Dr. Patrick Carnes, Leading Sex Addiction Expert, Video Interview

Hello, this is Joe Polish, president and founder of the Genius Network. And today I've got a very intriguing, interesting and special guest. His name is Dr. Patrick Carnes. He's a psychologist. I know this man personally. He's an amazing thinker. He's helped millions of people with a subject that I don't usually do interviews on. It's addiction. And his specialty is not only one of the world's leading authorities on addiction, but the world's absolute leading authority on a specific sort of addiction, which is sexual addiction. And we're going to talk in depth about addiction, but also a lot about sexual addiction. So I'm going to read something here, Pat, before I start asking you with some Q and A, just a short bio here. You've got a very long one, but I'm going to do a short one. Dr. Patrick Carnes is a nationally known speaker and author on addiction and recovery issues. Is the primary architect of Gentle Path treatment programs for the treatment of sexual and. And addictive disorders. He is currently the executive director of the General Path Program at Pine Grove Behavioral center in Hattiesburg, Mississippi. Dr. Carnes is also the CEO of New Freedom Corporation and New Freedom Publications in Carefree, Arizona. Well, first off, thank you for.

You're welcome to be here with you. It's fun.

It'll be fun. It'll be fun. It'll be interesting. Well, there's so many different areas I could go down. I mean, just to give the viewers and listeners some background. Who is Pat Carnes? What are some other things? You've been on Oprah eight, nine times. You've been on almost every talk show under the sun. You've gotten just an enormous amount of publicity. Many, many people in the addiction field and many other field is mental health, know who you are. You've got, I believe, hundreds, 800 plus therapists that actually use many of your methodologies and treatments for addiction. So who is Pat Carnes?

Well, I was just thinking about next week I'm going to be 65, which means I've been at this now for almost 40 some odd years. In many ways I've watched the whole addiction field come into its own, become recognized. And now as a lens, I'm watching at this phase of my life, just the significance of it growing. And so for me, it's been a very meaningful career. I think one of the blessings you can have in life is when you have meaningful work. And I've been blessed with really meaningful work. I've been able to learn a lot every day, you know, I find out you can do things, things sexually I never knew you could do before. You know, I mean, the learning curve is incredible. But if it weren't so serious and so significant for so many people, I think that's the real value. We're in a struggle. We have a significant challenge in this culture. We now know that addictions aren't just a myth that you have to take a chemical. You can be addicted in many ways without using chemicals. In this country, we have over a third of our adults who've got a problem with obesity. Compulsive overeating is one of our major addictions, sexual addiction. We're now at a place where we have an epidemic, or we have 2/3 of our kids watching pornography while they're doing their homework.

Two thirds of kids watching pornography while.

They'Re doing their homework.

I wanted to highlight that.

That's it. 34% of them go on to really pursue that and are at risk for what we call sexually compulsive behavior. The problem is this whole field has changed, because when I started, I would hear guys talking about finding their father's Playboy collection. And now I'm hearing people talking about that. The level of stimulation, what they're finding on the Internet. The answer is no spouse can compete with the Internet. Plus, we have drugs we didn't have before. We understand about work and stress, things connected with stress, how it changes the brain. And so it's a time where we're talking about our most significant health issue in this country, and we're blind to it, because if you look at all the kinds of issues that are involved, it's our most expensive thing. Medically, it's our biggest problem. Socially, it's our biggest problem in schools, and it's our biggest source of crime, and it's our biggest source of injury for children. And we as a culture, do not want to deal with it.

Interesting. Well, okay. Well, first off, I would be fascinated to know why that is the case. But I want to first have you define what is addiction. I mean, what does that mean?

Well, there's many definitions of what an addiction is, but here's what it boils down to. Addiction is a brain disease. The brain has become altered. And when a person starts a behavior, like a kid takes some nicotine, what he doesn't know is nicotine stays in his brain for 30 days, so he doesn't feel like he's got a problem. I haven't had a cigarette in three weeks. But the fact is, the brain is adjusting, and so it Feels like a choice when he starts and what happens if he uses it to cope with stress and cope with pain. The actual way that the brain is structured shifts, it moves. Even in gaming, we are now seeing that kids become so addicted to gaming that some, we are quite certain some kids brains don't actually unfold naturally. So what happens is that the brain is altered and it's self administered. You do this for yourself and has a lot to do with how you perceive things. So for example, you and I were joking before the show about this research out of Stanford where people were given the same bottle of wine. One group is told it's 90 bucks, other group is told it's 10 bucks. The group that got the 90 buck, they got higher than the group that had the 10 buck wine.

So same wine, same wine, thought it was $10, 90.

So it's really what your perception is. And so what happens then is that the brain actually then starts to reset itself, recalibrate itself. And then that person gets to a point where it crosses the line. It goes from where it's an impulse to where it becomes compulsive and then it becomes addictive. And then you have a problem where a person can't stop and they make promises to themselves they're gonna stop. And they can't stop because the brain is now at a place where it can't go backwards by itself. So it's, it's a little bit like other things that you know of Alzheimer's or other brain diseases. There's now something wrong with the brain and we can see it, we can look at it, see pictures of it. We know that it's a problem and that it'. Treatable.

Okay, so you said it's a brain disease. And I mean I've, you know, done a lot of reading on addiction. I go to conferences. I mean I'm very much an addictive thinker.

I've been one of the biggest conference goers I know.

Yeah, well, a lot of things. And I'm fascinated with the whole subject of addiction because I believe, you know, mental illness in the worst possible states will manifest itself as an addiction. And from a layman standpoint, meaning to me, I interpret it as something where willpower, choice, all of those things doesn't matter. Okay, and I want to ask you about that. There's behavioral addictions such as sex, which we're going to talk heavily about today. Gambling, eating, Internet. And then there's chemical addictions, alcohol, drugs, things that are consumed. Is there a difference between a chemical addiction versus A behavioral addiction, other than the way that it's acted out.

Well, what's important is that everybody understand it taps into the same parts of the brain, so it's the same reward centers, uses the same chemicals. Like dopamine, for example. If you have a good meal, it raises your dopamine 50%. If you have sex, it raises it 100%. If you drink alcohol, it raises it 100%. Take methamphetamines, raises it 1,100%. So sometimes some things are too good. The brain can't. You can't be a recreational user, meth, and not have a problem. See, and there are other things like that. So the first thing that you need to understand is it taps into the same parts of the brain. What makes it different. And especially with food and sex, they are different than everything. Which is why many of my patients will say heroin addicts, cocaine addicts will say by far sex was much more difficult than their cocaine or their heroin. And part of the reason is, first of all, the brain will categorize anything sexual, both men and women, 20% faster than anything else. We are wired to be sexual because it's about survival. Food is about survival. Food and sex are also sensate. In other words, we are the only country in the world that has a dessert card. Yeah. And the reason we do is because the presentation and the smell is part of how you sell the food. The food industry has been very effective at marketing and building ways in which it gets people to buy food that's not good for people. So the senses are very important. And so a cocaine addict doesn't care how his cocaine is packaged. Just watch the cocaine. But food and sex presentation can mean a lot in terms of what does that mean to the person, how that person looks. Just think of words, Joe, that you can think of right now that would apply to both food and sex. Hunger.

Delicious. Beautiful.

Yeah, exactly. In other words, erotic. Yeah.

So you have see how my brain just works like this.

Yeah. But the point is that they're regarded as two of the toughest addictions because of how they're wired. And then they are intimately connected also with historically issues around trauma, sexual abuse. Many people who are overweight have been sexually abused. It's a way to defend themselves sexually. Sex addicts have been abused sexually. Fear is a big factor in all addictions. Every addiction has what we call a stress factor. You really can't have an addiction without stress because of what it does to the brain.

Interesting. Well, here's one of the reasons that I wanted to interview you for one. I don't know the exact cliche, but it's that which is most private, is most public. Yes, this is a condition which you absolutely know, have more statistics than you could ever shake a hat at and millions of people suffer from. But if you go out onto the streets, no one wants to admit it. Talk shows never, I've rarely seen unless like you're interviewed or something where there's ever a proper interpretation of it. It's such a shame and guilt based condition. But so many people, including a vast majority of our listeners, many of who are entrepreneurs and CEOs, would never want to admit to it. Most of the depictions of sexual addiction or addictions in general are typically wrong. Whenever they show a 12 step, supposed 12 step meeting on TV, it's usually really not how it works. And you know, we're living in a world where this condition is so prevalent and so many people are suffering from it, but there's not a lot, if any real major public support for it. And there's millions of people that deny it even exists, including supposed doctors. And so it's changing, it is changing dramatically.

