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Discussion Individuals

The dangers of spiritual bypass

I’ve had quite a few clients who have a spiritual practice but who are finding that that is not enough to cope with some personal challenges. 

They may meditate or pray regularly, and perhaps attend a church, Buddhist centre or some other spiritual group. And yet they do not seem able to shake the problem that brings them to therapy – which could be a relationship issue, anger management, addiction, depression or some other problem that seems intractable.

It sometimes turns out that these clients have had a ‘spiritual bypass’. This phrase, coined by psychotherapist and Buddhist John Welwood, applies when a person seeks to avoid dealing with unresolved personal  issues from the past. Instead they use their spiritual practice to try and be ‘above it all’ and strive to be good, kind, generous, forgiving etc.

Obviously there is nothing wrong, and in fact a lot to be praised, in being kind, generous or forgiving. The problem arises, however, when these become ‘rules’ or positive injunctions.

In that case we can end up suppressing the ‘non spiritual’ parts of ourselves – our anger, jealousy, envy or even sadness.

In an interview available on his website*, Welwood says: “We often use the goal of awakening or liberation to rationalise what I call premature transcendence; trying to rise above the raw and messy side of our humanness before we have fully faced and made peace with it.”

A common aspect of people with a spiritual bypass is compulsive helping or rescuing. This is because many spiritual texts, whether of an established religion or ‘new age’ type beliefs, promote putting others first. Believing too rigidly in this teaching can lead people to devalue their own needs and feelings, in favour of helping others.

But this kind of helping or caring can actually cause indirect problems, both for the helper and the person being helped. The helper may feel resentment if their help is not being sufficiently appreciated, while the person being helped may pick up on this expectation and feel patronised.

Another common  problem is attitudes to anger. While many of us, spiritual or not, struggle with how to relate to angry feelings, it can become a major issue for people who have been taught that anger is somehow unspiritual or unloving. 

Of course, unthinking or chronic expression of anger can create many problems and we need to reflect on what may be underneath these feelings. But viewing this emotion as somehow a problem in and of itself can lead to negative consequences. 

One of my favourite books on the tension between spiritual values and the messiness of everyday life is Jack Kornfield’s After the Ecstasy, the Laundry. In this he quotes an advanced Buddhist practitioner, who returns from a long spiritual retreat.

“Some months after [my spiritual retreat]…came a depression, along with some significant betrayal in my work. I had continuing trouble with my children and family too. Oh, my teaching was fine, I could give inspired lectures, but if you talk to my wife she’ll tell you that as time passed I became grouchy and as impatient as ever.”

For such people it can be difficult to acknowledge that their spiritual practice may not been enough to tackle some of these recurring problems and that they have somehow ended up using their spiritual practice to maintain their neuroses.

None of this is to say that having a spiritual practice is at all unhealthy – the opposite in fact. It’s more about the way that we engage with a spiritual practice. It can be tempting to think that now we have a road map to meaning and fulfilment, that all we have to do is give ourselves fully to this practice and our problems will be solved. 

The reality is that we also may need therapy to help us in some of those areas where our spiritual practice doesn’t seem to have the answers or may have, in fact, made the problem worse.

*www.johnwelwood.com

Kornfield, Jack, 2000, After the Ecstasy, the Laundry, Random House, London.

Categories
Couples

Couple therapy – making sense of emotions

Recognising and naming what we are feeling is a valuable part of couple therapy, but it’s not something that comes easily to most of us.

It is important to learn how to recognise and name what we’re feeling because, in one sense, we are what we feel.  It is often through our feelings that we reveal ourselves to others, that they get an understanding of what we want, what we’re passionate about, what moves us. And that helps create intimacy.

Identifying what we are feeling is also essential for us  as individuals in terms of knowing and understanding ourselves.

But unfortunately many of us are not fully aware of what we’re feeling and, even when we are, we may be reluctant to share that with our partner for fear of appearing silly or being judged. 

This can apply, in particular,  to emotions such as sadness or vulnerability, as many of us are brought up to see these as examples of weakness. Similarly, for many people acknowledging anger is very uncomfortable because in many families the children are given the message that it is not acceptable to show anger. 

There is also a very strong problem-solving attitude in our culture. One that says, “it doesn’t matter what you’re feeling, just focus on the solution.” While that may be an appropriate response in some situations, in couple problems it doesn’t work because usually part of the “solution” is working with the emotions that are present and allowing them to help point us towards a new experience of being with our partner. 

