Tag Archives: addiction

You want honesty?

“I don’t feel like I can be honest”

The lament of the…well, of many people, but here, today, in this context, I’ll stick to an old chestnut–the compulsive person–and let the reader extrapolate what they will. What can’t they be honest about? their problem behaviors: drugs, sex, violence. If you have forbidden or just difficult thoughts are you meant to share them? Is there really a gap between thought and behavior? Think quickly, your compulsive self doesn’t think (think?) so. Meanwhile, doesn’t a complaint about honesty imply a willingness to listen to thoughts that acting out behaviors displace?

For those confused by that question, I shall retrace my steps and describe the concept of “acting out” as first explained by Freud (1914). Action replaces thought, feeling, and memory. Compulsive behaviors, for example, are substitutive: they displace energy from one objectionable idea to another, and the latter idea, though objectionable, is actually a lesser idea. That’s right, says the average dissenter, straining to understand this cant yet suspicious of its source…sounds NPR-like, or something. Yes, annihilating another or others in the plural may yield a sting of guilt, but it’s preferable to the sting of victimization, which is belittling, annihilating and, for the sake of posterity…so ultimately shaming. Make me great, as in big, again, not small. The small do not win, H.G. Wells be damned*.

An illustration, perhaps. A person has a complaint about an intimate partner–said partner has become less attractive physically. She’s a women whose hips have expanded. He’s a man sporting a “dad-bod”. Or, either has become difficult in some personal habit and is obstinate in the face of protest. “That’s your problem”, they dismiss, not perceiving the cliff of calamity that can greet such carelessness. The person who “acts out” with porn, drink, an affair, the reckless spending of money, is typically seeking an escape from such impasses. Not so fast, argue those cathected to the narratives of compulsivity. They aver that addicts will do what they do when they want to no matter what stressors or stimulants exist, therefore dog-whistling deflections are contra-indicated, if you please. Sorry, allow me a moment to slap my hand that taps on a keyboard, chastise the mind that thinks what it thinks. See, a question remains, slipping past the modern repressive: do the rules du jour mean that the “obstinate” partner is at fault for the mooted acting out that may or may not follow–ya know, that spending, hoarding, drinking, to infidelity and therefore betrayal hierarchy?

No, and the reader, if you haven’t already opened a new tab and becoming ensconced in a video instead, may notice that I will dodge dichotomies as if they are intellectual potholes. What I am saying is that conflict avoidance is the meta-essence of escapism, and that “acting out” and so-called betrayed partners share a responsibility–that’s right, share–for the relational phenomenon of checking out. Regarding those complaints about your physicality, your lessened drive, your attribution of “this is all you want” to your plaintive other, your wearying politics, or your fixed notions of what constitutes romance and “genuine love”–all the things about which you are politer, more open-minded during the the courting stage of a relationship. So, do you really want to talk about all that stuff, and potentially revise your views. Yes? No? What do you want?

** a reference to The War of the Worlds wherein the tiny, heroic virus does what humanity can’t: defeat the alien

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Bumper sticker treatment

I’ve heard it before a thousand times. I wrote about it in a book that was published three years ago by a prominent exponent of modern psyche literature: Rowman & Littlefield, now Bloomsbury. Getting Real About Sex Addiction could have been written twenty or thirty years ago, largely because not much has changed in that time. Some who toil in the field of sex addiction think that much has changed in that time because they weren’t in the field prior to that point and think that the things they observe and talk about weren’t being noticed before they came along. Well, some things, like bumper sticker treatment, have not changed at all.

              A woman calls me up, asks if I treat sex addiction, as my web profile suggests I do. I confirm that I do, though I add that I don’t presume that condition upon meeting a prospective patient. Rather, I assess a person’s situation over time, explore the meaning of concepts like addiction, compulsion, voyeurism, monogamy, sexual freedom, etc. “Uh-huh”, says the woman. “What about integrity?” she asks, which signals that she’s either done some reading on these subjects or else had a conversation or two with a sex addiction specialist. I think this because SA specialists like to use words like integrity while claiming they aren’t judgmental and aren’t looking to impose their morality on anyone. That means they think masturbation isn’t as sinful as religious zealots think it is, that pre-marital sex is normal and healthy, and that habitual porn use might be okay as long as one isn’t lying about it to an intimate partner. Pause. That is an area of moral judgmental, they might concede: don’t lie, or keep secrets and then lie when confronted about said secrets. Actually, that’s not a moral judgement, they’ll amend. It’s merely ethical, or it’s about values, which is conveniently broad and ambiguous. Ethics is not the same thing as morals. Ethics is morality light, and it’s humanistic, vaguely feministic, as opposed to being hoarily patriarchal and otherwise over-doggish.

