Välkommen till Behandlingskliniken för Sexberoende och Anhöriga

Eftersom sexberoende inte finns i DSM använder vi på DBK Sverige American Society for Addiction Medicines definition av beroende som underlag för vårt arbete (i perentes är ord vi själva lagt till för tydlighetens skull):

 

Beroende är en primär, kronisk sjukdom i hjärnans belönings – och motivationssystem, i minnet och tillhörande nervbanor. Dysfunktion i dessa nervbanor manifesterar sig i karakteristiska biologiska, psykologiska, sociala och andliga (negativa) konsekvenser. Detta återspeglas i en individs patologiska strävan efter belöning och/eller lindring genom att använda kemiska substanser och/eller (specifika) beteenden.

 

Beroende präglas av oförmåga att konsekvent avstå från, och försämrad förmåga att kontrollera beteendena; begär; minskat erkännande av de betydande problem beteendena orsakar för personen själv och i relationer till andra; och (andra) dysfunktionella reaktioner.

 

Liksom andra kroniska sjukdomar innebär beroende ofta cykler av återfall och remission. Utan behandling eller i att engagera sig i sitt eget tillfrisknande är beroende progressiv och kan leda till invaliditet och för tidig död.

 

Nedan är en länk till en artikel som beskriver anledningen till varför vi använder denna definition av beroende:

 

http://eriksundby.blogspot.se/2014/08/vad-ar-ett-beroende.html?spref=bl 

 

När vi började erbjuda ett behandlingsprogram för människor som lider av sexberoende och/eller kärleksberoende och deras anhöriga kom vi till en punkt där vi insåg att vi hade behov av mer kunskap än det som fanns i Sverige då. Vi sökte runt efter den kunskapen och hittade den i USA, där man hade över 30 års erfarenhet av att arbeta med sexberoende, anhörigtrauma och medberoende relaterat till sexberoende. Vår personal har antingen gått eller går i utbildning i USA för att kunna erbjuda bästa möjliga hjälp till dem som söker hjälp hos oss. DBKs behandlingsprogram baseras på IITAPs (International Institute of Trauma and Addiction Professionals) "Task centered approach"- det vi kallar för uppgiftsbaserat behandlingsprogram© Nedan finner ni de antaganden som denna behandlingsmetod baseras på, samt den litteratur och forskning som ligger till grund för detta.
Först kommer ett påstående, sedan kommer den forskning och litteratur som ligger till grund för påståendet. Denna lista uppdateras naturligtvis kontinuerligt.

 

Påståenden bakom DBKs uppgiftsbaserade behandlingsprogram©:

Sexberoende är en hjärnsjukdom. Den förändrar hjärnan på cellnivå;

 

•Kauer, J. A. & Malenka, R. C. (2007). Synaptic plasticity and addiction. Nature Reviews. Neuroscience, 8(11), 844-859.
• Koob, G. F. & Le Moal, M. (2008). Addiction and the brain antireward system. Annual Review of Psychology, 59, 29.
• Cozolino, L. (2002). The neuroscience of psychotherapy: Building and rebuilding the human brain. New York: Norton.
• Teicher, M. H. (2007). Childhood abuse, brain development and impulsivity. MASOC/MATSA Joint Conference. http://www.mclean.harvard.edu/research/clinicalunit/dbrp/seminars.php
• Kolb, B., Gibb, R., and Robinson, T. E. (2003). Brain plasticity and behavior. American Psychological Society, 12(1), 1-5.


Sexberoende skapar förändringar i hjärnans nervbanor

 

• Koob, G. & Kreek, M. J. (2007). Stress, dysregulation of drug reward pathways, and the transition to drug dependence. The American Journal of Psychiatry, 164(8), 1149-1159.
• Canales, J. J. (2007). Adult neurogenesis and the memories of drug addiction. European Archives of Psychiatry and Clinical Neuroscience, 257(5), 261-271.
• Piasecki, T. M., McCarthy, D. E., Fiore, M. C., and Baker, T. B. (2008). Alcohol consumption, smoking urge, and the reinforcing effects of cigarettes: An ecological study. Psychology of Addictive Behaviors, 22(2), 230-239.

Sexberoende aktiverar också allmänna och befintliga nervbanor i hjärnan

 

• Tarko, V. (February 7, 2006). Addicted to sex and money: Our brains lust after money with the same neurons that they crave sex [Electronic version]. Softpedia.
• "Drugs, food, sex, gambling, and aggressive episodes all give prompt, salient, and short-lasting relief to the people who indulge in them. In addition to sharing pleasure-inducing properties, both substance use and other mood-altering activities tend to produce an intial state of euphoria, which is then followed by a negative emotional state; that is, a high followed by a low. This posteuphoric discomfort gives further impetus to reception of the rewarding activity. The old "hair of the dog" remedy of drinking to relieve hangover symptoms is consistent with this idea." - Milkman, H. & Sunderwirth, S. (1987). Craving for ecstasy: The consciousness & chemistry of escape. Lexington, Massachusetts: Lexington Books. Pg. 3.
• Adams, T. C., and Epel, E. S. (2007). Stress, eating and the reward system. Physiology & Behavior, 91, 449-458.
• Carnes, P., September 2001. Addiction Interaction Disorder Core Lab. Information presented at The September Institute with Patrick Carnes, Scottsdale, AZ.
• Miller and Gold 1995. Psychiatric Annals. 25, 673-678.
• Wines, D. 1997. Exploring the applicability of criteria for substance dependence to sexual addiction. Sexual Addiction & Compulsivity. 4, 195-215.
• Amico, J. 1997. Assessing sexual compulsivity/addiction in chemically dependent gay men. Sexual Addiction & Compulsivity. 4, 291-297.
• Griffin-Shelley, E., Sandler, K.R., and Lees, C. 1992. Multiple addictions among dually diagnosed adolescents. Journal of Adolescent Chemical Dependency. 2, 35-44.
• Johnson, M., 1999. Cross-addiction: The Hidden Risk of Multiple Addictions. New York: The Rosen Publishing Group, Inc.
• Campbell, R.J., 1996. Psychiatric Dictionary. (7th edition). New York: Oxford University Press.
• DSM IV 1994.
• Minuchin, S., Rosman, B., and Baker, L. 1978. Psychomatic Families. Boston: Harvard University Press.
• Bateson, G. 1978. Breaking Out of the Double Bind. Psychology Today. 12, (3):43-51.
• Orford, J., 1985. Excessive Appetites: A Psychological View of Addictions. NY:John Wiley & Sons Ltd.
• Csikszentmihaly, M. 1990. Flow. New York: Harper & Row.
• Van der Kolk, B. 2001. The Assessment and Treatment of Complex PTSD. Traumatic Stress. Rachel Yehuda, ed. American Psychiatric Press.
• Van der Kolk, B., 1988. The Trauma Spectrum: The Interaction of Biological and Social Events in the Genesis of the Trauma Response. Journal of Traumatic Stress. 1 (3), 273290.
• Johnson, James F 1865. The Chemistry of Common Life, Vol. 2, p 159. D. Appleton at Co.

Sexberoende tillhandahåller fler sätt att aktivera nervbanor i hjärnan

• "The problem when so much dopamine is being released at once is that all the other common pleasure-generating activities of life start to feel dull and non-motivating. The brain has been sort of "hi-jacked" by the addictive behavior that produces so much dopamine and pleasure. The brain starts to perceive these addicted behaviors as essential to survival like eating and drinking and will do everything to favor and privilege the addiction over everything else...Finding activities that can release a similar amount [dopamine] is not easy. The most common are drugs, alcohol, gambling, sex." - Bordeaux, P. (2008). Gov. Eliot Spitzer's addiction. Forbes.com. Retrieved March 13, 2008, http://www.forbes.com/2008/03/12/spitzer-addictive-behavior-oped.
• Miller, W.R. (1977). The Addictive Behaviors: Treatment of Alcoholism, Drug Abuse, Smoking, and Obesity.
• Orford, J. (1985). Excessive Appetites; a psychological view of addictions.
• Milkman, H. and Sunderwirth, S. (1987). Craving for Ecstacy: How Our Passions Become Addictions and What We Can Do About Them.
• L'Abate, L. (1991). Handbook of Differential Treatments for Addictions.
• Heubner, H. (1993). Eating Disorders and Other Addictive Behaviors.
• Coombs, R. H. (2004). Handbook of Addictive Disorders: A Practical Guide to Diagnosis and Treatment.
• Freimuth, M. (2005). Hidden Addictions.

