Between the cute stuffed animals was an ugly, humpbacked dragon with only one eye. Once, as I walked past, I saw some patients kicking this creature around and calling it names. I stopped and asked why they were abusing this ugly, but harmless, dragon. One patient replied, "He's green and ugly and reminds me of my addiction. These may take the form of neglect, abuse, abandonment or the absence of an appropriately nurturing caregiver. Addictive behaviors show up, sometimes early in life, according to Hatch, as a coping strategy in the form of self-medication to emotional pain. Sex addiction, in particular, creates a sense of excitement and pleasure, while simultaneously ensuring emotional distance and avoidance of true connection the kind of intimacy that can leave one open to being hurt. This can include developing a sense of unworthiness (which can cause guilt and shame in sexual experiences), extreme risk-taking with the goal of achieving fleeting pleasure and re-creation of the traumatic experience, also called trauma reenactment. For example, someone with a traumatic background may develop extreme anxiety as an adult. When I experienced this, in seconds, the person who I depended on and was deeply connected to went from being a source of support and companionship to being a source of pain, fear and deep uncertainty. My relationship, which had created a stable base from which I was able to operate in the world, was suddenly a rickety, wobbly mess. If your safety is at risk, you should not tolerate physical or sexual violence and should seek help from appropriate authorities. Common physical boundaries include: Exiting volatile situations: Remove yourself when conflicts become heated. Physical separation: Request personal space and time away to think and heal. In my work with sex offenders, I often used the term transitory guilt, which is a short-lived guilt that is very intense in nature and not manageable to carry around in one s mind, to describe the offensive cycle of behavior. A myriad of thinking errors or cognitive distortions are used to decrease and eventually eliminate the guilt, thus putting the offender in a position to reoffend.