Articles on sexual addiction

What Is the Real Cause of Addiction?

Ms. Raisa Luther, Psychotherapist
Do you sometimes wonder what the actual cause of addiction is?  It’s a unique mix of risk factors and influences — genetic and environmental. It’s uncommon that merely one thing drives an individual to addiction. Instead, it’s a heady mix of nature and nurture. Here’s how these work together to create a potentially devastating condition:Nature (Genetics)1. Dopamine handlingSome people are genetically predisposed to addiction. Such individuals are born with a certain genetic make-up in their dopamine receptors that makes them ‘enjoy’ potentially addictive substances more than ‘normal’ people. This increases the risk for addiction.2. Psychological issues and self-medicationGenetics often influence indirectly. For instance, persons living with other psychiatric disorders associated with genes (such as depression, anxiety, bipolar disorder, etc.) can have a tendency to self-medicate with an addictive substance.  They feel ‘better’ with medication – this may lead to addiction. Over time, escapist self-medication can escalate to addiction. In such cases, it is not a tendency toward addiction but the propensity for an underlying vulnerability that can lead to addiction.Nurture (Environment)Apart from genetics, environmental factors also play an important role.1. Childhood traumaEarly life negative experiences, such as neglect, emotional or physical or sexual abuse, etc., can increase the risk for addictions regardless of genes.According to a study, unresolved early life (prior to 18 years) trauma can lead to later-life problems. Survivors of chronic childhood trauma are: 1.8 times as likely to smoke cigarettes1.9 times as likely to develop obesity2.4 times as likely to experience anxiety3.6 times as likely to be develop depression3.6 times as likely to be promiscuous7.2 times as likely to get into alcoholism11.1 times as likely to become a drug addict2. Early exposure to addictive substances or behaviorEarly exposure to alcohol or drugs can lead to chronic addiction. In today’s world, kids are exposed to drugs such as marijuana and alcohol at a younger age (12 – 14 years) and are vulnerable to addiction in later years. Due to Internet and the massive supply of easily accessible erotic content, children as young as 11 get their first exposure to porn. About 41 percent of existing adult sex addicts were using porn before age 12. Studies indicate that the lower the age of first use, the higher the likelihood of addiction — sexual and otherwise. The cause of addiction isn’t nature or nurture. Both can come together in a person and influence his or her behavior.Treatment is effectiveWhatever the causes, the presenting problem may be an addicted person – abusing alcohol, drugs or indulging in some other damaging behavior. Recovery requires support from professionals. Just as the causes may vary, treatment also needs to be individualized to suit the individual. Addiction therapy also involves helping the addict resolve his childhood issues.  

