Monthly Archives: January 2020

The long and the short of it: a dialogue

 

So, the zeitgeist in sex addiction for so long has been to question whether sex addiction is an excuse—ya know, something that lets creepy, no-good scoundrels (heterosexual men, basically) off the hook, absolving them of…whatever the assessment of addiction is meant to let them off the hook from. Punishment, presumably: punishment from courts, employers, wives and girlfriends. Wives and girlfriends mostly. If a man has a sex addiction then he has a disease. He has an affliction, merits compassion and support, not judgement. Cue the next bit wherein someone says it’s understandable that betrayed partners would launch into a volley of judgement upon discovery of secretive behavior. They’ve been traumatized, after all, and not just by the addictive behaviors, the obsessive use of porn and prostitutes, plus those sleazy hook-ups and online affairs. Beyond that, these partners have been lied to incessantly; subjected to years of obfuscation, counter-accusations of paranoia, controlling behavior. Now the cat’s out of the bag he wants compassion, cries this beleaguered figure! Seriously? After years of being told I’m crazy I’m supposed to just accept his abject apology and then go along with this crap about addiction, while thinking what? Oh, poor thing, he just can’t help it. Let me tell you something, I’m…

Okay, I don’t hear that so much—that I’m-about-to-march-out-of-this-office diatribe. But I do hear of it from those who have previously been to therapists who tread a little close to the door marked GIVING ADVICE. Their “educational” comments carry an inflection of sympathy—too much sympathy for the angry person who is looking for someone to be angry with them, sort of. Yes, tsk tsk, exudes the right-minded listener instead, regarding that misbehaving other. What may follow next is a flurry of suppositions: how pervasively has this behavior, plus the secrecy, affected your life? How many conversations, potential intimate moments have gone awry because he was elsewhere emotionally, not truly present with you? What about the diminishing of romance, of your sex life, even? How many times have you been denied sex because he was with someone else, or thinking of someone else, taking care of himself, forgetting about you? How many times did he come home late from work? Now you know what that was about. And think about all the money that’s been spent, or the time that’s been wasted. No wonder his career has stalled, and how has that affected you, burdened you, given that you work also, plus you do the lion’s share of stuff for the kids. Treatment? For him? The person who really needs compassion and support is YOU.

There’s a subtext to such counsel, one that is rarely made explicit because that would render the message ironic. The task is to insinuate the potential for revenge while maintaining the position of victim/survivor. So, that subtext, stripped of its artifice, goes something like this: ya know, there’s a silver lining to all of this. If you’re honest, this relationship has had problems for years and until now you weren’t sure how much the problem was him versus you. You thought he had fallen out of love with you, thought you were a B, like what your last boyfriend thought, plus what your sister used to say about you. Anyway, do you have any idea how this could be used to your advantage? Do you have any idea how much this lets YOU off the hook? From now on being difficult is no longer your problem. You being difficult becomes your entitlement. Yes, I know you didn’t want this. I get that this was your worst nightmare, besides something terrible happening to your kids, of course. And I know that thinking he’s out of control will keep you up at night, worrying where he’s at when he’s traveling—who is he with, and whether he’d leave you high and dry. But think about it: this addiction thing can be the punctuation of all arguments for the forseeable future, and you can leverage his guilt. Believe me, sister, you may have the pain, but now he’ll get the blame at last.

             In most niche fields in psychotherapy, this kind of subtext, as well as the manifest content would be tagged as scapegoating. In psychiatry we have the term identified patient to in fact direct clinical attention to a systemic problem versus a “one-body”, internal or intrapsychic disorder, as it may be termed within a psychodynamic framework. In sex addiction treatment, however, the singular focus upon the acting out person’s “problem” is a virtual orthodoxy, reflecting an alliance of social and professional forces: on the one hand, the mores of social justice, which counter-privileges the perspective of underprivileged populations, especially women; on the other hand, a traditionalist objection that posits sexual betrayal as the most sensitive of personal offenses—an offense that clears the table of mutuality, allowing for an old-fashioned script of who’s been good and who’s been bad. Yes, says the offended partner, “I am no angel”. Translation: that’s all we’re going to say on that subject for a very long time, maybe ever. That’s the flip side of the “excuse” phenomenon. Reductionism, short term interventions, simplify and thus remove not only ambiguity, but also responsibility that might otherwise be dispersed; the addiction treatment stratagem, peopled by professionals with first-responder heroism encoded within their approaches, makes supportive gestures easier, confrontation of problem behavior more, shall we say, economical. Whoa, wait a minute, hold the phone, says a sex addiction specialist. Oh, I see. A dialogue:

Specialist: Are you saying that’s what a therapist would say to a non-acting out partner? We don’t give those kind of messages to non-acting out partners. Well, okay, we might say some of those things but not to encourage revenge, and you have to remember that most partners in these situations have been gaslighted and then traumatized by their discoveries. After all, do you have any idea what it’s like to pick up your partner’s phone, and by accident (maybe) read a thread between him and some other woman that is obviously sexualized, and know in your gut that it’s been going on for years. So of course we hold the acting out person’s feet to the fire. Of course we encourage polygraph tests, full disclosure. That’s necessary and fair for the partner so she can begin to heal…with the truth, the full truth of his past and present behavior. But anyway, we do counsel the women that the issue may be complex and that at some point it would be important to address in couples therapy some of the long-standing communication issues within the couple relationship.

