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He was well presented and wore ironed smart-casual attire several items of clothing displayed a designer label. His face was clean-shaven and he used a styling product on his hair that had recently been cut. Adam wore cologne and his mobile phone and watch appeared to be recent and high-end models. Adam made the same effort with his appearance during each of the subsequent therapy sessions. This would correspond to a Body Mass Index of 26—27, meaning that Adam is slightly overweight.

Adam has no visible tattoos or piercings. Without being asked, he turned his phone to silent at the start of the assessment session and at each subsequent session. Adam is confident and well spoken. He helped himself to biscuits and coffee he drank two cups of coffee during the min session.

Although Adam did not exhibit problems in expressing himself, the account of his problematic sexual behavior provided at the initial session appeared rehearsed. When discussing his symptoms in detail, Adam talked for longer than needed and would attempt to brush over important details. He would sometimes talk out-of-turn i. At these times, Adam assumed a more tense body posture and became overconfident and borderline defensive. Adam explained that approximately 4 years ago i.

Adam introduced his wife to watching pornographic films both before and during sexual intercourse. He stated that neither he nor his wife had been particularly interested in pornography prior to this time.

Adam reported that for a period of approximately 2 months, the frequency and duration of sexual contact with his wife increased. Adam began to accrue a collection of online and offline pornographic films and started using them as a focus for masturbation. Six months after he first started to watch pornography i. He stated that it was at about this time that he also started to become sexually aroused by watching men masturbate themselves, and by watching gay sex films up until this point, Adam had always described himself as being heterosexual.

He started to add gay sex films to his online and offline portfolio, and decided that he was bi-sexual. He reported that although his marriage was failing, a divorce became inevitable when his wife found out that he had been watching gay pornographic films on his computer. Adam had left his computer to answer the door but had left the online film playing.

He had built up a network of female and male sexual contacts across the country, including a small number of individuals with whom he engaged in sexual activities on an unpaid i. Adam stated that at that time i. Consequently, he decided to sell his home to raise capital and he moved into rented accommodation. Adam stated that he always has protected sex and that as far as he is aware, he has never contracted a sexually transmitted disease.

He confirmed that he has never engaged in sexual contact with or watched pornographic films involving individuals under the age of 18 years. Adam acknowledged that he often masturbates i. Adam explained that unless an individual he meets online gives a strong indication that a date will lead to sexual contact e. Adam denied any suicidal ideation as well as gambling, substance, or alcohol dependency but explained that the majority of his sexual encounters are accompanied by some form of alcohol consumption.

The scale is scored on a four-point Likert scale from: The scale contains the following adjectives or short phrases in relation to the job a person is currently employed in: Higher scores indicate greater levels of job satisfaction.

The level of goal attainment is determined by behavioral descriptions of functioning. Scores for individual goals are combined and then the GAS conversion key is utilized to calculate a global score. In the current clinical case study, five equally weighted goals were formulated. A score of 50 indicates an expected level of goal achievement and higher scores indicate greater levels of goal achievement.

Changes in each of the following outcome measures — based on the preceding day period — were assessed using daily dairy-keeping by Adam baseline values shown in brackets: Each of the aforementioned outcomes were assessed at four separate time points: All of the above scales are established screening instruments with good psychometric properties.

However, with his marriage deteriorating and perceiving that his wife was uninterested in sex, he experienced masturbating using pornography and occasional contact with sex escorts to be an increasingly important outlet for satisfying his sexual urges.

For approximately a month period, Adam exhibited a reasonable degree of behavioral control over his sexual urges, and it is likely that his use of pornography and sex escorts did not become addictive and problematic until after he divorced. Rather than seek long-term relationship partners after divorcing, Adam became locked into his pattern of sexual behavior and allowed it to intensify. Inevitably, his sexual behavior became maladaptive and an addiction feedback loop ensued.

Watching pornography or engaging in paid or casual sexual contact induced temporary positive affective and sensory states. Subsequent contact with sexual stimuli triggered these memories and resulted in a craving to re-experience the affective and sensory response.

Adam continued to reinforce his pattern of problematic sexual behavior until interpersonal and intra-psychic conflict reached a point that he could no longer deny that his behavior was unsustainable in the long term. In fact, Adam confirmed that his primary motivation for approaching the psychotherapist was because of their expertise in the therapeutic use of Buddhist principles and practices.