              Anyway, my woman caller sort of blocked out of her mind the bit about exploring meaning because she’s already determined certain meanings. She dissociated, some might offer, on the hint of uncertainty—an aspect of her trauma, perhaps. When trauma is invoked in this context it’s another way of saying that thinking has stopped when something cognitively dissonant arises. She’s already diagnosed her husband as a sex addict having checked boxes on an online questionnaire and then watched videos about narcissism, which is often tagged as a sex addiction companion. “It’s not a diagnosis”, I say pedantically, referring to sex addiction, not narcissism. It doesn’t matter. It might as well be a diagnosis as far as this caller is concerned. She thinks several other labels are diagnoses also, all because someone has attached the word disorder to a series of bad words. She says she’s done her research. That doesn’t mean scholarly, peer-reviewed professional psyche literature. She’s been listening to a podcast about betrayed partners comprised entirely of female subjects, and speaking to a sex addiction specialist who delivered a familiar chestnut of preliminary telephone consultation: “his behavior has nothing to do with you”. It’s hard to say when this greatest hit of infidelity treatment intervention was first drawn from the pop psyche toolkit. Claudia Black’s Deceived, published in 2009, featured a chapter that was headed by the phrase, and I’ve heard it quoted back to me countless times since, at least. Apologists for this brand of proto-counsel will staunchly defend the necessity of making such a pronouncement early in a treatment episode, even before it has properly begun. The rationale includes the following: the importance of reducing blame that is typically directed at impacted partners, which includes the likelihood that the sexually addictive pattern has been lied about for protracted periods, possibly years, and that the betrayed partner has been made to feel stupid or crazy for having harbored suspicions of secretive, unfaithful behavior. Beyond the compulsivity of the behavior itself, this pattern of lying, of obfuscating (SA specialists like that word too) constitutes a form of psychological abuse tantamount to an act of rape. Therefore, it is necessary to validate the long-denied suspicions and declare a new era of healing wherein all assertions by the designated sex addict are taken with a fat grain of salt.

              Just one or two…or three, four, or five things to inject here: firstly, as suggested earlier, this assessment category—sex addiction—is not exactly an exactly defined condition, let alone something that can be pronounced with ironic impulsivity. So, as an introductory intervention, the treatment-orienting, bumper sticker pronouncement—“his behavior has nothing to do with you”—is predicated on an assessment of sex addiction that has not been properly made when this pearl of support is typically delivered the first time. It is an a priori, or presumptive supposition. Were a range of unfaithful behaviors cast as hitherto unknown, in which case the full scope of the behavioral pattern would also be unknown, the behaviors might be characterized as non-addictive, maybe aberrant, and therefore imbued with relational meaning: it was a “revenge” affair; the unfaithful partner was feeling lonely because the so-called impacted partner was verbally abusive, neglectful—in other words, the unfaithful behavior was very much to do with them, as it were. As the reader might glean, or know if having read my 2-year old blog entries or a handful of my podcast episodes over the last couple of years, this narrative is largely reserved for women who present for infidelity or sex addiction treatment. Actually, back up: the presumptive narrative is such that a would-be female patient would likely not be cast as a sex addict so quickly unless they were self-identifying as such.

              This is the real reason why sex addiction treatment is dominantly aimed at men—nothing to do with “lesser resources for women in psychotherapy”, which is a BS cover story promulgated informally by sex addiction cognoscenti who either ignore that most psychotherapists are now women, or they tacitly believe that anyone who hasn’t earned one of their precious sex addiction merit badge certificates is not really qualified to indoctrinate the consumer base with their bloated assumptions and derivative theories. The theory and meta-psychology on the gender disparity is as follows: many social workers, couples therapists, psychologists, etc., hold a semi-educated view that Freudian theory remains applicable to masculine sexuality and ego while asserting that it doesn’t apply to women. That Freudian theory holds that the human mind operates in a more or less economic manner, discharging libido, seeking to achieve a state of homeostasis that controls or lessens stimulation, including excitement and restive anxiety. Humans “discharge” is the idea, ultimately seeking equilibrium. The psyche or mental apparatus, as Freud put it, experiences vicissitudes, quotas of affect, a primarily quantitative manifestation of desire and need. Many still believe heartily that this theory of mind adequately explains masculine mentality, or at least masculine sexuality, therefore male sex behavior is not relational: “he” seeks pleasure regardless of context, or emotional state, much less the qualitative state of an intimate relationship. Ergo, the phenomenon of sex addiction, including the prejudice that it exists much more in men, is simply a derivative of this roughly one-hundred year old economic model of the mind.

              See, somewhere in the mid-20th century, along came object relations theory (a subdivision of psychoanalysis), plus humanistic and feminist influences upon modern psychology, to assert that not all minds work like this, and that women’s minds certainly don’t work like this, and that we should all think more positively, more wholesomely, more relationally, about what drives the human soul, whether we think religiously/spiritually about these matters or not. So, while “boys will be boys” ideas are readily grafted onto psyche assessments and verbose theoretical pronouncements, those of girls and women are nuanced to integrate elements of social conscious/unconscious forces: societal influences, the oppressive sexist external, not so much an impinging libidinal “drive” from within. For at least fifty years, the foot soldiers of our mental health army, including myself, have been trained to think that problems besetting the feminine are borne of social forces that are inhibitive, not an internal, biological compulsion, or a biological drive supplemented by an internalized social force that privileges rather than inhibits. Fifty years! That’s a long time to consider how things have changed or should change. It’s a long time to recite bullet points, learn the jargon, the right vocabulary, answer the questions correctly on an exam, or write the correct thing in an academic paper, or post on the Psychology Today letters to the editor, or more latterly, their popular blog-spaces, sympathetic, progressive ideas about psychological phenomena.

              Phenomenology is a big word signifying a rabbit-hole topic about why things are as they are, and how we as a collective got here in this state of affairs, as Esther Perel puts it. Bumper stickers, like letters to an editor, are likewise anachronistic, if better for the near-sighted. Blogs seem passe also, buried in the internet miasma. Tik tok and podcast presenters: these are the carriers of messaging these days, not writers. And the message is a formulaic, mini-essayistic delivery, something that will fly off the tongue and serve as a validating selling point—sorry, intervention tool—for a consumer who says they need treatment in order to learn something new about themselves, something they don’t understand, something previously unconscious…ya know, something that will make them feel better (NOT!). What do you want to hear? If you’re a provider, meaning a therapist, a social worker—a sex addiction “specialist”—what are you prepared to say if something rare happens, like a man calling you up for a consultation who claims that his wife is a sex addict, and he is a betrayed, impacted partner? The chestnut phrase coined by advocates, not neutrals, will come to mind. You know how it goes: “his…wait…her? His”, you start again, stammering because your tongue is letting you down, confused. Her behavior has nothing to do with you. Would you think it? Could you say it if you did?

And do we have to lean in further to gender stereotype to find what’s truly axiomatic amid bumper sticker thinking? So, as stated, I’ve heard the catch-phrases a thousand times. I’ve pushed back with something I’ve said maybe a hundred times, and written at least once before in, ya know, that book I mentioned. It’s this: of course, the person engaging in the behavior of taking their sexuality outside of a committed relationship is solely responsible for that likely repetitive behavior. The “acting out” person needs to own that, as SA specialists say, and not blame a partner for having gained weight or becoming conservative in their sexual tastes, or whatever the trope on this part of the debate is. Incidentally, the term “acting out”, widely used now in psychotherapy, was first coined by Sigmund Freud in 1914 as part of a paper that introduced another seminal term and idea, the “compulsion to repeat”. The concept of acting out refers to action (behavior) that unconsciously replaces thought, feeling, and memory. Okay, all that’s already too long for a bumper sticker, and simplistic treatment providers who con people with catch-phrases that make them feel better are reinforcing defenses when they, in effect, say you don’t have to look at your part in this. What’s this mooted “part”? It’s part two of the axiom, the twist if you like:

Addicts, non-addicts, cheaters, co-dependents, wives, husbands, boyfriends and girlfriends, theys and thems–whatever label you’re using to describe yourself: if you’re in a committed relationship then you have and have had a responsibility to talk, listen, and do those activities properly, as in think about what someone is saying to you, as in empathize, suspend for some indeterminate period how you think, even how you see the world. In psychoanalysis, this is termed “taking back projections”–yeah, I know, another catch-phrase. Take a look at your reactions to events, notice your struggle with dichotomies of good versus bad, villain versus hero, perpetrator versus victim, instead of good and bad, the idea that heroes and villains are contained in each of us but often projected onto others. No, once again, I don’t mean you’re responsible for someone else’s affair-seeking behavior or porn use. If you read this and then think, “so, you’re saying it’s my fault”, then you’re illustrating my point about the problem of dichotomizing. I mean that you’re responsible for the many problems in a relationship that you don’t want to deal with.

