Tag Archives: sex addiction treatment

Female Sex Addicts: the protected species

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

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

                                                                 —from London Fields, by Martin Amis

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

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

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

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

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

Okay, stop it now

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

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

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

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

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

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

Leave a comment

Filed under Uncategorized

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.

Leave a comment

Filed under Uncategorized

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

Leave a comment

Filed under Uncategorized

The sex addiction excuse: the main points

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

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

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

Graeme Daniels, MFT

Leave a comment

Filed under Uncategorized

Isolation: treatment of an impacted partner

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

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

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

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

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

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

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

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

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

Leave a comment

Filed under Uncategorized

The Sex Addiction Personality

Talk about isolation. Aren’t they all in the closet, these so-called sex addicts? What else are we calling them, by the way? Ya know, what’s the underlying sh….stuff? What’s the personality upon which this pattern of miscreant behavior lies? Well, you know what to do. Make a few calls, talk to some people who say they’re trained in sex addiction (SA) because they’ve taken a handful of weekend courses. In one of their certificate-earning workshops an instructor may have covered the topic of personality pathology, or disorder. At this point, a few stats will have been brought out. About 65% of sex addicts will have also met criteria for narcissistic personality disorder, and another 20% will have narcissistic traits if not meeting full diagnostic criteria. And those subjects will likely be male, for the most part. I don’t know if the numbers will be that high—I’m making them up, of course. Anyway, although not studied very well (we must ever be reminded of this point!), female sex addicts are more likely diagnosed in greater numbers with borderline personality disorder, which is increasingly synonymous with PTSD because a lot or most of the former have the latter syndrome also. This means that while men in SA treatment are considered self-centered, objectifying, exploitative, and suffering from much concealed personal and especially sexual inadequacy, women are treated as having abandonment issues, having likely suffered sexual abuse and general societal disregard, and in their addictions they just can’t stop “loving” people to make themselves feel better.

             There. A bit simplistic, perhaps, but then I’m taking my aim at a field that is guilty of a whole lotta simplifying in my opinion so I’m mirroring them, to use a term employed to treat narcissists, actually. But don’t listen to me. Make your calls. Read the books that represent the “gold standard” of sex addiction treatment; the blurbs on the specialist websites; the bullet points within instructive blog essays that are nothing like mine. Tell me after you’ve done all your research that the above impression doesn’t stand as the orthodoxy of this field. It shouldn’t stand, you know, and not just because the orthodoxy relies upon stereotyped profiles borne of rote personality testing, inane questions like, “do you identify with the following: if I ruled the world it would be a better place (?)”, rather than clinical impressions formed over time in intensive relationship with and by someone educated and trained in what, after all, was originally (not mythically) a psychoanalytic concept. I’m referring to narcissism and borderline personality on this point, and the concept of Transference. However, there’s another reason why the typical personality narratives of sex addiction treatment should be challenged: they’re leaving out one important category.

             In Getting Read About Sex Addiction, I actually give this matter short-shrift, this being a secondary area of interest in mine and Joe Farley’s book—personality disorder, that is. If it weren’t for the offhand assignment of narcissism to so many addicts I might not have bothered, and one view I don’t venture is that high-profile, expensive, short-term treatment programs likely do serve a lot of narcissistic men, perhaps because they have money, lots of free time, and no doubt their powerful selves have rendered them attractive to affair-available women whom we should not profile as being drawn to narcissistic, powerful men because that is a.) not de rigeur, and b.) not very nice, whether it’s true or not. But there’s a lot of people out there, men and some women I figure, who are more porn-addicted than affair-seeking; more privately fantasy-seeking in the digital age; more in the cuts of 21st century society; exhibiting less bravado, if perhaps a similar, if more intellectualized disregard of using people for sex. There’s a word for this lesser spotted bird, this unicorn in the personality mix. It is a schizoid, not to be confused with a schizophrenic, and he (or she) is a thing, believe it or not. He (I guess I’ll go with another stereotype) has been written about for years, though it’s hard to say who was first to scribe on the matter.

