Tag Archives: sex addiction treatment

March 26, 2022 · 3:51 pm

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.

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March 12, 2022 · 4:24 pm

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.  

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February 26, 2022 · 3:58 pm

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?

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September 11, 2021 · 3:05 pm

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.

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August 3, 2020 · 7:58 am

The biggest elephants slip out of sight

So, let’s take a step back, get some perspective and understand some things, or alternative opinion, at least. Sex addiction, a concept dominantly aimed at men over the last thirty years, exacerbates a divide already created by the narrative of feminine virtue. To be fair, the sex addiction field (movement?) isn’t responsible for generalizing undercurrents that collapse upon closer inspection. Take the following scenario, for example: a couple are in therapy, speaking of a sexual episode that serves as an interlude between contentious arguments. After lovemaking, one partner asks, “Are we good now?” thinking that sex has saved the day. The partner responds coolly, “We haven’t solved anything here. What makes you think our issues have gone away?” So, at this point I have not revealed who is who in this arrangement, as in who the man is and who the woman is (sorry PC monitors, my client base is dominantly heteronormative). What if I offer a couple of interpretations? Let’s see where the biases land, shall we? So, I suggest that the first person asks “Are we good?” with the assumption that sex will re-establish a bond; the episode was “relational” and intended as an affirmation of the couple’s togetherness. The second partner remained irritated by the first partner throughout the lovemaking but was sufficiently aroused to put aside, for the most part, feelings that may have interfered with performance. This person thus satisfied desire but later asserted a moral high ground with respect to the couple’s conflict: talk about having it both ways.

              So, who is who? Well, if one absorbs the platitudes published under the umbrella of sex addiction treatment, one would be inclined to believe that the partner motivated by “relational” goals would be female and the person intent on getting laid but still maintaining a superior attitude is male. I’ve read numerous articles or books that dispense such generalities, anticipating the nodding heads of a Greek chorus while failing to address or even imagine nuance. That chorus seems increasingly homogenized, speaking with transparent rhetoric. To encourage protest, it affirms assertiveness: “stand up for your rights”, etc. When it disapproves of speech, we hear critiques like “divisive”, and “hate speech”. To decry unpopular opinion, one simply needs to cast it as hateful in the modern zeitgeist. Approved speech that is suppressed is called silence—an imputation of cowardice. One is encouraged to “show up”. However, if you show up with the wrong opinion, then you are self-serving: it is a “photo op”. Back to private, microcosmic scenarios, my warring couple and a pair of interpretations: The first person—the “Are we good?” partner—thinks that sex is an effective circumvention of conflict. It is the answer to all problems, a kind of all you need is love approach. Now here’s a twist. The second partner agreed to have sex thinking (falsely) that the conflict had actually been resolved beforehand. This person had been hoodwinked by the partner’s seeming contrition, only to feel increasingly foolish during the lovemaking episode, which felt familiarly cold and unloving.

             Again, who is who now? Same scenario, different interpretations, but I think each would elicit biases as to which gender is being represented based upon stereotypes promulgated by self-help and sex addiction literature. I could evoke further scenarios, leave these relatively lightweight scenes behind and address what I believe are the biggest elephants confronting our field. The issues therein conflate matters of sexual addiction, post-modern sexual mores, progressive and conservative politics, and congeal thought upon the darkest behaviors on the sex addiction fringe: acts of abuse, and of sexual assault. Would these issues elicit further biases? Of course they would. The baseline assumption is that women comprise the dominant faction of sexual abuse victims while men are vastly over-represented as perpetrators. With respect to violent sexual assault, there is surely little to contest this particular assumption. But amidst an era wherein definitions of coercive sex are broadening to include instances of pressured sex, or compliant but later regretted sex, then notions of perpetration begin to blur. Mine and Joe Farley’s forthcoming book, Getting Real About Sex Addiction, cites research of the last decade that increasingly implicates female victimization of male partners, employing a construct, “Made to penetrate”, that has gained traction in research circles in recent years. It was so important I stuck it in the footnotes. Anyway, my skepticism: the idea has yet to gain traction with mainstream culture, and likely not with credulous readers of self-help literature. The problem, as I see it, is two-fold: firstly, boys or men may be even less likely than women to admit being coerced into sexual activity, fearing an emasculating response, especially if the alleged perpetrators are female. I can imagine reactionary society openly mocking their accompanying accusations as cowardly, unmanly. I imagine a corollary of women’s experience, which on the whole means something that’s been observed all along: sexual abuse desexualizes its victims, it seems. Meanwhile, a progressive rebuke might focus upon a moral equivalence argument, a point of symmetry that is not desexualizing, but rather de-individualizing: something vaguely territorial, perhaps; something along the lines of, yes we suppose this happens, but does it really compare to the rates or levels of abuse that have been meted out by men against women?              

Back to the standard pretexts of sex addiction treatment, which is all about treating people, men and women, equally. Right? Well, take a glance. Take more than a glance at literature—books, blogs, you tube videos, whatever—that purport to represent men’s sex addiction versus that of women. Notice that women are more likely tagged with the label love addiction, which, in comparison with the salacious concept of sex addiction, enobles women’s sexual acting out behaviors, and therefore turns on its head society’s task of mailing out scarlet letters. Meanwhile, instead of Narcissistic Personality Disorder, female sex or love addicts have “complex trauma”, which is an ambiguous contrivance, suggesting experience grounded in external phenomena, and then internalized as personality-altering characteristics—a more palatable, stigma-free assessment category whose plainspoken synonyms are words like victim or survivor, not creep, jerk, or pervert. I have other bullet points on this theme, but you get the gist. So, here’s the thing: in general, the biases of our profession reflect the progression of psychodynamic thought as it has moved into the 21st century. A hundred years ago psychoanalysis posited drive theory as a model of how the human mind works: something internal, a libidinal/aggressive energy within a human being strains to express itself, and will do so to one degree or another, despite the ego defenses that work to hold it back. Repression. Latterly, Object Relations theorists like D.W. Winnicott injected that the fate of this drive is contingent upon the variability of a nurturing environment, but analysts like Jean LaPlanche, Jessica Benjamin, Carol Gilligan or the Lacanian Julia Kristeva excoriated this reduction of women’s sexuality to the maternal/child bond. These views have long since been adopted by feminists and other social justice advocates (who now represent a plurality in our field) who externalize an understanding of psychopathology, at least selectively. Misogyny is therefore a kind of original sin, reflecting an ancient subjugation of women. Misandry, its lesser observed twin, is a social protest against that which is variously conscious or unconscious, but not repressed.

              This has in turn been picked up by the sex addiction field, yielding watered down versions of Object Relations theory with substitute jargon so that its principals can pretend originality. It means that female sex or love addiction is understood primarily as a reaction to either repressive sexual mores that disadvantage women, or else it constitutes an identification with an aggressor phenomenon. This is a theory first advanced by one-time psychoanalytic outcast Sandor Ferenczi in the early 1930s. It offers that sexual acting out behavior is a re-enactment of a sexually traumatic (as in victimizing) past. There. Now here’s the next thing. Assuming that OR theory also applies to men, you may wonder how that plays out. How do we graft the theory onto what we think happens to them? Well, firstly, it would mean that male sex addiction is not simply a matter of excessive drive, contrary to the essentialist beliefs of many. It would mean that males act out sexually either because the nurturing (or not) environment is permitting/expecting them to be promiscuous, or else because they have also been developmentally traumatized in some way. As indicated in the last entry, the most popular theory with respect to this category of trauma is the abusive, alcoholic father story, with second place going to disillusioning mentors: molesting priests or sports team coaches, for example. The first chestnut, which smacks of Oedipus Complex derivatives, offers that passive boys, symbolically castrated by overbearing fathers, struggle to make it with the women they admire, instead pursuing vulnerable women who substitute for their abused mothers. But to identify with the adult male sex role as it once was is to symbolically re-traumatize women, or even commit incest with them if partners and mothers are psychically linked. Thus, sexual desire must be split-off, directed at women who cannot be hurt because they are transiently involved or not psychologically real—hence prostitutes, strippers, and porn stars.

