What I learned AS a sex therapist

I haven’t always been a traditional therapist.

My early career was spent working with the justice involved population. From roles of monitoring and supervising, to assessment and treatment. Years later I became your typical therapist; sitting in a comfy chair empathetically listening to clients. My role as a sex therapist ranges from topics regarding sex play, building desire, and healthy self pleasure, to compulsive sexual behaviors and sexual offending treatment. In my over 20 years I have discovered a lot about people, and a lot about me. Here are some discoveries i’ve uncovered while working as a sex therapist.

Leave you at the door

When entering the field of counseling and therapy, just as in any field, you need to be sure this is what you want. Admittedly there are a variety of potential career paths to take as a therapist, so the options exist if you need a change. As a grad student a few of the tenants of therapy is to be nonjudgmental, nonmaleficence (do no harm) and create beneficence (do good). I like to think of this as leaving ‘me’ outside so that I can create space for the client. The less I bring me in, the more I am able to listen openly and with genuineness. As a sex therapist, i am to listen.

Expect the unexpected

I recall people being surprised that I would be working with the justice involved population, let alone people convicted of a sexual offense. Maybe it’s because i was so young? Whatever the reason, guess I just didn’t match their expectations. The point is that the same idea applies to my clients. I can’t have a preconceived idea of who they are or what they represent. Whether they are involved in the legal system or want hotter sex with their partner. I don’t know their story. I don’t know their needs and goals for therapy. As a sex therapist, I am to be a compassionate ally.

Learn to laugh

Yes, really. Therapy isn’t always serious. Laughter sometimes is the best medicine and it can be very therapeutic when talking about sex. Clients bring in their embarrassing stories, learn a new term or slang, share a meme. As a sex therapist, i am to balance levity with lightheartedness.

Choose knowledge

I am a firm believer that therapy is a place of education just as much as a place for healing. So let’s talk about sex, baby. Let’s talk about anatomy and desire. Let’s talk about fantasies and sex toys. Let’s talk about learning to create plans that prevent future victims. As a sex therapist, I am to educate.

I’ll admit that when i graduated I didn’t envision myself being a sex therapist; I have no regrets!

Let’s talk about sex , baby! Lets talk about sex (addiction)!

Sex is a natural human activity, a way to express love and connection. Sex can be fun solo or with partner(s), so how can it be a problem? For many, sex can become an addiction. While there are many points on the continuum to discussing sex, for our purposes we will focus on addiction to sex. 

Then what is sex addiction?

Addiction is a common term; one often overused and over simplified. In fact people make flippant remarks about being ‘addicted to’ tv shows, a specific drink or roller coasters for example. This generalizing can diminish the seriousness of addiction to those that are truly trapped in its grips. The American Society of Addiction Medicine (ASAM) looks at the “interactions among brain circuits, genetics, the environment, and an individual’s life experiences” to assist in identifying when a person has an addiction. They go on to say that addiction can be of substances or behaviors. 

Also referred to as a compulsion, being hypersexual or having out-of-control sexual behaviors, sex addiction is one of the core treatments at the International Institute of Trauma and Addiction Professionals (IITAP). They have defined sex addiction as “a pathological relationship to a mood altering experience (sex) that the individual continues to engage in despite adverse consequences.” That can be a complex definition so let’s break it down into every day language. 

• Pathological refers to the abnormal connection between the cause (addictive behavior) and effect (consequences) of a condition on a persons physical and psychological health. 

• Mood altering is the ability of a substance, activity or object to change moods. 

• Adverse consequences are unwanted, unhealthy, or unsafe outcomes due to engaging in the behavior. Arrest, physical injury, loss of employment are examples of adverse consequences to any number of addictions.  

Addiction treatment professionals follow common rules related to the identification of addiction. As a therapist it’s important to distinguish between a clinical diagnosis or a behavioral observation; depending on the experience and licensure of the therapist some are able to provide a clinical diagnosis like those found in the Diagnostic and Statistical Manual (DSM) or the International Statistical Classification of diseases and Related Health Problems (ICD). 

Sex addiction can include behaviors such as: voyeurism (e.g. peeping toms), exhibitionism (e.g. flashers), frequent anonymous sex, paying for sex (e.g. engaging in prostitution), and pornography use, including role play, cosplay, amateur, type of sexual positions, etc.  

I like sex, a lot! Does that mean I’m addicted to sex? 

Absolutely not! Sex brings with it innumerable benefits, including enjoyment, connection, confidence and procreation.  That fact that you enjoy sex, makes it that much more pleasurable! Sex as a addiction is when the individual has lost much of the pleasure and intimacy of the act and is focused more on meeting their cravings or urges (remember that pathological relationship mentioned above). 

Just as in identifying other addictions, such as substance, gambling, or nicotine, there are criteria that must be met. Some of those criteria include:

• Loss of control—engaging in the compulsive behavior more than you intended to

• Efforts to stop—repeated attempts to stop the compulsive behavior without success

• Loss of time—significant amounts of time is spent getting ready, engaging or recovering from engaging in the behavior. 

• Continue despite consequences—even though the individual may experience adverse consequences, they continue to engage in the compulsive behavior

Please note that this is not a comprehensive nor conclusive indication that someone is addicted to a substance or behavior. You are encouraged to  speak with a licensed therapist if you are concerned about your own or someone else’s behaviors.

Now what? Is there treatment available? 

Treatment does exist for someone with sex, porn or love addiction. It’s important that the therapist you work with has experience helping those in sex addiction but it’s not essential that the therapist have a certification in sex addiction. Consider it an added Sarah at Total Wellness 365 is a Certified Sex Addiction Therapist, Candidate through IITAP. Prior to getting her certification she has worked with those in addiction for over 10 years.

Therapist working with sex addiction clients will help them develop a clear understanding of their specific addiction cycle. Then teach skills to interrupt the cycle by creating a plan to incorporate healthy replacement behaviors, reducing risk and increasing wellness as a new lifestyle. Recovery is takes time; it also takes hard work, patience and support. If you or someone you know are interested in learning more about this subject, here are some additional resources. If you are interested in finding a sex addiction therapist, you can search here.