G: Hey there, welcome. This is Graeme Daniels, psychoanalyst and author. I am a co-author of Getting Real About Sex Addiction and more recently, the author of An Analyst in Training, and I am the winner of the American Psychoanalytic Association’s Lee Jaffe prize for my paper, “Panal Treatment of an Alcoholic with Substitute Addictions”. I am here today with a guest, dr. Davide Sakmanov, host of the podcast, “the empathy coach”, plus the workbook, “do it the right way: a practical guide for behaving properly”. Davide Sakmanov, welcome to the show.
D: Thankyou for having me
G. So, Dr. Sakmanov—sorry, the doctor—is that a medical title?
D: No, it’s a sobriquet, as it were
G. A nickname? So, you’re Doctor Davide?
D: I prefer coach Davide. The doctor thing is more of a nom de guerre, if you will
G: Nom de guerre. So, this is war. And you’re not a doctor
D: Not as such
G: Or an academic?
D: Umm…define academic
G: a Ph.d, for example
D: No, not a Ph.d. Sorry, are we here to discuss my credentials?
G. Only if you don’t have any?
D: Alright, if it’s like that, then I’m an MSW, a CCPSC…
G: MSW—social work. CCPSC?
D: Certified Process Safety Professional
G. Is that a mental health credential?
D: It can be. Look, I thought we’re here to talk about my intervention model for the treatment of sex addicts and their impacted partners. You’ve written your big to-do paper on “substitute addictions” or whatever—good for you, and I read it in fact—but I’m here to talk about my model of care that emphasizes empathy. I call it the 2 Es idea—emphasis and empathy—that are the building blocks of a paradigm that has drawn countless listeners and followers…
G: Countless? I mean, if you’re referring to your podcast, it’s easy to track #s. It tells you how many people you have listening, so it’s only countless if you don’t know how to read numbers
D: Okay, thousands. Is that what you want to hear? I have thousands of listeners, and lots of readers
G: Lots?
D: Yes, lots. I’m popular. Very popular. You’re popular too, I’m sure, though I bet not AS popular as me
G: Okay, we’re popular. Maybe you’re more popular, let’s leave it at that, shall we? Let’s talk ideas
D: (relieved) Yes, thankyou. Gawd…
G: Okay, so in your model, the—lemme get this right, Recovery Empathy Couples Therapy Unified Mission– just thinking of what that spells, actually—you bring together couples who have been impacted by infidelity issues, sometimes other addiction issues (we’ll come back to what that means, maybe) to do interventions relating the traumatizing effects of cheating behavior, which includes use of online pornography, utilizing feedback from a treatment team of collaborating professionals. So, I’m curious in particular what that last part means, the “utilizing feedback” from a treatment team
D: Right, so as you probably know, old school therapy models, addiction models, recommend that the sexually misbehaving person, or perpetrator as we call him, does his personal therapy work privately while the woman does hers separately without any coordination that would make her feel safe. The thing is, as the partner, you have every right to know what he is doing and what his treatment plan consists of, and you get to weigh in as to what you believe will strengthen the relationship.
G: Well, there are a number of phrases there that bear exploration, but firstly, again, regarding “utilizing feedback” and say, the “right to know what he’s doing”: do you mean that impacted partners have a right to know, and therefore should know via feedback of a treating therapist, when a cheating behavior has occurred? Are you asking individual therapists to inform other therapists in a treatment team, and thereafter, their impacted partner clients, when a behavioral slip or relapse has occurred?
D: We can do it that way. I know of countless occasions when that has proven therapeutic both for the perpetrator of infidelity and the impacted partner. We know from our clinical experience that disclosing behavioral slips makes an impacted partner feel safer, plus it’s relieving for the other person to have that experience
G: Clinical experience. Not exactly proof, as you put it, but let’s say we agree that it can be therapeutic for an acting out person to reveal their secret behavior to a partner. But you’re suggesting, I think, that the disclosure would occur via an informant therapist, not the perpetrator, as you put it.
D. It doesn’t have to work like that. It would be best, I guess you’d say, if the perpetrator did the disclosing.
G: Under duress? Meaning, it would be “tell your partner or else we will”
D: See, I think you’re trying to make this something it’s not
G: I’m more than trying, I think I’ll succeed in making it sound like what it is. You’re saying that if a client in your program reveals to their individual therapist that they have slipped in their behavior—let’s say, looked at porn—then that individual therapist would communicate that information either directly to the impacted partner, or to that partner’s individual therapist, who would in turn relay that info to the impacted partner, yes?