As couple therapist Robert Taibbi says*, part of the therapist’s job is to draw out new emotions: “Your job is to change the communication, to stir the emotional pot. You’re moving toward the holes, looking for what they are not saying. This is where their anxieties and, ultimately, the solutions lie. “

Often in couple there will be a mirroring – one partner may be rather emotionally contained and the other “over emotional”. While not always the case, in heterosexual couples there is often a gender aspect, with the man finding it harder to name what he is feeling.

When I’m working with couples I’m often trying to get them to be clear about emotions. So, rather than “upset”, I ask if they mean “upset angry” or “upset sad”, as there is a big difference between the two. 

I may also introduce “feeling” language into my comments in the session. For example, “I’m wondering if that was annoying for you when Jill said that?” Or, if a client seems to be wiping away imaginary tears, I may offer the suggestion that they may have been feeling sad. 

For people who are rather detached from their emotions it can be difficult when they are asked questions about how they are feeling, so I sometimes offer the idea that there are four primary emotions – fear, sadness, joy and anger – and ask which of those primary feelings is closest to what they are feeling. This can help open up something new in the conversation between the couple. 

When we are able to say what we are feeling and have our partner acknowledge it, we can feel validated. This is something that a couples therapist can help with, encouraging and coaching the one partner to simply acknowledge the feelings of the other partner.

Acknowledgement is not agreement. We are not saying that because parent A is angry that means partner B is in the wrong. We are instead saying that partner A is angry and partner B can acknowledge that reality without immediately feeling the need to defend themselves. A further step can be taken in the therapy, whereby partner B not only acknowledges the other person’s anger but also is able to understand why they my be feeling angry. 

For clients who really struggle to know what they are feeling I may suggest they keep an emotions diary between sessions. This is something that can be easily done using a small notebook or mobile phone, just jotting down several times a day what they are feeling at that moment and (if they know) why they may be having that feeling. 

Part of the process of identifying emotions is understanding that sometimes we use one emotion to hide another. This is particularly so with anger and sadness. Some people major in sadness and find it very hard to acknowledge anger, perhaps because that was a taboo in their family of origin. For others it’s the opposite – they can get angry easily but sadness is taboo. Helping these individuals acknowledge and feel the underlying emotion can be valuable in creating a more authentic connection within the relationship. 

Doing Couple Therapy, Robert Taibbi, 2009, The Guilford Press.

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Uncategorized

The power in therapy of ‘talking to yourself’

One of the revelations that many who enter therapy experience is that the process becomes not just talking to the therapist but also, in a deeper, way talking to themself.

This was highlighted recently by artist and cultural commentator Grayson Perry, in the BBC Radio Four programme Start the Week. (see link at bottom of this post).                                                                                                                                  

Grayson Perry

Perry, who went into therapy in his late thirties because of anger issues that were threatening his close relationships, says that up until then he was suspicious of therapy: “I used to take the mickey out of it and I found it a little bit irritating but then gradually I met a lot of my wife’s therapist friends and thought ‘these people are really nice to talk to’.”

Once he began the process, he says, he found the sessions cathartic: In a way you’re doing therapy on yourself. I used to say I’m going to therapy now to talk to myself.”

This made me think about how part of the power of therapy is not getting the observations or thoughts of the therapist, but actually hearing yourself speak out loud the thoughts that have been rattling around your head in an often unformed way.

Clients often say to me: “Having this space once a week, where I can speak all this out loud, makes things seem clearer in my mind and I get to see more of what’s really going on.”

But while therapy may be, in some ways, a conversation the client is having with themselves, I strongly believe that this also depends on the presence of the therapist. It is the fact that there is another human being, who is interested in your experience and who is listening, that helps create the conditions for the client to really open up.

And when we have the space to open up we are often able to see patterns of behaviour in our lives and may ask ourselves, ‘Why did I make that choice?’

Through the relationship with the therapist the client is able to gradually deepen his relationship with himself. He learns that his feelings are important, that there are often deeper emotions he may not be in touch with and that much of his behaviour is underpinned by unconscious patterns.

Start the Week, BBC Radio 4

 

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Discussion Uncategorized

Developing a healthy ‘internal leader’

My way of working with clients involves seeing them (and myself) as made up of different parts. While we may think that we are unified, coherent personalities, when we pay attention to what is going on inside us we often discover a collection of many different parts, or sub-personalities.