             The first to make a labeling stab was Melanie Klein, who offered the term paranoid-schizoid to denote a “position” of development that entailed the defense of splitting (first termed by Freud), which in turn meant the keeping separate of good and bad internal objects (internalized caregivers, or parents), resulting in split object relations, the tendency to employ “mechanisms” that projected parts of self (unwanted) onto others so as to protect the ego and the idealized object. Klein was in fact influenced by W.R.D Fairbairn, an independently-thinking Scotsman whose conceptualizing wrought an “endopsychic structure” comprised of split objects allied to a split ego, yielding a fragile personality that seeks security in an inner world. It’s likely Fairbairn, not Klein, who gives us the idea of a schizoid that is nuanced from a paranoid (Klein), who is fundamentally withdrawn socially, prone to regression and especially isolation. Following Fairbairn, the likes of Wilfried Bion, while focusing upon psychotic processes, also observed the paradoxical contact-seeking need within this isolationist figure, and indeed regarded that such needs are intensified in tension with an aggressive withdrawal. Also, figures like Harry Guntrip in the sixties and beyond supplied clinical vignettes to help us understand the dilemmas of those who experience what Fairbairn termed a “futility” that manifests as apathy yet lies beyond the affective presentations of what we term depressive.

             Why this schizoid personality develops is unknown, or at least unclear. D.W. Winnicott, not talking about schizoid personality, wrote encouragingly of the capacity to be alone, deeming it a kind of developmental achievement. Winnie thought the analytic situation a recreation of this bond, at least potentially so. It is something to learn to tolerate, this being alone thing, and he thought that mothers who weren’t “good enough” (cheesy phrase, much attributed to him whether he liked it or not) impinged upon their children with their own needs. Beatrice Beebe, a contemporary attachment researcher, called something similar the “maternal loom”, referring to mothers who get in their babies faces too much, overstimulating them (hello, future sex addict, maybe?) causing them to avert their gazes, look at…something else. Lacan’s followers, following Freud’s premises regarding infantile sexuality, and speaking of what Lacan termed the imaginary register, called this tense, overexcited state a jouissance. Bowlby’s acolytes, those who assigned attachment styles like the resistant/ambivalent category, will have known what Winnicott was on about and thought less of infantile sexuality. Meanwhile, those observing avoidant styles of attachment might have glanced at the schizoid phenomenon, or else they might have brushed up on their Meier’s Briggs material, thinking it all reminded of introversion or, if neurological tests were called for, perhaps autism. These are some of the analogue ideas. Point being, schizoid personality is something of a unicorn: a rarely seen, oft-dismissed category of human being, preferably called something else.

             And yet, the internal conflicts that the schizoid faces (or doesn’t) are not rare at all. Indeed, it might be that average human travails mirror what psychologists James Masterson and Ralph Klein termed the schizoid dilemma and the schizoid compromise. To explain these terms: the schizoid dilemma is to seek closeness with others while maintaining autonomy, bearing in mind that schizoid personalities tend to privilege the latter over the former, rendering them strange and detached. Their “compromise” is to find that which achieves human connection but doesn’t surrender autonomy, hence fantasy plus a unique affinity for the digital age. Now, there are many in our midst who would argue that species do not evolve or even survive if they don’t confront such dilemmas and discover compromises. Our growth depends upon our capacity and longing for community. At the same time, our sense of humanity, which includes a craving for uniqueness, decrees that fitting in, absorption, dilution of the one by the group leads to another kind of death.

There’s a slight hint amid theoretical thinkers that a schizoid isn’t really sexual. Perhaps they’d had too much of the maternal loom once upon a time—like, around the time that giraffes start walking in their corresponding development. Later, they (babies, not giraffes) gazed back, but only on their terms, voyeuristically we think. It’s that gaze…you know, that one. But regarding this diagnostic question, you might wonder who will care. Really, will it matter whether porn or sex addicts are secondarily tagged as narcissistic versus schizoid, or even the largely feminized category of borderline? They’re all pathologies, aren’t they? So, while I wind down my commentary on Getting Real About Sex Addiction in the dawn of its publication, I’m aware of stirring the pot on a lesser controversy.  Seriously, the parts of the book that will truly ruffle feathers are those that diss short-term treatment solutions versus psychoanalytic method; or, it’ll be the thread of dog whistling commentary about the sex addiction field’s anti-male bias. Some won’t care if the text actually contains even-handed commentary on both sexes, plus a tinge upon sexual minorities. For them, if sex addiction treatment is to be pathologizing, then it must only be so in reference to heterosexual men. Anything else is to disobey the latest memos about moral equivalence.

Not that an attention to schizoid process (or cultural messages that simulate the attention) isn’t encoded in the semi-public dialogue anyway. Consider the rhetoric that accompanies identity politics: when a person is talked about as a victim or survivor, at least in part because they belong to a marginalized group, their advocates might still reference a schizoid process by referring to denied aspects of self. These will be the split-off aspects of self, which in the case of a sympathetic figure, will be his or her denied positive or resilient qualities that have been insufficiently nurtured and are therefore insufficiently recognized by the subject, hence what they need is building up, empowerment, etc. Meanwhile, those who are cast as addicts or perpetrators or some other disparagement may be described as having a similar intrapsychic process, only their denied qualities will fall under the umbrellas of guilt and inadequacy, hence what they need is bringing down, deflation, and so on. You could call this justice if you like but you might also notice the employment of psychoanalytic thought to support whatever cause you choose. Anyway, I’ll sign off for now on a relatively benign point of interest. Sex addicts: more schizoid than narcissistic, don’t you think?

