Carol Juergensen Sheets LCSW, CSAT, PCC
Recently I interviewed Dr. Jon Caldwell, a psychiatrist from The Meadows who is helping sex addicts to look at their urges and cravings differently. This is an excerpt from my internet radio show on sex addiction that you can download on iTunes if you wish to hear the whole show. If you struggle with urges and cravings you might want to give these techniques a try.
If you would like to hear the whole show, please click here.
Carol: You have been doing a lot of important work around this topic. I thought, if you could express and explain to our listening audience, in your opinion what is mindfulness?
Jon: Mindfulness really has grown out of contemplative traditions, religions and traditions that come from Buddhism, from contemplative traditions in Christianity and Sufism. Many religious practices have thought that trying to really spend time with our raw experience just as it is, noticing the present moment and noticing the experiences of the present moment have a lot of value for general well-being. These practices have been around for thousands of years actually, and in the last 3 decades or so here in the US, we have been studying these practices. Generally the way that most people talk about it is mindfulness. The definition that’s mostly used for mindfulness was given to us by Jon Kabat-Zinn, and it’s really bringing an unconditional nonjudgmental attention to our experience in the present moment.
Carol: That is really important, isn’t it, to be nonjudgmental.
Jon: That’s right.
Carol: So many sex addicts have so many negative thoughts about themselves and about this disorder, so you just did a great job of explaining mindfulness. Now you actually believe that there is a science to this, that it can be studied and it can be measured, is that correct?
Jon: Yes. There has actually been quite a lot of research done in this area. Again, Jon Kabat-Zinn is really the father of mindfulness in the US and in the West. Nearly 30 years ago, he developed a stress management clinic at the University of Massachusetts, and he started working with patients who have chronic pain, patients who are not able to get relief through typical medical treatment. From that beginning, he developed an 8-week course that helps people to learn the skills of mindfulness and self-compassion. He taught them some yoga, so they had more awareness of the body, and then he began to study what happened to these folks as they spent time in this 8-week course. What he found was that people had real genuine improvement in their pain, and they also had better quality of life. There are at least 2 things happening. One is that it seems to have a biological effect on the body. If you think about the toxic effects of stress and chronic stress, including things like pain and disease and psychological stress, then this is a way for people to learn to work with the body that alleviates some of that stress. It’s a form of a coping mechanism, a way of being with our experience in such a way that it helps to reduce the stress and the strain on the body and the mind. In addition to that, it seems to really help with general well-being and positive emotion. There’s more joy and happiness and peace and calmness that comes through this practice.
Carol: This is a subjective question, but would you say that addiction is one of the most powerful stressors in a person’s life?
Jon: We know that people who find themselves in an addiction oftentimes have been dealing with very stressful things for some time, and the addiction is a way to try and manage what’s happening in their life. They’ve probably been dealing with stress for years, if not for most of their life, and they’ve turned to the addiction as a sort of way to manage that. The tragedy of course is that the addiction ends up being more stressful. Not only does it cause a lot of strain in people’s social lives with family members and in their workplace, but it has a lot of stress and strain on the body itself. This includes anything from food addiction, substance addiction, sex addiction; all of these addictions create tremendous stress in the body and in the mind. So yes, I do agree with that.
Carol: My feeling was that oftentimes you’ve got these terrible traumatic experiences from childhood on up, and then in addition to that what ends up happening is you develop the addiction and now you have that double stressor of feeling bad about the trauma, sometimes even reenacting the trauma, and then having the addiction to cope with the trauma which makes you feel worse about yourself. So with mindfulness, what do you work on first?
Jon: Mindfulness and the different techniques that go with it are sort of interesting. The techniques can be specifically applied to the addiction or to the trauma, but they can also be applied quite generally and help both conditions simultaneously. When you think about it, some of the Buddhist psychology says that the source of our suffering here in this life is not necessarily the pain that we will all encounter, the pain of being in this mortal existence. We’re going to run across problems with our body, and we’re going to grow old, and we’re going to lose loved ones and we’re going to have changes in our role and what we’re able to do in terms of functioning. Ultimately, we’re going to die. All of that is sort of the natural pain of life, but the Buddhists said that we don’t have to have suffering piled on top of that. What we end up doing so much of the time, we push our experience away. We resist our own experience. We either avoid it, suppress it, repress it, or we find some pleasure like sex, food or drug, and we hold onto that as a way of avoiding what is really here, the emotions and the thoughts and the various pains that just come with being alive. There is a tendency to avoid what is uncomfortable and to hold onto what is pleasurable. In some ways, that basic tendency, that basic human conditioning, is present in both how people deal with trauma and in how they deal with addiction. These techniques I do with mindfulness are really helping us to not move toward holding onto something pleasurable or avoiding something painful, but instead to learn to be with our experience just as it is; to have a measure of acceptance and allowance, and sometimes even being able to befriend our experience. To be able to really welcome our experience and come home to ourselves in our own experience is the wonderful benefit of this work. It allows us to be here with what is here and not always run from our experience into addiction or into some sort of emotional upheaval that comes with trauma.
