So, before we get started there’s something you should know. I specialize in the treatment of sex addiction, yes. But, that doesn’t mean that I don’t regard sex in all its variety as a rather healthy way to express oneself.
I’m what’s known in psychotherapeutic circles as, ‘sex positive’. Sex, in short, is a good thing. It’s not to be unreasonably constrained as sexual creativity is a sublimation that can turn, for example, stress and anxiety into release and good feeling.
I bring this up because there are many who assume that the treatment of sex addiction necessitates the constraining of sex to one particular form, monagamous sex within a committed relationship. I’ll be honest. For most clients this is the goal, and it’s a goal that makes a lot of sense.
As an example, if you’re married with children to a partner whom you love but the relationship is on tenterhooks because of your addiction, it probably makes sense for you to aim for monogamy. The chances are it’s what you signed on for when you married, and your partner is unlikely to accept anything less. It’s often the case that the married sex addict comes to me and says something along the lines of, ‘I love my partner but I feel trapped. We don’t communicate well, and he/she doesn’t get me.’
The entire point of the uncontrollable sexual behavior is to take up emotional space so that intimacy (which places the sex addict at risk emotionally) and negative emotions like anger, depression, boredom, and isolation don’t have to be felt. So, I’m not surprised to hear about the distance and lack of understanding within the relationship.
The truth is that this distance existed well before the discovery of the problematic sexual behavior by the partner, if relevant. Closing the gap between partners through re-establishing intimacy and trust is paramount to the healthy survival of the relationship. So, in the case of the coupled sex addict who wishes to stay in his relationship monogamy is often an appropriate goal for therapy.
In similar cases where monogamy is not the client’s goal, it’s my job as a therapist to point out the inherent conflict between wanting to maintain a loving relationship and wanting to continue with the problematic sexual behavior.
However, not everyone that comes to me for treatment is a sex addict interested in a monagamous relationship. And what’s more, sexual behaviors that are not addictive for those who are addicts are still on the table as long as they fit the addict’s own views of acceptable sexual expression (including but not limited to views on monogamy) and occur between (or amongst!) consenting adults.
All too often, pressure is placed on sex addicts to fit into the box of monogamy and interpersonal sex alone. Fetishes, polyamorous relationships, and other taboo modes of expression are regarded as off-limits without demonstration of relevance to the addiction.
I think the automatic bias towards monogamy confuses sexual behavior with a basic capacity to be involved in an intimate relationship. Uncontrollable sexual behavior runs the gamut in terms of severity. Commensurately, some clients seeking treatment have the capacity for intimacy but need help prioritizing and maintaining intimacy within the relationship while others have an addiction that is so established that intimacy is not immediately possible.
Where intimacy is possible, there is more latitude for experimenting with other behaviors in an open therapeutic format subject to the values and wishes of the client. Where intimacy is completely elusive, it perhaps makes sense to focus on monogamy with perhaps an initial period of sexual abstinence. The general idea would be that the abstinence would force emotion that had been repressed by the uncontrollable sexual behavior to surface.
Although problematic to process initially, intimacy is not possible without access to emotion so the initial discomfort is the unfortunate price to be paid for intimate potential.
The sexual repertoire that is appropriate for those suffering from uncontrollable sexual behavior must be investigated person by person and include an assessment of desired activities, level of uncontrollable behavior, commitments to others and the person’s ability to accept the consequences of his behavioral choices. In this way, the array of specific sexual behaviors within the repertoire is secondary to the need to address the particular addictive pattern.
In other words, it’s not sex in the abstract that matters. It’s the specific sexual behavior that is related to the addiction that is the concern. In fact, attempts to curtail sexual behaviors that are not related to the addictive pattern may be counterproductive as these unrelated behaviors may provide a useful outlet for discharging sexual libido in a controllable fashion.
It’s worth thinking about – whether you’re suffering from uncontrollable sexual behavior yourself or just know someone who is.