Me: Really? At what point would you begin that?

Specialist: Well, we wouldn’t. Our program’s only two weeks long, so we’re more about offering support and education—getting them started, teaching them about addiction and coaching boundaries, that sort of thing.

Me: Ah yes, getting them started. Reminds me of the “let’s get ‘em in the door” ethos of drug treatment; the “let’s fill some beds” mantra that program administrators used to utter to intake coordinators. It’s familiar to me, that get-them-started-then-forget-em-when-they’re-gone thing.

Specialist: It’s not like that. We give them referrals to couples therapists, people who truly know about sex addiction and understand about the traumatic impacts upon partners

Me: So, that “complexity” you spoke of—is that a euphemism for shared responsibility for a bad relationship, or do you imagine or hope that follow-up support groups and couples’ therapy will fossilize the dichotomous roles of victims and perpetrator?

No answer. Or none that isn’t a glib reiteration of previous points, anyway. So much for dialogue. I’ll just cast my mind back to those scores of books and academic papers, or that conference or two where revered figures in our profession were asked before an earnest crowd, what are the most significant factors in a positive therapeutic outcome? The therapeutic relationship, a gnomic elder would reply. I know, because I’ve heard that response more than once, and I’ve watched intently as heads nod in acknowledgement of the word. The therapeutic relationship. It seems to say everything and nothing, doesn’t it? Maybe it sounds like an offhand remark, or a platitude, and perhaps it is, though it’s not quite the oldest idea in modern psychology. Freud took a while, I think, to come upon the idea of the transference-love phenomenon in analysis—or the transference-hate equivalent. Before this, he’d traversed failed experiments in hypnosis, techniques like the talking cure, even the more resilient practice of free association, until discovering that a patient’s resistance to care, based upon feelings transferred from prior experience and relationships, is the most important hurdle to surpass if treatment is to succeed. I think our profession’s truest elders still think this the key to positive outcomes. Free association, as in a stream of unfettered thought, doesn’t come easily, yet that outcome is more important than most people think. And a clinician’s countertransference is part of the equation: he or she uses their internal experience and reflects something back that points to something missing in the patient–a lost self experience, as many have written of it. It’s a slow process, one that may take months or even years.

There are many who enter a psychotherapy episode, or who provide care, who simply do not understand this mysterious exchange. Some may think the magic happens in moments of inspiration—change on a relative dime because of a divine taking in. Yes, you work through that conflict with that person whom you had to endure for a spell and later, when they’re gone and no longer stirring your resistance, you reflect upon how they really helped you, and so maybe you’ll go back one day and tell them how they changed your life by telling you a blunt truth days before never having to see you again. Yes, that’s how that happens. Do they last, these prescriptive plans, these outlines of change that many leave therapy with. Do those galvanizing confrontations that didn’t stick before stick ever after? We like to think so. If we’re honest, we think not.

Leave a comment

Filed under Uncategorized

Money thinks

 

Stemming from the Latin addictio, meaning giving over or surrender, the term addiction has come to denote a provocative concept in modern mental health, stirring associations with significant behavioral disorders with a medical underpinning: the activation of a brain’s reward system, connected by neuronal pathways, leading to patterns of reinforced pleasure-seeking behavior despite the continuation of negative personal consequences connected with said behavior. In psychodynamic terms, addiction is perhaps a shorthand for another kind of unconscious yet unrepressed phenomena. No, I’m not referring to social prejudice—yet—but rather to what is broadly termed acting out: that is, acting out feelings versus being aware of and expressing them. “I’m not doing it on purpose”, says a relapsing, self-identified addict (and the listener wonders). “Not consciously,” I have sometimes responded, eliciting quizzical looks. What’s the difference, the eyes ask? These are meandering thoughts yet still brevities, offered for menu-style perusal in mine and Joe Farley’s book, Getting Real About Sex Addiction, which of course focuses on pleasure-seeking as it relates to sex, plus the fallout that typically ensues. This tends to include estrangement from committed partners (the most common pretext for treatment described in out book), which may or may not have existed prior to the onset of addictive behaviors, which lends itself to a sinewy and fascinating treatment process, minus the dirty details—the real stories, for the most part. Besides the medical/behavioral elements, moralism and ontological philosophy do hegemonic battle on this topic, with advocates for variably impacted groups offering views that privilege the groups they represent. It seems to my co-author and I that a mini-culture war pits intimate partners, genders, and even sexual minorities against one another, and it may be that neither the theorists, the psychiatrists, the partners’ advocates, the LGBTQ advocates, nor the 12-step confidantes have all the bases covered. In terms of who is getting closest to the truth, as in the dirty details and the real story of addiction, I’d vote for the satirists.