              Alternatively, if trauma theory were to analogize the male and female childhood experience, or even offer what Freud originally suggested with his latterly withdrawn Seduction Theory, then practitioners would offer what they typically suggest when the subject is the sexual traumas of women: a once sexual victimization at the hands of a male perpetrator. And some men report such victimizations, and usually they indicate a male perpetrator which, if then linked to a later heterosexual pattern of addictive behavior, would make about as much sense as the Electra Complex makes to critics of Freud’s Oedipal theories. See, if a repetition compulsion or aggressor identification were in effect, then otherwise heterosexual boys and later men would therefore manifest ego dystonic same sex attractions, which in turn might lead to homophobic reactions, manifesting as a reaction formation, or perhaps the reputedly defunct Conversion disorder. And how frequent are these phenomena, the reader might wonder? With respect to heterosexual men, OR theory filtered through modern assumptions and empiricism suggests that hypersexualized boys “model” (Cognitive Behavioral Therapy’s term for internalization) the example of their sexually incontinent fathers, in this way remaining bonded with their bad male objects later in adulthood, which in turn elicits guilt when this identifying behavior conflicts with consciously-held goals, like those “how to respect women” ideals incessantly imparted by their disgruntled, single mothers.

              There you have it: father blaming. Lucifer the angel expelled-from-the mountain-of-God stuff (remember that one?). Not God blaming, or Eve blaming. Certainly not slut shaming. Mother blaming?

              Actually, it’s been suggested…with euphemisms, mostly, or ambiguity. Think Jean LaPlanche, and plenty others, actually. Otherwise, Excess gratification, enabling a Narcissistic development—the failure to say “no” early enough, often enough, to that omnipotent, more often male (we think) than female child, who clings, protrudes with fingers, embraces and scratches with equal ferocity to an object that may respond in kind. Think Object Relations theory. It’s another chestnut, actually. Made its rounds, got covered in psychopathology 101 if you ever took such a class; if you were ever listening. But wait. Saying “no” to what, the reader might further wonder? Does this mean a child that isn’t sufficiently weaned from the breast? Is that a sexualized child, so repressed until later, until after puberty—when all the parts and fluids are simply working more fully, having arrived online, so to speak? Careful, the medical field thus argues. You’re entering the taboo zone now, so let science come to the rescue and say what facts and fate have decreed. Besides, nobody is reporting such childhood abuse as you are implying. Why don’t more of our clients/patients report on this? Gee, d’ya think it might have something to do with implicit, preverbal memory not being available for autobiographical recall? And even if it was, who would go there, at least plainly? I touched on this touchy subject in my earlier blog, “Life Weans The Giraffe”, and here I’ll “touch” on it, this final word, this ancient and original horror once again, with or without scare quotes. And so, to those who think the answers lay in a forensic grasp of an actual past, versus the phantasies of infantile experience, here is my climactic provocation on this multi-layered subject of sex addiction etiology: …no, can’t write it. Sorry.

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March 1, 2020 · 7:16 pm

Where’s the meat?

 

A conversation:

“I don’t hear the meat of this. I mean, you’re talking about someone who won’t or can’t read your manuscript, or about a publisher who is unresponsive, but I don’t hear what this book is about, even”

Pause. I’m drawing breath…with a sigh.

“Well, it’s…(another pause) a book that presents a psychoanalytic or psychodynamic perspective on the treatment of sex addiction. Firstly, it takes a look at the definitions of that term, profiling the various attempts to…organize or codify the term as a diagnostic category. Then it casts the concept as useful but also limited, or that it’s been discussed in a limited fashion by hegemonic elements in the field”

“What does that mean?”

