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Dr. Jaffe recently gave an online lecture (webinar) for HealthCentral on the processes involved in choice and control of behavior during addiction and drug abuse. We’ve written quite a bit on here about the neuroscience of impulsivity issues and the genetic predisposition to addiction and this talk really covers some of the most important aspects of this topic. I’m also attaching a link to the presentation materials that go along with this talk so that you can follow along (Wellsphere Webinar 1 – Choice Vs. Control). There was definitely quite a bit of material (on both neuroscience and genetics) that we couldn’t get to, so hopefully having the presentation will help you follow along and learn.
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As part of our Anonymous No More series, we bring addiction stories of addicts who are in different stages of recovery and are willing to share their take with you without the veil of anonymity. The point is to once and for all humanize addiction, and addicts, and reduce the stigma of addiction as a condition that leaves people hopeless forever. Jennie Ketcham has already publicly shared some of her story with the world, and if her recovery from sex addiction isn’t an example of humanizing and de-stigmatizing the addict, I don’t know what is. From her humble beginnings, through her porn career, to her role on Dr. Drew’s show “Sex Rehab with Dr. Drew,” Jennie has been leaving her mark on this world for years. I know her story will leave a mark on you.
Jennie Ketcham – Sex Addiction is a slippery disease
Like in alcoholism or drug addiction, the sex addict must hit rock bottom before any change can be made. The biggest problem with this particular addiction is the intrinsically shame-based nature of the disease, with core issues making that first step into recovery the biggest and most difficult step one could ever take. To say, “I am a sex addict,” is to admit total and utter defeat in an arena that is most private and sacred.
My name is Jennie Ketcham, and I am a sex addict. My bottom line behavior, behavior I absolutely cannot participate in if I wish to lead a healthy and happy life, is compulsive masturbation, porn, sex with strangers, sex outside my committed relationship, selling sex for money, and sexualizing people, places and things when I feel uncomfortable. For most people, these behaviors are already unacceptable. For a sex addict however, it’s regular Tuesday night. I am 27 years old, my sexual sobriety date is April 6th, 2009, and I ended up in the program of recovery by mistake, but it was the best mistake I ever made. And believe me, I’ve made plenty.
Up to April 6th, 2009, I was a Porn Star. I’d been in the adult business since 2001, and had worked my way to the upper echelons of porn. By the time I quit, I was managing a webcam studio, directing and producing my own content, and working whenever I wanted. I had heard about Dr. Drew and his new rehab show, “Sex Rehab with Dr. Drew,” and thought it would be the perfect publicity stunt for my webcam studio. I figured if I could get national press, the studio would take off and I’d be able to retire a happy woman. This is the superficial line of thinking that led me to rehab. These are the reasons I actually needed to be there.
Jennie the sexually addicted porn star
When I lost my virginity at thirteen, I realized I have something boys want, and decided to use my sexuality as a means of getting what I want. From my first sexual experience to my last pre-recovery, I was detached, emotionless, and cruel: it was a power struggle and I wanted to win. However, it never appeared as such, always the actress, and I played my sexual exploits off as curiosity and apathy. I’d have sex because I was curious. I wouldn’t call them (him/her) again because I didn’t care. When I joined the porn business it felt like the perfect career. I could have sex with as many people as I wanted, and didn’t have to care about any of them. And they wouldn’t care about me. I’ve never been able to accept love, and this is one of my biggest problems.
I’ve been a compulsive cheater since my first boyfriend, have never been able to maintain a monogamous relationship, and never felt any guilt about my extra-curricular activities. The problem isn’t that I lacked a conscience, it’s that I never felt significant enough to make an impact on any one person’s life. When I joined the porn industry I was no longer required to be monogamous, as it was my job to have sex. It became harder and harder to care about anybody I had sex with, and if feelings of love did start, I’d shut the relationship down before I could destroy it with my behavior.