Leave a comment

Filed under Uncategorized

Isolation

Not a good thing, we’re told, especially in the context of addiction. Isolation: has a negative connotation, don’t you think? Not like the word “alone”. In Getting Read About Sex Addiction, Joe Farley and I make several references to aloneness, isolation, or else we spin polemics about the pros and cons of doing things by oneself. Sex addiction seems like a loner’s pastime. Porn addicts do it alone, then keep what they do secret, which furthers the aloneness. Affair-seekers probably boast more about sexual conquests, just as they always have, but they’re even more secretive, or glib about their habits, for they have even more trouble to avert; more to lose, it often seems. Isolation. More than most addictions (excepting that of food, maybe), sex addiction happens in isolation, and is talked about in peer circles the least, hence the solution of groups, and of disparaging isolation, if not quite aloneness, within the milieus that treat this still-mooted condition.

             The ways to be alone, let us count the ways: well, first of all, those who wear labels like sex addiction absorb the pathology of a system. Within a family, and especially a dyad, as in a couple, the addict holds the “badness” of a relational problem. He or she is the problem, which is isolating. Our book critiques the habit of splitting as it manifests in many forms, and offers that sex addiction, while useful as a signifier of phenomena, ought to be carefully, not impulsively assigned. Furthermore, we cast doubt on terms like “perpetrator” and “victim”, which split matters into good and bad, right and wrong, which renders problems facile; histories reduced to recent events, not dense, developmental histories.  Otherwise, we refer to isolation in several other contexts, applying nuanced meanings: referring to the “incipient shame” of the addict, suggesting an early development dimension to their affective leanings; that an addict or “acting out person” isolates his or her affect, which means directing feelings towards action, not thought or feeling, which cues the therapeutic solution: let’s talk. The associated institution of 12 step recovery echoes the ethos that self-expression within a nurturing environment is an antidote to an isolationist pattern.

             Not everything that happens alone is pathologized in our writing. To be that rigid in our thinking would exhibit splitting; it would suggest a paucity of thinking. Thinking. We tend to think it happens alone, away from the noise of a crowd, but we extol its practice in collaboration. Collaboration: now there’s a loaded word, another term that casts a shadow upon aloneness. Be a team player. Don’t go it alone. Well, okay, but this paragraph is meant to represent another view, the virtues of being alone. In our first chapter, I refer to the “mischief” of breaking rules, of testing boundaries that represent authority, the group, society—all because…well, because there’s something good, something irresistible and actually worthy about going it alone. So, we thumb our noses, do our own thing at times, practice what I term (not unique to me) anodyne sexuality, like flirting, which hangs perilously close to an abyss of verboten sex, depending upon who is doing the flirting and in what context. We might agree about the new rules, or as society extols paradoxically, we might think for ourselves, do our thinking alone.

             The habit of going alone while stepping on others’ toes (Freudians take note) has been given another pathologizing label: narcissism. In sex addiction treatment, this aged construct has been co-opted by practitioners and lay observers alike, and now has the status of corollary to a sex addiction assessment. Pity, for its another saturated concept that has been reduced in the service of splitting arguments, the outrage of the betrayed or the plainly envious. It’s not that the condition doesn’t exist. Yes, narcissism is a thing. But its offhand attribution, the shoot-from-the-hip assignment to patients in sex addiction treatment bristles against conscience. I suppose Freud pathologized the condition also, by implication. Originally, as in 1914, he wrote that infants exhibit primary narcissism, a state of auto-erotic being before cathecting their sexuality to caregivers (dubbed objects, hence object relations theory), and upon resolution of Oedipal taboos, towards genital sexuality and the selection of post-pubertal partners. From this notion of auto-eroticism, many presume immaturity and pathology to the alone state, thinking it a slippery slope towards inflatedness, arrogance, and lack of empathy for others—the familiar catalogue of narcissistic traits.

