Qualified Therapy: Why it's Important, How to Find it, and Why it Complements 12-Step Work w/ Dan Drake

Host Tara McCausland and therapist Dan Drake  discuss the importance of finding a qualified clinician that has specialized training in sexual addiction and betrayal trauma. They suggest questions/ways to vet a therapist to ensure best therapist-client fit. They explore  how having a therapist during the disclosure process is helpful, and paint a picture of what the therapeutic process might look like in the first year. They also touch on  the value of combining the 12-step program with therapy. Dan points out the importance of seeing qualified therapy as one part of a wider community of support available to those healing from sex addiction and betrayal trauma.

Links for this episode:
Dan's website
Disclosure Workbooks
Questions to Qualify Your Therapist

Chapters

• 0:00 Introduction and Upcoming Events
• 2:26 Guest Introduction: Dan Drake
• 3:06 Why Qualified Therapy
• 4:09 Understanding the Importance of Specialized Training
• 11:32 Finding the Right Therapist: Tips and Red Flags
• 23:05 The Role of Individual and Couples Therapy in Healing Process
• 25:35 The Role of Therapists in Disclosure Process
• 27:17 The Impact of Trickle Disclosures
• 31:09 The Therapeutic Process: From Start to a Year Out
• 33:40 The Importance of Honesty, Safety, and Trust in Recovery
• 40:26 How 12-Step and Therapy Work Together
• 47:19 Advice for Newcomers and Long-Term Journeyers in Recovery

Transcript

Qualified Therapy w/ Dan Drake

Introduction and Upcoming Events

Tara: [00:00:00] Hey friends. I'm excited to share this episode with you with guest expert, Dan Drake, who gives so much great information about why qualified therapy and how to go about finding a qualified therapist. But before we jump into that, I did want to share a few save the dates with you. So first of all, coming up on February 6th, we have [00:01:00] something that we've never done before.

It'll be a Vision cast and online fundraiser where we will actually do an auction for recovery items that have been donated - things like, journals, art, surrender boxes. So you should be able to go to salifeline.org and register for that. Of course it's free. It will be online on Zoom. And we hope to see you there so you can get a feel for what SA Lifeline is up to in 2024 and have an opportunity to support this great cause and link arms with us as we continue to work to recover individuals and heal families. 

Also, we have our annual SA Lifeline Women's Workshop coming up on April 19th and 20th in Mapleton, Utah. This is a great opportunity for a small-ish group of women to gather and to connect and learn and heal together from the effects of betrayal trauma. So again, that's April 19th and 20th and if [00:02:00] registration details are not up yet, they will be very soon. So some great things are coming up. And by the way, if you want a little email reminder about some of these things coming up, you can go to salifeline.org and sign up for our newsletter. That will help you know when registration is available for upcoming events, etc, new blog posts and other recovery tools that we're making available. We're grateful to have you as a part of our community. 

Guest Introduction: Dan Drake

So without further ado, here is our interview with Dan Drake. Dan Drake is a licensed clinician, a certified clinical partner specialist supervisor, as well as a certified sex addiction therapist supervisor. He has co-authored several books, including Full Disclosure, How to share the truth after sexual betrayal and Letters from a Sex Addict, My life exposed. Dan is also EMDR trained and he is the founder and clinical director of Banyan Therapy Group in Los Angeles, California. In addition to his [00:03:00] clinical background, he has spoken domestically and internationally. 

Interview Begins: Discussing Qualified Therapy

Tara: Welcome to the pathway to recovery podcast. I'm your host, Tara McCausland, and I'm thrilled to have here with me Dan Drake. Dan, thanks for being here with me today. 

Dan: Thanks, Tara. Thanks so much for having me. I'm excited to be here. 

Tara: So as a background for our listeners - if you've been listening recently, you know that we've been going through the recovery puzzle and we have been touching on the four pillars, the four outer pieces of our recovery puzzle. And so today we're focusing on the qualified therapy piece, which from an SA Lifeline standpoint, we don't do in- house therapy, but we recommend qualified therapy as an integral part of the healing process.

So today we'll talk about why qualified therapy, why it matters, how to find a qualified therapist, maybe what you ought to look for. Also how qualified therapy and 12 step work together really nicely to help people on their [00:04:00] pathway to recovery. So Dan, you're ready?

Dan: I'm ready as ever. I know this is huge, but I hope we can.. I'm looking forward to it.  

Tara: It’s a lot to cover. 

Understanding the Importance of Specialized Training

Tara: So the first question that I feel is important to ask is, “Why is it important to find a therapist who has received specialized training in sexual addiction or betrayal trauma recovery?” 

Dan: Yeah, that's a really good question. I think the short of it is... let me just explain my grad school experience. I had a two unit Addictions Course, total, my whole grad school experience to be trained as a therapist. I could be wrong. I don't know if sex addiction was ever mentioned. 

So in grad school, I hope it's different now, but at least then, you find people that have had, you know, full training, whether that's as psychologists or master's level therapists, but many people don't receive the training.

