Riding the high that you are disgusted with

A monologue:

“So, did I tell you I had this higher power moment? No? Oh man, I gotta tell you this. So, I’ve been doin’ well, right—I’ve got something like ninety days since I’ve done anything like inner circle, or middle circle behavior. Then I get this thing I gotta do mid-week for my job. I’m going down to this storage place, got my documents in order, gotta secure some space for our lab. It’s a semi-regular part of my job, and I’ve been to this place before, and it’s a fairly easy errand to run, only I need to carry some equipment so I say to this intern in our office, ‘hey you—and I’m pointing to him like this—let’s go, I got a job for you. Anyway, we head down there, get inside this place which is in the middle of this industrial park where there’s hardly anyone around and…behind the counter there is this totally cute girl who walks up to the front desk and…I can just tell—I’m not tryin’ to be a dick—that something’s happening. I mean, she’s smilin’ and being totally helpful right from the get-go, and being talkative, which makes me feel talkative and I can feel right away a surge of confidence. So, we do some business. There are these forms to fill out for the securing of the space we need. Meanwhile, the intern’s just standing there, waiting to be told something but not saying anything. The conversation is totally between me and this girl, right! I can’t remember exactly what we’re talking about—I make some cute remarks about what it’s like to work in storage or something—I mean, whatever, I’m just being funny, or she’s responding like I’m funny, giggling and everything. But she’s not stupid. She’s being sweet and kinda’ funny herself and she’s lookin’ at me like she’s into me. She’s fixing me with these eyes that are just, like, shining into me. Plus, the order starts taking a long time, as in longer than it should do, and eventually one or two other people are coming into the office and she’s gotta attend to them, only when she does she gives me this disappointed look, saying she’ll be right back, like she wants me to stick around. She does this two or three times and I can tell it’s a way to stall, only at some point it becomes awkward because my goddamn intern is still standing around saying nothing and acting like a third wheel. So, eventually we’ve gotta leave because we’ve completed what we need to do and she’s saying things like, ‘well, there you are…’ with a trailing, unsure sound in her voice, like she’s waiting for me to do something to keep this thing going. Actually, one thing I did do while she was helping another customer was grab a business card that might have been hers and I wrote on the back of it my phone number while she was away, thinking I’d come upon some reason to give it to her, only no logical reasons emerged, so…Anyway, we leave the store with me feeling frustrated because that all felt good, ya’ know—I mean, it’s been I don’t know how long since I just let myself flirt like that with someone, and I didn’t wanna’ stop. At the same time I didn’t wanna’ continue this thing because I had this voice in my head which was saying, ‘you know this is only gonna’ end up in a bad place. Nothing good can come of this. I don’t wanna’ keep being that guy’. But minutes later I’m outside my car after we’ve dropped off some equipment and it’s time to go back to the office, and I have an idea. The intern had come in a second car and I tell him that there’s something I forgot but he doesn’t need to stick around so he can just go back without me. Then I can go back inside and say something similar, like, ‘hey, I just forgot this one thing, apologize for inconvenience’—except that was bullshit, of course—and we’d continue the conversation and…I don’t know…I just didn’t want that feeling to end, ya’ know? So, moments later I’m back in the store and feeling like the coast is clear because it’ll just be me and the girl. No one else around. And when I walk back in and she sees me she smiles and she laughs, like she knows what’s happening, only what she says is a joke about the forms being a pain in the ass or something. Then something weird happened. Actually, two weird things happened. First, while I’m filling out some other form that I totally don’t need but whatever, she starts talking about her life and telling me about her problems—something to do with her kid and her mom. That’s all she mentions, so I don’t know if she was married—she didn’t have a ring on. And it was strange, though it soon became this really cool and intimate conversation, even though it wasn’t as much fun as it was earlier. Also, the whole time we’re talking, I’m aware of the card that’s in my pocket that has my number on it and at any moment I could take it out and give it to her, because now she was trusting me with intimate details of her life. But I didn’t. Then this older woman comes in—another customer—who is also talkative, so the girl starts having to deal with her like she did the other previous customers, like she’d get rid of this lady soon enough so we could resume our thing. Only the woman won’t leave. This woman is way chatty and is a regular or something, and starts talking about something in her life that she thinks the girl is interested in or knows something about. And this goes on for like another ten minutes…so long that at some point I can’t keep up the pretense that there’s anything left for me to do. I mean, I’ve totally exhausted whatever pretext I could possibly come up with for sticking around. I know it, and the girl knows it too as she finally comes over, does this inspection-like thing with my form and says—again—‘yeah, so…looks good. So, you’re all set’ in this voice that’s trying not to sound disappointed but wishing she could tell this other lady to get lost. And I smile and shrug—something lame because I didn’t know what else to do. Anyway, I leave, right? And as I’m walking out, part of me is feeling like I did before—frustrated and everything, missing that good feeling and wanting it back—but another part of me is feeling this relief coming on, like this was all predestined, as if that old woman had been an angel that had been sent down to be this nuisance, but a nuisance that would rescue me from a bad decision, plus the feeling of a high that I’d later be disgusted with. It was like someone or thing was looking out for me”

