digital communications after your arrival. Seeking Integrity will notify whoever you want about your arrival, but you will not be allowed to use your phone or any other digital device for the first 72 hours of treatment.

Why does Seeking Integrity look at both substance abuse and sex/intimacy issues?

These issues often travel hand-in-hand. Sometimes substance use and sexual behavior occur in tandem as a way of overcoming sexual shame, overcoming low self-esteem, disinhibiting oneself sexually, or enhancing the sex or drug experience. Other times sexual behaviors alternate with substance abuse, typically with substances being used to numb the shame of recent sexual behavior.

Many men who engage in both substance abuse and compulsive sexual behavior will admit to one problem but not the other. They admit they have a problem with substance abuse, but not sex and intimacy. Or they admit they have an issue with sex and intimacy, but not substances. Sometimes they go to rehab for the issue they’re willing to admit to, and then relapse related to the untreated half of their problem.

At Seeking Integrity, we understand the interplay between substance use and sex and intimacy issues. And we know that if these behaviors are in any way paired or fused, both issues must be addressed or relapse is almost inevitable. So whatever it is that you admit to when you enter treatment, we’re going to uncover the behaviors that are tied to it, and we’re going to address your problems completely and holistically. Because that is the best (and we think only) true pathway to long-term recovery and healing.

I thought 'chemsex' was a gay issue. I’m not gay, so why would I come to Seeking Integrity?

Co-occurring sex and substance problems show up in every population, not just gay men. Admittedly, the term ‘chemsex’ has been used to describe gay and bisexual men with paired or fused meth/cocaine and sex problems, but in reality, all types of people struggle with the combination of substance use and sex. This includes alcoholics, opioid addicts, and those who use drugs to enjoy or tolerate sex and intimacy. The universal underlying issues for such people are not sex and/or drugs; the underlying issues are trauma, intimacy, and relationship losses. These are the underlying concerns we treat at Seeking Integrity, and they are there with addictions of all types.

What should I pack (and not pack)?

Please check the weather for the location of the facility where you are seeking treatment. Pack appropriately, with comfortable clothes. There is no need to ‘dress up’ while in treatment. Revealing clothing is not permitted, so don’t bother bringing it. You will be doing some experiential therapy that may occur outdoors, so bring appropriate clothes for that. Bring clothes for daily walks and hiking as well. You needn’t overpack, as our residences have a washer and dryer you can use. Make sure you bring all of your prescribed medications. Bring your phone and other digital devices, as well, as learning to use these devices in healthy ways will be part of your treatment process. We have books, movies, and music at our treatment centers, but feel free to bring your own, keeping in mind that your free time in treatment is limited.