Some do go on to get further training. I guess I always wonder if [00:05:00] you are getting further training, why aren't you focusing in this field and getting certified? Because there are certifying organizations that give you specialized training. So I guess the short answer to why look for someone with specialized training is because we're not trained for this in school.

So you'll have people that say they're specialized when they may not be. I mean, for example, if you look on Psychology today in my area, there'll be a ton of therapists that pop up, because you can just do a checkbox that says “I specialize in sex addiction or whatever.” It says something like that.

I don't know many of those people. They aren't my colleagues that I work with. I know most of the local specialists because it's a small-ish community. So I think it's really important for kind of anyone listening for you to know [this]. Anyone can say they specialize, but this is a hundred percent what I do in my practice. It's not five percent or I worked with a porn addict once and so I can say I specialize in this. This is what we do. 

I'm assuming many people's experiences [00:06:00] who are listening have been like those I’ve seen. Unfortunately, many people that have come to me have been through multiple therapists before they've come to me. They've had terrible experiences. Someone saying, “Well, it's just porn, you should get over it,” thinking somehow that you're being prudish. Or have these misguided conceptions of or not even understanding what betrayal is or the impact of betrayal. We've just found people we've had to help undo the kind of institutionalized trauma that comes from the actual therapist, even though they may be well meaning. I'm not saying they're not well meaning, they just don't understand many people. So that's a short answer, but yeah, anyone can say they're specialized. Not many people actually are. 

Tara: Right. Well, and I've said before on this podcast that not all therapists are created equal if we’re talking about receiving specialized training in this area. You might liken it to when we have a physical issue. If we're having digestive problems, we're not going to go to the heart doctor, right?[00:07:00] There's very specialized training for our physiological issues and we seem to understand that. But it seems like in the therapeutic world, there's some confusion about it. “Oh, well, they're a therapist, so they must know how to deal with this stuff.” 

Dan: I one hundred percent see that. I usually try to use medical analogies because I think it makes sense for us. If I had a heart issue, I'm not going to go to a general practitioner. I want to go to a specialist who does this, this is what they do. And I would say for myself personally, and it probably came through more wisdom over the years, I thought I could do more than I actually could. What I've learned over the years is knowing what I do well and then referring out for the things that I don't do well at or other areas that I'm not specialized in.

Why reinvent the wheel or try to force something when there are people that specialize in certain areas? Let me find you the best help. And I think either it might be a therapist’s optimism, at best, or maybe their own kind of pride or [00:08:00] lack of education, or maybe their fear somehow that gets in the way of them saying, “You know, I might not be the right fit for you. There is somebody who I do know.”

I don't know, especially for your listeners, I have found this to be the issue too. Sometimes people will choose a practitioner of faith and that becomes even more important than a specialist who isn't of [their] faith. And that's a trickier, bigger conversation, I understand. But I find sometimes, yes, of course you want to have someone that respects your belief system, your morals, your values, of course. But sometimes there are people that profess to be specialists in an area that really aren't. Even if they share the same faith, it doesn't mean they're actually going to steer you in the right direction.

So I understand that's a big complicated issue and I'm not suggesting it's either/or, I mean, hopefully it can be on both ends. But I also see that being an issue for plenty of clients too.  

Tara: I really appreciate you bringing that up. Partly because in [00:09:00] this world of like YouTube and Instagram influencers, it's amazing how people have a certain faith and they might draw a certain audience because of their faith. And people will just kind of take what they have to say as just hard truth because they are of the same faith tradition. And then they put themselves out there as a specialist or as the authority on this subject.

We could probably talk for a while about that, but in one of our previous episodes, I just cautioned our listeners to go out, seek for good information. But really vet those people who are the big name influencers who are saying, “Follow me because X, Y, Z, and that might include because I believe the same things you do religiously.”

Dan: On that point, even I, as a therapist, even if someone shares my or is part of the same faith tradition that I have and maybe even the same congregation or [00:10:00] whatever, I don't presume to think that we actually are talking about the same things.

I still want to get to know them. I mean, I still won't assume. We might have a common language. We might understand things, but I don't know, I guess I still don't assume that we're all on the same page with all this stuff. and I love that you said clients are consumers.

Clients should vet the therapist. You should vet your therapist, ask the questions, you're interviewing them, you know, and they're also interviewing you. Are you the right client for me? Or am I going to be the best fit for you? But I think there's this, I don't know what you'd call it, interview process, I guess, where we can see, “Are we the right fit to work together?”

Just because you got a referral name or you're desperate, you don't have to go see that one person. You can see that maybe this isn't the right fit. Let me talk to somebody else. And I always say, especially after a betrayal, as a therapist, I've learned over the years that I can't and shouldn't expect trust right away from a client.

I hope I'll show myself trustworthy. I'm pretty confident I will, [00:11:00] but I never expected because why would I since people have been betrayed or they've  been wounded by other professionals in the past. So let me show myself trustworthy through my actions and through my commitment, dedication. I guess that goes to one of these pieces of humility, as much as you can have some humility with the provider too. 

