What kind of cookie are you making? Understanding Cross Compulsivity

A metaphor to understand cross-compulsivity is the process of making a cookie. One of the first things you do in making cookies is to review the list of ingredients. Typically this list includes flour, eggs, water, sweetener, fat, and a raising agent. Beyond the basics, most of the other ingredients reflect the type of cookie you are making. If you’re making chocolate chip cookies, you need chocolate chips. If you want oatmeal raisin, you need those ingredients. White-chocolate, macadamia with cran-raisin requires those ingredients.

Using the metaphor further, a person can make a slight change in the ingredients and achieve different results. For example, there are many options in the type of fat to use. If you use butter, you get a soft, creamy cookie. Margarine gives you are smaller, harder cookie. (In the cooking field, these nuances are a big deal!) Each of the different types of fat results in slightly different taste and textures.

Coming back to cross-compulsivity, many of the ingredients between cross-compulsive behaviors are the same. Whether it is sex, drugs, eating, spending, or other form of acting out, there are overlapping ingredients. It is the specific behavior that adds the type of cross-compulsivity similar to the types of ingredients that define the type of cookies (chocolate vs oatmeal vs sugar vs peanut butter, and so on). Drugs create the flavor of drug addiction; sex means sexual compulsivity; eating means eating disorders and so on. This similarity helps explain why a person might address or “fix” one problem behavior, and simply switch to a different problem area. It also helps why addressing the underling cycle is important. Similar to the cookie, there are similar ingredients within the acting-out cycle. In my approach I use thoughts, feelings and high-risk situations as the ingredients to the acting out cycle. It is important to identify the basic ingredients to your acting out cycle versus only focusing on the problematic area. Otherwise, you risk simply changing the type of cookie you are making in your life.

Concurrent Issues with Sexual Compulsivity

When someone receives treatment for any compulsive behavior, it is common for other problematic behaviors to occur. In my work, I've helped people get their chemical use behaviors under control, only to see their sexual behaviors escalate. Once we've identified and provided interventions on the sexual behavior, a new problem such as spending, or gambling, or anger, or eating concerns arise. The problem is that treatment needs to address the entire acting out dynamic versus simply stopping negative behaviors. It is this recognition that shapes the next sections of the workbook.

Depending on your current place in life, there might be other issues that need to be addressed. This process is sometimes referred to as “triage” where an honest review of the issues occurs. The process includes prioritizing these issues, and developing treatment plans to address the most important issues first. Only you, in consultation with your support network, can prioritize the issues. It may not be wise to address the sexual compulsivity behaviors at this time if other issues are more important. At the same time, if the sexual behavior contributes to the concerns, then it may be even MORE important to address the sexual behavior.

In the list below are the issues to be addressed in the remainder of the workbook. I've tried to be complete, but I have no doubt the list is not exhaustive. If something is relevant in your life, please add it to the list. You might want to review your sex history and your sexual time line and determine to what degree some of these events are present in your time line. As you read through the list, score each topic area on a four point scale where:

1) Not a concern - (i.e., never abused as an adult or growing up.)
2) Minimal concern - (i.e., only feel anxious at certain times, I don't think it is connected to my behaviors at this time.)
3) Major concern - (i.e., my relationship is in danger of ending because of my behaviors.)
4) Emergency concern -(i.e., I'm so depressed, I wish I would die.)

If there is anything that is a "4," please seek immediate help. If you find that you are in a depressive episode, for example, you might rank it a 3. But, if you are having suicidal thoughts or feelings, the concern is an emergency and immediate intervention is necessary. Any concerns with a score of four require support and services before you address the other issues.

Once you have scored the topic areas, go back and rank the areas that are of most importance. This is simply a process of sorting out the 4, 3, 2, and 1s in an order that makes sense with you. This becomes a tentative plan about which topics should be addressed first in your treatment process.

• Emotional Expression
• Anger Expression
• Communication Skills
• Assertiveness
• Boundaries
• Shame
• Masturbation
• Fantasies
• Intimacy
• Touch
• Body Image
• Sexual Competency
• Positive Sexuality
• Sexual Satisfaction/Dissatisfaction
• Safer Sex issues
• HIV/STD
• Sexual Functioning
• Sexual Identity
• Chemical Dependency
• Depression
• Grief
• Anxiety
• History of Physical and/or Sexual Abuse
• Gambling
• Spending
• Working
• Eating Disorders