Therapy for Sex Addiction: Dealing With Intimacy

September 24, 2016

Any definition, discussion or exploration of compulsive sexuality begins thusly:

“Sex addiction is an intimacy disorder characterized by” blah, blah, blah.

Then it goes on to name the symptoms: pre-occupation with thoughts sexual; persistent, unrelenting urges to sexually act out; continued use despite adverse consequences, loss of control and so forth.

Such definitions are frustratingly vague. While emphasis is given to the symptoms of sex addiction, the idea of it being “an intimacy disorder” never seems to be addressed. This is unfortunate, indeed. I think a “disordered” pattern of intimate relations is at the core and foundation of this debilitating syndrome.

Vanilla sex addiction, fetishism, exhibitionism/voyeurism, BDSM, and all the other various and moribund kinds of sexual perversions are fueled by the very basic (and healthy) motivation to connect.

Sadly, somehow or other, the urge to connect is misfired. Rather than seeking a real relationship with a real person who might, in fact, satisfy some of one’s real relational needs, the sexually compulsive tries to connect with the “unreal” in fantasy. It is a solo act. Sex, for a person who has a perversion or addiction, is always a narcissistic, self-centered endeavor. It is not related sex. The endorphin rush of the sexual high is so dear to them that it precludes any idea of sharing sexual pleasure with a cherished one in the service of enhancing a bond.

What is intimacy?

Let’s look at the word “intimacy”. From the dictionary: the word is derived from the Latin intima, meaning “inner” or “inner-most.” The definition suggests that to be intimate, you need to know your real self. This ability to be in touch with our inner core is a requisite to being intimate.

Our intima holds the innermost part of ourselves, our most profound feelings, our enduring motivations, our values, our sense of right and wrong and our most embedded convictions about life. Importantly, our intima also includes that which enables us to express these innermost aspects of our person to “the other”.

So, to be in relationship, and to know yourself/your partner sexually, you need to know and respect your intima. The intima is also the way in which we value and esteem ourselves and determines how we are with being with others. To put it simply, if don’t value yourself, you can’t value another. If you’re not aware of needs and wants, or are shamed by them, then sex becomes no more than a fuck.

I think every person I’ve ever seen in my consulting room for sexual compulsions suffers from estrangement from his intimus. We can survive the disapproval of others. The feeling can be painful, but it’s nothing compared to the disapproval of ourselves. Your personal well being and your ability to love another cannot survive your dislike or disrespect of yourself. If you dislike yourself, you’ll never be comfortable with your sexuality.

It bears repeating… the outstanding quality of intimacy is the sense of being in touch with our real selves. When “the other” also knows and is able to express his/her real self, intimacy happens. Sexuality is both an expression of that intimacy and a bond that enhances intimacy. With this kind of personal/sexual intimacy, our growth experience as humans is energized, enhanced, and fueled. Intimacy is the most meaningful and courageous of human experiences. It’s why people long for it so.

The Perils of Intimacy

However, despite this universal longing, fear and avoidance of intimacy is a reality for many people. People fear and even dread that which they most long for. No wonder there’s such a demand for psychotherapists!

So why would people fear, avoid or sabotage this wonderful thing called intimacy and, in the process, avoid person-related sex?

Sexual compulsion is the end point, the tip of the iceberg, if you will, of a long history of developmental events that begin in early attachment difficulties with caretakes, subsequent overwhelming experiences the child is unable to assimilate, an impaired ability to regulate feelings and impaired self-development.

The capacity for bonding with others is vital for human survival and well-being. Our capacity for intimacy is formed in the crucible of the first two years of life. Mothers that are needy, narcissistic, depressed, enmeshed (over-involved), distant, too protective, controlling, chronically angry, addicted to substances, frustrated with their husbands and displace their needs onto their children… raise children who have the psychic imprint of closeness as being dangerous. They also raise children who will carry self-hatred into their adult lives unless they get good treatment.

If the child’s need for attention, soothing, stimulation, affection, touch, discipline, validation, and so on goes unmet, or is met with feedback that is punishing, invalidating or rejecting, the consequences are woven into the structure of the developing personality. Such children may turn into themselves and disconnect from others, regulating their emotions through the use of substances or process addiction, like sex. They fail to learn to utilize others to soothe or comfort themselves. This increases the child’s vulnerability to mental health problems. These people actively seek familiar environmental interaction, thereby recreating and reenacting familiar early rejections and frustrations with others. They spend their lives further cementing their original isolation.

They develop a rigid defense system (boundaries, walls, turning inward to not need others) in order to psychologically survive. But what worked for them as children doesn’t work for them as adults. For these people, the vulnerability of intimacy harkens back to a time when they were vulnerable as children and they fear re-traumatization in their current relationship.

When a person like this is loved – seen in an affirmative light and encouraged to grow and change – this rigid defensive structure is threatened, so their psychological equilibrium is disrupted. Being loved is not congruent with the negative tapes they run about themselves. They can’t allow the reality of being loved to affect their basic defensive structure. Being vulnerable and open to change feels so threatening that they eschew close relationships and mature sexuality.

Entering into a relationship without having some resolution of childhood wounds results in various kinds of fear of intimacy: fear of being found inadequate, fear of engulfment, fear of the loss of control, fear of losing autonomy, fear of attack, fear of disappointment and betrayal, fear of guilt and fear of rejection and abandonment and so forth.

For this reason, I believe that current sex addiction therapy doesn’t go far enough. Focusing on symptom change techniques, such as relapse prevention, abstinence and social skills training, is necessary, but not sufficient. Successful treatment for sexual compulsions ultimately depends on a depth-approach that can ameliorate the underlying attachment disorders and manifestations in adult intimacy. Literally, a new pattern of way of attaching needs to be “carved” into the brain – the person learns a totally different model of relating.

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