I’ve been a compulsive masturbator since I started performing in hardcore boy/girl scenes. I decided to train myself to orgasm to non-sexual things, and nearing the end of the behavior, found myself masturbating upwards of 6 hours every day I wasn’t working. At the time I thought I was bored. In recovery, I am able to see the underlying issues, and have found a solution that works for me.
Sex Rehab with Jennie Ketcham
In rehab with Dr. Drew, I was prohibited from masturbating, sexualizing, having sex, drinking, drugging, every numbing device I’d become accustomed to using. When the effects of these behaviors wore off, when my oxytocin levels started to even out, when the alcohol and marijuana drained from my system, I was left with uncomfortable feelings I couldn’t identify or process. With the help of trained specialists, I started to understand what was going on behind my compulsive, dangerous behavior, and with the program of recovery I’ve learned how to deal with life. I am powerless over compulsive sexual behavior, and my life had become unmanageable. I came to believe that a power greater than myself could restore me to sanity. I made a decision to turn my will and my life over to that power, and every day since has been better than before.
I was celibate for over nine months, trying to get back in touch with the Jennie pre-sex. I attend bi-weekly therapy sessions, and follow every direction given by either therapist or sponsor. I trust in the program of recovery, and have learned how to treat myself like the precious young woman I am. I have become a woman of grace and integrity, I have dreams that aren’t pornographic, and my first healthy committed relationship with a man I love. I have a relationship with my family, something that had fallen off in addiction, and am someone who does what she says she will do. There isn’t a single moment that goes by that I don’t worry about falling back into my destructive cycle, but now I have the tools necessary to live a healthy and productive life.
When I walked into rehab wanting publicity for my company, the joke was on me. I had accidentally walked into the first day of the rest of my life, and one minute in recovery is worth a thousand days in addiction. I am blessed through and through, and I take it one day at a time.
A final word on sex addiction recovery from Adi
You’ll notice that Jennie’s bottom-line behaviors are very far from the often stigmatized view of the sex-addict as a rapist, or pedophile. While there’s little doubt that there are sex addicts that fall into those categories, the vast majority of addict engage in activity that might, for others, be relatively benign but that has become compulsive in their own lives. My issues with sex addiction revolved around seeking sexual partners outside my marriage and migrated from my bedroom to online chat sites after I got caught cheating. What’s also very clear when reading about the recovery experienced by Jennie is that with the proper guidance, treatment, and time, addicts can go on to become fully functional in ways that many out there believe are nearly impossible. As Jennie mentioned in her reference to Oxytocin levels, a huge aspect of addiction recovery is letting the body reset, or at least attempt to re-establish, its functioning to pre-addictive-behavior levels in the brain and elsewhere.
Jennie Ketcham used to live a life that left her unattached and cold, though for her, it didn’t seem like much was wrong until she saw the other side thanks to her stint on “Sex Rehab with Dr. Drew.” Most other addict’s aren’t very likely to end up on a reality show that specifically addresses their problem (though A&E’s intervention may help some of them), but the knowledge that others with similar problems have recovered and are living full productive lives that would have been unthinkable should give hope to every struggling addict. It’s what works in group therapy everywhere and what gets some people into treatment in the first place. By living her recovery without anonymity, Jennie is showing endless other addicts that life with addiction is possible. That’s what addiction stories do – they give hope.
Actor Chris Klein has checked himself into rehab following his second DUI arrest that occurred on June 16. A police officer pulled him over after he was spotted swerving across the westbound 101 Freeway in Los Angeles. His blood alcohol content was nearly three times the limit of .08.
Chris Klein was previously arrested on DUI charges in 2005 and his PR rep issued the following statement:
“After recent events, Chris was forced to take a clear look at a problem he has been trying to deal with himself for years. He understands now that he can not beat this disease alone. He thanks everyone for their support as he takes all the necessary steps to deal with his addiction and asks for privacy while doing so.”