Sexberoende påverkar perception, värderingar och en persons sätt att tänka

• Zak, P. J. (June 2008). The neurobiology of trust. Scientific American, 88-95.

Deprivation formar en sexberoende persons hjärnfunktioner och det man tror på

• “Addictions and deprivations are cyclic balancing agents of the brain.” Carnes, P. J. (1997). Sexual Anorexia: Overcoming Sexual Self-Hatred. Center City, MN: Hazelden.

En sexberoende persons förmåga att fokusera och uppnå resultat i livet förvrängs till besatthet och dysfunktion

 

• "The problem is that it has become fashionable to regard whatever we feel inside as the true voice of nature speaking. The only authority many people trust today is instinct. If something feels good, if it is natural and spontaneous, then it must be right. But when we follow suggestions of genetic and social instructions without question we relinquish the control of consciousness and become helpless playthings of impersonal forces. The person who cannot resist food or alcohol, or whose mind is constantly focused on sex, is not free to direct his or her psychic energy." - Csikszentmihalyi, M. (1990). Flow: The psychology of optimal experience. New York: HarperPerennial. Pg. 18.

Sexberoende personer har ett genetiskt anlag att utveckla beroende

 

• Carnes, P. J. (1991). Don't call it love: Recovery from sexual addiction. Chapter 4. New York: Bantam.
• "Tiny differences in genes we have in common make some of us more vulnerable to breast cancer, alcoholism or infections..." - Holtz, R. L. (March 21, 2008). Tiny gene variations can even alter effect of the pills we take [Electronic version]. Science Journal, B1.

Barn och ungdomar som exponeras för sex på ett traumatiskt sätt kan utveckla sexberoende

 

• Dube, S. R., Anda, R. F., Felitti, V. J., Chapman, D. P., et. al. (2001). Childhood abuse, household dysfunction, and the risk of attempted suicide throughout the life span: Findings from the. Retrieved March 4, 2008, from http://lirnproxy.museglobal.com.
• Schilling, E. A., Aseltine, R. H. & Gore, S. (2007). Adverse childhood experiences and mental health in young adults: A longitudinal survey. BMC Public Health, 7(3), 30.
• Anda, R. F., Felitti, V. J., Bremner, J. D., Walter, J. D., Whitfield, C., Perry, B. D., Dube, S. R., & Giles, W. H. (2005). The enduring effects of abuse and related adverse experiences in childhood: A convergence of evidence from neurobiology and epidemiology. European Archival Psychiatry Clinical Neuroscience, 256, 174-186.
• Hillis, S. D., Anda, R. F., Felitti, V. J., & Marchbanks, P. A. (2001). Adverse childhood experiences and sexual risk behaviors in women: a retrospective cohort study. Family Planning Perspectives, 33(5), 206-221.
• Edwards, V. J., Holden, G. W., Felitti, V. J., & Anda, R. F. (2003). Relationship between multiple forms of childhood maltreatment and adult mental health in community respondents. The American Journal of Psychiatry, 160(8), 1453.
• Felitti, V. J. (2003). The origins of addiction: Evidence from the Adverse Childhood Experiences study (English version). Published in Germany as: Felitti VJ. Urspruge des Suchtverhaltens - Evidenzen aus einer Studie zu belastenden Kindheitserfahrungen. Praxis der Kinderpsychologie and Kinderpsychiatrie, 2003; 52: 547-559.
• ACE Study - Adverse Childhood Experiences by Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion. Taken from: http://www.cdc.Rov/NCCDPHP/ACE on 11/26/06.
• Perry, B. D. (2001). Bonding and attachment in maltreated children: Consequences of emotional neglect in childhood. www.childtrauma.org.
• Perry, B. D., Pollard, R. A., Blakley, T. L., Baker, W. L., and Vigilante, D. (1995). Childhood trauma, the neurobiology of adaptation and use-dependent development of the brain: how "states" become "traits." Infant Mental Health Journal, 16(4), 271-291.
• Wills, T. A., Walker, C., Mendoza, D., and Ainette, M. G. (2006). Behavioral and emotional self-control: Relations to substance use in samples of middle and high school students. Psychology of Addictive Behaviors, 20(3), 265-278.
• Lussier, I., Derevensky, J. L., Gupta, R., Bergevin, T., and Ellenbogen, S. (2007). Youth gambling behaviors: An examination of the role of resilience. Psychology of Addictive Behaviors, 21(2), 165-173.
• De Young, Mary, and Lowry, Judith (1992). Traumatic bonding: clinical implications in incest. Child Welfare League of America, LXXI, 165-175.
• Feinauer, L. (1989). Comparison of Long-Term Effects of Child Abuse By Type of Abuse and by Relationship of the Offender to the Victim. The American Journal of Family Therapy, 17:1, 48-56.
• Russell, D. (1984). The Prevalence and Seriousness of Incestuous Abuse: Stepfathers Vs. Biological Fathers. Child Abuse & Neglect, 8, 15-22.
• Terr, L. (1983). Chowchilla Revisited: The Effects of Psychic Trauma Four Years After a School-Bus Kidnapping. The American Journal of Psychiatry, 140, 12.
• Teicher, M. H. (2007). Childhood abuse, brain development and impulsivity. MASOC/MATSA Joint Conference. http://www.mclean.harvard.edu/research/clinicalunit/dbrp/seminars.php

Överväldigande stimulering och trauman påverkar utvecklingen av sexberoende

 

• Warner, J. (June 16, 2006). Erotic images excite women's brains as well as hormones [Electronic version]. WebMD.
• Anokhin, A. P., Golosheykin, S., Sirevaag, E., Kristjansson S., Rohrbaugh, J. W., and Heath, A. C. (2006). Rapid discrimination of visual scene content in the human brain. Brain Research, 1093, 167-177.

Trauman är en viktig faktor i utvecklingen av sexberoende

 

