Talking Sex Rehab With Jill Vermeire – Episode 4

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Licensed marriage and family therapist Jill Vermeire was on hand during the filming of Sex Rehab with Dr. Drew, bringing her clinical expertise to the world of reality TV. She’s agreed to lend us her perspective on the show’s shoot, as well as the rehabilitation of the cast. Below, Jill talks about the show’s fourth episode: withdrawal, the amount of time the patients are asked to refrain from masturbation, Kari Ann’s “disrespectful” (according to Phil) wardrobe, and art therapy.

The episode opens on the patients struggling with withdrawal. Can you talk about how the concept of withdrawal pertains to sex addiction versus drug addiction?

Sex addiction is a behavior addiction, as opposed to a chemical addiction. With drugs and alcohol, you’re going to see the withdrawal pretty quickly after you remove the drug because the body is chemically and physically dependent on it. With sex addiction, when you remove the drug–whether it’s masturbation, pornography, acting out with other people–it’s not as immediate of an effect, because the brain chemistry isn’t addicted to the chemicals, it’s addicted to the behavior and the emotional and psychological components of it. It takes a little bit longer for withdrawal to set in. Patients can still exist for a while just on what we call “euphoric recall,” and the high of their last acting out, which does produce the chemical oxytocin in the brain. The effects of oxytocin and dopamine and serotonin start to wear off days to weeks after the last major release when they’re related to the addiction. You’re not going to see the withdrawal effects until at least a week after the last acting out or hit.

Besides the fact that they’re talking about it a lot and that you can note the jitteriness of their behavior, how can you be sure that the patients are not masturbating?

The truth is that we can’t. It’s based really on an honor system, and how committed they are to their recovery. Just like in real life with my real life patients every day in my practice, I check in with them at the beginning of every session about their time sober. It’s really up to them and how much integrity they want to bring to their recovery as to whether they’re honest about what they’ve done. If you create am environment where it’s not shaming, and if they’re able to start to trust you and trust the process, they’re going to be more willing and more likely to be honest and forthcoming with their behaviors and whether they’ve acted out. We also had the night lights in their rooms, so if one of the producers or night people had seen something, we would have heard about it.

I know it probably varies from person to person, but how long do you usually tell them to refrain from masturbating?

Thirty days.

What’s the philosophy there?

It’s just a good number. It’s one month, it gets them into their withdrawal, and then you get to start to see what the feelings are underneath the acting out. If chronic masturbation is part of their sex addiction, then it means they’re using it to numb out, check out and avoid feelings. They’re using it to deal with uncomfortable feelings or things they can’t tolerate. When you take away the coping mechanism, you’re going to see what it is they’re trying to medicate. There are plenty of people who can masturbate in a healthy way, and I have plenty of patients who don’t masturbate at all. I have plenty of patients who have acted out sexually, but have never touched themselves. They think that their private parts are gross, you know? This is a spectrum disorder. It’s not black and white, and nobody falls into one specific category. You really have to decide on an individual, case-by-case basis what is included in their addiction, and what needs to be eliminated for a while so you can allow the underlying feelings and issues to come up. It’s the same thing as removing cocaine, alcohol, or any other drug: if you allow them to keep using the drug, you’re never going to see what’s really going on underneath it. It’s not until you take away that coping mechanism that you really see what the underlying issues are.

Do you have any thoughts on Kendra refusing to participate in group because Kari-Ann was there?

Kendra had shut down at this point. I really think what was going on was that she grew up in a very chaotic environment. Her mother was very unstable, and I think Kari-Ann really brought up a lot of that for her. I think Kari-Ann really represented specifically her mother, but probably some other women in her life that were unstable and not safe. And Kendra learned to deal with it growing up by shutting off the feelings, shutting down and putting up the wall and becoming very guarded. Through this, we got to see how Kendra dealt with it in her past, and how she currently deals with it. That’s the awesome thing about the group treatment process: when you have a lot of people, each individual person will remind somebody of something else in their life, or someone else from their life. So it’s going to trigger old behaviors and defense mechanisms and survival techniques. And then we get to really see what happens out in the world for this person.

