Nicotine addiction and smoking cessation treatments give help to every smoker wanting to overcome their addiction to nicotine.

Effective Treatments for Tobacco and Nicotine Addiction

Extensive research has shown that treatments for tobacco addiction do work. Although some smokers can quit without help, many individuals need assistance in quitting. This is particularly important because smoking cessation can have immediate health benefits. For example, within 24 hours of quitting, blood pressure and chances of heart attack decrease. Long-term benefits of smoking cessation include decreased risk of stroke, lung and other cancers, and coronary heart disease. A 35-year-old man who quits smoking will, on average, increase his life expectancy by 5.1 years. 

Read more info on Dangers of Nicotine.

Nicotine Replacement Treatments

Nicotine replacement therapies (NRTs), such as nicotine gum and the transdermal nicotine patch, were the first pharmacological treatments approved by the Food and Drug Administration (FDA) for use in smoking cessation therapy. NRTs are used (in conjunction with behavioral support) to relieve withdrawal symptoms—they produce less severe physiological alterations than tobacco-based systems and generally provide users with lower overall nicotine levels than they receive with tobacco. An added benefit is that these forms of nicotine have little abuse potential since they do not produce the pleasurable effects of tobacco products—nor do they contain the carcinogens and gases associated with tobacco smoke. Behavioral treatments, even beyond what is recommended on packaging labels, have been shown to enhance the effectiveness of NRTs and improve long-term outcomes.

The FDA's approval of nicotine gum in 1984 marked the availability (by prescription) of the first NRT on the U.S. market. In 1996, the FDA approved Nicorette gum for over-the-counter (OTC) sales. Whereas nicotine gum provides some smokers with the desired control overdose and the ability to relieve cravings, others are unable to tolerate the taste and chewing demands. In 1991 and 1992, the FDA approved four transdermal nicotine patches, two of which became OTC products in 1996. In 1996 a nicotine nasal spray, and in 1998 a nicotine inhaler, also became available by prescription, thus meeting the needs of many additional tobacco users. All the NRT products—gum, patch, spray, and inhaler—appear to be equally effective.

Additional Medications to Treat Tobacco Addiction

Although the major focus of pharmacological treatments for tobacco addiction has been nicotine replacement, other treatments are also being studied. For example, the antidepressant bupropion was approved by the FDA in 1997 to help people quit smoking, and is marketed as Zyban. Varenicline tartrate (Chantix) is a new medication that recently received FDA approval for smoking cessation. This medication, which acts at the sites in the brain affected by nicotine, may help people quit smoking by easing nicotine withdrawal symptoms and blocking the effects of nicotine if people resume smoking.

Several other non-nicotine medications are being investigated for the treatment of tobacco addiction, including other antidepressants and antihypertensive medication, among others. Scientists are also investigating the potential of a vaccine that targets nicotine for use in relapse prevention. The nicotine vaccine is designed to stimulate the production of antibodies that would block access of nicotine to the brain and prevent nicotine's reinforcing effects. (learn about: Effect of Nicotine on the Brain)

Behavioral Treatments to Quit Smoking

Behavioral interventions play an integral role in smoking cessation treatment, either in conjunction with medication or alone. They employ a variety of methods to assist smokers in quitting, ranging from self-help materials to individual cognitive-behavioral therapy. These interventions teach individuals to recognize high-risk smoking situations, develop alternative coping strategies, manage stress, improve problem-solving skills, as well as increase social support. Research has also shown that the more therapy is tailored to a person's situation, the greater the chances are for success.

Traditionally, behavioral approaches were developed and delivered through formal settings, such as smoking-cessation clinics and community and public health settings. Over the past decade, however, researchers have been adapting these approaches for mail, telephone, and Internet formats, which can be more acceptable and accessible to smokers who are trying to quit. In 2004, the U.S. Department of Health and Human Services (HHS) established a national toll-free number, 800-QUIT-NOW (800-784-8669), to serve as a single access point for smokers seeking information and assistance in quitting. Callers to the number are routed to their state's smoking cessation quitline or, in states that have not established quitlines, to one maintained by the National Cancer Institute. In addition, a new HHS Web site (www.smokefree.gov) offers online advice and downloadable information to make cessation easier.

Quitting smoking can be difficult. While people can be helped during the time an intervention is delivered, most intervention programs are short-term (1-3 months). Within 6 months, 75-80 percent of people who try to quit smoking relapse. Research has now shown that extending treatment beyond the typical duration of a smoking cessation program can produce quit rates as high as 50 percent at 1 year.

Learn more about Nicotine Withdrawal.

