The Role of Empathy in Healing from Sex Addiction: An Interview with Carol Juergensen Sheets

By: Robert Weiss PhD, LCSW

I have known Carol Juergensen Sheets, aka Carol the Coach, for quite some time, having appeared on her Sex Addiction podcast, as well as her Betrayal Trauma podcast, and having welcomed her as a guest on my own podcast, Sex, Love, and Addiction. Carol is a Certified Sex Addiction Therapist and coach who frequently appears on both television and radio discussing sexual addiction and related issues. She is the author of Sexual Addiction: Wisdom from the Masters, and, more recently, Help Her Heal: An Empathy Workbook for Sex Addicts to Help their Partners Heal. Her workbook on empathy prompted a recent conversation, as we share the belief that developing empathy is a major step on the pathway to healing for sexual addicts and their betrayed partners.

I found our conversation both interesting and enlightening, and I have excerpted the best bits below in Q&A format. Because our conversation was lengthy, I’ve split this post into two parts. Part 1 is a general discussion of empathy and how sex addicts can develop it. Part 2 looks at rigorous honesty, therapeutic disclosure, and things a sex addict can start doing right away to display empathy.

Q) Carol, just to get started, how do you define empathy?

Empathy is the ability to put oneself into somebody else’s shoes and understand how they feel. It’s very different than sympathy. It really is about feeling another person’s feelings and understanding that person’s situation.

Q) In my experience, men are typically not as good as women at empathy. Would you agree with that statement?

Yes, absolutely. I believe that women have an innate ability to feel empathy because they bear children. As mothers and (historically speaking) primary caregivers, they have to have the ability to form relationships right off the bat. So they’re more relationship-oriented, and to be good at relationships you have to be able to feel empathy. Basically, I believe women have been socialized to be empathetic, whereas men have not.

Q) You just said that to be good at relationships you have to be able to feel empathy. I certainly agree, but I’m curious to hear exactly how important empathy is in marriage and other romantically intimate relationships? 

I believe empathy is the primary foundation for any good relationship because it involves vulnerability, feelings, trust, and sharing. When you have those ingredients in a relationship, you’re much more likely to connect on an emotional basis. You’re much more likely to feel intimately connected. Intimacy is the ability to form a solid connection, and empathy is the way to get there.

Q) Judging from the fact that you wrote a workbook for sex addicts on developing empathy, I’m guessing you see a dearth of it, as I do, when working with sex addicts and their betrayed partners.

I do. That said, their level of empathy has not been studied, so we really don’t know much about this. Is there an inherent lack of empathy in sex addicts that contributes to the formation of their addiction, or does their addiction lead to a decrease in empathy? Are they born with an empathy deficit, is it environmental in childhood, or has their addiction robbed them of it? Whatever the answer is, you can’t be a sex addict and hold important secrets and be empathetic at the same time. It’s impossible. I do think there are some sex addicts who initially had empathy, but then they got involved in a behavior that became so compulsive that it interrupted their ability to maintain empathy. The addiction overrides empathy. But that may or may not be applicable to all sex addicts

Q) I think that most likely it’s a mix of people who never had it or never learned it, people who lost it via early-life trauma, and people who lost it via addiction. At the end of the day, to me, the cause is less important than the remedy. Which brings us to your workbook. Can you describe the steps you use to walk sex addicts through the development (or redevelopment) of empathy?

I definitely wrote the book for sex addicts rather than their betrayed partners, though a lot of partners are probably reading it. The first thing I do is walk addicts through an understanding of their own brain, to help them understand why they have a sex addiction, the dopamine hit and the other neurochemicals that are produced.

Then we talk about the betrayed partner’s brain. We talk about the fact that when she finds out she’s been betrayed, it affects her amygdala, which puts her in fight, flight, or freeze mode. And then affects the anterior cingulate, the part of the brain that helps process information. Basically, her executive functioning goes offline, and she behaves very differently than she’s ever behaved in a relationship.

When you’ve got that going on, it’s very difficult for a recovering addict to know how to proceed. They typically will either defend themselves or retreat completely.

Next, we move to feelings. With feelings, I simplify it to the top five: anger, sadness, loneliness, fear, and happiness. And then shame and guilt to the side. Those are the primary emotions that the addict feels. When the addict starts doing exercises in this book to understand what he’s feeling, he’s much more likely to be able to recognize his betrayed partner’s feelings, which is an immensely important part of developing empathy.

After the feelings section of the book we work on communication – the four styles of communication [passive; aggressive; passive-aggressive, and assertive]. And of course we teach the last style, assertiveness, because the addict needs to be clear and direct about what he thinks, feels, and wants as part of being honest and redeveloping trust and a sense of connection.

Most sex addicts find that difficult because they don’t feel like, after what they’ve done, they have a right to be assertive. They have devastated their partner and they think that because of that they don’t have the right to ask for what they need. So I spoon-feed them how to be assertive. Basically, the technique is to first recognize the betrayed partner’s pain, then state your own needs, and then remind the betrayed partner that you know you caused the pain. When you sandwich assertiveness like that, it goes much, much better.

Next, we talk about AVR, a formula I created which is Acknowledging the issue, Validating the primary feeling, and then Reassuring the betrayed partner of the changes that are being made. Of course, the only way AVR can happen is if the addict has some good sobriety. And by good sobriety, I’m not talking about the length so sobriety so much as quality. But I am saying that the addict needs at least 90 days away from his addictive behaviors.

Then we go through the ten tools that I think are imperative for recovery:

Attending Recovery Meetings

Getting a Recovery Mentor/Sponsor

Reading 12-Step Books (such as the Green Book in SAA)

Doing 12-Step Work

Participating in 12-Step Fellowship

Going to a Certified Sex Addiction Therapist

Being Part of a Sex Addiction Therapy Group

Prayer/Meditation/Journaling

Reading About Sex Addiction Separate from Treatment and 12-Step Recovery

Accountability Tools

Next, we talk about conflict. I believe that in healthy relationships, conflict is inevitable, and it breeds intimacy. It’s actually a good thing if handled correctly. So I teach sex addicts how to depersonalize the conflict, to understand their behavior is likely at the root of it, but not to take it in. I don’t want addicts to go into a shame cycle because if they do, they won’t be able to heal themselves or help their partner heal. So I teach the seven principles of depersonalizing conflict.

Lastly, we talk about techniques for developing empathy.

There are daily, weekly, monthly check-ins. We talk about reflective listening and how important it is to do that to reduce defensiveness. We talk about mirroring. All the tools that you need to rebuild a relationship and let your partner know where you are.

It’s a pretty simple book but it’s not for dummies. It’s for sex addicts who want to show their betrayed partner they care and want to help the partner heal.

The whole premise, this is my belief system, is that when the addict uses empathy to restore the relationship and the betrayed partner begins to heal, it goes full circle and they both heal. It’s a tough process, though. The addict’s arousal template takes three to five years to fully heal, and partner betrayal takes 3 to 5 years to fully heal. But the addict and the betrayed partner can work on their own issues at the same time, and they can each do certain things to help the other.