 

Or her

 

 

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Epater Le Patriarchie*

 

The ontology of addiction has been the central controversy in the sex addiction treatment industry for quite some time, alongside the quieter issue of whether upward interpretations (those that pre-suppose capacity) are appropriately directed at the habitually acting out. But neither of these should be the most controversial topics in this field anymore. What should be? Well, the clues are in the demographics of who presents for treatment; who typically presents as the impacted others, and thirdly, who are the treating professionals holding the protean sexual ethics that gird the treatment process. In communities with a diverse client base, those ethics reflect progressive values that obviate the casual pathologizing of sex, but in my suburban neck of the woods, a curious blend of traditional biases and menu-feminism continues to dominate discussions. More often than not, women presenting as betrayed partners exhibit authority with respect to intimate relationships; they are the standard bearers of what constitutes emotional maturity. This is a real problem in our profession: women who enter individual therapy, or couples therapy, or who direct their hapless male partners into therapy having read pop psychology literature that teaches that they have more empathy; that they have bigger limbic systems or thicker Corpus Callosums connecting their right and left hemispheres, thus enabling greater sensitivity to blah, blah, blah…ya know, that BS. Read feminist author Cordelia Fine’s Delusions of Gender, one of several books profiled in mine and Joe Farley’s forthcoming book, Getting Real About Sex Addiction, plus one or two recent studies we quote, to obtain a proper debunking of such femicentric myths.

And the myths extend to sex addiction treatment, skewing conceptions of male and female sex addiction, leading to diagnoses as well as intervention strategies with essentialist biases. I wouldn’t suggest that practitioners do not hold their male patients in high regard—that they do not sympathize with their lives or wish them well. I don’t mean anything as caviling or facile as that. However, I do suggest that our professional models of care, with their catalogues of nomenclature, jargon and assumptions now privileges feminine perspectives in psychotherapy because A) that’s now the dominant consumer base for psychotherapy in The United States, and B) Women represent the majority of practitioners in mental health care. I know it’s not like this from the female perspective. I’m sure my female colleagues would report that many domineering men enter therapy, including couples therapy, making their wives’ lack of sexual appetite the identified problem of treatment; overbearing fathers who assert that “lack of discipline” is the prevailing problem of all systems. But at least such clients are publicly and professionally decried, whereas the analogous excesses of our feminine client population are not. It’s becoming more common, for example, to read articles or hear of workshops that draw attention to negative patriarchal attitudes, masculine narcissism; the problem of “difficult men”. Do we read about or hear of ways to combat the problem of matriarchal attitudes? Female narcissism? Would our profession’s proletariat tolerate a workshop—especially one taught by a male therapist—entitled, “How to work with difficult women?”

The word is out upon patriarchy: heavyhanded parenting, sexual entitlement, and while many men do bring their passive Stepford wives to female therapists for a corrective talking-to, I think the example of women directing men to a redeemer class of men is more common these days. Thus, the worst offenders on this matter of skewed approaches may be male therapists. I’m speaking of a certain type of male therapist: he’s a rock star type—knows how to patronize feminine needs, advocate for them; be that man who will show other men how to be men in the 21st century. Ugh! I can conjure this hero in a couples’ session: he sits forward, talks straight, emphasizes action over words, patronizing the bias that thinking or the expression of it is overrated, and stares “man-to-man” into the eyes of his adversary, that “narcissistic” guy who won’t show his vulnerability, but instead terrorizes the women in his life, plus his kids, with his bad temper, his selfish entitlement. This rock star therapist will set him straight, and some women will love this guy, privately wishing he could replace the dinosaur that’s the subject of intervention. And can you imagine how this scenario is exacerbated when the context of treatment is that dinosaur’s sexual acting out? His mooted sex addiction?