Adam is not challenged in his current role where he receives minimal supervision. His primary reason for declining to apply for internal advancement opportunities was that the increased responsibility would interfere with his sexual activities. Following informed consent, Adam received the secular MAT intervention that was administered by the second author a psychotherapist and meditation teacher.

In addition to mindfulness, MAT incorporates practices that are traditionally followed by Buddhist meditation practitioners including techniques aimed at cultivating: A min break was scheduled immediately prior to the guided meditation, and Adam received a CD of guided meditations to facilitate daily self-practice. The participant provided written consent for their data to be published in an academic journal in anonymized form.

The early intervention phase focused on establishing therapeutic alliance, as well as core therapeutic conditions such as active listening, unconditional positive regard, accurate empathy, respect, and genuineness Wells, During the second week of therapy, five GAS compatible goals were proposed by Adam and agreed by the psychotherapist: A goal of reducing sex-related financial spending was discounted because it was deemed as something that might encourage riskier sexual behavior e.

A further key aspect of the early intervention phase was introducing Adam to the practice of mindful awareness and in particular breath awareness. In this manner, Adam started to develop the necessary foundations for subsequent meditative development as well as a method of arresting ruminative thinking.

The mid-intervention phase comprised five key elements that were administered in conjunction with mindfulness training:. The final phase of treatment concentrated on preparing Adam for therapy termination. While he felt that his psychological well-being and control over sexual urges had considerably improved, Adam expressed concerns over relapse due to loss of face-to-face therapeutic contact.

To help alleviate such concerns, Adam was advised to continue with his daily practice of meditation and to keep a daily register of sexual behavior, stress levels, and sleep patterns. Coping strategy cue cards were formulated that Adam agreed to refer to on a bi-weekly basis.

Finally, a procedure for emergencies was discussed, dates and times for planned telephone contact were agreed, and three min booster sessions were arranged at 4-week intervals.

Following completion of MAT i. He exhibited clinically significant change i. Between t 3 and t 4, Adam abstained from watching pornography and using online sex websites. This paper reports findings from the first clinical study to investigate the utility of mindfulness for treating sex addiction. The intervention utilized in the present study i. The male adult participant Adam demonstrated clinically significant improvements in addictive sexual behavior as well as depression and psychological distress.

Improvements post-therapy were also observed in sleep quality, job satisfaction, and non-attachment to self and experiences. This study highlights the need for tailoring treatment outcomes on a case-by-case basis. An ideal outcome would have been Adam expressing an interest in finding a long-term relationship partner and abstaining from paid and unpaid casual sex encounters.

However, the participant was clear that a long-term relationship was not on their personal agenda, and so therapeutic goals had to be adjusted accordingly. Although Adam continued to use sex escorts post-treatment, his use of them was at a much lower frequency, and scores on the SAST-R suggested that he was no longer addicted to sex. In other words, observing a behavioral urge helps to objectify it and this allows it to dissipate of its own accord.

However, in reality, the biological intensity of sexual craving could mean that mindfulness alone is insufficient, and that other meditative treatment techniques are required. This suggests that individuals with problematic behavioral urges and other mental health issues are unlikely to accrue the necessary grounding in mindfulness i.

SG-MBIs, that generally integrate a range of contemplative techniques, are therefore arguably well suited to treating behavioral addiction. In addition to targeting craving for sexual contact i. As observed in other clinical case studies of MAT involving individuals with behavioral addictions [e. This study extends this literature by reporting on the use of mindfulness as a therapeutic intervention for treating sex addiction. As with all clinical case studies, the single-subject design, and the absence of a control condition, means that findings may not generalize to other individuals suffering from sex addiction.

The study was also limited by the use of a day period for assessing aspects of sexual behavior, as this time period may not reflect long-term behavior patterns. We confirm that all authors of this article had access to the study data, are responsible for all contents of the article, and had authority over manuscript preparation and the decision to submit the manuscript for publication.

We confirm that the participant provided full written consent for their data to be published in an academic journal in anonymized form. National Center for Biotechnology Information , U. Journal List J Behav Addict v. Published online Jun This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium for non-commercial purposes, provided the original author and source are credited.

This article has been cited by other articles in PMC. Abstract Background Sex addiction is a disorder that can have serious adverse functional consequences. Discussion and conclusion The current study extends the literature exploring the applications of mindfulness for treating behavioral addiction, and findings indicate that further clinical investigation into the role of mindfulness for treating sex addiction is warranted.