Try to explore the antecedents of your trauma responses and then notice that “….has nothing to do with you” in the context of an intimate adult relationship is a profoundly wrong suggestion. You think this is blaming, trying to get you to listen, and to think about what you bring to a flawed relationship? If you’re an impacted partner, you think this is “disrespecting” or not understanding your trauma? Okay, do a little research on that topic (trauma, I mean), and I don’t mean re-reading your favorite chapter in a self-help workbook. Actually, do a fair amount of research, act as if this is worth your time. Read American Psychiatric Association criteria for PTSD and find categories pertaining to avoidance of distressing stimuli, what afflicted persons do, repeatedly, to avoid uncomfortable feelings, alternating between states of dissociation, which essentially means emotional cut-off, hyper (meaning excessive) and hypo (under-reactive) states of arousal. Do a Wikipedia search on a man named Sandor Ferenczi, who wrote about trauma, childhood sexual abuse and how that impacts people in adulthood, nearly a hundred years ago. Revitalizing Freud’s once proposed and then renounced Seduction Theory, he paved the way for generations of traumatologists by arguing that episodes of trauma are not self-contained but rather re-enactments of developmental trauma, likely spawned in childhood. You’ll find that addictive states and those of trauma are eerily analogous, at times crossing over in individuals, otherwise blended within a dyad (a couple) in which the pathologies only appear to be segregated. This is probably why afflicted people tend to find and bond with each other, feeling compelled to repeat something forgotten.

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This is what Eric said

“I was a jerk,” says a patient about an argument with his spouse. He says the conflict was about dishes, and before that about whose turn it was to put the baby to sleep. Later, he reveals layers: he’s been trying to quit alcohol while his wife comes home drunk from a weekly “girls’ night”. He is further disentitled following her discovery of his recurrent porn use on their shared laptop a few weeks earlier. Their sex life has been negligible for nearly a year. They don’t talk about that. They argue about dishes.

In the treatment of compulsive sexual behaviors and their impacts upon loved ones, much attention is paid to the dual habits of pleasure seeking and conflict avoidance. Within the problem of conflict avoidance, an often employed if not directly identified habit is displacement, a defense mechanism first characterized by Sigmund Freud (1913) as that which transfers emotions from one idea to another to allay anxiety in the face of sexual and aggressive impulses. The alcoholic substitutes the bottle for the breast, gratifying an infantile oral impulse while disguising its expression. How does compulsive sex displace sexual instinct or substitute for it? Via perversion, Freud argued. Voyeurism, exhibitionism, fetishism, Don Juanism: these recurrent, habitual behaviors are all deemed unhealthy to one degree or another, but none is as “deviant” as an original sexual impulse from which the libidinal energy is displaced: incestuous desire.

Modern psychoanalysis does not insist that its unwitting patients engage in problem sexual behaviors because of an unconscious and unresolved Oedipal conflict, however much its adherents may think the theory still has merit. One derivative theory of displacement was popularized by Dr. Patrick Carnes in the treatment of what he terms sex addiction. Carnes (1983) explains that a sex addict holds negative core self-beliefs such as “I can’t trust anyone”, “no one would like me if they knew me”, and “my most important need is sex”. The antecedents of these beliefs are desexualized in Carnes’ model. The sex addict transfers onto ritualized sex his or her needs for companionship, tenderness, understanding, control and self-esteem; hence a rationale for a psychotherapeutic treatment that encourages patients to open up with their uncomfortable feeling states and seek alternative methods of affect regulation versus the “self-soothing” that compulsive sexual behaviors yield.

In diagnostic criteria and assessment protocols, “loss of control” is a sine qua non of substance use disorders and other addictive patterns. Amongst contemporary psychoanalysts who treat addiction, such as Dodes (2003), Director (2005), and Volkan (2021), a compulsive person’s loss of control is deemed paradoxical. The afflicted person seems drawn to experience that also appears to motivate an escape from the same phenomena. The alcoholic, sex addict, or compulsively “acting out” figure seems motivated to control an environment, other people; to seem omnipotent, in denial of “split off” states of vulnerability, of underlying helplessness. The result of their compulsive behavior, plus the indicator of a problem that merits treatment, is the loss of this sought-after control. Scrambling efforts to re-establish control are sometimes observed in extreme reversals, termed reaction formations by Freud (1907). The person with the escalating habit may adopt judgmental attitudes towards those who engage in the same problem behaviors. The impulse towards an opposing position (“I was a jerk”), or self-denial in the aftermath of a compulsive act, lessens the anxiety produced by the problem behavior in the first place.

The term “acting out”, often used by self-identifying sex addicts to denote a range of compulsive behaviors, is also derivative of psychoanalytic theory. Freud (1914) used the term acting out to indicate action that replaces memory, thought and feeling: “what is he acting out? His inhibitions, his attitudes, his pathological character traits”. This is a feature of the subject’s compulsion to repeat, in order to achieve mastery of trauma (via repetition), plus an unconscious desire to restore an original inorganic state (Freud, 1920). Death drive. An inclination towards insanity, “doing the same thing over and over again, expecting a different result”—self destructive action or tendency, a recovering addict might translate.

Regarding diagnosis, among the criteria for loss of control is the patient’s experience of “marked distress” related to recurrent behaviors and their impacts upon occupational or educational activity, or social and family functioning. Ley (2024) writes that it’s problematic if criteria for diagnosis is met simply because failure to control intense, sexual impulses or urges elicits distress due to moral incongruence based on religious values. Ley reports that he and others are pleased to see that the World Health Organization’s ICD-11 category of compulsive sexual behavior disorder (CSBD) features an exclusion statement for those whose marked distress is due entirely to moral judgments and disapproval about sexual impulses, urges, or behaviors. So, recurrent sexual behaviors should not be deemed out of control simply because they place someone at odds with religious dogma. But what about moral judgments that are not religious in pedigree, that are based upon a more fashionable Superego? What if, in the course of treatment, a subject is “educated” in a humanistic moral view which states that compulsive sexual behaviors demean and objectify women, or the view that CSBD induces betrayal trauma in impacted partners? If a subject is initially unmoved or unaware of the consequences of their behaviors but later exhibits distress because they’ve been taught that their behaviors harm loved ones and strangers, would they then meet criteria for the CSBD diagnosis? The question and grey area that’s being mined here is whether a person’s distress is externally-sourced and not the result of an internal conflict.

Psychoanalysis holds that assessment of that which is internalized is problematic when ideas are repressed and affects are dissociated. However, just because the subject is unconscious of internal experience doesn’t mean that distress isn’t in the psyche, there to be uncovered in treatment. The subject acts, repeats, instead of remembering, thinking, or feeling, and while Freud was not writing in the context of addiction per se when he conceptualized repetition compulsion, he may have provided with it the most important foundational idea in modern psychology pertaining to addiction. Further, this theory is relevant to treatment of impacted partners of sex addicts/those diagnosed with CSBD. Stephanie Carnes (2008) writes, “you may be questioning how your family background contributed to your choice to be in relationship with an addict. When older, it’s possible that you sought out mates who replicated aspects of your childhood”. In my experience, this kind of speculation is unpopular with some impacted partners, especially those who adopt a fixed, “your problem, not mine” attitude in treatment.

This patient’s idea for their own treatment is a palliative approach designed to offer emotional support and relief of suffering, not interpretations of underlying pathology that may lead to re-enactments of relationship problems. This is “victim-blaming”, assert clinicians who are allied to this position. Often, the result is a muddied clinical picture in which impacted partner patients are educated about complex trauma, which suggests developmental arrests that long predate the discovery of a partner’s compulsive sexual behaviors. Meanwhile, a preferred takeaway from treatment is that of an episodic trauma assessment and related syndrome, derived principally from the discovery-of-sexual behavior event, with long-standing lingering effects. The complexity is assigned to the extension of hyper and hypo arousal reactions to a variety of contexts, including “triggers” that don’t explicitly concern sexual behaviors. This patient feels threatened by any exploration of their pre-discovery, historical traumas, believing alongside their advocates that it will falsely mitigate the responsibility of their sexually compulsive partners.

A notable exception is their recognition of parallels to discovery events and prior clues towards disturbing problems. I find amongst impacted partners a tendency to remember instances in families of origin wherein family problems were denied or rationalized, or else censored from discussion until evidence of problems crossed a threshold—something like a discovery event—that compelled attention to the once ignored problems. These partners speak of “felt” experiences, times they knew something was wrong but didn’t protest, only to then feel betrayed and enraged when they later felt entitled to speak. Discovery of sexually compulsive patterns in their later partners does indeed replicate this history, they observe. One thing they won’t know is how this kind of phenomena was characterized in yet another psychoanalytic theory that has been paraphrased or re-branded by other models of treatment. What Freud called deferred action, or afterwardness as early as 1895, and what French psychoanalysts later called the apres-coup, refers to how sexuality in particular is transmitted in childhood via enigmatic messages, are constructed in fantasies, and are later presented in reality, the sexual-as-translated, which is then disturbing in effect. We don’t speak or even think of what we don’t or didn’t once understand, or that which is forbidden to speak of or think about. We speak about the dishes instead.

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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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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 ultimate risk of addiction treatment

 

In the field of addictions work, so-called, it is common for practitioners and later patients who integrate ideas to cast addiction as a problem of emotion.

The addictive personality is one who is pleasure and novelty seeking, and risk taking, it is said. Risk-taking except in the area of intimacy, wherein he/she is likely avoidant. Psychoanalytic theory, attachment theory, and a host of techniques derived from either, are supported by neurobiological research, which affirms that unconscious process, communication that occurs implicitly, via eye contact, body language, and voice prosody, is mediated via the prefrontal orbital areas of the brain, and nurtured (or not) in human beings during early childhood development. The role of the therapist in our society, not unlike that of the early caregiver in some respects, is to serve as an auxiliary ego, using words, reflection, tone and physicality: to connect.