             While Heinz Kohut gets much credit for having carved out a space for so-called “healthy” narcissism since the 1970s, the term has hardly left the closet of weaponized terms, thus narcissist and sex addict have become virtual synonyms in the 21st century. And remember, in the sex addiction lexicon you’re a narcissist whether you’re a habitual masturbator (being alone) or exploiting others, using others’ bodies as masturbation tools instead of practicing sexuality with an air of presence, consideration for the other, with generous attention to foreplay, emotional nurturing, passionate interplay, play of a sexual kind—all the virtues that someone has decided represents non-addictive, non-isolationist, sexual health. In this model, masturbation generally gets a bad rap, being the pastime of the anti-social if, perhaps, the socially undesirable. But not all famous theorists have denigrated the masturbatory, go-it-alone tradition. By implication, at least, psychoanalytic hero D.W. Winnicott was perhaps a champion of what he won’t have called self-abuse. Read “The capacity to be alone” from 1958. Yes, that’s right: the fifties. Not exactly the era of sexual revolution. In this paper, Winnicott writes of the capacity be alone as a developmental triumph, not a pathology. It is a signal of maturity, of what others might term secure attachment, to accept being alone, even in the presence of the other. And he was writing of a child’s experience. What’s a later version? Think for yourself while listening to others. That’s one example. Do some things by yourself. Have fantasies, even those of the so-called primal scene, by yourself, because to share on that is TMI. Even do it by yourself.

Leave a comment

Filed under Uncategorized

Diversity, Inclusion, Exclusion, and dicks

*FYI: this is this blog’s 300th entry

We don’t know what we don’t know. Circular thought. It’s popular, I notice: often employed, I simply mean. Not so much by patients, or clients (guys in my groups). The latter wouldn’t employ the term because they’re not sensible to its ironic, wistful purpose; the apparent longing.

Guys in my groups, my sex addict treatment groups, tolerate my invoking the unconscious, I wrote in “The group’s the thing”. Indeed, sometimes they run with the idea, though they prefer to say subconscious for some reason none of us know, perhaps because the “sub” prefix/qualifier denotes a shred of what they’d prefer to retain: a sense that they know what they’re doing, that intentions and wishes aren’t so far down in the mind. Otherwise, it’s useful to suggest that they don’t know what’s up, as in conscious, because that appears to defer responsibility. Seriously, can’t you get away with anything if you just say that it was unconscious. I didn’t mean it: “it” being an Id-like representative; an aggregate of bad behavior blended with notions of bad self. Well, this won’t do, suggests a finger-wagging psychoanalyst, only you wouldn’t see them wagging that finger if they sat behind your prostate (I meant prostrate–now there’s a Freudian slip), on-the-couch lying figure. You’d just hear the tsk tsk in their voice, feel the eyes rolling. Analysts are human, too, despite their reputations among some. They don’t like being stereotyped, or discriminated against, and they certainly don’t like their ideas being co-opted or misused. Responsibility, they invoke, sort of. You may not know this, but it’s incumbent upon you to keep thinking about what you don’t know, and in time, like any day now (like seriously, we’re waiting!), say something…ya know, real.

Some think that it’s time for psychoanalysis to move on, and I don’t mean that it should die (actually, some might want that—un or subconsciously) like my friend Jason did recently, but rather grow, evolve, as in strike out to new frontiers, go where no man or woman or not either has ever gone before. Some refer to this undiscovered country as the analytic third, while others will rightly think that it’s a cheesy Star Trek and then Shakespeare allusion. It’s both, or all three, I guess, which suggests that my thinking is not black and white, either/or, or binary. There is a triangular reality, like that of the Oedipal situation, come to think of it. Life was once the experience of a singular figure—an auto-erotic, narcissistic trip, wrote Freud, that later undergoes a watershed of development within a fraught relational triad. Not so, rebuked the likes of Winnicott after pointing out the air raid warning amid the so-called controversial conversations of the mid-century object relations revolution. Life, or the unit of consciousness, is a dyad of mother and child from the outset (or near enough), not a singular entity, he argued. As for the Oedipal triangle? Well, that comes later, Winnicott likely conceded, while asserting that its “drama” was not a primary cause of phenomena. Sure, the relationship’s the thing, agreed some contemporaries, plus many who followed them, especially feminists. Freudians re-asserted the triangle, reminded that life really moves on when the father enters the picture, bringing his baggage of Superego, in turn inherited from the primal horde. Klein and her followers deferred once, saying this does occur but earlier than when Freud said it would, plus it manifests as a web of intertwining projections and introjections. Lacan and his people said something else that I haven’t figured out yet, often using words like indexing, or expressions like “in the register of…”.