And I think the factors that have made it change, first of all is we have a lot more science and there are a lot more people like me out there working on it that have studied sex addiction and are prepared for this. Now in the comprehensive textbook of psychiatry, psychiatrists are starting to draw a bead on it. The Clinton experience helped in a very strange way. I wish the Clintons know ill will in this. I really, I think they've had many struggles and have given much. But the fact that there was a public discussion. I remember the afternoon when the Monica Lewinsky thing hit. We had every major network newspaper wanting a diagnosis of Bill Clinton. Between 1:00 o' clock in the afternoon and 2:40. I remember where the place just went up for grabs. And of course that's something I'd never met Bill Clinton. We don't do that over the phone. We don't. That's not how. But what was interesting was to hear the reporters talk because the reporters started using language, anxiety reduction, compartmentalization, the language of therapy. And if you read what was written afterwards, why a person would take the risks that were taken and the stories that are now documented, what that did is it brought us, if we were like 30 years behind, brought us forward maybe 10 or 15 years. And then the thing that people can't seem to duck, there are two major things they can't duck. The Internet is changing everything. It's changing our sexuality, it's changing our culture. No spouse can compete with the Internet.

What do you mean by that? No spouse can compete with the Internet?

Because, you know, I mean, I think of in my marriage, I've been married to my wife Suzanne since 1995. And just what it takes to deal with her. I mean, it's. I mean, she's a. She is. To have a good relationship takes so much work and stuff to deal with one really good woman. And it's kind of how we have evolved over time is to be able to deal with a person one at a time. Most cultures find that serial monogamy works best. However, when you go online, you're looking at 50 pictures and you pick one and it takes you to another deal and there's 50 pictures more like the one that you picked. And so it becomes a selection mechanism. And it takes you to a place where it gets you to some of the deepest places sexually that people live. And so you can be instant messaging five people. You can have the amount of stimulation. Remember what I said about you can't be a recreational user of methane, okay. Online, if you really get into gets to a place, especially if it gets to what we call accessing the unresolved in people, there's in Harry Potter. Do you remember the Harry Potter story when Harry found the mirror of Erised, which was desire spelled backwards, and he saw his parents, and then Ron came and looked at it and saw himself being carried off the Quidditch field and Dumbledore came and said, boys, when you look in the mirror, you see what you desire the most. You have to be very careful. People have been lost in the mirror. And what happens online is people get into things that they can't do. I just can't do.

But it's erotic, it's arousing. And so it just wires the brain.

Yeah. And there's a word that we use called the MESA factor, which means machine. Enhanced sexual arousal takes the brain and elevates it to a level that requires so much stimulation that being with just one woman doesn't do it. I hear that from my patients all the time. And. And there's a new, recent New York, New Yorker cartoon where the guy rolls over, honey, it just doesn't work if it's not on the Internet. No joke. That is where it gets for people. And the problem is, is you get kids who started when they're in the fifth grade. Like, there's a new book out that just a study of 100 universities involved in this study and they asked, when did you start looking? And I think it was like 40% of the men and 36% of our current college age students started looking at the Internet sexually before the age of 10. And parents haven't a clue. Joe, we have a tsunami coming. We have a tsunami coming. A change in sexual behavior. It's going to take us 100 years to see what it does to the species.

Interesting.

What we know is a culture is shaped by how men and women treat each other and how we raise our children. It's shaped by those things. You can forecast how violent a culture is going to be. All the terrorism that's currently on the planet is, is really is that fundamentalist urge to protect an old way of sexuality and family that's shifting. It used to be that a woman would have eight children and 90% of her time were just to give birth in the hope that two of those children would live. Today, even in the developing world, they're having two children. And it costs so much to get that kid to the point in a knowledge economy. And Drucker and the kinds of stuff that you guys talk about all the time, it's about, we're in an entrepreneurial world. You have to have knowledge and you have to have ability or you can't compete. Well, to prepare a kid for that costs so much for a family to prepare that kid. So what that means is women now only 10 to 15% of their time is into childbirth. That means women are free. You have to negotiate with them. They can't be owned. And so the big struggle that a lot of this is about is really about family life. And the Internet is changing it all.

So first off, totally fascinating.

One of.

Your first books, which was out of the Shadow, this is the first book ever written on sexual addiction. You first wrote it out of the Shadows, Understanding Sexual Addiction. You wrote it in 1973. It was not published until 1983. When you first started talking about this, you were attacked, you were ridiculed. People doubted it. You know, it's that whole, I don't know who came up with it. Truth goes through three phases. First it is ridiculed, then it's violently opposed, then it's accepted as self evident.

And everybody said that, you know, well, I knew it all the time. Is that third phase.

Right, right, exactly. And you've got.

I've seen those phases are going back.

Yeah, well, we had dinner last night and you were saying that you were speaking to. You were speaking to a group of entrepreneurs in Africa recently. And you had like really well renowned.

CEOs of major corporations stand up and.

Credentialize you and say, this guy is for real. This stuff absolutely is true. And you never had that in the beginning.

I did not have that in this country, for sure.

Yeah. And so anyone that's watching this, I know there's going to. I mean, really, the truth is, I would like to say that everyone knows somebody that has an addiction, has an alcohol problem, a drug problem. But the reality is, not only does everyone that's watching this know someone, a large portion of people watching this absolutely have addictions.

Many of them are living with somebody with one for sure.

Right. And so part of this is I want this to be a very helpful, useful knowledge product for people to first off be aware that this actually exists and then give them some what to do and how to do about it, including, I'm going to recommend some of your books and whatnot. But for the people out there that really don't know the difference between maybe going out when they're younger or currently and having a wild night out, drinking or partying or one night stand or something, when does it, how do they know when it's really an addiction or when it's just, I don't know, maybe making choices that aren't the best thing, but you're feeling like wild one night. I mean, how does someone know that?

I get asked by media people all the time, you know, well, how many affairs does it take to make a sex addict? And that's a little bit like asking me, well, how many drinks does it take to make an alcoholic? And it really isn't so much. It's about what goes on in the brain and how you are, how you are preoccupying and obsessing.

Can I say this too? Because I want to really make sure I make a point of this. When you say it's a brain disease, you have brain scans and, and the brain of an addict is different than the brain of a non addict.

Right? True. Yes.

And you, I mean you've, I think you coined the term arousal template.

Yes.

Okay. Which is when you first get introduced to sex, whatever it is that turns you on, that you found exciting, that gets pretty much cemented in the neural pathways of your brain.

And we call it an arousal template. And you know, we now have it so that there are groups of things like we measure now 240 behaviors and they kind of go together in groups. And so if you were to see me, like, I mean, I don't do therapy anymore. But I work with therapists and their patients, and the first half hour I look like a magician, and I'm not. What it is is I know the map. And so if I know somebody who touches people inappropriately in crowds, I know that he also will hide in places and voyeur people. I know that he also will insert sexual humor into places that don't fit. That if he's a pastor or a counselor, will touch the grieving widow and his fingers will touch inadvertently, it will appear. Or the computer nerd who goes into the woman's computer and leaves a picture. It's the invasion. So we start looking for maps of things that. What all those things have in common is invading in someone's space without somebody knowing it, doing it secretly. So we look for those maps, and they're an arousal template, and they start to morph. They start to change into bigger things. They sometimes are rooted in sexual abuse patterns, sometimes they're accidental. But they have an inordinate power. Like that wine tasting we were talking about earlier. They take on a meaning that is bigger. So, like, for example, your entrepreneurs, your CEOs. I did the study last year of 150 CEOs of major American corporations. And we wanted to see what the behavior of choice was.

Just sexual or any behavior of choice.

Sexual behavior. These are all sex addicts by far. It wasn't even just a little bit or statistically significant. It was huge. They preferred the hiring of an escort over any other kind of thing. And what became very clear, it was about convenience. It was about money and the power of money and about power. And no complications. I'm too busy for complications. So escorts were the ones of choice and part of it. Also, it's interesting to me when you were talking about how it's kind of hidden in the culture, you think over this past couple years of people whose public behavior. I mean, I'm not just talking about way back with Clinton. I'm talking even in recent history who have gotten into trouble with things that they knew better, that they knew better. People who had prosecuted others, knew the rules, but not able to stop. So what is that joke then?

Exactly? What is it?

So what we learn is that arousal template, Once it gets in the reward center, it's. There's a loss of contact with reality. In other words, the reality returns after they've done it and say, oh, my God, I can't believe I did this. And they hate themselves. But the fact of the matter is, when they're in that reward, this is true. By the way of gamblers. People do high risk financing kinds of things. They feel they have a system. Their belief about it can distort reality. There was a study at Stanford Business center about the Jerry Kiev. People like the guy in France, the banker, got into trouble. Those type of people. We see this in so many different ways, that there is this loss of reality that goes with the addiction.

Well, let me ask you, are these people bad people?

No, no, they're wonderful people, often very achieved so with a real honor court taking pride.

But they have a behavior that is getting them in trouble, that is violating.

Them, goes against it. Yeah. One of the ways that you know is that there's a great guy who wrote about the money disorders this way by the name of Jacob Needleman. And he says, you always know that addiction is present when the person is living in contradictions. So the sex addict might say, I love my wife, but then he's unfaithful to her parent. I love my children but spends no time with them. They're contradictions. And the only way that addictions work is when there's contradictions like that.

Interesting.