These may include a part of us that criticises or judges us (the inner critic), a vulnerable yes often playful part (the inner child), a part that tries to win approval from others (the pleaser), a part that can feel defeated or powerless (the victim) and many others.  These sub-personalities are connected to the idea of archetypes (universal patterns of behaviour and being) developed by psychologist Carl Jung.

But what kind of internal leader do we have who is in charge of these different parts?

According to therapist Stacey Millichamp, in her book Transpersonal Dynamics, our personalities can be compared to political regimes. We may have an internal ‘dictator’ who orders the rest of the psyche to behave in a certain way.  These kind of clients tend to be very controlled, even uptight. 

Milliband says: “Honesty is suppressed and freedom from the regime must be found through covert, secretive means…[there is a] fear of punishment, disallowing spontaneity and creativity.”

Such clients can be hard to work with because they often keep secrets, fearing that if they are honest in therapy it will be used against them in some way.

A different client may have a fragmented psychological regime in which there is a lack of internal leadership that can create a frightening and chaotic internal world for the person.

Part of the therapist’s role is helping such clients develop a strong internal leader who speaks to them in a firm but compassionate way. Such a leader can allow the difference parts of ourselves to be expressed in an appropriate way.

The internal leader is a bit like having an ally who we can rely on, who is on our side but who will also tell us the truth about ourselves. 

So, how do we develop such an internal leader or ally?

According to Milliachamp, there are several ways:

  • think about a historical or present day leader who inspires you and describe in detail what you admire about that person
  • develop self-talk that is evidence based and encourages getting reality checks about situation’s in your life.  This is because often we have fantasy scenarios in our heads that are based on negative ways of seeing the world and our place in it.
  • spend time with people who embody the leadership qualities you are seeking. This may be in person but could also include attending workshops or reading books. 

The client may also look to their therapist to model positive psychological leadership and I have had clients who have said things like, ‘When I found myself in that situation I heard your voice in my head and that helped me decide what to do.”

Categories
Discussion Individuals Uncategorized

When staying positive can become a negative

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We live in a ‘think positive’ world, in which people are encouraged to hide or deny their vulnerability.

But this can come at a cost, as shown in research published this week by the charity Macmillan Cancer Support*. The research showed that this ‘think positive’ attitude among people with cancer, espcially those with a terminal diagnosis, was preventing honest conversations about end-of-life care.

More than a quarter of people surveyed said they found it hard to talk honestly about their feelings around cancer and a similar number said they felt guilty if they could not remain positive or portray themselves as a ‘fighter’. Health and social care professionals were generally reluctant to bring up the subject of end-of-life care with patients, the survey found.

The result of this was that many people with cancer were not having vital conversations until far too late and were dying in hospital against their wishes.

I believe this research has wider significance and shows the down side of an excessive focus on ‘thinking positive’ or being a ‘fighter’.  There is an important place for these qualities in life, but when taken too far it can become denial and a way of avoiding vulnerability.

When we adopt a think positive attitude too rigidly, we can easily slip into viewing ‘negative’ emotions such as vulnerability, fear, sadness and anger as somehow wrong or things to be battled against.

Miriam Greenspan talks about this in her book, Healing through the dark emotions. By ‘dark’ emotions she she doesn’t mean they are bad but rather that as a culture we have kept these emotions in the dark.

“In the throes of grief, fear, or despair, we generally believe that giving feelings like these too much space in our psyches is a sign of emotional weakness or breakdown,” says Greenspan.

She describes this attitude as ‘emotion phobia’ and says that while we can push these feelings away for much of the time, sooner or later we experience a major loss, shock or trauma and our habit of pushing away dififcult feelings no longer works.

In my work as a psychotherapist I often have clients who have got the message, usually from childhood, that their feelings (and particularly their ‘difficult’ feelings like sadness, vulnerability, fear or anger) are not okay.

These are the clients who want me to make such feelings ‘go away’. Instead I encourage them to try and name the feelings they are struggling with, to locate where in their bodies these feelings live, to see if they can allow these feelings to be present and to trust that there is a purpose in these feelings.

My experience is that there is always a reason for particular feelings in our life. If we can shift our perspective away from judging the feeling (and ourselves for having it) to being willing to experience it we can begin a different kind of ‘conversation’ with the feeling.