Psychoanalysis in this mid-century era was perhaps moving between the breast and the phallus, unsure as to the nexus of development, and half-thinking that growth and evolution hinged around our relationship to sex, but otherwise thinking that something more human (as in humanistic) and less Darwinian and animal-like was the truth: that we are relational beings, seeking intimacy, attachment, someone to talk to, and even before that, developing non-verbally a proto-self with a containing other, one who provides strength in an ambient if not omnipotent fashion, not cognitive interpretations that may aim at the unconscious. Ya know, we’re not just looking for someone to…ya know. Did you get that, those of you who think Psychoanalysis is or was phallocentric? It was Klein (a woman) and then Winnicott (yeah, a white guy) who pointed us in this direction…like, seventy years ago! Anyway, this dialogue as to what’s important has been going on for some time now, air raids notwithstanding, and it’s all gotten a bit tiresome I have to say, which may be why the dialogue’s being shaken up even more recently, with added elements that have also gotten short-shrift. It won’t be a dialogue anymore, you see. It will be something like a trilogue, to indicate an analytic third, which means someone or a set of someones who have previously been excluded.

Race. See, it’s time to talk about race. Again. Wait, I mean to really start talking about it. We’re often saying, aren’t we—I mean, in whatever circles, professional and not, that we’re in—that it’s really time to start talking about race. I said it once, I think, in a blog long ago: my “token” entry about the verboten subject. Race. It is to psychoanalysis in the 21st century what sex was a hundred years ago: the thing we don’t talk about; the taboo; the thing about which we say, “we don’t know what we don’t know”. Talk about black and white thinking. We’ve forgotten the spectrum of colors in between. I won’t name them. That would be insensitive. That might cause racial injury, deliver an impact regardless of my intentions. But it is time for voices of color, people of color, and thinking in color, to have its say. They might start—indeed, they seem to start—by telling people like me, those at the top of the privilege charts (male, white, heterosexual: the anti-trifecta), that we don’t know things that others know. We can’t know things, as in the experience of people of color, of people like them, because we’re not them; because we haven’t had their experiences, and we’ve been barely aware of our own privileged experience, let alone their underprivileged existences. But we can learn and listen, even though we can’t really know the experience of the other, which shouldn’t stop us from trying to…well, we’re going in circles here, which is okay as long as we keep thinking. That is analytic thinking, I think.

In the meantime, I might continue to take refuge in the cozy bosom of universalism, the happy experience of commonality, which is what I’ve got; it’s especially gratifying when it occurs with those who are different from me in the catalogues of diversity. I have a new friend who loves soccer as much as I do, attaches meanings to its rituals that are at least analogous to my projections, and he is Portuguese, and his favorite team is a worthy institution, Benfica FC, while my favorite team is a mainstream option, the iconic Manchester United. See, sport: the universal language. I have a patient whose identities contrast with my trifecta: a woman, bisexual, and of Asian heritage, she laughs at the irony of her belief that upon several years of analytic therapy with me no one seems to understand her like I do. Or, less earnestly perhaps, I can point to the experience of a Mexican man in my practice—a tattoo-ridden, macho yet oddly genteel figure (perhaps “smooth” would be a better description) who womanizes, distances from intimacy, chases pleasure in the shadows, would bring Glock pistols to a fist-fight, drive fast cars towards cliffs if he could afford them. Regardless of where he is from, he would seem to fit the model of the libidinous, death-driven figure that Freud and others have envisioned; the kind of man who doesn’t seem “relational”. His is a decidedly male, “heteronormative” fantasy no doubt, one that is routinely castigated as toxic, narcissistic (as determined by past and present society), but he is not quite the dinosaur that many might wish him to be.

Yes, let’s not objectify him as he does others. He’s a human being, after all. He’s a sex addict as well, which is also a human being, albeit one with a lot to answer for. The latest dream he shared with me might have scared many, but it didn’t disturb him. Demons, he intoned casually. And gargoyles. Or, a kind of gargoyle, he amended with a smirk. These and other nasties had populated the fiery pit of his dream, but it didn’t rouse him. He didn’t wake up in a sweat, grabbing his nuts and looking down to see if his penis had been severed. It’s the punishment he anticipates, he smirked. But not from an afterlife. He’s got no fear of doctrinal fate; no dread of the fire and brimstone, or of sharp knives threatening an emasculating cut-off. Amid the trail of his chuckle, we let a silence settle, both of us lapsing into a still reverie. Somehow, we thought the same thing: what if the thing is not so much loss as absence, as in an absence of past as well as present. He frowned, curious about my thought. I was on to something, he figured, despite differences that were cultural, generational, and something else not easily pinned down. “You mean like no dick at all?” he asked, intuiting my thought. “Yeah,” I uttered. “Imagine there’s nothing there and you’re in the twilight zone peopled by these androgynous, phallusless creatures, and you ask, where’s my dick and they’re like, ‘what’s a dick?’ and you’re like, oh shit…”

