An Open Letter To Patrick Carnes


A heartfelt letter written by a member of the Sisterhood:

Dear Patrick Carnes, Stefanie Carnes, Robert Weiss, All CSAT Counselors And Sex Addiction 12 Step Advocates,

Please consider this letter an urgent request to change the current 12 step/co-addict approach that has been perpetuated in the field of sexual addiction. The historical underpinning of Bill Wilson’s model for alcoholism has serious negative implications for evidence-based practice, even for sobriety standards, even though its evolution at a time when nothing else was available did have merit. Wilson and his partner adapted religious principles for living a sin-free life – where does religion have a role in diagnostic acumen? (Maybe it did for Bill because he was plagued with so many compulsions and addictions himself including sex).

Religion is a cultural and spiritual function of our humanity but 12 Step seems to be the only place where religion is considered part of a medical treatment plan. The modification of the phrase ‘God as you know it’ does not change this fact. Just as the Bible was written for a world that existed over 2000 years ago and deserves to be considered in the context of contemporary mores, so too must the 21st century approach to compulsive/addictive behaviors.

People who are addicted or compulsive become increasingly deceptive over time. Possibly it is the capacity to be deceptive that might lead to the compulsion, who knows which comes first? Even the descriptions of mental-health disorders in this country are subjective and highly vulnerable to great scrutiny by different clinicians, unless somebody is revealed to be acting so egregiously that they have violated acceptable legal and moral standards. Isn’t that what propels sexual acting out into a diagnostic category, acting egregiously? Prior to that it is infidelity or as you like to distinguish adultery. Sexual acting out is a form of betrayal that changes the landscape of everybody’s lives (and it is only betrayal if the partner has not signed up to be in bed with 50 other people). Its origins are complex and rarely begin with the partnership and are usually not revealed until there has been some kind of bond established and then broken.

To describe a partner as a volunteer rather than a victim is actually another egregious betrayal by the professionals who claim to be providing care. Of course this is a family problem – the family has been blown apart and prior to the explosion was living in a fractured reality that was being established without their consent. Even in cases where the partner might have known ‘something was not right’ the culture of entitlement, socially gendered norms for male behavior, and economic and family displacement after divorce, does not render a partner as a co-addict or volunteer in the hi-jacking of their lives.  Would you say this to someone who has been subjected to other recognized forms of domestic violence?

Sexual acting out is about power. That has been established through many years of rape research.  Someone who acts out against the partnership and family is raping the principles of said partnership, unless both people agreed to screw whomever, wherever, and whenever. At the point that couples show up for treatment, and it is usually couples, sadly there are few men or women who are putting themselves in the hands of addiction professionals who haven’t first destroyed a family as well as themselves. It is therefore often because the story has become too unmanageable to hide and the scattered pieces of everyone’s lives are strewn about the roadside.

This is not a couple problem – let me emphasize this! This is not a couple problem!

This becomes a family problem when children are created in a union that is untenable because it is built upon lies. Of course every couple colludes when they marry, it is part of the ‘happy ever after’ delusion, but this problem, sexual acting out, lies within the person who is out of control. This does not necessarily mean that there are no other influencing factors but when someone robs a bank and their partner does not know about it and did not participate in the crime what part of the law says that they should also be arrested and thrown in jail?

The pattern of diagnosis toward partners is a symptom of the patriarchy that continues to victimize men and women, because male partners of women who act out are described in gendered terms that are also typically used to describe women in general: co-dependent, enabling, under-developed, clingy, hyper-vigilant. Who wouldn’t be hyper-vigilant when they are under attack from an unknown assailant (lies) and a known assailant, their partner?

The sad legacy of this behavior leaves everyone in shreds. Perpetuating the myth that you can have greater intimacy by accepting yourself as a co-addict is also abusive. Don’t get me wrong, it might work for people who, already victimized, are now vulnerable to being victimized by the system that they have reached out to for help, but if empowerment and liberation is the goal this is not the language or kind of care that resurrects anyone’s sense of self. Not the person acting out, the partner, or the family. And, let us not forget the people on the other side of the sexual acting out equation, the sex workers and prostitutes, who in a recent survey by a sex trafficking organization say, at a rate of 98%, that they hate what they do.