Sources:

• U.S. Department of Health and Human Services. The Health Benefits of Smoking Cessation: A Report of the Surgeon General. Atlanta, Georgia: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 1990.
• Hall SM, Humfleet GL, Reus VI, Munoz RF, Cullen J. Extended nortriptyline and psychological treatment for cigarette smoking. Am J Psychiatry 161:2100-2107, 2004.
• U.S. Department of Health and Human Services. Reducing Tobacco Use: A Report of the Surgeon General. Atlanta, Georgia: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2000.
• Henningfield JE. Nicotine medications for smoking cessation. New Engl J Med 333:1196-1203, 1995.
• National Institute on Drug Abuse

A detailed look at nicotine addiction treatment to help you stop smoking: nicotine replacement therapies and products, medications for smoking cessation, and counseling - support groups.

Nicotine Addiction Treatment to Help You Stop Smoking

Some individuals are able to just stop smoking. For others, studies have shown that pharmacological treatment combined with behavioral treatment, including psychological support and skills training to overcome high-risk situations, results in some of the highest long-term abstinence rates. Generally, rates of relapse for smoking cessation are highest in the first few weeks and months and diminish considerably after about 3 months.

Behavioral economic studies find that alternative rewards and reinforcers can reduce cigarette use. One study found that the greatest reductions in cigarette use were achieved when smoking cost was increased in combination with the presence of alternative recreational activities.

Nicotine Replacement Therapy for Treatment of Nicotine Addiction (non-prescription)

For most people who are trying to quit smoking, nicotine replacement therapy is useful. According to one study, nicotine replacement therapy doubles your chances of quitting smoking.¹ When used properly, all forms of nicotine replacement products appear to be about equally effective. Keep in mind, however, if you are pregnant or have heart disease, nicotine replacement therapies may not be right for you. Also, it's important to remember that before starting nicotine replacement therapy, you must quit smoking entirely.

Several nicotine replacement therapies can be obtained without a prescription.

Nicotine chewing gum (Nicorette, others) is one medication approved by the Food and Drug Administration (FDA) for the treatment of nicotine dependence. Nicotine in this form acts as a nicotine replacement to help smokers quit smoking. The success rates for smoking cessation treatment with nicotine chewing gum vary considerably across studies, but evidence suggests that it is a safe means of facilitating smoking cessation if chewed according to instructions and restricted to patients who are under medical supervision.

Nicotine lozenge (Commit) is a tablet that dissolves in your mouth and, like nicotine gum, delivers nicotine through the lining of your mouth. The lozenges are also available in 2- and 4-milligram doses. The recommended dose is one lozenge every couple of hours for six weeks, then gradually increasing the intervals between lozenges over the next six weeks.

Another approach to smoking cessation is the nicotine transdermal patch (Nicoderm CQ, Nicotrol, Habitrol, others), a skin patch that delivers a relatively constant amount of nicotine to the person wearing it. A research team at the National Institute on Drug Abuse's Intramural Research Program studied the safety, mechanism of action, and abuse liability of the patch that was consequently approved by the FDA. Both nicotine gum and the nicotine patch, as well as other nicotine replacements such as sprays and inhalers, are used to help people fully quit smoking by reducing withdrawal symptoms and preventing relapse while undergoing behavioral treatment.

Prescription Nicotine Replacement Products

Nicotine nasal spray (Nicotrol NS). The nicotine in this product, sprayed directly into each nostril, is absorbed through your nasal membranes into veins, transported to your heart and then sent to your brain. It's a quicker delivery system than that of the gum or patch. It's usually prescribed for three-month periods, for a maximum of six months.

Nicotine inhaler (Nicotrol inhaler). This device is shaped something like a cigarette holder. You puff on it, and it gives off nicotine vapors in your mouth. You absorb the nicotine through the lining in your mouth, where it then enters your bloodstream and goes to your brain, relieving nicotine withdrawal symptoms.

Non-Nicotine Medication to Help with Smoking Cessation

There are other medications to help you in your efforts to quit smoking, but they should be used in conjunction with a behavior modification program.

One tool in treating tobacco and nicotine addiction is the antidepressant medication bupropion, that goes by the trade name Zyban. This is not a nicotine replacement, as are the gum and patch. Rather, this works on other areas of the brain, and its effectiveness is in helping to make nicotine craving, or thoughts about cigarette use, more controllable in people who are trying to quit. As with many medications, bupropion (Zyban) has side effects, including sleep disturbance and dry mouth. If you have a history of seizures or serious head trauma, such as a skull fracture, don't use this drug. Another antidepressant that may help is nortriptyline (Aventyl, Pamelor).

Varenicline (Chantix). This medication acts on the brain's nicotine receptors, decreasing withdrawal symptoms and reducing the feelings of pleasure you get from smoking. Potential side effects include headache, nausea, an altered sense of taste and strange dreams.