The skewed approaches are grounded in a plethora of orthodoxy about how men and women are raised and therefore what shapes their development; and though careful women therapists may leave to those rock stars the harder foot work of confronting angry, hypersexualized men, the marching orders they carry out still reflect a feminine hegemony. Even popular figures like Esther Perel, admired perhaps for her paradoxically challenging neutrality, betray bias in how case illustrations are conceptualized. For example, in State of Affairs: rethinking infidelity, she rightly challenges, in my opinion, the common supposition that women’s sex drive is inherently weaker, only to then imply that the feminine drive is imbued with more imagination and relational intensity. Now, in keeping with the spirit of my last entry, I’m not one to pull the science card and say, where is the evidence for that theory? At the same time I think, where’s that opinion coming from? Who decided that it was a given, that it needn’t be substantiated? Next, in comparing (I think anecdotal) accounts of men and women’s regrets upon having affairs, she reports that women say things like, “I lost myself”, while men are more prone to say, “I lost my woman”. In descriptions like these, Perel accentuates the theme of self-determination in the meaning of women’s affairs, and while a traditional interpretation of the “I lost (her)” expression may assign romantic longing to the grief-ridden man, I think Perel is attaching a proprietorial connotation to the male figure’s experience. By doing so she suggests a lesser sympathy for him, instead joining the progressive critique of masculine possessiveness that is so fashionable in contemporary psychotherapy.

There are other subtle examples of bias in Perel’s largely admirable text, but the most egregious case of epater le patriarchie lies in her equally subtle adherence to an Oedipal Complex-derived theory of male infidelity, plus a diatribe about how female adulterers are treated worse by society than male infidels. Intrigued by a commonly-observed figure that is a decent, genteel man who nonetheless engages in affair-seeking or compulsive porn use, she paraphrases collegial psychologists who profile for such men a background of abuse at the hands of alcoholic fathers. The result is a hapless, codependent figure caught in the middle between a castrating patriarch and a downtrodden wife and mother. Subsequently, these boys become men who protect vulnerable women who are blurred in their minds with their mothers; hence, they deny their own feelings, including their libidinal impulses, which they believe are intrinsically harmful to these women—such is the distorted identification with the bad father. Sex with the mother/partner blur becomes a taboo—incest, even. The affair-seeking behavior is therefore a splitting defense: the man must keep separate his libidinal self, protecting the good, as in his image and her delicate feelings. Now, on the one hand, this is a fair interpretation of an Oedipal triangle, but one that relies upon the conscious memory of the abusive father and a bias towards blaming pathology upon that phenomenon. Robert Bly, in his then-zeitgeist writing of the nineties, observed a similar triangle between “nice” men and their enmeshed mothers and distant, angry fathers. But while also observing that such men fear their own feelings, Bly’s men’s movement slant afforded more sympathy to the exiled father, and more blame, I think, to the emotionally incestuous mother.

For the most part, Perel is not hamstrung by the need to appear “evidence-based”. Her book is riddled with pronouncements that she doesn’t feel compelled to substantiate, alongside an arbitrary few that she does feel obliged to support. For example, when asserting that infidelity is the worst thing that can happen to a marriage, according to Americans—even worse than incest of domestic violence—she cites Gallup polls indicating that people condemn cheating more than they do reckless gambling, divorce, or even suicide. Strangely, in a passage that’s only a few sentences long, she fails to give numbers supporting the claim that infidelity is deemed worse than incest or DV. That’s because that claim is unlikely, I say. Next, there’s a passage claiming that society judges more harshly “other women” than it does cheating husbands. Honestly, this complaint makes me laugh. It never seems to occur to plaintive women, whether they are feminist in sensibility or traditionalist, that this bias, which I agree does exist, is actually grounded in feminine chauvinist beliefs. This is like men complaining that they are “expected” to make more money than women. Yes, you’re expected to make more money because you do make more money. Correspondingly, the flip side of women’s relative lack of sexual freedom is an assertion of either moral superiority, superior self-control as it relates to sexual urges, or in general, a belief that women are the more mature gender, both emotionally and sexually. There. That’s my unsubstantiated, non-evidence-based pronouncement. After all, it’s women who covet and lay claim to the white dress, as there is nothing in a groom’s sartorial splendor that affords him a virtuous, as in virginal air. So yeah, I guess Beyonce was more pissed at that “other woman” than she was at her “errant” husband, as Perel asserts. But that’s a result of traditionalist assumptions. The woman lapsed to the man’s standard. That Jay-Z is a dirty dog is deemed a given. Duh!