D: Under the terms of an honesty agreement that we have our clients sign, then yes, that’s how that might play out. I don’t see a problem with that
G: The terms of an agreement? Is there an understood window of opportunity in which the acting out person must disclose to a partner?
D: We like 48 hours. We think that’s enough
G: Between disclosure to a therapist and thereafter to a partner, or between the onset of the behavior and disclosure to a partner?
D: Okay, well I guess the former in practical terms since the disclosure to us is when we’d remind the client of the honesty agreement
G: (upon pause) Do you find that they need reminding? Presumably, they are aware of this agreement all along, or certainly upon agreeing to it. You’d think it would influence whether they choose to share with a therapist an instance of cheating behavior, as your program defines that. Don’t you think that sets up a dynamic that contaminates the authenticity of disclosure? Why would your clients share their secrets with you if you’re going to either inform, in effect, their partners, or else guilt them into doing that?
D: I think you’re getting into the weeds here. Our method has helped untold number of couples heal after years, even decades of deceit and disloyalty
G: Which you seem to think you can dissolve with an honesty agreement and a “come to Jesus” moment in your office. I think you’d consider this matter “the weeds” because your training around confidentiality issues has been remedial
D: Remedial? Lemme tell you something, our program has gotten more positive feedback from all corners of this industry than your outdated psychoanalytic whatever…ever will
G: Again, I’m sure you’re a big hit on tik-tok
D: See, now you’re being a snob. Our program employs the golden seal of approval from leaders in the field of sex addiction: renowned experts in a condition that afflicts millions of men across the world
G: They’re experts in a condition not recognized by the AMA or APA, by the way.
D: It is recognized, meaning sexual compulsivity is recognized, by the WHO
G: Yeah, only as recently as 2017, and with a caveat within its criterion language that warns against diagnosis for moralistic reasons. You don’t merit diagnosis of sexual compulsivity disorder just because you “violated your own values”, like masturbating when you think it’s a religious sin, or because objectifying women via porn violates a feminist affectation. Also, why are men the only focus of your program? The pronouns you use imply that the perpetrators of this sexual abuse, as you think of it, are dominantly if not exclusively male
D: Not exclusively, but most are male. I think it’s harder for women, they have to face the stigma relating to their sexuality, so for them sex addiction or infidelity treatment is really shaming
G: which would be moot if the “right to know” or the “trauma” of their impacted partners were being privileged, as it is in your model. So, why wouldn’t male impacted partners be calling you in #s asking for you put their wives and girlfriends under privacy-violating cross-examination, to “hold their feet to the fire” with honesty agreements, full disclosures, polygraphs?
D: Like I said, I think it’s more complicated
G: Meaning you don’t know why you don’t attract male impacted partners
D: I think maybe they don’t want to appear weak so they don’t…who knows?
G: Sure, who knows? Women don’t want to be shamed for their sexual desires. Men don’t want to appear as victims, would rather act out and feel guilty—actually, that is something I think is true—but maybe these are side issues, “weeds” that are unworthy of attention, as far as you are concerned. Back to the main point: you think the impacted partner, likely female, has a “right to know” what the perpetrator is doing in his behavior. They have a right to know whether that perpetrator’s individual therapy is facilitating expression of appropriate guilt and awareness of the full impact of the perpetrator’s behavior upon their partner’s emotional, physical, and spiritual health
D: Absolutely!
G: And those perpetrators will gladly disclosure those slips and relapses, past and recent past, moved by your coaching about how their partners deserve to know the truth! They will be galvanized by learning the extent of their impact upon their loved ones—they will learn how they have induced hyper-arousal, high anxiety, self-blaming, in an innocent partner—and in developing this awareness, they will not only significantly reduce if not entirely halt their harmful sexual activity, they will take empathy to another level, privileging a definition of empathy as meaning the validation of an impacted partner’s feelings and perceptions, whether they are distorted or not: the “perpetrator” will eliminate argument from their repertoire of conversation; validation of their partner’s feelings and perceptions will become a near reflex. They will surrender their will to the power of God as they understand it. They will extinguish negative feelings that are denied but acted upon, and love…will prevail
D: I know you’re being sarcastic, but yes…all of that
G: Well, I doubt you understand all of that. And given your stance, plus—I will concede, that of many professional counselors, licensed and not—an astute consumer of psychotherapy might wonder why a mental health professional versus a clergyman is even necessary when it comes to infidelity treatment. A priest, or anyone for that matter, can say that an intimate partner has “a right to know” truths. Anyone can point out the common sense that secretive behaviors violate consciously made agreements about sexual exclusivity. What difference does it make that an “expert” can recite the criterion of PTSD syndrome. You want details? Vivid anecdotes to relate to? Go to CODA meetings. They existed long before you came up with what you think is your original “empathy” model.
