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Female Sex Addicts: the protected species

“In the books, they say, rather wistfully, that men want to put their faces there. Return to mother, Keith. But I don’t agree. I don’t think men want to put their faces there.”

“Let me tell you what women want. They all want to be in it. Whatever it is. Among themselves they all want to be bigger-breasted, browner, better in bed—all that. But they want a piece of everything. They want in. They all want to be in it. They all want to be the bitch in the book.”

                                                                 —from London Fields, by Martin Amis

So we come to the topic of female sex addicts and the social/political undercurrents that shape the treatment of them. Nowhere in the realm of sex addiction treatment is the specter of gender bias more apparent than in this supposedly lesser studied area. As we might say in our book (and we don’t typically, to avoid cheesiness), let’s get real about something: the average therapist in this country, and certainly in California, is not a patriarchy-imposing old white male with a bow tie dispensing turgid interpretations with an air of aloofness. It (or, excuse me, she) is a white female, educated at varying points over the last 50 years, who talks a lot about “systems”, aims words like boundaries, empowerment at women especially, which is code for go for that position on that soccer team, go for that job or promotion, make sure you’re making as much money as men, and only have sex when you really want to. With male patients that tactical stance shifts. With men the tendentious terms are vulnerability, intimacy, comprising a code that says go home, help with the domestic chores, cook a meal or two, pick up that daughter from soccer practice, and with respect to sex, “hey, have you thought about what she thinks is sexy?”

See, the problem mainstream society has with Freud is not just that he told women they have penis envy, or that men are superior to women (actually, he thought the reverse in some ways), or that he told some women that their sexual victimizations were all in their heads, reflecting their desirous fantasies, not the revulsion contained in their symptoms (we only know that because he copped to this, in a famous case called Dora). It’s that he and his followers continued to follow Superego guidelines which instruct boys to identify with fathers, separate from mothers, and more or less adapt to and follow a traditionalist path versus the noble trail of social revolution. Therefore, latter day progressives, if they are inclined towards psychoanalysis or the exploration of the unconscious, tend to prefer the likes of Jung or Winnicott, or modern inter-subjectivists who instruct men to fem up, support the levelling of fields, do the equality thing, which means surrendering to inequality in some contexts, which is what the field leveling alludes to. Well, as mine and Joe Farley’s book and this blog often imply, it’s problematic if understandable to treat individuals not as individuals but rather as group representatives. Our book is more about helping individuals, not systems, which paradoxically meant devoting considerable print to how sex addiction treatment programs subtly background individuals within a systemic framework. The stories of individuals are richer, if diluted by generalities, the intrusions of groupthink. As for helping, as I consider that task in itself, our book isn’t necessarily “helpful” in the conventional sense of healing anyone or anything, much less a non-leveled system, with anything except thought. As much as anything, we just wanna say how things are.

Years before writing Getting Real About Sex Addiction, I’d talk with female therapists who either specialized in sex addiction or else worked with individuals and couples whose lives were impacted by this much-debated, is-this-a-thing condition. If a patient in question was a partner of an identified sex addict, they’d be called an impacted partner, or sometimes a betrayed partner; once they were called co-addicts—not so much anymore. Female sex addicts were and are another breed of client, lesser spotted in treatment circles, or lesser identified as such, anyway. Called Love addicts, maybe, which sounds nicer: you love, not so much lust. As for their partners, they’d be called…well, I’m not sure what they’d be called, actually, especially if they are male. Angry, unforgiving, abusive or potentially abusive men, if the decrees of my female colleagues were to be accepted—not “betrayed” partners. See, female sex addiction is a relatively rare bird. Not much has been written on the subject. Supposedly not much research has been done, and our text only references one book that is entirely devoted to it: Marnie Ferree’s edited 2013 volume, Making Advances: a comprehensive guide for treating female sex and love addicts. Therefore, despite the widespread understanding that sex addiction is a “pathologizing” label, the paucity of study about female sex addicts is cast as systemic neglect of women. As a system we are denying help borne of stigmatizing labels. Reminds me of the reductio ad absurdum from Dr. Strangelove: “Gentlemen, you can’t fight in here, this is the war room!”

Humor. My deflection, my coping with absurdity, revealing yet also distancing, because humor reveals what is out of synch—that I am out of synch with the times. Like Italian cinema of the early sixties (yeah, I know—not exactly trending), I leave the surfaces of earnest realism (*my bicycle has been stolen!), and spend time with interior lives, the contemplation of what’s happening on the inside. Humor draws attention to the contradictions, presenting a surprise, which shames, embarrasses, causes us to cover our mouths, our eyes. We laugh. We laugh it off. I have tried to laugh off contradiction and absurdity, being out of synch with the times, the zeitgeist that psychotherapists like to think they’re in front of. Stigma. That’s the reason women don’t enter therapy for the treatment of sex addiction. That’s an opinion I’ve heard numerous times from my fellow therapists—women mostly. The likelihood that most SAs enter treatment under duress having been “discovered” (thus rendering the prospect of “choosing treatment” moot) is ignored by the former argument. Anyway, the argument persists: to identify as a female sex addict is to risk hearing epithets like “slut” or “nymphomaniac”. From whom would they hear this in sex addiction treatment? Scores of slut-shaming, patriarchy-imposing male therapists who dominate our field in 2022 while feminist-leaning women struggle to achieve a foothold in the profession? Hmm…regardless, I’m sure men have it way easier: they only have to put up with terms like “pig”, “dog”, “pervert”, “gender violence perpetrator” or “asshole” from their relatively forgiving, not-as-angry, traumatized and sympathetic partners, and maybe the labels sex addict and narcissistic personality disorder from therapists who have so worked through their countertransference issues and wouldn’t dream of using clinical language to disguise ad hominem attacks.

Sarcasm. Yes I know. Very declasse of me. Anyway, back to the narratives: female sex addicts are continuously neglected by a pathologizing sex addiction treatment industry, and—let’s not forget—also by impacted male partners who somehow neglect to employ that mythical plurality of patriarchy-imposing male clinicians. Or, unlike girlfriends and wives, they simply overlook the option of mandating their female partners into treatment with relational ultimatums, or polygraph exams or uber-dignified “full disclosure” exercises to elicit honesty, hold accountable the assh—sorry, the empathy-deserving afflicted. When will women be granted the kind of celebratory, loving attention that Tiger Woods publicly received, or that Anthony Weiner once enjoyed to the benefit of his political career, or that jettisoned Pee Wee Herman into a career strato…wait, what happened to him?

Okay, stop it now

The men who take part in my therapy groups have gotten the updated memos. They’ve been told they are privileged so their sexually addictive behaviors will be excused by a society that simultaneously deems their behavior objectifying and indecent, unlike female sex addiction which is more relational, part of a misguided yet somehow less abusive repertoire of self-discovery. Well, they’re not paying for it, you see. Notwithstanding virtue-signaling terms like “self-discovery”, which attaches so-called problem behaviors to the cause of sexual freedom, or capitalist hypocrisy (some things we shouldn’t pay for. Really? I can think of worse things than sex that we contentedly pay for, regularly), or the thin tissue of horseshit that our profession pathologizes female sexuality more than it does that of men, those who proclaim that sex addiction is an excuse think that what constitutes an “excuse” is any response to sexually deviant or acting out behavior that is anything less than punitive action—ostracism, incarceration, castration, etc.—and is tantamount to an unjust act of clemency towards those who act with exploitative and objectifying intent, especially towards women. Given how disproportionately the term sex addiction is aimed at men versus women, it’s transparent that the concept of sex addiction lends women a 21st century narrative via which they can derogate male sexuality: in particular, male partners whose frequency of desire outstrips their own, or whose non-monogamist thinking, at least, may be religiously or irreligiously impugned.  

