Sexual compulsion and the internet

As a mental health therapist working in the community mental health system, I'm constantly challenged by a myriad of presenting problems clients would like to work on in therapy. While I've been working in the field of co-occurring disorders (ie, addiction and mental health) since 2005, there are certain disorders I'm very skilled in and others I have very little knowledge or experience to draw from.

I'd venture to guess that an individual presenting to therapy is confident that their therapist can help them tackle any and all presenting clinical problems. Unfortunately, this is not always realistically possible. Sometimes the problem is totally out of the scope of a clinician's educational or professional competence. In these instances, referral to a more appropriate professional specialist is warranted. In a majority of cases, however, it is important for clinicians to take the initiative to seek either (or both) supervision, case consultation with trusted colleagues, and self-motivated professional development via continuing education classes/workshops or reading professional literature on the particular subject.

With that said, I was recently presented with a case involving compulsive masturbation and addictive online sexual behavior. I found myself (internally) floundering within this extremely sexually revelatory session with my client....not out of discomfort of the subject matter being discussed, but out of not knowing how to specifically help someone with this particular issue. Especially given how vulnerable my client felt telling me and wanting the client to continue feeling confident or courageous enough to proceed with treatment.

I found myself both intimidated and intrigued by this newfound clinical challenge, that of sex/cybersex addiction. Immediately and somewhat ironically, I searched various sites online for well-written and highly rated professional books on the topic. Much to my surprise, it was a disappointing and difficult search. While there are a plethora of books promoting "healthy" sexuality and how to explore one's sexuality in healthy/safe ways, books on sexual addiction are few and far between. The book I ended up getting wasn't even one I thought would be very helpful, but it ended up being decent.

"In the Shadows of the Net" by Carnes, Delmonico, and Griffin explores and analyzes the dangerous allure of the Internet on one's sexual proclivities, especially given the technologically dependent society we live in. Although certainly not to be used by any means as an excuse to act out compulsive sexual behaviors, the availability of sexual content and ease of anonymity online makes it that much easier for an individual to get sucked into a downward spiral of unhealthy and unmanageable sexual behavior. Chapters in this book include identifying problematic behavior ("Do I Have a Problem with Cybersex? and "Understanding Problematic Sexual Behavior on the Internet"), analyzing sexual arousal and intimacy ("What Turns You On? The Arousal Template" and "Courtship Gone Awry"), and how to change/recover from sexually addictive behaviors ("Boundaries," "Taking That First Step," "Changing the Way You Live," "Preventing Relapse: Maintaining the Changes You've Made," and "Family Dynamics and Cybersex"). I found "Understanding Problematic Sexual Behaviors on the Internet," "What Turns You On?," "Courtship Gone Awry," and "Boundaries" to be most helpful.

Upon reading the second half of the book, I realized recovery for sex addiction is very similar to alcohol and drug addiction. The author posits that there is a stronger propensity for relapse with sexual addiction than other addictions. Not sure I agree with that, though the relapse prevention model is very much akin to those used in alcohol/drug recovery programs and seeing that made me feel more confident in my professional capabilities to help a client seeking recovery for sexual addiction. I might even take it one step further and pursue a training to become a Certified Sex Addiction Therapist.

Who can say their work is never boring or that they're always learning more about the human condition?

Therapists.

The Standout

Compared to the general population, I've had few lovers throughout my life (though I suppose that depends on how one defines "lover," "sex," etc)...even fewer that were really passionate about me and satisfied me to the core (ie, mentally, emotionally, and physically). In fact, my experience has primarily been the opposite....selfish lovers with whom I went out of my way to satisfy, giving generously until I could give no more and often with little to no reciprocation. They weren't terrible men, just not emotionally intelligent men in the bedroom.

As I entered my 30's, I have yearned for something more....a man who can demonstrate as much sensual passion and generosity with me as I can with him.