Tara: Well, the next question here, as you were answering the first question, you said that you get a lot of people coming to you who have been through multiple therapists.

Finding the Right Therapist: Tips and Red Flags

Tara: And so, how do you go about finding the right therapist and what are some and maybe this is a tough question for you to answer, but what are some red flags that the therapist that you're meeting with might not be the best fit for this particular issue?

Dan: Yeah, good question. That's a big question. I'll just refer people back to your website if they don't know. I mean, you have questions to ask your therapist, things [00:12:00] to be thinking about, how do you vet, how do you qualify your therapist. So there are some really good resources you have. So I'd follow those. 

You want to look at experience. So I think that's a good part. You talk about experience, sure, you don't want to have someone new. That said, experience enough, you know, even if they're specialized, you want to also know, how do I say this diplomatically, people that have been doing this for a long time may not be up with what's current.

They may not understand. They may not be like, for example, the field shifted, what, 10, 15 years ago from a co-addict model, primarily. [Now] we understand the impact of betrayal; so there could be codependency, co-addiction, but also there's this huge thing of betrayal and rupture.

So if someone [has] just been doing the same thing for  multiple decades, they may not be interested in the current shifts and learning. If you can get a sense maybe from their website, maybe it's not direct, but where are they with their kind of current [00:13:00] thinking, are they aligned with what's new in the field. 

Personally, I want to keep growing. The day that I say I know everything and that I've got this all, please tell me to retire, I tell people because then I've stopped being helpful. Because the field shifts all the time. So we all want to know, are they continuing to learn and grow in this area? So experience helps. 

I think an openness to get a feel and the nice thing is these days we can sort of vet therapists before you've even met them. You can watch videos if you can. Sometimes therapists won't have content online, that's okay. But do you get a sense from their website? What type of person might they be? So character does make a difference because yes. Therapists have modalities, but you also want to get a sense of “Who is this person? What's my gut impulse with this person? Do they have a certification?” 

So that's another big thing we talked about, there are [00:14:00] multiple different ones (certifications). The biggest one I know would be the CSAT, certified sex addiction therapist. That's the most comprehensive certification out there. If someone's gone through the CSAT training, they've gone through typically four modules of training, which is 20 days of training. They've had to do multiple hours of supervision post training. So there's a lot - it's not just, you go through a four hour course and you get a stamp or something, you have to actually do a lot.

So that's for someone working with the addict, but also there's the APSATS, which has certified clinical partner specialists or certified partner coaches. There's some other ones out there. I know SASH (The Society for the Advancement of Sexual Health)  has one, Doug Weiss has his, there's other certifications too, but those are some of the big ones. So if someone's specialized, it is really important. 

Some red flags, let's see, what are some red flags? So I would say[00:15:00] again, I think, how do they treat you? How do you feel? Use that information.

So if you're a betrayed partner, for me, I think for anyone working. Let's say if I'm working with the addict, even if I'm not going to be working with a partner, I want to make sure the partner feels safe with me. Because I'm not just working with one individual. I'm working with this person in the context of a couple and a family. So if you're a betrayed partner, do you have any access to that therapist or is there some sort of channel? Maybe it's not direct, maybe it's through your own coach or therapist.

Does this person collaborate? Or are they sort of an island? And I find [that] the therapists that are kind of the island, that gets more problematic because we're dealing with a relational rupture and family, you know, there's a lot of moving pieces. So how collaborative are they? Sometimes people as part of a team helps that [00:16:00] collaboration. 

I'm just looking through your questions...I don't want to reinvent the wheel with some of these, but some of the flags. What's their view of pornography or do they align with your values is going to be an important one. If someone's saying, “All porn is wrong,” and this person's saying, “Well, porn's not the problem, it's our shame about porn,” then you're going to have a value misalignment, which is probably going to be problematic.

Or, where do they see the problem in the relationship? So I'm trained personally as a systems therapist, so marriage and family therapist. My training was, if I have a couple coming in to see me, then my focus is working with the couple. So the couples’ problem, or there's a problem in the coupleship means two people had a part in that problem.

If someone's coming from that frame, that may be fine theoretically, down the road. But that's not what we're dealing with right out the gate with betrayal and sex addiction, [00:17:00] we're dealing first with a rupture. The added cause is typically through lies and deception through their secretive behaviors that created damage so that just kind of destructive, emotionally abusive behavior created damage and the relationship.

And if I don't address that rupture from the beginning and I assume there's two people with two equal parts, then it's a problem because we haven't actually named that there is an injustice that went on. And there is, kind of victimization for lack of better words - not intentional. I'm not trying to say the addict meant to do it, but that is what happened. 

So I think if you can ask what the therapist's sort of theoretical framework is and how they handle betrayal or betrayal trauma, I mean, even that term betrayal trauma, what their understanding of it is will help you get a sense.

