1. 1.There are a variety of forms of hypersexual craving. 2.There has been an enormous growth of sexual addictions since the advent of the internet. 1 A New Paradigm for Treating Hypersexual Addiction By Steven Vazquez, Ph D

2. 3.As with all addiction treatment, resolution of sexual addiction is generally slow and relapse is common. 4.Research on the genetic component of addiction and on the brain’s pleasure center has advanced addiction understanding. Non-pharmaceutical means for the rapid treatment of addictive craving has not been previously available. 2

3. 5.While diagnostic procedures and understanding of the dynamics of sexual addictions has grown, rapid forms of treatment have lagged in the best current sex addiction programs. 6.The approach of Emotional Transformation Therapy ® (ETT ® ) provides a new treatment paradigm that can resolve addictive craving long- term as rapidly as in a single session. 3

4. Readiness and Denial Cross-Addiction Secrecy Detoxification Addiction Issues 4

5. Self-Medication Through Addiction Co-Addiction: Wherever there is an addict, there is likely to be a co- addict. 5

6. Multiple Addictions One addiction is part of a ritual for another addiction. One addiction can reduce shame so another addiction can take place. 6

7. One addiction can be alternated with another addiction. One addiction can intensify the effects of another. 7

8. Pros of Twelve Step Programs Provides support by other people who the client can identify with Confronts denial and dishonesty May provide attachment bonding needs Free of charge 12 Steps can be healing 8

9. Cons of Twelve Step Programs Risks possibilities for making drug or sex contacts May over-identify the client as an addict after their addiction is permanently extinguished 9

10. May not be a religious or social fit for a client 12 Step zealots may put down therapy 10

11. Inpatient treatment 16 Step Groups 11

12. Rapidly resolve emotional distress within minutes. Rapidly resolve traumatic events. What Emotional Transformation Therapy ® Can Do 12

13. Change disturbing physical symptoms, within minutes, without pharmaceuticals. Rapidly resolve addictive craving, long-term, without medications. 13

14. Rapidly access and transform the addictive template. Rapidly change dysfunctional enabling emotions/thoughts of co-addicts. Consistently facilitates states of extreme wellbeing without drugs or addictive behavior. 14

15. Using pharmaceuticals to stop addictive craving or symptoms of addiction communicates a dangerous message that answers are found in chemicals outside of the person’s inner resources. 15 Using Drugs to Treat Addictions

16. ETT ® does not create artificially induced side- effects in the manner that pharmaceutical agents do. 16

17. Ecological Psychology Our visual ecology and the brain are seen as a single unit with a series of mutually interacting feedback loops. 17

18. When light enters the eyes, photoreceptor cells convert light into neural impulses via biochemical processes. These light initiated neural impulses can potentially travel throughout the entire brain impacting key brain functions directly or indirectly. 18 The Visual Environment and the Brain

19. Specific retinal codes in the molecules of the retina of the eyes influence which specific routes the neural impulses will travel in the brain. Light initiated neural impulses change brain chemistry. 19

20. Many of these visually initiated neural routes impact “non-image forming” brain mechanisms such as those that control emotions, thoughts, physical symptoms and are not involved in “seeing” per se. 20

21. By selecting the precise wavelength of light, or the specific angle of entrance of light, all within the context of a specific mental state, external light can be directed to change brain mechanisms responsible for disturbing symptoms. 21

22. Emotional Transformation Therapy ® (ETT ® ) Interpersonal Process Precise External Visual Stimulation Brain 22

23. Interpersonal Process Fosters trust and confidentiality so that verbal disclosure is possible Promotes safety so that targeted brain mechanisms can be engaged 23

24. ETT ® uses highly specific forms of therapist attunement to clients, which are custom-tailored to each client’s attachment pattern resulting in optimal interpersonal impact. 24

25. Visual light stimulation elicits attachment patterns to emerge and then allows them to be available for change. 25

26. Interpersonal processes can engage a clients’ attachment pattersn. Attachment patterns dictate how a person regulates their emotions. 26

27. Secure Attachment – Emotional Trajectory Duration Brief efficient transitional time Highest 10 9 8 7 6 Intensity 5 4 3 2 Lowest 1 Conclusion 27

28. Resistant/Ambivalent Attachment – Emotional Trajectory Compared to Secure Emotional Trajectory Duration Highest 10 9 8 7 6 Intensity 5 4 3 2 Lowest 1 28

