S3 E3: Dr. Erica Sarr on Sex Addiction and Recovery

Clinical Psychologist Erica Sarr takes a sex-positive approach to her work as Clinical Director at Gentle Path, where she helps men dealing with compulsive and disruptive sexual behaviors. With the continuing commercialization of sex in our culture and the “lurid” connotations attached to it in much of society, Dr. Sarr recognizes the power in opening up the conversation in order to move men with sexual addiction issues — and all of us — toward healthy sexuality.

Podcast Transcript

Dr. Erica Sarr
You’re not alone. You don’t have to do it alone. And you really can’t do it alone. You have a right to feel how you feel. You have the right to make steps that make you safe, both for the attics and the partners. So you’re not alone.

David Condos
Welcome to Beyond Theory, the podcast powered by Meadows Behavioral Healthcare. That brings you in depth conversations from the frontlines of mental health in addiction recovery. I’m David Condos. For someone with an alcohol addiction recovery usually means never drinking again. But for those with a sex addiction, life and recovery isn’t that simple. So how does Dr. Erica Sarr helped men dealing with compulsive, destructive sexual behavior? Learn what long term healthy sexuality looks like. Let’s get out of the abstract and see how this applies in the real world. It’s time to go beyond theory.

Dr. Erica Sarr
I’m Dr. Erica Sarr, and I’m the clinical director at Gentle Path with The Meadows.

David Condos
Thank you so much for being with us today. Dr. Sarr,

Okay. So yeah, we’ll start with kind of launching into your story and who you are as person, the journey you took to getting into this world of recovery?

Dr. Erica Sarr
Sure. So I guess the best way to describe it is I’ve always been interested in why people do what they do. Um, and so I briefly toyed with the idea of joining the FBI or the CIA, because that seemed like, ways that you could use your talents and your interest in understanding why people do what they do file. Yeah, yeah. Um, but that really wasn’t my path. So ultimately, you know, I did a few things I moved around. Ultimately, I landed on deciding to go into psychology. So I went into a master’s program in Maryland, and met a mentor there who said, I know this guy who works with sex offenders, how do you feel about that work? And I said, Well, I want to work with sexuality, like that’s a really important part of this process for me. Because I’ve always found that a really fascinating part of the human experience that people commercialize and discuss in lurid ways, but they don’t really talk about it or

David Condos
not really, the truth of it, the meaning.

Dr. Erica Sarr
Yeah. And so I’m open to working with sex offenders. So I went, and that was my placement. And my master’s program. That was my clinical placement. And I remember putting my hand on the doorknob at this place. I mean, like, what if I can’t do this. And that was my last hesitation, because the therapist I work with are wonderful. The clients were wonderful, they really wanted to be understood. For the most part, there are a few people who were struggling more, but mainly, they were grateful that somebody cared about their experience and wanted to help them get well

David Condos
and was actually treating them

Dr. Erica Sarr
yeah, person, like a person. Yeah, the program I went to, has a specialty program where I could get a dual degree in human sexuality. And so I really am highly specialized in that area. And so I worked largely with offenders. Again, I worked in forensic foster care with juvenile offenders, and adult offenders, and ultimately, actually, in my final placement ended up working in a sex addiction clinic. And my first thought about the sex addiction clinic was, what if these are just sex offenders with money,

David Condos
they can get away with things, right,

Dr. Erica Sarr
because I really didn’t have a framework to understand sex addiction. That wasn’t the model that I’d really worked under. And I was really worried about that. Because a lot of folks in the sex offender world, their outcomes really were affected by their socio-economic status. But when I got into that work, I was like, Oh, no, this is a thing. Like, people are worried that it’s just an excuse. But when you talk to someone who’s like, I’ve spent $300,000 in the last two years on sex workers, and I don’t have $300,000 there’s a compulsive aspect to that that’s hard to deny. Right? There. It’s one thing to cheat. Not every cheater is an addict, but to to cheat at that level that literally in the face of life altering circumstances, you can’t stop. So I was really intrigued. So I enjoyed the work there. I stayed on after my internship, and, you know, ultimately, met some people from the meadows at a conference. They really liked the work I was doing around healthy sexuality in sobriety, and kind of invited me to join their team. And slightly over a year ago, I took over as Clinical Director here at the gentle path program, which is the men’s sex addiction unit.