This behavior is not about sex. It is about lies, ownership, entitlement, power, trauma, despair, and patriarchy. The mental health system that uses these same methods to treat the problem is also acting egregiously. I am not saying that compassionate care is not warranted for the individual who behaves this way, I am saying that compassionate care is accountable-care, and accountable-care is complex. It is not 12 Step, or 13 Steps (and I am sure you know what that means). It is a million steps of indeterminate conclusion that leaves room for the stories of loss, abandonment, neglect, and possibility on both sides of this equation.

Sometimes leaving is the best answer for both partners, what is not the answer is to diagnose one person with cancer and give the other one chemo.

9 thoughts on “An Open Letter To Patrick Carnes”

  1. This letter is so succinct. I am struggling through the process of learning that my 22 yr marriage partner has been lying to me and unfaithful- that he is a sex addict, compulsive liar, lacks empathy and even the capacity to fully acknowledge the acts he has perpetrated. He lies even to himself. We have been subjected to Patrick Carnes’ books- and the therapists who endorse that model- it is literally impeding our ability to progress- because we both think it is impossible to digest. He can’t stand the forgive yourself- your wife participated in this- and I can’t stand the forgive him- forgive yourself- HOLD ON!!! He hasn’t even finished telling the whole truth- we haven’t even gotten to the why in the world he came to me like this and how he was able to take it so far for each and every year of our marriage- I laid in a hospital bleeding to death- he went to a strip club- got a lap dance to celebrate – while I was still in the hospital- bleeding- ……that was 2 years into our marriage during the birth of our first son. PLEASE do not tell me that I sent him to that club- while I was fighting to stay alive- and PLEASE do not tell me to forgive myself for that. This model- is sorely out dated- and frankly it is dangerous. To equate a chemical addiction to a process addiction, then to further suggest that with prayer they may be treated the same- well – it’s down right mal-practice. It needs to be fixed- just like the patients turning to it. Don’t cover the noise- find the squeak!!

  2. I’m not sure about Rob Weiss, but I do know that Stephanie Carnes and, more recently, Patrick Carnes along with many other practitioners have adopted the trauma model for treating partners of sex addicts rather than the co-addict model. It really does reflect what we go through more accurately and, I hope, through getting more education out there that more professionals will adopt this model.

  3. They may have adopted the model but a cursory Google search on their writings will tell you emphatically that they are only giving lip service to the trauma model. Every single one of them still endorse those awful meetings for the partner. If you weren’t co dependent going into those meetings then you certainly will be afterwards. Those meetings make the “stepford wives” look enlightened. Pure and unadulterated battered women. It’s a sin.

  4. Here here! I despise the approach taken by Carnes and only since I have started to read around SA, became aware of this very damaging and narrow view. Its appalling , abusive and down right criminal in my opinion to further victimise or traumatise people who have been through living with SA in their homes. Its convenient to overlook the pathological lying, the manipulation and called it dishonesty and overlook the impact this has on partners and families. Its psychological abuse pure and simple, to undermine a persons intelligence, their feelings, their intuition and their grounding or trust in themselves and the world around them. It ought to be criminalised. Partners don’t volunteer for this, part of the problem here is that partners basic rights e.g. the right to make an informed decision about their lives and when choosing a partner , the right to boundaries and have them respected, the right to feel safe, the right to psychological well being and the right to be treated with respect, right to have physical health respected and right to fidelity are completely violated thanks to SA’s, their pathological lying, propensity for deception and in my opinion extremely selfish and narcissistic personalities. I resent greatly the way out and opportunity it affords SA’s to further project blame on to those they already scapegoat and harm by doing so. Wrong doing is wrong doing, there is no justification, no excuse and Carnes explanation leaves nothing to be desired, nothing to be proud off, and nothing to offer those who already carry trauma, hurt, humiliation and devastation.