Which prompts a return to female sex addicts, whom we still neglect with our helpful-if-pathologizing sex addict labels, even in an essay that was meant to be about them: in Making Advances, the authors argue, “women are different than men. Their brains are different, socialization is different”. Further, they assert that women do best when a therapist is sensitive to their attachment histories, injuries and attachment needs. Now, do they mean to imply that men’s needs are not governed by trauma and attachment needs, or less so? Perhaps not, but given that these recommendations were delivered in the same passage as the “women are different” platitudes, one would think an inference along those lines could be made. Imagine if books, pundits, podcast-pontificators started calling out misandry the way they call out the misogyny of male sex addicts. Imagine if they knew the word misandry. Imagine if they started calling what female sex addicts do hate, not trauma; misandry instead of the tendentiously circular “internalized misogyny”; “toxic femininity” instead of sexual empowerment; sex addiction instead of its ennobling synonym, love addiction. Would their treatment still be condemned as “slut-shaming”? Recently, I’ve been hearing of men and women leaving marriages, seeking divorce because a partner won’t accept transition to a polyamorous lifestyle. Is that not a betrayal of a contract? is it a form of sexual entitlement, of “gender-based violence”? I’d bet that a woman leaving a marriage under that pretext is hearing from a progressively-minded therapist, someone who otherwise espouses betrayal trauma something like, “well, you’re exploring different sides of yourself for the first time”—said with airs of sympathy.   

Referring to the mythos of the ages, I refer in mine and Joe’s book to the legends of Uranus and Orpheus to represent the images that men hold in feminist society as rapists, seducers, opportunists…gazers. Elsewhere, I expound upon the Madonna-Whore complex, a mythopoeic term coined by Freud to denote the dichotomizing (splitting) of women by men into irreconcilable images: the ideal of the nurturing, wholesome woman versus the demeaned, sexualized “whore”, reflecting a struggle to overcome unconscious, Oedipal taboos against that which stirs sexual feelings towards anything resembling the maternal. In deference to the modern zeitgeist, I could have pointed to the Minotaur, the half-man, half Taurus who rapes and cannibalizes a hapless female virgin in The Labyrinth—the sculpted image of which caused a stir when presented by modern artist Damien Hirst. What a fuss, but also what a capturing of man’s present-day image. This conjuring precedes the man, not the woman who enters sex addiction treatment in contemporary culture, for there is little in trending or mythopoeic thought that draws attention to the ways women dichotomize men. What? You don’t even know what I’m talking about? Well, does the term Saint-Brute mean anything to you? Don’t you love a man in uniform, the guy with the snarl and the six-pack abs, and not so much that “nice guy” whom you later (like, when it’s time to “settle down”) declare is sexy because of his “acts of service”? The guy who is the “right” choice even though he’s a bit dull for you? Getting warmer? Anyway, that’s sidelined, cryptic thought, and things will remain this way until unctuous yet well-positioned thought-shapers decide that fields have been sufficiently leveled, human beings can go back to being individuals instead of group representatives, and gender commentary in our media and academic circles achieves a state of genuine parity.

             So, what am I saying of my female colleagues, most of whom I don’t know closely, with respect to how they treat male versus female sex addicts? And have I truly examined my own biases when I treat men versus women? I’ll certainly admit that more men come to me with the term sex addict poised upon their lips, at least in part because the term has been directed at them. Women? Not so much. They utter the term nervously, querulously, as if performing a reconnaissance of themselves, the concept, of me as a would-be listener, and possible judge. They’ve talked to women before, you see, and they’ve felt something odd: a mix of pious adherence to the zeitgeist values of the day—that you go, girl ethos that would protect women from slut-shaming society, blended with a sense of a familiar disdain. The modern ethos can’t quite block it out, it seems, and the women I talk to still perceive it, still feel the sting of the old Superego within the post-modern “be accountable” verbiage. Me, I’ll reference the buzz words, the subscriptive jargon, but usually with an air of otherness—I’ll observe it, detach myself from advocacy, and remain credulous of something undiscovered. I’ll ask the same questions of women that I’ll ask of men. I won’t point fingers with moralistic intent, figuratively or not. I’ll ask what is the impact upon significant others rather than instruct, or educate. I’ll ask patients to think, not to substitute my thinking for an absence of it. But I won’t collude with reversed, neo-double standards that my profession pretends don’t exist**. If you’re a first-time reader of this blog, you may not know what I’m getting at. Or maybe you will. Think of it this way: it’s 2022, not 1989. Take a look around, have a listen. Note the jargon that prevails in the Psychology Today articles, the latest books by Rebecca Solnit or Terrance Real; what the bumper stickers say; what tweets get re-tweeted versus ignored or excoriated.   

*an allusion to Vitorio De Sica’s 1948 film, The Bicycle Thief

**Ask an average SA specialist why fewer women than men are assessed and treated as sex addicts and they’ll likely say that there are fewer resources for women than men for the treatment of SA: this is BS in my opinion as it ignores the fact that 70% of licensed psychotherapists are women; or else it implies that practitioners must have the relatively slight Certified Sex Addiction Therapist (CSAT) credential (a referral base which may be lesser comprised of women) in order to treat SA. I think the plurality of women in the field of psychotherapy are more than capable, qualified (and certainly willing) to speak to women about their sexual behavior, whether it’s addictive or not, a problem behavior or not. BTW: SA specialists might also imply that SA is primarily a men’s issue, hence the disparity in care, though this sets up yet another circular argument within this field.

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Betrayal Trauma

Someone asks me, “does betrayal trauma exist?”. Sounds like an analogy to, “does sex addiction exist?”. Okay, let’s nip the first one in the bud: of course, it exists. It’s like asking do wounds exist (trauma meaning wound)? The question is what does the fuller term mean? What does it mean in the context of sex addiction treatment? And most importantly, what are the implications of the term for a clinical process, especially one framed in systemic language?

