SA and OCD: Part II

Last week certified sex addiction therapist and clinical partner specialist, Dan Drake, began looking at the topic of SA and OCD. This was in response to a community member question: “How often do you find the SA (sex addict) also has OCD?"

You can see the first part of Dan's answer here, where he dives into the various ways "sex addiction" (which can go by various other names) is seen by counselors and therapists.

Dan's Answer... Part II

Let’s return to the original question, how often do SA (sex addiction) and OCD (obsessive compulsive disorder) go together?

It’s rare that I see someone that meets the full criteria for both SA and OCD. That said, I definitely see some features of OCD going together with SA, particularly with obsession/rumination. Many addicts I’ve seen over the years DO tend to have OCD-type features. Addicts can get preoccupied and get laser focused in some areas at the expense of other areas. They may preoccupy about cleanliness and orderliness in some areas while being completely disorganized in other areas. This may very well go beyond his or her sexual behaviors.

Addicts tend to live compartmentalized lives. They often have learned that they need to be seen a certain way (charming, successful, powerful, capable, good enough, etc.) because they fear being exposed for their underlying inadequacies (feeling less than, bad, unworthy, unlovable, incapable, like a fraud, etc.). So addicts spend a lot of time polishing a shiny exterior to divert attention from their vulnerable underbelly. They muster energy to hold up a shiny façade so that nobody exploits their perceived weaknesses.

Some compulsive ways that addicts polish their exterior are: meticulous grooming, hyper focus on order in the house, rigid rule following, etc. These behaviors may also show up in ritualized or rigid behaviors from the addict, since part of the addictive cycle for an addict typically involves some kind of ritualized behaviors. The ritual builds up the intensity of the sexual high for the addict. The longer the person lives in an active addiction, the more ritualized (and potentially rigid) their lives may become. And the longer they live as Dr. Jekyll and Mr. Hyde the more they are distressed by that part of themselves that they want so badly to hide. So as you can see, some of these obsessions and compulsions may very well show up looking like OCD.

What do we do with all of this? I recognize this is a short but complicated question to address. Whether you’re the betrayed partner or the betraying partner, I’d strongly recommend to first make sure you get a clear diagnosis of the problem from a qualified professional. And as you can see, there are a lot of different views on sex addiction out there. If a full diagnosis of OCD does apply, OCD treatment is absolutely in order.

Yet, for those OCD-like features that show up as a part of an active addiction among many addicts, it’s important for him to learn new coping tools, as well as a new way of relating to himself and the world around him. I’ve found that the more addicts work on their underlying shame that creates their hidden secret life, the less they have to polish their exterior. As they become more integrated over time, their public and personal lives line up more and more. This allows some of those rigid and obsessive behaviors to begin to diminish.

I know the journey of healing from betrayal trauma and the impacts of SA is not an easy one, even more if it becomes complicated with other issues such as OCD. Yet women and men are healing every single day. You can do this! My heart is with you on this journey.

Dan Drake is a licensed professional counselor, certified sex addiction therapist, certified clinical partner specialist and board member of APSATS. He works out of Banyan Therapy in Los Angeles and is the co-author of Letters from a Sex Addict.

Thanks Dan for sharing your wisdom with the community! We need to take a small break from our Ask the Experts series now as our next expert, Barb Steffens, is very busy as she prepares to present at the annual Society for the Advancement of Sexual Health (SASH) conference — where she is receiving a lifetime achievement award this year for her amazing work for partners of sex addicts, particularly in the advancement of the PSA trauma model. So, for the next few weeks we'll be looking at "gaslighting." Let's remember to pray for her as she goes, once again, to present our case before a therapeutic community that doesn't always "get it."

This song reminds us that there is One who invites us to lay down the burdens we have placed on ourselves through sin and shame and take on our true identity in Him.