Gilbert defines codependence as an unhealthy approach to a relationship in which people behave as either helpless victims who need the other to rescue them, or who act as the rescuer, but at their own expense. She writes, “Codependency: excessive emotional or psychological dependence upon another person—typically one who requires an unusual amount of support and attention on account of depression, anxiety, narcissism, mental illness, low self-esteem, trauma, and/or addiction. An intense feeling of responsibility for another person’s life. The utter abandonment of yourself in order to fixate upon them. The belief that by healing them, you will be healed” (46).

She explains that she has had a long habit of approaching relationships in a codependent way, and in hindsight she feels that her relationship with Rayya was mutually codependent. For instance, she recalls feeling that she needed Rayya’s support and coaching to feel empowered and confident. Without Rayya, she felt unprotected and exposed. Meanwhile, Rayya leaned heavily on Gilbert, who became her financial provider and ultimately, the enabler of her addiction. While Gilbert grew to resent Rayya’s extreme dependence on her and the chaos it caused in her life, she continued to pay for Rayya’s addiction, demonstrating their powerful codependent dynamic.

Gilbert defines love and sex addiction as a powerful habit of seeking out romantic relationships and encounters in order to feel safe, happy, and validated. She identifies as a “love and sex addict” and presents this addiction as one that is just as powerful and potentially devastating as a substance use addiction because of how it wreaks havoc on people’s personal lives and mental health. She writes, “I believe that sex and love addiction is a matter of life and death. In my case, without a doubt, it always has been” (36).

The classification of compulsive sexual and romantic behaviors as addictive is contentious among psychologists and psychiatrists. Neither sex addiction nor love addiction is listed as a clinical diagnosis in the Diagnostic and Statistical Manual (DSM), and some argue that these labels risk pathologizing and stigmatizing normal human behaviors. Even so, many people feel that the addiction framework describes their experience and helps them to get a handle on their compulsions. For Gilbert, understanding her approach to sex and love as an addiction is the first step toward gaining control over her emotional life.

A process addiction is a set of addictive or compulsive behaviors that cause distress or interfere in unwanted ways with a person’s life. Gilbert labels her love and sex addiction a “process addiction” since she is not addicted to certain substances, but rather to the pursuit of people. She explains, “Process addictions are characterized by extreme compulsivity around certain behaviors—gambling, shopping, hoarding, eating, sex, control, obsession, gaming, skin picking, etc. Put simply: Rayya was addicted to drugs; I am addicted to people” (36).