Addicts and trauma survivors would appear to have something in common: a penchant for disconnection, or dissociation, as trauma researchers indicate. John Bowlby, the founder of attachment theory in the latter half of the twentieth century, offered that psychoneurosis derives from protracted separation anxiety: that children deprived of maternal care first protest, then despair, and then finally exhibit detachment, which is characterized by dissociation, a state of disembodied escapism. What latter day research indicates is that infants and toddlers’ levels of the steroid hormone cortisol maintain elevated levels when a caregiver is either absent or insensitive. If such a child is deprived of all caregiving, cortisol levels stay chronically high and therefore children will develop passive parasympathetic strategies of dissociation. Habituation of the brain to the opioid-releasing state of dissociation thus becomes a “default mode” of affect regulation. The result: a predisposition to addictive behaviors, and insecure attachment in the form of an unresponsive, intimacy-avoidant personality.

This perspective is a paradigm shift for many seeking treatment for problems of substance abuse, sexual acting out, food addiction, and such, because society’s inclination is to externalize the problem of addiction: it is the substances that are addictive, for example—not so much that a predisposition within an individual exists. Meanwhile, sex addiction is a term used by some to exert an alternative, moralistic argument against sexual promiscuity, or alternative sexual lifestyles, rather than an assessment term that draws attention to a mood or mind-altering use of behavior. Food addiction is a label that is likewise criticized for being a thinly veiled attack upon the obese, especially obese women. The problem with labels is that they elicit persecutory anxiety, especially in those prone to what Melanie Klein once termed the paranoid-schizoid position, a primitive stage of childhood development. The benefit is that labels, like any succinct form of communication, draws quick and urgent attention to problems that merit just that.

The reason why the paradigm shift is important is so that preventive measures can flourish. Education is of course important, but education in the cognitive, Socratic sense is only the beginning, not the end of the intervention. We can, as we have for decades as a mental health community, provide appropriate medical care for those whose dependencies (to opioids and alcohol, for example) merit such monitoring and focus; we can concurrently and thereafter dogmatize that the consequences of addiction (jails, institutions, and death, to quote 12-step programs) are prohibitive; we can gingerly (or not) shame addicts into realizing that their behaviors are self-centered and immature, and we can impose various consequences based upon the premise that imposing limits will alter behavior (actually, limits are a good idea, but are mostly beneficial for friends and family—not as an agent of change in treating addiction). But for real change, the following is necessary.

Consciousness. Structure. Honesty. Time. Consciousness comes first. Not consciousness of the problems outlined in the last paragraph. There’s plenty of consciousness-raising about that already. Consciousness of feeling states, beginning perhaps with bodily sensations, as mirrored, amplified, and sometimes spoken to by an observant other, perhaps a therapist: someone who will monitor the moment-to-moment reactions of the patient; modulate closeness, sensitive to the fears that may manifest as withdrawal, whether the person is aware of their defenses or not. Structure comes in the form of routines: go to therapy, 12-step meetings, work and family obligations, etcetera—those necessary things to do to support growth and recovery. Time: the re-building of this afflicted self takes time, patience, and ongoing consciousness, about things like bodily sensations, feeling states that are felt and not—about that which has been driven underground, into the unconscious, and otherwise discharged via behavior.

This recovery process is another kind of risk. The biggest risk of all: to re-attach.

 

Graeme Daniels, MFT

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How do I…?

How do I…?

  A question that emerges after the story has been told, the problem outlined. A man doesn’t trust himself: he has a plan to stop doing what he’s been doing for a long time, perhaps his entire life. He’s determined; the stakes are higher than they have ever been before, which usually means that others will be affected. Guilt will be key. The guilt stems from the prospect of failure, a background of it, and the implicit knowledge that there is something inside that demands expression.

 How do I…?

 As a therapist, I attend to the question on its own terms, responding with an outline’s semblance. First I mimic the crowd, who also knows the story, the history of the problem, and the stakes. Those stakes are reiterated. Regular reminders about the consequences of problem behavior: the impacts upon self and especially others; the damage to health, career, family. To hear some, you’d think that nothing more than such interventions are called for in the prevention of self destruction. I think that therapy supplies the subtext: people care; the man, despite himself, and despite the observations of some, cares also Further, reality can be cruel. Fate is indifferent.

 Implicit is the call for fellowship. The man in question has been isolating, not talking to others, getting lost in himself. Where is the accountability? I ask. I’m quick to explain: I don’t mean he should answer to me, or that he owes anything to anyone. At an early stage of therapy, I avoid stepping into dynamic roles wherein lines of authority are unconsciously laid. I mean something subtler; having something like structure, containment—that there is someone to speak to, to be honest to, when mania has run its course.

 How do I…?