Top 10 Myths About Addiction You Probably Believe

Ms. Raisa Luther, Psychotherapist
Think you know about addiction? Then these common myths may sound familiar:Myth 1: Drug addiction is voluntary behaviour.  You start out occasionally using alcohol or other drugs, and that is a voluntary decision. But as times passes, something happens, and you become a compulsive drug user. Why? Because over time, continued use of addictive drugs changes your brain - in dramatic, toxic ways at times, more subtly at others, but virtually always in ways that result in compulsive and even uncontrollable drug use.Myth 2: Drug addiction is a character flaw.  Drug addiction is a brain disease. Every type of drug - from alcohol to heroin - has its own mechanism for changing how the brain functions. But regardless of the addiction, the effects on the brain are similar, ranging from changes in the molecules and cells that make up the brain to mood and memory processes - even on motor skills such as walking and talking. The drug becomes the single most powerful motivator in your life.Myth 3: You can't force someone into treatment.  Treatment does not have to be voluntary. Those coerced into treatment by the family or the legal system can be just as successful as those who enter treatment voluntarily. Sometimes they do better, as they are more likely to remain in treatment longer and to complete the program. In 1999, over half of adolescents admitted into treatment in USA were directed to do so by the criminal justice system.Myth 4: Treatment for drug addiction should be a one-shot deal. Like many other illnesses, drug addiction typically is a chronic disorder. Some people can quit drug use "cold turkey," or they can stop after receiving treatment just one time at a rehabilitation facility. But most people who abuse drugs require longer-term treatment and, in many instances, repeated treatments.Myth 5: We should strive to find a "magic bullet" to treat all forms of drug abuse.  There is no "one size fits all" form of drug treatment, much less a magic bullet that suddenly will cure addiction. Different people have different drug abuse-related problems. And they respond very differently to similar forms of treatment, even when they're abusing the same drug. As a result, drug addicts need an array of treatments and services tailored to address their unique needs. Finding an approach that is personally effective can mean trying out several different doctors or treatment centres before a "match" is found between patient and program. The 12 - Step program has proved to be the most effective treatment (WHO); a 12 - Step rehab with competent protocols to address the individual needs of clients is obviously the best bet. Myth 6: People don't need treatment. They can stop using drugs if they really want to. It is extremely hard for people addicted to drugs to achieve and maintain long-term abstinence. Research shows that when long-term drug use actually changes a person's brain function, it causes them to crave the drug even more, making it increasingly difficult to quit without effective treatment. Intervening and stopping substance abuse early is important, as children become addicted to drugs much faster than adults and risk greater physical, mental and psychological harm.Myth 7: Treatment just doesn't work. Studies show drug treatment reduces drug use by 40 to 60 percent and can significantly decrease criminal activity during and after treatment. There is also evidence that drug addiction treatment reduces the risk of infectious disease, Hepatitis C and HIV infection - intravenous-drug users who enter and stay in treatment are up to six times less likely to become infected with HIV - and improves the prospects for getting and keeping a job up to 40 percent.Myth 8: No one voluntarily seeks treatment until they hit rock bottom.  There are many things that can motivate a person to enter and complete treatment before that happens. Pressure from family members and employers, as well as personal recognition that they have a problem, can be powerful motivators. For teens, parents and school administrators are often driving forces in getting them into treatment before situations become dire.Myth 9: People can successfully finish drug abuse treatment in a couple of weeks if they're truly motivated. For treatment to have an effect, research indicates a minimum of 90 days of treatment for outpatient drug-free programs, and 21 days for short-term inpatient programs. Follow-up supervision and support are essential. In all recovery programs, the best predictor of success is the length of treatment. Patients who are treated for at least a year are more than twice as likely to remain drug free, and a recent study showed adolescents who met or exceeded the minimum treatment time were over one and a half times more likely to stay away from drugs and alcohol.Myth 10: People who continue to abuse drugs after treatment are hopeless. Completing a treatment program is merely the first step in the struggle for recovery that can last a lifetime. Drug addiction is a chronic disorder; occasional relapses do not mean failure. Psychological stress from work or family problems, social cues - meeting some from the drug-using past - or the environment - encountering streets, objects or even smells associated with drug use - can easily trigger a relapse. Addicts are most vulnerable to drug use during the few months immediately following their release from treatment. Recovery is a long process and frequently requires multiple treatment attempts before complete and consistent sobriety can be achieved.

Addiction and Personality Problems

Ms. Raisa Luther, Psychotherapist
Addiction has many faces and is much more than just repetitive using of drugs. There are many aspects surrounding the addictive individual and one of those is personality. Personality problems are an often ignored and misunderstood aspect of addiction recovery. What are personality problems? They may be simply defined as a problem in the way one interacts with people. For people with a ‘maladaptive personality’ or a personality that is not able to adapt to the environment. For such people, willpower alone is not enough to change their basic personality.Addiction and personality disorderLet us compare chemical dependency and personality disorders. In chemical dependency, the causes usually vary from drug and alcohol use, changes in brain chemistry and function to heredity. However personality problems may be triggered off by stress, threatened or real losses, childhood issues, family imbalance, changes in brain chemistry and function and heredity too.We are surrounded by a variety of personality types- shy, balanced, extrovert and many more. Each personality type is characterized by a few traits. For example to shy personality may have traits of introversion, self-centredness, isolation. To an extent these are present in everyone. But when does a trait become ‘maladaptive’? When it leads to chronic distress with friends and/or family, work or in other areas of life. Some maladaptive personality traits are – maladaptive self- centredness, maladaptive anger management, over separation and over attachment, negative thinking (depressive thinking) and so on.The problem in personality problems lies in distorted thinking. Following are some examples of distorted thinking:Black or white thinking: Since you’re a recovering addict you can’t take any medication because all medications are drugs.Over generalizing: I made one mistake and now I can’t do anything rightCatastrophising: The doctor has called me and I probably have cancerJumping to conclusions: She didn’t look at me when I waved at her from across the street so she hates me.Personality in addiction treatmentHow do we deal with personality problems in the purview of addiction? In addiction counseling, therapists focus on helping the individuals identify and work through their feelings of shame. Using the AA slogan “silence is the enemy of recovery” one needs to reach out to others and talk about the shame.Counselling for personality problems often focuses on thoughts, feelings and interpersonal skills. The first step is to acknowledge that there is a personality problem. This is akin to breaking through denial in chemical dependency. Then self-centred thinking, shame reactions need to be changed along with evaluating a need for taking medication.Although change is slow and not always easy, it is a rewarding endeavor that will enhance the quality of your recovery. 