We can then begin to explore what this feeling is trying to draw our attention to in our life, or pehaps to  something in our distant past that needs to be given a place.

* https://www.macmillan.org.uk/aboutus/news/latest_news/fighting-talk-can-leave-cancer-patients-unable-to-talk-about-death-and-dying.aspx

Categories
Discussion

What does our psyche want now?

I recently attended a talk by the American depth psychologist and author James Hollis, whose books I had long admired.

James Hollis
James Hollis

“I often ask my new clients if they they think they have a soul and what it may be asking of them,” he said. That made me think. Hollis did not mean soul in the Christian sense, but rather the part of us that is separate from our ego, that is part of our unconscious and that has a connection to something larger than ourselves.

In the traditional religious meaning, soul is opposite to body, but in depth psychology soul refers to the Greek word psyche. Rather than being this ethereal, floaty thing that many of us imagine, in this sense soul is closely connected to our human experience, particularly our deep emotions, our longings, our joys, our mystery. This was an idea developed particularly by the archetypal psychologist James Hillman.

By ego, I mean the part of ourselves that we are aware of and which we think of as ‘us’, but which is only the tip of the iceberg and does not encompass our unconscious. It is our ego that tries to control our lives, and our environment, and which is constantly on the lookout for threats.

We need our ego to run the business of life, but if its needs dominate then our psyche/soul may need to make itself felt through neurosis and painful symptoms.

Writing in his book What Matters Most, Hollis says soul is a metaphor to describe our essence: “It is the energy that blows through us, that enters us at birth, animates our journey, and then departs, whither we know not, at our passing.”

Soul, by its nature, is actually impossible to fully define. While it lives in the unconscious it is constantly making itself felt in our conscious lives, through our emotions, dreams and imagination.

The reason Hollis asks his clients if they think they have a soul is because he is wanting to get away from the assumptions many people bring to therapy; that they have a ‘problem’ and that it is somehow the therapist’s job to get rid of this problem.

Depth work is not about solving the problem but about recovering the life we’ve somehow lost along the way, he says. Clients often come with a symptom, such as an addiction, a depression, an anger issue or a relationship problem, and they want the therapy to eradicate this symptom.

But depth therapy does not “cure” people or eradicate symptoms. “We don’t solve these problems, we outgrow them,” says Hollis. But to outgrow them may mean exploring what the meaning of the symptom is, what is our psyche trying to get us to pay attention to in our lives?

Mostly we are governed by our egos and we think we know what we want or what we need. But the psyche/soul may have a different idea of where we need to go. It is our ego that desperately wants to get rid of the symptom.

Some approaches, such as cognitive behavioural therapy (CBT), try to get rid of the problem the client brings. CBT can help, and I use some CBT  approaches in my integrative therapy. But my experience is that often CBT can seemingly get rid of the symptom, only for it to re-appear in another form. If the underlying issues are not dealt with this is always a risk.

But how do we know what our psyche is asking of us? One way of exploring this is through therapy with a practitioner who has experience in working with the unconscious. Other ways in include noticing our dreams and what they may be telling us.

As palliative care doctor, and therapist, Michael Kearney says in his book Mortally Wounded: “My own personal and work experience has [shown me]…that soul is connected to depth, to death, to the imagination, and that it brings with it a sense of meaning.”

 

Further reading

By James Hollis:

Swamplands of the Soul, Inner City Books, 1996

What Matters Most, Gotham Books, 2010

By Michael Kearney:

Mortally Wounded, Morino Books, 1996

Categories
Couples

Why couple therapy won’t ‘fix’ your relationship in the way you expect

“Be patient towards all that is unsolved in your heart and try to love the questions themselves…the point is to live everything. Live the questions now. Perhaps you will then 9504443699_d6effb8b17_zgradually, without noticing it, live your way some distant day into the answers.”

  • Rainer Maria Rilke

The quote above, from the Austrian poet Rilke, says something about the couple therapy process and how changes in a relationship are often achieved not by applying a new technique but rather by a gradual shift in awareness and perspective.

Many couples who are struggling in their relationships come to therapy to be fixed. Or, more accurately, they come to get their partner ‘fixed’. They hope that the therapist will tell their partner what he or she needs to do differently or what techniques the couple needs to put into practice in order to solve the problem they come with.

While there is a place for techniques and tools in helping couples tackle their problems, it is naive to think that these alone will lead to sustained improvements.

