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Sexual Health in the Age of Sex Addiction

As a member of the sex addiction fellowships for more than a quarter of a century, I’ve heard a lot of stories about suffering as well as celebration. Yet, the words sexual health  are rarely spoken. Why is this the case? It seems that there is much more focus on overcoming problematic sexual behaviors rather than developing a fun, meaningful, deeply connected sex life. As a result, the sustainability of long-term sexual recovery is not always addressed and sexual health often becomes an afterthought.

The World Health Organization defines sexual health as follows:

“…a state of physical, emotional, mental and social well-being in relation to sexuality; it is not merely the absence of disease, dysfunction or infirmity. Sexual health requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence. For sexual health to be attained and maintained, the sexual rights of all persons must be respected, protected and fulfilled.” (WHO, 2006a)

Although I’ve been familiar with this definition for many years, its significance only came to my attention recently as part of a workshop I attended at the national group therapy conference. My talented colleagues, Douglas Braun-Harvey and Michael Vigorito have developed a non-pathologizing, affirming and forward-thinking Sexual Health model. I believe this approach is a missing link toward creating more purposeful sexual expression in recovery.

In their book Treating Out-of-Control Sexual Behaviors: Rethinking Sex Addiction (2016), Braun-Harvey and Vigorito define OCSB as a “sexual problem of consensual urges, thoughts, or behaviors that feel out of control for the individual.” They go on to say that “sexual health conversations matter.” Their open-hearted approach is based on honest conversations that often go underground rather than openly explored.

They have developed a clinically-sound treatment approach allowing individuals to determine if they have a problem and their level of motivation to work on their behavior. Rather than labeling it or using typical “disease model” language with their clients, they look for ways to bring out the integrity of the individual while promoting a shift from secretive behaviors to transparency. This usually takes place within the context of individual sessions as well as a weekly sexual health men’s group.

They believe that ending your existing relationship with out-of-control sexual behaviors is not supposed to be about deprivation; instead, it’s about celebrating one’s birthright as a sexual being. What do you really want your sex life to look like? How do you choose to express yourself as a sexual being? In this article we will follow one young man’s journey with porn and some specific strategies to heal from it.

There is no cookie-cutter approach to healing from sexual compulsivity, but one thing I do know: there is still a lot of anguish both in the twelve step rooms and in my office, and sexual health conversations offer a refreshing, non-judgmental way to look at these problematic behaviors with curiosity. Rather than a one-size fits all method, we will begin to think about sexual health as an essential dimension of your well-being.

Charlie was the oldest of three children raised in a middle-class suburb of Boston by well-meaning, hard-working parents. Because his family lived paycheck to paycheck, Charlie was often left on his own after school before his parents arrived home by 6. He was a well-behaved, conscientious child left responsible to look after his younger siblings.

As a teenager, Charlie became tired of this adult-like responsibility and as puberty arrived, he became more interested in exploring internet porn rather than taking care of his little brother and sister. At first, his curiosity was peaked when a friend showed him the easy availability of porn images. Before long it became his afterschool secret--a daily habit that expanded into compulsive masturbation and eventually unintentional self-harm of his genitals.

His relationship with porn became more and more time-consuming resulting in less contact with friends and family. Charlie became more reclusive, grumpy and disconnected. By the time he left for college, he began to realize that he just didn’t feel like his old self anymore. The engaged, fun-loving Charlie had gotten lost in the seductive world of porn.

Where did you get your sex education? In the pre-HIV world of the 1970’s, my public school “health teacher” arrived in my 6th grade class and showed us colorful slides of body parts that were anatomically-correct but rather one-dimensional and confusing. There was little or no discussion about intercourse, contraception or STDs – and of course nothing related to same-gender sex. As I understand it, things really haven’t changed much in the past forty-five years, and the idea of sexual pleasure is not commonly discussed.

In the Netflix series Sex Education, the protagonist, Otto is a curious teenager whose mother is a sex therapist with a home office where she offers seminars focusing on the wonders of the vulva. Vicariously, Otto picks up on some of her sexual wisdom and expertise, and he is dubbed the “sex kid” at school. He opens an underground business to dispense advice to his naïve but sexually-active cohorts. Although Otto is a virgin himself, he tries to reassure others in the school and does so with moderate success.

