Episode 10: Dr. Connie QuinnThe layers of Sex Addiction

Discover insights on sex addiction, relationships, and finding healing in a sex-positive environment.

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Hello World, and welcome to the Choices Books and Gifts podcast, where “You Always Have Choices.”  

Today's guest I'm proud to present is Dr. Connie Quinn. Hi Doctor. 

Good morning. Good morning. Thank you for having me. And please, please call me Connie.

Thank you, I shall.   So, I'm going to read a little bio on Connie, and we'll go from there. Dr. Quinn is an expert in anxiety, depression, substance abuse, sexual health, and eating disorders. She also practices LGBTQIA-aware / friendly therapy. She is a certified sex therapist – which – that’s what Connie will be speaking to us about today.

So, Connie, I'm going to just jump right in and ask some questions, and I'll let you take the show from there.

All right. That would be great.

First of all, what is sex addiction? What defines it?

That's a great first question. I feel like the field of sex addiction has gone through so many iterations of understanding what it really means. I practice through the lens of it's an addiction if it is impairing your social health, personal, professional, and daily functioning. It's an addiction - if it's an addiction for you. Many folks come into treatment at any level of care, into a therapy session or therapy practice, and say, “I’m an addict.”  And I mostly say, “Says who?”; “Well, my wife, my partner.”  And I'm like, “Okay, well then, let’s peel back the layers there.”

There are camps of providers in the world of sexual health that feel very much that addiction is sort of a label. And then there are other providers that want to look at it through a trauma lens. And other providers look at this through a more cognitive behavioral (approach) - you have free will to make changes and choices around your behaviors.

Got it. Got it.

It's a little early to be talking about sex in such great detail. So, I've got to rev up here.

All right, it sounds like a lot of 12-step programs, where if it impedes your life, it's a problem. And I wanted to roll into this - is sex addiction a physical addiction?

That's sort of saying, what's the basis of rape?  Which is a little heavy. But it can be rooted in physical sensation. It can be rooted in a trauma response. It can be rooted in an attachment response. I think it's multi-causal.

And how did you get involved with it, if you don't mind me asking, why this? 

This is a great story. So, I graduated from Adelphi School of Social Work in 1996 and did an internship at a non-secure detention (center) in Rhinebeck, New York. I worked there for about a year. I was grateful to have a job. And then a friend of mine said, New York State is hiring - you should apply. I got through and they said, well, you can work with substance abusers, or you can work with sex offenders. And I thought, well, my dad is an alcoholic- I don't want to work with substance abusers - I'll work with sex offenders. I didn't know Jack/anything about sex offender treatment, but I got a really good state job.

So, then I became very immersed in the social control element of sex offender treatment at the juvenile detention level and spent about, my gosh, I guess about eight years working at the limited secure and the secure level, with sex offenders, as a treatment provider. I worked with exclusively young adult men who were doing extensive sentences, many of them life for very violent crimes of a sexual nature.

That's how I got into it.

It gets a little much after a period of time. Many people make pivots when you start working in the area of sexual impulsivity and violence and so on. Nine or ten years, I said, I can talk about sex. It's something I'm fluent in. I want to make a pivot and help people derive more pleasure.

Work through certain sexual challenges and bring more awareness to sexual health issues. So that's sort of the story.  A nice girl from Long Island working /winding up in the field of sex; like my parents are very proud. Lol.

I'm sure they are today - that I don't doubt.  Is sexual addiction related to trauma - how does that all work - trauma and sexual addiction?

I think there is a very strong relationship between traumatic events and a whole host of challenging behaviors, sexual compulsivity, sexual behaviorism being one of them.  If you look at the ACES study, the ‘Adverse Childhood Events Study”, done by Kaiser in California, and the health outcomes when there are adverse childhood events, a.k.a. traumatic events – they can present very differently. 

And it's just really how you choose to act it.  You could be promiscuous, you could engage in chronic, compulsive masturbation as a way of self-soothing. You can be more anti-social in those behaviors. You could act out with food; you can act out with spending. So, it really depends. But there is a very significant relationship between trauma of some sort.  As you define it – “that was traumatic for me”- and addictive behavior.

Is sexual compulsivity the main (addiction), or does it lead into other (addictions) - like if you have sex addictions, you have alcoholism, as you said, food addictions or acting out in other ways.  Or can it be stand-alone? 