Most subtle, however, and likely unintended, except on an unconscious level maybe, is the echo of the ancient feminine voice in the lament, “I lost myself”, that Perel attributes to women who have sought affairs. Yes, I know that thought—mine or hers—may sound a little precious, but my thought pertains to a series of passages in Getting Real About Sex Addiction that cite feminist historians’ theories of prehistorical societies. One such theory asserts that society was once matriarchal in its power structure and only became the opposite when men discovered the significance of their role in procreation and proceeded thereafter to usurp social authority. After this, the story goes that women were subjugated, their mythical images consigned to the sea, hence the ubiquity of metaphors that link womankind with water, and man with the later emerging dry land. Ontogeny recapitulates phylogeny, said biologists in the nineteenth century, to indicate that an embryo’s development mirrors that of a species. Freud subscribed to this principle, also. So, for each individual man, one woman, the mother, was once in charge of everything. For man as a collective, women were once in charge of everything. Then came the battle. Women lost. The battle continues, and man’s love/hate of woman manifests partially in his sexual liberty, taken to excess says one of several polemical movements taking aim at masculine privilege: sex addiction treatment.

It’s funny, but I’ve known a lot of people, clients mostly, who identify as addicts. Wait, that’s not the funny bit. What’s funny, as in strange, is that most of the addicts I’ve known will lie, blame, deflect, self-pity, act out, lie, blame, deflect, self-pity, all in a perpetual cycle, over and over again, until they die in some cases. Some of them stop. Seriously, in a manner that only addicts seem to manifest, some stop their behaviors and become hardcore acolytes of a “recovery” lifestyle: assiduous participants in treatment, therapy, 12-step meetings and general fellowship; dogmatic proselytizers of religiously inflected principles; somewhat closed-minded yet reliable stalwarts of rectified living, complete with rigorous diet plans, exercise regimes and otherwise clean habits that would put the average person to shame. In the aftermath of their active days of excess, the lying, blaming, deflecting and self-pity are not so much extinguished as muted—a stoical nod of acknowledgement and regret hides a repressed hatred of something, subdued under a remainder-of-life gag order. Of the heterosexual male sex addicts I’ve known, some betray residual resentment towards the officious women in their lives—wives and girlfriends, mostly (there’s that phrase again). Others, those “decent” men that Esther Perel writes about, have picked up the narrative of abusive fathers, sinister uncles, cousins and violating mentors, implying with ambiguous, half-formulated though not wholly misguided logic that such abuses are the root causes of both low self-esteem and the addictive behaviors that soothe. The one thing they won’t do is blame mothers. The one thing men will rarely do—not with words, because it breaks the world—is blame mothers for the bad that comes from sex.

*a play on the term epater le bourgeoisie, a rallying cry of the French decadent poets of the 19th century. The term epater means “to shock”.

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The Shadow of Esther Perel

 

One of the peripheral yet significant influences upon Getting Real About Sex Addiction has been the writing of Esther Perel. Actually, to be honest, though I have been aware of her work for years, I didn’t get around to reading her latest, State Of Affairs: rethinking infidelity, until the period wherein I was writing my own book. Reading Perel’s now best-selling non-fiction was not central to my preparation because my research focused less on social commentary than on resources more directly relevant to our title and subject: the body of literature under the heading of sex addiction or sex addiction treatment, and because of mine and Joe Farley’s interest in psychodynamic approaches, the wider body of psychoanalytic literature that is the true antecedent of that sex addiction literature anyway. Nonetheless, I picked up Perel’s book alongside my own writing, thinking it would stir supplementary ideas (which it did) about sex and society, which I decided I wanted to comment upon after all, and still further because I’d once listened to a TED talk of Perel’s. Though I don’t quote her particularly in my chapters, much less borrow from her impressive range of commentary, I was surprised by my reactions when reading her work. I was surprised at the level of envy that her writing evoked in me—envy of a certain freedom from orthodoxy with which she practices, and that I imagine has made her writing so compelling for so many.

For a therapist who has worked with many self-identified sex addicts, practicing within a non-conformist nook aside the treatment field’s contrived standards, this has meant the following: Perel seems to exist on the periphery of sex addiction treatment, and she responds to broader range of sexual contexts than are covered via mine and my co-author’s heteronormative client base. Though a variety of sexual acting out behaviors, some habitual, are profiled in her book, the concept of addiction barely gets mentioned in it. In one passage, she lists a number of diagnoses that might possibly be assigned to someone repeatedly engaged in affair-seeking behavior, only to lightly dismiss them in favor of more sympathetic assessment language. In another, she cheekily refers to sex addiction as the “malady du jour”, implying a distrust of the term’s reductionistic meaning. How very French, or Belgian, her turn of phrase. In her view, firstly, prose is duller than poetry, and more pertinently, what may otherwise be called sexual acting out or sexually addictive behavior is more often cast as acts of self-discovery (for women especially), with betrayal serving as a secondary phenomenon, more relevant to a non-acting out but committed partner, of course. A multi-lingual practitioner with a cross-cultural perspective, Perel explores the dialectic between human needs for closeness and freedom, and how that conflict unfolds within a public debate about monogamy; she argues that western society looks upon affairs with a “no fault” attitude—indeed, this position is codified into divorce law, though she does not comment upon that angle per se. However, she observes that this is rarely the case when an infidelity is discussed in her therapy office, and in my experience, this certainly is not the case when the pretext of mental health treatment is sex addiction. In fact, in mine and Joe Farley’s book, I argue that part of the point of the addiction framework, from a non-acting out partner’s perspective—actually, what may even be attractive to non-acting out partners—is that this framework strips away the “no fault” narrative by placing singular blame for infidelities at the acting out person’s feet.