A few years before sex addiction was a commonly used term, an a priori disorder and a recognized thing, author Martin Amis did for sex addiction what David Foster Wallace would do for drug addicts a decade later in his encyclopedic magnum opus, Infinite Jest. Amis gave the reader a taste of the sex addict’s mind, of his manic turn of thought and phrase; of the inchoate mechanisms that generate decisions, process experience, emotion. In his novel Money, the acting out is unrepressed and rendered conscious (largely, anyway) for the reader’s voyeuristic (our acting out) or otherwise sublimated pleasure. Here, for example, is a passage about brothel economics and dissatisfaction:

That session with She-she had done me no good at all. Although I had tarried in the Happy Isles for well over an hour, the actual handjob was the work of a moment—forty-five seconds, I’d say. I had to rack my brains to remember a worse one. ‘You must have been really excited,’ said She-she quietly, as she started plucking tissues from the box. Yes and no. Between ourselves, it was one of those handjobs where you go straight from limpness to orgasm, skipping the hard-on stage. I think She-she must have activated some secret glandular gimmick, to wrap it up quickly.

Note the wry, detached voice. An astute ironist, Amis gave his protagonist, John Self (such a psychodynamic name!), an observant mind, and while Self is an ignorant slob with his fictional peers, he is literate with the reader, which gives us something to hope for. The addict thinks! Yes, he acts out: he is compulsive, ethically reprehensible; he is violent, exploitative, and shameless, yet his dignity persists because his humor, honesty and intelligence are intact, affording him a charismatic villain’s appeal. Because Self has no one to answer to except the invisible reader, he is guileless in his confidences, and also unembarrassed by the pitiful failures he shares for our pleasure. Without apology, he admits his affliction and defends it with proprietorial hunger:

Besides, pornography is habit-forming, you know. Oh yes it is. I am a pornography addict, for instance, with a three-mag-a-week and at-least-one-movie habit to sustain. That’s why I need all this money. I’ve got all these chicks to support…

Never mind the anachronisms, the essence of immersion, of relationship with anonymity, has likely not changed in the forty years since Amis’ seminal publication. Meanwhile, there is no shadow consumer, as I term long suffering, non-acting out partners in Getting Real, for this character to report back to. The imagined reader is his only judge, and while he or she may be disgusted or rendered indignant by the anti-hero’s shenanigans, there is collusion in being the reader; in being, in effect, no less a voyeur than if watching one of Self’s porn clips, plus his masturbatory routine. In a novel like Money, there is complicity alongside a critical witnessing. Author and protagonist take us on a tour of debauchery, and as a novel suggests drama, there is a crisis afoot for the reckless Self. Of course, before the written word, the reader has no responsibility beyond that of a passive confidante; unlike a therapist, he or she need not pretend to relate to or distance from the wayward behavior of the confessor. There are no goals for the reader to assert; no warnings that we have to issue, and no calamity that we have to do anything but wait for. And we don’t have to answer to a shadow consumer either.

As a result, we get more than we bargain for. More information, more insight, than we bargain for if we read a book like Money, which is about an addict and narcissist’s mind as it takes a treacherous journey. Self wonders aloud, plays with his own thought like an X-rated Richard III: What is this state, seeing the difference between the good and bad and choosing bad—or consenting to bad, okaying bad? For the struggling, recovering person who is not afraid to think his own thoughts, John Self is a learned companion in a study of pleasure and pain. And it’s not just about addiction, this book, but about the medium of porn, with its degenerate, inferior, yet truthful venture beyond repression barriers. See, it goes without saying that sex has always been in our music, our plays, films and books, yet I must say this a lot, I find, to people who don’t want to think about sex—not really. Still, we’ve insisted sex be present lest the action of art become dull and plainly unincentivized. We’ve asked only one thing across most contexts, across most societies: that sex appear artfully, perhaps subliminally, with reminders that we are more than our savage, venal and aggressive drives. Porn is therefore dangerous. It defies this traditional artifice, stripping us of our pretenses, and refusing to honor our niceties, or the institutions that require us to pretend so that civilization itself may continue. Yes, it’s that bad, porn. We hate it that much.

 

Leave a comment

Filed under Uncategorized