Klein is receiving treatment at the Cirque Lodge in Utah. The Cirque Lodge may sound familiar to you as Mary Kate Olson, Eva Mendes, and yes, Lindsay Lohan have received treatment there as well. Klein is enrolled in a 30-day alcohol addiction program and plans to stay longer if needed.
The L.A. City Attorney’s office says Chris Klein faces four days in jail (a slap on the wrist?) if he is convicted of his second DUI offense. In accordance with a California law for repeat DUI offenders, Klein will also have to install an interlock device in his car if he wishes to drive again. This device will require him to perform a breathalyzer test in order to start the engine.
It’s not everyday that I get an invite to speak with NIDA‘s director, Dr. Nora Volkow, and so, even though it required my creative use of some VOIP technology from a living room in Tel-Aviv, I logged onto a conference call led by the leading addiction researcher. When my colleagues, Dirk Hanson and Elizabeth Hartney, were introduced, I knew I was in good company.
Addiction research directions the NIDA way
The call focused on some NIDA interests, including a nicotine vaccine, which Dr. Volkow seemed confident will triumphantly exit phase 3 trials in less than two years and potentially enter the market after FDA approval in three years or less. The vaccine, which seems to significantly and effectively increase the production of nicotine antibodies in approximately 30% of research participants, has shown promise as a tool for smoking cessation in trials showing complete cessation, or significant reduction in smoking among participants that produced sufficient antibodies. Obviously, this leaves a large gap for the 70% of participants for which the vaccine was not effective, but a good treatment for some is much better than no treatment for all. For more on the vaccine, check out Mr. Hanson’s post here.
Aside from the nicotine vaccine (and on a similarly conceived cocaine vaccine), our conversation centered on issues relevant to the suggested new DSM-5 alterations in addiction-related classifications. Dr. Volkow expressed satisfaction at the removal of dependence from the title of addictive disorders, especially as physical dependence is often part of opiate administration for patients (especially pain patients) who are in no way addicted to the drugs. Dr. Volkow also noted that while physical dependence in relatively easy to treat, addiction is not, a matter that was made all the more confusing by the ill-conceived (in her opinion, and in mine) term. Additionally, the inclusion of severity ratings in the new definition, allowing for a more nuanced, spectrum-like, assessment of addiction disorders, seemed to make Dr. Volkow happy in her own, reserved, way.
Treatment matching – rehab search for the 21st century
As most of my readers know, one of my recent interests centers on the application of current technology to the problem of finding appropriate treatment for suffering addicts. I brought the problem up during this talk, and Dr. Volkow seemed to agree with my assessment that the current tools available are nowhere near adequate given our technological advancements. I talked a bit about our upcoming addiction-treatment-matching tool, and I hope that NIDA will join us in testing the utility of the tool once we’re up and running. I truly believe that this tool alone will allow more people to find appropriate treatment increasing the success rate while maximizing our system’s ability to treat addicts.
Involving the greater public in addiction research
It wasn’t until the end of the conversation that I truly understood the reason for the invitation (I’m slow when it comes to promotional issues) – NIDA is looking to move the discussion about it’s goals and directions out of the academic darkness in which they’ve lurked for years, and into the light of online discussion. I’m in no way offended by this, especially since this was exactly my point in starting All About Addiction in the first place. If anything, I’m honored to be included in the select group of people NIDA has chose to carry their message, especially since the conversation was an open, respectful, and data-centered one. I hope more of these will occur in the future.
Resolving confusion about addiction
One of the final points we got to discuss in the too-short hour we had Dr. Volkow on the “phone” had to do with the oft misunderstood concept of physical versus psychological addictions. I’ve written about this misconception in the past, and so I won’t belabor the point here, but it’s time that we gave our brain the respect it deserves by allowing it to join the rank, along with the rest of our body, and the physical realm. We’re no longer ignorant of the fact that our personalities, memories, feelings, and thoughts are driven by nothing more than truly physical, if miniature, happenings in our brains. In the same way that microbe discovery improved our well-being (thank you Pasteur), it’s time the concept of the very physical nature of our psychological-being improves our own conceptualization of our selves.