“It means that our book critiques the trend in which sex addiction is exclusively, or near exclusively, treated as a behavioral disorder, with interventions aimed at understanding the consequences of ‘out of control or problems behaviors’ rather than an understanding of what those behaviors are about, or if one prefers, the underlying reasons why the behaviors are happening, or even what’s happening within the dissociative spells which trigger the action that is called addictive behavior. Insight as a modality is rejected by most addiction specialists, as well as, it seems, those who speak on behalf of traumatized partners. People don’t want to think so much about what happened—they want to do something, as if the understanding is a known thing, circumscribed by the labels. You hear of treatment “plans”, or “protocols of intervention” as if these represent standards of intervention, predicated upon a known assessment. We offer the view that short-term interventions lead to short-term positive outcomes, but with narrow understandings such that regression is likely, leading to repeated if episodic entries into mental health care systems. We even illustrate cases, at least two examples, in which patients fled—and I mean fled—our style of treatment because they were afraid of their own minds, didn’t want to think in the manner that our approach called for. So, our book offers an outline of how to intervene initially, as in upon crisis, but also with an in-depth focus such that progress is sustained”

“An outline of what? It’s still not clear what this treatment would entail. Also, you use words like ‘traumatized’ alot without explaining what you mean, as if the meaning were a given”

Hmm, my listener now seems impatient, maybe annoyed. I am too, or am and she’s not, maybe. I entertain a brief reverie: one day I’ll be famous for my oblique way of putting things, not put on the spot and caviled at; reverent readers will strain to understand my prose instead of me straining to make myself understood. One day. One day I will write Bob Dylanesque crypt that credulous readers will make an effort with; work hard to understand.

“Working through transference, for example. The book’s aimed at professionals so not everyone will get what that means, but practitioners should—the idea is not so esoteric. Our book reiterates something that’s been said by many others but again, not in the context of sex addiction treatment: the only real way to learn about patterns of thought, behavior, or feeling is to create the conditions such that these patterns are evoked in the treatment, with the therapist or analyst—then the deep-rooted conflicts can be addressed honestly and be dealt with. That takes time for that to happen organically, which is why in-depth therapy isn’t like a class, or a six-week rehab”

Silence, which I take to mean something like agreement. I breathe normally again, but I don’t learn whether my supposition is wrong. That’s part of the deal. The response of the reader, the listener, the other, isn’t really a known thing. Something subsides. A softening in my chest suggests a retreat, or a relenting. I’m off the spot. Thoughts relax, drift now that my polemical moment is past. Associations take over, back to an earlier theme.

“Maybe I worry about the response to our book, or the lack of it. I feel dependent on the figures that are involved currently. I don’t think there are many who would platform my views, or Joe’s. It’s funny, that’s a word I haven’t used until recently—platform, I mean. Is that a millennial term? Who knows? I don’t care for it. It seems pejorative: intended to de-legitimize dissenting speech, and to indicate by implication the privileged positions of those who hold the microphone…or control the space on the shelves.”

I’m being oblique again, but my listener doesn’t respond. Is she following me? Bored? I change subjects, sort of.