So your question about how do you know that you're in trouble is when you're doing things that you don't feel good about afterwards and you promise yourself you're never going to do them again. In fact, we have a little scale that physicians now use because physicians are starting to look for the problem. Emergency rooms and urologists. I mean, people get into trouble physically or STDs, what have you. And if they are preoccupied, can't stop thinking about it, if they've harmed others, if there is some abuse, if they're ashamed of their behavior, if they're sad, and if they have sought help for it and it's been unsuccessful, these things are indicators that. I mean, sometimes it's finding the right therapist too, which is a question you and I have talked about. But.

And I'll ask you about that because one of the things, you know, that I want to do is identify problem, what it is, give people some insight that are not even familiar with it, and then what do you actually do about it? Now, I know you're a big believer of 12 steps, and I'd love to hear your perspective on what is 12 steps? Why does it work? I hear a lot of people say, well, you know, 12 steps don't work because I know, you know, I have a stepbrother that is an alcoholic and he went to meetings and he never quit drinking. And I'll say to these People. Well, it's not about going to meetings, kind of going to a 12 step group. And that's all you do is sit in a meeting. It's kind of like going to a gym and looking at the exercise equipment. And then you don't get physically in better shape. Well, you got to get on the machine.

We should switch sides here.

You're giving a great explanation, but you know so much about 12 steps. And you've always been a huge supporter of them, along with therapy and whatnot. And I've heard you just give great descriptions of what Dr. Bob and Bill W. The founders in the 30s that started alcoholics Anonymous, what they created. I mean, what is 12 steps? Because I want to encourage people to have places to go and for people to realize that there are resources, lots of them, so many, the majority of them in sexual addiction, all having been created or started by you. Sexhelp.com is one of your. I mean, how many people go to sexhelp.com every month?

About a half a million people a month.

Really? Half a million?

About 11,000 a day.

Wow. So this is like people are out there looking for this. And this is still one of those conditions that, you know, you hear people say, well, it doesn't exist. And I even hear people say, well, if I could have any addiction, I'd.

Like to have a sex addiction. The joke is a way to distance themselves from. From it for sure.

Right? So.

So my answer to that. Let's step back for a minute. Okay. One of the things that early in my career, I want you to picture my life in 1984, because out of the Shadows had come out now. I got into a deal with that book right out of the gate. I did my first workshop in Washington, D.C. i'd always been kind of an underground manuscript, you know, and, you know, we'd show it secretly at workshops and we'd talk about it, but we wouldn't, you know. So my very first public workshop was in Washington, D.C. and by the second day, I realized I thought there were going to be a lot of critics and what have you. People were so hungry to talk. And I realized that my life had changed. You know how I realized? I realized I hadn't made it to the urinal alone in two days. People walked, right? And they just kept talking to me. And it's an activity I prefer to do in private, actually. And the fact of the matter is that they were so hungry. And then when I got. After I did the workshop, I got on the plane, and that time, the Book was called the Sexual Addiction. I got on the plane, I was sitting in the front seat, guy sat next to me and he says, so why are you in Washington? I said, well, I'm here doing some business. What kind of business? And I hate that question. And I said, well, I'm a psychologist and I was here doing a workshop. He says, what was it on? I said, well, it was on sex addiction. I was almost embarrassed myself. I just wrote a book about that. He says, I got it right here. And he pulled it right out of his deal. He says, the problem is it's never going to sell.

So he had your book with him. What are the chances?

And I said, why isn't he going to sell? He says, because people will look at this and they will not be able to go up to the cashier. You've got to change the title of the book. I was thinking of calling your publisher and asking them. And now this is not. When you have a digital. This is changing plates. 1983, right?

No Internet.

Yeah, but he called the publisher, publisher said, he's absolutely right. They changed the name to out of the Shadows. And of course, the rest is history. That is the book that I went on the first Donahue show with. And you have to remember the tremendous amount of fear that existed at that time. And so I'm sitting there then in that summer, and I realized something. I realized, okay, we've named it and we know that people can get well from it, but we have no proof of this. And I was just kind of. Everybody was celebrating around me and I realized we've just started. So what I did is I got seven researchers and we followed a thousand sex addicts and their families for seven years. And that's that book there.

Okay, which is a fascinating book. Let's talk about this. And I would encourage anyone that is resonating with any of this and finds it very interesting to read these books. You will get a very thorough education on sexual addiction. In its absolutely not what people think when they hear sex addiction. I mean, I keep going back to this. It immediately throws up a label. It conjures up an interpretation that most.

Of the time people think offenders. They think all kinds of weird stuff. And it's pretty mainstream, most of my patients, pretty mainstream. But what we found out, to answer your question, there was a recipe. We studied the people who were successful. They did certain things, had a therapist. They had to be in group, group psychotherapy with a therapist. They had to go to a 12 step meeting. And what became further defined for us is that it was just as you said, I go to meetings and it didn't work. I'd hear that. Well, I'd. Have you got a sponsor? Well, no. Did you ever give a meeting? No. Did you ever do service? What have you. It's really about getting involved in the process.

Did you ever do the steps?

12 steps is about 12 steps you got to do that you can't just attend. But we found when I started doing. After we did that, and I started taking this recipe and doing it with hospital people, patients and following them. The people who did that, they didn't slip. We found like 23, 24% get the steps 1 through 9 and 18 months, and virtually nobody slipped if they did the work. That's what put me onto the fact how important it was, what I didn't know then, Joe, because science wasn't far enough along. Now we know why it works. Because in order to change the circuitry of the brain, you have to feel safe. Safety is the very first thing, because the brain will not change. And so, like, for example, Amnesty International could not get torture victims to get into therapy until they put them in a room with other torture victims. You have to be with people who really know and can nod their heads. I know exactly what that feels like.

Yeah, I talk about that a lot with referencing that which I learned from you, is that it's the mutual suffering that other people went through. Prisoners to where they don't have rapport with other people that haven't kind of been there in the trenches.

It's very important for that floor level of safety. And then the other part, one of the biggest things that will change the brain more than anything else, a story, which is what the 12 steps are about. Because the story is the most cognitively complex. In other words, it's the hardest thing a brain does is to assemble a story. So addicts have to assemble their story. All the things that you do in a 12 step meeting and in therapy really change it takes. You can see this in brain scans. It takes about almost two years to see the brain, actually. You want to know what the schedule is? Yeah. Yeah. It takes about 40 days for just for things to stop seething in the brain. And then it's an additional 90 days. The brain kind of resets itself when that happens. What we found when we followed them, and they start feeling, okay, I'm going to be okay. Then all these feelings that they haven't had for a long time just hit them and they are flooded. And it's about the time of what we call a fourth and fifth step in them. But basically it's grief, fear, anger, all this stuff starts needing that's never been dealt with, never been regulated.

So in a lot of ways, the addiction, the behavior, the drinking was a.

Way to keep a lid on it.

It's just a medication, it's an attempt to avoid pain.

Yes. If a person is going to relapse, it's not going to be in the first six months, it's going to be in the second six months is when they're most likely to relapse. Also physically, when they go through that, it's an ordeal. Physically, they can get more sick. Their immunological system becomes suppressed. I mean, all the classic symptoms of the body being less swell because they are in so much turmoil. Once they get through that, then it takes about a year to start re engineering things and then it takes about another year for the family and marriage and kids stuff to straighten out. It's literally a three to five year process.

What if someone has a sexual addiction and they don't deal with it, what happens?

Well, they'll go through a lot of partnerships, they'll have big losses, they'll end up in jail. If we ever get some of the strains of HIV that are in other countries, in this one and it starts, I mean, we will have just a nightmare.

And because of the Internet, which I'm absolutely fascinated by, I saw you do a PowerPoint presentation at a conference and I've been going for the last three or four years to these conferences where there's lots of doctors and everyone thinks I'm a doctor, which I think is kind of funny. And I listen to you.

You look so distinguished. When I sit in the audience, you look very good.

And you were talking about how the neural pathways change by literally sitting in of front, front of a computer. And you know, to me what hit me like a ton of bricks is that we are a culture that is now sitting in front of a device that is altering our brains. I mean, we're literally evolving our brains in many ways not in good places. And you mentioned that people that never had sexual compulsions that are now in their 60s, 70s and 80s are seeking out treatment for sexual out of control sexual behavior because of the imagery that they have access to that they never had access to. Like 10 years ago you couldn't find stuff that you can find in two seconds on the Internet that is so explicit, that is so vulgar, that is abusive, that. And what's weird about it is it's because it's sex, it's sexually charged. And there's a curiosity, a morbid curiosity to look at the stuff to be consumed by it. And this is accelerating at a rate quicker than probably anything. And that's why I think it's so important to get this message out to people to look at this sort of stuff.