Kids - Are They Really Affected by Parents' Addiction?

Ms. Raisa Luther, Psychotherapist
In our experience, parents usually think that their addiction has not really impacted their children in any significant way. Also, in our experience, this is not true – actually believing in the lie that the child is not affected by addiction in a family, is part of the addictive denial.Addicts' children are most affectedKids are highly sensitive, their growth process is dependent on it. They feel, taste, absorb and internalize what’s around them, including the toxic soup of addiction. Kids love their parents. Since they sense that the parents are not in control, they begin to take ownership of the problem believing it’s their fault. Shame, blame and guilt rule in addicted households. And addiction is cunning: the desperate and repeated attempts by family members to ‘fix’ the problems are doomed to fail, over and over again.A simple yet powerful exercise we use at Hope Trust’s Family Support Program to help children is we ask them to write a letter to addiction, not to the parent(s). Children share this letter with parents and it’s often the first time parents understand how damaging addiction has been in the lives of their most cherished ones.Children are explained that addiction is a disease and their addicted parent is not bad, but sick. Surprisingly, children accept this fact readily and are on the path to recovery themselves by forgiving the huge ‘betrayals’ by the parent. A rehab is a place to heal, not a punishment – this they can actually see and feel as they visit their parent and also interact with other members. They can sense the sincerity and genuine help being extended by the professional yet friendly counsellors at Hope Trust. They begin to understand that recovery is the gift of freedom, not a label suggesting you’re broken or faulty.And they discover the joy of having their parents back in the family – a truly priceless gift!

Sexual Response Cycle in Males

Dr. Ramesh Maheshwari, Sexologist
Men and woman, with some sexually arousing stimulus, proceed through orgasm and end with a return of the body to a sexually unstimulated state. This is described in four stages: Excitement, Plateau, Orgasm, and Resolution. There is no sharply defined moments when one stage ends and the next begins. Each phase merges with the next phase.ExcitementMen: Erection of penis, marked increase in its size, and a rise in its angle. Erection may be triggered by penis itself or by sexually stimulating sight, smell or thought. It occurs in 3 to 8 seconds.A small penis may double in length, while in a large penis lengthening is less marked.Partial elevation and increase in the size of testes.Plateau Full erection of penis. Increase in size and full elevation of testes. Little secretion from Cowper’s glands appears at the Urethral meatus.OrgasmOrgasm occurs in two distinct stages. In the first stage the Vas deferens, the prostate and Seminal vesicles begin a series of contractions that forces semen into the bulb of the urethra. The man experiences a sensation of ‘Ejaculatory inevitability –the feeling of having reached brink of control. At this point ejaculation cannot be stopped. In the second stage of orgasm contraction of urethra and penis combined with contraction in the prostate to cause ejaculation (spurting of semen out of tip of penis). During ejaculation the neck of the urinary bladder is tightly shut to avoid any mixture of semen and urine. The rhythmic contractions of prostate, the perineal muscles and the penis occur initially at 0.8 seconds intervals.Male orgasm and ejaculation are not one and the same process. Although the two occur simultaneously, orgasm refers to muscular contraction and release of sexual tension, while ejaculation refers to the release of semen. Orgasm without ejaculation is common in boy before puberty.ResolutionMan is not able to have multiple orgasms. Immediately after the ejaculation man enters a ‘refractory period’ during which further orgasm or ejaculation is impossible. Usually the erection subsides quickly. There is grate variability in the duration of refractory period. It may last from few minutes to many hours. This period gets longer with each repeated ejaculation. As the man gets older, the refractory period gets longer. The period of return to the unaroused state is called the ‘resolution phase’. The anatomical and physiological changes that occurred during excitement and the plateau phase reverse. Blood is pumped out of penis and therefore loss of erection. The testes decrease in size and descend in scrotum.