And someone who says, “Well, I'm trained in X couples model, and this is how I approach it.” It might be fine down the road, but usually we still have to address the rupture that happened [00:18:00] right here before we can actually get to those pieces. So I'm usually concerned when I hear someone thinking they're going to bypass any of the pain that the betrayal caused.

Tara: So just as a review, and I will reference our list of questions that we have on salifeline.org to vet a therapist. But some of the things that you said that I think are worth repeating; [finding] someone that is up to date in the most recent research and development and understanding of sexual addiction and betrayal trauma is really helpful.

I also like how you talked about “How do you feel?” Use your feelings, your intuition as a barometer of, is this even a good fit? Do I even get along with this person? 

Open to collaboration. I've heard on a few occasions where an addicted spouse will come home and tell the betrayed spouse something that was said between them and the therapist that might be really hurtful. Or even not consistent with [00:19:00] what's happening in the relationship. And that person that betrayed has had to go back to the therapist and say, “Is this really what you said?” So I think that being open to collaboration with other therapists, being willing to have dialogue with the betrayed spouse.

And then this, I feel like [this] is so key, the value alignment. I can't tell you how often you hear horror stories about people walking out of therapist offices and they excuse the behavior as, “Oh, well, you just got caught. Everybody does this,” or “Porn is not the problem,” as you said. So I think those are all really good suggestions. And then for those who are interested, on salifeline.org, if you go to the recovery puzzle and then you just scroll down to the qualified therapist piece. There is a download that you can get just for free right there for you - questions to qualify your therapist.

So I don't know if I would be so bold as to actually take that into your first therapy session. But [00:20:00] just so you're aware, as you're feeling out that relationship initially.

Dan: Well, even if you do, what's the therapist's response? Do they start to get defensive?

You know if someone brought that in, I would feel like, “Okay, is this an inquisition maybe?” Maybe, but the spirit of it is, “Okay, so this person really wants to make sure that I'm safe.” And so here it's safe, right? We're trying to find a safe fit that I can trust, [someone] who's actually going to help us move in the right direction.

If I could get that spirit of it, that would help. I have had people come in, even before meeting with me, they'll fire off like five questions. I wouldn't do it in email. It's worth seeing the response. I have had that come to me in email and I'll respond, and I'm not offended. I just think it's like, okay, you're trying to vet me probably because there are a lot of people that do harm out there. 

If you're seeking a specialist, it's nothing against this organization, they just take a different stance, it's important to find a sex addiction therapist, not a sex therapist. [00:21:00] So a certified sex addiction therapist, not a certified sex therapist.

Tara: A hundred percent. 

Dan: I just have to say that. And again, I think sex therapists do amazing work. But what their goal is, is a little bit different than what my goal would be. And usually they can, they'll do things that later down the road, can really support couples. But this is a huge mistake that I think a lot of people make, and they're seeing a sex therapist. Then they're working on their sex life when the betrayed partner is kind of like, “I’m reeling from the impact of this betrayal. I'm not ready to talk about sex right now.”

So just something to be aware of, depending on what you're needing and where you are to understand if that person actually does understand, because sex therapists actually don't take a sex addiction model. They've been public with that. 

Tara: Yes. Thank you so much for bringing that up. There are people that I feel like have become big influencers in this realm that are sex therapists, not sex addiction therapists. So we kind of want to stay in our lane, right? So we can really help people.

Dan: And this is [00:22:00] also confusing. That's the other thing I want to say. If you look and I put a graphic, and I'm sure they're changing all the time, there are different people and it also depends on what part of the country or the world you're in - some people don't take sex addiction as an actual model. They discount it and they have their own approach.

So Doug Ron Harvey in San Diego - “out of control sexual behavior.” I like Eli Coleman up in Minnesota. He talks about it more like “compulsive behavior” and not sex addiction. So there's different people all over the country. Bill Herring's model, I think, is great. I think it's “chronically problematic sexual behavior” or something. 

So just so you know the specialist field often isn't even in sync yet. So it's still a little bit confusing. That's why I like these questions because it helps you get a sense [of] where that person is. And again, taking that in and self empowerment. How do I feel with this person? If I'm triggered by this person, is that related to the person or is it something that gets activated? It's just worth looking at. 

Tara: So then, a big [00:23:00] question that often comes up, and you said that sometimes you are working with couples simultaneously.

The Role of Individual and Couples Therapy in Healing Process

Tara: What are your recommendations regarding individual versus couples therapy, depending on the stage of the healing process? 

Dan: It seems like it should be a simple question, but it's really complicated. 

The traditional approach had been to let people do their own individual work for a season, let's say a year even, and then we come together to do the couple's work. That is one approach and it works on some level because I think there is a lot of individual healing to do prior to working on couples’ issues. I will say, and I heard John Leadem, he's a therapist,  said this at a conference. I heard him say something to the effect of, “I don't know much about geometry, but what I do know is parallel lines never intersect. “

And so I do think there's a world if we're doing just separate work for a season, and I actually don't see.. the parallel lines are not intersecting, I actually see them usually verging further apart. [00:24:00] So someone like, Carol Jurgensen Sheets ERCEM model, if anyone's aware of that. It's a newer approach, The Early Recovery Couples Empathy Model. 

