Sexual Health in the Age of Sex Addiction (Part 1)

As a member of the sex addiction fellowships for more than a quarter of a century, I’ve heard a lot of stories about suffering as well as celebration. Yet, the words sexual health are rarely spoken. Why is this the case? It seems that there is much more focus on overcoming problematic sexual behaviors rather than developing a fun, meaningful, deeply connected sex life. As a result, the sustainability of long-term sexual recovery is not always addressed and sexual health often becomes an afterthought.

The World Health Organization defines sexual health as follows:

“. . . a state of physical, emotional, mental and social well-being in relation to sexuality; it is not merely the absence of disease, dysfunction or infirmity. Sexual health requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence. For sexual health to be attained and maintained, the sexual rights of all persons must be respected, protected and fulfilled.” (WHO, 2006a)

Although I’ve been familiar with this definition for many years, its significance only came to my attention recently as part of a workshop I attended at the national group therapy conference. My talented colleagues, Douglas Braun-Harvey and Michael Vigorito have developed a non-pathologizing, affirming and forward-thinking Sexual Health model. I believe this approach is a missing link toward creating more purposeful sexual expression in recovery.

In their book Treating Out-of-Control Sexual Behaviors: Rethinking Sex Addiction (2016), Braun-Harvey and Vigorito define OCSB as a “sexual problem of consensual urges, thoughts, or behaviors that feel out of control for the individual.” They go on to say that “sexual health conversations matter.” Their open-hearted approach is based on honest conversations that often go underground rather than openly explored.

They have developed a clinically-sound treatment approach allowing individuals to determine if they have a problem and their level of motivation to work on their behavior. Rather than labeling it or using typical “disease model” language with their clients, they look for ways to bring out the integrity of the individual while promoting a shift from secretive behaviors to transparency. This usually takes place within the context of individual sessions as well as a weekly sexual health men’s group.

They believe that ending your existing relationship with out-of-control sexual behaviors is not supposed to be about deprivation; instead, it’s about celebrating one’s birthright as a sexual being. What do you really want your sex life to look like? How do you choose to express yourself as a sexual being? In this article we will follow one young man’s journey with porn and some specific strategies to heal from it.

There is no cookie-cutter approach to healing from sexual compulsivity, but one thing I do know: there is still a lot of anguish both in the twelve step rooms and in my office, and sexual health conversations offer a refreshing, non-judgmental way to look at these problematic behaviors with curiosity. Rather than a one-size fits all method, we will begin to think about sexual health as an essential dimension of your well-being.

Charlie was the oldest of three children raised in a middle-class suburb of Boston by well-meaning, hard-working parents. Because his family lived paycheck to paycheck, Charlie was often left on his own after school before his parents arrived home by 6. He was a well-behaved, conscientious child left responsible to look after his younger siblings.

As a teenager, Charlie became tired of this adult-like responsibility and as puberty arrived, he became more interested in exploring internet porn rather than taking care of his little brother and sister. At first, his curiosity was peaked when a friend showed him the easy availability of porn images. Before long it became his afterschool secret--a daily habit that expanded into compulsive masturbation and eventually unintentional self-harm of his genitals.

His relationship with porn became more and more time-consuming resulting in less contact with friends and family. Charlie became more reclusive, grumpy and disconnected. By the time he left for college, he began to realize that he just didn’t feel like his old self anymore. The engaged, fun-loving Charlie had gotten lost in the seductive world of porn.

Where did you get your sex education? In the pre-HIV world of the 1970s, my public school “health teacher” arrived in my 6th-grade class and showed us colorful slides of body parts that were anatomically-correct but rather one-dimensional and confusing. There was little or no discussion about intercourse, contraception or STDs — and of course nothing related to same-gender sex. As I understand it, things really haven’t changed much in the past forty-five years, and the idea of sexual pleasure is not commonly discussed.

In the Netflix series Sex Education, the protagonist, Otto is a curious teenager whose mother is a sex therapist with a home office where she offers seminars focusing on the wonders of the vulva. Vicariously, Otto picks up on some of her sexual wisdom and expertise, and he is dubbed the “sex kid” at school. He opens an underground business to dispense advice to his naïve but sexually-active cohorts. Although Otto is a virgin himself, he tries to reassure others in the school and does so with moderate success.

If Charlie had spoken with Otto about his compulsive porn habits, maybe his fate would have been different. Yet, the lack of sex education from families and schools often leaves kids with misconceptions and profound isolation. How might this be different?

In Part Two of this article we will take a look at some strategies that most of us were not given as teenagers. As mentioned earlier, sexual health is one missing link of sex addiction recovery, and it’s never too late to begin your sex education.

Reprint June 5, 2020, Westside Post.

Andrew Susskind, is a Licensed Clinical Social Worker, Somatic Experiencing and Brainspotting Practitioner and Certified Group Psychotherapist based in West Los Angeles since 1992, specializing in trauma and addictions, and he has mentored associates in his private practice since 1997. His recent book, It’s Not About the Sex: Moving from Isolation to Intimacy after Sexual Addiction (Central Recovery Press, June 2019) joins his workbook, From Now On: Seven Keys to Purposeful Recovery which was released in 2014.