Nicotine vaccine. The nicotine conjugate vaccine (NicVax) is under investigation in clinical trials. This vaccine causes the immune system to develop antibodies to nicotine. These antibodies then catch nicotine as it enters the bloodstream and prevent the nicotine from reaching the brain, effectively blocking the effects of nicotine.

Counseling, Support Groups and Smoking Cessation Programs

Many people need help to quit smoking. A number of telephone helplines are available for people giving up nicotine, such as the National Cancer Institute's 800-QUITNOW, or 800-784-8669, and the American Cancer Society's at 800-ACS-2345, or 800-227-2345.

Your doctor may also be able to recommend local support groups or smoking cessation programs. Additionally, some people find that a form of counseling called behavior therapy can help them come up with productive ways to change the behaviors and thoughts associated with smoking.

Sources:

• Stead LF, et al. (2008). Nicotine replacement therapy for smoking cessation. Cochrane Database of Systematic Reviews (1).
• National Institute on Drug Abuse
• Mayo Clinic

Covering the different types of treatment for shopping addiction, including shopping addiction therapy, and where to get shopping addiction help.

If you or a family member have a problem with overspending or over-shopping, it's important to seek professional shopping addiction help. Getting a psychological evaluation is a good first step. (Wondering if you are a shopaholic?)

Shopping Addiction Therapy

For treatment of a shopping addiction, therapists use cognitive-behavioral therapy to help the person recognize and change their behaviors. Some compulsive shoppers may learn to limit their shopping and for the most severe patients, the therapist may recommend that someone else control their finances altogether.

It's not unusual for addicts, in general, to have co-existing psychiatric disorders, such as depression. Antidepressant medication may be considered as a treatment.

There are also 12-step programs for support, like Debtors Anonymous and Shopaholics Anonymous. And many compulsive spenders run up of tens of thousands of dollars in bills, so credit counseling is also helpful.

Behavior Changes Important Step in Shopping Addiction Treatment

In discussing shopping addiction treatment, psychiatrist, Dr. Donald Black, recommends some basic changes in behavior that will have a big impact on breaking a shopping addiction:

• Admit that you are a compulsive spender, which is half the battle
• Get rid of checkbooks and credit cards, which fuel the problem
• Don't shop by yourself because most compulsive shoppers shop alone and if you are with someone you are much less likely to be spend
• Find other meaningful ways to spend time

Terrence Shulman, head of the Shulman Center for Compulsive Theft and Spending has some additional suggestions on his website:

• Reduce temptations
• Make lists before going to the store; buy what you need only - call folks, take a trusted friend
• Wait so many hours before purchase
• Do you need this or do you just want it?
• Develop other ways to handle emotions
• Develop fun things to do
• Learn to ride through urges and preoccupations
• Develop habits in stores

And keep in mind that while behavior change is clearly crucial to treatment and recovery from a shopping addiction, so is reaching out for help.

Sources:

• Donald Black, MD, professor of psychiatry at the University of Iowa College of Medicine
• Terrence Shulman, LMSW, ACSW, The Shulman Center for Compulsive Theft and Spending

Tobacco facts show inhalation of nicotine via cigarette smoking produces the most rapid delivery of nicotine to the brain, with drug levels peaking within a few seconds of inhalation.

Tobacco Facts: How Cigarettes, Tobacco Products Suck You In

There are more than 4,000 chemicals found in the smoke of tobacco products. Of these, tobacco facts show nicotine, first identified in the early 1800s, is the primary reinforcing component of tobacco that acts on the brain. This is the key to becoming addicted to cigarettes.

Cigarette smoking is the most popular method of using tobacco; however, there has also been a recent increase in the sale and consumption of smokeless tobacco products, such as snuff and chewing tobacco. These smokeless products also contain nicotine, as well as many toxic chemicals.

Tobacco is Addictive, Cigarette Addiction is Only A Matter of Time

The cigarette is a very efficient and highly engineered drug delivery system. Tobacco facts reveal that by inhaling tobacco smoke, the average smoker takes in 1 to 2 mg of nicotine per cigarette. When tobacco is smoked, nicotine rapidly reaches peak levels in the bloodstream and enters the brain. A typical smoker will take 10 puffs on a cigarette over a period of 5 minutes that the cigarette is lit. Thus, a person who smokes about 1-1/2 packs (30 cigarettes) daily gets 300 "hits" of nicotine to the brain each day. It's no wonder cigarette addiction (nicotine addiction) is prevalent among smokers. In those who typically do not inhale the smoke—such as cigar and pipe smokers and smokeless tobacco users--nicotine is absorbed through the mucosal membranes and reaches peak blood levels and the brain more slowly.

