Levels of Understanding and Knowledge in Recovery

In moving through treatment for sexual compulsivity, it is important to understand a development process in the level of knowledge that occurs for a client. Consider the following five different levels of understanding.

1) Ignorance is not bliss
Clients may say, “I don’t know why I do this. I don’t know how to stop. What’s going on? What’s a feeling?” In this stage, we have to work with clients who struggle with the question of whether or not they have a problem. How many times have we heard “I don’t have a problem with my behavior; others have a problem with my behavior.“ The major task at this point is lack of information, or in some cases denial.

2) Recognition
Clients start to be aware that something unhealthy is occurring. The level of confusion and minimal awareness is a trademark at this point. When others point out a thinking error, or feeling or whatever, the client can recognize the concepts, but may not have been able to figure it out on their own. With help, the client is able to grasp what others are talking about. The major task at this point is learning and teaching.

3) Recall
Here the client is able to accurately talk about the information, and even proactively offer insights about his/her behavior. Awareness such as “I was feeling sad, mad, and/or glad.” Or, “I was stuck in unhealthy thinking errors.“ In my opinion, when a client gets to this point, therapy becomes “fun” since the client is doing more of the work. The major tasks at this point are support and education to fill in the blanks.

4) Integration
In this stage, the client is able to do the majority of the work. Clients will understand the components of the cycle, and grasp connections between the material and their other issues. Daily insights are occurring. The major task is coaching and occasional direction.

5) Creation
This stage is the art of therapy. Clients are making connections between the material, recovery, and other aspects of their lives. Recovery moves away from a process or task to a profound change in the way clients live their lives. Transformational insights are occurring. The task of the therapist at this point is to stay the hell out of the way. Too often we impose our framework when in fact the client is creating their framework for healthy living.