Carol: You used those words like repression and suppression, so for our listening audience, repression is when you absolutely forget about the pain and you ignore it and you avoid it and you don’t even know it’s there, whereas suppression is you minimize that. You’re saying that those 2 things are coping mechanisms. They can actually be helpful initially but ultimately end up interfering with that acceptance process which is so important in dealing with whatever pain and suffering we’ve experienced.
Jon: Yes, I totally agree.
Carol: So that is a difficult concept for anybody out there listening who has been, unfortunately, I use the term “fighting” their sexual addiction. You’re actually encouraging them to surrender to it, and to accept it as part of life so that they can then work with it and go with the flow.
Jon: Yeah, this is a very interesting point, Carol, I appreciate that you brought it up. There is a little bit of friction that’s inherent in this process. When I’m working with people with sexual addiction, many of them when I bring up the topic of mindfulness and acceptance, they really struggle with how to incorporate that into their recovery process.
Here’s just one practical example of a way I use mindfulness in my practice with people with sexual addiction. Sometimes what I find is that people can really get into a struggle with the addictive tendencies. This can be applied to alcohol, drugs, all the rest as well, but what they oftentimes do is many times especially in recovery, there’s this struggle with what’s happening in the mind, the cravings that are coming up around sexual addiction. People can sometimes find themselves really battling inside of their mind with the stuff that’s coming up. I’ve had a number of people in recovery who say, “It feels like I’m just as distant and not present and struggling now that I’m in recovery than when I was actually dealing with all these cravings.” As if the thought of don’t do it, don’t look, don’t go to that side; all of that tension in the brain saps a lot of their energy and their awareness of the present moment. One of the things I find a practical technique is actually to try and release people from that struggle within their mind.
For example, if somebody in recovery from sexual addiction has a thought that comes up, a trigger; let’s say they drive by a billboard and there is an image on the billboard that really triggers them into some thinking and maybe even an old memory about their addiction, the tendency for many people is to say, “Oh no, I can’t think about this.” There’s this strong resistance to what is happening. The mindful approach would be to just notice that there is a craving there, and to step back from the experience and you might just label the craving with something very neutral. Again, non-judgmentally, label it as I like to use the term “desire.” The person would look at the billboard and say, “Ah, desire.” Desire is a natural human tendency. We all desire. We all have sexual desires. We have desires for food. We have desire for pleasure, so we just label it very gently with something called desire, and then just notice there is this triggering happening in the body and in the mind. Instead of either latching onto it and following that trill to an old memory or resisting it very strongly, you just step back from the experience of what’s triggering and just notice what’s happening. You might be able to pay attention to your breath, or you might pay attention to the feel of your hands on the steering wheel, and just notice this desire or feeling inside of the body happening. You don’t have to do anything with it. You don’t have to push it away. You don’t have to change it. You don’t have to run from it, but you can have a momentary experience or desire and then come back into something in the present. That doesn’t mean you have to just sit there and wallow in that. You may pick up the phone and call your sponsor. You may decide I have to hit a meeting tonight, but you’re not running from it or pushing away your experience, you’re just recognizing that this is part of the process to whole-hearted living, to fullness, just being with our experience the way it is.
Carol: Is that what you would consider self-compassion? When you feel something, and instead of attaching shame and guilt to it, you just have that mindful awareness of it, reframe it, call it something like desire, and then move on from it.
Jon: That’s right. It’s been shown in a lot of studies now that the practice of mindfulness really seems to facilitate greater self-compassion. Whenever I work with people in recovery and I’m using mindfulness as a technique to help them, I always incorporate some tools around self-compassion. You’re exactly right, they go hand in hand. Many times when we start to open to our own experience, we encounter some difficult feelings and thoughts, and it takes a lot of gentleness and self-compassion and care to really hold our experience in a loving and self-compassionate way so we can be with what we find there. The tendency for many people is when that desire comes up, when they’re triggered by something in the environment or even something inside; let’s say they remember a past event that has a trigger to it. The first thing they might think is oh great, here I go again, I can’t believe I’m still in this place where these things trigger me. Why can’t I get over this? Why can’t I do this better? There’s a lot of negative self-talk that goes along with it. This approach brings a lot of gentleness and compassion, so you might say I just noticed I got triggered inside. Again, back up from your experience; take a breath, and say, “So this is still part of my recovery process.” These thoughts still come up. I notice desire right now.