Chemical dependency and intimacy dysfunction are closely linked and both need to be treated simultaneously.  To address intimacy in recovery it is crucial to treat the chemical dependency first. However, if issues of intimacy and sexuality are not addressed by the therapist, the patient will find it difficult to bring up this topic on his/her own initiative.

Some of the problems an individual may have are : Difficulty with intimacy in relationships, uncomfortable with sexuality in recovery, incest and child abuse, shame as a barrier to intimacy, dependency needs of men and women, having inadequate boundaries, sexual problems for men and women, sexual compulsivity, sexual orientation concerns and intimacy and aging. Unfortunately the relationship between intimacy and chemical dependency is poorly understood. However, for therapists who work in clinics and treatment centers this relationship can not be ignored. Treatment can not begin until the practitioner clearly understands the total dynamics of intimacy.

Intimacy is a description of a relationship between two or more people. In an intimate relationship, the individuals involved express “feelings in a meaningful, constructive, respectful and mutually acceptable manner which leads to the psychological well-being of the individuals involved” (Coleman,1988, p.7) This communication helps both individuals negotiate  roles and rules in the relationship and facilitate resolution of conflict. there is a misconception that intimacy equals sex. Intimacy can be found in many types of relationships such as marital intimacy or family intimacy and can be expressed emotionally, sexually, socially, intellectually, or spiritually. Intimacy includes understanding, acceptance, patience, loyalty, vulnerability and openness. Although intimate relationships are not absolutely necessary for survival, they are necessary for good mental and social health.

Intimacy dysfunction occurs when an individual has a developmental or pathological barrier to engaging in intimate behavior. Some examples of these barriers include: physical abuse, emotional neglect, sexual abuse of children, relationship discord, rape, violent relationships. All of these dysfunctions have a high correlation with chemical dependency. Drugs and alcohol serve to medicate/numb feelings produced by these dysfunctions and/or to assist an individual in being intimate/sexual.  It is crucial that treatment deal with both the chemical dependency and the intimacy issues. The behavioral and reeducation approaches of sex therapy have been helpful to many individuals in recovery.

One of the inevitable consequences of physical abuse, sexual abuse, and neglect is shame. Shame is a feeling of unworthiness or of being unwanted. This shame inhibits an individual from feeling worthy of an intimate relationship. Feelings of shame are a result of some type of family intimacy dysfunction. Chemical dependency practitioners are beginning to view shame as one of the underlying elements in addictive behaviors. Individuals, who have not received love, have been abused or neglected feel bad about almost every aspect of their person. Another consequence of family intimacy dysfunction is a lack of well established boundaries. These limited boundaries can be seen as ambiguous, overly rigid or invasive in relation to physical or psychological space. Lack of personal boundaries, overly rigid boundaries, or lacks of respect for other’s boundaries: these are the seeds of intimacy dysfunction.

Couples come into my practice all the time and say “my partner is not intimate”. What they usually mean to say is that their partner does not want to have sex, or there is no touching anymore, or we don’t talk about feelings etc… One of the first things I do is educate them on what intimacy truly is. We also begin a process of exploring intimacy patterns in the family of origin and what each partner brings to the table from their past. Part of the growth process is debunking intimacy myths, raising awareness and then taking action towards healing the past and building intimacy in recovery.

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