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Articles by David H Jacobs Ph.D

Why do people keep on drinking after the first few?

Why do people keep on drinking after the first few? The answer shouldn’t be circular or tautological, as in ‘That’s what alcoholics do.’ The answer should actually shed some light on the matter. I’ve asked myself this question many times in the course of doing therapy with problem drinkers. I’ve asked them, too. This seems to be one of those questions that the person doing the activity in question has a hard time answering. Read more

Why Do People Who Drink Excessively Need Personal Therapy?

Why do people have to be in therapy in order to stop drinking? You’d think that bad outcomes themselves would be reason enough to stop or at least lead to being careful and moderate. Why would a person need therapy in order to stop harming himself and getting himself in trouble? The simple answer is that people are doing the best they can in living’”doing the best they can to cope with the stress and challenges of life as they experience them. Read more

To What Extent is the Addict Responsible?

Freud once commented that we are responsible for our dreams because well, who else could be responsible? This is Jewish humor, as I well know. Are we really responsible for our dreams? What actually are we responsible for and why? This is a pressing question for both husband and wife after (typically) the husband’s infidelity of one or more sorts has emerged (I must say many of the men I see have been strikingly lax in trying to cover their tracks). Is the husband bad or sick or both or something else or what?
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man thinking about when to seek therapy

The Identified Patient

I typically meet men who describe problematic sexual behavior following an ultimatum given by their wife to get into treatment or else. They have been discovered. Their wife wants their sexual addiction treated. The men are sitting in my office because they want the marriage to continue. Why they want the marriage to continue, is frequently not that clear. There are often children, money, and property involved. Reputation is involved. The prospect of losing their familiar way of life is not attractive. Read more

Is Sex Addiction a Disease?

I have a friend who has diabetes. His pancreas does not produce enough insulin to keep him healthy or even alive. He would die without injections of insulin. He lives in and is dependent on his body as automatic, self-regulating, cause-effect machine, just as we all do. He is no more responsible for the workings of his pancreas than for a solar flare, the weather, the temperature at which water boils, the atomic weight of hydrogen, etc. Read more

Sex Addiction Treatment

The goal of diagnosis is to formulate a realistic and adequate statement of what is the matter. Treatment has no direction without a grasp of what is ailing an individual. I have discussed my view of what is going on in sex addiction in a companion piece. As with all addictions, what is the matter in the case of sex addiction treatment must refer to what is actually driving the person’s insatiable need for the addictive activity and all the fantasizing, planning, arranging, plotting, and scheming that goes along with it. Read more

What Drives Sex Addiction?

Calling a behavior or activity an addiction connotes an insatiable yearning to engage in the behavior or activity. Sex addicts spend a lot of time and energy (and often money) looking for and engaging in sexual activity of some kind. A desire to have sex presumably needs no explanation; what needs explanation is the insatiable, driving, devil may care, indifferent to consequences character of the role of sex in the lives of some people.
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Whose Interests Really Matter?

One cannot be precise about the figures, but it is all too apparent that many people grow up having to endure very serious adversity within their own family. In 1962, in a landmark article appearing in Journal of the American Medical Association, a group of emergency room physicians implored medical colleagues across the country to stop covering up parental battering of infants and young children.Maltreatment of children within the family is not a pleasant topic, but it will not do to make believe it does not happen or that it is rare. Read more

Sex Addiction Treatment

The goal of diagnosis is to formulate a realistic and adequate statement of what is the matter. Treatment has no direction without a grasp of what is ailing an individual. I have discussed my view of what is going on in sex addiction in a companion piece. As with all addictions, what is the matter in the case of sex addiction treatment must refer to what is actually driving the person’s insatiable need for the addictive activity and all the fantasizing, planning, arranging, plotting, and scheming that goes along with it. Read more

Knowing How You Feel and Being Less Ashamed

Acting in the moment, what you actually say and do, frequently seems to have a mind of its own, that is, frequently seems to escape your intentions, plans, professed values, rehearsals, strategies, resolutions, cost-benefit analysis, past experiences, etc. Read more

How Does Change Occur in Psychotherapy?

I think it will be helpful to me and to prospective and beginning clients to try to provide an overview of how I think about …

Make-Believe in the Addiction Treatment Industry

Therapists shouldn’t be in the business of make-believe. There is a great deal of make-believe in the addiction treatment …