What’s apparent is that the term betrayal trauma has clinical as well as moral/ethical implications. The clinical pertains to the syndrome of symptomology linked to trauma, as well as the strategies of intervention that are directed at trauma patients. In the context of sex addiction, it’s not clear whether most or even a significant number of impacted or betrayed partners meet full criteria for a PTSD diagnosis. As the reader may know, that designation requires meeting symptom criteria over several categories, and features phenomena like dissociation, avoiding stressors, being exposed to stressors, having nightmares and flashbacks, experiencing variable (and contradictory) states of hyper and hypoarousal. But in treatment trauma phenomena might be observed as therapists and patients discuss trauma as a subjectively-defined phenomenon. More generally, trauma pertains to a wounding event or pattern, but then also the attempt to adapt to that trauma, plus how that trauma impacts memory, perception, and reactivity to stressors. More specifically, the term betrayal trauma is grounded in a theory about developmental history. The term refers to situations wherein the subject has relied upon another for support and therefore must dissociate (deny/forget for the purposes of this context) awareness of betrayal in order to preserve the relationship, however abusive the relationship is. The concept is therefore also about dependency between people, and the theory’s pedigree lies in observations of a parent-child dynamic, echoing the theories of Freudians like Sandor Ferenczi, who famously taught concepts of “identification with the aggressor”, which informed awareness of the mooted Stockholm Syndrome, and his “confusion of tongues” concept, which refers to the over-stimulation of children via an adult/child seduction.

Principals of the sex addiction model haven’t ignored betrayal trauma. Patrick Carnes—he of the sex-addiction coining, Don’t Call It Love fame—wrote in his book The Betrayal Bond that trauma repetition is characterized by doing something over and over again, usually something that took place in childhood and started with a trauma; that it “relives” a story from the past, inclines sufferers to engage in abusive relationships repeatedly, repeating painful experiences, people, places, and things. Yes, I know. That last turn of phrase sounded familiar, didn’t it? That “doing something over and over again” bit—that sounded familiar too. You think it’s that phrase that’s quoted in 12-step meetings? Think it was something Albert Einstein said? Well, think again. It was Sigmund Freud. Repetition compulsion, it was called. He wrote about it while World War I played out and consolidated the idea around the time the so-called Spanish flu (you know, the Covid of his day) took the life of his daughter. Freud wrote of repetition that it brings mastery over trauma, unconsciously. The aspect that Freud didn’t cover was the piece about becoming like the abuser—that we credit to Ferenczi. Anyway, I’m not saying the latter-day derivative concepts are wrong, just derivative. Also, something else Carnes suggests about sex addicts likewise applies to trauma repetition. The behaviors/symptoms of trauma survivors: don’t call it love.

The concept of betrayal trauma is not difficult to accept in itself any more than the concept of addiction is hard to accept. But after we’ve duly acknowledged that betrayals are painful, and then wrung our hands dry from sympathy, it’s still necessary to think about phenomena so that platitudes or hyperbole don’t prevail. So, here’s the unusual and therefore lesser-spoken of thing: what’s difficult to digest—and this pertains to both concepts—is the back and forth between consciousness and unconsciousness that both trauma survivors and addicts tend to proclaim, at least by implication. An addict often proclaims that he/she is acting out of habit, unaware, saying things like, “I don’t know why I do this,” or “I don’t know what I was thinking”. And with respect to concrete activity (versus, says, insight into deeper reasons), we know this is BS because addicts also obsess over details, calculate their activities, and consciously lie about their behaviors, before and after their fruition. As for trauma survivors, well, we hear that they avoid painful stimuli; that they deny or dissociate awareness of betrayal because of their relational needs; that they are in shock, caught off guard by the “discovery” of the addictive pattern. Conversely, at times they are not only aware of the trauma-stirring behaviors of others, they are “hyperaroused”—that is hyper-vigilant, anything but avoidant; rather, they seem compulsively drawn to that which upsets them. Paradox? Probably. The back and forth suggests a reaction to trauma, and therefore a post (not pre) stressor response pattern. We obsess over something so as to prepare for the worst—if you like, a backwards or preemptive form of avoidance.

Then there are other seemingly contradictory presentations, like that of the so-called gaslighted partner which, if said to exist in tandem with betrayal trauma (which I often hear of), would seem to render at least one of the phenomena unlikely, at least concurrently. Why? Well, gaslighting is about persuading someone that the thing they suspect is happening is not happening, and that they are crazy for insisting that it is happening. The term comes from a 1938 play and later film about a…it doesn’t matter. It’s about lying and then pretending that the person who doesn’t believe the lie is nuts*. But the term also implies a vigilance that predates the discovery that has rendered the problem behavior undeniable, which is contrary to a pattern of avoidance of clues, including dissociative symptoms, that implicitly precede though they might not always proceed from the trauma of discovery. As observers, we can grasp how a trauma sufferer may be alternately over and under-stimulated following a crisis, just as an addict is at times deadened, unstimulated, in withdrawal or guilt-ridden following a binge, for example. But can you claim to have repeatedly not noticed problem behaviors because of dependency needs but also insist that persistent inquiries into suspect behaviors are repeatedly, and concurrently, brushed off? Again, this would only make sense if the chronology of presentations is blurred but then clarified: that a partner’s scrutiny of an acting out figure is tentative prior to discovery–in other words, primarily trusting if skeptical of the denying reports of the depended-upon figure–and then intensified into hyperaroused indignation after a discovery event.

Meanwhile, an underlying element of this issue is not clinical, much less medical. The ethical/moral dimension of the betrayal trauma concept is both subtle and not. For providers and patients, the matter of trauma is not just one of clinical presentation (i.e.: symptoms of anxiety), or of etiological (origin) theory, but also one of justice. In betrayal trauma, there is a victim and there is a perpetrator, meaning someone who has done harm. See, in our contemporary society, it’s not enough to say that a behavior is immoral or wrong. Today, we must either demonstrate or declare that we’ve been wounded, hence the necessity of attaching the word trauma to the moral construct of betrayal. In this way, sex addiction treatment, and betrayal trauma models in particular, borrow the ethos of the civil court: no harm no foul. Less subtle, however, are the concrete implications of the victim/perpetrator divide. As the identified miscreant, a perpetrator is often guilted into surrendering habitation rights, money, sometimes time spent with children or even custodial rights, or most conspicuously, the prerogative to initiate sex. The euphemisms that leverage these concessions—terms like “boundaries”—are meant to be subtle, as in genteel or discreet. They’re not. Only the words are genteel and discreet.

Further, this blending of sex addiction treatment with notions of justice has a gendered inflection, one that plays (and trades) upon our most basic suppositions about male versus female sexuality. The reason betrayal trauma models focus on betrayal is partly about monogamistic values, but it more prominently concerns feminine vulnerability. And this is true only because of the demographics of sex addiction treatment: far more men, and specifically heterosexual men, are assessed as sex addicts than are women—again, so much for the chestnut that modern psychotherapy/psychiatry stigmatizes female sexuality more than that of men (unless you’re one of those who thinks that sex addiction is a compliment, or a leniency-affording “excuse”). Anyway, female vulnerability: here I’m referring to the submission that women experience in the act of heteronormative sex; of their need to trust in the reliability of their male partner, who may also be vulnerable, but only in emotional terms, not so much physically. This point is a bullet item of so-called moral equivalency politics. Basically, the vulnerability of men does not match the vulnerability of women, therefore male sexual acting out is more oppressive, more abusive, threatening, etc., than anything women might perpetrate. In theory, men are treated as impacted or betrayed partners also when their partners have perpetrated infidelities and such, but if you read or listen carefully to most of the unctuous pundits on these matters, you might detect the whiff of bias in their jargon: the “betrayed” male is likely an abusive or possessive figure, “narcissistically wounded” by the betrayal (versus the more sympathetic “traumatized”) of his female partner, which then triggers an underlying misogyny within his subsequent anger. You get the script. From SA specialists, he might receive a subtle re-conditioning effort: a sort of half-hearted patronizing of his betrayal, coupled with a discreet shepherding from attitudes of patriarchal privilege to a woke recognition of female sexual freedom.