If Charlie had spoken with Otto about his compulsive porn habits, maybe his fate would have been different. Yet, the lack of sex education from families and schools often leaves kids with misconceptions and profound isolation. How might this be different?

In Part Two of this article we will take a look at some strategies that most of us were not given as teenagers. As mentioned earlier, sexual health is one missing link of sex addiction recovery, and it’s never too late to begin your sex education.

In Part One we learned about a teenager named Charlie whose relationship with porn became his secret life. Now let’s take a look at a few action steps that Charlie might consider to develop a more satisfying and pleasurable sex life.

  1. Know that your brain and body need to recalibrate after years of viewing pornographic images. It will take up to a year to physiologically shift from images on a screen to a real person in front of you. Be patient and know that you’re exploring the unexplored part of you—your sexual self.
  2. If you experience erectile problems without the use of porn, speak to your physician or a sexual health professional who can walk you through some steps to get to know your body again. This process may take time but know that you have not done any permanent damage.
  3. Sex therapists and sex coaches are trained to focus on sexual health issues. Sex addiction therapists are trained to focus on compulsive sexual behaviors. Ideally, find someone who is certified in both areas. They are not always easy to find but it will be worth it to interview several candidates to find someone you feel you can discuss even the most sensitive and vulnerable areas of your sexuality. When sexual expression becomes secretive and shameful, it tends to only get worse without professional help. Find the very best support in your area or possibly on-line.
  4. With the help of your therapist, moderate your problematic porn behavior to see if it’s possible to decrease the amount and frequency of porn you’re consuming. If that doesn’t work, take more drastic measures such as asking a tech-savvy friend to block all porn sites on all of your devices.
  5. Once your porn sites are blocked, use your computer and phone for safe, productive uses. Join chat communities focusing on those who have a problematic relationship with porn. Read articles about the physiological and sexual effects related to excessive porn use. Find others who have stories of healing and hope.
  6. Consider twelve-step support if you and your therapist identify your issue as compulsive and persistent. Attend at least six different meetings in-person or on-line in order to find out which meetings resonate for you. You are biologically wired for connection, and 12-step communities provide a sense of belonging based on sharing a similar problem.
  7. Read books related to your problem. The Porn Trap by Larry and Wendy Maltz is a solid resource to consider, and my recent book It’s Not About the Sex also addresses the underlying issues you may be facing.
  8. Once your compulsivity has slowed down, ask your therapist to help you develop a Sexual Health Vision. What does sexual pleasure mean to you? What would feel more satisfying, fun and liberating? Allow plenty of time and soul searching to develop your vision of sexual health.
  9. Go to a men’s group with an emphasis on sexual health. You will find others who identify as being in recovery from various types of compulsive sexual behavior, and the focus will be about finding your true sexual voice and helping others do the same. Group therapy offers its members a powerful opportunity to build shame resiliency and camaraderie.

Sexual health is often overlooked, yet it’s just as significant as mental health, emotional health, physical health and spiritual health. Because puritanical ideas of sex are still pervasive in American culture and sometimes in the twelve-step rooms, exploring your sexual health is a courageous path of self-discovery as you find your true self beyond out of control sexual behaviors.

Andrew Susskind is a Licensed Clinical Social Worker, Somatic Experiencing and Brainspotting Practitioner and Certified Group Psychotherapist based in West Los Angeles since 1992 specializing in trauma and addictions, and he has mentored associates in his private practice since 1997. His recent book, It’s Not About the Sex: Moving from Isolation to Intimacy after Sexual Addiction (Central Recovery Press, June 2019) joins his workbook, From Now On: Seven Keys to Purposeful Recovery which was released in 2014.

Contact information:

Andrew Susskind, LCSW, SEP, CGP

2550 Overland Avenue, Suite 100

Los Angeles, CA  90064

(310) 281-8681

andrew@westsidetherapist.com

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