Yeah, don’t tell me that some things don’t cut through time, differences of culture, of privilege that is legal, institutionalized and economic. Now, I know that transference and countertransference are not just dyadic phenomena, as Winnicott, Balint, Fairbairn, Benjamin, and whomever else has said. Yeah, I know there is an analytic third comprised of the separate worlds we were born into; divergent histories that preceded and steered both of our lives. But sex and addiction, two bread and butter topics in my day to day, have played reconciling agents, bridging gaps that would otherwise have created blank division. Dicks. Who knew? We knew. We knew all along, ever since the apple fell and the differences were there for all to see.  

Leave a comment

Filed under Uncategorized

Intersections

A writer I like says that each page contains hundreds of decisions. A parent or an analyst might say the same about an hour in their day. Not me. Sounds like too much hard work, for the conscious mind anyway. It’s good to know that another part of me is on call, though, thinking of all the layers, making some decisions at least, mostly about psychoanalysis, lesser so about writing. They entail different relationships, you see: with live “in your face” figures on the one hand; distanced, mysterious readers—you—on the other. That’s me thinking about and making decisions about relationships, or as we say in psychoanalysis, that’s me thinking about object relations. That’s that part of object-relating, or is it object-creating? Are we still creating objects, meaning caregivers and others into which and from which we get ourselves?

According to some, D.W. Winnicott dropped a mic on psychoanalysis when he declared that a subject tests the object with his or her omnipotence; that for him the concepts of merger and fusion were not so much denoting pathological states (“stigmatizing”) as necessary stages of development. See, we need a robust figure for an object, a “rock” who can take all that we can dish, not be destroyed, and still love us. That’s right: love. That old thing. Turns out it’s all we need after all, especially when we’re at our worst, within our omnipotent, infantile fantasies. Supposedly, this message contrasted with what Sigmund had to say 40 years before Winnicott. Freud had conceptualized stages of primary process (the “id”) and primary narcissism, which he too described as necessary in the growth of human beings. This meant a movement from an infantile, auto-erotic state, to one in which we attach to an object (a mother), and then necessarily withdraw, which ultimately leads to the replacement of the mother with one based upon her model, or else we withdraw into ourselves (secondary narcissism). We cathect that libidinal energy to an ego, and from there we…wait, what was the difference?

No, No, I get it, sort of. For the likes of Freud and later Bion, the task of life is to learn reality (the reality principle) and to adapt to that reality—like not getting to have your mother (sexually), or even have her at your non-sexual beckon call. If you learn reality, it’s because of frustration (plus other frustrations derived from that) or at least the capacity to learn from frustration, or else one lapses into psychosis. That idea’s more Bion, actually. Anyway, Winnicott appeared to nuance if not quite flip the script, specifying that the “frustration” is a failure of a nurturing environment to be just that. Ah D.W., you brazen finger-pointer you. Who were you to say that a maladjusted child was one whose mother was just not strong enough—not “good enough”, as that concept was cleaned up—to settle the child’s excitable nerves, his over-stimulated, omnipotent, mother-possessing self? Wasn’t Sigmund right to assign responsibility to the innate excitability of the child, and to later place him before a righteously law-imposing patriarch at the ripe age of 3-5 and nip that object-seeking, taboo-traversing impulse in the bud? Well, who knows whether Sigmund really thought that dads were more decisive than moms in the raising of a child, but he didn’t think that omnipotence was something to caress and tolerate, like Winnicott did. And who knows whether the latter thought that parents were getting it wrong when the perversions started to happen, or when hysterias began to stiffen limbs and refrigerate the nether regions?

In treatment, this all becomes a prescriptive template for a therapeutic process. For Freud, this meant the application of what he termed an evenly hovering attention; an abstinence from gratifications of varying kinds, all derivative of sexual desire; attention to rules, the implicit validity of a Super-ego, a pathway to discontented civilization. Civilization is discontent, observe many, but we’re meant to do something about that, not just sigh, accept our lots in life and sublimate. Sigmund wasn’t much of a protester, I guess. His followers, students and so on: they weren’t activists. Now, to be fair, to be a Jewish activist, a protester against how things are in 30s central Europe would likely not have worked out. Old Siggy would have been shot or oven-roasted for saying that a harsh Superego derived from a parental template intersects with the malady of anti-semitism or fascism in modern society. Yeah, cancel culture has nothing on what Sigmund fled to London from.  