Perel goes on to espouse other ideas that sex addiction specialists would likely bristle at but which speak to ever changing mores governing ever altering configurations of intimate relationships. Among others things, she suggests that sexual ethics have been profoundly impacted by rates of divorce over recent generations, and that social media and protean technology have revolutionized dating norms. Contrary to prostitution, affair-seeking has never before seemed so widespread, so easy, and perhaps, she dares to suggest, so acceptable. Amid this backdrop and regarding the secrets that affair-seekers keep, she doesn’t necessarily recommend honest disclosure, full or not, to impacted partners, thinking that such confessionals, while potentially healing for those partners, invariably shift and even constrict dialogues between couples. Discussions of betrayal take over from those of meaning—what was the meaning of the affairs, for example. I agree with Perel’s critique. Breaking from ethical standards that influence the practice of couples therapy, at least in The United States, Perel also suggests that therapists might keep secrets of individual partners within couples therapy, as long as a couple agrees ahead of time to this prospect. Perel argues that this can allow a therapist to hear of a secret from one partner and explore its meaning with that person separately, while simultaneously working with the other partner, and possibly hearing secrets from that person also. This is a compelling divergence from American psychotherapeutic orthodoxy even though I am not quite persuaded to abandon my own adherent practice in this area. Finally, and perhaps most controversially, Perel further suggests that the currently popular focus upon impacted partners’ trauma with respect to infidelity obscures an older and more salient (her view) discussion of good old-fashioned jealousy.

Perel’s avoidance of the addiction paradigm in favor of the old infidelity model may signal a reactionary trend. Has sex addiction had its day as a concept? Has the zeitgeist past, at least? Perhaps too many people look at pornography on a regular basis these days, or “hook-up” with multiple partners on a regular basis, or have so-called emotional affairs or clandestine connections via social media with old girl or boyfriends. Maybe they want and can effect threesomes or foursomes with their neighbors; want to engage in “kink” behaviors, or more plainly, want aggression in their sex lives as long as it’s consensual, however that’s arranged. If this abundance of options coupled with altered rules is the new norm then addiction—a concept meant to denote that which is out of the norm—won’t apply to those who are habituated to these norms and not inclined to self-criticism. Novelty-seeking and excess are in the eyes of beholders who don’t expect novelty; who think limits, and even sacrifice of pleasure-seeking, are normal by-products of a healthy and mature life. So Esther Perel may be right to avoid labels that represent standards that are out-of-date for many—however scary that may seem to some. She has the privilege, it seems, of not being bound by a sex addiction paradigm: to not practice, say, amongst strident peers or unctuous pundits who assert protocols of intervention, or who proclaim standards of assessment upon which subsequent interventions are predicated. She has no doubt earned her voice of independence, but imagine what would be different were she a relative novice training at a sex addiction treatment clinic. She might be tight-lipped with words like “reductionist”, which critiques diagnostic thinking, but find traction with the term “agency”, which indicates empowerment. Or, she might absorb words or terms like “paradigm” or “paradigm shift”, which are popular with those who like to think they’re starting revolutions in care standards. She’d likely adhere to an approach that posits addiction as a behavioral disorder whose deeper or subtler meaning is of secondary importance to managing crises that tend to be cyclic, and perpetual. When treating partners, she’d likely be schooled into an understanding of their trauma or induced trauma, and be cautioned against pathology-insinuating or “victim-blaming” suggestions of jealousy. Lastly—and this is a viewpoint I shall privilege in my next entry—in a field that has hitherto dominantly aimed its labels of addiction and narcissism at heterosexual men, she might further adopt the condescending, anti-male bias that sex addiction treatment quite pervasively represents.

 

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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.

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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.