Phil also is affected by Kari Ann, specifically her wardrobe choices. He calls them “disrespectful.” Do you agree?

That was Kari Ann finding any way she can to act out. Women, especially female sex addicts, use clothing as part of their acting out behavior. I became the fashion police. On a daily basis, several times a day, I was having some of the women go back and change, or hike up their pants, or cover up. And some of the women, Amber for example, really honestly don’t understand how provocative their clothing is. There were time when I would ask Amber to cover up, and she would look at me in bewilderment: “What? This is revealing?” It was like relearning how to be a woman of grace and integrity, which is a term I use with all of my clients. This doesn’t mean that you have to wear a potato sack. It doesn’t mean you have to be mummified. You want to dress in a way that you feel great about yourself, but you’re not getting a hit. They can have attractive and sexy outfits that flatter their bodies and speak to who they are and their personalities, but Kari-Ann is a great, great, great example of using her clothing to get a hit. Whether she identifies that or not, or has the insight or not, she was finding ways, since we took away a lot of her “drugs”–her sex toys, her masturbation, sex with men, and seduction–that was her way of still being able to feel high. And it was really frustrating, and it was something that I commend the boys for being so tolerant of. Phil got very, very upset because it was right there in his face, and he was in withdrawal so he was extremely agitated because he was so uncomfortable. His skin was crawling. It was almost like having a cocaine addict in withdrawal, and having a pile of cocaine sitting in front of them.

Any thoughts on the art therapy?

The art therapy was amazing for some of the patients, because it really helped them get a lot of their feelings out in a form other than talking. One of the defense mechanisms that a lot of people will develop is that they will shut down verbally. They’ll almost go into a pre-verbal state of mind when confronted with their trauma, which means they actually shut down to the point where they really can’t find the words. Especially if the trauma happened to them early in childhood, they’ll resort back to that developmental age they were at in their brain, because that’s where that trauma is stuck, in that developmental part of their brain. If someone has that kind of experience, art therapy can be amazing. I’ve seen amazing results from people who aren’t responding to just talk therapy. You give them some crayons, you give them some paints, you give them clay, and they’re able to really show you through their art what is going on for them, and the feelings that they couldn’t find the words for. So, I was thrilled with the art therapy. We had some amazing experiences with some of the patients. Phil had a really cathartic experience. Duncan had a great experience. [So did] Nicole. Kendra completely shut down, because it brought up the violence from her past, which she couldn’t tolerate. You almost see her go into a very small child-like state of mind. I get chills just talking about it, because it’s so moving. You don’t see Kendra who she is now — you see this little girl show up. It’s this terrified child, who has all of this violence going on around her, and just covering her face, and almost going to curl up into a fetal position. It’s really moving.

Check out some screen shots from the episode in the gallery below:

View Photo Gallery

Learn more about Jill and sex addiction at her website, and follow her on Twitter.

Related content
Sex Rehab with Dr. Drew show page
Sex Rehab with Dr. Drew videos and extras

  1. Rod says:

    Why are the patients on Sex Rehab and Celebrity Rehab allowed to have tobacco and/or caffiene addictions?

  2. Rich Juzwiak says:

    Drew answered that question in this interview:

    http://blog.vh1.com/2008-11-27/examining-rehab-2-with-dr-drew-episode-6/

  3. Doreen says:

    My heart goes out to those in this program. I am a 51 year woman who sees a beautiful soul in them, and for some reason Amber has become my favorite. I don’t understand where in the process Kari Ann and James are at now, but hopefully it will come to light as the weeks go by. They are extremely brave people. and I truly hope they all recover and become whole. My 17 year old and I watch and talk about the program. The last couple of years we watched Dr. Drew’s show and Sober House. Thank you for caring for others. I hope they realize there are people who do care about them even though they might not know them.