• Public health; Adult health problems linked to traumatic childhood experiences (1998) Cancerweekly Plus.
• Scaer, R. (2005). The Trauma Spectrum: Hidden Wounds and Human Resiliency. New York: W. W. Norton & Co.
• Teicher, M. H. (2007). Childhood abuse, brain development and impulsivity. MASOC/MATSA Joint Conference. http://www.rnclean.harvard.edu/research/clinicalunit/dbrp/seminars.php
• Berry, J. (1992). Lead us not into temptation: Catholic priests and the sexual abuse of children. New York: Doubleday.
• Binder, Renee L., MD (1981). Why women don't report sexual assault, Journal of Clinical Psychiatry, 42:11, 437.
• Black, Albert Jr., PhD (1990). Jonestown - two faces of suicide: a Durkheimian analysis. Suicide and Life-Threatening Behavior, 20(4), 285-306.
• Burkett, E., and Bruni, F. (1993). A gospel of shame: child sexual abuse and the Catholic church. New York: Viking.
• Calof, David (1988). Adult survivors of incest and child abuse, part one: the family inside the adult child. Family Therapy Today, 3, 1-5.
• Carnes, Patrick J., PhD. (1991). Addictive Partners: Mirrors of Obsession. Don't Call It Love, 143-180. Bantam Books.
• Charney, Dara A., MD, CM, and Russell Ruth C., MD, CM, FRCP (1994). An overview of sexual harassment, American Journal of Psychiatry, 151:1, 10.
• Fortune, M. M. (1989). Is nothing sacred? When sex invades the pastoral relationship. San Francisco: Harper.
• Fossum, M. & Mason, M. (1986). Facing Shame: Families in Recovery. New York: The Guilford Press.
• Gabbard, G. (1989). Sexual exploitation in professional relationships. Washington D C: American Psychiatric Press.
• Gordon, David (1978). Therapeutic Metaphors. Cupertino CA: Meta Publications.
• Gutheil, Thomas G., MD (1991). Patients involved in sexual misconduct with therapists: is a victim profile possible?, Psychiatric Annals, 21:11, 661.
• Gwartney-Gibbs, Patricia A., and Lach, Denise H. (1992). Sociological explanation for failure to seek sexual harassment remedies, Mediation' Quarterly, 9, 365.
• Hoyt, Seiden, Richard H., PhD, MPH (1979). Reverend Jones on suicide. Suicide and Life-Threatening Behavior, 9(2), 116-119.
• Kroth, Jerry (1984). Recapitulating Jonestown. The Journal of Psychohistory, 11(3), 385.
• Lasaga, Jose I., PhD (1980). Death in Jonestown: techniques of political control by a paranoid leader. Suicide and Life-Threatening Behavior, 10(4), 210-213.
• Lebacqz, K., and Barton, R. G. (1991). Sex in the parish. Louisville, KY: Westminster.
• Leong, K. S. (1989). Sexual attraction and misconduct between Christian therapists and their clients. Dissertation Abstracts International, 50, 4225B.
• McLaughlin, Barbara R. (1994). Devastated spirituality: the impact of clergy sexual abuse on the survivor's relationship with God and the Church. Sexual Addiction & Compulsivity: The Journal of Treatment and Prevention, 1.
• Mellody, Pia, Miller, Andrea Wells and Miller, J Keith (1989). Facing Co Dependency. San Francisco: Harper.
• Ochberg, Frank M., MD (1988). Post-Traumatic Therapy and Victims of Violence. New York: Brunner/Mazel.
• Ochberg, Frank M. and Soskis, David A. (1982). Victims of Terrorism. Boulder CO: Westview Press.
• Post, Robert M., MD (1992). Transduction of psychosocial stress into the neurobiology of recurrent affective disorder. American Journal of Psychiatry, 149:8, 999-1010.
• Schoener, G. R., Milgrom, J. C., Luepker, E. T., and Conroe, R. M. (1989). Psychotherapists'sexual involvement with clients.
• Sipe, Richard (1995). Sex, Priests and Power. New York:Brunner /Mazel Publishers.
• Van der Kolk, Bessel (1988). The trauma spectrum: the interaction of biological and social events in the genesis of the trauma response, Journal of Traumatic Stress, 1, 286.
• Van der Kolk, Bessel (1996). Traumatic Stress. New York: The Guilford Press.
• White, William L. (1986). Incest in the organizational family. Illinois: The Lighthouse Training Institute, 108-109.
• Whitfield, Charles (1992). Denial of the truth: individual and political dysfunction in the Thomas-Hill hearings. The Journal of Psychohistory, 19(3), 269-279.
• Agger, Inger (1989). Sexual torture of political prisoners: an overview. Journal of Traumatic Stress, 2(3), 305-318.
• Briere, John (1992). Child Abuse Trauma: Theory and Treatment of the Lasting Effects. Newbury Park: SAGE Publications.
• Courtois, Christine. (1988). Healing the Incest Wound: Adult Survivors in Therapy. New York: W. W. Norton & Company.
• Dolan, Yvonne. (1991). Resolving Sexual Abuse: Solution-Focused Therapy and Ericksonian Hypnosis for Adult Survivors. New York: W. W. Norton & Company.
• Grove, David & Panzer, B. I. (1991). Resolving Traumatic Memories: Metaphors and Symbols in Psychotherapy. New York: Irvington Publishers, Inc.
• Money, John, PhD, Annecillo, Charles, ScD a Hutchison, MMH (Spring 1985). Forensic and family psychiatry in abuse dwarfism:
• Munchausen's Syndrome by proxy, atonement, and addiction to abuse. Journal of Sex & Marital Therapy, 11(1), 30-40.
• Murray, M. (1991). Prisoner of Another War. Berkely: Page Mill Press.
• Van der Kolk, Bessel (1989). The compulsion to repeat the trauma, Journal of Victims of Sexual Abuse, 12, 389.
• Anderson and Coleman. (1991). Childhood Abuse and Family Sexual Attitudes in Sexually Compulsive Males: A Comparison of Three Clinical Groups. American Journal of Preventive Psychiatry and Neurology on Medical Aspects of Sexual Addiction/Compulsivity, Spring.
• Blum, K. ,Trachtenberg, M., & Kozlowski, G. (1989). Cocaine Therapy: The Reward Cascade Link. Professional Counselor, Jan./Feb.
• Carnes, P. (1989). Contrary To Love. Minneapolis, MN: CompCare Publishers.
• Carnes, P. (1991). Don't Call It Love. New York:Bantam.
• Earle, Ralph and Crow, Gregory (1989). Lonely All The Time. New York: The Philip Lief Group, Inc.
• L'Abate, L., et al. (1992). Handbook of Differential Treatments for Addictions. Boston: Allyn and Bacon.
• Milkman , H. & Sunderwirth, S. (1982). Addictive Processes. Journal of Psychoactive Drugs.
• Schwartz, M. (1992). Sexual Compulsivity as Post-Traumatic Stress Disorder: Treatment Perspectives. Psychiatric Annals, 22, 6.
• Sunderwirth, G. & Milkman, H. (1991). Behavior and Neurochemical Commonalities in Addiction. Contemporary Family Therapy, Oct.
• Wilson, Peter, (Ed.), (1992). Principals and Practice of Relapse Prevention. New York: The Guilford Press.
• Blizard, Ruth A. (1994). Attachment to the abuser: integrating object-relations and trauma theories in treatment of abuse survivors. Psychotherapy, 31(3), 383.
• Buchanan, L. & Buchanan, W. (1992). Eating Disorders: Bulimia and Anorexia. Handbook of Differential Treatments for Addictions. Boston: Allyn and Bacon.
• Edwall, G., Hoffman, N., & Harrison, P. (1989). Psychological Correlates of Sexual Abuse in Adolescent Girls in Chemical Dependency Treatment. Adolescence, Summer.
• Evans, S. & Shaefer, S. (1987). Incest and Chemically Dependent Women: Treatment Implications. Journal of Chemical Dependency Treatment, 1(1).
• Evans, K. & Sullivan, J. M. (1990). Dual Diagnosis: Counseling the Mentally Ill Substance Abuser. New York: The Guilford Press.
• Feinauer, Leslie L. (1989). Comparison of long term effects of child abuse by type of abuse and by relationship of the offender and the victim. The American Journal of Family Therapy, 17(1), 48-56.
• Hagen, T. (1988). A Retrospective Search for the Etiology of Drug Abuse: A Background Comparison of a Drug-Addicted Population of Women and a Control Group of Non-Addicted Women. National Institute on Drug Abuse:Research Monograph Series, Mono 81.
• Miller, B. A., Downs, W. R., & Gondoli, D. M. (1989). Delinquency, Childhood Violence, and the Development of Alcoholism in Women. Crime a Delinquency, 35(1).
• Rohsenow, D. J., Corbett, R., & Devine, D. (1988). Molested As Children: A Hidden Contribution to Substance Abuse? Journal of Substance Abuse Treatment, 5(1).
• Root, M. (1989). Treatment Failures: The Role of Sexual Victimization in Women's Addictive Behavior. American Journal of Ortopsychiatrics, Oct.
• Shaefer, M. R., Sobieraj, K., & Hollyfield, R. L. (1988). Prevelence of Childhood Physical Abuse in Adult Male Veteran Alcoholics. Child abuse and Neglect, 8, 15-22.
• Sullivan, E. J. (1988). Associations Between Chemical Dependency and Sexual Problems in Nurses. Journal of Interpersonal Violence, 3(3).
• Bliss, Eugene (1986). Multiple Personality, Allied Disorders and Hypnosis. New York: Oxford University Press.
• Braun, B. G., MD, (Ed.) (1986). The Treatment of Multiple Personality Disorder. Washington, D. C.: American Psychiatric Press.
• Briere, John (1992). Child Abuse Trauma: Theory and Treatment of the Lasting Effects. Newbury Park: SAGE Publications.
• Foy, D. (Ed.), (1992). Treating PYSD: Cognitive-Behavior Strategies. New York: The Guilford Press.
• Herman, Judith Lewis (1992). Trauma and Recovery. Basic Books: A Division of Harper-Collins Publishers.
• Kluft, Richard, MD (1985). Childhood Antecedents of Multiple Personality Disorder. Washington, D C.: American Psychiatric Press.
• Kluft, R., MD (1987). First Rank - Symptoms as a Diagnostic Clue to Multiple Personality Disorder. American Journal of Psychiatry, 144, 293-298.
• Kluft, R., MD (1985). The Natural History of Multiple Personality Disorder in Childhood Antecedent of Multiple Personality. Washington D. C.
• Lew, Michael (1988). Victims No Longer: Men Recovering from Incest and Other Sexual Child Abuse. New York: Harper and Row.
• Putnam, Frank W. (1989). Diagnosis and Treatment of Multiple Personality Disorder. New York: Guilford Press.
• Putnam, F. W. (1991). Recent Research on Multiple Personality Disorder. Psychiatric Clinics North America.
• Ross, Colin A. (1989). Multiple Personality Disorder, Diagnosis, Clinical Features and Treatment. New York: John Wiley and Sons.
• Van der Kolk, Bessell (1987). Psychological Trauma. Washington D. C.: American Psychiatric Press.
• Young, W. (1988). Observations on Fantasy in the Formation of Multiple Personality Disorder. Dissociation, 1, 13-20.
• Young, W. (1988). Psychodynamics and Dissociation: All That Switches is Not Split. Dissociation, 1, 33-38.
• Abramson, E. & Lucido, G. (1991). Childhood Sexual Experience and Bulimia. Addictive Behaviors, 16.
• Buchanan, L. & Buchanan, W. (1992). Eating Disorders: Bulimia and Anorexia. Handbook of Differential Treatments for Addictions. Boston: Allyn and Bacon.
• Covington, Stephanie. (1991). Awakening Your Sexuality: A Guide For Recovering Women. Harper San Francisco.
• Fossum, M., & Mason, M. (1986). Facing Shame: Families in Recovery. New York:W.W. Norton & Company.
• Gil, Eliana. (1991). The Healing Power of Play. New York: The Guilford Press.
• Goldfarb, L. (1987). Sexual Abuse Antecedent to Anorexia Nervosa, Bulimia, and Compulsive Overeating: Three Case Reports.
• Irons, Richard, MD, and Laser, Mark, PhD (1994). The abduction of fidelity: sexual exploitation by clergy - experience with inpatient assessment. Sexual Addiction & Compulsivity: The Journal of Treatment and Prevention, 1(2), 119-129.
• Maltz, W. (1991). The Sexual Healing Journey: A Guide for Survivors of Sexual Abuse. New York: Harper Collins Publishers.
• Maltz, W. & Holman, B. (1987). Incest and Sexuality: A Guide to Understanding and Healing. Lexington, MA: Lexington Books.
• Foy, D. (Ed.) (1992). Treating PTSD: Cognitive-Behavior Strategies. New York: The Guilford Press.
• Love, P. (1990). The Emotional Incest Syndrom: What to Do When a Parent's Love Rules Your Life. New York: Bantam Books.
• Money, John (1986). Lovemaps: Clinical Concepts of Sexual/Erotic Health and Pathology, Paraphilia, and Gender Transposition in Childhood, Adolescence, and Maturity. New York: Irvington Publishers, Inc.
• Schwartz, M. (1992). Sexual Compulsivity as Post-Traumatic Stress Disorder: Treatment Perspectives. Psychiatric Annals, 22, 6.
• Graham, Dee L. R. (1994). Loving to Survive. New York and London: New York University Press.
• Gutheil, T. (1991). Patients Involved in Sexual Misconduct With Therapists: Is a Victim Profile Possible? Psychiatric Annals, 21:11, 661-665.
• Herman, Judith Lewis (1992). Trauma and Recovery. Basic Books: A Division of Harper-Collins Publishers.
• Van der Kolk, B. 2001. The Assessment and Treatment of Complex PTSD. Traumatic Stress. Rachel Yehuda, ed. American Psychiatric Press.
• Van der Kolk, B., 1988. The Trauma Spectrum: The Interaction of Biological and Social Events in the Genesis of the Trauma Response. Journal of Traumatic Stress. 1 (3), 273-290.

