Sex Addiction and the Concept of Healthy Sexuality

The opposite of sex addiction is not “healthy” sex. It is a common misconception that what’s wrong with sex addicts is that they have “unhealthy” sexual habits and that sex addiction treatment replaces these with “healthy” sexual behaviors.

First off, being a sex addict is not about a particular set of behaviors, proclivities, preferences or fantasies. That’s not what makes it a problem. When sex addiction therapists say that “sex addiction is not about sex, it’s about pain” they mean it literally.

Why all the talk about healthy sex?

Here’s my take. Sex addiction therapy has recently been under assault by people who are afraid of what they think it means. Their fear seems to be that sex addiction treatment will try to enforce conformity to some narrow or moralistic notion of what sex life should be. This might be described as so-called plain vanilla sex, i.e. sexual intercourse, in “appropriate” ways, in a romantic context, etc. etc. This is sometimes condemned as a “hetero-normative” (straight vs. LGBT) standard.

In reality, sex addiction therapists make no such assumptions. But it may be that the prospect of being dubbed “sex negative” by the people who fear for their sexual freedom has caused some sex addiction specialists to say, in effect, “we’re not judging people for their sexual misdeeds, we’re just trying to promote sexual health“.

The trouble is that even with the most liberal interpretation of “healthy” sex (e.g. sex that is consensual, caring, etc.) there is still a judgment being made about the person’s sexual behavior. Sex addiction therapists do not look at certain behaviors as problematic per se. It is not necessarily a sign of an addictive disorder if you like looking in your neighbor’s window in the hope of seeing them naked (although it has the potential to get you arrested). Sex addiction therapy, to put it bluntly, is not about changing what turns you on.

Using sex as a drug

In practice, sex addiction treatment attempts to deal with a pattern that the client sees as problematic; that’s why the person is being offered help. They are experiencing negative consequences from the way they live their lives and they realize that they can’t change on their own.

But what sex addiction treatment addresses is the underlying pain that causes the person to lead a secret life of compulsive and potentially harmful behaviors. This is not to take a negative attitude toward sex in general but is merely to acknowledge that any definition of addictive sex ultimately comes down to eliminating a symptom: the use of sex as a drug.

Sex like all potential drugs of abuse is being used to medicate unpleasant feelings. The drug allows the person to escape through numbing or through hyper-arousal. The person escapes feelings of loneliness, abandonment, inadequacy, fear of intimacy and so on. Surprisingly, this use of sex to deal with stress and pain often begins in a troubled childhood with early reliance on masturbation.

Sex addiction as a symptom

If sexually addictive behavior is looked at as a symptom of deeper problems, problems dating back to stressful or hurtful experiences in the past, then it is those deeper issues that we are treating when we work with addicts. The overt behavior can represent a reaction to repressive messages about sex that lead the addict to feel shame around sex and to move toward sexual secrecy. Often there is childhood emotional trauma, sexual trauma or other injury to the parent-child bond with resulting conflicts about intimacy and vulnerability.

Just because the DSM (Diagnostic and Statistical Manual) describes something as an addictive disorder, such as pathological gambling, doesn’t mean that it stands on its own as a disease entity. I have heard it said that if the DSM dealt with the real underlying problems rather than the surface behaviors it would only be three pages long. By the same token, the fact that a destructive pattern of behavior like sex addiction is left out of the DSM doesn’t make it go away. It’s still there in real life.

And by the way, sex addicts do not always present as “over-sexed” or hypersexual.  It’s not what you do, and often it’s not even how much you do it.  It’s the how and why you do it that represent the underlying problems and cause all the chaos and dysfunction in life.

So what do we “treat’?

So if the sex addict is actually suffering from unresolved trauma, intimacy avoidance, early attachment injury, dissociation, emotional dysregulation, boundary issues, or any other manifestation of emotional damage, then why don’t we treat these things? The answer is we do just that. We think of them as a syndrome, a group of signs and symptoms that hang out together and which we call sex addiction (or sometimes multiple addiction or addiction interaction in order to include interrelated addictions in the same person.)

Our goal is to solve these underlying problems, not to get the client to engage in different, supposedly healthier sexual behaviors. But as with any drug, the first order of business is to detox from the drug. But this is only the very first step in a long process. In addressing the deeper issues people can escape the shame and limitations of their addiction.  They can get off the merry-go-round of chasing after a sexual hit and can begin to lead a fuller life. And in recovery people are enabled to integrate sex into their lives in the ways that suit them. Really.

Find Dr. Hatch on Twitter @SAResource and at www.sexaddictionscounseling.com

Advertisements

No comments yet.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

%d bloggers like this: