Early attachment disturbances and trauma can lead to narcissism and addiction as coping mechanisms for emotional needs. Shame, from not having dependency needs met as a child, is a core belief for many addicts. Healthy relationships and intimacy through recovery can help meet needs in a healthy way and reduce shame. Therapists must confront, contain, educate, and work within the relationship to help clients replace addictions with healthy coping skills.

1. What if Love Never Comes: Narcissism and Sex Addiction as Emotional Survival Robert Weiss LCSW, CSAT Executive Director The Sexual Recovery Institute www. sexualrecovery .com Managing Director Sexual Disorders Program Life Healing Center of Santa Fe www.life-healing.com

2. Sexual Addiction Cycle Ritual Fantasy Acting Out CONTROL RELEASE Numbing Shame/Blame/Guilt Despair Any strong emotion ... Generates and stimulates our dependency needs Fossum/Mason/Carnes/Weiss et al. SHAME

3. Feelings Sadness Joy Anger Needs Nurturing / Understanding Mirroring Echoing / Support Inform

4. What are the Survival Needs of Infants? Food and Water = Nutrition Dry and Warm = Shelter Holding, Mirroring and Stimulation = Love

5. What happens to the infant if any one of these three are missing? the infant if any one of these three are missing? Absent Food = Death Absent Shelter = Death Absent Love = = Death (failure to thrive)

6. Conclusion We Need “Love” to Survive Throughout the lifecycle

7. Shame prevents us from asking others to meet our needs (to love us fully) Shame is the felt experience of being defective — brought about through early attachment deficits and trauma. Shame is learned as essential dependency needs are denied or subverted and the child turns upon themselves as being the problem. Shame is the essence of Carnes ‘ Core Beliefs of (sex) addicts.

8. Examples of Shame Based ‘Core Beliefs’ No one would love me as I am If you knew all about me, you would abandon me I am a deeply flawed (unlovable) person This is the essence of narcissistic self-obsession, driving most relational interactions

9. Development of the Inauthentic (Shamed) Self Genetic or Predetermination— Personality, Affect Management Skills Familial Shame Abuse—Psychological, Physical, Sexual Environmental / Cultural Factors All of which reinforce that I’m better off not needing anyone!

10. So Who is the Problem? Not Mom Not Dad My Needs are the Problem . . . The Self is Shamed :(

11. How does the self get shamed? Primary Narcissism

12. Attachment and Addiction Early attachment disturbances appear to be a key root cause of both narcissism and sexual addiction. Compulsivity and obsession offer some relief from the pain, rage and fear of the disrupted, empty self in those who never learned how to find comfort in healthy relatedness. The compensating compulsive behaviors eventually take on a life of their own.

13. At-A-Boy!

14. “ It is thus impossible for the grandiose person to cut the tragic link between admiration and love. In his compulsion to repeat he seeks insatiably for admiration, of which he never gets enough because admiration is not the same thing as love. It is only a substitute gratification for the primary needs for respect, understanding and being taken seriously” Alice Miller: The Drama of the Gifted Child

15. Narcissistic Defenses Employed to Suppress, Avoid and Distract from Dependency Needs Addictions (substance and behavioral) Intense Self Focus, Self Blame (shame) Pathological Care Taking / Encouraging Unhealthy Dependency Thrill Seeking / High Risk Activities Dissociation / Fantasy Rage / Abuse Passivity / Helplessness and/or Drama Intense Self Focus, Self Blame and Shame Seduction and Objectification (Sexual or Emotional) Objectification

16. Beware the “Granola Narcissist” “ Granola Narcissist”

17. What does your addict have to say about the need for relationships and intimacy? “I hate myself for being so needy” “I hate my neediness” “I hate my addict” BUT—I STILL HAVE TO GET MY NEEDS MET

18. Adaptive or Survival Based Coping Skills Can Provide Self soothing Calm Distraction Stimulation In the absence of and/or limited experience with healthier, more integrated relational means of self stability.

19. Addicts Don’t Learn About Their Emotions Addicts Don’t Learn From Their Emotions Addicts Learn to Disavow Their Needfulness Most Addicts Would Rather Eat Dirt Than Ask For Help (acknowledge need) In Other Words ... This information should guide treatment

20. “ The Narcissistically cathected child has the chance to develop his intellectual capacities undisturbed, but not the world of his emotions and this will have far-reaching consequences for his well-being.” Alice Miller: The Drama of the Gifted Child

21. Healthy Ways to Meet Integrated Emotional Needs RECOVERY! Asking for Help - HONESTY! Reliable/ Mutual Friendships and Love Relationships -INTIMACY! Achievement (Goals, Career, Objects) Self Soothing and Self-Care Activities Healthy Physical Intimacy and Sexuality Play and Creative Activity THIS INFORMS RECOVERY PLANNING

22. Working Through 12-Step and/or Faith Based Support (building community) A Safe Therapeutic Relationship (intimacy) Psychotropic Medication (reduced reactivity) Residential Treatment / Trauma Work (shame reduction and skill building) Stable Life Circumstances (work, family, relationships) Alternative Therapies - EMDR, Mindfulness Practice, Somatic Experiencing, DBT etc. Spirituality

23. Our Role and Job Confront, Contain and Intervene—This shows you that I care; I see you Promote Accountability—I want you to care too Educate, Provide and Encourage Resources Normalize Through Interpretation and Understanding—Shame Reduction Provide Hope Psychodynamic Process—work within the relationship Be Genuine and Accessible

24. Role of the Therapist Confront, Contain and Intervene—This shows you that I care; I see you Promote Accountability—I want you to care too Provide Structure and Encourage Resources Normalize Through Interpretation and Understanding—Shame Reduction Provide Hope Psychodynamic Process—work within the relationship To Be Genuine and Accessible

25. What if Love Never Comes? Narcissism and Addiction as Emotional Survival Robert Weiss LCSW, CSAT Executive Director The Sexual Recovery Institute Managing Director, Sexual Integrity Services The Life Healing Center of Santa Fe www.sexualrecovery.com