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Pine Grove Behavioral Health and Addiction Services

Trap Doors

Sex addiction treatment clinical interview process

Clinicians have been seeking key questions to help in the assessment process for sex addicts to accurately provide sex addiction help. This type of interview for sex addiction treatment would be similar to the CAGE process for alcoholism. Nine variables were identified out of a data set of 1600 inpatients and 80,000 on line assessments. These questions work for all patients regardless of gender or orientation. The variables have been placed to form the acronym TRAP DOORS which is in part acknowledgement of the difficult and unforeseen consequences that sex addicts often face. These variables become a series of questions which help diagnose and determine the severity of the addiction. The key sex addiction quiz questions are:

These sex addiction quiz questions provide a diagnostic process for the clinician and a spring board for discussing sex addiction help. Throughout the sex addiction treatment assessment process therapists must now examine any stereotypic images of what men and women do sexually. For it is clear that sex addiction in women is not only more prevalent, but the shades of behavior are becoming less distinct between men and women. Therefore it is critical to focus specifically on the addictive process, and not be distracted by what the specific behaviors are. This is why assessment processes like TRAPDOORS are very helpful in a time of great sexual change.

The Codependency Wild Card

Partners and family members of sex addicts struggle with codependency as well as which often obscures women and their sex addiction. Co-sex addiction is a more reactive state than codependency to other addictions. If someone chooses alcohol over you, it is very difficult. The difficulty is compounded if your partner chooses other sex partners over you. The “wrath” of betrayal is catalyzed exponentially if the codependent is also acting out but has not been discovered yet. Sometimes we are most angry at others because of that which we hate in ourselves. Consider the following examples:

These examples show being obsessed with your partner can add to personal denial about your own behavior. Clinicians need to be mindful how co-addiction works and separate out what is addiction and what is co-addiction. In the late eighties and early nineties I followed a thousand families for seven years. Out of that research nine variables emerged in the co-addiction process. They are as follows:

NINE CHARACTERISTICS OF CO-ADDICTION

COADDICTIVE CHARACTERISTICS

 

TYPES OF BEHAVIOR

 

% COADDICTS

1. Collusion

Joined addict to present united front
Kept secrets to protect addict
Lied to cover up for addict
Became hypersexual for addict

71

66
53
37

2. Obsessive preoccupation

Focused totally on addict to avoid feelings
Constantly thinking about addict's behaviors and motives
Checked addict's mail, purse, briefcase, etc.
Forgetful

67

62

 

58
57

3. Denial

Denied personal intuitions
Kept overly busy and overextended
Believed I could eventually change addict
Totally denied the problem

83
72
68

43

4. Emotional turmoil

Emotions were out of control
Went on emotional binges
Experienced free-floating shame and anxiety
Always had a crisis or problem

79
78
74

63

5. Manipulation

Played martyr, hero, or victim roles
Used sex to manipulate or patch disagreements
Failed efforts to control sexual acting out of partner
Made threats to leave but never followed through

92
61

61

54

6. Excessive responsibility

Blamed myself
Believed if I changed, addict would stop
Took responsibility for addict's behavior
Created dependency situations where I was indispensable

75
62

62

59

7. Compromise or loss of self

Gave up life goals, hobbies, and interests
Acted against own morals, values, beliefs
Changed dress or appearance to accommodate addict
Accepted addict's sexual norms as my own

61

59

53

43

8. Blame and punishment

Increasingly more self-righteous and punitive
Destructive to others
Homicidal thoughts or feelings
Had affairs to punish the addict or prove worth

64

54
36
21

9. Sexual reactivity

Numbed my own sexual needs and wants
Rarely felt intimate during sex
Made excuses not to be sexual
Changed clothes out of sight of addict

68

66
43
34

The table summarizes supporting data for each path reported by partners in the study. By looking at these variables it helps to identify what questions to ask about the partner's reactivity to sex addiction and the need for sex addiction help.

*Source: "Don't Call It Love" by Dr. Patrick Carnes

Psychology Internship Program

Pine Grove has an excellent internship program that offers a wide range of training activities in our three rotations. We are able to offer interns opportunities for training in residential and outpatient settings working with adults, adolescents, and children. We are APA accredited as a single entity pre-doctoral psychology internship program under the name of Pine Grove Behavioral Health & Addiction Services, Doctoral Internship in Professional Psychology (PG-DIPP).

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