29. Aggressive Attachment – Emotional Trajectory Compared to Secure Emotional Trajectory Duration in time Highest 10 9 8 7 6 Intensity 5 4 3 2 Lowest 1 29

30. Exaggerated Attachment – Emotional Trajectory Compared to Secure Emotional Trajectory Duration Highest 10 9 8 7 6 Intensity 5 4 3 2 Lowest 1 30

31. Inhibited Attachment – Emotional Trajectory Compared to Secure Emotional Trajectory Duration in time Highest 10 9 8 7 6 Intensity 5 4 3 2 Lowest 1 31

32. Avoidant Attachment – Emotional Trajectory Compared to Secure Emotional Trajectory Duration in time Highest 10 9 8 7 6 Intensity 5 4 3 2 Lowest 1 Disengagement 32

33. Undifferentiated Attachment – Emotional Trajectory Compared to Secure Emotional Trajectory Duration in time Highest 10 9 8 7 6 Intensity 5 4 3 2 Lowest 1 33

34. Psychosomatic Attachment – Emotional Trajectory Compared to Secure Trajectory Duration Highest 10 9 8 7 6 Intensity 5 4 3 2 Lowest 1 Implicit Somatic Emotion Conscious Emotion Two Simultaneous Patterns 34

35. Role Reversal Attachment – Emotional Trajectory Compared to Secure Emotional Trajectory Duration Highest 10 9 8 7 6 Intensity 5 4 3 2 Lowest 1 Empathetic Emotion Self Emotion 35

36. Disorganized Attachment – Emotional Trajectory Compared to Secure Emotional Trajectory Duration in time Highest 10 9 8 7 6 Intensity 5 4 3 2 Lowest 1 Dissociation 36

37. No Signs of Attachment – Emotional Trajectory Duration Highest 10 9 8 7 6 Intensity 5 4 3 2 Lowest 1 No Characteristic Pattern 37

38. 1.ETT ® can facilitate rapid relief of intense, overwhelming emotion. Most addictions occur as a means to manage/avoid unresolved emotions. Without these distressing emotions, addictive behavior is unlikely. 38 ETT ® for Addiction Treatment

39. 2.ETT ® can facilitate a change in the co-addict enmeshment with the addict through targeting the brain’s tempero-parietal juncture to differentiate self from another. 39

40. ETT ® Techniques Multidimensional Eye Movement (MDEM) MDEM uses external visual stimuli to replicate eye scanpaths that access precise neural networks related to a specific symptoms. 40

41. Spectral Resonance Technique (SRT) SRT uses a specialized spectral chart of highly saturated colors to identify and rapidly reduce emotional escalation or dissociation. 41

42. Peripheral Eye Stimulation (PES) Peripheral goggles are used to isolate specific beams of environmental light by controlling the angles at which they enter the eyes. This process can precisely access specific neural networks to rapidly change emotional, cognitive or physical symptoms. 42

43. Peripheral Eye Stimulation (PES) PES can also be used with a light emitting device. 43

44. Light emitting device uses state- of-the-art red-green-blue technology to access precise wavelengths of light from hundreds of options. 44

45. Attachment patterns come from caregiver-child relationships. Deficiencies in attachment patterns become incorporated internally. This leaves a person vulnerable to seek external sources to relieve these deficiencies. Addiction and Attachment 45

46. Addiction as an Attachment Object My addiction feels like _______. a friend It’s always available a partner a nurturing parent a safe source 46

47. My Addiction helps regulate my emotions _________________. to acquire escape from unpleasant circumstances to relieve anger to relieve sadness or depression to relieve boredom to relieve anxiety 47

48. to relieve loneliness to relieve negative self-perception to acquire comfort to acquire energy to acquire states of wellbeing to acquire engagement 48

49. 49 Oxytocin is known as the “cuddle hormone” because it produces a feeling of wellbeing associated with love or affection. Oxytocin is initially produced in the paraventricular nucleus of the hypothalamus that projects to the pituitary for distribution in the brain. Oxytocin

50. Oxytocin is naturally produced by: 1.Lactation in women 2.Sexual climax 3.Affectionate touch or perceived social support 4.After eating food 50

51. People report experiences associated with oxytocin production by means of precise visual brain stimulation combined with interpersonal processes. Oxytocin priming can be facilitated by ETT ® to achieve the protective benefits of oxytocin without addictive acting out. 51