There's two things in that, though. One is that, I mean, it is true. For the first time in my career in the last five years, I've had to really cope with geriatric sex addiction in. I mean, none of us were ever trained for this, but it just started showing up where you were having elderly who were having trouble with it. But there are other changes happening, Joe. One of the things we're seeing is women in both gambling and sex. The Internet has changed addiction because women will take risks on the Internet that they won't take in other environments. Unusual for a woman to go into an adult bookstore, for example, but on the Internet she'll try. So 40% of the people who are in trouble are now women. And they're doing very male like things, putting themselves in extraordinary jeopardy, meeting people who are dangerous, part of high risk people. Very common thing happening on the Internet. The other part to remember. And all of this, the other thing that I wanted, because the Internet is. Does seem to be the catalyst, but there are a lot of people out there listening that this was already underway before they were born. Before they were born.

How's that?

Well, several ways it's very connected to being in fear. So if you're a second or third generation Holocaust survivor and you hear the stories, you manifest the same kind of ptsd or if you're an African American woman in this culture, they have a lot of what we call sexual anorexia, or shutting down being sexual because they hear the stories of slavery that are unresolved and it's passed from one generation to another. So you hear those stories or you have. Like in my family, my father was very violent and they would tell jokes about it, and yet I would see him as violent and I'd see everybody laughing at it. And it would seem so incongruent to me because scared me to death and everybody, dad lost his hat again because he's in another fight in a bar. So what we know is that the previous generation brings in history. They bring in some DNA like most animals. Addicts have some DNA of nomadic tribes. We know that the dopamine strands are shorter for people who are alcoholic. Eating disorder, attention deficit disorder, Tourette's that they already have a dopamine problem. I mean, we know that stuff. This is before they're really even out of the gate. The next thing that happens by the age of two, there's a thing that happens between a parent and a kid where the kid has what is called the gaze of the parent. And what it means, I'm not just changing diapers, feeding, what have you, but where the parent just spends time looking at the child. Very important. They call it attachment. Only 8% of sex addicts get into what we call secure attachment. Basically they have problems in how to connect with people. Another way to define addiction is a failure to buy, a failure to bond. And that affects the brain fundamentally. And then if there's fear in the family as they're growing up and they're abused the worst at age 10 for girls and 12 for boys, if it happens at those ages, how the brain actually is structured changes and all these neurochemical that excite the brain and make you feel more alive. Stress chemicals. We are convinced that stress, first of all, there's a little piece of the brain on the bottom. Term for it is corpus callosum. But what it does is it puts in the front part of the brain a chemical called oxytocin that helps you make decisions that is smaller in kids who are very afraid growing up so they didn't get to keep their ability to stop themselves is affected. And then if they're exposed between the ages of 12 and 16, if you get drunk, your chances say at 13 or 14, chances of being an adult alcoholic, very high. If you smoke, very high. If you gamble, very high. Now think Internet. Yeah. So it's a big problem.

So what do we. Okay, so.

So obviously there's lots of routes that people get there. And what's important for your CEOs and your entrepreneurs to remember is a lot of these guys like living on the edge. I mean, you know that's true, right?

Absolutely.

And they're part of the risk of what makes them great. And one of my heroes, and I know he's a hero of yours, a guy by the name of Hai Sentamahaly. Yeah. Author of Flow Flow. Part of his service in this whole thing was to notice that people of great achievement access their brains in the same way addicts do. And so what becomes very important is getting people to have a sobriety or stop the behavior. That's only part of the battle. And they also need to understand that they also have to live where they are happy and excelling at what they do. They don't have that pursuit of excellence. They're not in that zone where they are at their best. They ain't gonna stay sober.

Oh, fantastic insight. And so what you're saying is that he found that the same process that a super achiever, be it an athlete, an entrepreneur, an artist or.

Right.

Or whatever that access is to be in that state called flow, is the same pathway that an addict uses. It's just that one leads to great, wonderful things, the other leads to self destruction of themselves and maybe other people.

So there's a difference between focus and obsession. There's a difference between challenge and stressed out. And the stressed out is where a lot of guys go and what they do is they get hooked on the stress of it.

You know, it's interesting, I interviewed Hugh Downs right here. He was sitting where you're at, and.

I was sitting right here.

We did a video interview and he made this distinction between being stress, stress versus distress. He says certain levels of stress are very good. But when it gets into distress, the brain becomes very.

Brain has to have challenge. We're like sharks in water moving. I mean, our brain has to have the challenge. So where the problem is is that like there's a couple new books out, one by a journalist that talks about war, gives us meaning. And he's talking about the fact about how reporters just being in crime scenes, being in war areas, what have you, emergency room physicians, CEOs. Am I going to make it? Not going to make it. In other words, you've got people who get hooked in it in such a way that it becomes destructive to them to learn how to be able to calm themselves and to have a sense, a piece of themselves that has a quiet. That's part of what recovery is almost creating that. That island within what we call an inner observer who notices, monitors the traffic of the brain. That is what you have to build. And there's a piece that we found that's very important I don't want us to lose sight of. And that is that it doesn't get better if the family's not in on this.

So you need to. Okay, let's talk about this. Okay. Someone's watching this right now. They clearly know they are someone they're with or that they know they care about has a sexual addiction.

Yes.

And here comes the issue of, well, who do you tell? Disclosure.

Yes. I mean, well, here's what we found. We found that first of all, involving family members in therapy up to recovery rates when the partner realizes, which takes a little while because when he or she starts off, they're pretty mad. It takes a while to get some perspective. They have to learn so much about, you know, don't talk to me about a brain disease. You know, you cheated on it. Yeah. You go for the emotions, which, as it turns out, often they have a history of going for emotions anyway. But the point is, and we learned that in alcoholism, the Al Anon has said for years the spouse is sicker, which turns out to be true, because they've been traumatized. The broken promises, the lies, have traumatized these people. And the spouses have more distress than the addicts. Children have more distress. Parents have more distress. And so there's some real truth to that. When they figure out that they are also part of the problem and they need to get help for themselves, then a big shift happens in the family. Whole thing starts to work differently, and that's really critical. Oftentimes the family is about six months ahead of the addict in that process of understanding that there's a problem. Interesting.

We live in a society that wants to punish people that do what they would consider bad things. And clearly, I know as well as you, you know, you're not out there supporting child pornography and rapists and things like that. Although a lot of those behaviors stem from people being abused, people living with physical, mental, sexual abuse. And it manifests in those areas.

They're repeating what was done to them.

Right. So, you know, one of the things when I think people learn about addiction is they have an empathy and understanding of what causes other people to be the way they are. And I think acceptance and understanding is a hell of a lot more useful than vindictiveness and revenge and retribution. All those things. At what point do you make the determination of who to punish or keep away from society versus who do you treat? Because we were, you know, I won't make this too long winded. We were having this conversation before the camera started rolling about in this state where individuals that can have pornography, like child pornography on the Internet. Instead of me explaining what we talked about, I'd like you to just share that, because that was fascinating to me.

I think where we start off is I started talking about that when I do speeches and public presentations. So many elderly are now coming, and the reason is they have kids who are in jail. And we had a. I remember very vividly there's this. In this one event, this woman, late 70s, and a man also. I mean, osteoporosis. Both of them having a hard time walking up, and she said, you know, I'm here because I just want to know how this happened. My son is going to get out of jail. He touched a child and can he get help? And the man said, well, my son had three pictures on his computer and he's away for 21 years and your son is getting out after 18 months. And that was it in a nutshell. Because right now this state is pretty mainstream. It is really politically expedient to be against child porn. The problem is there are so many people who are getting. We don't have enough jails. It's a treatable problem. The FBI is very close, clear that the people who are dangerous are the people who are making the child pornography. People who have it doesn't mean they're the traditional term pedophile and that they're sociopathic and they're never changed. That's simply not true. There are many different kinds of pedophiles. We were all pedophiles at one time because we were all children. We were all attracted. I remember Ann Lukosh in the second grade and Karen Anderson in the fifth grade. I remember them. I was a child attracted to other kids on the computer. If there is sexual abuse in a person's history and you go and access that, you're going to be curious. And then they get picked up for that. There's something disproportionate now, really clear. If somebody drunk, is drunk and drives, they're going to get punished and they should because they have endangered the public. I'm not saying do away with consequences. That's not what I'm saying at all. What I'm saying, though, is understand that we have a treatable problem here and we have states. I've talked to the head of the Bureau of Prisons for this country, and she looked at me and said, this is a couple years back. She says, we're putting people in jail who don't belong there. We all know that. But politically we can't fight it.

And so there are people that are being punished for, like, photos online that are getting harsher punishments than. Did you say before first degree murder?

Yeah, it's worse than first degree murder in this state.

Worse. I mean, that's insane.

There's no plea bargain. There's nothing that you can do about it. But we're pretty mainstream. You can go to other states that really are worse about it. The problem is. Okay, so let me give you an example. I have a guy right now, 25 years old. He started on the Internet in the late 90s, in the fifth grade, he was looking at pictures of kids and fascinated by them. In the eighth grade, he's picked up for child parenthood. They said, it's ridiculous. He's a kid. So. But he never dated. He just stayed online looking at the same pictures. So developmentally, he never grew up. He never did the nice, normal social development that a child goes through. And so the result of that is that when I told him you would be regarded as a sex offender, he was stunned. You know, so we have. In cases like that, we have to take them, help kind of rebirth them into a dating mode and helping them to understand themselves. The public has not got clarity about this. Parents have got to start to learn to talk to their kids about what they're doing online, because they're doing it. And the other thing is, if there is a problem. And that's why the Mending Shattered Heart is an important book.