But anyway, it's a model for how we help couples, maybe not do couples therapy, but help them deal with safety stabilization issues and help them move closer together. I don't have the luxury, we can't put people in bubbles for a year. They're living together. And if the addict isn't understanding betrayal or betrayal trauma, or the partner’s trauma experiences, we're going to have big problems and it's going to create ruptures and all over the place and in the family, how that intersects. I think there's a role of getting into couples support if you can, if people have the resources and availability.

I wouldn't call it couples therapy though, and we may call it couples triage or managing safety in the relationship. [00:25:00] I think couples therapy when you seek out a couples therapist, it tends to be, we're working on our communication issues or our relationship, which I think is further down the road.

Building Security and Stabilization in Relationships

Dan: Right now we're just trying to help build security and stabilization back in the relationship early. 

Tara: Thank you. Yeah, I'm sure that it is a lot more complex than, “Give it a year and then you can come together.” 

Dan: Well, because people are, I mean, week in, week out, things are blowing up because addicts don't understand what the partner's going through and they don't get it and they make things worse usually until they understand.

The Role of Therapists in Disclosure Process
Tara: Yeah. One of the primary reasons I see, for having a therapist especially early on, is for this event of disclosure. Disclosure can be really traumatic for the betrayed partner. And so I'm curious. Why is it helpful to have a therapist aid in the preparation of and the delivery of a full disclosure? 

Dan: It's another good question. Janice Cottle and I created some [00:26:00] disclosure workbooks for couples. We didn't ever set out to do this much work on it, but we realized how poorly these things can go. And also we thought, you know, it can get really expensive if my recommendation is to have two therapists, one to prepare the partner, one to prepare the addict or the disclosing person. That can get expensive. We understand. So we created workbooks that could be used for people that, if they have a guide, maybe it's even a clergy member. We're doing trainings, not just for therapists, but also for coaches and also for other professionals, because we understand disclosures don't just happen for those that can afford it in the therapy office.

It can happen elsewhere. So that said, having a guide, a trained professional guide to help through or a qualified therapist, usually I recommend that. Because one, if I'm preparing the addict, for example, it's to help that person, help him to share the whole truth. If he starts to get defensive or going to shame - to help try to manage that as much as we can. Take breaks if we need to to help [00:27:00] keep him present and empathetic and open and vulnerable. So, that part and also on the partner side, it's to help the partner stay grounded and regulated, not dissociated. Just really help support them so we have advocates there, but on the prep side.

The Impact of Trickle Disclosures

Dan: We know, unfortunately, and I'm sure I hate to think it, but I'm positive people listening, they're going to have had experience of trickle disclosures. I don't even call those disclosures. I call those confessions. Usually prior to this full disclosure, we find people share either too much information or not enough information.

So our job as professionals is to help kind of titrate that to get all the information that the partner wants to know? What don't they want to know? I do a written disclosure process so it helps the addicts. I'm also working on any rationalizations or minimizations or justifications or blame shifting stuff.

I'm editing all that out or too much detail, graphic [00:28:00] detail, all that stuff. I'm trying to filter [that] out so that the partner gets everything that they want to know without it sounding like... Can I give an example? I don't want to be too graphic. Like, in my first review of a document, I might have something like “In March of 2005, when you were six months pregnant, I, blah, blah, blah, blah, blah, filmed the sexual act.”

If I see that in the addict's guide, I'm trying to think, how's the partner going to read that? How's the partner going to hear this when they're listening to it? Most partners, most women are going to hear, “Oh, so it's my [fault], I was six months pregnant and you know, you're blaming me basically.” So anything related to the partner I'm taking out.

So forget the six months pregnant. If the partner wants to connect that together, they will, but I don't want [them to] in any way think, “Well, you know, it's because you were pregnant and you didn't want, you didn't want sex with me. So that's why I did this.” I'm trying to filter all that stuff out and I'm talking to the [00:29:00] client about that saying, “Your job is to be fully transparent with this information, fully accountable with this information without minimizing your blame shifting.

It sounds obvious, but it actually takes a lot of work and revisions to do that because [for] addicts, it's scary to put all your information out there. So they try to hedge it a little bit. But I think giving support so that hopefully it's accurate, the client does a deeper dive. So all the information out there. 

We talk about polygraphs added to this, adding those things possibly. So there's a lot of reasons, but I think because most people, when they do it on their own, it's usually not done well. It's either too much information or not enough, typically.

Tara: Yeah, and that trickle disclosure or aka confession I think tends to add to the trauma of the spouse. We're trying to diminish that as much as possible.

Dan: Yeah. Thinking [00:30:00] medically, do I want to go through multiple partial surgeries to get an issue solved? And then I heal up a little bit after that surgery only to find out, no, there's more. We still have to go back in there and take out some more. And then, there's more, there's more, there's more. I mean, each of those things, we know, any data that I've seen on disclosures, that's the most traumatizing form of disclosures, the trickle-down.