Case history Occupational history Adam works in a sales position that involves regular domestic travel and overnight hotel stays. Family history Adam was raised by his biological parents who both work in public sector roles.

Educational history Adam graduated from a British university with a BSc degree that he passed with upper second-class honors. Religious history Adam did not describe his biological parents as being particularly religious. Behavioral observations At his initial assessment with the psychotherapist and at each subsequent meeting , Adam was cognizant as to person, place, time, and circumstance.

Body composition and decomposition: This aspect of the practice drew upon Buddhist sutras that include detailed meditations on the composition of the body and its decomposition following death. The objective was to help Adam understand more about the true nature of the object of his desire i. For example, one of the guided meditations involved mentally deconstructing the body and identifying its constituent parts that in themselves are not particularly desirable e. Another guided meditation involved visualizing the process of decay that the body undergoes following death i.

Adam experienced difficulty in implementing this technique outside the therapeutic sessions, and explicitly requested a more direct and supportive approach. Consequently, a controlled scenario was enacted whereby Adam sat opposite the therapist with a laptop computer that had the sound turned off. He was administered a guided meditation while one of his online sex films was playing the psychotherapist could not see the film.

Adam was requested to keep his eyes closed but to intermittently and briefly open them to glance at the film. Adam was thus shown that he could psychologically accommodate and work with sex urges without them dictating his mental state and behavior. Compassion and loving-kindness meditation: Adam was encouraged to view such individuals as human beings i. Adam was guided using meditations intended to undermine a belief that the self or for that matter any phenomenon intrinsically exists see Discussion section for further explanation.

Techniques such as guided discovery, logical reasoning, and Socratic questioning were employed to help Adam test the validity of his assumptions concerning sex.

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Bowen escorts casualsex Sydney Adam met his wife approximately 2 years after leaving university and was married for 4 years. Netbooks Pakistan makes troops threat over India standoff Pity the poor other woman Pick of the week: Crime The Times Christmas Books Adam was thus shown that he could psychologically accommodate and work with sex urges without them dictating his mental state and behavior. Personen te zien in foto's zouden geen eigenlijke leden kunnen zijn. Chinese Democracy the Sunday Times review Game review:
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The MAT intervention also led to improvements in sleep quality, job satisfaction, and non-attachment to self and experiences. Salutary outcomes were maintained at 6-month follow-up. The current study extends the literature exploring the applications of mindfulness for treating behavioral addiction, and findings indicate that further clinical investigation into the role of mindfulness for treating sex addiction is warranted.

Estimates of sex addiction prevalence vary considerably according to gender, age, culture, sexual orientation, taxonomy e. Sex addiction is associated with among other things increased risk-taking behaviors e. Consequently, there is a need to empirically and clinically evaluate tailored treatments that target the specific symptoms of sex addiction. A recent development in treatment for both chemical and behavioral addictions has been evaluative research into the therapeutic effectiveness of mindfulness.

However, to date, no study has explored the applications of mindfulness for treating sex addition. SG-MBIs, such as the Meditation Awareness Training MAT intervention, integrate a greater range of meditation techniques and subscribe to a definition of mindfulness that is arguably more congruent with the traditional Buddhist construction. This paper represents the first study to explore the utility of mindfulness for treating sex addiction.

More specifically, it presents an in-depth clinical case study of an adult male suffering from addictive sexual behavior who underwent treatment utilizing an SG-MBI. In both episodes, antidepressants were administered. Adam works in a sales position that involves regular domestic travel and overnight hotel stays. His role affords him the use of a fully expensed company car and provides him with considerable flexibility in terms of work location.

He typically spends three nights per week in a hotel and he generally visits the company offices 1 day each week. Adam has been employed in his current role for the past 4 years. He previously performed various sales roles and completed a 2-year salaried graduate training program upon leaving university.

Adam was raised by his biological parents who both work in public sector roles. Adam has not disclosed the details of his mental health problems to any of his family members. Adam graduated from a British university with a BSc degree that he passed with upper second-class honors. At the time of graduating, he considered completing a Masters of Business Administration but decided to take paid employment instead. He attended state schooling and his A-level grades enabled him to attend his first choice of university.

Adam met his wife approximately 2 years after leaving university and was married for 4 years. Adam did not describe his biological parents as being particularly religious.