That's another book, Mending Shattered Heart.

That's the one that my daughter Stephanie did. She's also a family psychologist like me, and we work together in Mississippi. And she. It's an edited volume in which it's intended for the spouse, one of our little family conflicts. Because now I am working for my daughter, and I was dependent on her in order for me to get my chapter done. And so she calls me up and says, dad, your chapter is still outstanding. And I said, daughter, I'm so glad that you've not even read my chapter and you think it's outstanding. So it's always been the outstanding chapter. But the whole purpose of it is collecting what we've learned about families, about how important it is for families to be involved. There are people, partners out there, both men and women, who really know that there's a problem. And they've caught things, they've seen things, whispered things, things that don't add up. And they know. They know, and they need to know there's really help that they can get. It's really important that they get that part.

Before I forget, I want to ask you about the link between add, ADHD and addiction, because I know there's a high percentage of crossover people that have ADD ADHD also have addictions. People that have addictions have ADD adhd. What can you speak to on that area?

Well, part of it we've already mentioned. We know that they have some similar genetics. We know that that's there. Our friend Csikszentamahaly, he says that addiction is the ultimate attention deficit disorder. In other words, the brain. It puts order in things for the brain It's a way that organizes the addict, organizes his life around this. And it's really hard. I think sometimes, like I think of people in your business, they'll kind of organize either their day or what cities they go to, or what part of the city they're going to be around or when they're next going to be able to whatever and how much it takes for them to manage that. It's an ordering process. And so in many ways, what happens is that the brain craves that order. And if there's attention deficit disorder, it's one of the things that an addiction kind of steps in the place to supply order. And we see that as an incredible part. One of the things that now I believe is going to happen is Dan Ammon, a good friend and a marvelous physician who've been on PBS and writes about this stuff, talks about the fact that he says that mental health is the only part of medicine that doesn't systematically look at the organ. It's treating the brain, and that's the brain. And the fact is that I don't care who you are, if you got a problem and you get a picture and you know your spouse is telling you, your kids are telling you, your therapist is telling you, but you get a picture and you can say, it's got these holes of where your brain isn't operating like it should, man, it just stops people cold that they can see it. And the same thing that's also true, Joe. And this is an important thing. If you take. Take something that is an objective measure, like a test, like on sexhelp.com we have an instrument that works for men and women, gay men, it's the same thing, but it's really turning out to be a very effective way of showing where you are in relation to others. And so seeing something, you filled out. And so what is that test called?

Because I would actually.

It's called the sex addiction screening test, and it's@sexhel sexhelp.com sexhelp1word.com they can take it. And over a score of 6, you got a problem. The average outpatient is 10. The average inpatient is 14. And sometimes people have to go and just stop their lives in order to get the traction they need. I see patients with science 17, 18, 19, all the time. And it's very helpful for people to have objective measures. And now we have a very large instrument which is teaching us a lot about those maps we were talking about earlier.

Well, when we were having dinner last night, you said that you've learned more.

This is between the eel and the. What was the other thing? Yeah, you were trying to get me to try.

Trying to get you to start Yellow Tail. And you said that you have learned stuff within the last eight to nine months. That there's more than you've learned in the last decade that's true about advancement. So what are some of the cutting edge latest things that have been discovered about addiction?

Well, there's several categories of them. First of all, things are morphing. We're getting more scales, more precise. Like there are differences between people who voyeur and people who do pornography. We're seeing how it's becoming more discreet. They won't do voyeurism, they'll just do pornography. We are seeing a big difference between how people behave and how they think. In other words, they will think in ways that they will never allow themselves to behave, but they'll act out to a certain level that they'll allow themselves. But what they're thinking is very different. We've never had the measure of the thought. So let me give you an example. Had a major movie producer and his thinking was like an offender taking advantage of, of the vulnerable. But he would only act out with escorts. So if you just took off, you know, did he do prostitution or not? But if you didn't know this other part. So I said to him, I bet you in your job you are a bit of ruthless. He says, yeah, well, I'm kind of known as a hatchet man. And so you could see there's a pattern there between how he does his business and when they start to pursue it, what kind of prostitutes and who he picks and how he treats them. So you see that the other thing that's becoming really more clear in ways that we've never seen before is what we call eroticized rage. And eroticized rage is a lot about, first of all, breaking rules. But it comes in different segments. One is they have rage comes out where people use force. But also there's a whole category about the abuse of power. The CEO who has 146 women on the payroll that he's had sex with, for example, they're all single parent women. He's taken advantage of 146. Yes.

So I mean, you see this stuff.

As an example, you know, so. But he's abusing power, but he's also angry with women. There's another one which is a lot about people wanting to invade space, but only so far. And then there's kind of a reverse deal where People actually like to be hurt that's out of anger and to be punished. And we're starting to understand loads more about that. And finally there's a whole entitlement. I do this because my wife isn't sexual with me. Or I do this because my husband doesn't pay attention to me. Now, for example, we recently had a woman whose husband was a very spotlessly clean politician having oral sex with a stripper. What's something a wife who feels neglect could do to a husband who has this squeaky clean deal? What could she do to be a problem for him? That would be exactly a way to do it. Do you follow what I'm saying?

Yeah.

Okay, so the point I'm making is there's a whole category like that, blaming the spouse and the spouse's flaws is a leading part of that. But also oftentimes, especially in leadership, like we were talking about clergy earlier. See this in clergy.

You know what I meant. Earlier, before we were filming.

Where dad is an absentee dad and mom uses the kid as a confidant. He's the little man of the house. He's the, you know, then it's like women become too much. It's too much for a little guy to handle all this stuff. Mom's confiding in him, telling him all this stuff way too early. And as a result he doesn't trust any woman and there's anger there. And so then he'll marry a woman like his mother who's critical and what have you and, and then goes out and acts out. So one of the things, we now have a way of measuring that in these various categories. And so we're seeing these patterns emerge. One, because the science has gotten better. Two, because we have more people. I mean, we have more hospitals doing treatment. We have many more therapists doing the work. And as we accumulate the data, we're able to say so, so much more than we could in 1983.

Okay, so. Which is fantastic because there's tremendous. So what I see here is we have a ton of advantages because so much advancement and understanding has, and people in the know have an acceptance of this and know that there's a real cause. It's not just someone sitting around saying, hey, I'm going to be a bad person and do bad things. On the other side is we've got the acceleration of, of exposure and imagery and everything that goes along with the Internet. So it's kind of this double edged sword that's going on here.

And from a business perspective, like we Just had a know of them, just saw some data of a major corporation which figured out that they're losing 90 minutes a day per employee on Internet 6.

Really?

Bottom line issue.

Let's talk about the. I mean, you gave some percentages, but how many millions of people in, if you even know that they can statistically can gauge accurately. Let's talk about some stats.

We think it's about 6% of the population that keeps emerging as a statistic.

Just in America or worldwide.

Well, cultures shift. I was talking to colleagues in Singapore and they say, you know, you couldn't get anybody to be trained in alcoholism. It's not a problem in Singapore, but gambling and sexual, major problem. Now I go to Russia, they're going to get the alcoholism thing. Both sides are going to get the trauma deal.

So you said 6% in the U.S. yes. How many people view Internet pornography? I mean, daily? When does it occur? How many? I mean, what are people looking at? And I want to come back and tell you so story about a recent plane flight I had where I spent five and a half hours in first class next to a guy that was in the Internet pornography business. And we had a very fascinating conversation.

Tell the end of that story because then I'll pick up from there.

Okay, well, so I was out of the country. I was flying back, back home, and I sat next to a guy and I said, what do you do? And he kind of, for a moment, kind of paused reluctantly, and he said, said, I'm in Internet pornography. And I'm like, really? And he's like, yeah. So we proceeded to talk for about, I mean, not about the entire flight. And this guy told me that, you know, he lived in Brazil and he was, you know, moving back. He was flying to Arizona because there was a convention for Internet pornographers. And so I kind of withheld any of my thoughts about my understanding of addiction and sexual addiction during my trip out of the country. One of the books I'd read had been about pornography addiction. So I had all these kind of stats in my head. And so for 90 minutes he was telling me about how he met the love of his life who's going to move to the States and live with him. And it was because of the Internet business, pornography business, that he found the love of his life. And he wanted to write a whole book about it. And I said, well, was it because the Internet pornography business or just chance? And he's like, well, it was really about chance. Anyway, by the time the conversation was done, he had told me that 80% of the revenues are down in the Internet pornography business because of all the free content that's being uploaded. So they're scrambling, trying to figure out how to charge for it. On one hand, that sounds really good because people aren't making money with the stuff. On the other hand, you just know how much more it's being proliferated out there and people are being exposed to it. So by the time we were done, he basically admitted that he was a sex addict. Because I explained to him what sex addiction was. He never really quite thought about it or knew it. And I didn't give him that much information, but I did, you know, I described to him what I thought and he, by the time we were done, he said, you know, I want to get into another business. I'm looking for a way out of this. I was hiring three to four prostitutes a day in Brazil.