Sexberoende skadar hjärnan

 

• Amen, D. G. (2005). Making a Good Brain Great. New York: Harmony Books
• Teicher, M. H. (2007). Childhood abuse, brain development and impulsivity. MASOC/MATSA Joint Conference. http: / /www. mclean. harvard. edu/ research / clinicalunit/dbrp /seminars. php

En grund för utvecklingen av sexberoende är försummelse eller störd anknytning (särskilt under den tidiga barndomen)

 

• West, Malcom, PhD and Sheldon, Adrienne E. R., BA (1988). Classification of
pathological attachment patterns in adults. Journal of Personality Disorders, 2(2), 153159.
• Solomon, M. F., and Siegel, D. J. (2003). Healing Trauma: Attachment, Mind, Body, and Brain. New York: W. W. Norton a Co.
• Teicher, M. H. (2007). Childhood abuse, brain development and impulsivity. MASOC/MATSA Joint Conference. http://www.mclean.harvard.edu/research/clinicalunit/dbrp/seminars.php

I sexberoende finns avgörande skambindningar - skamprägling

 

• Bradshaw, J. (1988). Healing the shame that binds you. Deerfield Beach, FL: Health Communications.
• Carlsen, Mary Baird (1988). Meaning-Making: The Therapeutic Processes in Adult
Development. New York: W.W. Norton & Company.
• Fossum, M. & Mason, M. (1986). Facing Shame: Families in Recovery. New York: W.W. Norton & Company.
• Harper, James & Hoopes, Margaret (1990). Uncovering Shame: An Approach Integrating Individuals and Their Family Systems. New York: W.W. Norton a Company.
• Kaufman, G. (1989). The Psychology of Shame: Theory and Treatment of Shame-Based Syndromes. New York: Springer Publishing Company.

En sexberoende har snedvridna och orealistiska föreställningar om sina beteenden

• Brecklin, L. R. and Ullman, S. E. (2001). The role of offender alcohol use in rape attacks: an analysis of National Crime Victimization Survey data. Journal of Interpersonal Violence, 16(1), 3-20.
• Bader. Arousal.
Carnes, P. J. and Adams, K. editors. (2002). Clinical Management of Sex Addiction. New York: Brunner-Rutledge.