David Condos
Yeah, yeah. And so looking at Gentle Path now. Yeah, I know that space On a lot of the teachings of Patrick Carnes, who’s a Meadows Senior Fellow as well. And so talk about kind of how you integrate his teachings into the program like on an on an on a day to day, kind of day to day kind of way. Well, yeah.

Dr. Erica Sarr
So like, task number one is breakthrough denial. So that’s what we spend a lot of time doing. Hopefully, we don’t spend some days entire stay on task one. But, but that’s a big part of the work. Some other tasks are integrated on a day to day basis have to do with like restoring bodily integrity, and accountability, and building a culture of support. And so the guys go to daily 12 step meetings to build that culture of support. Most of the therapy takes place in group therapy, not because I don’t have the resources to do individual, I mean, I could if it was the right thing to do, put everybody through eight hours of individual therapy a day. And some people are happily like, how much does that cost? I gotta check. And I just tell them, I’m like, it’s not, it’s not the way to treat your issue. You can’t treat intimacy in isolation. So you have to get used to telling people your story, your shame, telling your truth. Having your accountability and have somebody look you in the eye and say that behavior is not okay, I’ll still show up for you, I’ll still help you. I’ll still eat lunch with you. But you need to know that wasn’t alright what you did. Because those are the earmarks of a healthy relationship. Everybody let somebody down. Everybody makes a mistake. Everybody’s occasionally not their best selves. But if we try to hide that from people, it just exacerbates on a day to day basis. And so feelings like sadness, pain, guilt, are useful. But most people come in saying how do I live a life where I only feel peace and joy for the rest of my life. And that’s where we integrate pmld is working over other senior fellows when we look at the her trauma model. And we’re like, Well, you know, all these emotions, including sadness, and anger and fear, are natural parts of the human experience can be useful. Yeah. And you want to have those if you try to remove those, you’re actually trying to live a crippled life, a stunted life. And that’s not really going to serve you. Well.

David Condos
Now, and that’s kind of missing the point. Yeah. All right. So so with gentle path, it’s focused on men with sex addiction, and things kind of related to that. Tell us about kind of the spectrum that you’re seeing what what is the population look like for the men that you’re working with?

Dr. Erica Sarr
Yeah, I think that’s changed over the years. And it’s still, it’s still changing, because technology is getting out in front of us in leaps and bounds. You know, every industry knows that technology is changing faster than regulation, and law and all that. And so we’re just discovering, and just being able to do some of the research now around the effects of pornography, things like that, because the the traditional model that Dr. Carnes studied and researched was about people who came from rigid and disengaged family systems, where they didn’t learn about healthy intimacy, they didn’t learn about connection in a healthy way. And so sex was kind of the medicine that filled in as an illusion for real authentic attachment and intimacy. What we’re finding now is some of our younger sex addicts have perfectly healthy attachment and healthy families. But they’ve been watching hardcore pornography since they were like 10, because they did a web search. And whereas back in the day, a 10 year old boy might have been interested in what the girls in his class look like. But nowadays, they’ll get 10 million pages of explicit sex scenes, you know, which is actually traumatic for children, because they don’t really understand what’s going on. Yeah. And so that changes the whole course of their sexuality. So you start to get things like porn induced erectile dysfunction, which is, you know, erectile problems, and young men who don’t have any medical reason for that to be happening, other than they’re just conditioning their bodies to pornography versus face to face. Yeah, human interaction. But the current state of how people interact with pornography, how they interact with the sex work industry, how they interact with, you know, all those bits of technology is, is currently problematic for how our brain is structured.

David Condos
So technology is really changing how you do your job.