“I don’t know, maybe I’m projecting all this stuff about unimportance—making judgements about the indifference of others when this project has slipped into the background of my own life. I have other priorities also, I guess. (Pause) It reminds me of something I took care of, or tried to anyway, on the weekend. I’d gone back to that train store where I bought the locomotive model that doesn’t work—ya know, that revitalization of my old toy that I’ve been speaking of. I spoke to the guy at the shop who had worked on it and phoned me, saying its motor was dead. He asked, “Tell us what you want to do”, implying the ball was in my court to request a repair. I’ve been reluctant because this model’s been repaired once before already, and I’ve only had it for a month and a half. The first instance was my fault—I’d admitted that—because I’d connected the wires to the wrong terminals on the transformer. But I fail to see how its burnt out motor was a result of anything I did. Anyway, I sort of said that, to which the guy made no response. He’s a pretty stolid guy, like the stereotype I’d previously assigned. He’s a tinkerer, not a thinker, I think (soft laugh). There’s an air between he and I, like he thinks I’m a dilettante: someone who’s into trains for the short-term, just in time for Christmas or something. I won’t stick around, he thinks. I’m not a serious customer; not a real hobbyist. Anyway, so I asked, “ Can I get an estimate on a repair?”, thinking he might agree to meet me halfway, cover the cost of the replacement motor while I pay for the labor—something like that. He didn’t bite on that, however. He just said, “Okay, we’ll get back to you with an estimate,” in a clipped voice”. I was more or less satisfied, I suppose. Not satisfied by the outcome, which hasn’t occurred yet. Don’t know when that will happen. I just mean that I like how this is going so far…how I’m dealing with it, stretching it out because it’s worth it to do so. See, I could make a fuss and a demand, but where would that leave me, with them? Or, I could just slink away, hiding my dissatisfaction, and take my business elsewhere.”

I sensed in my listener’s silence a patient consideration: what is the relevance of this aside? I sighed amidst a lengthy pause.

“To your point, it’s not enough that I want to be read. I want shelf-life. I want to stick around because of an idea: an idea that it’s not so important what sex addiction is or even what we do about it. It’s about how we think and then talk about it.”

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January 27, 2020 · 9:19 am

Epater Le Patriarchie*

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

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

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

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

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

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

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

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

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

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January 19, 2020 · 1:33 am

The Shadow of Esther Perel

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

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

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

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

Graeme Daniels, MFT

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January 11, 2020 · 5:13 pm

The long and the short of it: a dialogue

 

So, the zeitgeist in sex addiction for so long has been to question whether sex addiction is an excuse—ya know, something that lets creepy, no-good scoundrels (heterosexual men, basically) off the hook, absolving them of…whatever the assessment of addiction is meant to let them off the hook from. Punishment, presumably: punishment from courts, employers, wives and girlfriends. Wives and girlfriends mostly. If a man has a sex addiction then he has a disease. He has an affliction, merits compassion and support, not judgement. Cue the next bit wherein someone says it’s understandable that betrayed partners would launch into a volley of judgement upon discovery of secretive behavior. They’ve been traumatized, after all, and not just by the addictive behaviors, the obsessive use of porn and prostitutes, plus those sleazy hook-ups and online affairs. Beyond that, these partners have been lied to incessantly; subjected to years of obfuscation, counter-accusations of paranoia, controlling behavior. Now the cat’s out of the bag he wants compassion, cries this beleaguered figure! Seriously? After years of being told I’m crazy I’m supposed to just accept his abject apology and then go along with this crap about addiction, while thinking what? Oh, poor thing, he just can’t help it. Let me tell you something, I’m…

Okay, I don’t hear that so much—that I’m-about-to-march-out-of-this-office diatribe. But I do hear of it from those who have previously been to therapists who tread a little close to the door marked GIVING ADVICE. Their “educational” comments carry an inflection of sympathy—too much sympathy for the angry person who is looking for someone to be angry with them, sort of. Yes, tsk tsk, exudes the right-minded listener instead, regarding that misbehaving other. What may follow next is a flurry of suppositions: how pervasively has this behavior, plus the secrecy, affected your life? How many conversations, potential intimate moments have gone awry because he was elsewhere emotionally, not truly present with you? What about the diminishing of romance, of your sex life, even? How many times have you been denied sex because he was with someone else, or thinking of someone else, taking care of himself, forgetting about you? How many times did he come home late from work? Now you know what that was about. And think about all the money that’s been spent, or the time that’s been wasted. No wonder his career has stalled, and how has that affected you, burdened you, given that you work also, plus you do the lion’s share of stuff for the kids. Treatment? For him? The person who really needs compassion and support is YOU.