 

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Happy endings/beginnings

Happy Star Wars week! Have you seen it yet, the supposed last installment of the franchise? I haven’t. Is it uplifting? A downer? My first question will seem strange in the future, when I imagine more readers may be giving these entries a look than they will right now. Time will obliterate this moment of wondering. In time, as in the next week or so (an eternity in my present circumstances) I may get around to seeing Star Wars: The Rise Of Skywalker (think that’s what it’s called). Forty two years after the first film came out, I am far removed from the excitable state that had me seeing the first installment back in the day. Like I shall be on Christmas day next week, I am a jaded adult wanting to sleep in rather than get up early to see if Obi Wan—sorry, Santa—has brought toys.

If I’m excitable or indeed compulsive about anything then it’s about corrupting things like the Star Wars mythos with sexualizing commentary. At least, that may be the view of clients and a few others who have been on the receiving end of my associations recently. One moment a man is innocently speaking of holiday plans, a weekend outing to see the new Stars Wars movie with his kids, and soon enough there are links in the air, connecting his idle thoughts with exercise routines and sexual fantasy. A languid sharing had undercurrents of arousal, I said: the plan to visit a gym would stir energy, place him in mixed company, with thoughts of improving his condition, building up his body…for what? The man caught my drift but perhaps didn’t like the suggestion. He’d wanted to keep things light and wholesome. I can tell because a compliant but begrudging man lowers his voice, starts to sound like a grumbling bear emerging from hibernation. He doesn’t like the talk that threatens to stir something threatening and I feel a bit like a fly that might get swatted any moment. Anyway, he insisted on lighter matter, turning back to the plan of taking his kids to see Star Wars and reminiscing about the first series of films that he’d also seen as a kid. A New Hope, the first film, released in 1977, is still his favorite he declared. A gratuitous recollection of trivia followed. The first Star Wars film was actually episode four, he recounted—suggesting three prequels that would not emerge for another generation. The first film had the best story, he went on to pronounce, and the most triumphant ending.

Not like the second (or fifth) film, The Empire Strikes Back, I suggested, colluding with the sublimated flow for the time being. That’s right, he agreed, adding that despite the deeper story-line, the eloquence of Yoda as he tutors young Luke in the ways of The Force, the ending is a downer. Depressing. Luke gets his hand cut off by Vader’s light saber and the future of the rebellion is uncertain.

Bummer.

Not the happy ending of Star Wars, the first film, I remarked. Exactly, intoned the man, thinking (briefly) that we were on the same wavelength. Strange term—happy ending—I then ruminated. Strange that for most recovering (or not) sex addicts the term happy ending has been co-opted and given a sexual meaning, pertaining to manual stimulation and illicit massage parlors, even sex slavery. I detected a slight sigh in my listener as I extended my comment, pointing out that happy endings in action films are usually orgiastic. For a spell I indulged my own tangential reminiscing, thinking that such endings were few and far between in the seventies. Star Wars, if the reader recalls, has often been described as a revitalization of the western ethos, only in space. See, by the mid-seventies the western, or at least the kind of playful, serial westerns that my father will have once enjoyed, were in decline, replaced by serious, socially-conscious action fare—stuff like The Godfather, or Taxi-Driver. The remaining westerns of that era—the odd, residual John Wayne flick, for example—were tired and unoriginal. Or there were good films that were complicated or too thought-provoking, like Robert Altman’s McCabe and Mrs Miller. Not as much fun. Star Wars, todays’ kids won’t know, was a throw-back to a time when it was okay to like a simple action story with good guys and bad guys and not worry that Marlon Brando would tell you off for enabling stereotypes and oppression.

Come to think of it, maybe the culture hasn’t changed so much since the seventies in that respect, so maybe Star Wars still serves the same function today as it did then. Anyway, so why did I have to go and stir the pot and spoil the fun with my weird evocations of unconscious process? One moment, this poor man was having a nice moment, thinking of the happy ending wherein Han and Luke are getting medals hung around their necks by the lovely Princess Leia, with the cute and comic support characters Chewbacca, C-Threepio and R2D2 looking on, grunting or else making their funny electronic noises; then suddenly I’m making more comparisons with Empire: in the first film, the darker back-story is under the surface. As viewers of the light-hearted space western, we don’t yet know, though we might dimly feel, the Oedipal crisis that awaits Luke—that he will be tasked with fighting Darth Vader (a play on dark father, according to Robert Bly in Iron John), who will symbolically castrate Luke before finally succumbing to his son in the third film, Return Of The Jedi (the third film also resolves the near miss on the incest between Luke and Leia—whew, that was a close one, says the ego!). Then I conjure the climactic scene of Star Wars, with Luke as the lone fighter/sperm diving in his spaceship at the giant death star/egg; then he shoots his last shot, his precisely-aimed photon whatever/wad that strikes at the hard-to-get-at slot, leading to a giant blast explosion while—I swear to God—it looks to me now (okay, not so much when I was eight) that Luke hangs his head back, breathes out and pulls back like a man who has just…well, you know. But enough. I’ve surely done enough harm with my words.