Dr. Erica Sarr
Yes. So on top of that, so that adds a new kind of cadre of a different kind of sex addict compared to we still have our folks who have Have childhood traumas, childhood sexual abuse, you know, family of origin issues, those kinds of things. So we still have folks who follow the classic model. But we also have other folks, because I’m so interested in, in human sexuality in all its forms, we get folks who have problems that they need to address in a residential study setting, but maybe aren’t sex addicts, and we kind of try to help them sort that out. And they come and they abstain from sexuality for 90 days, while they’re, you know, in our program, and for 45 days after, not because they’re an addict, but because they’re like, I want to get a little bit of breathing space to sort out what’s going on for me sexually.

David Condos
So kind of just taking a pause to reassess what’s going on.

Dr. Erica Sarr
So we, you know, we don’t do conversion therapy that’s not legal or ethical or doesn’t work. So we don’t do any of that. But we do sit with people in the struggle, we say, okay, you have this behavior, you want to stop, but you have this fear about who you are, let’s just look at all parts of that. And you’re the only person who can make a decision about that.

David Condos
Yeah. And so, kind of within that broad spectrum, how do you define sex addiction.

Dr. Erica Sarr
So it kind of goes off of how I how I define addiction in general, which is taking any behavior or substance, and using it to manage an emotion. And usually maladaptive Lee managing emotion, right? So sex is not bad. In and of itself, food is not bad in and of itself, you know, but when we start using sex, or food, or money, or work or shopping, or substances, substances kind of come immediately with their own problems, because they’re foreign agents into the body. So they’re not supposed to be there, right, the brain, you know, treats them in a different way. Behavioral addictions are even more challenging, because you’re taking a natural process your body wants to have sexual relations with, with, you know, other creatures it wants to eat. Gambling is kind of based on that survival instinct of pattern recognition and things like that. And it wants to do those things, but it started to use them in a problematic way. And so that’s kind of how I define it for folks. Because we get a lot of addiction interaction where people have been sober from alcohol for 25 years, never dealt with the underlying pain that was causing them to drink. And upon reflection, realize they’ve been acting out sexually, that whole time. And they’re like, Oh, it was dry, but not sober. And that doesn’t mean it wasn’t an amazing accomplishment to not drink for 25 years, it absolutely was. But they never dealt with the underlying stuff. And so what I tell them is, it’s like it’s the same cake, you just put different frosting on it. And the cake is still there. And that’s what has to be dealt with. If you want real change. Yeah.

David Condos
And so you mentioned earlier about like, boundary, but yeah, so what what role do boundaries play? And kind of how do you help these men understand how to set and maintain healthy boundaries, if they’re, if they’re not used to that?

Dr. Erica Sarr
depends on where they come in with an understanding. Some guys are like, what is a boundary? Like, they don’t even couldn’t even define that concept. And we’re back to basic concepts. Like, if you had a dog, And you didn’t want it to run out of your yard, you’d have to have a fence or a chain. Those are boundaries, right? So let’s assume that your childish impulses to say, ooh, I want candy. Ooh, I want to touch that lady, you know who I want to drink, whatever it is, is a really enthusiastic dog. And until you get time to train that dog, it has to be behind a fence. Right? So we start with having you go to rehab, it’s basically a fence. What I want to do is train you to train your dog. Right. And I’m not calling in dogs, about that metaphor, but

David Condos
like the behavior, yeah, the childish impulses. Yeah,

Dr. Erica Sarr
it’s a very enthusiastic, new part of ourselves. You know, if we get Freudian, that’s the ID, right. But so we might start with that. But then we talk about not just boundaries, but boundaries that they’ve set, but that they’re resentful about or boundaries that are invisible. So like, maybe they never realized that when they got married, they had an invisible belief that their wife would be sexually available to them every day. And then they got married and they had kids and their wife is working and they’re working and they realize like sometimes weeks or months go by And maybe their partner doesn’t have as high a sex drive as them or isn’t into what they’re into or whatever. But they never talk about it because they never learned how to talk about things. And so they gradually build resentments. And so part of the boundaries work is you have to tell people what you want, right? They’re not obligated to give it to you, but you’re more likely to get what you want,

David Condos
if you’re sitting as communication is right.

