Sex Addiction or Else?

One of the fun things of being a Sex Therapist is the type of questions that people ask me. Questions related to sex addition have been a very popular, common lately due to all the social media and celebrity news. Clients call me and ask me if they are sex addicts based on the descriptions they have given to me. Whole Foods staff and strangers ask me related questions when they find out what I do. Friends call me to get more information about Tiger Woods, Charlie Sheen and sex addiction for their curiosity. So, is sex addiction real? Is it really that popular?

First of all, I don’t diagnose people I haven’t met. More importantly, I don’t use the diagnosis of sex addition. I know it is a very common and scarily a normal term for people to throw out there nowadays but I don’t see it. I have worked with many people with different sexual variation, fantasy, trauma, fetish, gender orientation, fantasy, and involvement with sex workers, but I have never seen sex addition.

Don’t get me wrong – I work with this population. I have heard clients telling me how they can’t keep from doing self – destructive, problematic sexual behaviors. I however, still do not see sex addiction.

What Do I See in My Practice?

I see people who question, “am I a sex addict?”. They regret the sexual choices that they have made and sometimes deny that these are the decisions that they have made. I see people who want to change and see the advantage of changing but are not ready or do not want to give up what makes them feel good, relieved, loved, wanted, understood, powerful or attractive.

They lack the space to explore and expand their sexual routines so all they can do is staying in their rigid sexual practice and repeat the same, unhelpful pattern. I see people who do what they need to do to get relief when they are hurt. They want to care about others but they care more about getting themselves the help and giving themselves the immediate gratification.

Well, that sounds pretty selfish and narcissistic, right? Isn’t that common though? Narcissism is a common human condition. We all want pleasure and no pain.  We are all selfish. All of us have done something that we know is not good for ourselves and/or destructive to our relationships with others. We might be spending more time watching reality TV show instead of spending time with our loved ones. Some of us spend more time baking cookies and eating them than going out for a walk. We might be spending more money on buying purses instead of saving them to pay off loans. Problematic sexual behaviors is another way people get their needs and wants met.

That’s why I prefer using the term “Out of Control Sexual Behaviors (OCSB)” to describe clients instead of sex addiction or sex addict.  We all have strong urges, thoughts and/or behaviors that feel out of control, and hence we do something to manage them to get relief and feel better. In this case, theses urges, thoughts and/or behaviors are sexual, which create more problems for the public because we live in a sex negative, rigid, binary culture.

“There is no dignity when the human dimension is eliminated from the person. In short, the problem with pronography is not that it shows too much of the person, but it shows far too little.”

— Pope John Paul II

What’s Really Going On?

It is not that people with OCSB do not want to make the right choices. They are people who are really unhappy with their sexual choices and the subsequent consequences but they find it too hard and too painful to make different choices. That step becomes more difficult when they do not have a place in their world where they can openly and honestly share with their partners about their deepest desire, darkest secrets and wildest sexual dreams. When who they are and what they long for in their cores are suppressed, they are going to feel out of control. Won’t we all? That’s why sex addiction might be really describe what’s really going on with them.

Like Marty Klein had said, “…it’s not about sex. It’s about the immature decision making…  Feeling out of control is different than being out of control.”

Treatment for Out of Control Sexual Behaviors (OCSB)

The whole treatment uses Dr. Braun – Harvey’s (2004) OCSB Clinical Pathway as a guideline to help clients achieve and optimize their sexual health. I will focus on 6 principles: (1) consent, (2) non – exploration, (3) protection against Human Immunodeficiency Virus (HIV), Sexually Transmitted Infection (STI), and unwanted or planned pregnancy, (4) honesty, (5) shared values, and (6) mutual pleasure (Braun – Harvey, 2014, p. 19).

A critical part of my treatment is to do a thorough, proper assessment. I invite my clients to discuss the sexual part of their stories, fantasies, acts and dreams. This is important because I need to get a Unique Client Picture in order to develop an individualized treatment plan with my clients that will best address their needs and concerns (Braun – Harvey, 2014, p.56). This stage of treatment is about exploring and gaining a better understanding of client’s strengths and weaknesses related to sexual health.