More comprehensive information on The Effect of Nicotine on the Brain.

Tobacco Facts: Nicotine Adrenaline Rush

One of the well-known tobacco facts is that immediately after exposure to nicotine, there is a "kick" caused in part by the drug's stimulation of the adrenal glands and resulting discharge of epinephrine (adrenaline). The rush of adrenaline stimulates the body and causes a sudden release of glucose, as well as an increase in blood pressure, respiration, and heart rate. Nicotine also suppresses insulin output from the pancreas, which means that smokers, especially those with cigarette addiction, are always slightly hyperglycemic (i.e., they have elevated blood sugar level). The calming effect of nicotine reported by many users, especially those with cigarette addiction, is usually associated with a decline in nicotine withdrawal effects rather than direct effects of nicotine.

Sources:

• Lowinson, Joyce H., Substance Abuse: A Comprehensive Textbook, p. 390, 2005.
• National Institute on Drug Abuse
• Bornemisza P, Suciu I. Effect of cigarette smoking on the blood glucose level in normals and diabetics. Med Interne 18 :353-6, 1980.
• Federal Trade Commission. "Tar," nicotine, and carbon monoxide of the smoke of 1294 varieties of domestic cigarettes for the year 1998. Federal Trade Commission, 2000.
• Benowitz NL. Pharmacology of nicotine: addiction and therapeutics. Ann Rev Pharmacol Toxicol 36:597-613, 1996.

People who are addicted to shopping get a high from an addictive behavior like shopping. Brain chemicals kick in, making the person feel good.

No one knows what causes someone to become addicted to shopping or engage in other addictive behaviors like alcoholism, drug abuse, and gambling addiction. Evidence suggests that some people, maybe 10%-15%, have a genetic predisposition to addictive behavior. That, coupled with an environment in which the particular behavior is triggered, can result in the addiction.

Addicted to Shopping: How Your Brain Can Fool You

While the causes of addictions like shopping addiction or gambling addiction remain uncertain, why addicts continue their destructive behaviors is better understood. Some individuals get a high from shopping (or any addictive behavior) which causes the sufferer to lose control and buy many items for which they have no need. Endorphins and dopamine, naturally occurring opiate receptor sites in the brain, get switched on, and the person feels good, and if it feels good they are more likely to do it -- it's reinforced and soon they are addicted to shopping.

Compulsive shopping seems to be associated with:

• Emotional deprivation in childhood
• Inability to tolerate negative feelings, pain, loneliness, boredom, depression, fear, anger
• Need to fill an inner void - empty and longing inside
• Excitement seeking
• Approval seeking
• Perfectionism
• Genuinely impulsive and compulsive
• Need to gain control

Risks Factors for Becoming Addicted to Shopping

Marketing professor and researcher, Kent Monroe, of The University of Illinois at Urbana-Champaign, notes that "compulsive buying is an addiction that can be harmful to the individual, families, relationships. It is not just something that only afflicts low-income people.” Monroe and his colleagues found compulsive buying was linked to materialism, reduced self-esteem, depression, anxiety, and stress. People addicted to shopping had positive feelings associated with buying, and they also tended to hide purchases, return items, have more family arguments about purchases and have more maxed-out credit cards. Kent says compulsive shoppers (shopaholics) also experience higher rates of family conflicts, stress, depression and loss of self-esteem.

You can find a short shopping addiction quiz here that measures symptoms of shopping addiction.

Source:

• Shopaholics Anonymous

Shopaholics, people with a shopping addiction, take shopping to a whole different level even when they can't afford to do it.

In a Stanford University 2006 study, 17 million Americans were estimated to be shopaholics and nearly half were men. At the time of this landmark study, researchers coined the term "compulsive buying disorder". Like any addiction, the shopping addict exhibits these behaviors: loss of control, increased tolerance, negative consequences, and withdrawal symptoms such as preoccupation, denial, lying, etc.

Shopaholics: Signs and Symptoms of Shopping Addiction, Compulsive Shopping

"Shopping, done to excess, can spin out of control and lead to serious problems, eroding rather than enhancing your quality of life. The more you use shopping as an attempt to fill an inner void, manage your feelings, repair your mood, or pursue a 'perfect' image, the more likely it is that you need to take a closer look at what this behavior is costing you."

- April Lane Benson,Ph.D., compulsive shopping treatment expert and author of I Shop, Therefore I Am: Compulsive Buying and the Search for Self

On Dr. Benson's website, she lists the following symptoms of shopping addiction (compulsive shopping) for the shopaholic, shopping addict, to be aware of. If you answer yes to any of the following, you may want to consider talking to your doctor or a mental health professional for further follow-up (and bring this questionnaire with you).

Find comprehensive information about Shopping Addiction Treatment.

Frequency/ Intensity of Shopping

• Do you often go on buying binges?
• Do you find yourself spending more time and/or money buying on the Internet, in catalogs, or on the shopping channels than you want to?
• Does money burn a hole in your pocket?

Reasons Why and When

• Do you go shopping because you want to make yourself feel better?
• Do you often buy things because you think they will make you more like your ideal image?
• Do you sometimes feel that something inside of you pushes you to shop?
• Do you shop to avoid doing something else in your life?

Feelings Before, During and After

• Do you go on buying binges when you're lonely, anxious, disappointed, depressed, or angry?
• Do you feel "high" when you go on a buying binge?
• Do you feel anxious, guilty, or ashamed after you go on a buying binge?

More Symptoms of Compulsive Shopping

Impulsive/Compulsive/Addictive Aspects

• Do you buy things even though you don't need or can't afford them?
• Do you ever feel on edge, agitated, or irritable when you haven't been able to buy something?
• Have you tried to stop overshopping but been unable to?

Financial Consequences

• Do you find yourself making more and more use of credit acquiring more cards, increasing your credit limit, etc.?
• Have any of your purchases ever resulted in problems with your bank or legal problems?
• Do you worry about your spending habits but still go out and shop and spend money?

Other Consequences

• Are your relationships with family and friends suffering because of your buying?
• Has the craving to buy something ever caused you to miss a social engagement?
• Has your job performance been suffering because of your buying?

Denial, Avoidance and Shame

• Do you hide your purchases and shopping trips from family or friends?
• Are you not opening your mail or answering your phone because you don't want to face the consequences of your buying?
• Do you not know, or not want to admit, how much you shop?

You can find a short shopping addiction quiz here that measures symptoms of shopping addiction.

In-depth information on compulsive shopping aka over-shopping or shopping addiction; including causes, symptoms and treatment.

Compulsive shopping or over-shopping is similar to other addictive behaviors and has some of the same characteristics as problem drinking (alcoholism), gambling addiction and overeating addictions. And while shopping addiction is not a recognized mental health or medical disorder, many mental health professionals believe it should be.

"People who 'shop till they drop' and run their credit cards up to the limit often have a shopping addiction," says Ruth Engs, EdD, a professor of applied health science at Indiana University. "They believe that if they shop they will feel better. Compulsive shopping and spending generally make a person feel worse."

A 2006 Stanford University study concluded that compulsive overspending or over-shopping is a legitimate disorder that affects approximately 6% (17,000,000) of the U.S. population and that men and women suffer about equally.

What is Shopping Addiction, Compulsive Shopping or Over-Shopping?

"We all shop for many reasons," says shopping addiction expert Terrence Shulman, LMSW, ACSW, "but the addict buys to relieve anxiety and over time the buying creates a dysfunctional lifestyle and more-and-more of their focus is on shopping and sometimes the cover-up too."

Donald Black, MD, professor of psychiatry at the University of Iowa College of Medicine describes it like this: "Compulsive shopping and spending are defined as inappropriate, excessive, and out of control. Like other addictions, it basically has to do with impulsiveness and lack of control over one's impulses."

Shopaholics (as they are sometimes referred to) when they are feeling "out of sorts" shop for a "pick-me-up." They go out and buy, to get a high, or get a "rush" just like a drug or alcohol addict.

The People Who Engage in Over-Shopping, Compulsive Shopping Behavior

According to Engs, shopping addiction or over-shopping tends to affect more women than men. They often buy things they do not need.

Holiday seasons can trigger shopping binges among those who are not compulsive the rest of the year. Many shopping addicts go on binges all year long and may be compulsive about buying certain items, such as shoes, kitchen items or clothing; some will buy anything.

Engs says that women with this compulsive disorder often have racks of clothes and possessions with the price tags still attached which have never been used. "They will go to a shopping mall with the intention of buying one or two items and come home with bags and bags of purchases."

In some cases, shopaholics have an emotional "blackout" and do not remember even buying the articles. If their family or friends begin to complain about their purchases, they will often hide the things they buy. They are often in denial about the problem.

Because they can not pay their bills, their credit rating suffers. They have collection agencies attempting to get what is owed and may have legal, social and relationship problems. Shopaholics may attempt to hide their problem by taking on an extra job to pay for bills.

And while some people joke about it, for those sufferers, family members and friends affected, shopping addiction is no laughing matter.

Read more information about Shopping Addiction Treatment.

Sources:

• Prof. Ruth Engs, RN, EdD, Indiana University, Department of Applied Health Science
• Donald Black, MD, professor of psychiatry at the University of Iowa College of Medicine
• Terrence Shulman, LMSW, ACSW, The Shulman Center for Compulsive Theft and Spending

You can find a short shopping addiction quiz here that measures symptoms of shopping addiction.

How do you build a healthy relationship? Here are the steps to building and maintaining a good relationship as well as pitfalls that can harm a relationship.

The Beginning Stages of a Relationship

While the early months of a relationship can feel effortless and exciting, successful long-term relationships involve ongoing effort and compromise by both partners. Building healthy patterns early in your relationship can establish a solid foundation for the long run. When you are just starting a relationship, it is important to:

• Build. Build a foundation of appreciation and respect. Focus on all the considerate things your partner says and does. Happy couples make a point of noticing even small opportunities to say "thank you" to their partner, rather than focusing on mistakes their partner has made.
• Explore. Explore each other's interests so that you have a long list of things to enjoy together. Try new things together to expand mutual interests.
• Establish. Establish a pattern of apologizing if you make a mistake or hurt your partner's feelings. Saying "I'm sorry" may be hard in the moment, but it goes a long way towards healing a rift in a relationship. Your partner will trust you more if he or she knows that you will take responsibility for your words and actions.

As the Months Go By: Important Things to Recognize as Your Relationship Grows

Relationships Change. Changes in life outside your relationship will impact what you want and need from the relationship. Since change is inevitable, welcoming it as an opportunity to enhance the relationship is more fruitful than trying to keep it from happening.

Check in Periodically. Occasionally set aside time to check in with each other on changing expectations and goals. If a couple ignores difficult topics for too long, their relationship is likely to drift into rocky waters without their noticing.

What to Do When Conflict Arises

Disagreements in a relationship are not only normal but, if constructively resolved, actually strengthen the relationship. It is inevitable that there will be times of sadness, tension, or outright anger between you and your partner. The source of these problems may lie in unrealistic/unreasonable demands, unexplored expectations, or unresolved issues/behaviors in one partner or in the relationship. Resolving conflicts requires honesty, a willingness to consider your partner's perspective even if you don't fully understand it, and lots of communication.

Healthy communication is critical, especially when there are important decisions regarding sex, career, marriage, and family to be made. The following are some guidelines for successful communication and conflict resolution.

• Understand Each Others' Family Patterns. Find out how conflicts were managed (or not managed) in your partner's family, and talk about how the conflict was approached (or avoided) in your own family. It is not unusual for couples to discover that their families had different ways of expressing anger and resolving differences. If your family wasn't good at communicating or resolving conflict constructively, give yourself permission to try out some new ways of handling conflict.
• Timing Counts. Contrary to previous notions, the best time to resolve a conflict may not be immediately. It is not unusual for one or both partners to need some time to cool off. This "time-out' period can help you avoid saying or doing hurtful things in the heat of the moment, and can help partners more clearly identify what changes are most important. Remember - if you are angry with your partner but don't know what you want yet, it will be nearly impossible for your partner to figure it out!
• Establish an Atmosphere of Emotional Support. Emotional support involves accepting your partner's differences and not insisting that he or she meet your needs only in the precise way that you want them met. Find out how your partner shows his or her love for you, and don't set absolute criteria that require your partner to always behave differently before you're satisfied.
• Agree to Disagree and Move On. Most couples will encounter some issues upon which they will never completely agree. Rather than continuing a cycle of repeated fights, agree to disagree and negotiate a compromise or find a way to work around the issue.
• Distinguish between things you want versus things you need from your partner. For example, for safety reasons, you might need your partner to remember to pick you up on time after dark. But calling you several times a day may really only be a "want."
• Clarify Your Messages. A clear message involves a respectful but direct expression of your wants and needs. Take some time to identify what you really want before talking to your partner. Work on being able to describe your request in clear, observable terms. For example, you might say, "I would like you to hold my hand more often" rather than the vague, "I wish you were more affectionate."
• Discuss One Thing at a Time. It can be tempting to list your concerns or grievances, but doing so will likely prolong an argument. Do your best to keep the focus on resolving one concern at a time.
• Really Listen. Being a good listener requires the following: (a) don't interrupt, (b) focus on what your partner is saying rather than on formulating your own response, and (c) check out what you heard your partner say. You might start this process with: "I think you are saying..." Or "what I understood you to say was..." This step alone can prevent misunderstandings that might otherwise develop into a fight.
• Restrain Yourself. Research has found that couples who "edit" themselves and do not say all the angry things they may be thinking are typically the happiest.
• Adopt a "Win-Win" Position. A "win-win" stance means that your goal is for the relationship, rather than for either partner, to "win" in a conflict situation. Ask yourself: "Is what I am about to say (or do) going to increase or decrease the odds that we'll work this problem out?"

Healthy and Problematic Expectations in Relationships

Each of us enters into romantic relationships with ideas about what we want based on family relationships, what we've seen in the media, and our own past relationship experiences. Holding on to unrealistic expectations can cause a relationship to be unsatisfying and to eventually fail. The following will help you to distinguish between healthy and problematic relationship expectations:

• Respect Changes. What you want from a relationship in the early months of dating may be quite different from what you want after you have been together for some time. Anticipate that both you and your partner will change over time. Feelings of love and passion change with time, as well. Respecting and valuing these changes is healthy. Love literally changes brain chemistry for the first months of a relationship. For both physiological and emotional reasons, an established relationship will have a more complex and often richer type of passion than a new relationship.
• Accept Differences. It is difficult, but healthy, to accept that there are some things about our partners that will not change over time, no matter how much we want them to. Unfortunately, there is often an expectation that our partner will change only in the ways we want. We may also hold the unrealistic expectation that our partner will never change from the way he or she is now.
• Express Wants and Needs. While it is easy to assume that your partner knows your wants and needs, this is often not the case and can be the source of much stress in relationships. A healthier approach is to directly express our needs and wishes to our partner.
• Respect Your Partner's Rights. In healthy relationships, there is respect for each partner's right to have her/his own feelings, friends, activities, and opinions. It is unrealistic to expect or demand that that he or she have the same priorities, goals, and interests as you.
• Be Prepared to "Fight Fair." Couples who view conflict as a threat to the relationship, and something to be avoided at all costs, often find that accumulated and unaddressed conflicts are the real threat. Healthy couples fight, but they "fight fair" - accepting responsibility for their part in a problem, admitting when they are wrong, and seeking compromise. Additional information about fair fighting can be found here.
• Maintain the Relationship. Most of us know that keeping a vehicle moving in the desired direction requires not only regular refueling, but also ongoing maintenance and active corrections to the steering to compensate for changes in the road. A similar situation applies to continuing relationships. While we may work hard to get the relationship started, expecting to cruise without effort or active maintenance typically leads the relationship to stall or crash! Though gifts and getaways are important, it is often the small, nonmaterial things that partners routinely do for each other that keep the relationship satisfying.

Outside Pressures on the Relationship

Differences in Background. Even partners coming from very similar cultural, religious, or economic backgrounds can benefit from discussing their expectations of how a good boyfriend, girlfriend, or spouse behaves. What seems obvious or normal to you may surprise your partner, and vice versa. If you are from different backgrounds, be aware that you may need to spend more time and energy to build your relationship. Take the time to learn about your partner's culture or religion, being careful to check out what parts of such information actually fit for your partner.

Time Together and Apart. How much time you spend together and apart is a common relationship concern. If you interpret your partner's time apart from you as, "he or she doesn't care for me as much as I care for him or her," you may be headed for trouble by jumping to conclusions. Check out with your partner what time alone means to him or her, and share your feelings about what you need from the relationship in terms of time together. Demanding what you want, regardless of your partner's needs, usually ends up driving your partner away, so work on reaching a compromise.

Your Partner's Family. For many people, families remain an important source of emotional, if not financial, support. Some people find dealing with their partner's family difficult or frustrating. It can help to take a step back and think about people's good intentions. Families may offer well-intentioned advice about your relationship or your partner. It's important that the two of you discuss and agree on how you want to respond to differing family values and support one another in the face of what can be very intense "suggestions" from family.

Friends. There are some people who seem to believe that "I have to give up all my friends unless my partner likes them as much as I do." Giving up friends is not healthy for you or the relationship, except in circumstances where your friends pressure you to participate in activities that are damaging to yourself and the relationship. At the same time, keep in mind that your partner may not enjoy your friends as much as you do. Negotiate which friends you and your partner spend time with together. You might ask: "Which of my friends do you enjoy seeing and which ones would you rather I see alone or at other times when I'm not with you?"

Eight Basic Steps to Maintaining a Good Relationship

1. Be aware of what you and your partner want for yourselves and what you want from the relationship.
2. Let one another know what your needs are.
3. Realize that your partner will not be able to meet all your needs. Some of these needs will have to be met outside of the relationship.
4. Be willing to negotiate and compromise on the things you want from one another.
5. Do not demand that a partner change to meet all your expectations. Work to accept the differences between your ideal mate and the real person you are dating.
6. Try to see things from the other's point of view. This doesn't mean that you must agree with one another all the time, but rather that both of you can understand and respect each other's differences, points of view, and separate needs.
7. Where critical differences do exist in your expectations, needs, or opinions, try to work honestly and sincerely to negotiate. Seek professional help early rather than waiting until the situation becomes critical.
8. Do your best to treat your partner in a way that says, "I love you and trust you, and I want to work this out."