In my experience couple therapy is more of a stuttering, unpredictable process than a linear improvement. Over time I would expect a couple’s relationship to improve but it is often a case of two steps forward one step back. There may be periods where nothing seems to be improving at all.

But if the couple is able to stick with the process and hold a little less tightly their desire for a solution to their problem, something different can emerge.

Often that something different comes from each partner being willing to feel their pain, and sometimes to share it, without immediately blaming the other person.

Frequently one of the things that needs to happen in couple therapy is for each person to understand how they have contributed to the stuck place the couple finds itself in. Once we begin to recognise our own responsibility we can then stop pointing the finger so quickly at our partner. This takes the pressure off them a little, which can open up a space for something new to enter the relationship.

In my own relationship I’ve found that, when I’m unhappy about something, the simple act of being heard by my partner can make a difference. It often means that the thing that was annoying me so much doesn’t seem quite so difficult any more.

As couples we can sometimes get stuck in an “I win, you lose”  mentality, in which power struggles take over and we feel that unless we get our way it will be unbearable. The reality is that it is always going to be difficult for two people to share their lives and that we need to find ways of making space for the differences but still allowing each person to have their feelings acknowledged.

John Welwood, one of my favourite writers on relationships, says in his book Journey of the Heart, : “Techniques rarely have any impact when used as short cuts, to bypass letting a difficulty affect us, work on us and move us to find our own genuine response to it.”

(Photo courtesy of Tom Blackwell, creative commons, at Flickr.com)

 

 

Categories
Discussion

Are parents responsible for how their children turn out?

Your children are not your children.

They are the sons and daughters of life’s longing for itself.

Kahlil Gibran

“I blame the parents”, is a common judgment, often muttered under the breath when in the presence of a badly behaved child or young person.

This kind of judgement highlights why being a parent can bring up a lot of anxieties, when it comes to what sort of person the child develops into.

And it can be a heavy burden, if a parent believes that he or she is responsible for “negative” character traits or behaviours, or for a child’s seemingly unhappy disposition.

But sometimes I believe that parents can take too much responsibility and can even beat themselves up for not being good enough.

Donald Winnicott, a pioneering paediatrician and psychotherapist, came up with the idea of the “good-enough” parent. This referred to the parent who provides a good-enough environment in which the child feels loved but is also given healthy boundaries.

It’s important to recognise that this does not mean parents can’t make mistakes. Making mistakes is inevitable – perfection is not possible. The idea of being good enough gives us permission to be imperfect and to be compassionate towards ourselves as parents.

I remember one mother, who was distressed when she saw her daughter behave in an insecure and “needy” way, convinced she had passed this onto her. Even if there was some truth in this, it would have been passed on in an unconscious way. We cannot help but pass on messages to our children through our own behaviour.

But judging ourselves harshly as parents is not the answer, I believe, as long as we have done our best given our own conditioning.

In any case the kind of person a child develops into will depend on different factors. Good-enough parenting is one factor, while inherited characteristics will be another. As the child gets older, peer pressure will play an increasing role as will the values in the society or culture the child grows up in.

But I believe there is also something else at play, which is harder to describe or measure. I’m thinking of the mysterious force which makes each person the unique individual they are.

Sure, we can look at children and make sense of their characters by referring to how they have uncle John’s creativity or mum’s dancing ability. But in his book The Soul’s Code, James Hillman talks about the guiding force that all humans are born with. He uses the analogy of the acorn becoming an oak, arguing that every person arrives in the world with a possible calling or destiny.

Hillman argues that modern psychology has become reductionist, attributing a child’s obsessions or “pathologies” to poor parenting or genetics.

A different response would be to welcome the uniqueness of each child, even the parts that cause us pain or discomfort as parents. Perhaps we could then trust that the child will find its way in the world, following its own calling or destiny.

Categories
Individuals

Is it ‘selfish’ to have needs?

Clients will often seem puzzled when I ask them what their needs are in life. Some will even deny they have needs at all or regard it as somehow selfish to acknowledge them.

Those who find it difficult to recognise their needs are sometimes those who spend much of their lives focusing on others, on trying to keep everyone else happy.

But I would say that having difficulty in recognising our needs and getting them met in an appropriate way applies to many of us – not just people who have been brought up to deny their own needs.