Psychology of Sexual Response

Dr. Ramesh Maheshwari, Sexologist
One of the qualities of human being is its capacity to be modified by its experience. The process is known as learning & conditioning. Most of the aspects of human sexual behavior appear to be the product pf learning and conditioning. As individual may prefer a particular type of individual as sexual partner-tall/short, younger/older single /variety of partners, heterosexual /homosexual ,petting/immediate coitus, single/variety of positions.Flagellation Masochism, Transvestism and variety of fetishes appear to be the products of conditioning fortified by some other aspects of personality and by inherent capacities.So called aberrant types of behavior meaning the less usual types of conditioned responses may be disadvantageous, but they are of social concern.  The classification of behavior as normal or abnormal represents moralistic Classification rather than any scientific one. Once known as perversion was later called as Deviation and now as variation.Individuals become erotically aroused when they observe other individuals engaging in sexual activity. Most males are likely to respond quite immediately to such stimuli to come to erection and to seek the opportunity for sexual activity. These are Sympathetic Response. The restriction which the human societies place upon the public performances of sexual act arose from attempt to control the sympathetic response of the bystanders.Males are more often conditioned by their sexual experience than females. There is tremendous variation in which different individuals may be affected by psychological stimuli females differ from average males. Females masturbate without associated sexual fantasies while all males do fantasize while masturbating. Females never had sexual drams while they slept while all the males have nocturnal sex dreams. Males are erotically aroused by seeing photographs or paintings of nudes are produced primarily for consumption of males. There are no male/female nude photographs or magazines produce for consumption of females. Heterosexual males are aroused by observing females breasts, genitalia or some other part of  the females body while most of the females are not aroused by observing male genitalia. Males are inclined to initiate a sexual relationship trough genital stimulation. Most females prefer to be stimulated tactilely in various other parts of the body before the activity is concentrated on the genitalia. It is complaint of married females that the husband is interested in nothing but intercourse. On the other hand it is a constant complaint of married male that his wife will do nothing to him which means that she does not tactilely stimulate his genitalia.Many males have their sexual activities where there is some light. Male is stimulated by seeing genitalia or other parts of the body of sexual partner while females are much less attracted by observing the male partner genitalia. Females do not prefer light during their sexual activity.   Many husband fail to comprehend that their wives may need general physical stimulation before they are sufficiently aroused and aroused and want a genital union.Males are erotically stimulated by seeing pornographic literature or films, while females are not stimulated by the same. Females like to deal with general emotional situations affectional relationship and love.Wall inscriptions in public toilet provide information on extent and nature of the suppressed sexual desires of males and females sexual material on the walls of male toilet are drawings slang words phrases or genitalia. In female toilet walls the inscriptions referred to love associated names lipstick impressions or drawings of hearts; but no genital action inscriptions are observed.Many males marry so as to have an opportunity to have coitus regularly with their wife; while an average female marries to establish a home to establish a long term affect ional relationship with her spouse and to have children whose welfare becomes the prime business of her life.Average male has a greater need than for females for regular and frequent sexual outlet.It is difficult for the males to understand that females are not aroused by seeing male genitalia. Many males conclude that she is no longer in love with him. On the contrary many females feel that their husbands are vulgar or perverted because they want to display their genitalia. Difficulties develop in marital relationship because of this failure of females to understand male psychology, and of males to understand female psychology. 