“Great shot, kid. That was one in a million”, exults Han Solo, affirming the risen hero, Skywalker.

Indeed it was. Now that’s a happy beginning/ending.

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Life weans the giraffe

 

Not so randomly placed in mine and Joe Farley’s book, Getting Real About Sex Addiction, are the ontological issues surrounding the term sex addiction. It’s in the title, even, this suggestion that what we’ll be doing is examining the term sex addiction more than any other mental health abstraction and therefore addressing the problem of problem sexual behaviors: is this a thing, a variously skeptical public asks? The members of Sex Addiction Anonymous (SAA) have of course made their decision on this question. Committees of The American Psychiatric Association and The World Health Organization have not quite made theirs, rejecting the proposed diagnosis Hypersexual Disorder in the case of the former body, and recently (and provisionally) accepting the diagnosis Excessive Sexual Drive in the case of the latter organization. To be clear (or not), neither of these terms are synonymous with the construct of sex addiction, but we’re in the same ball park here. The issue is complex. It is medical, psychological and meta-psychological, as in ontological: is a human being’s sexuality a function of biological drive and are problem behaviors therefore a matter of excess desire? And even if that natural conclusion is drawn, where is the role of nurture in the matter of etiology? Are we talking about an interpersonal versus an intrapsychic event, as in a phenomenon derived from early childhood development—a weaning that went awry versus a web of innate fantasy (or phantasy as Object Relations terms it) within an infantile mind? Or is the broader social and cultural environment the more prominent accomplice in a dysfunctional sexual development?

We’d prefer to think so, at least. And so we hear weary chestnuts that even the most progressive-minded observers must be tired of hearing by now: theories of pubescent or post-pubescent development wherein boys are subject to mores that encourage their essentialist aggression, their concomitant sexual freedom, with consequent pressure to conform and therefore perform when being so deterministically sexualized. Meanwhile, girls are discouraged by societies across cultures from expressing freely their sexuality; they are raised to be demur, ashamed of their sexuality, and therefore passive or possibly manipulative in their sexual expression. And even if this is changing somewhat in a millennial age (really, have you noticed?), then it is surely a reaction to those previous oppressive norms, yielding a confusing transition phase wherein girls, boys, or those along the gender fluid continuum (suggesting a flight from binaries) switch roles at times, thus conforming to a newly burgeoning if less-defined ethos. And so we observe a faction of diffident men and boys who speak of respecting the feminine as if they are resisting in their stance a combined biological and social force upon their being. And we observe women and girls who seem increasingly aggressive and entitled in their sexual freedom while proclaiming the lack of freedom that is afforded them by an arbitrary social reality. In analytic terms, this is the realm of the unconscious but not the repressed, these habits and mores that we download from the culture. By unrepressed I mean something that is not kept away. Isms and other mores may be unconscious, but as we routinely observe, they are hardly kept away. They leak and make a mess, pervading our experience.

The premises of these positions must be difficult for the average mental health professional to sustain given the contradictions of theory and life itself. Firstly, within our profession’s demographic map, that average person is likely female, white and therefore privileged in terms of race, at least. She has been raised and subsequently educated within an atmosphere that encourages or affords (not privileged—we only use that word in this context if we’re feeling critical) a social justice lens, which means supporting narratives that advocate for the underprivileged. In Getting Real, I argue that within the niche field of sex addiction treatment (and perhaps psychotherapy as a whole), this demographic phenomenon of recent generations results in a skew that targets a privileged (non-ironic diction) client population–heterosexual men—for devaluation. The aggregate of thought suggesting how males and females are socialized towards sexual behaviors and identities emphasizes the post-pubescent experience, which for some might imply agreement with an embattled psychoanalytic idea: that pre-pubescent and certainly pre-verbal sexuality is repressed, as in kept away, and for the most part is not leaked and is therefore a lesser factor in pre-teen childhood development. There is no scientific evidence of an Oedipus Complex, say critics of psychoanalysis. There is evidence of pre-verbal attachment styles, the capacity to communicate and comprehend on a pre-verbal level, thus children’s psychological development is profoundly impacted from birth onwards by events, both benign and traumatic, that occur perpetually.

