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Greetings and Happy Holidays! I hope that the end of the year finds you well. This has always been my favorite time of year, from the leaves changing to the first snowfall I feel invigorated. The holidays themselves bring much excitement and gratitude for all the gifts in my life. Having said this, the holidays have the potential to be filled with stress. While shopping for gifts and making cookies can be wonderfully fun, things such as this can add to an already stressful work and home life. Further, seeing family and loved ones can be fulfilling, but also bring up issues and questions. For instance, this may be the first time seeing some loved ones who don’t know about your recovery or who you have started to realize impacted you as a child. How you prepare yourself for these situations is crucial to managing your sense of safety and recovery.

While you cannot prepare for everything and may in fact over prepare to the point of overwhelming yourself, you should start to think of some situations. For instance, discuss with your partner or spouse and therapists how you want to disclose to people that you may be seeing for the first time or if you want to disclose at all. Discuss with your therapist those family members that you find intrusive or you are having a traumatic reaction to and figure out boundaries ahead of time. Remembering your self care and PCI during this time of year is crucial because often we put ourselves last and pay the price for it later. Don’t be afraid to say no if going to one last holiday party will just be too much. Remember to budget so you don’t feel shame when the bills come due in January.

Next to self care, remember the things that make the holiday important to you. It isn’t the gifts or the parties or the “keeping up appearances.” For many, there are important spiritual components that help to ground oneself or for others it is the gift of time with family and the beauty and grace that comes with the season. I hope you stay safe and look forward to a new year with all that it has to offer. I also hope you find time to be a kid a little bit this season as this is a wonderful time of year to nurture your inner child; I know I do.

Happy holidays from all of us at the ECU and we look forward to seeing you at the alumni reunion.

As always, Peace, Hope Ho!

First Step Counseling

The KeyStone Center ECU believes that first step work is paramount to laying a solid foundation for successful recovery and KeyStone provides each of its clients with an individualized first step counselor. We sat down with our first step counselors to get their take on this founding step of recovery. Here is what they had to say:

PAUL GREWAY: One area of treatment unique to the ECU is that each community member is assigned a Step One/Recovery Counselor. It is important for each community member to begin step one on an individual basis while in treatment. This work assists the clients in moving away from the isolation that sex addiction fosters. In addition, step work on an individual basis helps with developing intimacy, which is necessary for working a program of recovery. Step one helps the client begin to gain an understanding that they cannot stay sexually sober on their own. In order to work a successful recovery program, a client must ask for help and interact with others while in treatment and while participating in twelve-step meetings. Working the steps is also a means to reduce shame. The work in step one addresses the process of surrender, which allows a client to work a program of recovery and distance themselves from the self-centeredness and entitlement that came with their active addiction. By working step one, a client will be able to reduce shame through working a program of recovery and accepting their powerlessness and unmanageability.

MILTON M: I am a recovering addict. I don’t like to specify what kind of addict because I don’t believe it makes a difference. I have been in recovery for twenty-five years and I have not acted on my addiction since April 16, 1989. I work at the ECU helping clients with the First Step. Some of the tools I utilize in my first step counseling work are readings from the 12-step literature and Patrick Carnes’s work. I find myself addressing a variety of reservations a client might have about their treatment. They may say that they have decided to go to treatment because their wife or some other outside force wanted them to seek treatment. They may struggle with the first step and express that they believe that since they still have a family, hold a good job, a good savings, and are not facing legal problems, they have their lives under control. I help them to work through understanding how unmanageable their lives have truly become. These clients are spending a month at a residential treatment facility for their addiction and they need to ask themselves how they got here. Their lives are often filled with lies, shame, betrayal and deceit. It’s our job to have clients accept that they need help. I work with them so they can see how far their addiction has pushed them. We try to shatter their illusion that it is still OK for them to continue in their addiction and we work to shatter the belief that any kind of outside social acceptability is equivalent to what life would look like in healthy recovery.

When working on the First Step it can be overwhelming to discuss their future healthy sexuality (something we do address at our alumni reunions). During this stage of a sex addict’s early recovery, it is the same as trying to discuss with an alcoholic what it would be like to be a healthy social drinker. Instead, we primarily focus on the obsession and compulsion of their behaviors. If you choose not to use your tools for recovery, it will lead you to relapse and continuing to be active in your addiction. There are two things that I love about my work at KeyStone. The first is that moment when a client begins to chase me down wanting to discuss the First Step and I can see the light bulb has gone off for them. The other is when I receive a call from a past client or maybe see them at one of our alumni reunions and they share with me that they are using the tools that I gave them during their time at KeyStone to lead a healthier life. Our alumni reunion is a really gratifying time for me because of this reason. I begin to feel vulnerable when I see all those clients whose lives I’ve touched. The First Step is a very powerful tool. Applying the five spiritual principles of honesty, open-mindedness, humility, willingness and acceptance can make such a difference in a client’s life.