 Continuity. How do you keep it up, your motivation? A woman changes her mind, doesn’t want what she wanted last month, has forgotten what drove her in another mood; what seemed different. The next twisting, turning switch must be explained while the past is denied. A therapist is memory—an aspect of containment. Something changed. Why? The question doesn’t compel answers as much as it does thinking, the protraction of curiosity, and slowing down. Very little has to happen “right now”.

 How do 1…?

Needs. A subset of the why question: why do people do what they do, especially if what they do generates guilt? Why doesn’t guilt itself motivate change? Why doesn’t remorse always do what courtrooms think it should? People do what they do in spite of guilt, in spite of shame, guilt’s less confident twin. Truth—that something within—hurts; it hurts self and others, and it always will. It needs out. It needs to be released, titrated in the spirit of compromise, for if it can be discharged without anyone knowing, then no one gets hurt.

 How do I…?

 Hope. When continuity has broken down; when the relapse once cast as a mere change of mind has returned the individual back to square one, a knowledge of pain lingers. The day after is another appointment. The fellowship, in all likelihood, is still there. People still care. The questions are still worthwhile. Curiosity is resilient. The therapist is in his office, waiting.

Graeme Daniels, MFT

 

 

 

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Memory of skittles

 

Do you remember going to movies as a kid, expecting colorful, fun adventures; a gripping, if not especially meaningful story? And do you recall those films whose lulls in exciting action, featuring longwinded dialogue (by my youngest standards, that meant all dialogue besides the phrases “look out!” or “we’re running out of time”) that left you confused, or bored, or possibly disturbed? Some stories, books or films, deposited ideas that I failed to grasp when I was young, but they left residues that my mind later absorbed, reorganized, and therefore put to different uses. Like…

I’ll eschew a Jungian pretense, a scholarly attempt to know the cross-cultural and time immemorial derivatives of modern storytelling. If Willy Wonka & the Chocolate Factory, the first ever film my parents took me to see (that I recall) is based upon, or is meant to parallel some Biblical or otherwise mythical antecedent, I was and still am ignorant of such information. When I saw the film when I was four, or maybe five, circa 1972 or 73’, I came away from the experience, like many other children I think, delighted by the color and mischief of the story. The rainbow images were childlike psychedelia, and an apt reflection of the candy ephemera I and most kids seem to fall in love with. The characters and story of Willy Wonka seemed fun and mildly comic; I was inclined to smile, laugh or even squeal at the playful action. At the same time, however, I recall feeling oddly disoriented by the menacing character that was Willy Wonka, and vaguely concerned for the sympathetic hero, the “honest” Charlie Bucket.

The morality aspect was not lost on me, even as a four or five-year-old. I was, after all, supposed to be downloading guilt around about this time, so a timeless cautionary tale about honesty or greed was actually, uh, well-timed, developmentally speaking. I recall the theme of gluttony being most impactful at the time. This may have been because I was at a movie theater, where candy snacks will have been (as they are still), with no sense of irony, sold in oversized portions to parents and children. I may have been more conscious, via experience, of greed and gluttony issues. Lying or treachery versus faith and honesty were likely not yet my cutting edge concerns. Maybe for me life was more about what I could do, when I could do it; when it was time to play, to stop playing; when is it time to notice too much of a good thing. The theme of patrimony, of passing down a legacy—notions of continuity and mortality—to a worthy heir, was lost on me.

It isn’t today, of course, but as I watched Willy Wonka recently over the holidays (it somehow seems an appropriate Holiday feature), I considered that the themes that resonated with my five-year-old self, that were implicitly deposited then, and which lingered thereafter, are still the ones that resonate most today. An addict is someone who is drawn by a figurative candy store; is seduced by an anticipation of pleasures: if not color or adventure, then of joyful affiliation, like-mindedness and play. The consequences of eating too much, of being self-centered, entitled or arrogant, are observable, but more so by onlookers, not the actors, save for a hero, the one survivor who will be redeemed, and rewarded with a happy ending. As a kid, I didn’t fully understand Charlie Bucket’s happy ending—that piece about inheriting the kingdom, whatever that was about. I just thought he’d been rewarded for not being too greedy. I might have looked at my mother to see if she were directing my attention, hoping I’d get this message, and thus I’d pick up my empty wrappers and not ask for more.

When people taste freedom for the first time, or for the first time in a while (going off to college, life after a separation), there is a sense of loss, one that may be felt palpably or tacitly, like the original losses. Buried. Not Buried. This is when the candy store opens its doors.