Because we start to build, we think, “Okay, I finally have some security. This is the foundation. Oh no, wait, my foundation crumbles again. There's not a foundation, there’s more. It  becomes the “M word.” The word “more” is triggering because the addict would say, “Oh wait, there's more.” So even that word itself is triggering or “I have something to tell you.”

Tara: Or, “Do you have a few minutes? I need to tell you something.”

Well, I think that workbook that you mentioned might be of interest to our listeners. And so I'm going to link that workbook in the show notes and link to [00:31:00] your website, et cetera.

Dan: Thank you. 

Tara: Well, so maybe this is too broad of a question because I'm sure that it's variable depending on the couple. 

The Therapeutic Process: From Start to a Year Out

Tara: But could you walk us through what people might expect with the therapeutic process from, kind of a start to maybe a year out? 

Dan: Okay. It's a great question. I'm just thinking and this is where I start to think like this is sort of “pie in the sky” for those that have resources. So I don't presume that everybody can do this. I just want to say that ideally if someone's coming in and they're in a relationship, which typically is the case, then usually the betrayed partner needs support. The betrayer, the addict needs support and the coupleship needs support. And usually I like to have it with three different therapists if possible, not the same person.

So that's the “pie in the sky.” [00:32:00] Ideal. I understand that [it] can get expensive and not realistic for some, I get that. There are other options. So it doesn't just have to be that.  But for the addict, the addict does need some support. So I try to get them and we'll go to this in a bit, I'm sure, but go get them linked to a 12 step community pretty early if I can, because that's where they're going to do a lot of their healing.

I'm going to hopefully take some of those pieces and start helping them build a relapse prevention plan, more top down. What went wrong? Why? What happened here? Let's shore up the foundation, let's get some sobriety recovery tools built. And then my job is to help that person twofold. 

One is to get the recovery and then also help them to restore the relationship where there's been an attachment breach. So that's complicated. Everyone comes in with different levels of understanding and empathy. And if I have someone who's more narcissistic, they may not get it. [00:33:00] And I have to teach them what happened and what betrayal trauma is, what you're seeing is normal and you know, all that kind of stuff. So there's a lot of education, but then there's usually trauma work underneath it. So getting to do that trauma work with the person.

The couples we already talked about a little bit early on. I think the first year to me is more “How do we build safety in the coupleship [and] start to rebuild trust? Honesty. I can share this too, if it's helpful, a new book I have is on the intimacy pyramid. It's a conception I thought of a while ago for disclosure, but I think it works with basically rebuilding and there's five layers to it.

The Importance of Honesty, Safety, and Trust in Recovery

Dan: So first honesty, we're trying to rebuild honesty, then safety, then trust. After that, we rebuild vulnerability and intimacy on top of those three things. But I think the first year, I really want to focus on the bottom three. So we’ve got to rebuild honesty, some conception of truth and honesty, which is usually [00:34:00] disclosure. I don't know how we rebuild anything if we don't know if it's the full truth that we're working with. 

Again, I wouldn't force a partner to do disclosure if she didn't want to, they didn't want to. But I really want to focus [on], “How do we build and rebuild safety back in this relationship and trust?” Those are the things I'm focused on. So boundaries would come in, have the partner understand boundaries.

The addict understands their own boundaries and how they build their own tools and support. That's super vague, we can go into way more detail if you want, but those are some of the things I'm thinking.

Tara:  No, I think that helpful, those three pieces as the foundation - the honesty, the safety, the trust that you're really working on and certainly the boundaries that come in so that we can create safety, right?

Because they're going to be patterns within that relationship where both people will feel unsafe. Obviously you can't say, “Well, on week one, we're going to be doing this,” because we're working with living, breathing[00:35:00] evolving human beings. 

I'm curious what your thoughts are on what we ought to expect as far as how long couples are doing their work. And of course, we'll have setbacks, but doing their work, how long should they expect to be in the therapeutic process?

Dan: So I will say this, this number gets thrown around a lot. Pat Kearns, when he did his research, he was saying three to five years for couples. That's the kind of standard that many people will say. My experience though, I do think the addict needs something consistent. I don't know that the addict needs long term therapy forever. I think that person, if they've done the work and they have built up a solid tool, I think that's where 12 step can come in and a community. So they don't need a therapist for that accountability support long term or even to kind of work through what's usually underneath the sexual behaviors, trauma stuff.

If they work through some of their trauma, maybe it doesn't have to be perfect. But [00:36:00] when are we ever done working through stuff? We could always benefit, but I think if they've gotten it and then they've established these tools for themselves and they're implementing it and they're working this stuff on their own, with their team.

I found partners kind of come and go, so they may not need as much ongoing [therapy]. Maybe they need some support right now and then they kind of do their thing, then come back. There's generally three phases. And that's what the APSAT’s (The Association of Partners of Sex Addicts Trauma Therapists) model uses, it’s Judith Herman's three phases of healing.

