Seksverslaving: het vuile kleine geheim van therapiseptember 10, 2020
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Any close examination of the term “sex addiction” reveals a number of psychotherapy’s dirty little secrets. None of them are pretty, and just talking about them in the wrong room is going to get some professionals upset.
Embarrassing Secret #1: The vast majority of therapists are as ill-informed as the general public when it comes to sex. This should come as no big surprise, as the vast majority of therapists are recruited from the general public. OK, but what about their fancy education? Doesn’t that help? Sorry, but it doesn’t, because, unfortunately, the vast majority of educators know little about human sexuality.
On top of knowing little about normal human sexual behavior or diversity, most counselors are uncomfortable with any subject related to human sexuality. Their education, in the main, has failed to desensitize them to sexuality in the way a medical school hopes to desensitize future doctors toward human organs or the sight of blood. Think of homosexuality: A normal variation on human sexual diversity, yet considered a disease until 1973 when the Diagnostic & Statistical Manual of Mental Disorders (DSM) finally delisted it. The National Association of Social Workers didn’t make the same move until 1993.
Embarrassing Secret #2: “If you build it, they will come” is as true about sex addiction theory as it is about any other field of dreams. Playing on people’s ignorance of “Just what exactly is normal anyway?” the sex addiction industry has been built into a financial bonanza. Sex addiction treatment centers will thrive because there are gullible people who fixate on rigid religious beliefs, and lots of therapists (who may or may not share those beliefs) willing to take their money.
Industry websites pull sex addiction claims out of their sex addiction pants: “In the U.S., sex addiction is common,” or “Many say sex addiction is growing,” or “3% to 5% of the population had some form of addictive sexual behavior.” This is the “sciency” version of a politician saying, “I’ve heard a lot of people think he’s crooked. Frankly, I can believe it!” By the way, 5% of the population? Over 16 million sex addicts? That’s some good mental-health market-share money right there.
Embarrassing Secret #3: The sex addiction model serves as handmaiden to religious fundamentalism. After a century of resistance to mental health science, fundamentalism decided to beat therapists at their own game by joining them. Only, instead of scientific diagnoses, sex addiction is a repackaged moral diagnosis. Your (formerly) sinful behavior is (now) a sickness or mental illness.
Consider the fact that we live in what is easily the most materialistic society in human history, yet there are no treatment centers focused on helping hoarders and compulsive shoppers. These patients can get help but they’re never labeled addicts. In contrast, consider the sexual fixation of religions in general, which see sexuality as a competitor in the marketplace of experiences of awe, mystery, and wonder. As a result, we have sex addiction specialists everywhere while property-addiction therapists are nowhere to be found.
What we need to do: We all need to understand that “sex addiction” does not exist in objective reality. “Sex addiction” is (presumably) a construct that was created in an attempt to help people. Schizophrenia is another construct that attempts to help us deal with another human problem. Attention Deficit/Hyperactivity Disorder (ADHD) is another. The author of a nationally syndicated column regularly mocks ADHD as merely a construct, forgetting that all of our language about mental health is made up of construct upon construct. The only question about sex addiction or any other construct in mental health is, “Is this model helpful in the treatment of hurting human beings?” The answer is no, it is not. Consider what appropriately trained therapists who’ve worked through their own discomforts around sexuality might see if they looked at the issues underlying sexual concerns:
- The teen who masturbates a lot (by other peoples’ standards) is still normal. The solution is sex education—for mom and dad (and let’s not forget the therapist).
- The sex-starved spouse whose relationship problem is loneliness and feeling unloved. This is a tough one for any therapist who’s expected to somehow unscramble the eggs. The solution may be dissolution of an incompatible relationship.
- The man or woman who craves, say, anal stimulation from a spouse (which is a lot more common than you might think), but whose belief system tells them they’re sinners. The solution may be found in the challenge to integrate sexuality (objective reality) and spirituality (personal values).
The takeaway is that the notion of “sex addiction” fails to address the innumerable permutations of human sexuality that fall within the range of normal. It fails to address underlying conditions such as the myriad expressions of early childhood trauma where sexual pleasure (or shopping, eating, or controlling) serves as a self-soothing behavior.
Instead, sex addiction focuses on the manifestations of all of these conditions. It treats “sex addiction” patients like those sexually abused children of yesteryear who acted out angrily and were subsequently diagnosed as having an anger problem, when the real problem was their sexual abuse. Sex addiction is a flawed construct that allows us to ignore everything human about human sexuality, and directs us to focus on sexual acts as the problem. This model didn’t work out so well with conversion therapy, did it? That’s why all sexual orientations, especially heterosexuals, need a bigger model and will need constructs that make sense. Although our sexuality is perhaps the most private and intimate part of who we are, trying to treat sexuality without understanding the context of human relationships is ultimately useless.