Dr. Erica Sarr
Another part is the idea that no is a complete sentence. Right? these are, these are guys who are really good at finding the reasons why boundaries don’t matter, or boundaries don’t apply to them, or just in this one instance, couldn’t you. And they’re able, for a long time in their lives to get across boundaries because of charm, force, money, power, whatever. And they’re really not used to finding any any stops. And that’s often an echo of having no boundaries in childhood where they had someone who sexually violated them, or a parent who was never there for them or never told them no. And so it was a model for them that no, isn’t isn’t Okay, answer. That’s part of being a functional adult is sometimes things don’t go our way. And I don’t get to act out because I didn’t get my way. Like, that’s not. That’s not how an adult world works. That makes perfect sense to them when they’re in their trauma. Well, you didn’t give me a cookie. So I stole my cookie, right? You, you, you won’t show up for me emotionally the way I want. So I’ll go get a girlfriend who will is their way of saying I wish he would show up for me the way I want. But, and feeling like it’s an imperative. And that’s, that’s what’s so difficult is that sometimes he drives these drives, that’s the compulsive part is that they feel imperative to follow through on, which makes it different than kind of a classic, just having an affair because it’s easy. And it’s there, you know?

David Condos
Yeah, yeah. And so shifting gears a little bit, I know, you’ve mentioned that you have a special passion for tech addiction, Video game addiction, I guess, give us an overview of that. How does that show up? And how is it similar or different to some of these other compulsions we’re talking about,

Dr. Erica Sarr
it shows up a little less, probably because we’re spending so much time working with sex that we often don’t have time to get to it. The tech addiction, I would love to spend all the time in video games, because I’m a video gamer, myself. And I just like I think sex is a really beautiful, amazing creative part of the human experience that gets hijacked to manage our emotions in a way that wasn’t intended. I love video games, there’s tons of research about how they’re awesome, and they can do lots of good things for us. And people can also completely vanish into them if their real world isn’t what they want it to be. Any kind of technology has the potential to be used, the way you want it to be used, because the sex industry is often on the forefront of any technological innovation. Because they know they have an end product that sells they the

David Condos
demand is there the money is

Dr. Erica Sarr
so even even their early beta versions that aren’t so great. Somebody wants it because it’s the need a new thing that sexual so

David Condos
and so looking at kind of the your end goal in the work that you do. What does my long term healthy sexuality and recovery look like?

Dr. Erica Sarr
Ideally, it’s going to look like more connected sexuality. And that may be with a partner, it may be just connected with yourself. Right? The idea is that healthy sexuality is that which doesn’t coerce anyone is consensual with everybody involved, brings you closer to joy and pleasure and connection, rather than shame and fear and pain and degradation. Right. And so if solo sexuality is kind of your choice or your path, and you can figure out a way that that makes you feel connected to, you know, a higher power or your value system. Great. If that’s monogamy, great. If it’s consensual non monogamy. Great. It’s going to be more challenging for you as an addict, but it’s it’s possible but it requires a lot of communication and a lot of work. And what are the biggest pitfall I’ve seen people make is that they want to make those decisions too soon. They haven’t gotten far enough away from the betrayals that they’ve done to others to say, okay, now’s the time to really kind of start weighing these things. We ask our folks to be sexually celibate for 90 days not again, not because I think sex is bad, but because I want to give you a little bit of breathing room to really think about it. Like from a sort of, like, observing ego kind of one level up like okay, what am I really deciding here rather than being impulsive? I want it now what’s good for me? What’s congruent with my values? What’s congruent with what feels right with my identity? And, and I also tell people don’t draw party hats on the calendar a day 90, like, because you might be there. Because I’ve had people who called me frantically on day. 17 be like me and my wife had this amazing connected sex did I relapse? I’m like, No, you’re good. Like, like, it was a consensual process. It was connected, it was beautiful, good talk about with your therapist, but you’re good. And I’ve had people who got today at nine and call me frantically and said, I can’t have sex with my partner. I’m not there. In my own system. I’m too traumatized. But I feel like if I push it out, they’re gonna feel rejected. And so it is it is a process and it’s a unique process. And you have to be in consultation. So that’s a that’s a big part of it. Yeah.