  5. Response to JoAnn Russell’s “An Open Letter To Patrick Carnes, Stefanie Carnes, Robert Weiss, All CSAT Counselor and Sex Addiction Advocates” November 3, 2013

    This letter is now 7 years old, but continues to have relevance today in that it presents ideas that many people hold and that I consider erroneous.

    Ms. Russell is not a fan of the 12 Steps, but does not present any good argument for her position. To begin with, the 12 Steps are a wonderful guide for anyone wanting to live their best life, whether or not they identify as an addict. In brief, they ask a person to recognize those things in life they can control and those they cannot and then relinquish the attempts to control the uncontrollable and just give them to a higher power. The higher power is whatever they conceptualize as greater than themselves. So, for instance, as a therapist, I can educate people about how their limbic systems and prefrontal cortices work to cause them distress. I can help them recognize alternatives to unfulfilling behavior. I can guide them in attempts to change their behavior so they can be in harmony with their life goals. What I cannot do is change them. So, when I am with a person who is struggling with their misery and is unable to make any substantive changes, I give them to a higher power. I acknowledge to myself that I cannot make them happy or change their lives and I don’t need to make myself miserable in futile attempts trying.

    The rest of the 12 Steps encourage people to take a personal inventory of what’s not working for them and of characteristics and values that are not in harmony with who they want to be and then to let those go by asking for strength to do so from that higher power. When ready, people can make amends to people they have harmed, continue to take personal responsibility for their behavior, and ultimately help and be of service to others.

    For Ms. Russell and others who struggle or resist this concept of a higher power, I ask that they ask themselves which of these two statements is true:

    I am the greatest power in the universe.
    I am not the greatest power in the universe.

    Moving on in this letter, Ms. Russell gets confusing as she bounces back and forth between the addict and the partner. Over the past 7 years, Dr. Stefanie Carnes, Dr. Rob Weiss, and other CSATs have all been very focused, active, and vocal about affirming the trauma experienced by betrayed partners and not pathologizing their responses. Dr. Weiss created the term “prodependence” towards this end and his book – Prodependence: Moving Beyond Codependency – is being embraced by many clinicians and partners of addicts.

    Finally, comparing a sex addict to a rapist or domestic violence offender completely misses the mark of the nature of addiction. At the heart of addiction is the fact that the limbic system is at the mercy of the hijacked dopamine reward system. While lies, entitlement, etc. may be part of the problem, suggesting that the addict is acting in a deliberately harmful manner towards a partner is just wrong. Yes, addicts cause harm and yes, partners and children are harmed, but what separates the addict from a sociopath or narcissist is the despair they experience upon realization of that harm.

    Ms. Russell’s basic message that partners are not responsible for addicts’ behavior and that they ultimately need to make decisions in their own and their children’s best interest is a sound one. Unfortunately, it gets lost in the tangents that misinform and deflect from the true nature of addiction.

  6. Carol, thanks so much for taking the time to offer your thoughtful viewpoint on the very complex issue of what we call sex addiction. I hope that your comments will inspire more dialogue. ~ JoAnn

  7. Just a note, for anyone who may not have read the article carefully. The very first sentence clearly states, ‘A heartfelt letter written by a member of the Sisterhood:’.

    I did not author the letter, although I do agree with most of what she wrote.

  8. I discovered my husband’s sex addition almost 2 months ago and he immediately began counseling. He is seeing a CSAT counselor but was asked to read Patrick Carnes book. I am listening to Your Sexually Addicted Spouse by Barbara Steffens and Marsha Means and completely identify with the trauma model. ‘I don’t want him to get the wrong info from his counselor about my side of the story.
    What do I do? Do I ask him to switch counselors? Do I speak to his counselor to see if that in fact is his take on the spouse’s role? How do I find someone who will do a full disclosure with polygraph?

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