BERNIE: I’ve been working at KeyStone for about 12 years now sharing my experiences, strengths, and hope with the residents. Being a First Step counselor allows me to help those in recovery and to help me keep my own sense of recovery intact and continue to work the program. I like the definition of step one, which states “we admitted we are powerless over our addiction and that our lives have become unmanageable.” This step is the membership requirement of any 12-step fellowship. We must accept that our lives are disturbed by our addiction in order to move forward with recovery. I think that the requirement of step one, admitting and accepting that we are sex addicts and surrendering to the program, is the way to achieve success in recovery. This step along with steps two and three are the building blocks of recovery. In my experience, many clients who seek residential treatment come to really embrace the first step. They transform as they understand their powerlessness over their addiction and see that if they continue with their addiction, those who are affected by their addiction also face unmanageability in their lives. It’s important to not rush the First Step. The definition of insanity is continuing to do the same thing over and over and to expect different results. Our First Step work at KeyStone helps to break this cycle with our clients. Some clients misjudge the power of their addiction and it is important that they realize they have had enough pain and are ready to accept the powerlessness over their addiction. It’s very difficult for some people who work the first step to understand that they are not “normal.” They make statements like, “why can’t I watch pornography when others can.” The first step work that we do plays an important role in a client accepting their addiction and therefore redefining “normal” in the context of that addiction.

FRANK: The First Step gives clients the groundwork for beginning their recovery. Even for those clients who have been in the recovery process before, the opportunity for them to work one on one with an inpatient counselor on the First Step gives them the chance to dig deeper and more thoroughly than they have before. This also allows clients to look more closely at the impact addiction has had upon themselves and others. Utilizing the encouragement and support of their recovery community, clients are given the rare opportunity to recreate themselves midway through life. Being able to identify and shed the expectations that others have placed on them, clients are able to replace those burdens with a new set of values and sense of self-worth.


Rory C. Reid, Ph.D., LCSW, Assistant Professor, Department of Psychiatry Research Psychologist, Neuropsychiatric Institute University of California, Los Angeles

Over 10 years ago, I had a patient show up in my office saying he had lost three jobs because he couldn’t refrain from viewing pornography at work. I was somewhat baffled by his case and agreed to see him even though I had never encountered anyone with out of control sexual behavior other than patients who were sex offenders (which he was not). I conducted a full psychological assessment of him and noted that he had difficulty with boredom, regulating his emotions, he couldn’t concentrate very well, was impulsive, and frequently felt stressed or overwhelmed with his responsibilities. Soon after, more and more of these patients began showing up in my office, so I started gathering data on them from their psychological evaluations in order to begin looking for patterns or trends that would help me have greater insight and facilitate treatment planning. Looking back, I’ve learned a lot but admit there is so much I still don’t know. That being said, here are a few observations from research I’ve published with various colleagues in scientific journals on the topic of hypersexual behavior.

Unpleasant Emotions
One of the most consistent findings across multiple studies is that hypersexual patients typically have difficulty managing their emotions — specifically negative emotions such as shame.1-6 Shame often emerges when individuals have harsh critical judgments about themselves stemming from beliefs that they are flawed, inadequate, or unimportant. To some extent, we all have moments of shame, but for hypersexual individuals, it appears these moments are frequent and persistent. Sex is then used as a coping strategy to “deal” with negative feelings and escape having to experience unpleasant emotions. But, as most patients will say, it doesn’t work and actually ends up creating more problems that in turn, intensify the shame. As I’ve traveled around to various facilities in the United States and elsewhere in the world, I’ve been impressed with how Dr. Mary Deitch and her staff at KeyStone use Schema Theory to unravel some of the stories and beliefs that activate negative emotion. This is a rather novel approach and reflects some innovative thinking on the part of KeyStone.