We are physical, spiritual, and awesome, but only if we recognize what it is that makes “us.”
I can’t hide it any longer, I just have to confess: I hate the way addiction treatment is managed nowadays. With over 25 million people meeting criteria for addictions in the U.S., only 10% are seeking treatment on a yearly basis. Sure, part of the problem is that others just don’t want it, at least yet, but there’s something else going on and it’s terrible.
The horrible pain of finding addiction treatment
If you, or someone you know, needs help for an addiction, your options aren’t just limited, they’re hard to find and are simply too stressful to deal with. Where do you even start? Most people wouldn’t dare go to their neighbors or family members with something like “Bobby is really struggling with his cocaine problem, do you have an idea of what we should do?” Instead, everyone is left fending for themselves, scared of going to doctors for fear of later insurance trouble, ashamed to admit their difficulties for fear of being stigmatized, and inundated with conflicting information about their chances for recovery if they do seek help.
So people go online, they seek out information, and they call provider after provider, often getting only partial semi-truths. At the end, most are left confused and the rest simply check in to the first place that will take them given their financial reality. Could you imagine if the same were true when someone broke their leg?
But isn’t addiction treatment really useless?
No, it’s not. Treatment works. It’s just that most people don’t get the treatment they need and end up paying the price (literally and figuratively). Well guess what, help is possible, it’s available, and it shouldn’t be this damn hard to find!
I think it’s about time we create a system that makes it easy for those suffering from addiction to find the right treatment for them. Not everyone needs treatment that costs $50,000 a month, and to be perfectly honest, that treatment is rarely better than much cheaper options. Still, no one would know that given bogus advertisements by rich addiction-industry-players that promise cures and fixes. The truth is that recovery is a difficult road and that different individuals may need different treatment.
Still, we know things that work: CBT works, motivational interviewing works, social-support, contingency-management, exercise, meditation, and specific medications work! So why is it that the addiction treatment industry still looks like something put together by a couple of addicts who suffer from too much self-focus and not enough organizational-capacity? Well, probably because that’s exactly our reality at the moment.
How can we make things better? Matching rehabs to patients
I say it’s time for a new age, especially given the passage of mental-health and addiction parity laws and the slow, but eventual inclusion of our most vulnerable citizens in the American health care system. As addiction-treatment becomes (finally) incorporated with medical care, the increased resources are going to mean an increased need for some standardization. It’s time for us to put people in treatment that works, that everyone can afford, and that is easy to find.
We’re currently testing a system that will use some basic, and some a bit more advanced, criteria to help direct addicts towards the right provider for them. Don’t have much money and working full-time? Then residential treatment should probably not be your first choice? Medicated for schizophrenia? You better stay away from providers that don’t offer serious mental health services (though they’ll sure take you if you walk through their doors)
We’re still figuring out the kinks, trying to improve the system even further than its current state, which I think is nothing short of magical. Eventually, I hope that it will be available for everyone, giving people real, reliable, objective access to addiction-treatment providers that do good work across the united States. It’s that easy to find a condo to buy, why shouldn’t it be that easy to find help?
Yes, I have almost 10 years of research experience into what works, but in truth, most of the issues here probably don’t require that at all. What’s needed is a little big-picture thinking and a little less fine-tooth combing. Hospitals can triage people based on a pretty quick, efficient, assessment. We can too.
Okay, I feel like I have to say something what with all the noise and hoopla going on. For the past few weeks even my friends have been coming up with questions, asking if Tiger was really in sex rehab. He was , I’ve got inside sources and even without those, he’d have done it just to save his skin.
But I think the man has a problem. His little speech today shows that he’s been talking about the right kind of stuff and that he is, at least outwardly, committed to changing his life. Still, that could all be show, right?
Want to know why I think he’s being truthful? The man got caught up with 14 different women!!!
