Treating problematical sexual behaviour in London – Noel Bell Psychotherapist in London

Seeking help and support for dealing with the consequences of problematical sexual behaviour can be a confusing and dispiriting time. There can often be a lot of misunderstanding about what constitutes problematical sexual behaviour and the meaning of terms such as ‘sex addiction’, ‘love addiction’ or ‘codependency’. Confusion can be compounded when seeking help by the various modalities and schools within counselling and psychotherapy, quite apart from the different theories underpinning addiction treatment. This webpage will help to clarify some of the potential confusion.

Call Noel now on 07852407140 for help with problematical sexual behaviour, for yourself or if someone in your life is caught up in the addiction.

Sex addiction is a term commonly used in the addiction treatment fields but does not actually hold an ‘official’ diagnosis. Neither the Diagnostic Statistical Manual (DSM), currently in its fifth iteration published in 2013, a compendium of mental disorders and diagnostic criteria published by the American Psychiatric Association (APA), nor the International Statistical Classification of Diseases (ICD), currently in its 10^th edition, recognises the sex addiction label. In spite of this there is a plethora of addiction treatment and rehabilitation centres offering specialist treatment programmes specifically for sex addiction.

Love addiction appears in many literature searches but does not feature in any recognisable diagnostic tool either. In 1986 the 12 Steps Recovery programme fellowship of Sex and Love Addicts Anonymous (SLAA) published their Basic Text, Sex and Love Addicts Anonymous. This discussed characteristics of and recovery from both love addiction and sex addiction. The SLAA programme essentially asks its members whether they assign magical qualities to others, idealise and pursue them, then blame them for not fulfilling their fantasies and expectations. There are other 12 step fellowships too in addition to many books on the topic and the term can be used sometimes interchangeably with sex addiction.

Codependency is a term that describes someone who struggles to operate in the world from their innate self. Their thinking and behaviour is orientated around another person, but it can also be around a process or a drug. A codependent is someone who uses another as their sole source of identity, value and well-being. This can be a way of trying to restore within themselves the emotional losses from their childhoods.

You may well be reading this webpage as you feel that your own sexual behaviour, or that of someone close to you, is causing real concern in your life. Here are some suggestions for devising a way forward when someone is trying to come to terms with problematical sexual behaviour:

Design what is a healthy sexuality for you

It should be your own business what you decide as a healthy sexuality for yourself. For some it can be useful to keep it simple and view healthy sexuality as involving consenting adults, where there is mutual respect and no lies or deceit. Some will view monogamy and fidelity as part of that standard whilst others will view a healthy sexuality for them as potentially involving multiple partners. The key is that you devise your own standard. What are alternative life choices for one person are potentially problem areas for another.

Educate yourself about addiction treatment models

Learn about the disease model of addiction, the life process model and self-medication model. Treatment centres and addiction counsellors will often use the disease model of addiction by default. They typically follow the 12 Steps of Recovery view of addiction or what is also known as the Hazelden approach or even the Minnesota method. The 12 Steps of Recovery came about from Alcoholics Anonymous. The founders of AA did not exactly view addiction to alcohol as a disease but rather as a mental and spiritual “malady”. Physical sensitivity to booze was initially thought of as an “allergy”, whilst the spiritual malady expressed itself as being in discomfort with life on life’s terms.

The 12 Steps approach is based on the substance abuse formulation which advocates total abstinence where the addict is suffering from a progressive and fatal brain disease. Recovery from alcoholism can be entered into by availing of a daily reprieve to arrest the illness as there is no cure. Applying this model to behavioural addictions the 12 Steps advocate an abstinence based approach and belief in a God of your own understanding to overcome a seemingly hopeless state of mind and spirit. This treatment model is essentially a one size fits all approach.

The life-process model of addiction views addiction not as a disease but as a habitual response and a source of gratification and security that can be understood only in the context of social relationships and experiences. Rather than suffering from a progressive and fatal disease an individual has the ability to overcome addiction by repairing relationships and personal strength of will. Treatment could involve psycho education which might include harm reduction or moderation management therapeutic interventions. This model assumes treatment should always be tailored to the individual rather than applying standardised treatments. The focus should be on teaching people how to cope with life away from active addiction. A new set of positive decisions can take place that creates a healthier way of living.