If psychoanalysis has something to say about modern society then it has extended its definition of a child. So here we (we?) introduce the concept of intersectionality to broadly declare that psychoanalysis has something to say about the state of the world, not just Oedipal triangles of children and parents—though, to be fair, Freud had been commenting on the world and not just the interior lives of his patients at least since Totem & Taboo in 1912, and later, certainly, in Beyond The Pleasure Principle, Civilization and its Discontents, and the epilogueish Moses and Monotheism. But let’s not quibble. Basically, the modern zeitgeist is to suggest that object and subject are figurative terms denoting positions of power and not having it, of being an underdog within the shadow of an institution, a “system”, etc, and within the corridors or streets of morality construction there are varying rules and therefore new Superegos. And it might take a philosophy or critical thinking expert to identify the metapsychology which declares that rage is the exclusive prerogative of the underdog, hence the progressive dislike of people who seem angry but don’t deserve to be so.

Melanie Klein, in her contributions to psychoanalysis, emphasized that the infantile fantasies of children contain states of paranoia and frustration, leading to splitting defenses, a withdrawal from “bad” objects, plus a fear that one’s own internalized “bad” object will do harm. This interweaving of introjection and projection, and attendant frustration, is a product of dependency, and so, as we extrapolate to culture, we must look at dependencies in interpersonal relationships, power dynamics between groups. In our book, Getting Real About Sex Addiction, Joe Farley and I focus our attention on the interdependence between heterosexual men and women, primarily. We do not mean to be “exclusive” of sexual minorities, but the truth is that psychotherapy is segregated by a number of demographic factors, and group identity is a factor, so we do not market to sexual minorities because we are not sexual minorities ourselves. Also, while race is of course an important—perhaps the most important cultural dimension for psychoanalysis to address in the 21st century—its intersection with sex addiction is unclear and the dependencies contained are imbalanced. People of color depend upon the justice of white people in an institutionally dominant white America. In microcosm, a person of color looking for a therapist is more dependent upon its dominantly white demographic—this is why it seems more incumbent upon white practitioners to practice “diversely” than it is for providers of color. Otherwise, in what ways are white people dependent upon people of color?

However, the thing is…we’re interested to explore in our book the ways in which men and women are dependent upon one another because—with respect to sex, at least—they are more or less equally at each other’s mercy—a unique phenomenon between social groups. Again, this is a heteronormative perspective. A gay man or woman may have numerous relationships across gender boundaries, but they do not have their intimacy needs met by the opposite sex so there is relatively little tension in such dynamics and therefore less to compel attention to the needs of the gendered other. That’s another extrapolation of the Freud-Bion axiom: it is tension, frustration, the prospect of adaptation, that informs motivated action. Yes, a rabbit hole, but if I may grab a rung on a ladder on the side of that abyss, I mean to say what numerous analysts think: that members of the gay (and perhaps transgendered communities) live in a part-object (one sex) world, which if true would be ironic given their reputation for celebrating “gender fluidity”. The LGBTQ (plus) communities may, like racial minorities, consider themselves inextricable from a dominant culture, but like all individuals to some extent, its members can indeed live or at least fashion private realities.

And a further irony is that such realities contain less widely known battlegrounds. I don’t know. Is there a battle of the sexes within the LGBTQ communities, with the notion of “sexes” as I allude to it elasticized? Are there internalized, gendered differences to contend with however much those differences have been…wait—here’s a writer’s decision, cut from the intersections—would it be cool to say cut off?

Leave a comment

Filed under Uncategorized

The nubile area of study

I can’t remember the last time I wrote a full entry about mine and Joe Farley’s book, Getting Real About Sex Addiction. If you actually read this blog, you might be thinking that this thing is an elaborate ruse—you know, a pretense of impending publication, designed to…actually, why would we do that? See, the thing is this: this book has been on the cards for two years, and I know—I’ve been writing about it in this forum, or alluding to its impending arrival, for that same stretch of time, roughly. But believe me: the book is—how should I say it—real. We wrote most of it in 2019, then a bit more in 2020; then, upon Covid…well, we had to write some more then, didn’t we? Therapy—all therapy—changed. Ostensibly, we’ve had an interested publisher all this time, a guy (plus a company) who had once published Joe’s mentor, James Masterson. That got us a foot in the door, like a foot in a door to a room with no one in it because everyone’s left the party that’s inside. In “Lost in the rough” (an entry from over a year ago now) I wrote and moaned that this publisher was brushing us off, waning in his interest, wouldn’t give us a contract. Wouldn’t put a ring on it, I quipped.