They classified themselves as Anglican Christians and according to Adam, attended church only at Christmas. He tried meditation and visited the Buddhist countries of Thailand and Nepal including visiting Buddhist temples in these countries.

Adam frequented a Buddhist center in the UK for a period of 6 months during his mid-twenties. At his initial assessment with the psychotherapist and at each subsequent meeting , Adam was cognizant as to person, place, time, and circumstance. He was well presented and wore ironed smart-casual attire several items of clothing displayed a designer label. His face was clean-shaven and he used a styling product on his hair that had recently been cut.

Adam wore cologne and his mobile phone and watch appeared to be recent and high-end models. Adam made the same effort with his appearance during each of the subsequent therapy sessions. This would correspond to a Body Mass Index of 26—27, meaning that Adam is slightly overweight.

Adam has no visible tattoos or piercings. Without being asked, he turned his phone to silent at the start of the assessment session and at each subsequent session. Adam is confident and well spoken. He helped himself to biscuits and coffee he drank two cups of coffee during the min session.

Although Adam did not exhibit problems in expressing himself, the account of his problematic sexual behavior provided at the initial session appeared rehearsed. When discussing his symptoms in detail, Adam talked for longer than needed and would attempt to brush over important details. He would sometimes talk out-of-turn i. At these times, Adam assumed a more tense body posture and became overconfident and borderline defensive. Adam explained that approximately 4 years ago i.

Adam introduced his wife to watching pornographic films both before and during sexual intercourse. He stated that neither he nor his wife had been particularly interested in pornography prior to this time. Adam reported that for a period of approximately 2 months, the frequency and duration of sexual contact with his wife increased. Adam began to accrue a collection of online and offline pornographic films and started using them as a focus for masturbation.

Six months after he first started to watch pornography i. He stated that it was at about this time that he also started to become sexually aroused by watching men masturbate themselves, and by watching gay sex films up until this point, Adam had always described himself as being heterosexual.

He started to add gay sex films to his online and offline portfolio, and decided that he was bi-sexual. He reported that although his marriage was failing, a divorce became inevitable when his wife found out that he had been watching gay pornographic films on his computer.

Adam had left his computer to answer the door but had left the online film playing. He had built up a network of female and male sexual contacts across the country, including a small number of individuals with whom he engaged in sexual activities on an unpaid i.

Adam stated that at that time i. Consequently, he decided to sell his home to raise capital and he moved into rented accommodation. Adam stated that he always has protected sex and that as far as he is aware, he has never contracted a sexually transmitted disease. He confirmed that he has never engaged in sexual contact with or watched pornographic films involving individuals under the age of 18 years. Adam acknowledged that he often masturbates i. Adam explained that unless an individual he meets online gives a strong indication that a date will lead to sexual contact e.

Adam denied any suicidal ideation as well as gambling, substance, or alcohol dependency but explained that the majority of his sexual encounters are accompanied by some form of alcohol consumption. The scale is scored on a four-point Likert scale from: The scale contains the following adjectives or short phrases in relation to the job a person is currently employed in: Higher scores indicate greater levels of job satisfaction.

The level of goal attainment is determined by behavioral descriptions of functioning. Scores for individual goals are combined and then the GAS conversion key is utilized to calculate a global score. In the current clinical case study, five equally weighted goals were formulated. A score of 50 indicates an expected level of goal achievement and higher scores indicate greater levels of goal achievement.

Changes in each of the following outcome measures — based on the preceding day period — were assessed using daily dairy-keeping by Adam baseline values shown in brackets: Each of the aforementioned outcomes were assessed at four separate time points: All of the above scales are established screening instruments with good psychometric properties. However, with his marriage deteriorating and perceiving that his wife was uninterested in sex, he experienced masturbating using pornography and occasional contact with sex escorts to be an increasingly important outlet for satisfying his sexual urges.

For approximately a month period, Adam exhibited a reasonable degree of behavioral control over his sexual urges, and it is likely that his use of pornography and sex escorts did not become addictive and problematic until after he divorced. Rather than seek long-term relationship partners after divorcing, Adam became locked into his pattern of sexual behavior and allowed it to intensify.

Inevitably, his sexual behavior became maladaptive and an addiction feedback loop ensued. Watching pornography or engaging in paid or casual sexual contact induced temporary positive affective and sensory states. Subsequent contact with sexual stimuli triggered these memories and resulted in a craving to re-experience the affective and sensory response.