Sexberoende innebär tvångsmässiga beteenden

 

• "Our knowledge of drug taking, gambling, television watching, and consuming behavior in general must lead us to expect that the availability of a reinforcing activity will result in the population distributing themselves along a skewed frequency distribution curve. Whatever the activity, the majority engage in it in moderation or not at all. Fewer and fewer people do more and more of it. Very heavy, frequent, or immoderate indulgences in the activity is abnormal only in the statistical sense, but almost always carries greater risk of the incurring of various "costs" (loss of time, loss of money, social rule-brealing, bodily damage, impairment of performance, etc.)... it would be most surprising if there were no dissonant or "compulsive" heterosexuals.” (Orford, 1978.)
• Orford, J. (1978). Hypersexuality: Implications for a theory of dependence. British Journal of Addiction, 73, 299-310.
• Philaretou, A. G., Mahfouz, A. Y., & Allen, K. R. (2005). Use of Internet pornography and men's well-being. International Journal of Men's Health, 4, 149-169.
• Delmonico, D. L. & Miller, J. A. (2003). The Internet sex screening test: A comparison of sexual compulsives versus non-sexual compulsives. Sexual and Relationship Therapy, 18, 261-276.
• Putnam, D. E. (2000). Initiation and maintenance of online sexual compulsivity: Implications for assessment and treatment. CyberPsychology & Behavior, 3(4), 553-563.
• Dodes, L. D. (1994). Compulsion or addiction. JAPA, 44(3), 815-835.
• Hayaki, J., Anderson, B., and Stein, M. (2006). Sexual risk behaviors among substance users: Relationship to impulsivity. Psychology of Addictive Behaviors, 20(3), 328-332.
• Teicher, M. H. (2007). Childhood abuse, brain development and impulsivity. MASOC/MATSA Joint Conference. http://www.mclean.harvard.edu/research/clinicalunit/dbrp/seminars.php

Varken den sexberoende personens eller terapeutens goda intentioner i sig kan göra att man tillfrisknar därför att sexberoende personer är dåliga på att fatta hälsosamma beslut

• "What happens physically is that the prefrontal cortex—the part of the brain responsible for making wise decisions and considering the eventual future consequences of a particular behavior—becomes overpowered by the limbic system. The cortex, the sort of "conductor" of the brain's orchestra, is no longer in charge, losing it's ability to control the pleasure-seeking limbic area in its insatiable search for pleasure." - Bordeaux, P. (2008). Gov. Eliot Spitzer's addiction. Forbes.com. Retrieved March 13, 2008, http://www.forbes.com/2008/03/12/spitzer-addictive-behavior-oped.

Varken den sexberoende personens eller terapeutens goda intentioner i sig kan göra att man tillfrisknar därför att sexberoende personer har problem med självreglering

 

• Campbell-Meiklejohn, D. K., Woolrich, M. W., Passingham, R. E., and Rogers, R. D. (2008). Knowing when to stop: Brain mechanisms of chasing losses. Biological Psychiatry, (3), 293-300.
• Teicher, M. H. (2007). Childhood abuse, brain development and impulsivity. MASOC/MATSA Joint Conference. http://www.mclean.harvard.edu/research/clinicalunit/dbrp/seminars.php

Varken den sexberoende personens eller terapeutens goda intentioner i sig kan göra att man tillfrisknar därför att sexberoende personer har intolerans mot yttre påverkan

• Pemmaraju Rao, R. (2007). Spiritual and Emotional Reasons for Addictive Behavior. Retrieved April 22, 2008 from [http://www.drrarna.com/addictions.htm].

Varken den sexberoende personens eller terapeutens goda intentioner i sig kan göra att man kan tillfriskna därför att sexberoende personer har anknytningsmönster som är otrygga

 

• Thorberg, F. A. & Lyvers, M. (2005). Attachment, Fear of Intimacy and Differentiation of Self among Clients in Substance Disorder Treatment Facilities. Retrieved April 22, 2008 from [http://epublications.bond.edu.au/cgi/viewcontent.cgi?article=1003Etcontext=hss_pubs].
• Creeden, K. (2004). The neurodevelopmental impact of early trauma and insecure attachment: Re-thinking our understanding and treatment of sexual behavior problems. Sexual Addiction & Compulsivity, 11(4), 223-247.
• Teicher, M. H. (2007). Childhood abuse, brain development and impulsivity. MASOC/MATSA Joint Conference. http://www.mclean.harvard.edu/research/clinicalunit/dbrp/seminars.php

Varken den sexberoende personens eller terapeutens goda intentioner i sig gör att man kan tillfriskna därför att familjesystemen som gynnar utvecklingen av sexberoende regleras av beroende/missbruk och deprivation…

 

• Carnes, P. J. (1991). Don't call it love: Recovery from sexual addiction. Chapter 5. New York: Bantam.

… som i sin tur förstärker neurokemin och interna känslomässiga processer

 

• Carnes, P. J. (1991). Don't call it love: Recovery from sexual addiction. Chapter 4. New York: Bantam.

Det som gör att man kan tillfriskna är innehållet i en behandlingsprocess:

 

• Det tar c:a 40 dagars behandling i vårt program för att skapa fysisk och psykologisk distans.
• Det tar c:a 90 dagar i vårt behandlingsprogram att börja omprogrammera nervbanorna i hjärnan.
• Det tar mellan 3-5 år (c:a) att etablera en stabil förändring (tillfrisknande).
• Alla beroenden behöver tas hänsyn till i en behandlingsplan. Även om påverkan av andra beroenden när det gäller omprogrammeringsprocessen är okänd för närvarande.
•Identifikation och integrering i tillfrisknandet är allmänt sätt slumpmässigt idag. Detta skapar en benägenhet för återfall och är slöseri med resurser.
• En del sexberoende personer behöver behandling på behandlingshem, men detta är inte möjligt i Sverige idag.
• Behandlingsmetodik som fokuserar på familjen skulle gynna fler personer, men vårt sjukvårdssystem behandlar inte multipla beroenden i dagsläget. I korthet behandlas en av våra dyraste folkhälsosjukdomar på ett dyrt och ineffektivt sätt.
• Det är nödvändigt att behandla de underliggande frågorna, dvs. trauman, för ett långsiktigt tillfrisknande.
• Det är nödvändigt att ha ett kontinuerligt forum för tillfrisknandet.
• Tajming, fokus och ansvarstagande är avgörande för långsiktig framgång.
• Traditionella privata praktiker tillhandahåller inte den struktur som behövs för behandling av sex och/eller kärleksberoende.
• Endast de utfallsstudier som har en löptid på minst fem år har visat verifierbar framgång.
• Behandlingen fokuserar på de aktiviteter och verktyg som är framgångsrik för patienterna.
• Terapeutisk gemenskap är en kritisk faktor för lyckad behandling.
• I en framgångsrik behandling behöver patienterna lära sig om hjärnan och ta till sig information och resurser för att förbättra hjärnans funktioner.
• För att kunna behandla sex- och kärleksberoende behöver man fokusera på professionella terapeuter som varit framgångsrika i sitt eget tillfrisknande.
• Långsiktig behandling av sexberoende ger resultat.