It wasn't until I had a kiss with a stranger one spontaneous night out on the town in Chicago about four years ago that something was awakened within me...a spark of what I had been missing out on in my teens and twenties. I felt a strong chemistry and undeniable passion that night; it defied explanation (at least to me). A few months ago I kissed a guy I knew fairly well; I felt the exact same feeling (possibly even stronger than with the stranger). Sadly, both experiences only resulted in kissing (ie, no sex). Sometimes when I'm yearning for a lover in my life I think about those two nights, about the 'what if I could have been with that guy just once?' What if it had not stopped with the passionate kissing? If just kissing was that amazing, how much more could I have felt if sex entered the picture? Would it have felt like the cliches found in romance novels or erotic literature?

Fantasies are usually better than the reality...what it would be like to kiss or have sex with a particular person. I'm not sure what's better or worse though....to have a sexual attraction to someone, only to be disappointed when that sensual chemistry isn't ignited (I've experienced this on more than a few occasions)....or to have an attraction to someone that has built up strongly over time and then only get an amazing kiss that leaves one wanting more, a mere tease.

The loss of a desirable fantasy to a disappointing reality or the loss of real erotic potential that will never come to fruition? Which is harder to accept? What if we only get one or two opportunities for 'standout lovers' in our lifetimes? And what if they got used up only on kisses and not the whole sexual nine yards?

Are standout lovers only meant to be savored in fleeting moments? If and when they are found, can they "stand" the test of time?

What really dictates our attractions?

Not sure why this occurred to me, but while I was out for a run in my neighborhood earlier I realized my friend Scott is currently one of the few close male (heterosexual) friends that I have not had any kind of sexual dynamic with throughout the course of our 4-5 years of friendship (at the same time, I'm also not a promiscuous woman by any means)....which then had me pondering if this is normal for friendships in the 21st century (ie, sex becoming a dynamic at some point in a friendship between two heterosexual or even two gay friends) OR if this is more the exception.

And I'm not talking about friends with benefits where there's a mutual agreement to engage in casual sex just for the aspect of physical pleasure. That's a whole other topic of discussion. What I'm talking about is specifically in regard to the context of the relationship you have with a friend.

What's funny for me is that male friends I have formed a sexual relationship with (and/or that have turned into a romantic relationship if even for a brief time) have more often than not been guys I didn't initially even desire or think about sexually. But the more I got to know these guys, something would shift or spark an attraction for me.

I remember about a month ago my coworker Sarah was telling my colleagues and I something she read or heard about (I can't remember her source, or if she even knew where she heard this)...a psychological/sociological theory or study that shows we have a tendency to become attracted to individuals simply by seeing or being around them all the time.

So how much of our attraction to a person is based on closeness (ie, being in the same physical environment...or "mental" environment like social networking, chat rooms,etc on a regular basis) vs. physical appearance? Or familiarity (ie, how intimately we know facets of their inner self) vs. someone you don't have much overall contact (physically, mentally, or emotionally)?

And if this is the case, perhaps we are less inclined to be superficial than we may believe we are when it comes to connecting with each other on a very human level...

Con-sensual?

When alcohol is involved, sexual activity between two people can become very questionable. Sex WITHOUT alcohol can be complicated enough, but add alcohol and hazy judgment? This does not make for a good scenario, especially if blackouts are a factor. Don't worry, I'm not talking about myself; it's something I heard today that really bothered me.

In any case, hearing about this particular story made me realize how much of a double standard it can be if you think about it and even more confusing to make sense of in a society already full of misogyny. Makes you wonder.

If a man and a woman get totally drunk, and the man blacks out later to find out he doesn't remember having sex with the woman....it's more likely perceived as a poor judgment call, but we don't question whether the man could have been drugged and raped, right? But when it's the other way around, we are alarmed and wonder: was it consensual? And is it really consensual if she can't remember that she consented?! Is it rape if she consented, but may have not been coherent enough to be aware of whether he did or did not wear a condom (because he was probably on the verge of blacking out himself)? Or was it a manipulative, sadistic drug-induced setup the whole time?