Interestingly, despite the possibly inadvertent influence of civil court discourse upon therapeutic interventions, the converse influence is not apparent. The impetus to punish—sorry, “hold accountable”—the wayward sexually acting out figure does not extend to the legal arena. For some time now, divorce courts have stopped punishing infidelity (whether they think it addictive, gendered, or not), instead issuing “no fault” decrees on such matters. That places the matter of crime and punishment back in privately figurative courtrooms. Mental health providers, the sex addiction specialists who in effect preside over these private disputes likely tread a line that straddles tradition and latter-day social justice principles. They “validate” the betrayal suffered by impacted partners of a sex addiction, and “educate” victim and perpetrator as to the impact of auxiliary misbehaviors like gaslighting. But they must also avoid being mere advocates of monogamy, for that might place them in alliance with the unfashionably religious, plus that dreaded system of girl-power thwarting patriarchy. This is why the progressive-leaning SA specialist speaks of violated consent rather than monogamy. In the modern zeitgeist, to consent and be honest are the moral imperatives, not the values of exclusivity.

As a result, sex addiction specialists tend to speak of betrayal while dodging the m word. Again, this is so that seemingly value-neutral concepts like honesty, or the analogy of contractual agreements (apparently an ethos that traditionalists and social justice types can both agree upon), can be invoked without provoking older Superego specters. The new Superego also prefers the term spiritual to connote a departure from the oppressive inflections of the word religion, which tends to suggest rules and dogma, things known (spiritual seems to indicate that which is unknown), not so much a connection to the divine, which is ambiguous, un-dogmatic and refreshingly new agey. The new S-ego prefers to invoke consent as the issue to supplant the concept of monogamy, but still to indicate the ethic of contracts. This, for example, features in Braun-Harvey & Vigorito’s 2016 list of ethical guidelines for sexual health, as indicated in their book Treating Out of Control Sexual Behaviors. See, then the matter is that a partner didn’t “consent” to the addictive pattern, and thus a perpetration of harm has occurred. A sound argument in itself, however much phenomena occurs in intimate relationships that would fall under the “I didn’t bargain for…” category. But most societies don’t craft marriage vows pertaining to excess shopping, hoarding, or video-game playing. And so, there’s no escaping the impression that moral tradition and developmental histories are what really drive the concept of betrayal trauma—not commonly upsetting behaviors or naturally occurring phenomena like threats to life and limb—what the PTSD diagnosis was originally meant to observe. Suggesting equivalences between traumas calls for a lot of reframing, or re-branding, designed to soothe the passage of words into the mind or down into that oft-decision-making gut. I’m not sure it’s convincing, actually, this rhetorical massage. I think we might as well add a term to the inventory of traumas. A psychiatrist and classics scholar named Jonathan Shay has termed this moral injury. How about moral trauma?

*If the reader is interested in a more artful and certainly less co-opted depiction of trauma, try Andrey Tarkovsky’s cult classic film, The Stalker. In it, characters are drawn to a mysterious zone, an area supposedly destroyed by a wayward meteor, leaving behind debris of a ruined civilization. A guide (dubbed “stalker”) leads interested soul-seekers into the forbidden area, taking them to a mythical room within the zone wherein all of the seekers’ personal needs, hopes, desires will be met. It seems a metaphor for an analytic or spiritual journey, and it is not without obstacles, including rules that the stalker appears to impose with neurotic impulsivity. This room: it cannot be approached too directly, too penetratively, he warns. Worldly goods, such as one character’s knapsack of presumedly invaluable items—an expression of his rational control—must be left behind. The filmmaker is saying something about an everyman or woman’s journey. He’s also saying something about how we must tenderly approach a scorched yet still beautiful earth.

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The lost hour

I remember the first time Nadja and I talked about loss. Actually, I think it’s fair to say we talked around that aspect. I mean, she talked around it. I let her talk around it in so far as I did not call her out on talking around the matter. The matter, as I call it, was her drinking, plus the fact that it brought negative consequences, like loss. Nadja thought the Board of Behavioral Science was being unfair in denying her an intern registration because of a DUI she’d picked up a year before. That was the event that had led her to me originally, though she didn’t come clean, so to speak, about that until six months into treatment. Anyway, the matter of loss was initially—perhaps originally and perennially—swamped under a defense of rage whose pedigree felt primal. See, the board was like her mother: an aloof, terse and judgmental object, denying validation, withholding approval, love. Why can’t she/they forgive, she might as well have been saying. Why can’t she look past imperfection, say that everything—that she—is okay.

The elephant in the room was her expectation that I’d be the same. After all, why else would she wait six months to stop burying the lede. It’s a good job that I’m nothing like aloof, terse, and judgmental such that projections like these would stick to me. I sort of recall the first time she coped with loss in the transference by dissociating, which in plainspeak meant that she’d go quiet, sport a look of dazed intoxication, and then begin swaying ever so slightly. “I can’t hear you right now”, she’d say, alerting me to a phenomenon that I’d simultaneously observe. At least, I think I recognized it on about the 3rd or 4th occasion, mostly because it looked roughly the same each time. Ah, you’re doing that thing, I will have thought—that thing you do when I’ve constructed an insight that hits on something, speaks some truth. What a waste of time it will have seemed as she tuned me out, making me feel what it’s like to be not listened to.

Over time I learned more about Nadja’s loss experiences: about her numerous losses in the realm of romantic love—oh how I paid the price for being a heterosexual male during those sessions; about the near loss of her toddler child in a swimming misadventure ten years ago. That incident brought accusations of parental neglect against her. Mortifying. Then there was the dual loss of her parents: first, her dad, to a medical misadventure, a botched cancer surgery. Then her mother: suicide. A year later. Nadja has reason to be mad. She’s known loss, I guess I’d say. Three years ago, I invited her to lay on the couch, be my first analytic case, though I never called it—her—that. She’d cut down on the dissociative gazing, I thought, was ready to deepen upon tolerating the critical transference in our sessions. Eventually, she took responsibility for her drinking, stopped blaming the board for holding her back. At some point, they stopped holding her back: they gave her a registration; more recently—finally—her therapist license. A big achievement, of course. I’d had her back all the way, she declared gratefully. I’d believed in her, implicitly. Good job, she thought. But she never became a control case. My loss, I think, and hers. I tried. She tried, sort of, but wouldn’t commit to coming more than two times per week. Now we’re terminating. Now that she doesn’t dissociate as much as she used to, she wants to replace me with a somatic therapist, a woman—not me. Only it’s taking a long time. I don’t know. Is nine months a long time to say goodbye? Seems this thing about losing, especially losing that which has been good and truthful, is really hard.