 

Referenser
• The Betty Ford Institute Consensus Panel. (2007). What is recovery? A working definition from the Betty Ford Institute. Journal of Substances Abuse Treatment, 33, 221 - 228.
• McLellan,T. A. (2002). Have we evaluated addiction treatment correctly? Implications from a chronic disease perspective. Addiction, 97(3), 249-252.
• Harwood, H. J., Kleinman, M. A., Kopp, P., and Cohen, M. A. (1999). Economic cost of alcohol and drug abuse in the United States, 1992: A report. Addiction, 94(5), 631.
• Cox, W. M., and Klinger, E. (Eds.). (2004). Handbook of Motivational Counseling: Concepts, Approaches, and Assessment. New York: John Wiley & Sons.
• Shaffer, H. J. (1990). Addictive disease in the Nineties: Lessons from the emperor. Psychology of Addictive Behaviors, 4(1), 57-64.
• Prochaska, J. 0., DiClemente, C. C., and Norcross, J. C. (1992). In search of how people change: Applications to addictive behaviors. American Psychologist, 47(9), 1102-1114.
• Koski-Jones, A. and Turner, N. (1999). Factors influencing recovery from different addictions. Addiction Research, 7(6), 469-492.
• Winek, J. L., and craven, P. A. (2003). Healing rituals for couples recovering from adultery. Contemporary Family Therapy, 25(3), 249-266.
• Egnew, T. R. (2005). The meaning of healing: Transcending suffering. Annuals of Family Medicine, 3(3), 255-262.
• Line, B. Y., and Cooper, A. (2002), Group therapy: Essential component for success with sexually acting out problems among men. Sexual Addiction & Compulsivity, 9, 1532.
• Christodoulidi, F. (2005). Book review of: Forgiveness and the Healing Process: a Central Therapeutic Concern in British Journal of Guidance & Counselling, 33(1), 141142.
• Hunt, S. M. (2002). An outline explanation of how therapy heals. The European Journal of Psychotherapy, Counseling & Health, 5(1), 55-69.
• Wan, M., Finlayson, R., and Rowles, A. (2000). Sexual dependency treatment outcome study. Sexual Addiction & Compulsivity, 7, 177-196.
• Blow, A. J., Sprenkle, D. H., and Davis, S. D. (2007). Is who delivers the treatment more important than the treatment itself? Journal of Martial & Family Therapy, 33(3), 298-317.
• Greenfield, S. F., Trucco, E. M., McHugh, R. K., Lincoln, M., and Gallop, R. J. (2007). The women's recovery group study: A stage I trial of women-focused group therapy for
substance-use disorders versus mixed-gender group drug counseling. Drug and Alcohol Dependence, 9, 39-47.
• Lubinski, D., and Benbow, C. P. (2001). Choosing excellence. Journal of the American Psychological Association.
• Lieberman, M. D., Eisenberger, N. I., Crockett, M. J., Tom, s. M., Pfeifer, J. H., and Way, B. M. (2007). Putting feelings into words: affect labeling disrupts amygdale activity in response to affective stimuli. Psychological Science, 18(5), 421-428.
• Petrucci, C. J., and Quinlan, K. M. (2007). Bridging the research-practice gap: Concept mapping as a mixed-methods strategy in practice-based research and evaluation. Journal of social Service Research, 34(2), 25-42.

12-stegsmöten är en viktig faktor för framgång när det gäller tillfrisknande

 

• 12-stegsmöten hjälper en person att lära sig hur man ska utvärdera sin egen och andras tillfrisknandeprocess
• 12-stegsmöten hjälper en person att upptäcka sin personliga inlärningsstil
• 12-stegsmöten hjälper en person att identifiera interna hinder
• 12-stegsmöten hjälper en person att skapa gemenskap och samhörighet med andra

 

Referenser
• The Betty Ford Institute Consensus Panel. (2007). What is recovery? A working definition from the Betty Ford Institute. Journal of Substances Abuse Treatment, 33, 221 - 228.
• Kelly, J. F. & Myers, M. G. (2007). Adolescents' participation in Alcoholics Anonymous and Narcotics Anonymous: review, implications and future directions. Journal of Psychoactive Drugs, 39(3), 259-269.
• Laudet, A. Stanick, V. & Sands, B. (2007). An exploration of the effect of on-site 12-Step meetings on post-treatment outcomes among polysubstance-dependent outpatient clients. Evaluation Review, 31(6), 613.
• Johnson, J. E., Finney, J. W. & Moos, R. H. (2006). End-of-treatment outcomes in cognitive-behavioral treatment and 12-step substance use treatment programs: Do they differ and do they predict 1-year outcomes? Journal of Substance abuse Treatment, 31(1), 41-51.
• Donovan, D. M. & Wells, E. A. (2007). Report; 'Tweaking 12-Step': the potential role of 12-Step self-help group involvement in methamphetamine recovery. Addiction, 102(1), 121
• "Addicts arrive at the doorstep of a Twelve Step program convinced they are unique in their badness, telling themselves, "No one has been as bad or as out of control as I have. No one would accept me or care for me." Being accepted in the fellowship, they learn through stories that they have an illness which in fact is common. What has been shrouded in agonizing secrecy for years becomes openly talked about. In working the first step, addicts admit that they, too - like all these other people - have become powerless over their illness." - Carnes, P. J. (1989). Contrary to Love. Pg. 163
• "The most important requirement for an effective metaphor is that it meet the client at his model of the world. That does not mean that the content of the metaphor is necessarily the same as that of the client's situation. "Meeting the client at his model of the world" means that the metaphor preserves the structure of the client's problematic situation. That is, the significant factors in the metaphor are the client's interpersonal relationships and patterns of coping within the context of the "problem," The context itself is not important." - Gordon, D. (1978). Therapeutic Metaphors. Cupertino, CA: META. Pg. 24.
• "With the secrecy and shame of the core beliefs alleviated by the program (12 STEP), the ability to incorporate new core beliefs is born. Other interventions in the addictive system contribute to the preparation of the new beliefs. Few have more significance than how the program helps addicts with their impaired thinking." - Carnes, P. J. (1989). Contrary to Love. Pg. 164
• "... addicts in recovery go through a profound grief process, as all of them do. For the sexual addict, sex has been the primary relationship - the main source of nurturing life. The end of that relationship is like a death. The addict who stops the addictive cycle, which gave meaning and direction to life, suffers a very real loss." "The Twelve Step program helps addicts through their grieving process; it disrupts preoccupation and obsession with sex and supports grieving over the loss of the pathological relationship." - Carnes, P. J. (1989). Contrary to Love. Pg. 167-168
• "The first step of the Twelve Steps helps with the denial and isolation in several ways. Addicts admit that they are powerless over the addiction and that their lives have become unmanageable. Usually they do a methodical inventory of all the ways the addiction proved more powerful, including all those events they would have done anything to avoid but were powerless to stop. Throughout the inventory, addicts note how life had become unmanageable and intolerable with the addiction. The process helps them own their loss. They admit (powerlessness) and surrender (unmanageability) to the illness and acknowledge their need for help. Once they have acknowledged a loss, most grieving persons become very angry. ...They feel angry at God for letting this happen, anger at the addiction, anger for loss of the addiction, and anger at themselves for not having done something sooner. By taking the second and third steps, addicts make a significant act of trust, acknowledging a higher power who can help them regain sanity. They then can turn their lives over to a Higher Power. This leap of trust requires acceptance of the fundamental dependency of the human condition. The addict can then make meaning out of the experience. ...Those who suffer losses, and pass through the stages of denial and anger, come to accept themselves through letting go...
Steps four and five help the addict bypass shame and gain self-acceptance. Step four asks addicts to make a thorough inventory of personal strengths and weaknesses, including all the ways they have not lived up to personal values. This careful look at themselves may cause sadness and remorse.
Step five invites the addicts to share their inventory with another person. ...The experience of relating all that history to someone else exposes the recovering person at an extreme level of vulnerability. Being so exposed, and yet being affirmed and accepted, creates healing of the highest order. ... In effect, the addicts can feel restored to the human community. Often great joy and relief occur after the fifth step has been taken.
As in all grief, the struggle does not subside with self-acceptance. Bereaved persons have moments during which they intensely search for the lost relationship. Addicts experience pangs of loss when their sadness and their desire for the old way returns. This is a time for "slips," loss of courage, euphoric recall, and testing limits. Once again the program provides a framework to help with this hanging on of grief. Steps six and seven ask addicts to be ready to let go of the defects of character which could bring back the active addictive life. Again, part of letting go requires a trust in a Higher Power and trust in the existence of a healing process. With steps six and seven,
the program participants identify the addictive "friends" - those beliefs, defenses, attitudes, behaviors and other issues that supported the addiction when it flourished. As the grieving process evolves, a new sense of identity emerges. With restored confidence, the bereaved seek reconciliation with people they had pushed away. For addicts, the renewal of identity takes concrete forms in terms of celebrating their progress. ... Building on this renewed sense of self, the addicts' shame no longer prevents reconciliation with friends and family. With steps eight and nine, the addicts list those people who have been harmed and make amends, hopefully to heal the breach in the relationship. Making these direct efforts brings comfort through further restoration of self and, in some cases, forgiveness. ...although the sadness never leaves, it is transformed becoming incorporated into our beings as part of that suffering that brings wisdom and depth of feeling to all of us. One simply learns to adjust life in order to carry the suffering.
Step ten encourages a daily effort to take stock of one's life using the principles of the first nine steps. Step eleven suggests that spiritual progress results from a daily effort to improve conscious contact with a Higher Power. Step twelve asks addicts to tell other addicts about the power of the program. They pass on what they have received.
These last three steps help the addicts integrate the program principles into daily life, and the program thus becomes an intervening system which disrupts the addictive system and provides ongoing support for the lifelong process of surviving the loss." Carnes, P. J. (1989). Contrary to Love. Pg. 168-171.