He.

He's like. And I had to escape it all. And I really don't want to do this anymore. It was really fascinating when you can turn shift, especially someone in that sort of field. But it was just interesting.

Well, it's more than interesting.

There's a lot more. But it's all safe for now because.

What is happening out there is, especially with Flash media and webcams, there are applications that go out there and swoop those things up as kids are trading pictures and what have you. So the Internet is being flooded with availability of stuff. And the problem is, if you look at this, you have no way of knowing how old this person is. You have no way of knowing. So I do a thing with audiences where I take pictures off the Internet and I ask them, guess how old the person is. And you know, they could be 12, they could be 25. I got a woman who looks exactly like she's 12 years old and she's an elementary school teacher, a porn star from Detroit, Michigan. But if you look at and one level, it doesn't matter, it's what you're thinking.

So it's what's going on, what the brain interpret.

So what really is at stake here is that when we say 6%, we have no idea. Because what we're seeing is that in high schools, the sexting, the level of text messages you talk to high school counselors. And the major crisis in this country where we're headed sexually, I'm going back to that thing. You shape a culture, it's shaped by how people are sexual. What we're moving to, one of the consequences of this is the casualty is going to be Intimacy casualty is going to be what you do with kids.

Well, Pat, you wrote this book here in the Shadows of the Net with several other authors breaking free of compulsive online sexual behavior.

And, you know, it's the only book that I ever wrote that in six months I wanted to rewrite because it changes so quickly. Because it changed so quickly. And we've revised it and it's just like the whole. It's such a shape, it's such a changing landscape, it's hard to keep a beat on it.

Well, what are some current stats on the Internet? I mean.

Well, it seems to be, first of all, in the history of this. Al Cooper broke as a sexologist who was skeptical when he started off about sex sex addiction. I found out that most pornography was downloaded between nine and five, that it was a business problem. People were doing it during the day. He did it first with a study of 9,000, then a 45,000 MSNBC. And one of the things that he also pointed out is that there are people who now had a problem that would never have gotten there if it hadn't been for the Internet. And so.

That'S an interesting statement. That never would have gotten there had it not been for the Internet, would.

Never have gotten there. And that's absolutely. I think the truth, because they up to that point had led pretty normal lives, didn't have the normal history that sex addicts would have. But they clearly got there because the Internet was the issue. And the other part that goes with this is that he was also the first to notice that women were being. Were participating much more. It used to be for every three sex addicts that were men, we'd have one woman. And he noticed that it was shifting. So the fact of the matter is we know that it's a daytime phenomenon, it's a workplace phenomenon phenomenon. And so we see people taking extraordinary risks with jobs. I've had people, bank presidents. I've had, you know, people who have lost work and huge sums of money because of what they were doing on the Internet.

What about ratios of men to women, sex addicts? What are the. How many. If you had a. Do you know, percentages of how many?

We think if it's evolving online, it's 40% are women.

Okay, 60% men.

So it's huge.

That's huge.

Yes.

I'd like to make a distinction between addictive sex, sex, healthy sex. I mean, what is healthy sexuality? I mean, how does someone know?

Well, I think that's the, that's, that's the point. We were talking about with kids is that sex works best in the context of a relationship. We know that. I mean, there's lots of evidence about that. And that what, what we work for, because there's another concept and maybe some of the partners might be experiencing this is what we call sexual anorexia, which is where somebody shuts down sexually.

So one could be excessive compulsion, the other out of control.

One gets, the other one shuts down. It's not infrequent that that happens. And so our goal, we're not anti sex. Our goal is to get to be where people really enjoy sex. In order to get there, it really requires a level of mindfulness and an ability to work through how to be present to a partner and to go through the things they now have to go go through. But what I'm here to tell you is that I have men present, couples who have struggled through all this, recommit, say their vows again, different vows, and have a different kind of sexuality. That's a real source of joy to them. The biggest problem in what the Internet really brings people, because there's a lot of faith, fear of discovery, there's fear about what I'm looking at. It's the kind of sneaking around stuff that goes with it, that takes what is erotic and what's lovely about eroticism and how wonderful eroticism is. I mean, it's an important part of our life. But we start off in a culture that start off with sex is dirty, save it for someone you love, you know, that whole old cliche. And we now are in a place where, you know, think of a fifth grader coming on a site, a torture site, for example, which features sexual torture. And what we know is that the brain keeps these images and, you know, so we think, we hunch to, that there are kids who are also shutting down and not allowing themselves to be sexual because of what they've seen. And it's about. The only way that this all changes is we need to have a conversation about sex as a country. Parents, kids, everybody. And what I really appreciate about the 12 step group groups is in the 12 steps, like if you go to an AA meeting and you go to an SAA meeting or an SAA meeting, you're going to find that the people who. You can't talk about sex without a greater degree of vulnerability. I believe, I honestly believe that the gift in all this is the people in recovery have an incredible message to give the rest of the culture about how after all this stuff, how do I get to where sex Is erotic and beautiful again. How do I reclaim that?

If someone's never had that, can they get there?

Yes, but it takes the work and the attention to be able to do that. All addictions are a bargain with chaos. We live in a culture that is a. That produces addiction in so many ways. It's the quick, it's the easiest solutions that we look for. And the convenience, food. I'm hurting, so I'll have an extra drink. You know, blanking out on the tv. In other words, that we're not being present to ourselves. And as a result, how can we be present to someone and sexually?

You know, it's fascinating. I mean, all this is so fascinating to me and so important to get this message out there. I mean, hopefully I'm doing my part well.

Yeah, I'm 65 next week. You and I were talking about this and there's a group of people who do research on wisdom. And what they find is that there is no wisdom that's codifiable. That wisdom is always an event. You can always tell when somebody says something wise. And they say that at the time when the brain is most advanced to be wise is at 65. So I'm waiting for the surge to hit me.

That is funny.

I haven't felt the surge yet. But I'll tell you what I have had is I've been given a gift in my life to be able to be part of opening up something which I think is not just fundamental to our culture, but to our species. This conversation is about our species will either take us down the tubes or we'll create and evolve into something bigger and better.

Yeah, that's interesting to say. This will sound like completely off the subject. There was a guy that I learned a tremendous amount about marketing from. His name was Gary Halbert. He passed away a few years ago. And he was extremely creative, extremely skilled, had taught many, many people how to be a marketer, how to become a millionaire, how to persuade and print. He's one of the world's greatest writers that I've ever, ever met. He's extraordinarily self destructive. And we spent, you know, years ago having lots of conversations about addiction and about self destruction. And he made this comment that the world advances on the backs of its neurotics. And I never forgot that statement. And you know my good friend Dr. Edward Hallowell, who's like the world's leading psychiatrist on ADD ADHD. You know, we've had lots of conversations about addiction. And you guys recently met. You know, he talks about that we live in a society where we're more connected electronically, but more disconnected emotionally and personally than ever before in history. And it's just getting worse and worse. And when you talked about addiction is a failure to bond, I mean, we live in that culture where people just. I mean, if they're connecting at all so much, it's not even in person anymore. And it's with computers. And then you wire in all of this stuff from the reptilian brain and desires and everything. It's just crazy. The thing about the world advances is on the backs of its neurotics. I work with some incredibly sharp, bright, very resourceful, very capable entrepreneurs. I mean, some of the top book authors in the world, some of the top thought leaders. And one of the things that I notice with some of them is that many of them are what I would consider very functioning addicts, very driven, some that have millions of dollars, they don't need any more money, but they keep addict and they do it at such a pace that they're in a constant state of angst. And then they medicate with drugs or alcohol or sex or gambling or overeating or whatever. And I'm sitting there going, you know, there's some of the most incredibly talented people in the world that are doing good things, that are suffering tremendously. And what I look at, I think you're the first one that that said this line. It was a quote from Bill W. One of the founders of Alcoholics Anonymous. It said, as alcoholics, we're trying to drink God out of a bottle.

Yeah, drinking God out of a bottle.

You know, I think gambling addicts is trying to gamble their way to God. A sex addict is trying to do whatever they're doing as an attempt to get to God. You know, whatever it is, it's that something more, something to give meaning to life. And you know, what I've said to some people is that if you're in pain, if you hurt emotionally, physically, whatever, there's nothing wrong with wanting the pain to go away. I mean, if you're in pain, you don't want the pain. The problem is the mechanism you use to either eliminate the pain or cope with the pain. And when that method is addiction or something that's self destructive, not only does it not make the pain go away, it makes it worse. And so my point is there's so many people that are listening to us right now that are really amazing, awesome people that create tremendous value in the world that have this area of their life that they have not dealt with that they may not have even understood. And hopefully through our conversation, they understand it more now. And they need to go somewhere. I mean, they need to, meaning when I say go somewhere, something that could help them, be it a 12 step group, be it reading some of your books, going to sexhelp.com and take.