The onset of sexuality is a function of hormonal development, says a medical argument—not some manner of release from childhood repression. Puberty is the psyche’s sexual alarm clock, indicating that it’s time for play of another kind; an incipiently adult kind. Feelings like joy, excitement, wonder, fear, shame, and guilt may all be observed in small children, some pre-verbal, some not. Emotional expression, proximity-seeking, may be developed or not, contingent upon the presence and consistency of a capable adult. The nature of a child’s attachment to a parent (or primary caregiver) will be internalized as a working model of attachment that will further shape development and relationships, possibly over a lifetime. That was John Bowlby speaking and writing over fifty years ago, saying something similar to what D.W. Winnicott was teaching, only with more attention to physical need than the fostering of a distinctive, creative mind. If you the reader are silently nodding in agreement, then you’re joining at least two generations of mental health providers who generally agree with these principles while implicitly thinking that sex is not part of the early attachment equation. You’ve likely been taught to believe that proximity or object seeking, plus patterns within those relational drives, are shaped interpersonally and by broader environmental norms; that we have implicit (neurobiologyspeak for the unconscious) memory of early attachment patterns, whether they were traumatic or not; that we have implicit bias (appropriating social justicespeak for the unconscious but not repressed) in relationships, yielding prejudice directed at distinct social groups. Yes, joy, creativity, and some of that bad feeling stuff is indeed fostered in a child’s development, but not sex. Not arousal, or longing. That potential is activated later…when it’s appropriate, of course.

So, why are there excesses? Why this untidy disorder, this chaos of spillage, as if life were some kind of cosmic dumping. There, says…something: here are your tools in a pile and a flood. Do with them what you will. Is addiction, for example, a blend of natural hormonal excess negatively complemented by an insecure attachment style, of weak or failing repression barriers? And if this shaping does occur both intrapsychically and interpersonally, shall we break with our profession’s current theoretical orthodoxy and resolve that sexual nurturing largely coincides with biological schedules and is dominantly imparted with the help of the cultural village? A village that also fails, perhaps. Because if this isn’t the roughly hewn plan then we must revisit what our developmental theories otherwise imply: go back to society with ideas it doesn’t want to hear and consider taboos, as in pre-teen or even pre-verbal sexual exposure, as the original source of sexual development. We’d have to imagine that arousal and longing are part of the same dyads or village-child-passing-around norms that bring food, enable good sleep, play and a spark of imagination. We’d have to imagine that breast-feeding, or the bathing of infants’ genitalia, or the physical control of their evacuations are truly antecedents of sexual desire, or that excesses in this private realm nurture later distortions of sex as much as any unconscious yet unrepressed social message conveyed via so-called modeling to a conscious mind.

Though it would likely elicit thought-blocking accusations of misogyny or homophobia, we’d need to re-think child-rearing in a way that might stir panic; contemplate sexual orientation in a way that would challenge etiological assumptions. If the excesses of sex addiction are rooted in early childhood development, trauma specialists sometimes suggest (but don’t prove) that childhood sexual abuse is an accomplice to later sexual acting out. In this way, modern psychology comes full circle, revisiting Freud’s original Seduction theory, only with a significant permutation. Instead of conversion symptoms like the paralysis of limbs, patients present with compulsive behaviors, what Freud described as repeating versus remembering, or the shorthand, repetition compulsion. Sandor Ferenczi later gave us the term and concept “Identify with the aggressor”, attempting to rescue Seduction theory from its then-exile, to denote a relational identification between victim and abuser—to indicate a kind of psychic hostage-taking. If the vast majority of sexual abuse perpetrators are male, as a mother-idolizing culture would have us presume, then why doesn’t a corresponding majority of male molestation victims report or manifest ego-dystonic feelings of same-sex attraction? Or perhaps they do and are therefore, in keeping with analytic thought, manifesting the defense of reaction formation via a false heterosexual identification. Does it seem complicated, this human development? Maybe that’s why it seems to be taking longer and longer for children and young adults to grow, with the meta-tasks of an internal, interpersonal, and collectivist set of systems to navigate. I understand that some animals in the wild are able to walk within a day or an hour of their births. They grow up quickly in less complicated systems, with simple brains that are mindlessly free of sexual neurosis. Are the plainer brutalities of nature—the ubiquity of predation, or the threat of being left behind if not ambulatory—the forces that force giraffes to their feet? Do their hormones help? Or do they “grow up” quickly in other ways, if you know what I mean? What if our life expectancies were less than a decade? Would we evolve a quicker, more expedient onset of the pubescent watershed, becoming unrepressed yet thoughtless, and actively or relentlessly sexual, all because it was necessary to survive?

 

 

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