Antaganden som är viktiga i det praktiska terapiarbetet 

 

“Verktygen i det uppgiftsbaserade behandlingsprogrammet© utgår från olika områden i livet – fysiskt, psykologiskt och relationsmässigt. Dessa områden har vi fått fram genom att undersöka det som fungerar för de patienter som deltagit i behandlingen”. P Carnes


Verktygen i det uppgiftsbaserade behandlingsprogrammet© är specifika aktiviteter utformade för att undervisa patienter, underlätta deras tillfrisknandeprocess och hjälpa dem att införliva grundläggande färdigheter för att kunna underhålla framgång i tillfrisknande.

 

Merril, M. D. (2007). A task-centered instructional strategy. Journal of Research on Technology in Education, 40(1), 5-22.


Alla verktygen i det uppgiftsbaserade behandlingsprogrammet© passar in i följande konstruktionsparametrar:

 

• De är forskningsbara och dikotoma (se nedan A och B för definitioner av ordet diktoma)

 

A. Dikotom variabel
Dikotom variabel (eng: dichotomous variable) är en variabel som endast antar två värden, t ex manligt och kvinnligt, liv och död, sant och falskt, rätt och orätt. Dikotom bedömning och betygsättning är sådan som endast har två lägen: godkänd-underkänd (eng: pass-fail)

B. Dikotoma diagnoser
I kategoriindelning av sjukdomar, t ex i ICD och DSM, tillämpas dikotomi på det sättet att läkaren eller psykologen med ledning av ett antal kriterier ska komma fram till om viss störning föreligger eller inte, om ett beteende är avvikande eller inte. Detta leder till godtyckliga gränsdragningar men är av värde för internationell forskning genom den minskning av mångtydigheten i psykiatriska terminologin som man uppnår på det sättet.


• De kräver fokus
• De integrerar styrkan i 12-stegsprogrammet och principerna däri


Det uppgiftsbaserade behandlingsprogrammets© verktyg innehåller aktiviteter som:

 

• kräver att man fokuserar för att kunna konsolidera
• reparerar skador som uppstått pga. beroendet
• stimulerar hjärnan och tillåter växt
• arbetar för att lösa frågor som bidrar till paradigmövertygelser (dvs. som ger näring till destruktiva inre dialoger).
• utnyttjar intern och kognitiv förmåga att konsolidera, koncentrera, och stimulera.
• gör att man systematiskt engagerar sig i meningsfullt samspel med andra.
• har tydliga indikatorer på framsteg och belöning för detta.
• engagerar alla delar av hjärnan men speciellt mitthjärnan och frontalloberna.
• verkar för vision och mening.
• hjälper till att skapa självkännedom genom att aktivera inlärning och gör nervceller flexibla, så man kan verka i en mängd olika miljöer.

 

Den uppgiftsbaserade behandlingsprogrammets© konstruktionsförutsättningar

Det finns en fysiologisk/biologisk grund för sexberoende. Sexberoendet är en hjärnsjukdom som:

• manifesteras i tvångsmässiga beteenden och störd förmåga att kontrollera normal funktion.

• sex- och kärleksberoende påverkar signalsubstanser, transportörer och receptorer i hjärnan och nervbanor, strukturer och processer i hjärnan

• sex- och kärleksberoende öppnar dörren för interaktion med andra beroenden och störningar och har likheter med andra beroenden (och en del skillnader). Det är alltså ofta förknippat med andra sjukdomar eller dysfunktioner (samsjuklighet med andra beroenden, personlighetsstörningar, affektiva störningar, och stressrelaterade sjukdomar).

 

Sexberoende har en biologisk grund

 

Referenser
• Blum, K., Braverman, E. R., Holder, J. M. (2000). Reward deficiency syndrome: A biogenetic model for the diagnosis and treatment of impulsive, addictive, and compulsive behaviors [Abstract]. Journal of Psychoactive Drugs, 32, 1-68
• Bressan, R. A., & Crippa, J. A. (2005). The role of dopamine in reward and pleasure behaviour - review of data from preclinical research. Acta Psychiatrica Scandinavica, 111(s427), 14-21.
• Drumright, L. N., Patterson, T. L., & Strathdee, S. A. (2006). Club drugs as causal risk factors for HIV acquisition among men who have sex with men: A review. Substance Use & Misuse, 41(10-12), 1551-1601.
• Fride E. (2005). Endocannabinoids in the central nervous system: from neuronal networks to behavior. Current Drug Targets. CNS and Neurological Disorders, 4 (6), 633-42.
• Fride E. (2005). Endocannabinoids in the central nervous system: from neuronal networks to behavior. Current Drug Targets. CNS and Neurological Disorders, 4 (6), 633-42.
• Goudriaan, A.E. (2006). Neurocognitive functions in pathological gambling: a comparison with alcohol dependence, Tourette syndrome and normal controls. Addiction, 101 (4), 53447.
• Gulsun, M. (2007). Treatment of compulsive sexual behaviour with clomipramine and valproic acid. Clinical Drug Investigation, 27 (3), 219-23.
• Kalenscher T. (2006). The neuroscience of impulsive and self-controlled decisions., International Journal of Psychophysiology: Official Journal of the International Organization of Psychophysiology, 62 (2), 203-11.
• Koob, G. F., & Le Moal, M. (2005). Plasticity of reward neurocircuitry and the 'dark side' of drug addiction. Nature Neuroscience, 8(11), 1442-1444.
• Lubman, D. I., Yücel, M., & Pantelis, C. (2004). Addiction, a condition of compulsive behaviour? Neuroimaging and neuropsychological evidence of inhibitory dysregulation. Addiction, 99(12), 1491-1502.
• Marinelli, M., & Piazza, P. V. (2002). Interaction between glucocorticoid hormones, stress and psychostimulant drugs. European Journal of Neuroscience, 16(3), 387-394.
• Nestler, E. J. (2005). Is there a common molecular pathway for addiction? Nature Neuroscience, 8, 11, 1445-1449.
• Olbrich, H. M., Valerius, G., Paris, Ch., Hagenbuch, F., Ebert, D., & Juengling, F. D. (2006). Brain activation during craving for alcohol measured by positron emission tomography. Australian and New Zealand Journal of Psychiatry, 40 (2), 171-178.
• Volkow, N.D. (2004). Dopamine in drug abuse and addiction: results from imaging studies and treatment implications. Molecular Psychiatry, 9(6), 557-69.

