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Sex Positive vs. Sex Negative

The debate between sex therapy and sex addiction therapy.

Source: Pixabay

The controversy in sex addiction therapy is most vocal when you come across clinicians who consider themselves sex therapists. Many subscribe to the notion that sex addiction therapy is a manifestation of an overzealous, conservative religious or moralistic community hell-bent on squelching an individual's freedom to express themselves sexually.

"The sex addiction model has become a vehicle for moral and religious forces to mask their moral judgments behind pseudo-scientific and quasi-healthcare-related facades. Religiously motivated groups have adopted the concept of sex addiction as a means to attack homosexuality, alternative sexualities, and pornography," says Dr. David Ley, the author of The Myth of Sex Addiction.

Unfortunately for Dr. Ley and many in the sex therapy community, they are either unaware or unwilling to acknowledge that sex addiction therapists are also "sex positive" but only in ways that don't impact a person's conscience or relational vows.

Sex addiction ironically isn't even about sex per se but the need to have sex as a means to cope, disconnect, or satisfy a relational void that addicts cannot find in their current relationships. In other words, sex addiction treatment is about helping clients develop healthy emotional intimacy with their partners in ways that don't infringe upon their values.

I think this is where sex therapists may get matters confused. Ley contends the sex addiction label is an attempt to keep society sexually repressed: "It is also used just as frequently to shame and suppress the sexual behaviors of others, reflecting moral and religious values towards sex. Ultimately, these dynamics reveal that the concept of sex addiction is based upon the idea that there is a ‘right’ form or amount of sex. This is a moral concept, not one based on scientific or medical research."

The governing body for sex therapists, the American Association of Sexuality Educators Counselors and Therapists (AASECT), mentions its vision of sexual health to be one where "...all individuals are entitled to enjoy:

  • Freedom of their sexual thoughts, feelings, and fantasies.
  • Freedom to engage in healthy modes of sexual activity, including both self-pleasuring and consensually shared-pleasuring.
  • Freedom to exercise behavioral, emotional, economic, and social responsibility for their bodily functioning, their sexual liaisons, and their chosen mode of loving, working, and playing.
  • AASECT believes that these rights pertain to all peoples whatever their age, family structure, backgrounds, beliefs, and circumstances, including those who are disadvantaged, specially challenged, ill or impaired."

Sex therapists in this group believe freedom is compromised by sex addiction therapists when the addiction therapists are helping clients stop their behaviors associated with problems that have developed from one's use of pornography, chat-lines, prostitutes, and the like. Freedom in their eyes may also be compromised when sex addiction therapists do believe pornography, extra-marital affairs, swinging, etc. does negatively impact a person's sexual life and his/her sexual health.

Psychologist Raj Sitharthan in Sydney, Australia condones porn use and deems it “healthy." He states, “If a male client is enjoying a healthy use of soft-core porn…then I’d probably advise him not to tell his girlfriend for fear of hurting her." So his view is one's sexual activities and desire to keep it hidden trumps transparency in a relationship.

In an online interview titled, "Porn is a Creative Marriage Boost," Dr. Aline Zoldbrod, a sex therapist and Diplomat in Sex Therapy with AASECT champions pornography use among couples and individuals: "I think a lot of people, especially men, use pornography as a shortcut to stimulate themselves when they have been in a long term, committed relationship with the same person for a long time. Actually, this is understandable. It’s normal. But lately, with all the talk about sexual addiction, I would hate to see perfectly normal sexual behavior become stigmatized."

Dr. Zoldbrod and others like her view sex addiction therapy as detrimental to couples and individuals when their definition of "normal sexual behavior" is questioned. Unfortunately, if people feel that their conscience (i.e. personal, cultural, moral, or otherwise) directs them not to engage in certain sexual behaviors they find negatively impacting their lives, sex therapists may try to invalidate those feelings as being prudish or extremely moralistic.

Furthermore, Zoldbrod implicitly shares her own views on healthy sexuality by affirming one of her male client's needs for sexual excitement. "One of my patients quipped, 'For guys, having lots of different women is the same as women and their shoes. No matter how neat the shoes you already have are, it’s always exciting to get a new pair.' So, we are looking at a normal developmental process which ups attachment and lessens excitement: not a recipe for easy, exciting sex in a long-term relationship.” But this viewpoint on sex can misguide not only sex addicts but the general population by confusing sexual intensity and arousal with emotional intimacy and/or love.

So if a client comes to therapy wanting to stop a certain sexual behavior, they will invariably get two very different treatment approaches depending on who they saw (i.e. if they saw a traditional sex addiction therapist compared to a sex therapist).

For example, let's say a female client is struggling with pornography and sexually acting out with multiple partners without her husband's consent. In addiction circles, we would help validate the client's feelings that these behaviors (if non-consensual and done in secrecy) are indeed harmful to the relationship and need to be disclosed to the husband as a means towards reconciliation, honesty, and intimacy. If this client saw a sex therapist, the therapist may explore the deeper meaning behind the fantasies while affirming the sexual desires are "normative" based on the sex therapist's own views on sexual health. Disclosing on one's sexual actions may not be encouraged if one was more aligned with the AASECT community.

In short, within sex addiction therapy, the goal is also of sexual health but one where therapists hold the client accountable to the vision he/she professes they want in their relationships instead of trying to change that vision.