There is a lot of media coverage lately about the concept of “sex addiction,” and with a recent Newsweek cover story and the release of a major independent film “Shame,” that coverage has only intensified. However, there is still a lot of confusion about what sex addiction actually is and even whether it is a real diagnosis. Numerous authors and researchers have thought about this phenomena in a number of ways- ranging from seeing this kind of out of control sexual behavior as an addiction akin to a chemical dependence, to a compulsion, to a form of obsessive disorder akin to OCD. All of these viewpoints have brought with them a heated debate that even has political undertones, as many critics have pointed out that the concept of sex as an “addiction” plays into the hands of a sex-negative perspective that allows itself to be co-opted by various conservative and religious groups, etc. Because of the political and religious implications, this has become quite an intensely debated, “hot topic” issue.
However, focusing too exclusively on any of these specific pet theories has the potential to obfuscate the real life experiences of individuals who really do struggle with their sexual behaviors. It may be very easy to jump to a stark position by advocating either the extreme of abstaining from all sexual activity or the other extreme of denying any negative consequences and encouraging a bold acceptance of the behavior as a means of taking on a sex-positive stance. However, any of these clinical positions may not properly serve the needs of the individual, since they are pre-determined and formulaic in nature, without taking into account the subjectivity of the individual.
In addition, a rigid adherence to any particular position has the added effect of “compartmentalizing” the individual’s struggles, separating them from the totality of that person’s experience. For example, an addiction perspective externalizes the difficulty as an addiction, yet does not adequately address the other areas of the individual’s life that may be affected by or may be affecting his or her sexual experience. Other approaches may also focus too narrowly only on the presenting problem by medicalizing or politicizing it, which again negates the internal experience of the individual, while also foreclosing the opportunity to view this situation in a holistic perspective as it relates to the individual’s thoughts and behaviors in their entirety.
Because of these concerns, the Sexuality, Attachment and Trauma (SAT) Project prefers to view out of control sexual behaviors in their global context, as characterological and systemic components of the entire person’s psychological makeup and behavior. For example, compulsive sexuality may also display itself in such ways as compulsive eating, compulsive caregiving, narcissistic or isolating behaviors, rigidity in thoughts and communication, superficial relationships, and controlling behaviors. In other words, the sexual difficulties cannot be isolated and compartmentalized in such a way that neglects to carefully examine the global nature of that individual’s characterological makeup.
By refusing to adhere to rigid clinical dogmas or formulaic approaches, the clinicians at the SAT Project are able to assess the etiology of the individual’s presenting sexual difficulties on an individualized basis, taking into account the individual’s complete psychological makeup, and viewing the presenting difficulties as just one aspect of an integrated perspective of the global nature of the individual’s difficulties. In this way, the clinicians at the SAT Project are able to bring in diverse clinical and theoretical approaches into their work, incorporating attachment, trauma, and object relations perspectives in informing the clinical work.
This area of treatment is at the heart of the Sexuality, Attachment, and Trauma (SAT) Project’s mission. The SAT Project is an outpatient clinic and research think-tank, based in New York City, that provides therapeutic intervention using effective and evidence-based treatment techniques to help individuals with sexual and relationship difficulties and conducts cutting-edge research on the etiology and treatment of out of control relational and sexual difficulties.