A Treatment of Sexual Addiction

Remember Charlie, a man in his early fifties who entered treatment after breaking up with a woman for whom he cared deeply. He had been married twice previously and had a daughter on welfare with five children who he was trying to help. Charlie also had a chronic inherited medical condition that required careful and frequent monitoring. He was motivated to understand the kinds of behavior that were getting in his way and we were able to make progress on a number of issues. But the persistent problem that he had mentioned from the beginning proved particularly resistant to treatment. Charlie continued to search out prostitutes and spent inordinate amounts of time and money on porn sites.

Why was this problem so resistant to treatment both for Charlie and for many good and caring men who act out sexually in ways that prevent them from developing relationships with their wives or girlfriends and ultimately go against many of their own values? I believe there are two factors operating here. The first is, as Charlie has told me many times, a biological imperative, a driving need that must be satisfied. It hits like a Mack truck even though he knows that prostitutes and porn sites are not the best methods for satisfying those urges, particularly since he has also expressed a desire for a committed and loving relationship.
The second factor, played out frequently in our culture, is one that portrays women as objects. Charlie certainly saw that message enacted in his early life. His father and uncles were hard drinking and hard partying men who abused women and cheated on them. So in spite of his efforts to be different from those men—and he specifically said that he had tried—there was a part of him that identified with that behavior. We sometimes talked about the angel and the devil on each shoulder and that the one didn’t know what the other was doing. We also stressed the importance of having them talk to each other!!

It was only when Charlie started to acknowledge the conflicting parts of his makeup and giving voice to the unwanted behavior that he was able to change it. The “devil” in him started to speak and I was listening. I heard detailed accounts of his exploits—cruising for women, visiting them in seedy apartments owned by pimps and drug lords, hearing about the needs of their neglected children and vivid accounts of the sexual acts they pursue. It was only then that we began to break through the defenses and compartmentalization that he has constructed. It was a difficult role for me to assume and I expressed my physical and emotional discomfort in listening to the material. But Charlie was now in the presence of a living, breathing woman, one whom he finds helpful and trustworthy. He could see first-hand that women are human beings with feelings and not merely a collection of body parts.

I believe that we overcome sexual addiction and other addictions as well when we confront what we are doing and allow the “bad” in us to speak. If done in the presence of an engaged and supportive listener we can bring unwanted behavior back into our conscious control.
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Next week I’ll talk about how we do this with our children. It’s so much easier if we can start this dialogue while they are young.

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