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Sexual Self-Empowerment: The Alternative to “Sex Addiction” Treatment for “Out of Control” Sexual Behavior Feelings

kh - pp - sex-addiction myth newsweek coverIf you want help for “sex addiction” – but from a non-judgmental, rational, science-based, helpful and supportive way, from a gay male specialist therapist who understands gay men’s sexuality and challenges, you’ve come to the right place.

Perhaps no other topic in mental health and therapy services in the media is as hot right now as what has been called “sex addiction”.  It’s a hot topic among female therapists who want nothing more than to confront, judge, and punish men who “cheat”, maybe as a result of their own negative experiences.  But therapy shouldn’t be about your therapist acting out her issues; a therapist’s job is to help you, not punish you.  And yet we are seeing too much of that punitive and judgmental approach, which is not helpful and it’s not scientific.  It doesn’t help the men or women who are in relationships to achieve healthy, loving, satisfying, and enduring relationships.  There is a sensationalism mixed in with the real clinical issues that guys need help with.  We’ve seen it on “Oprah”, in the presss, and in TV news.  People have heard about this “diagnosis”, who has it, who’s been affected by it, and who’s in treatment for it.

The problem is, it’s not a diagnosis.  Clinicians of all kinds, such as licensed psychotherapists (from many different graduate programs and many different professional therapist licenses, including marriage and family therapists, licensed clinical social workers, licensed professional clinical counselors, and psychologists), psychiatrists (who are MDs), nurses, researchers, and others use a publication by the American Psychiatric Association, called The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, also known as the DSM-5, to catalogue, categorize, and describe every type of legitimate mental health or psychiatric disorder treated currently in the United States.  And the fact is, “sex addiction” isn’t included in this book.  In fact, it was specifically rejected for inclusion in the Fifth Edition (which came out in May, 2013) by the various research and review committees for the DSM-5, due to “sex addiction” or even “hypersexual disorder” not having any consistent, reliable, provable research data that it even exists.  The science wasn’t there, only the judgment and the opportunism by therapists jumping on a bandwagon fad, supported by the church and lots of angry women upset about being “cheated on”.  But this is an overly-simplistic attitude toward real relationship problems, and almost always ignores the problem from a male point of view, and dismisses the needs of men in relationships.

“Sex Addiction” as a disorder was coined by an ambitious and entrepreneurial clinician, Patrick Carnes, in 1983 — at the very top of AIDS hysteria and sex-negative attitudes in the United States, when Americans were gripped with fear that sex was something to be feared, that could lead to illness and death.  Rather than help educate and clarify the myths around HIV/AIDS and sexual exposure risk, Carnes instead coined his own diagnosis in “sex addiction” with no research other than his own casual observation to back it up.  And it worked — it sold books, speaking seminars, TV appearances — and he even developed his own training methods and “certification” — of , by, and for his unproven “model” of treatment.  Instead of it being based in traditional mental health, it was based in addictionology, piggy-backing on the 12-Step program of Alcoholics Anonymous.  It wasn’t based in science, but it certainly sold — like hotcakes, making Carnes rich and also anyone who touted his particular brand of clinicalized moralism.

Much of the criticism of “sex addiction” as such has been eloquently critiqued in the works of David Ley, Ph.D., author of The Myth of Sex Addiction, and the works of Marty Klein, Ph.D., both noted sexologists.  They do a thorough job of defining and critiquing the many-layered issues that are behind “sex addiction” treatment, including its highly competitive, commercialized, mercenary aspect.  Treatment for this so-called “disorder” is often undertaken by naive individuals and couples who don’t know that such as a disorder doesn’t exist amoung serious mental health professionals or mainstream professional mental health associations, is not covered by insurance in most cases (because of the “disorder” not being in the DSM-5 or verified by empirial research), and is almost always undertaken by White, affluent clients in major urban centers — often at the demand of heterosexual women who ragefully and shrilly demand the “sacrifice” of having their “cheating” husbands undergo expensive and time-consuming “treatment” to validate their anger, perceived “betrayal”, and disempowerment.  Some “sex addiction betrayed partner treatment” tries to equate a woman whose husband has had sex outside their marriage as the equivalent betrayal and trauma of a woman who has been violently raped or repeatedly sexually molested as a child for a prolonged period of time.  While an outrageous claim, “trauma treatment” with this kind “woman good, man bad” rhetoric is not uncommon.  It also doesn’t come cheap.

All of this begs the question, “Is there another way of conceptualizing and approaching this?”  An approach that is appropriate for today, in the 21st Century, that gets away from AIDS hysteria, sex-negative thinking, judgmentalism, “slut-shaming”, and junk science?

At GayTherapyLA, we think there is.  That’s why Ken Howard, LCSW has taken many years to carefully develop a compelling — and effective — alternative approach.  It’s called “Sexual Self-Empowerment”, and it’s a program that helps people, male or female, become more self-aware of their sexuality, more in touch with their desires — what they want to do, and what they do not want to do — and to build more egalitarian, emotionally healthy, and physically satisfying emotional, social, domestic, and sexual relationships.