52. Observation: In sex addiction, women tend to report oxytocin experiences more as a result of affectionate touch and men tend to report these experiences more as a result of sexual climax. 52

53. Certain forms of “love addiction” coincide with sex addiction. Complete resolution of sexual addiction does not compromise the ability to have sex, but does change the quality of the sexual experience. 53

54. Deactivation of the brains’ pleasure center often yields anhedonia which makes seeking sex and/or affection have a compulsive quality and loss of voluntary control. 54

55. Constellation of Factors in Addiction Attachment Deficits Emotions Thoughts Physical Symptoms Behaviors Unconscious Emotions Unconscious Memory Traumatic Events Co-Addicting Enabling Addictive Craving Identity Issues Availability of Addictive Source Social Factors 55

56. 1.Attachment patterns control the form of emotional regulation triggered by a stressor. 2.Current events stress the person to react emotionally. How the Brain Processes Pleasure or Lack of Pleasure 56

57. 3.Emotional activation activates the following brain mechanisms during the addiction process: Orbitofrontal Cortex – This is the key brain mechanism involved in attachment imprints from early life relationship patterns. If significant attachment deficiencies exist, they are vulnerable to be activated under stress. 57

58. Amygdala – This is the key brain mechanism that signals alert to either potential threats or novel experiences and initiates emotional patterns established by each attachment pattern. 58

59. Medial Prefrontal Cortex – This brain mechanism is the primary control zone through which emotions are processed. If emotions are inadequately processed, they risk projecting dysfunction to the nucleus accumbens which can be translated into lack of pleasure. 59

60. Hippocampus – This brain mechanism is largely associated with memory functions. When stressors escalate due to inadequate emotional regulation, memory can be blocked. This temporary memory loss can involve lack of recollection of relevant coping resources, which can result in poor choices under stress. 60

61. Dorsal Caudate and Globus Pallidus – These are brain mechanisms within the basal ganglia that are associated with anxiety and motor control. These mechanisms contribute to the spontaneous actions that occur automatically in response to inadequate emotional regulation. 61

62. A1D2 Gene – Activation of the aforementioned brain mechanisms contribute to the activation of the A1D2 gene that contributes to the actions of the brain’s pleasure center. Once this gene is activated, it tends to remain activated long-term and contributes to the nucleus accumbens (pleasure center). 62

63. Ventral Tegmental Area – This brain mechanism is the final contributor to the brain’s pleasure center and is activated by all previously mentioned brain mechanisms. 63

64. 4.The type of emotional processing either activates or deactivates the A1D2 gene which makes it possible or impossible to experience pleasure. 5.The nucleus accumbens (pleasure center) can _________. enhance or inhibit emotion related to motor control areas project to other brain mechanisms that inhibit (GABA-ergic) or excite (Glutamatergic) the nervous system project dopamine to all other brain areas 64

65. 6.Once input to the nucleus accumbens has occurred, other brain mechanisms are activated by dopamine from the nucleus accumbens such as: amygdala - activates emotional responses medial prefrontal cortex – processes emotion 65

66. ventral pallidum – activates motor activity thalamus – distributes information to multiple brain sites hypothalamus – integrates emotion and physiology and can stimulate enkephalins Projections to these brain mechanisms result in either pleasure or the inability to experience pleasure. 66

67. 7.Loss of internal ability to experience pleasure __________________. causes pleasure seeking repeated use of an external source of pleasure becomes habitual once an external source of pleasure is found, gradual loss of voluntary control tends to occur 67

68. Caregiver-child Interaction Creates Attachment Patterns Attachment Patterns Regulate Affect Orbitofrontal Cortex/Amygdala/Medial Prefrontal Cortex Hippocampus/Dorsal Caudate/ Globus Pallidus Ventral Tegmental Area A1D2 Gene Activates Current Circumstances Activate Emotional Responses Nucleus Accumbens Enhances or Degrades info from emotion to motor control areas GABA-ergic (inhibitory) or Glutamatergic (excitatory) 68

69. Nucleus Accumbens Enhances or Degrades info from emotion to motor control areas GABA-ergic (inhibitory) or glutamatergic (excitatory) Dopamine Amygdala Medial Prefrontal Cortex Ventral Pallidum Thalamus Hypothalamus Results in pleasure or inability to experience pleasure 69