Taking the survey, getting a therapist, getting some help. Yeah.

So my question to you is, if someone has this condition, or any addiction for that matter, and you had to tell them through this format, through an interview, where to go, what to do next, where to start.

What do they do?

I mean, there's so many different things that they could do. But you're the expert on this. You've been through this road for 30 years. I mean, what would you recommend to give someone the highest possibility of success?

You ask questions that aren't just questions, they're workshops.

Exactly.

But let's back up for a minute.

Okay?

I see these guys a lot. They end up on my doorstep and they're wrecks. And one of the things I think as I listen to their story over time is they realize there's a bandwidth the brain has about how much you can handle. And it's filled with so many things. They have no idea about that bandwidth because a lot of it doesn't matter. Pine RNA doesn't matter. They're investing in things. You know, I got sick a couple years ago, as you know, and almost died. And you know, it was at a time in my life where I was looking at a lot of things anyway. And one of the things is coming to the conclusion that you just don't put time into things that don't matter. These guys have not learned about that, that your bandwidth is precious and how you put, where you put your attention. And one of the things that we know that therapy and the kind of what Scott Pick would call the examined life of dealing with their addiction, we have to teach people how to live with their anxiety. The truth is there is no human security. There isn't. There is always something or someone who can take you out. And learning how to live with the intolerable feelings and make allies out of them, where fear becomes not only a friend, but a great asset. Because as Aristotle said, without courage you have no virtue. You have to be able to face the demons. And by doing that, what we know is happening in the brain, because we are neuroscience is opening many doors for us. And it brings us to exactly what you were talking about. All of this work that one would go through in therapy and recovery and 12 steps gets different parts of the brain to talk to each other. So half to the other half, the top part to the bottom part, where you have your feelings, the storytelling, the integrating memory, the getting so that what you see is what you get. The learning how to focus, how to visualize. One of the most powerful things in the world is to have a vision. If your bandwidth is full of crap, you can't have the vision. That's truly about your. I mean, the childhood dream, the truly about you. Not somebody else's dream, but your dream that what eventually happens, we now know, is that the brain evolves to what they call transpirational, which means the overall functioning of the brain is at a much higher level. And the people who work these things deal with things most people in this culture never, ever really resolve for themselves. So it's not like this is the end of the world. The doing what you're talking about, Joe, is the great opportunity of this time. And there's enough of it happening and enough documentation that we now know why it works, that there's really hope in the midst of all this chaos. But it's only through these kinds of conversations. It's only for guys like you who are willing to take this kind of time to bring a message to people that they can learn about the value of 12 steps and learning that sex isn't just about release. There's a whole different thing about what does it mean to pull off a business but also create a living for people and to have people that you work with that you like to know that you're leaving a legacy in which the planet is better because you've been here. In other words, you don't put time into things that aren't important. Maybe that's what happens at 65.

It sounds like it. I think you've arrived, at least the wisdom part. Well, let's do this, because we're not. I don't want to be done just yet. I want to give people some recommendations on that. You have such a body of work that is not only valuable, I would put it on, you know, in the top five categories of things that will expand your mind and thinking. Even if you don't feel you've ever suffered from an addiction, reading about this and understanding it will. Anyone that's an entrepreneur has employees, and they will have employees. Not a matter of if. It's a matter of when you will encounter addiction.

It's where it is in your company that you don't own.

Exactly. So if people had to start with any of your Books. This is just, We've only got five here. You've written how many books?

About 20 of them.

About 20 books.

If they want to learn about sex addiction, they start with out of the shadows.

Start with out of the shadows.

They want to start moving for themselves and they want to start looking at it. Facing the shadow was the beginning of that recipe. So we're spinning out the recipe, a new one coming out called the Recovery Zone, which is just about to be released. You can actually, I think they're doing pre publication sales on it right now. But the reality is that they also, as they read, they need to find, they need to become an informed consumer. Not every therapist, they're of varying quality and not because they weren't well trained, but in this particular, not everybody's trained in addiction and similarly treatment centers. When somebody goes to a rehab, for example, you really need to ask questions. So on sexhelp.com, there's an advice for, for finding a good therapist. You know what to look for.

Okay, so someone. So sexhelp.com there are resources on how to find a therapist.

They can go into their zip code and they can actually get people who are recommended therapists in their own zip code. But it's also asking the right questions. You have a right to ask about how much they know about this and how much they do of this kind of business. And more and more therapists are getting more familiar and that's, that's growing and also of the treatment center. So what are you getting, you know, for the time that you put in and the money that you put in, treatment is a good investment. And if it's good treatment, if it's good treatment. Yeah. And so part of it is they should read, but they also need to find a guide. One of the things we learned that was part of the recipe. There's usually some, someone that they ride with for about three and a half years and they may send them to an inpatient setting or they may send them to a workshop or they may have them do some special work in different places. But there's almost always in the successful recovery story, a therapist who walks with them, that they develop a very committed long term relationship that averages about three and a half years of regularly seeing them. And then there's the group work that goes with it and the other things. But it's the beginning of the adventure. Because it really is painful, but it's an adventure.

But it can absolutely change your life, can save your life.

It does often.

Well, if someone wants to locate a 12 step group on sexual addiction. Where would you recommend they go?

Well, again, there's a whole list of them on sexhelp.com all of the major ones are there and how to contact them. And most cities have got them. I mean, it shouldn't be hard to find one.

Yeah. And me being a marketer who's made my living teaching people how to promote, one of the movements that I admire more than Anything is the 12 step community.

You talk about the Spider and the Starfish. Yeah, yeah.

I interviewed the author of the Spider and the Starfish and we talked about how the 12 step community is. Is a starfish, meaning it just grows. It's user generated. And they do it through the voluntary contributions of their members. They're not running TV ads because the system works. And a lot of people totally misunderstand or even know what 12 steps is about.

And they have fear about religion. They have all these fears about it. But you know what really works, Remember what I said about attachment, is you become. You meet some of the best friends you'll ever have.

Absolutely.

And so the result is that deep attachment. You start to make up some of those deficits that really have been there since you were very small.

You know, I think if someone wasn't even an addict. Just looking at the process of the community, a caring community that is about developing a better future. You know, one of the things that I've Heard said in 12 step groups is, you know, we're not here because of what we've done. We're here because of where we want to go. And, you know, if someone wants to go to a better place, well, I could talk to you forever. There's so many things I have to ask.

I can come back sometime.

Yeah, I will invite you back. Is there a cure for addiction? I mean, I see a lot of people claiming cures and.

And you know, yeah, I've seen some of those too. And everybody wants it to be a quick one. Right. And when you make a bargain with chaos, there's a price to pay. Always. And one of the things that's important to remember, and by bargain, I mean getting a shortcut. Remember when Faust sold his soul to the devil and he asked the devil, who are you? And he says, I am the spirit. Who denies that. You have to literally look at how bad things. I mean, there's somebody out there listening right now just has to see how bad things have gotten and accept that they really need to do something and take action on it. But the reality is that if they can do that and they get traction in it and they have some of those great friends. They become more effective problem solvers. They're bandwidth becomes clear because they're not trying to remember who they told what to. You know, those kinds of issues. And then therein lies the gift. And that's been my experience to be able to witness that for a long time now.

Well, I will say you are doing great work. You've done incredible work. You've brought knowledge and understanding and help to millions of people. And it is one my pleasure to get this information out to as many people as they can. I would encourage everyone that's listening to share this with any family members. Please get this message out. Read Pat's books. They're truly fascinating. Facing the shadows. Don't call it Love. Which is all the thousand sex addicts you followed. Inside the shadows of the net, there's many more. Pat Carnes, C A R N E S Go to Sex Help and any famous last words.

Thank you.

Thank you. I appreciate it.

You bet.

Hello, this is Joe Polish, president and founder of the Genius Network. And today I've got a very intriguing, interesting and special guest. His name is Dr. Patrick Harnes. He's a psychologist. I know this man personally. He's an amazing thinker. He's helped millions of people with a subject that I don't usually do interviews on. It's addiction. And his specialty is not only one of the world's leading authorities on addiction, but the world's absolute leading authority on a specific sort of addiction, which is sexual addiction. And we're going to talk in depth about addiction, but also a lot about sexual addiction. So I'm going to read something here, Pat, before I start asking you with some Q and A, just a short bio here, you've got a very long one, but I'm going to do a short one. Dr. Patrick Carnes is a nationally known speaker and author on addiction and recovery issues, is the primary architect of General Path treatment programs for the treatment of sexual and addictive disorders. He is currently the executive director of the General Path Program at Pine Grove Behavioral center in Hattiesburg, Mississippi. Dr. Carnes is also the same CEO of New Freedom Corporation and New Freedom Publications in Carefree, Arizona. Well, first off, thank you for.

You're welcome. Sitting down to be here with you. It's fun.