Adam continued to reinforce his pattern of problematic sexual behavior until interpersonal and intra-psychic conflict reached a point that he could no longer deny that his behavior was unsustainable in the long term. In fact, Adam confirmed that his primary motivation for approaching the psychotherapist was because of their expertise in the therapeutic use of Buddhist principles and practices.

Adam is not challenged in his current role where he receives minimal supervision. His primary reason for declining to apply for internal advancement opportunities was that the increased responsibility would interfere with his sexual activities.

Following informed consent, Adam received the secular MAT intervention that was administered by the second author a psychotherapist and meditation teacher. In addition to mindfulness, MAT incorporates practices that are traditionally followed by Buddhist meditation practitioners including techniques aimed at cultivating: A min break was scheduled immediately prior to the guided meditation, and Adam received a CD of guided meditations to facilitate daily self-practice.

The participant provided written consent for their data to be published in an academic journal in anonymized form. The early intervention phase focused on establishing therapeutic alliance, as well as core therapeutic conditions such as active listening, unconditional positive regard, accurate empathy, respect, and genuineness Wells, During the second week of therapy, five GAS compatible goals were proposed by Adam and agreed by the psychotherapist: A goal of reducing sex-related financial spending was discounted because it was deemed as something that might encourage riskier sexual behavior e.

A further key aspect of the early intervention phase was introducing Adam to the practice of mindful awareness and in particular breath awareness. In this manner, Adam started to develop the necessary foundations for subsequent meditative development as well as a method of arresting ruminative thinking. The mid-intervention phase comprised five key elements that were administered in conjunction with mindfulness training:. The final phase of treatment concentrated on preparing Adam for therapy termination.

While he felt that his psychological well-being and control over sexual urges had considerably improved, Adam expressed concerns over relapse due to loss of face-to-face therapeutic contact. To help alleviate such concerns, Adam was advised to continue with his daily practice of meditation and to keep a daily register of sexual behavior, stress levels, and sleep patterns.

Coping strategy cue cards were formulated that Adam agreed to refer to on a bi-weekly basis. Finally, a procedure for emergencies was discussed, dates and times for planned telephone contact were agreed, and three min booster sessions were arranged at 4-week intervals.

Following completion of MAT i. He exhibited clinically significant change i. Between t 3 and t 4, Adam abstained from watching pornography and using online sex websites. This paper reports findings from the first clinical study to investigate the utility of mindfulness for treating sex addiction.

The intervention utilized in the present study i. The male adult participant Adam demonstrated clinically significant improvements in addictive sexual behavior as well as depression and psychological distress.

Improvements post-therapy were also observed in sleep quality, job satisfaction, and non-attachment to self and experiences. This study highlights the need for tailoring treatment outcomes on a case-by-case basis.

An ideal outcome would have been Adam expressing an interest in finding a long-term relationship partner and abstaining from paid and unpaid casual sex encounters. However, the participant was clear that a long-term relationship was not on their personal agenda, and so therapeutic goals had to be adjusted accordingly.

Although Adam continued to use sex escorts post-treatment, his use of them was at a much lower frequency, and scores on the SAST-R suggested that he was no longer addicted to sex. In other words, observing a behavioral urge helps to objectify it and this allows it to dissipate of its own accord.

However, in reality, the biological intensity of sexual craving could mean that mindfulness alone is insufficient, and that other meditative treatment techniques are required. This suggests that individuals with problematic behavioral urges and other mental health issues are unlikely to accrue the necessary grounding in mindfulness i.

SG-MBIs, that generally integrate a range of contemplative techniques, are therefore arguably well suited to treating behavioral addiction. In addition to targeting craving for sexual contact i. As observed in other clinical case studies of MAT involving individuals with behavioral addictions [e. This study extends this literature by reporting on the use of mindfulness as a therapeutic intervention for treating sex addiction.

As with all clinical case studies, the single-subject design, and the absence of a control condition, means that findings may not generalize to other individuals suffering from sex addiction. The study was also limited by the use of a day period for assessing aspects of sexual behavior, as this time period may not reflect long-term behavior patterns. We confirm that all authors of this article had access to the study data, are responsible for all contents of the article, and had authority over manuscript preparation and the decision to submit the manuscript for publication.

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