10 Steps to Surmount Porn Addiction

Dr. A. V. Lohit, Sexologist
Are you addicted to pornography? Similar to many other addictions, porn can disrupt your life and lead to physical, emotional, social problems. Just imagine the time you wasted in that trash! But what is to be done? The good news is – you can triumph over your addiction. The next question is – how to do it? Here’s a step-by-step guide to help you overcome your porn addiction. Step 1: Acknowledge the problem. Do you realize that you are addicted? If you answered yes, you are already on the road to recovery. For majority of individuals, it is the most difficult thing to admit. Some think – it’s natural, others think – everyone does it. But what most forget is – it’s addictive nature wrecks havoc on personal and professional life. Step 2: Understand the cause. Addictions, to whatever it may be, are the manifestation of a much deep-rooted problem. Is a challenging work project the cause of continuous stress? Is a failed relationship the cause of continuous depression? You need to gain an insight into your own self to understand what’s messing up your life!Step 3: Identify the triggers. Do you feel like watching porn after a tiring day at work? Or, may be a tiff with your girlfriend? Or, perhaps when you are sitting idle at home and feeling bored? Certain circumstances spark off the intention to watch porn. At such times, you become prone to relapse, even if you are going strong with your resolve to stay away. Step 4: Remove your resources. Scratch and throw away the CDs and DVDs, put the magazines on the paper shredder, and place your computer in a spot frequented by others. It’s easier to stick to your resolution if you find it hard to get your hand on the stuff. But remember, your willpower is what will help you overcome your addiction. Step 5: Utilize your spare time. Boredom often leads to a little watching, which gradually eats up all your time. Don’t be idle. Why not take up the dance lessons you always wanted but never really got time for? Or perhaps you can invest your time in cooking meals for the family? Participating in team sports can also be a great way to use your leisure. Step 6: Socialize. Catching up with friends over a coffee, going to the movies with your girlfriend, taking time to visit your elderly grandparents, helping your kids with their science project, there are dozens of ways you can involve with others in a fruitful way. Why waste it on something as impersonal as pornography? Step 7: Use your imagination. Have you ever noticed how the initial excitement of watching porn soon changes to exhaustion once it’s finished? This is because the appeal is replaced with dissatisfaction. Instead of watching an aloof sexual encounter, why not focus on your own love life, and make the most of your romantic rendezvous. Step 8: Set small goals. Trying to quit at a single shot sounds perfect! But often this isn’t attainable. Don’t set a goal you are sure to fail. Remember, relapse may occur. But that isn’t the end of the world. Why not take it one step at a time? Every morning, wake up with the promise that you will refrain from porn for the day. Step 9: Assess success. Unless you are aware that you are on your way to achieve your resolve, you won’t feel happy. Take a pen and mark each day that you haven’t watched porn on the calendar. Place it where you can see it often. This will boost your morale and keep you on the track of giving up your addiction. Step 10: Talk to someone. If you are unable to give it up on your own, however hard you try, it’s best to get professional help. Talk to your doctor or a psychologist about your addiction. You can also open up to a religious teacher. Often times, they have dealt with such problems, and can help and support you to give it up. Don’t panic; it’s an addiction you can get rid of. Just pay attention to what you need to do.

Sexual Problems in Men

Dr. Rahman, Sexologist
Sexual problems in menFortunately, most sexual problems are treatable, so it is important to share your concerns with your partner and doctor.What causes sexual problems?Sexual dysfunction can be a result of a physical or psychological problem.Physical causes: Many physical and/or medical conditions can cause problems with sexual function. These conditions include diabetes, heart and vascular ( blood vessel) disease, neurological disorders, hormonal imbalances, chronic diseases such as kidney or liver failure, and alcoholism and drug abuse. In addition, the side effects of certain medicines, including some antidepressant medication, can affect sexual desire and function.Psychological causes: These include work-related stress and anxiety, concern about sexual performance, marital or relationship problems, depression, feelings of guilt, and the effects of a past sexual trauma.Who is affected by sexual problems?Both men and women are affected by sexual problems. Sexual problems occur in adults of all ages. Among those commonly affected are those in the older population, which may be related to a decline in health associated with ageing.How do sexual problems affect men?The most common sexual problems in men are ejaculation disorders, erectile dysfunction, and inhibited sexual desire.What are ejaculation disorders?There are different types of ejaculation disorders, including:Premature ejaculation -- This refers to ejaculation that occurs before or soon after penetration.Inhibited or retarded ejaculation -- This is when ejaculation is slow to occur.Retrograde ejaculation -- This occurs when, at orgasm, the ejaculate is forced back into the bladder rather than through the urethra and out the end of the penis.In some cases, premature and inhibited ejaculation are caused by a lack of attraction for a partner, past traumatic events and psychological factors, including a strict religious background that causes the person to view sex as sinful. Premature ejaculation is often is due to nervousness over how well a man will perform during sex. Certain medications, including some anti-depressants, may affect ejaculation, as can nerve damage to the spinal cord.Retrograde ejaculation is common in males with diabetes who suffer from diabetic neuropathy (nerve damage). This is due to problems with the nerves in the bladder and the bladder neck that allow the ejaculate to flow backwards and into the bladder. In other men, retrograde ejaculation occurs after operations on the bladder neck or prostate, or after certain abdominal operations. In addition, certain medicines, particularly those used to treat mood disorders, may cause problems with ejaculation. This does not generally require treatment unless it impairs fertilityWhat is erectile dysfunction?Also known as impotence, erectile dysfunction is defined as the inability to attain and/or maintain an erection suitable for intercourse. Causes of erectile dysfunction include diseases affecting blood flow, such as atherosclerosis (narrowing of the arteries); nerve disorders; psychological factors, such as stress, depression, and performance anxiety (nervousness over his ability to sexually perform); and injury to the penis. Chronic illness, certain medications, and a condition called Peyronie's disease (scar tissue in the penis) can also cause erectile dysfunction.What is inhibited sexual desire?Inhibited desire, or loss of libido, refers to a decrease in desire for, or interest in sexual activity. Reduced libido can result from physical or psychological factors. It has been associated with low levels of the hormone testosterone. It also may be caused by psychological problems, such as anxiety and depression; medical illnesses, such as diabetes and high blood pressure; certain medications, including some anti-depressants; and relationship difficulties