I think that it certainly can be stand-alone – but I think that this stuff gets very blurry. It’s not mono-causal. And in the area of 12 step, somebody stops drinking and drugging but check their Amazon cart - the shopping, etc.  Unless you really sort of address the underlying issues, this stuff oozes out. That doesn't make you a bad person; it makes you supremely human. But these things hang together.

Okay. So, there are some theories – are women more attracted to the love and men are more addicted to the sex? Like, how does that work? Is there a difference between men and women in that?

I think the popular answer is women are more attuned emotionally and socialized to be more emotional.

Of those that identify as women and those that identify as men are not.  Sort of right brain, left brain kind of reductionist way of looking at it. I think if you did a survey, you'd probably be right that - women are more attune to the emotional aspects of a relationship.

 Yeah, well, I mean, I think if you took a survey, you would probably find, what you're sort of hypothesizing that men are more visual / driven by different impulses (those that identify as men, or are non-binary.)  I think so much of it is how we're socialized too, and not to be reductionist, but I think women are still very much socialized to be raised to behave in a certain way – that women aren't drawn to sexual behaviors and aren't interested in being provocative and sexually satisfied.

I do think that it sort of takes place, more in the area of the emotional life of a relationship, than man who are sort of driven more sexually. And if you really look at theories of sexual cycles, men - their first response is a physical response - from a place of arousal. Women start from a place of desire, emotion.  So that's the low-hanging fruit way to look at it.  Everyone's a little different though. But, I think if you went into a love addicts meeting you would probably find more women than if you go into a compulsive-behavior disorder sex addiction meeting, where you would have potentially more men.

 Is there is there any shame around this - more shameful than in other (12-step) programs?

Shame is such a subjective, qualitative experience.  Guilt - I did a bad thing; shame - I am a bad person. So, anyone who's dealing with compulsive addictive behavior that is sanctioned to be outside the norm (whatever the hell that is) comes with a tremendous amount of shame.  Having worked with eating disorders, I know the shame around the restriction, bingeing, and purging (cycle) – is through the roof. It's a very personal experience - your relationship with shame.

I hear you. And I would imagine my guess is that it would prevent us sometimes - the shame - from getting some help.  I remember when I decided to get some help for myself, I had owned a restaurant in the area where I was acting out. And when it was suggested to me that I go to a meeting, I thought, “my God, there's going to be people there I know, I'm sure.”  So, I walked in and yes there were 12 customers I knew there, and they hugged me and said, ‘We were waiting for you. We had a chair for you.”  So, it's amazing how I wish there was a different dynamic around shame where we didn't have it as much and we could move past it and get the help we need, because I do think it kills a lot of people - shame. I do.

One of the books that I have found to be profound around shame, and I really didn't pick it up specifically for this was Brené Brown’s ‘Men, Women and Worthiness.”  Its like she's with you in a therapy session. So, I highly recommend that because she admits to food addiction, substance use addiction and has many years in recovery. I highly recommend that book.

Excellent. Excellent. I will take all your recommendations. For someone with a sex addiction and I don't know, I guess to me, it's sort of like food. Well, you cant abstain completely, but can a person who has a sex addiction, eventually, with work and whatnot, live a normal life?

Well, that's it's a great journey to go on as a provider, as a therapist, with somebody who's coming from a place where they use sex as sort of a weapon – weapon said with love, sort of -  that acting out mechanism because you feel like that is the best tool you have in your toolbox - is to hook somebody with sex or lead with sex because you're not feeling good enough about anything else that you have available to you.  To go from that place, to move toward a space of owning your sexuality, feeling good about everything that props up with sexuality.

So, can we get there?

Absolutely. People get there all the time. Like anything, it requires a tremendous amount of work. And, every time you start the work, you're one step closer to meeting your goal. And your goals could be very small to start. I always sort of talk about recovery, where you're moving toward healing as you're creating a quilt. Like the 12 steps - each step is a square of the quilt. And you start to sew the squares together, and suddenly, you're able to be a little bit more and more.   

But absolutely, people can get there. I mean, look, we know that there are folks out there that are acting out in deeply pathological ways and I think that's a totally separate category of individuals because I don't care who you love, how you love, what you do, Kink, PDSM, it must be with consent, and it cannot be against cannot be breaking the law.

Yeah, yeah.

So that's something that we put over here and that there's a very different sort of mandatory treatment reserved for folks that are engaged in that behavior. But for folks that have not broken the law but have compulsivity and addictive quality to the way that they act out their sexual relations, I feel that healing is possible, but it's going to require mechanisms in which you can stop the acting out, engage in the treatment of anxiety, depression, obsessive-compulsive disorder and trauma, potentially stop the substance use that disinhibits you and allows you to act out in other ways.  It is probably more common than not, that the sex sexual acting out behaviors hang with some substance stuff, some trauma, and so on.