So the first is safety stabilization. We really want to focus on safety stabilization. Then the next big piece, and this is where a lot of couples stall is remembrance and mourning, that second phase. That's grief work. That's trauma work. That's integrating the pain. And that's where the addict also needs to start learning, “My story, my experience has really also had an impact and harmed my partner.” So they need to be able to not only heal from their own stuff and the shame [00:37:00] they've had over their behaviors, they have to hold space for their partner and the partner's pain and grief.

And then family pain and grief too. I think there's, depending on how much the kids know, where that discovery happened and there's long term stuff. But that's where I think a lot of couples get stalled along the way is through the grief journey. 

So how long does that take? Man, I wish I could say.  Some couples, some families progress quicker based on where they're at. Some take longer based on what the needs are. I don't have a good number. I just have the three to five years, but I don't think it's not like you wait five years and it's all bad. And then five years happen and that's all good.

It's incremental. I think any of this stuff, we're working day by day and you'll see progress. And if you're not, that's another problem we need to address, but there should be some progress. Maybe not perfectly, not linearly, but there should be growth and healing and we're moving through [00:38:00] these phases.

Tara: Hmm. Yeah. And I think the main thing that causes me to ask that question is because I do think we often want the quick fix. We want the magic pill. We want this to be a fast process so we can get back to our real, not a real life, our normal life. And we hear that a lot in 12 step. 

Like early attendees will be like, “Okay, how long do I have to do this?” And so to help them understand, right now the pain is acute and it's going to take some time to get out of that acute pain, that acute trauma.

It will shift if you're doing your work and you'll find that you don't get triggered as often or when you do get triggered, you'll have the tools to move out of that. However, I think just in our day and age, our microwavable, Amazon Prime culture, the length of time that it takes to really heal is not just like a surgery and then you're done.

This is over a period of [00:39:00] time. We'd have to go in with this type of mentality. But recognizing that even though this isn't a sprint, it's a marathon, there are benches along the way where we can stop and pause. And there's joy in this journey. And that's kind of hard sometimes to get across to people who are really in the beginnings, the trenches of this.

Dan: I think that's a really good point, especially around the pain. Because if I'm in acute pain, thinking, “I won't get relief for five years,” that's not what we're talking about. This is couples rebuilding to a new relationship and hopefully one that is even stronger than they had before.

Of course it's not the same. Sometimes I use the word “rebuild” and then I've had some partners say, “We're not rebuilding, we're building.” It's not even a rebuild, it's a build. So, that takes time. If your house burned down, you're not going to build it tomorrow. 

It's going to take some time. It's going to take a lot of time to rebuild, but it won't be this horrible pain and you won't [00:40:00] get any relief. I certainly couldn't do this work if there wasn't hope for couples. I see the beauty of it. Couples that really work through this and forge a new relationship is pretty beautiful.

But yeah, I think being very delicate with yourself, very compassionate and giving yourself that space is really important. 

Tara: Yeah, thank you. Well, our final question before our final final questions. 

The Role of 12-Step Programs in Recovery

Tara: So you have alluded to 12 step a couple of times through this, which I appreciate. Here at SA Lifeline, a subset of SA Lifeline is SAL 12 step. We offer betrayed women and addicted men free trauma- sensitive, sponsor-essential, God-centered 12 step. This is where we often focus as an organization because this is what we offer that's unique, to some degree to us. But when we're talking about bridging the gap between qualified therapy and 12 steps, [00:41:00] sometimes people can't figure out how they work together. Or do they? Do they work together? And what is the role of the two of them in helping us on this pathway to recovery?

Because to be frank, Dan, we often find ourselves having to explain to therapists, really, we're not in competition here. We're here to help those who are suffering get some really good long-term healing. But what is the role of 12 step and how does that work with therapy? How could it or should it?

Dan: That’s such another good question. This is something [that] whenever I speak at a conference, I always try to petition the professionals. “Let's have professional humility here,” because I love 12 step. I think it's amazing. I think every human being could benefit from doing 12 step work. It's just about being a better human being. The world would be a better place if we all did 12 step forget an addiction, whatever.

I think anyone working the steps is going to be a better person. It [00:42:00] doesn't happen all the time, but I have collaborated directly with sponsors, with clients because let's say for example, around someone's ninth step amends. We may have differences of opinion, especially if that amends going to the betrayed partner.

I may have some feelings and professional input on what I think. Ultimately [it’s] not my amends to make. I will defer to the sponsor for that, but I may give some feedback as to how I know what the partner is expecting and some of that. So I think they work synergistically because I'm generally meeting with a client once a week, maybe two times or three, rarely. But [I] like [that] someone can have access to a sponsor, have a phone list, have people they can call, other brothers that they can call, other sisters, daily. At any time they have someone helping [to] guide them.

