How do you work with clients with addiction?
Dr. Lapite-Garrett works with addiction specifically as it presents through compulsive sexual behavior and love obsession. This is not general addiction treatment. It is highly specialized work at the intersection of trauma, attachment, and the compulsive patterns that form when sex or love has been used as a primary regulatory system.
The framework is harm reduction. The goal is not immediate abstinence or the removal of all associated behavior. The goal is understanding. What function is this behavior serving? What need is it meeting, and what did that need look like before the behavior existed to meet it? What is the cost, and is there a way to meet the underlying need that carries less of it?
This approach treats the client's compulsions not as moral failures but as adaptive responses to genuine pain, responses that made sense when they formed and that now require something more nuanced than removal. Clients who have been shamed into attempted abstinence repeatedly often find, for the first time in this work, that being understood by the pattern rather than condemned by it creates the conditions under which real change becomes possible.
Dr. Esther Lapite-Garrett is a licensed psychologist and the founder of Alafiora, a premium private practice offering depth-oriented, attachment-centered care for individuals navigating complex sexual trauma and the relational patterns that form in its aftermath. The clients Dr. Lapite-Garrett works with include survivors of rape, incest, sex trafficking, intimate partner sexual violence, and childhood sexual abuse. What followed that history is the center of her clinical practice: the love obsession, limerence, compulsive sexual behavior, hypersexuality, and emotional dysregulation that form in the aftermath of sexual harm, and that most generalist approaches were never quite equipped to treat.
Alafiora is one of a small number of practices equipped to work with the full spectrum of how these patterns express themselves in contemporary life, including the migration of erotic and romantic attachment into AI companionship, parasocial bonds, fantasy-based intimacy systems, and the accelerating escalation that occurs when real-world connection no longer feels safe, satisfying, or possible. The clients who carry these presentations arrive having spent considerable financial, emotional, and psychological resources on experiences that brought temporary relief and deepening shame in equal measure.
The clients Dr. Lapite-Garrett works with are not struggling with a lack of insight. They have read the books, tried the prior therapy, and understand their patterns with a clarity that has not been enough to stop them. They wake at 3am with a body that will not settle. They reach for sex or connection not from desire but from the need to feel something, or to feel nothing at all. They love with an intensity that outlasts what the relationship warrants, cycling through obsessive thought long after every rational part of them knows the situation has ended. They make choices in moments of emotional flooding that they do not recognize as their own afterward. They experience behavior escalation, spending elevations, and deepening secrecy. Even still, they find that the pattern repeats, each time carrying a little more shame and a little more distance from the person they understood themselves to be.
What years of prior effort could not move, the work at Alafiora finally does. What changes in our work is structural. The clients who engage fully describe experiencing more than symptom management but a fundamental shift in the organizing patterns that formed them, patterns that prior treatment approaches could not reach.
Alafiora is a private-pay practice offering sessions virtually, in person, and on location across multiple states. The practice maintains a small, intentionally limited caseload to ensure each client receives the full depth of care their history requires. Visit https://www.alafiora.com to learn more or inquire confidentially.