It'll be fun.

It'll be fun.

It'll be interesting. Well, there's so many different areas I could go down. I mean, just to give the viewers and listeners some background who Is Pat Carnes. What are some other things? You've been on Oprah eight, nine times. You've been on almost every talk show under the sun. You've gotten just an enormous amount of publicity. Many, many people in the addiction field and many other field is mental health, know who you are. You've got, I believe, hundreds, 800 plus therapists that actually use many of your methodologies and treatments for addiction. So what are some. Who is Pat carnes?

Well, I was just thinking about next week. I'm going to be 65, which means I've been at this now for almost 40 some odd years. Wow. And so in many ways, I've watched the whole addiction field come into its own, become recognized. And now as a lens, I'm watching at this phase of my life, just the significance of it grow. And so for me, it's been a very meaningful career. I think one of the blessings you can have in life is when you have meaningful work. And I've been blessed with really meaningful work. I've been able to learn a lot. Every day, you know, I find out you can do things, things sexually I never knew you could do before. You know, I mean, the learning curve is incredible. But if it weren't so serious and so significant for so many people, I think that's the real value. We're in a struggle. We have a significant challenge in this culture. We now know that addictions aren't just the myth that you have to take a chemical. You can be addicted in many ways without using chemicals. In this country, we have. Over a third of our adults have got a problem with obesity. Compulsive overeating is one of our major addictions, Sexual addiction. We're now at a place where we have an epidemic or we have 2/3 of our kids watching pornography while they're doing their homework.

Two thirds of kids watching pornography while.

They'Re doing their homework. I wanted to highlight that 34% of them go on to really pursue that and are at risk for what we call sexually compulsive behavior. The problem is this whole field has changed because when I started, I would hear guys talking about finding their father's playboy collection. And now I'm hearing people talking about that, the level of stimulation, what they're finding on the Internet. The answer is no spouse can compete with the Internet. Plus we have drugs we didn't have before. We understand about work and stress, things connected with stress, how it changes the brain. And so it's a time where we're talking about our most significant health issue in this country and we're blind to it because if you look at all the kinds of issues that are involved, it's our most expensive thing. Medically, it's our biggest problem. Socially, it's our biggest problem in schools and it's our biggest source of crime and it's our biggest source of injury for children. And we as a culture do not want to deal with it.

Interesting. Well, okay. Well first off, I would be fascinated to know why that is the case. But I want to first have you define what is addiction? I mean, what does that mean?

Well, there's many definitions of what an addiction is, but here's what it boils down to. Addiction is a brain disease. The brain has become altered. And when a person starts a behavior, like a kid takes some nicotine, what he doesn't know is nicotine stays in his brain for 30 days so he doesn't feel like he's got a problem. I haven't had a cigarette in three weeks. But the fact is the brain is adjusting and so it feels like a choice when he starts. And what happens if he uses it to cope with stress and cope with pain. The actual way that the brain is structured shifts, it moves. Even in gaming, we are now seeing that kids become so addicted to gaming and that some, we are quite certain some kids brains don't actually unfold naturally. So what happens is that the brain is altered and it's self administered. You do this for yourself and has a lot to do with how you perceive things. So for example, you and I were joking before the show about this research out of Stanford where people were given the same bottle of wine. One group is told it's 90 bucks, other group is told it's 10 bucks. The group that got the 90 buck, they got higher than the group that had the 10 buck wine.

So same wine, same wine, thought it was $10, the other was 90.

So it's really what your perception is. And so what happens then is that the brain actually then starts to reset itself, recalibrate itself. And then that person gets to a point where it crosses the line. It goes from where it's an impulse to where it becomes compulsive and then it becomes addictive. And then you have a problem where a person can't stop and they make promises to themselves they're going to stop and they can't stop because the brain is now at a place where it can't go backwards by itself. So it's a little bit like other things that you know of Alzheimer's or other brain diseases. There's now something wrong with the brain. And we can see it, we can look at it, see pictures of it. We know that it's a problem and that it's treatable.

Okay, so you said it's a brain disease. And I mean, I've, you know, done a lot of reading on addiction. I go to conferences. I mean, I'm very much an addictive.

Thinker, you know, the biggest conference goers.

I know well, a lot of things. And I'm fascinated with the whole subject of addiction because I believe, you know, mental illness in the worst possible states will manifest itself as an addiction. And from a layman standpoint, meaning to me, I interpret it as something where willpower, choice, all of those things doesn't matter. Okay, and I want to ask you about that. There's behavioral addictions such as sex, which we're going to talk heavily about today. Gambling, eating, Internet. And then there's chemical addictions, alcohol, drugs, things that are consumed. Is there a difference between a chemical addiction versus a behavioral addiction other than the way that it's acted out?

Well, what's important is that everybody understand it taps into the same parts of the brain, so it's the same reward centers, uses the same chemicals. Like dopamine, for example. If you have a good meal, it raises your dopamine 50%. If you have sex with, it raises it 100%. If you drink alcohol, it raises it 100%. Take methamphetamines, raises it 1,100%. So sometimes some things are too good. The brain can't. You can't be a recreational user of meth and not have a problem. See, and there are other things like that. So the first thing that you need to understand is it taps into the same parts of the brain. What makes it different. And especially with food and sex, they are different than everything. Which is why in many of my patients will say, heroin addicts, cocaine addicts, will say by far, sex was much more difficult than their cocaine or their heroin. And part of the reason is, first of all, the brain will categorize anything sexual, both men and women, 20% faster than anything else. We are wired to be sexual because it's about survival. Food is about survival. Food and sex are also sensate. In other words, we are the only country in the world that has a dessert cart. Yeah. And the reason we do is because the presentation and the smell is part of how you sell the food. And the food industry has been very effective marketing and building ways in which it Gets people to buy food that's not good for people. So the senses are very important. And so a cocaine addict doesn't care how his cocaine is packaged, just wants the cocaine. But food and sex presentation can mean a lot in terms of what does that mean to the person, how that person looks. Just think of words, Joe, that you can think of right now that would apply to both food and sex. Hunger.

Delicious.

Yeah.

Beautiful.

Yeah, exactly. In other words, erotic. Yeah.

So you have see how my brain just works like this.

Yeah, but, but the point is, is that they're, they're regarded as two of the toughest addictions because of how they're wired. And then they are intimately connected also with historically issues around trauma, sexual abuse. Many people who are overweight have been sexually abused. It's a way to defend themselves sexually. Sex addicts have been abused sexually. Fear is a big factor in all addictions. Every addiction has what we call a stress factor. You really can't have an addiction without stress because of what it does to the brain. Interesting.

Well, here's one of the reasons that I wanted to interview you for one. I don't know the exact cliche, but it's that which is most private, is most public.

Yes.

This is a condition which you absolutely know, have more statistics than you could ever shake a hat at and millions of people suffer from. But if you go out onto the streets, no one wants to admit it. Talk shows never, I've rarely seen unless like you're interviewed or something where there's ever a proper interpretation of it. It's such a shame and guilt based condition. But so many people, including a vast majority of our listeners, many of who are entrepreneurs and CEOs, would never want to admit to it. Most of the depictions of sexual addiction, or addictions in general are typically wrong. Whenever they show a 12 step, supposed 12 step male meeting on TV, it's usually really not how it works. And you know, we're living in a world where this condition is so prevalent and so many people are suffering from it. But there's not a lot, if any real major public support for it. And there's millions of people that deny it even exist, including supposed doctors. And so it's changing, it is changing dramatically.

And I think the factors that have made it change, first of all is we have a lot more science and there are a lot more people like me out there working on it that are, that have studied sex addiction and are prepared for this now. In the comprehensive textbook of psychiatry, psychiatrists are starting to draw a bead on it. The Clinton experience helped in a very strange way. It was. I wish the Clinton's no ill will in this. I really. I think they've had many struggles and they've given much. But the fact that there was a public discussion. I remember the afternoon when the Monica Lewinsky thing. We had every major network newspaper wanting a diagnosis of Bill Clinton between 1:00 o' clock in the afternoon and 2:40. I remember where the place just went up for grabs. And of course that's something I've never, I've never met Bill Clinton. We, we don't do that over the phone. We don't. That's not how. But what was interesting was to hear the reporters talk because the reporters started using language. Anxiety reduction, compartmentalization, the language of therapy. And if you read what was written afterwards, why a person would take the risks that were taken. I mean, and the stories that are now documented, what that did is it brought us, if we were like 30 years behind, brought us forward maybe 10 or 15 years. And then the thing that people can't seem to duck. There are two major things they can't duck. The Internet is changing everything. It's changing our sexuality, it's changing our culture. No spouse can compete with the Internet.

What do you mean by that? No spirit else can compete with the Internet.

Because, you know, I mean, I think of in my marriage, I've been married to my wife Suzanne since 1995 and just what it takes to deal with her. I mean it's. I mean she is. To have a good relationship takes so much work and stuff to deal with one really good woman. And it's kind of how we have evolved over time is to be able to deal with a person one at a time.