  4. brandy says:

    I have trouble sleeping so i usually put what I call “mindless ” stuff on so I can fall asleep and this episode tugged at me and I found myself sobbing watching jennifer and amber with their pain . I can share such empathy with them, I find Amber to be such a wonderful kind spirit and I think that is why people care so much for her , her heart is in the right place . Jennifer wants to get help and do the right thing and that makes me love her and want the best for her. I sound so silly like I know these women, I might not know them personally but I know their pain personally … I guess I should stop rambling

  5. shelley says:

    there is such a plethora of sexuality imbedded in our entire culture that it is no surprise that addicts appear in this guise. Same with booze. It is as though the diseased culture dresses up to please those that are not exactly choosing this behavior. Our culture and the behavior chooses them.

    It is sad; I cannot imagine any of these people actually being “in recovery” after the show. It’s back to the real world that obsesses about sex and booze. That is not something that can be erased.

    What can they do? Live underneath a rock. All this “work” and look out the window.

  6. Evelyn H says:

    I am inclined to sympathize more with Kari Ann than Kendra. Maybe because I, though not an addict, am NOT a morning person. I find that ones who are, do not understand we non-larks.
    I. for one, am much more interested in Kendra’s obsession with Kari Ann. To me it is a negative imposition upon the group. All of the gossip she perpetrates makes me much more sympathetic to Kari Ann and does nothing other than distract Kendra and all the gossip participants from focussing on their own issues recovery. I think that is the subconscious intent; to find a scapegoat.

  7. Ms Bacon says:

    Honestly, the blatant disrespect that spews from Kari Ann’s mouth makes me sick to my stomach. I would never DREAM of speaking to people the way she does and cannot begin to imagine what’s going on in her head when she pulls her shenanigans. It’s so frusterating to watch her behavior through a television, so goodness knows what it was like dealing with her in person.

    From listening to Howard Stern I learned from Dr Drew that she got into an altercation with staff and all involved were asked to leave the show. It’s very easy to see how anyone could lose patience with her! When she was on Howard herself, she played the victim still and blamed everything on other people.

    This girl is a lost cause and needs to grow up!

  8. Venus says:

    I’m disappointed that the person doing “art therapy” was a clinical psychologist. Art therapy is a new field that has been struggling to get recognition. This could have been a good opportunity for art therapy to get the word out about art therapy. It has so many benefits, when it’s done with professional trained in art therapy. I wonder if there was not one in the area or not willing to be on camera.

  9. Venus says:

    About Keri Anne, I think it’s a good idea to think about what it’s like to be in her head. I’m not saying to sympathize or to understand her. I’m saying to think about the thoughts a person like that has in their heads, in their emotions and what type of things are motivating behaviors like that.

    IMO, her behaviors are annoying and they’re meant to be. They’re also meant to be a wall. It’s unfortunate that she’s not ready to be in therapy but seems like there’s an inkling that she might need help eventually.

  10. Elizabeth says:

    A message for Amber -
    Hi, I understand the psychological factors that got you to a place where you think you are unattractive (unloveable, unworthy), and yet you know people respond to your physical beauty. I hope you are accepting of your other gifts – of intelligence, articulation, and compassion – you seem to be. So I just want to offer a word of encouragement in your struggles and appreciation for the bravery you have already shown. You’ve heard I’m sure that courage is being afraid and doing it anyway? And, I find you to be a striking beauty! I am a straight woman (happily married, 2 children) who was a makeup artist for Chanel, Lancome, etc. at one time. You actually have noble, even regal, quality in your face and carriage that is not diminished by your melancholy. Think of Julie Christie, Saffron Burrows, Cate Blanchett, Ava Gardner, Connie Nielsen…. and you will see what I am getting at. I hope these words from a stranger are helpful – I wish you health and happiness!

  11. Emmy says:

    I agree with Venus about having an actual Art Therapist do the “art therapy.” In fact, ethically art therapy should not be done with out one. An art therapist is trained specifically to use the art as a therapeutic process. Psychologists are great, but do not have the knowledge base of artistic media/medium and a whole host of other skills needed to properly conduct art therapy sessions. Please call it “art in therapy,” or “art as therapy” if you do not use actual Art Therapists.