70. ETT ® can consistently facilitate internal states of extreme wellbeing without the use of any substance or source of addiction. These states can provide the spiritual experience through natural means, that many addicts appear to be seeking through substance abuse or sex. 70

71. By accessing and facilitating change of the psychophysical craving state, the addictive template can often be rapidly changed resulting in: 71 How Craving is Changed

72. reversing the A1D2 gene activity neutralizing craving long-term regaining volitional control of behavior overcoming results in overcoming powerlessness of the addiction 72

73. 73 Factors that Affect the Speed of Craving Elimination If the client has had no previous education about the addiction process and no previous counseling, it may require a few sessions to orient him/her to the nature of addiction.

74. 74 If the client has other psychological diagnoses that require processing as well as addiction treatment (borderline personality disorder, obsessive compulsive disorder, dissociative identity disorder, etc.), it will likely take more sessions to complete treatment.

75. 75 If the client is currently not in touch with a craving experience that comes and goes, it may require two or three session to know for sure that the craving is relinquished. If the client lacks awareness and is unwilling to cooperate, treatment is slower.

76. 76 Factors that Enhance the Chance of a Single Session Elimination of Craving If the client has previously been through in-patient and/or out-patient, and/or 12 Step Groups, but continues to have addictive craving, rapid progress is likely.

77. 77 If the client’s dual diagnosis exists due to the addiction and consists of only depression or anxiety disorders, rapid relinquishment is likely. If the client is currently at a high level of addictive craving and is desperate for resolution, rapid elimination of craving is likely.

78. When the client has enmeshment experiences from the family of origin, enmeshment with the addictive relationship object is likely. This issue usually must be resolved for the addictive template to dissipate long- term. Underlying Issues of the Addictive Template 78

79. When significant addictive role models exist in one’s family of origin, these imprints should be identified and resolved in order to increase the chance of removing the addictive template. 79

80. When the client has neglect experiences from the family of origin, addictive relationship objects can become desperate needs. This issue usually must be resolved for the addictive template to extinguish long-term. 80

81. When the client has significant traumatic events in their past that are unresolved, these related emotions should be resolved to increase the possibility of dismantling the addictive template. 81

82. New alternative ways of coping and regulating emotions should develop in order to reduce the risk of developing another addictive template. 82

83. Current Addictive Craving EmotionsThoughtsPhysical SymptomsBehaviors Attachment Deficits and A1D2 Gene Expression Blocks Endogenous Pleasure Capacity Secrecy and Dissociation Contributes to Implicit Memory Unconscious Emotions/Traumatic Events/Identity Issues Leads to Intense Pleasure Seeking and Loss of Voluntary Control Stressful EventsSocial FactorsAvailability of SourceCo-Addiction Addictive Template 83

84. When the ETT ® method alleviates the addictive template long-term, the client typically experiences the following: Alleviation of the Addictive Template 84

85. 1.A complete cessation of addictive craving 2.A euphoric experience characteristic of the state of arousal pleasure that the person experienced previously with drugs or sex, except that the pleasure is even more elevated 85

86. A.This euphoria indicates a reversal of the activation of the A1D2 gene and reversal of the activation of the nucleus accumbens. 86

87. B.When these experiences occur, it indicates a rapid fundamental change in the addictive template, which usually results in long-term elimination of addictive craving. 87

88. C.Sometimes people will “relapse” by trying the addictive agent, only to find that it no longer has the same effect. Then a loss of interest in the addiction (not loss of pleasure) is likely permanent. 88

89. Treatment Subsequent to Craving Elimination 1.Process cognitive dissonance about suddenly becoming addiction-free after a long experience of addiction. 2.Explore transitional identity states to promote stabilization as a non- addict 89

90. 3.If there is a co-addict, facilitate change in the co-addict enmeshment and encourage Alanon participation for the co-addict. 4. Explore possible changes in the client’s social network to support the new identity 90

91. 5.Educate the client about what is normal sexual expression and recommend reading Alexandra Katehakis’ book Erotic Intelligence 91

92. Contact Information Steven Vazquez, Ph D Address:2520 Harwood, Suite 100 Bedford, TX 76021 Metro: 817-268-7050 Local: 817-684-9766 Fax: 817-684-855 Email: stevevazquezphd@sbcglobal.netstevevazquezphd@sbcglobal.net Website: ettcenter.com 92