Managing Stress
A second finding that seems to emerge frequently in our research is that many hypersexual patients struggle to manage stress.1,7-8 Stress occurs when we perceive various life demands to outnumber our available resources. In some cases, stress occurs unnecessarily from people who entertain a lot of catastrophic thinking (they assume or expect the worst case scenario which rarely happens). For others, stress occurs because they are taking on too much and have lost balance in their lives. Sometimes people agree to do more than is humanly possible because they underestimate how much time is needed to accomplish a task — this is a constant battle for patients with ADHD.9 I’ve also observed patients who lack assertiveness and struggle to say “no” when asked to do things. When I inquire why, they often reply by saying they don’t want to disappoint others or some indicate such requests are opportunities to “please others” and receive positive compliments that they desperately crave (e.g. you’re great, wonderful, so supportive, etc…). This latter pattern has been observed in both male and female hypersexual patients.10 Collectively, these findings suggest that it is likely insufficient to simply learn stress coping strategies such as time management, regular exercise, healthy eating, sleep, and so forth. Hypersexual patients need to have clinicians that can help them assess how stress occurs in their life and reorganize beliefs that activate stress and perpetuate patterns of turning to sex to deal with stress.

Brain Research
The media and some prominent individuals in the field are starting to discuss whether hypersexual individuals might have abnormal brain activity, leading to problems in regulating their sexual behavior. I think such speculations arise because it’s hard to make sense why anyone would choose a life plagued by so many negative consequences from sex.11-12 Nevertheless, perspectives that advocate for brain disease as an explanation for hypersexual behavior contradict our research13 at UCLA and at the present time there is no research offering strong support for this position.14 Personally, I find this encouraging because it may suggest that hypersexual patients are not victims of brain pathology and therefore they are empowered to make the necessary changes in their lives that will lead to sexual health, healing, and psychological well-being.

Moving Forward
Our research team recently completed a very important study15 that examined new criteria being proposed for Hypersexual Disorder that was advanced by the American Psychiatric Association under the direction of Dr. Marty Kafka from Harvard Medical School.16 We are grateful that KeyStone, along with other clinics in the country, supported this research by allowing us to interview their patients and assess whether the proposed criteria were valid and whether they could be reliably diagnosed among mental health professions. We are also grateful to the many patients throughout the country who gave the gift of their time and were willing to share their personal experiences with us. As the field grows, we hope to continue to learn more about hypersexuality, conduct research to assess what are most effective treatments, and begin to develop preventative strategies than can help avert the onset of this problem in the lives of younger generations.

1. Reid, R. C., Carpenter, B. N., Spackman, M., Willes, D.L. (2008). Alexithymia, emotional instability, and vulnerability to stress proneness in patients seeking help for hypersexual behavior. Journal of Sex & Marital Therapy, 34(2), 133–149.
2. Reid, R. C., & Carpenter, B. N. (2009). Demoralization, hypomanic activation, and disconstraint scores on MMPI-2 scales as significant predictors of hypersexual behavior. Journal of Sexual Addiction & Compulsivity, 16(3), 173–189.
3. Reid, R. C., Harper, J. M., & Anderson, E. H. (2009). Coping strategies used by hypersexual patients to defend against the painful effects of shame. Clinical Psychology & Psychotherapy, 16(2), 125–138.
4. Reid, R. C. (2010). Differentiating emotions in sample men in treatment for hypersexual behavior. Journal of Social Work Practice in the Addictions, 10(2), 197–213.
5. Reid, R. C., Stein, J. A., & Carpenter, B. N. (2011). Understanding the roles of shame and neuroticism in a patient sample of hypersexual men. Journal of Nervous and Mental Disease, 199(4), 263–267.
6. Reid, R. C. & Cooper, E. B., Prause, N., Li, D. S., & Fong, T. W. (2012). Facets of perfectionism in a sample of hypersexual patients. Journal of Nervous and Mental Disease, 200(11), 990-995.
7. Reid, R. C. Li, D. S., Gilliland, R., Stein, J. A., & Fong, T. (2011). Reliability, validity, and psychometric development of the Pornography Consumption Inventory in a sample of hypersexual men. Journal of Sex and Marital Therapy, 37(5), 359–385.
8. Reid, R. C., Garos, S., & Carpenter, B. N. (2011). Reliability, validity, and psychometric development of the Hypersexual Behavior Inventory in an outpatient sample of men. Sexual Addiction & Compulsivity, 18(1), 30–51.
9. Reid, R. C., Carpenter, B. N., Gilliland, R., & Karim, R. (2011). Problems of self-concept in a patient sample of hypersexual men with attention-deficit disorder. Journal of Addiction Medicine, 5(2), 134–140.
10. Reid, R. C., Dhuffar, M. K., Parhami, I., & Fong, T. W. (2012). Exploring facets of personality in a patient sample of hypersexual women compared with hypersexual men. Journal of Psychiatric Practice, 18(4), 262-268.
11. Reid, R. C., Garos, S., & Fong, T. (2012). Psychometric development of the Hypersexual Behavior Consequences Scale. Journal of Behavioral Addictions, 1(3), 115-122.
12. Reid, R. C., Carpenter, B. N., Draper, E. D., & Manning, J. C. (2010). Exploring psychopathology, personality traits, and marital distress among women married to hypersexual men. Journal of Couple & Relationship Therapy, 9(3), 203-222.
13. Reid, R. C., Garos, S., Carpenter, B. N., & Coleman, E. (2011). A surprising finding related to executive control in a patient sample of hypersexual men. Journal of Sexual Medicine, 8(8), 2227–2236.
14. Reid, R.C., Carpenter, B. N., & Fong, T. W. (2011). Neuroscience research fails to support claims that excessive pornography consumption causes brain damage. Surgical Neurology International, 2:64.
15. Reid, R. C., Carpenter, B. N., Hook, J. N., Garos, S., Manning, J. C., Gilliland, R.,…Fong, T. (2012) Report of findings in a DSM-5 Field Trial for Hypersexual Disorder. Journal of Sexual Medicine, 9(11), 2868-2877.
16. Kafka, M. P. (2010). Hypersexual Disorder: A proposed diagnosis for DSM-V. Archives of Sexual Behavior, 39(2), 377-400.