No matter, it seemed, as of late 2020. In stepped Rowman & Littlefield (who have published books like The Myth of Sex Addiction by David Ley), expressing interest in a book about SA with a psychodynamic or psychoanalytic focus. What followed was a review process which we passed with flying colors and by the end of the year, a contract was in place: the first of mine and Joe’s writing careers so cue applause if you please. Next, the last few months have been taken up with developmental edits plus miscellaneous tidbits, like a quibble about our title, plus the conversational style that I employ for this blog, or the “we” voice that Joe and I needed, thus blurring our literary tenors. About the title, those in charge might have wanted something plainer and less mischievous, though we held out for a title that—I have to admit—sounds a bit like a Bill Maher gag. To cut a long story short, the end of the rainbow is nye. This thing should be out soon…operative word being “soon”. So what? I don’t know. Do you care about sex addiction? Does anyone? Do we, the authors, even care still about this hoary subject; this creepy, nubile corner of the mental health industry?

That reminds me, editors of non-fiction don’t always like metaphors. In our text, I was challenged about using the word “nubile” when there was nary a virginal bride in nearby print. Good job that person left all my war metaphors alone, or else we’d really be fighting. But this touches upon the things I’ve learned I’m supposed to be when writing a psychology book: I’m meant to be more literal, more instructive, more—ya know, helpful. Problem is, we’ve written something different than that—something more interesting than helpful. I know because I kept saying so in the text, in preface to an illustration or an expository passage that was meant to be insightful or interpretative, but not directly instructive. “No shoulds”. That was mine and Joe’s mantra, sort of. It was mine anyway. I didn’t exactly tell Joe what he should write, but he seemed to get with the spirit and not tell readers what to do or what to think either. Good lad, that Joe. He did exactly what he should do: not tell people what they should do.

In the beginning, we had plenty of ideas about what we should do with this book, and from the get-go (strange phrase, that), we knew we’d be saying a lot that was different about this NUBILE area of study: sex addiction treatment. We knew we had things to say about how to treat SA from a novel perspective (the psychoanalytic), which we’d feel free to do because despite what some (too many) claim, there aren’t really standards in this sub-field of mental health. Seriously, if you’ve poked around in a non-sexual way and researched SA treatment, or reconned a few treatment centers or providers, you may have been told that there are gold standards of care in them thar hills where the retreat facilities lie, but it aint so. The condition of sex addiction doesn’t even exist in diagnostic manuals in the U.S., though it sort of exists as far as the World Health Organization is concerned, but even in that globalizing volume it’s being diluted as a concept, being called something else.

Anyway, that’s just the tip of condom on this subject. The bigger elephants in our text and subtext contain all the things that are covered by words like intersectionality and context. Except race. Despite it being at the top of the zeitgeist parade, as in a nearly obligatory subject to talk or write about these days, we are not branding ourselves on the right or wrong side of history with respect to race. Sorry. There was much to write about, and despite seeing a healthy diversity in both our practices, neither Joe nor I thought there was much about race to write about when the subject was already bursting at the seams with…well, that seems like another unfortunate metaphor that an editor might not like. Anyway, sex was the principal matter. Gender was the next most prominent matter: Men and women at war was the matter, because that’s the matter we’ve seen in our practices.

And that’s where we’ve aimed our bombing raids, especially me. Why? Partly because this element of the text would render it unique, that’s why? You’ll see, especially if you’ve seen already how psychology books are generally written and pitched. Actually, I shouldn’t act like I have the ideal vantage point from which to gauge these things. I really shouldn’t. It’s just that I did do a lot of reading, and not just of psychoanalytic literature, but also of sex addiction books, treatment workbooks or journal articles, etc. That was harder, as those books and articles are harder to read because…nevermind, they just are. Still, what I believe and presented to the reader in our book is the view that most authors in our field write for a readership with presumed sensibilities comprised of progressive, egalitarian, social justice values. We’re not opposed to this trend necessarily, but the point of writing about Nabokov a couple of blogs ago was to signal my own stab at ironic detachment, plus a secondary stab at the sociological assumptions that seem to pervade our profession. This will surprise many readers, especially the professional factions to whom the book will likely be promoted, because they’ll likely peruse “Getting Real” thinking it will be politically correct—that is, largely patronizing of orthodox progressive thought.

But it’s not. And yet, neither is it the opposite, which is why the book might be unique. It won’t be easily pigeon-holed, even by its soon-to-be detractors. We’re here to comment and suggest, not advocate. It’s about thinking, and suspending answers, like diagnoses, because…well, among others things, because we don’t have them.

Leave a comment

Filed under Uncategorized