D: Hold on. What is it you think I don’t understand?
G: Firstly, I don’t think you understand what I meant by “feelings that are denied but acted upon” because your model ignores unconscious process. I think you think that individuals can be coached to access their loving feelings, put aside what is implicit in acting out—angry feelings, underlying rage—and skip to guilt as a therapeutic tool that will heal. You think that perpetrators are NOT aware of the impacts of their behavior, hence needing education. They ARE aware to the extent that they attempted, at least, to keep their behaviors secret. To complicate matters, they are paradoxically in denial of impacts so as to protect themselves from feelings of guilt, which in turn stem from uncomfortable hostile feelings towards loved ones. It is therefore the INHIBITION of these thoughts, the failure to access AMBIVALENCE, that is THE PROBLEM. Your model, plus—I guess I’ll say, “countless” like it—emphasizes reactive love response designed to vanquish ambivalence. You think your clients or coachees can’t tolerate ambivalence, likely because you can’t tolerate ambivalence, so you preach “get over yourself” rhetoric
D: That’s not true. We talk about ambivalence. We understand ambivalence. We educate that ambivalence is normal
G: Yeah, educate, right. So, in this model of “She has a right to know” regarding slips, plus “what’s happening in the treatment”, that latter ambiguity implies that disclosure beyond the matter of perpetrating behaviors are subject to being relayed to the partner. Regarding empathy, if your client discloses a slip in empathy—let’s say, “I hated her guts yesterday”—that should be shared with the partner, or is there an agreed upon or tacit agreement that such thoughts would not be shared, and what would be the reason for not sharing? The client’s right to private thought? A fear that such thoughts would be traumatizing for the impacted partner, triggering a reactive outrage?
D: Probably more the latter. I see what you’re saying, there’s room for counselor discretion. I wouldn’t share that thought you mentioned. I think that would be re-traumatizing for the impacted partner, and plus I’d think that a defensive thought on the part of the guy
G: Probably true, though your thought about the impacted partner suggests an illustration of my earlier point: you think the impacted partner would not be able to tolerate the hostile feelings of her partner
D: She’d think he shouldn’t have those feelings, sure…
G: And you’d agree with her…
D: (Pause) yeah, I think so. Because I’d think he was being defensive. You said “probably” so maybe you disagree
G: I said probably because I wouldn’t foreclose the possibility that his anger may be legitimate, and that what’s defensive is the addictive acting out as a displacement, plus the inhibition of what may be a rightful protest
D: What rightful protest, hating his wife’s guts? How is that in any way healing?
G: Why do we have to rush to healing? Since neither of us is a doctor, can’t we look to understand the thought, which may only be an impulse, before we seek to eradicate it? So, forget informing the wife for the moment. If we did that, we’d likely get into managing or soothing her feelings, which I think interferes with the process of understanding, taking focus away from his internal problem. Besides, why not consider that the expression, “I hate her guts” is a reaction to a series of repressed thoughts, the content of which is obscured by what’s disturbing in the intense expression
D: Okay, I can see that, sort of…and I can see why we don’t have to share with an impacted partner, or encourage sharing with an impacted partner, every time this guy has an undesirable thought…
G: Right, so…
D: At the same time, I’d be concerned that by inviting more details about this rightful protest that is speculative, we’d be indulging a defensive pattern, which would take us in the wrong direction
G: That presumes a bi-linear process, plus the bias that all negative thoughts are a “slippery slope” that must be avoided. But lemme give an example: a man and his wife are in household garden together, having what at first seems like a benign disagreement about an arrangement of flowers. At first, the problem is that he had gone ahead with the flower arrangement without consulting with her. As they talk about it, the conflict escalates. He says, “what’s the problem?”. She says, “it looks fucking stupid!” and further starts cussing him out, after which he complains that she’s always abusing him or talking down to him. That scene ends with her storming off, shouting “I want a divorce” over her shoulder. Backstory is layered, the presenting problem at least 2-fold: 3 years ago, he was caught cheating on her, getting caught on film with another woman at a party—pictures and video posted online—then they went into couples counseling. He stopped the affair, acknowledged the pain he caused and listened to a lot of podcasts on that subject, has passed 3 polygraphs since, and generally lives in the proverbial doghouse. After a year of little more than mea culpas he says he started bringing up in couples therapy how she mistreats him…as in the flower arrangement instance. She admits she can cross a line and be harsh sometimes but says it’s because she’s still angry and traumatized about the betrayal of their marriage through his infidelities