 

Sexberoende är ett uppmärksamhetsproblem

 

• Beroende är den ultimata ADD (uppmärksamhetsstörningen)
• Människor är som bäst när de engagera sig i att utveckla sin egen kompetens genom fokus
• Beroende är ett sätt att skapa ordning
• Beroende är den optimala fantasin


Tillfrisknande innebär focus, flöde, tao

 

Referenser
• Arnold P.D. (2005). Attention-deficit hyperactivity disorder with and without obsessive-compulsive behaviours: clinical characteristics, cognitive assessment, and risk factors, Canadian Journal Of Psychiatry. Canadian Journal of Psychiatry, 50 (1), 59-66.
• Kalichman, S. C., Tannenbaum, L., & Nachimson, D. (1998). Personality and cognitive factors influencing substance use and sexual risk for HIV infection among gay and bisexual men. Psychology of Addictive Behaviors, 12(4), 262-271.
• Tarter, R. E., Kirisci, L., & Feske, U. (2007). Modeling the pathways linking childhood hyperactivity and substance use disorder in young adulthood. Psychology of Addictive Behaviors, 21(2), 266-271.
• Yoo, H.J. (2004). Attention deficit hyperactivity symptoms and internet addiction. Psychiatry and Clinical Neurosciences, 58 (5), 487-94.


Sexberoende är skambaserat. De komponenter som hänger ihop med detta är:

 

• Bristfälliga självkänsla
• Grandiositet, narcissism
• Förtvivlan, hopplöshet, depression
• Hemligheter, kategorisering
• Att det inte spelar någon roll hur mycket man presterar – man kan inte prestera fram tillfriskande
• Att man tvångsmässigt följer beroendesystemet
• Att det kan finnas andra problem som kan påverka

 

Referenser
• Adams, K. M., & Robinson, D. W. (2001). Shame reduction, affect regulation, and sexual boundary development: Essential building blocks of sexual addiction treatment. Sexual Addiction & Compulsivity, 8(1), 23-44.
• Claesson K. (2007). Shame: mechanisms of activation and consequences for social
perception, self-image, and general negative emotion. Journal of Personality, 75 (3), 595627.
• Knox J. (2005). Sex, shame and the transcendent function: the function of fantasy in self development. The Journal of Analytical Psychology, 50 (5), 617-39.
• Wilson, M. (2000). Creativity and shame reduction in sex addiction treatment. Sexual Addiction & Compulsivity, 7(4), 229-248.

 

Sex- och kärleksberoende är en intimitetsstörning

 

• Sex- och kärleksberoende personer har stora problem med anknytning
• Sex- och kärleksberoende är en patologisk relation
• Sex- och kärleksberoende innebär isolering och självmedicinering
• Sex- och kärleksberoende är en uppvaktningsstörning
• Sex- och kärleksberoende innehåller komplexa regelsystem för sex och intimitet
• Sex- och kärleksberoende är ett sätt att efterlikna intimitet

 

Referenser
• Butler, M. H., & Seedall, R. B. (2006). The attachment relationship in recovery from addiction. Part 1: Relationship mediation. Sexual Addiction & Compulsivity, 13(2-3), 289315.
• Corley, M. D., & Kort, J. (2006). The sex addicted mixed-orientation marriage: examining attachment styles, internalized homophobia and viability of marriage after disclosure. Sexual Addiction & Compulsivity, 13(2-3), 167-193.
• Fisher, H. (2000). Lust, attraction, attachment: Biology and evolution of the three primary emotion systems for mating, reproduction, and parenting. Journal of Sex Education & Therapy, 25(1), 96-104.
• Keane, H. (2004). Disorders of desire: Addiction and problems of intimacy. Journal of Medical Humanities, 25(3), 189-204.
• Reid, R. C., & Woolley, S. R. (2006). Using emotionally focused therapy for couples to resolve attachment ruptures created by hypersexual behavior. Sexual Addiction & Compulsivity, 13(2-3), 219-239.
• Valenti, S. A. M. (2002). Use of object relations and self-psychology as treatment for sex addiction with a female borderline patient. Sexual Addiction & Compulsivity, 9(4), 249262.
• Schwartz, M. F., & Southern, S (2000). Compulsive cybersex: The new tea room. Sexual Addiction & Compulsivity, 7(1-2), 127-144.
• Zitzman, S. T., & Butler, M. H. (2005). Attachment, addiction, and recovery: conjoint marital therapy for recovery from a sexual addiction. Sexual Addiction & Compulsivity, 12(4), 311-337.

 

Sex- och kärleksberoende är en maladaptiv reaktion på stress

 

• ett sätt att hantera trauman
• en förträngningsmekanism för jobbiga känslor och minnen
• ett sätt att tränga undan sorg och negativ känslomässig påverkan
• ett sätt att tillverka och underhålla Mörkrets Herre (missbrukspersonligheten)
• en allierad för att skydda sig själv

 

Referenser
• Creeden, K. (2004). The neurodevelopmental impact of early trauma and insecure attachment: re-thinking our understanding and treatment of sexual behavior problems. Sexual Addiction & Compulsivity, 11(4), 223-247.
• Earle, R. H., Dillon, D., Jecmen, D. (1998). Systemic approach to the treatment of sex offenders. Sexual Addiction & Compulsivity, 5(1), 49-61.
• Enoch, M. A. (2007). Genetics, stress, and the risk for addiction. In: M. Al'Absi. Stress and addiction: biological and psychological mechanisms (pp. 127-146) [Abstract]. San Diego, CA: Elsevier Academic Press.
• Luke, D.A. (2002). Assessing the diversity of personal beliefs about addiction: development of the addiction belief inventory. Substance Use & Misuse, 37(1), 89-120.
• Sinha, R. (2001). How does stress increase risk of drug abuse and relapse? Psychopharmacology, 158 (4), 343-59.
• Southern, S. (2002). The tie that binds: Sadomasochism in female addicted trauma survivors. Sexual Addiction & Compulsivity, 9(4), 209-229.

 

Sex- och kärleksberoende är en familjesjukdom och den kan drabba människor från alla socio-ekonomiska nivåer

 

• Sex- och kärleksberoende är en funktion eller roll i familjesystemet
• Förändring hos familjemedlemmar minskar symtomatologi
• I familjesystemet finns ett samspel i beroendeframkallande mönster
• Sex- och kärleksberoende har en genetisk faktor och anledningar som hänger ihop med omvårdnad

 

Referenser
• Robinson, T. E., & Berridge, K. C. (2000). The psychology and neurobiology of addiction: An incentive-sensitization view. Addiction, 95(12), 91-117.
• Robinson, T. E., & Berridge, K. C. (2001). Incentive-sensitization and addiction. Addiction, 96(1), 103-114.
• Schneider, J. P. (2003). The impact of compulsive cybersex behaviours on the family. Sexual and Relationship Therapy, 18(3), 329-354.

 

Sexberoende är ett identifierbart syndrom som innehåller -

 

• Diagnostiska kriterier
• Kluster av egenskaper som är prediktiva, tillförlitliga och giltiga
• Möjliggör för skillnader i definition, etiologi och behandling

 

(Observera att sexberoende som term inte används i DSM, utan visar sig i impulsstörningar, hyposexualitet och i parafili)

 

Referenser
• Bancroft J. (2004). Sexual addiction, sexual compulsivity, sexual impulsivity, or what? Toward a theoretical model. Journal of Sex Research, 41 (3), 225-34.
• Hollander, E. (2006). Behavioral and substance addictions: a new proposed DSM-V category characterized by impulsive choice, reward sensitivity, and fronto-striatal circuit impairment [Abstract]. CNS Spectrums, 11(11), 814-822.
• Martin, P. R., & Petry, N. M. (2005). Are Non-substance-related Addictions Really Addictions? American Journal on Addictions, 14, (1), 1-3.
• Schneider, J. P. (2004). Understanding and diagnosing sex addiction. In: Coombs, R. Holman (Ed.). Handbook of addictive disorders: A practical guide to diagnosis and treatment (pp. 197-232). [Abstract]. Hoboken, NJ: John Wiley & Sons.
 

--