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The Fog

The fog. A roadblock. The boat—as in don’t rock it. The can of worms—as in don’t open it. These are some of my—well, not my favorite metaphors, necessarily. Metaphors can be tritely employed, become unnoticed parts of verbal furniture. Don’t forget ships: they sail, and by doing so they suggest something else that’s slipped away, a calamity not prevented. Oh, and that reminds me of boulders. They block. Or they roll and crush. Don’t overthink them, said a friend once. He meant metaphors in general, not just boulders. Don’t overthink them? Don’t read into them, he clarified, forgetting himself. His favorite book was Catcher in the Rye. His second favorite was One Flew Over The Cuckoo’s Nest.

I suppose I started with fog because it’s the freshest metaphor I can bring to mind. It’s an oldie but goodie, but it showed up in my office the other day, reminding me first of a patient’s depression, then shortly thereafter of a writing assignment I hadn’t gotten to yet. J. was describing his state of mind the week he first heard of his now late-wife’s cancer. These days, he may have other apt metaphors for the stuck place he’s been in since her death, but fog is what came to mind as a signifier of confusion and comfort. The wife had been in a fog also: “I feel fine,” she said, following the appointment that first spoke of the tumor. Neither of them really took in the words. A year later she wasn’t fine at all. She was in another kind of fog, having lost a third of her body weight; roughly a third of her memory, by my patient’s estimation. Almost the entirety of her will in her last days. In the end the bond between had been foggy also—the apparent result of an affair the wife had been caught having a year before the illness was discovered. J. was stuck between resentment, guilt, and a layered coming together of loss.

He doesn’t dwell much upon the elements of fog. In that respect, he’s like my friend, incuriously using words, then moving on. For J., the metaphor of fog denotes a hateful condition that thwarts efficiency or focused energy. It’s something that keeps coming back. It’s unwelcome, something he and I should be working on, or something he should get medication for, not learn something from. Therefore, the reverie on foggy details is mine: I think of creeping white air of the type that hovers about my valley home on wintry days. Where I live fog is a rarity. It appears as if on schedule, heralding the height of a season, and a stilled, ritual presence. Its texture is moist but not sticky; its temperature is cool, which enables feeling cool; one can wade through it, seeing just a few feet ahead, which is all you need really if you move through life carefully, at a slow and sensible pace. You don’t have to get lost in a fog, not if you relax. I got lost in a fog—in the word fog, and with my indulgent conjuring. And as I waded sightless through the hour I lost touch with my patient, who had moved on to other words, but not moved on from his state of mind. But I think he saw me looking away, past his shoulder to some indefinite spot on a wall. His eyes seemed glazed, half registering my distraction but not speaking to it; not really noticing something important, that I was not paying attention. I looked back at him, seeking to recapture something, hide the sin of my disappearance. I’m sorry, I wanted to say. I’m sorry for your loss. I’m sorry I went away, but I’m back now. And I’m not going anywhere.

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Talking to the Big Guy

Okay, lemme see…what do I want to talk about? Uh, not that…maybe…near the end. But I wish…I wish we were on the phone, not that I don’t like to see Mr. D. He’s waiting for me now. He’s looking at me. I think he can see into me sometimes, like he can see my thoughts. I hope he didn’t see what I was thinking just a while ago. Anyway, I’d better say something: “Okay, where to start. Well, business first. I put the check in the mail for this month and next month, so that should have us covered”. That’s what I say. There. That should please him. Big smile. That’s right: give him a big smile, stretch this out. He’s not saying anything. Did he? Maybe he uttered something, but I barely heard it. That didn’t take long—not nearly as long as I thought it would. I guess I gotta come up with something. I don’t think he did say anything; I think he just nodded about the money thing.

“So, Mr. D I don’t…I don’t think I’m doing too good. I know you’re going to think less of me when I say that I let you down. I fell off the wagon, as people say—let you down, let down the big guy. That’s the most important thing, of course”. Also, I could’ve said I let father Larry down, too. I feel bad. I haven’t spoken to him in a while. I’ll confess to him later. Well, right now it’s Mr. D that I’m confessing to. It’s not the same, not as cozy as confessional. Not as spiritual. Mr. D: he’s the mental side of things. He’s looking at me weird again, like he does sometimes. I wish I knew what to say. I wish we could spread these meetings out, not come as often. I think I’d have more to report. Tonight, I feel like I’m spread thin. Ugh! What’s he thinking? He must think I’m a hopeless case, coming here every time, or nearly every time, talking about my sad stories, my slips and other failures.  I’m gonna start talking about….no, I need to tell him about Luce, even though I’m not proud of that. I don’t quite know what he’ll say but I should take that chance. He’ll probably disapprove, though he never really says it like that. I don’t understand all that he says sometimes, like that thing he says about—what was it—something about not wanting to say no to women, about waiting for them to make the first move so that I can think it’s their idea, not mine. I kinda get what he’s saying, something about it not feeling like my fault or responsibility. Anyway, I don’t know but I always feel better after I come here, for a little while anyway—like, until I start my car and drive away. Ha, that’s funny. But now I sound pathetic. It’s the same when I leave father Larry, or when I’m talking to the big guy. I feel good for a while and then…I just have to remember what father Larry says and what Mr. D kinda agrees with: I’m never really alone.

So far, I’m not feeling that kind of good tonight. Mr. D just said something else that sounds familiar and I kinda get it but not really. I blanked out for a moment there, was thinking about Luce again, darn it! My mind is…what? What am I thinking about? Where is my head at? What am I doing here if I can’t even concentrate for just one hour, or even just a few minutes? Who am I doing this for? Wait, that was a weird question. Is that me? Sounded like something Mr. D would ask, making a point about how I don’t do things for me. Okay, he’s talking some more now, the pressure’s off me for a minute. Actually, I think I like what he’s saying now—it’s interesting—but I wish he’d tell me more. I mean, I wish he’d give me some tools for how to use what we’re talking about. I have no idea. Wait, that’s what he’s saying now—that’s super-weird—it’s like one of those times he’s seeing into my head, maybe. He’s saying I have no ideas, and he sounds…I don’t know, is he angry with me? That’s…I don’t know. Hey, I just had a thought: I don’t like this idea about how I don’t have ideas. I should say that. I should say, you know what, I’m not sure this was a good idea after all.

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Good Sport

There’s nothing I can say in my defense so I won’t bother defending this thing I’m about to write. From the first moment to the last, the video was wretched, just one aural atrocity after another; one rabid sports fan after another spewing bile and gutter witticisms—the most absurd, hateful language anyone should have to endure, all because a team was letting them down. Letting me down also, I should add. I was no different. I was laughing my head off afterwards, thinking the vitriol was inspired. Burning my ears? Not exactly. That center forward: yeah, my grandmother could kick a ball better than he can. As for that goalie, I wouldn’t trust him to sit the right way on a toilet. He’s a disgrace. Has no business putting on the shirt, never mind kissing the badge of the tribe. Actually, now that I look at it—now that I say it out loud—I think I’m a disgrace. Acting like this, really? Barking at a television at six o’clock in the morning, then binging on post-game you tube commentary like a hypnotized adolescent. I don’t feel good about myself. It’s like I’ve sat up too late, slept in until noon, eaten too much sugar, not cleaned my teeth or brushed my hair. I feel all of that, earnestly, unhypocritically, impressively, for almost a minute. I’m into the freaks next, letting them carry my ball. The internet trolls: they’re much worse than me, I figure. They’re shameless, though they feel nothing but shame, have less to live for. They can’t possibly feel shame properly, looking and acting like they do; not as they film themselves frothing at the mouth, purging everything that hurts, contorting their faces, willing to get ugly for theirs and my evacuative pleasure. They’re doin’ it for me with this undressing they do. I’m living vicariously and I can match their deflation, if not their intensity.