There’s a subtext to such counsel, one that is rarely made explicit because that would render the message ironic. The task is to insinuate the potential for revenge while maintaining the position of victim/survivor. So, that subtext, stripped of its artifice, goes something like this: ya know, there’s a silver lining to all of this. If you’re honest, this relationship has had problems for years and until now you weren’t sure how much the problem was him versus you. You thought he had fallen out of love with you, thought you were a B, like what your last boyfriend thought, plus what your sister used to say about you. Anyway, do you have any idea how this could be used to your advantage? Do you have any idea how much this lets YOU off the hook? From now on being difficult is no longer your problem. You being difficult becomes your entitlement. Yes, I know you didn’t want this. I get that this was your worst nightmare, besides something terrible happening to your kids, of course. And I know that thinking he’s out of control will keep you up at night, worrying where he’s at when he’s traveling—who is he with, and whether he’d leave you high and dry. But think about it: this addiction thing can be the punctuation of all arguments for the forseeable future, and you can leverage his guilt. Believe me, sister, you may have the pain, but now he’ll get the blame at last.

             In most niche fields in psychotherapy, this kind of subtext, as well as the manifest content would be tagged as scapegoating. In psychiatry we have the term identified patient to in fact direct clinical attention to a systemic problem versus a “one-body”, internal or intrapsychic disorder, as it may be termed within a psychodynamic framework. In sex addiction treatment, however, the singular focus upon the acting out person’s “problem” is a virtual orthodoxy, reflecting an alliance of social and professional forces: on the one hand, the mores of social justice, which counter-privileges the perspective of underprivileged populations, especially women; on the other hand, a traditionalist objection that posits sexual betrayal as the most sensitive of personal offenses—an offense that clears the table of mutuality, allowing for an old-fashioned script of who’s been good and who’s been bad. Yes, says the offended partner, “I am no angel”. Translation: that’s all we’re going to say on that subject for a very long time, maybe ever. That’s the flip side of the “excuse” phenomenon. Reductionism, short term interventions, simplify and thus remove not only ambiguity, but also responsibility that might otherwise be dispersed; the addiction treatment stratagem, peopled by professionals with first-responder heroism encoded within their approaches, makes supportive gestures easier, confrontation of problem behavior more, shall we say, economical. Whoa, wait a minute, hold the phone, says a sex addiction specialist. Oh, I see. A dialogue:

Specialist: Are you saying that’s what a therapist would say to a non-acting out partner? We don’t give those kind of messages to non-acting out partners. Well, okay, we might say some of those things but not to encourage revenge, and you have to remember that most partners in these situations have been gaslighted and then traumatized by their discoveries. After all, do you have any idea what it’s like to pick up your partner’s phone, and by accident (maybe) read a thread between him and some other woman that is obviously sexualized, and know in your gut that it’s been going on for years. So of course we hold the acting out person’s feet to the fire. Of course we encourage polygraph tests, full disclosure. That’s necessary and fair for the partner so she can begin to heal…with the truth, the full truth of his past and present behavior. But anyway, we do counsel the women that the issue may be complex and that at some point it would be important to address in couples therapy some of the long-standing communication issues within the couple relationship.

Me: Really? At what point would you begin that?

Specialist: Well, we wouldn’t. Our program’s only two weeks long, so we’re more about offering support and education—getting them started, teaching them about addiction and coaching boundaries, that sort of thing.

Me: Ah yes, getting them started. Reminds me of the “let’s get ‘em in the door” ethos of drug treatment; the “let’s fill some beds” mantra that program administrators used to utter to intake coordinators. It’s familiar to me, that get-them-started-then-forget-em-when-they’re-gone thing.