4/12/2013 - 4/14/2013

  • 2 full days of workshops and group breakouts for alumni and partners of alumni
  • Sunday Brunch at the ECU

Marriott Renaissance Philadelphia Airport Hotel, 500 Stevens Drive, Philadelphia

Book your room ASAP as we have a limited number of group-rate rooms available at $115/night. Book using group code: KeyKeyA

Cost is only $100/person
More details and registration information
coming soon!

The Alumni Reunion is always a weekend full of informative presentations, close friends and a continued dedication to recovery. Alumni and their partners enjoy two full days of workshops and group breakouts with all their friends from the ECU. The weekend concludes with a Sunday Brunch at the ECU. The Alumni reunion is an extremely positive, emotional and fulfilling time for us all. To learn more about previous alumni reunions and the upcoming 2013 Reunion go to: http://www.keystonecenterecu.net/

Outpatient Program 2013

The KeyStone Center Extended Care Unit is very excited to announce our new intensive outpatient program (IOP) coming soon in 2013!

Our IOP will provide much-needed support to individuals discharging from inpatient/residential treatment programs. Many of our alumni have expressed a desire for more contact with the ECU post-discharge and we believe that our new IOP will be just the kind of step-down program they need to make the transition from the “protective bubble” of treatment to a healthy life in recovery!

Our convenient evening groups are ideal for individuals transitioning back into work and family life, and we will also be offering individual therapy as well! Groups will focus on relapse prevention, shame reduction, empathy, accountability and effective communication. We will also be offering groups designed to help clients identify and process their trauma using art therapy, experiential therapy and schema-focused therapy.

Clients will progress through a 9-week cycle, building relationships with their fellow group members and providing each other with the most important component of recovery: a trustworthy, dependable support network.

We are thrilled to have the opportunity to offer this kind of support to not only our alumni, but to qualified individuals from all the other reputable programs treating sexual addiction.

New Additions

Khaled Ashraf, MS

I’m excited to be working at the ECU. I work with a terrific group of folks that are well experienced in the field of trauma. I came to the ECU with a history working in addictions and the criminal justice field. I wanted to put all my past experiences to good use and working here at KeyStone allows me to do just that!

Crystal E. Heath, MSHSM, MSMHC

I was hired as a PRN Counselor at KeyStone Extended Care Unit (ECU) on June 15, 2012. My primary role was to provide direct patient care, monitor and deliver quality services to dually diagnosed/sexually addicted clients. While working PRN at ECU, a full-time Therapist position became available and I expressed interest in learning more about sexual addiction and compulsivity. On October 8, 2012, I was offered the full-time Therapist position.

Here are some reasons I am excited to work at ECU:
(1) the staff works together as a team,
(2) ECU is a continuous learning environment,
(3) the ability to enhance knowledge and skill set,
(4) working with a challenging population and
(5) acquiring clinical supervision.

My experience entails working in the following environments to include but not limited to special needs population, correctional facilities, education, at-risk youth and families.