And I can’t tear myself away from them. It’s over an hour now since the match finished and still I’m bathing in this aftermath of self-loathing and flagellation, just zoning out on chipped memories, how I wish things were like they used to be. The internet freaks are speaking for me, and not. I’m rolling with their mood swings, gazing back at their broken faces, just voyeuring their loss now. I’m starting to bristle at the unfairness, though. Through them I’m acting out some fantasy of unedited speech, unfettered rage—the license that lives far away from polite company, in an underground space during off hours. But one guy, the funniest one, is getting on my nerves calling out the right winger. Yes, the guy shouldn’t have been chosen to take that penalty. The number 9 should’ve taken it, no doubt. But spitting out that he should be sold the next morning, that we should never have signed him; that we should put him on a boat back to Brazil ASAP—that’s all a bit harsh. I’m glad I don’t play this game anymore. Glad I just watch, not that that’s much less toxic or exhausting. After all, it’s 9am and I’ve already ruined my Saturday with this bilious ritual. Soon I’ll be tired, need to go back to bed, feeling like I did as a kid, when it was time to stop playing and actually wanted to stop but couldn’t, or wouldn’t mostly because someone else wanted me to stop, needed me to stop. These days I can leave my toys on the playground, leave a mess that I can clean up later cuz there’s no one to step up and turn off my TV, that wretched monitor, and point me elsewhere to go do something worthwhile like reading a Bion paper for something like the 50th time. Still, it’s a good thing no one will see me like this. It’s a good job no one will know.

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Freud’s Bar

Okay, not quite. Freud’s Bar is a forum, formerly live, more recently on zoom, sponsored by the San Francisco Center for Psychoanalysis, that brings together members of that body to present and discuss matters relating to contemporary psychoanalysis. This video is a near replicate of a zoom video recorded on 4/28/2022 and subsequently made available for SFCP members but not otherwise made available because of the institute’s policies. Sorry. So, this is an encore, sans the rapturous applause of a 40-deep audience, one or two of which asked questions at the end. The reader may wonder if my oft-indicated co-author, Joe Farley, made an appearance at this event. The answer is yes. Joe appeared, looking fresh and jovial, dressed in a black robe, looking a bit like a Jedi knight, to deliver a superlative take on his case illustration of Dan and Vickie, which he wrote for our book Getting Real About Sex Addiction, which we talked about in the presentation. Sadly, Joe does not feature in this low-tech/budget re-make, but do not despair. Soon we may be podcasting or youtubing our thoughts together, and Joe’s Yeti-like elusiveness will come to an end. In the meantime, give this a listen, perhaps make a mental note or two. Thanks

Graeme Daniels, MFT

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The sex addiction excuse: the main points

Okay, I’ll make this entry relatively short lest ideas get lost in the mix, which is naturally a problem when issues are complex, as sex addiction is. There are many sides or aspects to the “is sex addiction an excuse” question, some of which I’ve referenced in other blogs so I’ll not repeat myself here. But so far the “excuse” question has not been the focal point of any particular essay so I’ve inadvertently buried the lede on this matter. Not any longer. Today I’ll express the point that gets some print in our book, even center stage in a later chapter that is about impacted partners. The book? Yes, you know, the one you’d know about if you had read any of the other essays on this blog. There’s only just over three hundred of them, after all. Take your time. What? Just write it again so you don’t have to read all of that. Well, you can get the title on any other entry of the last six months pretty much, but on the question at hand, here’s the deal as our current president would say: the sex addiction field is divided; that is split between forces that treat or advocate for sex addicts and those who more or less do the same for impacted or betrayed partners of sex addicts. I’m somewhere in the middle, having not gone to graduate school in order to change the world—meaning, I don’t consider myself an activist because my psychoanalytic stance, contrary to my writing, is not polemical in nature, though I do hold opinions activists tend to not like so they’d stick me in camps opposite to theirs anyway.

Here’s an example: I think that the “excuse” argument/position serves the defenses of both addicts and impacted partners, though because the excuse narrative is generally deemed a protection of the sex addict figure, my positing of an analogous excuse for partners will more likely annoy them as well as their activists. See, once again, the most strident among them think that sex addiction treatment is meant to be a unilateral challenge to the behaviors, attitudes, and underlying pathology of the addict, coupled with a dominantly supportive (meaning sympathetic) hand-holding exercise for the impacted-partner. This fosters splitting, a term that means something to psychoanalytic thinkers and less so to the public at large, much of which practices splitting on a daily basis. What is splitting? It’s binary thinking. It’s good/bad, perpetrator/victim; it is simplicity. It’s popular with those who covet simplicity because they haven’t the bandwidth for thinking when they are stressed. And they are frequently stressed so that creates a circular problem. Anyway, as I’ve suggested elsewhere, the first narrative is well known, and often true I might add: a person who calls himself an addict may do so to elicit sympathy, clemency from rightful consequences of their deceitful, disloyal behaviors (Judgy? No, I think that’s fair). Again, I think this “excuse” profile is a correct call out, but only for those who truly are dodging consequences, whether they are legalistic or not, and only pretending to take seriously their problems.

Now, to that other and much lesser spotted employment of the sex addiction “excuse”: How is sex addiction an excuse for an impacted partner of a sex addict? Well, firstly, consider and compare treatment feedback that addresses affair-seeking behavior versus sexually addictive behavior. Especially when the affair seeker is female, you would hear of a space yielded for a conflict resolution that recognizes a mutuality of relationship disorder; for a therapeutic process to touch upon relational issues, which by implication, both partners are equally responsible for. For evidence of this, read authors like Esther Perel or Alicia Walker who, in the shadow of a sex addiction field that aims treatment at men, assert ironies like “women are judged more harshly for their sexuality”. When the context is infidelity instead of addiction, one hears the so-called wayward partner saying things like, “I was lonely” or “I wasn’t getting my needs met”, and don’t be surprised if such positions appear legitimized by the neutral or activist authority that is the mental health intermediary. But if the affair-seeking is cast as a feature of sex addiction then all bets are off and the question of mutuality dissolves. Then responsibility falls squarely upon the addict while the impacted partner hears admonishments like, “his behavior is not about you”. This is why the label of sex addiction might (emphasis on “might”) be attractive to impacted partners, not just the would-be targets (sorry—subjects) of clinical intervention. What? You’re telling me that betrayed figures might choose a concept the ethos of which absolves them of any mooted “part” in the development of a problem? And lastly, might this potential secondary gain be one of the reasons why sex addiction has for many bumped the concept of infidelity to the curb as a condition of clinical concern?

