Sexual behavior is deeply rooted in the human experience. Few other forces in our lives are so closely tied to our biology, our emotions, our needs, our thoughts, and our learning history. Thus, it is not surprising that when something goes wrong in this area it can feel as if our whole world is out of control. People may find themselves engaging in abundant use of commercial sex (prostitutes, massage parlors, strip clubs, etc.), having numerous affairs or sexual liaisons, viewing pornography and/or masturbating in an excessive way, or some combination thereof. Very often, men and women find themselves lying to cover up various of these activities, or wishing they could stop or cut down but having little idea how that might happen. Sometimes, people are involved in patterns of sexual behavior that others find hurtful or problematic: They may be told, “You have an addiction,” or “That’s not normal—normal people don’t do that,” and so on. Typically, assertions such as these only add to the deep well of shame in which many find themselves. After all, what is “normal”? And what is a “problem” if a person believes what they are doing is not harmful? (Also, as of the end of 2018, “sexual addiction” was not a diagnosis officially recognized by the American Psychiatric Association.)
In the last 35 years, a great deal of thinking has gone into the assessment and treatment of compulsive and out-of-control sexual behaviors. There are various treatment models which conceive of these behaviors as addictions and thus apply a recovery/sobriety approach. Other modalities seek to discover what purpose a behavior may be serving for a person—psychologically, emotionally, etc.—so that an individual can begin to understand her or his patterns and thus let go of those patterns if they choose. There is no single approach that has been determined to be of greater efficacy than any other; what seems to be most helpful in my experience is a good and trusting fit between patient and therapist—a therapist who wants to, and sincerely believes he or she can, help because he or she has done so before.
Although I have worked with many clients struggling with sexual behaviors that are troubling them, including those who seem to have one relationship after another with “toxic” partners and those on the opposite end of the spectrum who yearn for sexual and emotional intimacy but feel paralyzed as to how to find it, I don’t believe that there is one “right” recipe for all. We are all human, with our thoughts, feelings, needs, and biological drives. I consider my job to be that of a compassionate and curious tour guide who helps a person get to know her or his mind at conscious and unconscious levels. My hope is that my office is a place where people feel safe and willing to understand themselves; to see why and how they have arrived where they are; and to begin to know a more authentic and liberated way of living that comes from within with the assistance of a beneficial client/therapist relationship.