Great Expectations

By KeyStone’s Family Therapists Michael Morton, MA, LMFT and Karen Martin, Family Therapist, MA

A number of years previously, the ECU had a sign in the dining room hanging above the door opening towards the kitchen. The sign read, “Expectations are premeditated disappointments.” Aside from the daily disappointments one experiences in the best of all possible worlds, the holidays and festive occasions may be especially challenging regarding the above quote. When we are struggling with addiction and recovery, these days become a critical learning opportunity in “accepting the things we cannot change and changing the things we can.”

In order to navigate the holidays, we request serenity and wisdom, two rewards of recovery and participation in the fellowship. Many in recovery may be sober but “not well.” Common co-occurring issues along with the addiction are depression and anxiety. Holy Days and holidays exacerbate one’s tendency towards projection and anticipation. These can then disrupt a sense of serenity and hence our capacity for emotional balance and making healthy decisions.

In the Twelve Steps and Twelve Traditions of Alcoholics Anonymous, Bill Wilson specifically points out the need to explore our past relationships, even before the addiction. In Step Four, he refers to our demands upon others and their retaliation in response. In Step Eight, he tells us “...defective relations with other human beings have nearly always been the immediate cause of our woes.” In simple terms people, places and things take on an added significance and power at special seasons of the year. We become more vulnerable and open to feelings and desires as the culture, family, old memories, and experiences are triggered.

We are of course ourselves, the major container of our holiday stories. The body, the mind and the soul intuitively remember and awaken us. The roots of addiction are planted within ourselves. However, we are by nature relational and thus dependent on others. In recovery, we are taught to become interdependent and that there is a “power greater than our self that can restore us to sanity.” Gratitude and participation in the fellowship are the best defenses against the possible pitfalls of expectations and disappointments during the coming season of celebration and remembrance.


In October of 2009, the Extended Care Unit began its ongoing podcast series. The series is geared towards clinicians, assistance professionals, sex addicts, family, partners and the spouses of sex addicts. We continue to add new podcasts throughout the year. To date, we address a variety of informative topics, including a multimedia presentation on our Professional Assessment Center, information regarding self care, defining sex addiction and a discussion on healthy sexuality and intimacy. We invite you to join us online for this online series at News & Events or just go online and click on the “Presentations & Media” link. Do you have a topic that you would like to hear discussed? If you have any suggestions for future podcasts, we would love to hear them! Please email your suggestions to Steven Bocchinfuso at: steven.bocchinfuso@uhsinc.com.

Some Recent Additions to Our Podcast Series Include…

Alumni Reunion Presentations: We are all looking forward to the upcoming 2013 Alumni Reunion! KeyStone would like to thank everyone that attended last year’s Alumni Reunion and to extend a special thanks to all our guest presenters. Perhaps you attended and would like to review some of your favorite presentations. Maybe you could not make it and wish you could listen in on some of the presentations. Well you now have access to a collection of video and audio podcasts from our 2012 Alumni Reunion presentations! Please visit the alumni reunion web page to view a presentation synopsis, learn more about past Alumni Reunions, download PowerPoint presentations, video and more. You can access our Alumni Reunion podcasts here:


Alumni Tell Their Stories of Recovery: Listen to our alumni share their stories of recovery. This is a great resource to share with your clients and peers! The KeyStone Center ECU invites you to listen to our ongoing Alumni Podcast series online. In this series, we sit down with a collection of our alumni and have them tell their stories of recovery in their own words. The result is a compelling group of individual stories that dive into the depths of struggling with Sex Addiction, exemplify the power of recovery, and prove to those seeking treatment that they are not alone. Visit this powerful alumni podcast series here:


The KeyStone Center ECU recognizes how important and valuable it is to collaborate with local resources. This ongoing Case Conference Series is a forum in which you can discuss your cases with your peers and help everyone to serve our area’s collective client population in the best way possible. If you would like to attend, have a case discussion in mind or want more information on how to present case conference materials, please contact Dr. Mary Deitch (mary.deitch@uhsinc.com) or Steven Bocchinfuso (steven.bocchinfuso@uhsinc.com) to register your free attendance.

Keystone Outpatient Conference Center
5000 Hilltop Drive, Brookhaven, PA 19015

More Information:
View full details and upcoming event dates on our News & Events page here:


The ECU newsletter is distributed to outside clinicians, alumni, potential admissions and all those curious about sex addiction. If you are reading this newsletter, you are eligible to write your own story or article. Interested in sharing something in our next newsletter? We would love to hear from you! Please contact us at 1-800-733-6840 or email Steven Bocchinfuso at: steven.bocchinfuso@uhsinc.com

Copyright © 2012 by KeyStone Center Extended Care Unit (ECU)  All rights reserved


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