 

Graeme Daniels, MFT

 

 

 

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As dark as it gets

 

“Around ten o’clock, Andrew revealed a surprise: he’d been in therapy before, as in before he’d ever called me. And not even therapy, but analysis: for two years. He left because he didn’t like what he started to feel, a parallel between his drug addiction and emerging sexual compulsion. Though tired, I perked up, sensing something coming. Andrew spoke theoretically, about chasing highs, going back to an original experience. It felt like a prefacing explanation, his talk of addiction, its bedrock principles. Then he told me about his first time, the predictable, clandestine grope with an older girl, when he was eleven, she fourteen. The dreams of that girl, and his lust for teenage girls in general had never gone away, but he wouldn’t tell me more, not while there were legal issues pending, files not yet written. With that stuff looming, I wondered why he’d tell me anything, but then, I am ever struck by the desire to be known, by someone. Andrew’s loneliness gripped my heart, even as he retreated from memory, back to theory. He had an idea about pedophilia, he said, lowering his voice. It related to that original experience, that primal desire to be a child, experience pleasure as a child—natural, he argued. Shortly thereafter, his face broke, as if the pain in his soul had just hit him: that unsolvable clash between ancient fantasy versus the demands of growth.”

— a passage from Venus Looks Down On A Prairie Vole

Several points here, will touch on just a couple for starters. In this chapter, Daniel Pierce, my troubled protagonist and therapist, has serendipitously reunited with a patient he’d A.) thought he’d lost after a bad intake session, and B.) is the man whose privacy he is being pressured to violate by a rogue former prostitute and later, lawyers. Check out my novel and you’ll find out why.

The above conversation happens in the “privacy” of a shared room in a sober living environment–both men’s retreat. What Andrew (alias Derek) reveals here he would likely not have in the structured, orthodox forum of the therapist’s office. The thoughts Andrew shares are of a kind that few, in my opinion, share unless a near-profound alliance has been established. The reference to analysis, as distinguished from therapy, implies the depth divide between models of care, and further suggests what Daniel and Andrew tacitly have in common: they both tend to leave before the going gets tough.

 

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Sexual Narcissism

IMG_0458

“I’m in porn.” He’d said it quickly, in a clipped voice, while looking away, like he’d wanted the words off him, shooed away. I gave him a stilled look at which he grinned teasingly, masking unease. “Well, alright. I’m getting into porn, I should say. I’ve been in one clip so far.”

“Uh-huh. What film? What’s its title?” Rick laughed again, and shook his head. I felt like an idiot, stalling with questions to conceal my blushes.

“What film? I don’t know, man. Who cares…what film? Big dicks. It’s called ‘Big dicks’. There. I just gave it a title.”

“I’m sorry. I don’t mean to—”

“Nah, it’s cool. I don’t know why I’m giving attitude, actually. I’ve got a name, if that means anything. Kane—Kane Able. How do you like it?”

“A play on…I suppose.”

“Sure.”

“That’s good,” I lied.

So I asked about plot. About the film with no name: I asked if his clip contained any plot, or acting, or even theme. Surprisingly, Rick, or Kane—was pretty sure I’d not make the shift on this one—said there was. Firefighting, he said, not surprisingly. His part, as in his role, was that of a firefighter who has entered a burning building to rescue a trapped woman, who is feebly crying out (I imagined the acting) until the hero arrives, ready to spare her. The room is very hot, about which the performers comment wittily, and then the room gets hotter, and soon they don’t care so much about the fire and…well, you get the picture.

“Any dialogue?” I asked. Rick looked at me as if I were reading from a book of stupid questions.

“I ad-libbed this one line as I came: ‘fire in the hole, baby’, I said.” This time I said nothing. “I know, don’t tell me,” Rick lamented. “Pretty dumb, huh?”

“Did she say anything, have any lines, ad lib or scripted?”

Rick shook his head, uttered a dismissive noise, like I’d asked whether the props spoke on set. I blew air through my teeth, and thought of Lira.

“That’s typical. It goes to show there just aren’t enough good roles for women these days.”

— a passage from Venus Looks Down On A Prairie Vole

An example of parody in my mischief novel: the name Kane Abel is a play on words, of course, common to porn actors. My favorite from the real world of porn? Peter North. Subtle, right? Anyway, Kane is otherwise Rick, a young man whom Daniel Pierce meets while living at a sober living house, wherein he’s in retreat from a fraught personal and professional life. Rick’s day job is in a seafood restaurant, as a chef. There he causes trouble, disturbing his boss and Daniel’s temp boss, Jimbo, by stirring unrest, harassing female staff, flirting with nubile customers, doing very little cooking, it seems, while strutting his sex like a farmyard stud. Rick likely thinks his place in the service industry has layered meaning. He’s the kind of man who feels entitled to promiscuity, who feels offended, let down by another man’s diffidence, thinking that humankind benefits from the indiscriminate sharing of seed. He’ll try to re-ignite something in Daniel, provoke a libidinal return in the grieving, wilted psychologist. That last line, Daniel’s teasing of a feminist complaint, glides over Rick’s head, not so much because of stupidity, but rather self-absorption.

The role of women. What indeed is the role of women?

**image by Philip Lawson

 

 

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