  12. cara says:

    this is in response to an episode i just watched on much more music, don’t know which one.

    I think the colored lady is not compatible to that girl. it seems like having such a varied group of people on the show, especially the british fellow who is very well worded an collected make her look like a flake. she should be discharged and come in more prepared. not sure why she didnt. i am sure she has already been humiliated since the show is probly over in real time.
    I dont think i its about drugs. things in her life are obstructing her recovery. i have been there i am 26 years old and i dont like to see the way shes being treated. although she is difficult it is a result of unfinished things and the way she is being handled

  13. Linda says:

    I don’t understand why the staff doesn’t tell Kendra to STOP already. She keeps talking about being attacked by KariAnn. Seems to me shes the one that started this whole beef by attacking her first in group. I didn’t at first care for KariAnn but she has now stopped being so ~~!^`^(#@&*+~_$%& y (so far) and never says anything to Kendra. She just gets up and walks away. Kendra is just mad that people are starting to like KariAnn. If it is not helping her therapy to be there then go home. KariAnn has now tried to get involved with group and others. Just not Kendra. Kendra comes off as a whining b—- who is trying to turn the whole house against one person and gets mad when it doesn’t work. Dr. Drew seems sometimes like hes afraid to say anything to them. Or maybe he was just speachless with some of KariAnns comments. LOL Still love you Dr. Drew

  14. Tina says:

    I really hope everyone in the group get their lives together. I believe they all are good people that have made bad decisions in their lives. I have to mention Kari ann, I believe she is their for publicity. I believe her manager told her to act like a a** to get camera time. I almost belive the things she said about her being rape and the other stuff is not 100% true. I really do not belive anything that comes out of her mouth. The thing that really stood out to me was when Kari was on the phone talking to her manager and he told her she needs to stay there for her career. I as so glad the pretty black woman call her out on her crap.

  15. Ana says:

    This show is the best show on TV! I was profoundly helped by Duncan’s issues while he talked to the psychiatrist. I too have been bonded to my trauma and have acted out at times to hurt my inner child all over again. This information was BRILLIANT! I love Duncan, and I wish we were best friends. I love his personality and his humor. I love Amber also and I am so thankful that she came on this show. I hope she forms a relationship with that rocker guy on the show who has a huge crush on her. The only thing I don’t like about this seasons show is all the idiot staff. That guy telling Duncan he didn’t understand his feelings because he’s not gay is an idiot. That black lady who pulled Kari Ann’s hair should be fired or should be working behind a desk.

  16. Nancy says:

    Why are they in white suits with googles?

  17. Arizona Fans says:

    We appreciate that Dr. Drew has brought this topic to the masses but the Reality needs to focus more on the REAL work that is done in session with Jill not just the super hyper client’s reactions. The world now needs to see what happens in a session not just the smoking and complaining after hours. If these clients were on site full time what went on that may not have been good TV drama but was really helpful therapy???

  18. Tee says:

    Bottom line: Keri Anne is wasting everyone’s time, including her own. With any addict, there has to be a certain level of desire to change when they enter a therapeutic environment, and her constant combative attitude proves that she isn’t ready to do what it takes to change.

    One-on-one therapy would probably work much better for her. Dr. Drew already said her emotional growth is stunted because of the abuse she experienced, and it shows constantly in her adolescent behavior. I think she’s poison to everyone’s else progress. Get her out of there. If I want to see temper tantrums I’ll turn the channel to “Supernanny”.

  19. Yvonne says:

    Keri Anne is a manipulative psychotic 61t(h! She intentionally causes conflicts in the house. She constantly tests the boundaries of the rules in that house to see how far she can take before she gets a reaction. She does what she does without consequence. I can’t stand her a55. That 5h1t with her has been going on for weeks. If she had thrown something at me she would’ve had a scratch on her _#*)!`*%+*_&@^@ too.