Specialist: It’s not like that. We give them referrals to couples therapists, people who truly know about sex addiction and understand about the traumatic impacts upon partners

Me: So, that “complexity” you spoke of—is that a euphemism for shared responsibility for a bad relationship, or do you imagine or hope that follow-up support groups and couples’ therapy will fossilize the dichotomous roles of victims and perpetrator?

No answer. Or none that isn’t a glib reiteration of previous points, anyway. So much for dialogue. I’ll just cast my mind back to those scores of books and academic papers, or that conference or two where revered figures in our profession were asked before an earnest crowd, what are the most significant factors in a positive therapeutic outcome? The therapeutic relationship, a gnomic elder would reply. I know, because I’ve heard that response more than once, and I’ve watched intently as heads nod in acknowledgement of the word. The therapeutic relationship. It seems to say everything and nothing, doesn’t it? Maybe it sounds like an offhand remark, or a platitude, and perhaps it is, though it’s not quite the oldest idea in modern psychology. Freud took a while, I think, to come upon the idea of the transference-love phenomenon in analysis—or the transference-hate equivalent. Before this, he’d traversed failed experiments in hypnosis, techniques like the talking cure, even the more resilient practice of free association, until discovering that a patient’s resistance to care, based upon feelings transferred from prior experience and relationships, is the most important hurdle to surpass if treatment is to succeed. I think our profession’s truest elders still think this the key to positive outcomes. Free association, as in a stream of unfettered thought, doesn’t come easily, yet that outcome is more important than most people think. And a clinician’s countertransference is part of the equation: he or she uses their internal experience and reflects something back that points to something missing in the patient–a lost self experience, as many have written of it. It’s a slow process, one that may take months or even years.

There are many who enter a psychotherapy episode, or who provide care, who simply do not understand this mysterious exchange. Some may think the magic happens in moments of inspiration—change on a relative dime because of a divine taking in. Yes, you work through that conflict with that person whom you had to endure for a spell and later, when they’re gone and no longer stirring your resistance, you reflect upon how they really helped you, and so maybe you’ll go back one day and tell them how they changed your life by telling you a blunt truth days before never having to see you again. Yes, that’s how that happens. Do they last, these prescriptive plans, these outlines of change that many leave therapy with. Do those galvanizing confrontations that didn’t stick before stick ever after? We like to think so. If we’re honest, we think not.

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December 14, 2019 · 9:00 pm

Objects don’t return

 

In Getting Real About Sex Addiction, there are several areas of ontological speculation, areas whose nature, existence, and organization are identified by the following terms: addiction, the mind, trauma, misogyny, misandry, and objectification. These abstractions, all made concrete to one extent or another by various pundits across intellectual disciplines, are discussed in mine and Joe Farley’s book within the intersecting frameworks of intrapsychic (one-body or instinctual), interpsychic (relational), or collectivist (broader social or systemic) models of thought. There. Take a moment to digest that mouthful of words before you move on, else you might get psychic indigestion. The terms presented for our offhand yet meaningful scrutiny—these things about which we ask, “is that a thing?”—are listed in no particular order of importance. And it’s not just their importance that seems arbitrary, so too do their meanings. Take, for instance, the term objectification, placed above in a fashion that is fittingly unfitting: a random sixth amongst a list of variably meaningful abstractions.