Graeme Daniels, MFT

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Isolation: treatment of an impacted partner

What about the spouse or partner of a so-called sex addict? Well, what about them, said sex addiction treatment programs for many years. That’s the narrative of advocates for impacted or betrayed partners—that their clients have been ignored by sex addiction specialists who privilege attention to the acting out party, focusing upon their needs while impacted others are told to back off, not intrude upon the afflicted party’s “recovery”. Well, this is a complicated issue so the pros and cons of partner isolation, or “backing off”, as I put it, bear exploration. Firstly, as someone who has worked privately, as in individually, and as part of a collaborative team for over twenty years, I’ll admit that I have supported the segregation of a partner’s program from that of an acting out figure on many occasions. The reason: there’s too much of a rush to “do something” when you treat sex addiction with a directly systemic approach from the outset of a treatment episode. Now, a possible point of confusion: problems relating to sex addiction may be systemic—meaning, that sexually acting out behavior aside, a couple shares responsibility for relational problems.

But the problem is that since impacted partners have been integrated into sex addiction treatment as part of a “systemic” approach, the field has more recently adopted a perpetrator/victim model that addresses angry women (mostly), promising them “accountability” (as often as not a euphemism for punishment, used to disguise aggression and therefore lessen guilt), and enabling splitting defenses that lead to binary conceptions, scapegoating sexually acting out figures while their partners are given a pass on most relational conflicts because they are “betrayed”. In this model most impacted partners are treated as victimized figures, repeatedly lied to or otherwise emotionally and perhaps physically abused—basically not responsible for most if not all problems between the couple. Now, there may be some who will retort that this take is unfair; that the model in fact expresses that perpetrator/victim roles are “fluid”, implying that impacted partners become abusive and traumatizing themselves. Yes. In plain speak, this means that impacted/betrayed partners exact revenge, feel righteous when they apply “boundaries” post-discovery of sexual acting out, but don’t generally, in my opinion, accept that mutuality contributes to a pattern of acting out. That violates the “his behavior is not about you” ethos, which is then generalized, so any abuse between the sexually acting out figure and the impacted partner is presumed to be unilateral. Interestingly, this tacit heurism doesn’t apply if the acting out figure is female in a heterosexual context. Only in that scenario will you hear sex addiction or betrayal trauma specialists speculate that the impacted partner (if male) is as much the perennially “abusive” figure in the relationship, if not more so. This is probably due to what I have dubbed a feminist tautology: feminine victimization is a redundancy; unless proven otherwise, it is treated as a given—one of the tacit rules within the intersectionality ethic.

If you’re an impacted partner (especially a female one) reading this you likely won’t like the ironic tone of what I just wrote, but the non-ironic, problematic thing is this: I’ve sat with a lot of couples over a lot years (in other words, not just people like you, Heather) and—quite simply—I’ve observed or else heard about the above-described narrative many more times than I care to enumerate. Regardless, this opinion will likely be the most controversial aspect of Getting Real About Sex Addiction because it flies in the face of current political correctness. The treatment of addiction intersects with social mores, but in our progressive zeitgeist only social underdogs get to be cast as scapegoats, not heterosexual men. This is why sex addiction treatment, which is primarily aimed at heterosexual men, more recently eschews the paradigms of codependency or systemic roles like “scapegoat”, which imply that addicted individuals carry the pathology of a system and are therefore not exclusively responsible for relational disputes. Now, to complicate matters, progressive SA specialists will argue that the opposite has been long-true: that the field’s bias has actually been to employ the codependency and scapegoat concepts so as to dilute responsibility and cast unfair responsibility on impacted and betrayed partners. If this was, say, 1989, I’d say they were probably correct, but my sense is that biases have been tilted in favor of impacted partners for some time now, likely because women now represent a majority of practitioners within the field of mental health care.

Anyway, Getting Real actually begins with an exchange between myself and an agitated partner of an identified sex addict. In that illustration, I observe the frantic efforts of the angry, scared discoverer of an unacceptable pattern of behavior. Amid demands for decisive and implicitly sooner rather than later change, I outline an approach that will point her in the direction of support groups, her own self-exploration, with lesser emphasis upon what she’d prefer: an auxiliary role in the oversight of her wayward husband. In a later chapter, I devote many pages to this woman, who had attended a partners’ support group but soon dropped out, dissatisfied; she then sought a “full disclosure” in couples therapy via a sex addiction specialist (CSAT), but found that dissatisfying also, her husband merely compliant, not sufficiently earnest or candid within that exercise’s largely structured protocols. For a year she languished alone, not leaving her marriage in a practical or physical sense, but nonetheless feeling more isolated than she ever had before. In her efforts to get closer to her husband, even rebuild the shaky foundation of their twenty-year old bond, she’d tried everything she could think of—everything except looking at her anger. That she did in individual psychoanalytic therapy, or so I chronicle in the book. It played out throughout our relationship, from the tense, testy consultation we’d once had over a phone, to a later, intensive episode in which her frustration emerged in the transference of our sessions*. We met twice a week at first, then three times per week at the height of our arrangement. I know. If you don’t know much about psychoanalytic treatments then you’ll likely think that excessive, or you might not know what transference is. Think of it this way: if you want to get to know yourself with the help of a professional, it’s best they see you as often as possible, for as long as possible. You see, that way a person’s real self has less chance to hide. It simply increases the pressure to do what we call the work.

             This woman—Anne is her pseudonym—thought that the work of therapy would be “supportive”:  she supposed, largely from her prior experiences in therapy that she’d be validated in her complaints about her husband; that she’d be encouraged towards various ways to “self-care”, accompanied by the half-presumption that she didn’t do this very well. She’d be introduced to legitimate if weaponized rhetoric: terms like “perpetrator”, “victim”, “survivor”, “narcissist”, and of course “addict” were all invoked by group peers, her former providers, mostly in reference to her husband. Headlining the psychoeducation were terms like “betrayal” and “trauma”—again, legitimate constructs but often employed in a manner that externalizes problems and circumscribes meaning, blunting efforts at self-exploration. Why look at yourself if someone else is really the problem? And please, I’ve heard the expressions that feign responsibility, from the offhand, generalized, “I know I’m not perfect”, to the backhanded self-blame of “I didn’t want to believe he was an addict” or the quasi, glib self-exploration of “why am I so attracted to abusive men? I know. I know…I have low self-esteem”. At first, Anne did indeed feel validated and supported by the treatment aimed at her. But soon enough she felt patronized, and was secretly aware that the story of her marriage wasn’t as simple as some were reflecting back to her. In her meetings with me, I validated one thing: her feelings of betrayal specifically relating to the acting out of her husband. Besides that, I offered precious little of what she ultimately found precious and unconvincing. That didn’t mean she would declare herself singly at fault for a broken marriage; she wouldn’t victim-blame or otherwise split so explicitly in her thinking.