I gather information on factors of vulnerability (e.g. physical health, mental health, and substance abuse), client’s ability to self – soothe and self – regulate, and any sexual and erotic conflicts (Braun – Harvey, 2014, p. 58). It is also in this stage of treatment that it becomes clear that the problematic sexual behaviors are usually the symptoms of underlying issues such as PTDS, mental health, unresolved relationship issues, self – esteem issues, early childhood injury, or untreated trauma and abuse are addressed.

Clients will get group and/or individual therapy to get support and skills so they can find their own unique ways of optimizing their sexual health and expressing their wanted sexual behaviors. Finally, clients will get re-screen and re-evaluate if treatment is complete or requiring further services (Braun – Harvey, 2014, p. 58).

For Couples

The majority of my OCSB clients come to me because one of the partners got caught acting out their problematic sexual behaviors and stepping out of their relationship contract. The revelation of the secrets devastate the relationship and the trust, which can be excruciatingly painful. The injured partner feels very betrayed and confused, which I can completely understand. The foundation is shaking, and the bond is broken. Couples counseling and individual counseling are often helpful to provide support, guidance, and most importantly, hope.

Once I have met with you, I can help you decide on what services would be beneficial for you and your relationship. We can develop a roadmap together to repair the trust, the respect, and the intimacy.

Out of Control Sexual Behaviors vs. Sex Addiction

I am not finding excuses for OCSB clients because their actions have caused a lot of pain and distress for themselves and for people in their lives. Calling them “Out of Control Sexual Behaviors” does not mean people have no control over their behaviors. It is not a “get out of jail free card” for them to remain unaccountable for their behaviors.  “Out of Control” is simply an expression of a person’s subjective experience. Not their behaviors!

I just want to encourage people to think outside of our rigid mindset of what’s considered “normal and appropriate” and start challenging the concept and the label of “sex addiction.” It comes with a negative connotation and creates more shame and guilt. It is a diagnostic label that describes a human behavior problem. It limits people’s space to explore their sexuality and become more complete, wholesome sexual beings. That also creates more barriers and pain in a couple’s relationship.

Sex is as much about opening yourself and showing your sexuality to another human being as it is about allowing them to show you theirs. If you want your  lover to expand their horizons with you, it’s vital that you give them the same curiosity of hearing their secrets without making them feel creepy about it.

— Roberto Hogue, Real Secrets of Sex: A Woman’s Guide on How to Be Good in Bed

 

I understand the importance of using labels but is “sex addiction” really helpful though? We are all different. We all have different “turn on” and “turn off” buttons.  American is a sex – negative country with a very rigid view and binary standard when it comes to anything sex related. For people who fall under those standards or are able to stay in that rubric, easy and hassle free. That however, does not mean people who don’t follow those standards are wrong or something’s wrong with them. What’s normal in one culture might be different in another culture.

We need to give them the same respect and same room to discuss their worlds. We give people space to talk about different types of food they have tried. Why can’t we give people space to talk about their sexual choices? Why do we categorize people due to our own discomfort? We can politely set boundary with people when we are asked to eat food that we don’t want to. Why can’t we do that with topics around sex?

Concluding Thoughts on What’s Really Important in Treatment,

Accepting the problem, having the motivation to change, and reaching out for help are the most important aspect of recovery. Out of control sexual behaviors or sex additions, you can decide what label you want to use. My passion is helping people find ways to integrate their sexual health into their day to day life. I want to help as many people as possible to have higher, more satisfying quality of life.

 As a result, I work with my clients in an open, honest, respectful and curious manner. That way they can explore their behaviors and the deeper longings and meanings behind them. I help them enhance them sexual health to have more pleasure and satisfaction in their sexual and intimate relationships.

I see my individual clients and couples blossom when they do the hard work together.. They have more exciting sex life, and deeper intimacy and connection. Repairing trust and healing pain are totally possible.  They use those so called “addictive behaviors” to their advantage in their sexual play and exploration.

Denver Sex Therapy Can Help!

Let me know if I could help you practice healthier sex or if you simply have some questions and/or feedback for me.

Please share to help more people have connected relationships and satisfying sex lives.