This is an important issue because we all have legitimate needs and just because we ignore them they do not disappear. In fact, when we ignore them or are unaware of them these needs will still be directing our behaviour at an unconscious level.

Beyond the very basic needs of food, shelter, safety, warmth and so on, our needs include:

 

  • Physical touch and affection
  • Sex
  • Time for relaxation
  • Understanding
  • Respect
  • Belonging
  • Intellectual stimulation
  • Fun and play
  • A spiritual life/sense of meaning
  • Friendship/companionship
  • Love

I think the reason many of us find it hard to identify and express our needs is because this was dangerous for us as children. We may have got the message, implicitly or explicitly, that our needs and wants were a bother to our parents.

For women there is also society’s message that they should be giving to others and be putting others’ needs (children, family) before their own.

 What happens when we fail to recognise or communicate our needs?

As stated above, if we ignore our needs they do not just disappear but will come out in unforeseen and often unhealthy ways.

For example, the person who doesn’t feel they have the right to ask for some down time when they get home from work may end up snapping at his or her partner or children.

Psychologist Pia Mellody describes how a child whose needs were not met appropriately can grow up into a “too dependent’ adult or an “anti-dependent” adult.

The too-dependent adult expects other people to take care of their needs and wants and does not take responsibility themselves. The anti-dependent, however, is unconsciously afraid to ask others to help meet her needs because that would make her feel vulnerable. She thus finds it difficult to be in a truly intimate relationship.

In her book Facing Codependence, Mellody says: “Not tending to one’s needs and wants appropriately is often connected to a feeling of low self-esteem (shame).”

The solution to this is gradually becoming aware of one’s needs and wants and finding ways to communicate them to others. As part of this process the individual will need to tackle the toxic guilt or shame that may arise when he begins to value his needs.

 

 

Categories
Individuals Men

What is sex addiction?

Sex addiction is a term that can invite scepticism – you may think of the movie star who cites it to explain his numerous infidelities. “It’s not my fault – it’s the addiction,” he protests.

While there may be some people who use the idea of sex addiction as a way of avoiding responsibility, there are many more who feel caught in a self-destructive but seemingly compulsive behaviour. It is a behaviour that can wreck relationships, drain bank accounts and even destroy careers.

For these individuals, more often men than women, an addiction to sexual acting out of some form is a sad reality. It can take the form of internet porn, the exchange of sexually explicit photos and messages on social media (sexting), paying sex workers, endless affairs or sex with strangers.

In this context “acting out” refers to sexual behaviour that has become a way of unconsciously avoiding painful feelings. In other words, the sexual behaviour has become a defence mechanism to deal with underlying pain, in the same way that an alcoholic uses alcohol or a gambling addict gambling.

What makes it sex addiction is the individual’s experience that, even though they recognise the behaviour is damaging their lives they feel unable to stop.

Sex addiction is a growing problem.

Never has it been easier to use sex to escape difficult problems or emotions. There is an almost infinite supply of free online porn of every kind, while the internet also makes it much easier to research and contact sex workers or find others to engage in sexually explicit chat or the exchange of images.

Psychosexual therapist Paula Hall, in Understanding and Treating Sex Addiction, identifies three kinds of sex addiction.

  • Trauma-induced – this includes sexual or other forms of abuse. It also includes major losses, such as the death of a close family member.
  • Attachment-induced – this happens when the child lacks a secure attachment to parents or caregivers. When attachment is problematic the child can grow up feeling insecure and find it difficult to soothe themselves when difficult feelings come up. There may be attachment problems if the parenting of the child is too harsh, too emotionally distant, abusive or neglectful. Or if the child is separated from parents for long periods.
  • Opportunity- induced – this refers to addiction that is not necessarily rooted in early trauma or attachment problems, but caused by easy access to internet porn, cyber sex, etc. The much greater accessibility of these, thanks to the internet, has led to an increase in this kind of sex addict, says Hall.

There may be an overlap between two or more of these categories.

The key issue in all this is that the individual realises that his or her use of sex is causing major problems in their life – and they can’t seem to stop. Frequently, the problems they bring to therapy may be about anxiety or depression or about how the use of sex has damaged closed relationships.

Although sex addiction has almost certainly been around for centuries it is only in recent years that it has become more recognised. “Advances in brain research and neuropsychology have helped us understand the nature of both chemical and behavioural addictions and appreciate the links with childhood experience and trauma,” says Hall.