David Condos
And so back to kind of when you were talking about what interested you about working in this field, you, you’re saying that kind of partially what you do is how you saw like our culture, kind of distorting it and kind of hijacking anything, like you said. So with anything that’s sexual, there’s gonna be a lot of misconceptions out, what would be one thing that you wish the general public understood better about sex and sex addiction and healthy sexuality.

Dr. Erica Sarr
I have so many things I wish people knew. The biggest thing that I wish that I wish that people knew about sex addiction is that it’s not an excuse for bad behavior. I think with things that happen in the media, sometimes people are afraid, well, anytime somebody cheats, or anytime somebody violates me, they’re gonna say they’re a sex addict. And they’re going to go away to some resort, and they’re going to get better. And then they are not to be held to account for their behavior. And, you know, I lecture to the military, and I’ve lectured to police, and they have that same fear. And I said, it is a misconception. If you have an illness, you have a responsibility to manage it. If your illness would cause you to blackout behind the wheel of a car, and you know that, but you knowingly drive and don’t do anything to manage that illness, and you crash your car, and you hurt people, you made a choice that hurt people, and you’re responsible for the consequences of that choice. And so, for me, it’s more about understanding, going back to the very root of what you asked me, Why did I get into this? helping people understand why they do what they do? Some people do it because they’re reenacting their trauma. Some people do it because they don’t have basic sex education. Some people do it because they have frontal lobe injuries. Some people do it because they have a compulsion. Some people like to see people hurt. Some people have, you know, embedded misogyny, the treatment programs for each of those people is radically different. I can do some of that work, I can’t do some of that work. So it’s important for me to figure out who I can help help the ones I can and send the ones I can’t to the places that they can be treated.

David Condos
And so just to wrap up, yeah, quick questions. First is, for someone who wants to dive a little bit deeper into this what what would be a favorite book or resource that that you would recommend on this topic?

Dr. Erica Sarr
I really like Alex carcasses mirror of intimacy. It’s like daily reflections on sexuality and intimacy. And it gives you not only like quotes, and things like that, you know, but something to really reflect on everyday related to your own intimacy with others. The other book that’s maybe less kind of recovery related, but I think it’s so profound for so many people that I’ve worked with, is called reinventing your life by Jeffrey young. And it’s about schema therapy, which is about the concept of that our past life experiences kind of put a lens over our eyes, by which we filter all future information. And we need to be cognizant of those lenses because it really does distort the choices we make. And so when you apply that to addiction, if somebody believes that everyone in the world is going to be an abuser, and there are only wolves or sheep in the world, why wouldn’t you be a wolf? You know, so you really help people look at that lens. If they can peel that lens back. They can have a different relationship with the world that profoundly affects their ability to be in recovery.

David Condos
Yeah, right. Finally, what what would be a piece of advice that you’d like to leave listeners with something that that’s meant a lot to you or that you find yourself passing on.

Dr. Erica Sarr
You’re not alone. You don’t have to do it alone. And you really can’t do it alone. If If, if the guys I worked with could have thought their way out of this problem, I never would have met any of them. They’re smart, they’re resourceful. Most of them are highly, highly motivated for change. And all of them are highly motivated to not be in pain. And they’re terrified of intimacy. And I also say that to their partners and their families, you are not alone. You are not crazy for still loving the person who’s betrayed you. You are not crazy for wanting to leave them. None of your choice, none of the choices are bad. And you, you have a right to feel how you feel. And you have the right to make steps that make you safe, both for the attics and the partners, so you’re not alone.

David Condos
Dr. Erica Sarr is a licensed clinical psychologist and the clinical director for Gentle Path at The Meadows in Wickenburg, Arizona. You can find out more about that specialized program for sex addiction treatment at gentle path meadows.com beyond theory is produced and hosted by me David Condos. You can discover more from this podcast, including videos of each conversation and beyondtheorypodcast.com. Finally, thank you for listening. And I hope you’ll join us again next time for another episode of Beyond Theory.

 

 

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