D: (pause) So, what’s the issue? Doesn’t that make sense? She’s been traumatized by his betrayal, now she’s sensitive to his not talking about things with her, so she gets upset because, as you might think as an analyst, the flower thing is a substitute for the affair-seeking plus keeping it secret and ignoring her. The task is for him to acknowledge the links there, show that he understands why she’s upset, and apologize for the fact that he doesn’t share his thoughts with her while he goes about doing whatever he wants to do…
G: I agree with what you’re saying to an extent: I’ve no problem with acknowledgements, the apologies, especially for not sharing his thoughts, and I appreciate your “it actually isn’t what it is” attitude towards the seeming source of conflict, the flower arrangement. However, your position still presumes a unilateral disorder, likely grounded in, as you might put it, “old school” addiction narratives: that person has THE problem, etc. Anyway, the thing is this: he says the abusive language got worse after discovery of his affair-seeking, but the condescending attitude, her talking down to him, is long-standing, is almost as old as the relationship itself so it predates the betrayal, and to compound the problem with irony, when he brings this up either with her or with therapists—and they had at least one episode prior his acting out pattern, he claims—both his wife and therapists dismissed the subject
D: Well, I’m not sure I buy that, especially if they were in therapy before the sex addiction or just cheating behavior started. As for now, I generally think it’s a problem to muddy the waters of treatment, focusing on matters that could be just a way to excuse the acting out behavior
G: But that in itself strikes me as a splitting response—that is, a black and white way of looking at the problem. You deny the possible or maybe likely complexity of the problem because it takes focus away from a singularly defined task, and also because that background complexity appears to justify acts of escapism. No one is saying that. That’s rather what you are inferring from the speculation of an old relational dynamic for which both parties bear responsibility, even if those responsibilities are rendered asymmetrical by the betrayal of infidelity. In my “clinical experience”, a variety of problems get shelved and obscured by the specter of sexual betrayal: betrayals relating to substance use, money, parenting choices, to name some issues. Only the specter of violence supersedes sexual betrayal as a source of clinical attention. Indeed, this may be the principal reason why cheating or sexual betrayals perpetrated by women are marginalized in most models pertaining to these problems. What’s the priority? The safety of a partner discovered in her cheating behavior by an angry, or otherwise abusive male. I have no evidence of this bias per se, but maybe you can tell me: if you had a female client who had cheated on her male partner, would you insist on that honesty agreement and pressured disclosure if she said she was afraid of his temper?
D: (wearily pausing) I don’t know. Maybe you’re right in one sense about this being complicated, and maybe that’s because there isn’t a moral equivalence about these kinds of situations.
G: Wait, what do you mean by that, moral equivalence?
D: Well, basically that women have more cause to be afraid of men’s anger than the reverse
G: So, what are you saying? Does that set up a double standard with respect to honesty agreements? Do you employ “man up and get honest” interventions with male acting out partners, but then refrain from coercive rhetoric with the fewer female subjects you treat?
D: I don’t think of it as a double standard. Again, I think this is a moral equivalence issue
G: How about we call it rationalized asymmetry. There. I’ve coined a new piece of therapeutic jargon
D: Yeah, I don’t know. Like I said, I just think we’re getting into the weeds here on some of these issues. People come to me, they come to you, wanting help, practical help mostly, with what to do when they’ve done something, maybe a lot of something, that they feel bad about and they want to make a repair, express their love despite whatever other feelings they have, move on and be happy. That’s what it all about, I think, and all I can say is that I think my empathy model has helped a lot of people to find spiritual wellness, forgiveness, peace, and overall happiness. Exactly how many people, I don’t know…just…
G: Countless people. Yes, I know. Well, thank you for coming on the show, Mr. or Doctor Sakmanov
D: How about coach Dave?
G: Sure, anyway this has been an episode of Getting Real About…well, I’d say psychoanalysis, or formerly sex addiction—not sure what to call this at the moment. It isn’t quite what it is, maybe. Thanks for listening
Graeme Daniels Psychewriter 