The self-medicating model of addiction, whilst not a coherent model, broadly sees addictive behaviour as essentially soothing emotional pain and loss from the past. There might be underlying anxiety, depression, past trauma, abuse or social isolation that seeks self-soothing behaviours as a form of emotional relief and a feeling of security. Psychotherapy would not concentrate on the addictive behaviour but on bringing insight into past hurts, help heal old wounding and transform a new attitude in life that embraces emotional well-being. Clients may embrace abstinence and choose sobriety as a positive and healthy life choice but not because they are suffering from an illness.

Identify your ‘low bottom behaviours’

It can be useful to devise a list of ‘low bottom behaviours’, that cause most trouble both internally and externally. Internally, it could be that you suffer most shame, guilt or remorse from behaving in certain ways and in certain situations. There might be behaviours that cause a great deal of unmanageability whereby you fear a loss of control. It could be that you are using sex or emotional dependence as substitutes for nurturing care, and support. Externally, it could be that certain behaviours threaten your professional reputation, cause relationship conflicts, jeopardise business interests or get you into trouble with the authorities.

Problematical sexual behaviours can often be culturally defined. That is why it is so important that you devise your own list of problem behaviours. Swinging, for instance, can be socially acceptable in some communities but can receive highly charged judgements in other communities. Same sex relations might create confusion and shame but the cause of such difficult feelings could reside in historical toxic messaging from family, schooling or religion.

Know your ‘high bottom behaviours’

As well as defining your ‘low bottom behaviours’ it could also be transformative to know what might be termed your ‘high bottom behaviours’. These make you feel good about yourself and are, as a consequence, intensely personal and unique to you. These boost your levels of esteem and mirror your positive self-affirmations. However, these positive and self-enhancing behaviours can get lost and forgotten about when addiction is in full force.

So often addictive treatment services focus on the negative parts of your life, the shaming parts, rather than on the positive aspects of your total being. The 4th step in the 12 step programme, for example, deals with a personal inventory and takes the 7 deadly sins as a template. Your addictive behaviours may have got you into trouble but those behaviours don’t have to define you. There are risks in defining past addictive behaviours as sinful. You are more than the totality of your addiction. What about your creativity, capacity for giving and receiving love, commitment to others, loyalty, generosity and sense of charity?

Agree a way forward for what might be termed ‘recovery’

Devising your list of ‘low bottom behaviours’ and ‘high bottom behaviours’ can help inform your choice of treatment and what recovery should look like for you. Which aspects of your life need an abstinence based approach and which aspects require a harm reduction approach? Applying a substance abuse treatment model to problematical sexual behaviour can be difficult. Total abstinence from drink and drugs might prove rewarding for some but total abstinence from sex can potentially create other related problems associated with avoidance. Abstinence from sex may be a feasible option for a time, and it can help to create clear thinking in the initial phase of recovery, but eventually you may want to apply a greater holistic approach to emotional well-being than the abstinence model.

To be in recovery from problem behaviour might mean, for example, being able to learn to appreciate sexual intimacy as a result of sharing, committing, trusting and cooperating in a healthy union with another human being. This could represent greater freedom than avoiding sex or behaving like a sexual anorexic.

Identify past wounding

Your problematical sexual behaviour may well have been just a series of bad choices, which, when corrected, can produce a healthier and more positive set of behaviours leading to a happier existence. However, it may also be the case that your sexual behaviour has effectively been trying to soothe past emotional wounding. Perhaps there had been developmental ruptures in the attachment phases, or traumas or abuse. Sometimes sexual behaviours can be unconsciously re-enacting past experiences such as abandonment (real or perceived), separateness, loss or self-hatred. Sexual behaviour could have been a form of self-medicating from past hurt. There might also have been difficult family constellations. It could be that there are many self sabotaging behaviours that cause suffering. A therapist can help you to identify your past wounding and help you to heal from a difficult emotional past.

Design a self-care regime appropriate for you

Do you know what works and what doesn’t work for feeling well? Do you know about healthy sleep hygiene? What about the crucial components of nutrition? Do you know the benefits of physical exercise? Boosting levels of neurogenesis, which is the process by which nervous system cells, known as neurons, are produced by neural stem cells, will counter anxiety and depression.

A healthy self-care regime should be tailored specifically for you. Could you, for example, learn to spot the situations that may make you feel vulnerable, physically, morally, psychologically or spiritually? How can your self-care and social support networks protect you from your core vulnerabilities? Active addiction can often represent periods of self-neglect and self-abuse and recovery can involve a healthier lifestyle where you are get in touch with your feelings.

Call Noel now on 07852407140 to arrange an initial appointment if sexual behaviour is causing problems in your life.