3 Common (And Frustrating) Excuses Addicts Use

Ms. Raisa Luther, Psychotherapist
It is most heartbreaking to watch a loved one succumbing to alcohol and drug addiction. For the family and close friends, it is an experience full of hurt, anger, shame, guilt and fear. And when they try and help the addict, it becomes frustrating since he tries his best to avoid treatment. The alcoholic or addict will try everything in his power - and they can be really clever in giving reasons – to convince his well-wishers why he doesn’t need to go in for treatment. Though family and friends may be tempted to believe the words of their loved ones (like once again believing in promises despite many broken ones), remember that the main goal of confronting people about substance abuse issues is getting them into a treatment program.The goal should be to somehow get the addicted person into a rehab, even if he is in denial about his problem. In such a scenario, rehabs such as Hope Trust in India have effective protocols to break the addict’s denial (with family interventions) and ultimately motivate him toward meaningful recovery.So what are the 3 most common excuses an addict uses to avoid treatment? In our experience, they are:1. ‘I can stop whenever I want to.’Despite repeated trials and promises, the addict is helpless in stopping his drug or alcohol use. He may try all sorts of controlling strategies, but all of them are likely to fail. However, he still feels, and claims, he can stop whenever he wants to.This excuse falls under the category of denial.2. ‘I know someone who went to treatment and relapsed, so why should I go?’Unfortunately, the sad truth about drug and alcohol addiction is that many who attend treatment programs relapse at one point in their lives. However, what this excuse gets wrong is that relapse is not a vote against addiction treatment programs, but a testament to how difficult it is to recover from addiction.The fact is that addiction is a highly relapse prone ‘disease’. But not seeking treatment is like saying “I know many who have taken treatment for heart disease, but still have suffered a heart attack”.Many experts believe that relapse is a natural part of the recovery process, and that people who recommit themselves to their sobriety after a relapse event are even more successful at living healthy lives than ever before. (Hope Trust’s statistics validate this). After all, just because something like addiction treatment is difficult does not mean that it is not worth doing. There are many who have undergone addiction treatment successfully and are leading happy, successful lives because of it. We need to look at the positive potential, not the negative possibilities. But then, an addict does develop a negative outlook and uses it to avoid treatment.3. ‘All my friends do drugs and drink alcohol. What am I going to do after addiction treatment?’This is a common and a genuine fear. An addict has come to believe that substance abuse and ‘fun’ are inter-related. He cannot imagine a life without alcohol or drugs. And his current social circle comprises only persons who similarly use alcohol and drugs and life without these ‘friends’ is unthinkable. This is one of the most difficult excuses to address, because people may have genuine feelings of companionship with those who they have drank or done drugs with. These friends know the struggles of addiction in intimate detail, and people may be reluctant to give them up so easily. Recovery means discovering new games to play, new playgrounds and new game mates. While in rehab, the addict begins to discover the sheer pleasure of staying clean – getting natural sleep with aid of drugs, tasting food as it should, laughing, sharing…and as they progress in recovery and other things in life begin to get settle down and get better (relationships, career, finances, respect in community, joy of service, etc) they begin to realize the true worth of sobriety and get further motivated.