I understand cheating, and if you know me personally, you know what I’m talking about, but still, 14 women?! One of my friends tried to compare Tiger to Kobe, but remember when the latter got caught? The fallout there consisted of one of the biggest diamond rings ever seen and little else.
If you haven’t read our posts about sex addiction, start here. Being a sex addict isn’t about being a player, a guy who loves strip clubs, or a kid with a large porn collection. I’d normally say that quantity doesn’t necessarily have to be part of sex addiction, which is also true for substance-based addictions. Also, I haven’t met with Tiger and I can’t diagnose him via press coverage. Still, given the stories that have come out, I’m pretty sure that tiger was spending quite a bit of time being occupied with the lies, deceptions, and planning that had to go into keeping 14 relationships secret.
I mean seriously, the guy’s followed around everywhere, which means he had to put some serious thought into this stuff, and when you hear his communication with the girls, it’s obvious he was telling stories everywhere. That sounds to me like a compulsive acting-out, not just impulsive sort of “why not?”
So Tiger, I hope you’re really getting help because when it comes down to it, you’re going to have quite a climb out of this little sand-trap. At the least, I hope you’ll be feeling a lot better about yourself when this is done, because aside from being a great golfer, it’s going to seem like there’s little else out there you can recognize.
When my life started seriously veering off track, a few of my friends sat me down and told me that they want to help me. At the time, drugs were paying my rent, and they literally offered me their couch to help me lower my cost of living. They were good friends and they really meant it. I didn’t take them up on it;I thought I was fine.
My first try at rehab
Fast forward 4 years, and my first attempt at rehab. I still didn’t really think I needed help, but my lawyer insisted that unless I wanted to spend the rest of my life behind state-sponsored bars, I should give this thing a try. I went in as a way out. I’d been living on drugs, mostly crystal meth, for the previous 5 years or so. I was a daily user, everyone I knew used, I was paying my rent with ounces of coke, but somehow, I thought everything was going well.
Two months or so after entering rehab, sitting at my recording studio pretending to work, I ran across a baggie that had apparently been left behind. It took me less than 15 minutes to find something to smoke it with.
I only used a little bit that day. I’d been off the stuff for almost 3 months, and I didn’t need a lot to get high. I also wanted to save enough for my next “workday.” I was back to using daily within 5 minutes. By New Year’s Eve that year, I was smoking with an ex-customer in the corner of her bedroom before her guests showed up for the yearly party. I ended the night bored at an ecstasy party with half-naked friends giving each other backrubs. This time, I knew something was wrong.
Another attempt at rehab
Needless to say, I got kicked out of that rehab facility. I spent the following two weeks sleeping on a friend’s couch looking for another treatment option. It was on my way to a meeting at noon on a sunny day in Santa Monica that I saw where I really was. Passing a homeless vagabond on the promenade, I did a double take. I knew the guy; we used to party together. I’m one misstep away from being homeless. I need help.
As I write this today, I am five years into a well-respected graduate program in psychology. I’m writing a book about my experiences, and by the time it comes out, I’ll have a Dr. posted in front of my name. But that wasn’t always my story, and as recently as 5 years ago, it was the unlikely ending to my tale.
The reason I’m sharing it with you here is because I want you to know that there is no magic number. There’s no right way to find your escape from the life, and there’s no necessary mindset when you try to save yourself. No one knows what is going to work for you yet. We’re working hard on figuring out a way to tailor treatment to specific people based on their drug use, their family history, their genes, and anything else we can think of. As of right now, we have no better answer than this:
Keep trying. No matter how many times you fall down, pick yourself up again. If AA doesn’t work for you, try something else. There are options, a lot of them. If you don’t know about any others, ask me, ask anyone. If you keep trying, keep believing in yourself, keep giving yourself a chance, you’ll find the way out eventually.
Until then, keep your head above water and come back here to learn more. As always, feel free to email me with any questions. I’ll keep answering.