My passages in the book on objectification don’t so much present an etiology of this term as comment on recent research on the subject. In my reading of studies about porn use, for example, I found that some researchers are revisiting the question of objectification, especially as it pertains to gender. It seems that trends are shifting and that porn use is becoming more, shall we say, egalitarian. Meaning, women are quietly using porn in rates that are starting to rival those of men, according to numerous self report studies. This has led researchers in Amsterdam in the Netherlands to question whether the porn industry has adapted its depiction of men and women in porn scenarios to reflect this shift in viewer demographics. Specifically, they sought to determine whether contemporary porn objectifies men as much as it does women (or approximately so), which would be contrary to accepted social narratives. I’d suggest that what prevails currently is a tautological, as in circular polemic wherein men who use porn or prostitutes are said to be objectifying women, while women who use porn or act as prostitutes are said to be objectifying women. This latter phenomenon is explained by the concept of internalization, an object relations and psychoanalytic theory. The popular rhetoric suggests an underlying ontological issue relating to both porn and addiction and so I canvassed literature to see how the concept of objectification was being defined. Though I found some variance, the most common meanings attached to objectification indicated a reducing of a person to a thing; an implicit demeaning, at least. In Getting Real I don’t contest this meaning though I question its selective application. With respect to the aforementioned study, the researchers designated numerous criteria for objectification and found in several categories equitable instances of objectification from women to men as from men to women. This was especially true with respect to what is often dubbed performative sex.

My own critique extends beyond this kind of forensic examination of porn, though I shall use as a springboard to my idea a convention that I have observed more than once within the porn medium. With apologies, I ask the reader to conjure the following: a man standing, or lying flat, erect in every sense, and appearing soldierly. Physically, he is at attention, but he is not gripped by ecstasy; rather he is gruntingly stoical, or blasé, or—one might consider—dissociative. For the viewer, he may be faceless, as in off camera from the waist up. Whether this is to protect the performer’s identity (especially in amateur porn) or results from his irrelevance to the pleasure of a presumably heterosexual male viewer is debatable, but regardless, he is not exactly personalized. The soldierly pose of the male performer is further apt because it presents a subliminal link to the role that has traditionally (and still does) “objectify” men of this type. In this militant role, they put their bodies on the line, sacrificing themselves, becoming objects of violence or symbols of civilization’s defense. Now then, patriarchs and feminists might ally with one another on this point, bristling against my comparison and the implied moral equivalence between this historical subjugation of men versus the sexual humiliation of women. Firstly, feminists in particular might point out that today many women are also soldiers, thus sharing that sacrificial burden, though on the whole the military remains dominantly masculine. Secondly, they might argue that soldiers, or even their symbolic gladiatorial substitutes, athletes, are treated as heroes, not mere objects to be used by a lustful society.

Really? I would think that even a casual glance at that last sentence would cause dissenters to pause. After all, on the sports front, not all or even a majority of participants become celebrated, or even achieve a lasting or lucrative career (even if they did, does one become less objectified if making lots of money?). Some of them, especially football players, experience chronic health and even mental health problems relating to their playing careers. How much do we really care? Meanwhile, history and even contemporary reality shows that while society and media pay regular lip service to the heroism of veterans, a darker truth lies in the legacy of neglect that survivors of combat have long known. The legendary British analyst, Wilfred Bion, a World War I veteran, felt invisible and used by the military command that recruited him and thrust him and his comrades into no man’s land. My grandfather, a veteran of both Dunkirk and D-day, never acted like—nor was he treated as—a hero. Thomas Childer’s book, Soldier from the War Returning, likewise debunks the myth that WWII soldiers were revered as much as our sentimentalized histories suggest they were. Instead, they endured long-standing economic and psychological struggles, misunderstood episodes of PTSD, and even social backlash from a misunderstanding public. And what about today? How many stories of unattended veterans’ disabilities, or of veterans’ struggles to find jobs or housing do we have to hear before we drop the pretense that we have privileged their lives and service? I don’t begrudge feminist scholars for having drawn attention to the ways in which the sisterhood has been and still is being demeaned. Furthermore, I’m not sure how much any movement is responsible for its menu-minded consumers. But the myopic, femicentric bias invested in the objectification concept merits the critique and satire that I bring to mine and Joe Farley’s book. So there. The reader has been warned, and consumers should be reminded of what they habitually do and what our surviving soldiers weren’t prepared for—that ancient warrior’s tacit sacrificial bargain with his original commanders. We throw our things, our objects, away. They were never meant to return.

Graeme Daniels

 

 

 

 

 

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