             In part due to the frequency of our meetings, she couldn’t hide the angry side of herself, even though she tried, by masking her frustration in subtle gestures of devaluation, and later—upon my interpretations of these moments—by overt expressions of complaint; her paradoxical need for an understanding beneath attempts to push me away. Part of her frustration in life was sexual. Like many impacted or betrayed partners, she hadn’t wanted a cessation or diminishing of her sex life, the semi-inevitable result of having discovered her partner’s cheating and porn-binging. Unlike some who invert the “excuse” phenomenon so often assigned to self-identified sex addicts, she wasn’t citing the sex addiction discovery as a pretext for refusing sex when loss of sexual interest was an underlying truism**. Nor was she a hypocritical monogamist, claiming betrayal while holding post-modern values that cast skepticism on the exclusivist, women-subordinating institution of marriage but still extolling the values of the white dress. Indeed, one of the feelings she wanted to explore in our treatment was her lifelong struggle with jealousy, and just as Esther Perel writes in her book State of Affairs, Anne felt that overwrought support for her betrayed experience had served to obscure this recently valid yet historically neurotic trait.

             Among the standard maxims within our profession and culture is the belief that jealousy, a derivate of hate, isolates. And we think this whether we are speaking of racism, toxic masculinity, misogyny, or its lesser observed analogue, misandry. Hate, or the perception of it, leaves us cold and distant; we lose empathy, othering the people we don’t know, or we forget the people we once knew and loved, or felt dependent on. I was reminded of this watching an old film recently in a state of unwitting jadedness. Ostensibly, I was looking for escapist fare as I selected Casablanca, one of the great romantic flicks of the WWII era, but also a story with hate and jadedness at its center. Rick, Humphrey Bogart’s character, is a cynical American expatriate wounded by, among other things, a lost love in the form of Else, played by Ingrid Bergman. When she returns to Casablanca with another love (for another man) but a lingering regret for having ditched Rick years earlier, she attempts reconciliation, only to find him bitter and drunk. In the aftermath of their tense reunion Rick asks, in effect, what did you expect? See, he felt entitled to his anger. No arguments from her—just a blank, wayward gaze. Ultimately, Else checks out, looks away, says she can’t feel anything for him in the face of his hate, even though she accepts his right to feel that way. Hate. Betrayal. Compulsion. Jealousy. Whatever it was, it had isolated them physically, emotionally. Psychologically, they were correspondingly split.

*Transference refers to feelings and unconscious thoughts that emerge in the therapeutic relationship that are based upon past relationships, especially those with primary caregivers

** I’m aware that this observation, paraphrased from one similar in the book, will be offensive to some readers. To be clear, I’m not suggesting that such ulterior wishes describe all or even most partners of sex addicts who enter treatment for themselves. But I am suggesting that this phenomenon exists, that it presents often enough, and that those who think this isn’t a thing are in another kind of denial.

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D has been reacting

D has been reacting to difficult situations with moral outrage for years. A thirty something married white man with one child, he holds a prominent position in a city government, and has been tasked with the management of a financial crisis amidst the Coronavirus outbreak—a crisis now largely traversed, he exclaims. Our exchanges are marked by venting outbursts: diatribes about workplace associates, political rivals and once allies, most of whom are turning their backs on him, blaming him for the budget cuts that they said were unfair and discriminatory, but which he says were necessary. D is a tall man with broad shoulders, the beginnings of a middle-age paunch, but the square jaw of a one-time high school football star. With a brittle, barely-holding-his composure tone in his voice, he decries the selfishness, the dishonesty, the immaturity of his peers. Sounding further like an indignant father of a spoilt pack of children, he speaks to an imagined audience, saying “wake up, people!” and “you’re lucky you even have a job”, half aware that his listener of the moment—me—is waiting to deliver a matter of fact observation. I’ll paraphrase:

“You chose this. You’ve come across this before”

I was referring to feelings stirred by previous, albeit lesser known public crises; by previous workplaces with hard authority figures as well as underperforming subordinates; by a detached, reportedly passive aggressive spouse; by an alcoholic and still difficult father. In each of these contexts, D’s discontent is not constant, but the pattern of reaction to stressors is consistent. When he feels betrayed or devalued, he responds in kind, whether he is acting upon frustrations with others or else suppressing his words and then releasing them upon me. Though he is not psychotic in his functioning overall, there are moments when he shares, and further holds eye contact with me, when it seems he might lose track of who is who in his life and in such moments, and therefore who merits the emotional deposit he wishes to make. At these times I feel pressure to respond. A hint of indignation rises up in me as I think of D’s entitlement (just as he is speaking of the entitlement of others) and pose to myself a provocative question: What did he expect?

“You feel turned upon”, I say, biding my time with a comment that seems benignly empathetic.

“It makes me question my path,” D eventually says, suggesting he’ll soon focus upon himself, observe something beyond the present moment of frustration. “I should get out,” he adds predictably. I think this set of words defensive: an escapist fantasy coming to the surface versus an understanding of what’s happening inside him. But D’s been talking like this to me for two years, which is likely sufficient for him to predict what I might think and then say. I know the backstory, of course. I’ll recall, he’ll expect, that he’s often described himself as selfish, immature, and—well, not dishonest. D asserts that with rare exception he’s always been honest. Integrity. With a crispness in his voice that he seems to reserve for that word alone, he’ll insist that integrity is the most important quality in a person. It’s a non-negotiable standard that he expects of himself and nearly everyone around him, save perhaps his three year old daughter. He might chuckle after that kind of righteous expression/whimsy. Again, though he likely won’t inventory the stories, he knows that I know the backstory: the teenage mischief; the locker room bullying, both received and dealt out; the college-era alcoholism and blackout sexuality; the sporadic thirty-something affair that preceded the birth of his child. These bullet-points don’t represent my judgements, but rather his.

What did he expect? The question didn’t leave the session. What had he hoped for, I nuance? I was softening the task with my wondering. I asked something like, “What vulnerability had you shown?” after he’d used that word—vulnerability—alongside trailing externalizations, words like “fairness” that further suggested what he’d expected, or what he’d hoped for. “I was warned not to make friends,” he states ambiguously, heralding another pattern that I’d noticed at least a year before. When D starts speaking of himself and his inner experience versus others plus his guesses about them he becomes vague with his language. The structure of his phrases becomes passive. Often, antecedents of pronouns are difficult to locate. All in all, there’s a sense that he wants to say something but wouldn’t mind if his listener becomes confused. Still, I gather his meaning, which has to do, ultimately, with his desire to bond with others: peers, subordinates, and authority. The reality of crises, of hard work and hard decisions disrupts the harmony of a happy family, a good team, friends, lovers, etc. He thought people loved him, cared about him, and would therefore “be supportive”, be understanding. Forgiving? And does D feel guilty?

What does he expect of me? Well, perhaps the same list of qualities and/or gestures, but he seems to expect a reality-check from me, like some manner of kick up the butt, which I don’t give. He gives it to himself. “Sure”, he utters offhandedly, not quite dismissively, after I’d given him the interpretation that I’d more or less summarized in the previous paragraph. I say, “You say ‘sure’ like the feelings are something else to shrug off, as if you shouldn’t really be feeling what you agree is there”

He chuckles. Is he laughing at my awkward turn of phrase, I wonder? Think I’m being playful? “It’s my way of swallowing it,” he replies by way of explanation. Tiredly, he then references his co-workers and the earlier diatribe, which now seems a spent force. “I’m a hypocrite”, he says, kicking his own butt again.

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