It's a different level of support accountability. I'll be an accountability person, whether that's through Covenant [00:43:00] Eyes or some other software. I'll do that. But I just think [that] there's something that a sponsor provides that a therapist just doesn't. Or the 12 step community. It's just so different than even group therapy because group therapy, yes, there's a definite benefit to it because you can have feedback and we can work through the intimacy issues.

But in a 12 step meeting, you get to learn how to be vulnerable and have your strength come, not through sharing the world as you want people to see it, but you're showing your vulnerability, you're getting help and support from other people that are there. Their voice, even if I have a professional voice, their voice is going to have a lot more weight because they're in it and they're going through it.

So there's just something so beautiful about peer support that I think is amazing. And I don't think we work at cross purposes and quite honestly, there's no way as a therapist that I can speak to someone the way that a peer or a sponsor can. There's just a way they can get in there differently than I [00:44:00] can.

I don't think we're doing the same work, there is some potential crossover if the community is giving feedback in terms of what the person should do in their relationship. It's not so clean, there's crossover, but if we all have the spirit of “We're trying to help this person heal.” We may have different, I'm going to call it advice, for lack of better words, advice to give. I think the team can work together. I see the 12 step community or their sponsor as part of their recovery team. I'm a part of the team. I am not “the” team.

The therapist that thinks they are the team and it’s “This is my ship and everyone else kind of comes under my ship,” I mean, that's an approach. But I think, again, having some humility, [knowing] that we are all parts of the team trying to help this person and this relationship, whether it's a partner or the addict.

At the end of the day, it's really making sure that the therapist, [00:45:00] maybe they have the professional experience, but I think it’s the whole team. I see a sponsor, I see accountability partners. I see we're all part of the same team. I'm not the team, I'm part of the team.

So I think that's really a critical conception to keep in mind because the 12 step community has so much more availability and it's the more cost effective, obviously. So there's a lot of resources and benefits you get from it and that support you can get ongoing, anytime. There's all that available, where therapists are just not as available.

Tara: Right. Perfect. Well, thank you. I really like how you frame that, that we are on a team and that every person on that team plays a specific role. And one can't replace the other, but I think that as you described, recovery work is really expensive and 12 step is free and it's a long term resource and a community of [00:46:00] people that can be there for it. As long as you need them and beyond, right? 

So thank you. I appreciate you explaining that from a therapist’s point of view. We are working together in this. We're not in competition. We don't have to be territorial. There's enough to go around. 

Dan: And I don't know how to ask the question, but maybe another way to vet [a therapist], another red flag is does this person seem territorial? Do they seem based on competition or do they have a spirit of openness and inclusivity and collaboration? Now, how [do] you quite get that, just from a question asked? But you may get a sense of that person. So I think it's important.

Tara: Well, you can ask that question and I believe it's the final question on the list of questions that listeners can download to vet a therapist. The last one is, “How do you feel about 12 step?” And I also understand that not all therapists are created equal, not all 12 step groups are created equal. And so you might have to shop around there too. [00:47:00] 

But yeah, again, I appreciate this explanation from you because we need to work together on this problem for the rising generation that has grown up with phones in their hands. We're going to have a lot of work to do as a community to heal well.

Advice for Newcomers and Long-Term Journeyers in Recovery

Tara: Our wrap up questions that I always end with, we like to ask them because we have people who are listening, who are on the beginning of their journey and others who might be more mid or kind of long term. What would you say to the newcomer, someone that's just stepping onto this pathway of recovery?

And then what would you say to the person that's been doing this for a while? 

Dan: For the newcomer, my heart goes out to you because I know this place can be confusing, volatile, especially for the partner, this is so confusing. It's a world, a community you never thought you'd have to be a part of. And here you are. So it can be so [00:48:00] earth shattering. 

But I think for everybody, give yourself a lot of grace, compassion, really try to put one foot in front of the other. There is hope, it won't be like this forever. That kind of chaos and uncertainty and the volatility is part of the early phase. But that's where we build safety.

We build honestly, we build trust and it can really go a long way towards repairing a foundation and healing the relationship. So don't be discouraged early on and it feels so overwhelming and daunting. Just really be encouraged. 

For someone long term. How do I say it? And this is specifically for the addict: don't get cocky. I found the two main areas where I see people struggle the most is early on and then later on, when they think they've got it all. So they start to let go of some of the supports. That doesn't mean you have to do the same level and depth [of] treatment or [00:49:00] whatever the whole time, but just be careful.

If we're taking off scaffolding, is this building going to stand on its own? What other supports do we need to do? So I would say really, and my phrase that I'd say all the time to clients [is], “There's no cruise control for recovery.” So just because you think you've got it and you think you can put it in cruise control.

If you think you've got it in cruise control, that means you're slowing down. So you always have to keep your foot on the gas and keep vigilant. So that's what I'd say. 

Tara: Wise words. Thank you so much, Dan. It's really been a pleasure. I appreciate all you've shared with us today and thank you for your great work in this realm. It's needed. So thanks again for being here with us.

Dan: Thanks, Tara. [00:50:00] 

Parts of this transcript have been edited for clarity.