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Why Can't He Stay Sober?

Is he still flirting with hitting bottom?

Many times, a sex addict shows up for treatment declaring that he’s ready and willing to stop his problematic sexual behaviors, only to continue acting out and lapsing in his sexual “sobriety.” With every intention to do the right thing, he may show up to therapy week after week declaring that he wants to stop his sexually destructive behaviors, yet he repeats his patterns over and over again rendering him frustrated and hopeless. He’s probably admitting to his therapist that he’s not completely complying with the treatment recommendations leaving his therapist feeling like he’s banging his head against a wall and asking himself, “What am I doing wrong?” because the techniques that have worked to keep many other sex addicts sober just don’t seem to be working for this one. This scenario can be terribly frustrating for both parties and may have the client feeling shame about not being able to “do it right,” raising the question, “Does an addict have to hit “bottom” before he’s really ready to get serious about his sobriety?”

In addiction terminology, an addict hitting “bottom” means that his addictive behaviors have created such destruction, pain, and unmanageability in his life that the only way out is “up.” For example, if an addict loses his job, family, and friends as a result of his addiction and ends up homeless, he’s said to have “hit rock bottom.” Every addict has a different “bottom” though. Some people have “high bottoms,” meaning it doesn’t take much for them to recognize they’re in trouble and need help, while others have “low bottoms,” meaning they have to lose everything that has meaning to them before they realize they have a problem. Some people say that hitting a “bottom” is the only way that an addict can find the motivation to do whatever it takes to remain sober. For some addicts this is true, and for others it’s not.

For clients who are having trouble staying sober and have not yet hit bottom, stating the truth can be a powerful therapeutic intervention. When your client trusts you and you tell him, “I worry that things haven’t gotten bad enough for you, you don’t seem ready to stop your behaviors because you haven’t hit your bottom yet” this can be a way of getting real and snapping him out of denial. It’s also helpful to predict or foreshadow what further destruction possibly lies ahead if he doesn’t get serious about his recovery. When a sex addict is alerted to the fact that life can get much worse than it currently is, it can give him the motivation he needs to immediately get into action. For others, they might decide that they’re not yet willing to give up their addiction or to commit to treatment, and (hopefully) will return at a later date when they’re in enough pain and ready to get sober. Clients who leave treatment only to return later after they’ve suffered worse consequences then the first time around, often have a different look in their eyes and a deeper level of commitment to staying sober.

By being honest with our clients in a non-judgmental way about our perceptions of their resistance, we’re taking a stand against their addiction and letting them see and feel our concern. This kind of honesty can have both parties joining together as a team, giving the client hope and relieving the therapist from solely carrying the burden of the client’s recovery.