Relationship Issues and Counseling

If you are feeling distressed about a relationship, you may wish to consider individual or couples counseling. Counseling can help you identify problematic patterns in your current relationship and teach you more effective ways of relating.

Reading List

• The Communication Skills Book by Fanning, Patrick, Matthew McKay & Martha Davis New Harbinger, (1995)
• The Seven Principles for Making Marriage Work by Gottman, John M. & Nan Silver Three Rivers Press, (2000)

About this Content

This article is based on an audiotape script originally developed by The University of Texas at Austin Counseling and Mental Health Center.

Sexual addiction (sexual compulsion) is an overwhelming desire to have sex. Do you have a problem with sexual addiction? Take our online sexual addiction screening test used to help in the assessment of sexually compulsive or "addictive" behavior.

1. Do you keep secrets about your sexual or romantic activities from those important to you? Do you lead a double life?
2. Have your needs driven you to have sex in places or situations or with people you would not normally choose?
3. Do you find yourself looking for sexually arousing articles or scenes in newspapers, magazines, or other media?
4. Do you find that romantic or sexual fantasies interfere with your relationships or are preventing you from facing problems?
5. Do you frequently want to get away from a sex partner after having sex? Do you frequently feel remorse, shame, or guilt after a sexual encounter?
6. Do you feel shame about your body or your sexuality, such that you avoid touching your body or engaging in sexual relationships? Do you fear that you have no sexual feelings, that you are asexual?
7. Does each new relationship continue to have the same destructive patterns which prompted you to leave the last relationship?
8. Is it taking more variety and frequency of sexual and romantic activities than previously to bring the same levels of excitement and relief?
9. Have you ever been arrested or are you in danger of being arrested because of your practices of voyeurism, exhibitionism, prostitution, sex with minors, indecent phone calls, etc.?
10. Does your pursuit of sex or romantic relationships interfere with your spiritual beliefs or development?
11. Do your sexual activities include the risk, threat, or reality of disease, pregnancy, coercion, or violence?
12. Has your sexual or romantic behavior ever left you feeling hopeless, alienated from others, or suicidal?

If you answered yes to more than one of these questions, we encourage you to take the results of this online sexual addiction screening test to your doctor or a mental health professional to further assess your needs. Treatment for sexual addiction is available.

Sources:

• From the Sex Addicts Anonymous screening tool. For personal, educational or research use only.

The treatment focus of sexual addiction is the same as with many addictions, involving counseling, 12-step spiritual recovery programs, and medical intervention.

Most sex addicts live in denial of their addiction, and treating an addiction is dependent on the person accepting and admitting that he or she has a problem. In many cases, it takes a significant event -- such as the loss of a job, the break-up of a marriage, an arrest, or health crisis -- to force the addict to admit to his or her problem. Outsiders may see the symptoms of sex addiction long before the sex addict sees them.

Treatment of sexual addiction focuses on controlling the addictive behavior and helping the person develop healthy sexuality. The goal isn't to eliminate sex from your life—although temporary periods of abstinence may be necessary. Some therapists describe it as the difference between alcoholism and social drinking—you're healthy when you can handle moderate amounts in nondestructive ways.

Treating sexual addiction includes education about healthy sexuality, individual counseling, and marital and/or family therapy.

Support groups and 12 step recovery programs for people with sexual addictions (i.e., Sex Addicts Anonymous) also are available. In some cases, medications used to treat obsessive-compulsive disorder may be used to curb the compulsive nature of the sex addiction. These medications include Prozac and Anafranil. The doctor may recommend medication to suppress sexual appetite. Drugs like Depo-Lupron (normally used to fight prostate cancer) and Depo-Provera (used for contraception purposes) lower androgen levels and, thus, sex drive. Because sexual addiction is usually accompanied by other disorders like depression, the patient will often take these medications along with antidepressants.

When conventional methods fail, a sex addict might consider enrolling at a residential treatment facility. Programs vary in length and usually run about $800 to $1000 a day.

Is recovery from sexual addiction possible?

According to The Society for the Advancement of Sexual Health, thousands of recovering addicts know that recovery is a process that works when these principles are followed.

• Acceptance of the disease and its consequences.
• Commitment to change.
• Surrender of the need to control the compulsion.
• Willingness to learn from others in recovery in sexual addiction
• Twelve-step support groups, professional counseling, and medication, if necessary.

Sources:

The Society for the Advancement of Sexual Health
Sex Addicts Anonymous