Yeah, I understand that. And I agree with that. When you have one thing, you can have others in which you said earlier, unless you deal with the core, other things will come up. You need to really dig down deep, get to the root of it.

And some people are not ready to do that right away.  We have to put some Band-Aids on, and somebody might start out in a 12-step program for the community for the “all in the same boat” phenomenon. As Gallum, a major group theorist and sort of the god of psychotherapy, one of the gods of psychotherapy, there are lots of therapists out there who tell people who have experienced trauma, you see, and then you might find a therapist, and that therapist tells you, wow, trauma, we've got to get you back in your body - when your body is not the safest place for you.  So, then you sort of backslide a little bit and you start using your body and it sort of causes a little bit more acting out. And then you need to find some more safe places. So, it is a journey.

It's definitely a journey. 

So let me ask you this. If what's the process? How do I start? What do I do?

It’s relationship-building.  You would come in, or we would these days, we would Zoom, and I would do a full assessment like I would do a full assessment on anybody, going through your current level of functioning, family history, and social community. I would do a full assessment.

So it's not so cut and dry.

No, it’s not cut and dry. It's very nuanced. And I think in private practice, we treat addictive behavior as just one of the variables that the patient brings to the table. 

For me, I'm very protective of people's anonymity and their privacy. If you were to go into an intensive outpatient program or a partial hospitalization program, residential or inpatient, we would have to really work on the diagnostic categories to make sure that your insurance would cover it.  

I want to make sure that people continue to have continued treatment, and very often, certain things are covered more easily than others.

Thank you. Thank you.  I've heard a few different things and I'm not sure maybe you'll clear it up for us. So, say you're in a specific program and you're sexting is that considered a slip?

If you were in the 12-step program, if you're looking at the abstinence of the behaviors that drove you to the program, whether it's abstinence. 

Can it ever be in the norm, the sexting, and the pornography?

 If what drove you into a treatment program is compulsive sexting, compulsive porn, then sure - If you're looking at it through a 12-step model, a slip is absolutely using those behaviors. If you were working with me and somebody reported, “I'm on some dating sites and, in order to make sure that somebody asks me out on a date, my sext/my text messages get a little provocative, and sort of what I lead with. is that a slip? - Not in my world.  Is that – “let's unpack that. Let's take a look at why do you feel like you need to make that leap it? How do you feel about what you bring to the table? And why aren't you sure that someone might ask you out?” And if they don't, that really doesn't have anything to do with you? That’s them, they're just not that into you.

We all have something we have to keep in our back pocket to keep us humble, to keep us aware.  If Mary feels like, “I know that it's very easy for me to lead with sex because it's always been successful in the past. But I want to break the pattern.”  Okay, Mary, put that statement in your back pocket and pay attention. Okay?

But if this person starts sexting their supervisor and lost their job and they are put on administrative leave, and commit to go into program, and they are sexting - that's a slip.

I do understand that. So, we're going to be wrapping things up soon. But say if someone comes in and is listening to this cast and they're not sure, what can we tell the person who's on the fence about getting some help?

It’s great to start out with a trained sexual health professional. And that doesn't mean that they have to be a sex addiction specialist, just somebody that has really good credentials, that creates a sex-positive environment, can do a really good assessment and work with that patient. I think the climate today around finding a therapist is really, really challenging. People want to use their insurance. Not everybody has insurance. It's cost prohibitive at times. I feel like, as somebody that's been in the field for a million years and have taught at Columbia and Adelphi.  We churn out a lot of therapists, not everyone is really cut out to do this work. And you have to really be a very careful consumer. I just I need to say that because, sometimes the therapeutic environment can cause more harm.

Yeah. Yeah. I always say to people who ask me for that type of advice, interview them, come in with a set of questions, and feel confident the person speaking to you can and will help. So, with that, first, I want to thank you so much, Connie.

 This is my pleasure. Absolutely. I feel so akin to the background, and I could go over to my dish of crystals, and half of them probably came from your store. 
That’s fantastic.   Thank you so much. So, I like to close with a closing statement. So, as we wrap up this episode of Choices, remember that life is a series of decisions that shape our journey. I hope our time together was inspiring and motivating. Stay empowered, stay well. And remember, “You Always Have Choices.”

Peace and blessings, and we hope to see you next week.

Excellent.  Namaste.

Thank you so much.

You're welcome.