When there is sex outside the relationship, from either party, we look at the couple as a system.  We examine what happened, or is happening, and why.  We examine what the respective partners feel is important to them.  We discuss the consequences of various behaviors.  What happens when a sexual impulse is indulged (assuming this is with a consenting adult)?  What happens when a sexual impulse is denied, or frustrated?  What happens in a couple, when the actions of one partner somehow hurt the feelings of the other partner?  How does a couple put their beliefs and actions about sex in a cultural context, according to their gender, nationality, family history, and spirituality?  How do partners create — or even re-invent — a sexual relationship scenario that is satisfying to both partners, but preserves a sense of emotional safety, physical safety, and mutual trust and commitment?

All of these issues, and more, are explored and discussed in a safe, honest, mutually-respectful atmosphere.  But what is not discussed, or rather indulged, is pop-culture, junk-science, sanctimonious hype.  Assumptions about homophobia and traditional gender roles/expectations are challenged, and not just automatically capitulated to, as if the sexism against women (and men!) that has always been in this country (among others) must always be.  Long-held myths about history, sociology, and especially religion are challenged, and the partners are encouraged to assess, evaluate, and interpret these forces as they see fit, not as “dictated” to them by their family-of-origin, their church, or their society.  And, to say the least, any hidden “agenda” of the therapist to punish “philandering” men or to judge “salacious” women because of their own personal history being expressed in their clinical work is taken out of the treatment equation — for legal, ethical, practical, and clinical reasons.

At GayTherapyLA, we dare to ask the bold questions.  What if the current, and recent past, interpretations of “sex addict” conceptualizations and behaviors were seen in a whole new light?  What if the moralism and sex-negative attitudes, and the sexism, heterosexism, and conservative religious overtones of “sex addiction treatment” were taken out, and only legitimate, evidence-based, sound, secular, mental health treatment that led to good outcomes were left in its place?

Using some of the concepts of SMART Recovery, which uses concepts of Cognitive-Behavioral Therapy, the Sexual Self-Empowerment Model used by all associate clinical staff of GayTherapyLA asks these tough questions, and puts them into practice: in individual, couple, and group therapy, as well as in occasional Couples Intensive Outpatient Treatment and Couples Workshops for gay male relationships, and even in non-traditional relationships such as triads or polyamory.

You are not alone.  And, you are not stuck with just one outdated “sex addiction” treatment model for affairs, sexual activity that feels “compulsive” (porn, etc.), sex outside the primary relationship, or sexual stalemate.  There is an alternative, and our unique model of Sexual Self-Empowerment, offered in a secular, non-judgmental, multi-theoretical, science-based manner is not offered anywhere else, by any other psychotherapy group practice.

Components to the Alternative, Sexual Self-Empowerment Model:

Sexual Self-Empowerment includes these tenets, points of view, assumptions, and operations:

  1. Mental health based, not addictionology based
  2. Addressed through a thorough biopsychosocial assessment model conducted by the clinician, with multiple possible diagnoses, not just one (non-existent) “Sex Addiction” “diagnosis”, but considering Impulse Control Disorder, Obsessive-Compulsive Disorder, Narcissistic Personality Disorder, Borderline Personality Disorder, Antisocial Personality Disorder, Generalized Anxiety Disorder, Major Depressive Disorder, Dysthymia, PTSD, ADD, or the effects of environmental stressors, substances, medical conditions, or medication side-effects.
  3. Re-defining Sex as normal and pleasurable, not a demonized “illness” (that is socially, religiously based)
  4. DSM-5 based, not “made up” by one entrepreneur and his entrepreneurial followers (i.e., Carnes)
  5. Extrapolatable to other cities, the field of mental health, research, diverse SES (not just Upper-SES, urban, “powerful” population – like the demographics BMW would market to)
  6. Truly Sexually Affirming, not “shaming by any other name”; free of the judgmental view of “healthy sex” as defined by the therapist; awareness of counter-transference by the therapist; therapist as asserting a value system on the client as “absolute” and unchallenged; “healthiness is embedded in social values” (David Ley)
  7. Gay-affirmative – not holding heterosexual, procreative relationships as “superior”
  8. Male-affirmative – acknowledging differences in gender approaches to sexuality; not demonizing men for thinking/feeling/behaving differently from women
  9. Free of conservative religious influence or conservative government/social influence
  10. Universal, not limited to the current time in history and sociological “titillate and condemn” zeitgeist
  11. Based on helping the client, not “up-selling” commercialized, wrap-around services
  12. Feminist-affirmative – Not portraying women as dependent on men’s “fidelity” as key to their economic and social survival, as “weak”, as “helpless” without relying on men’s economic support; not a “virgin value” or “dowry” or “woman as property” or “trade fidelity for subservience”, Capitalistic model and notion of a woman as a man’s “property”, with “responsibility” to “take care” of her, and only her, because of her dependence, which could not be “threatened” by any other woman; avoiding women getting revenge on male dominance by counter-controlling their cock as ransom for their subservience
  13. Applies Cognitive-Behavioral Therapy; addresses cognitions, self-talk, core schemas, behavioral exercises; changes from “weak” or “powerless” to self-empowered, self-directed, voluntary choices and critical/discretionary thinking
  14. Supports a personal, individual self-care plan for mind/heart/body/spirit, getting emotional and sexual needs met between consenting adults, regardless of imposed “outside” moral system that is culturally/society based AND conservative; removing labels of “sick/bad/wrong” in any sexual activity among consenting adults.
  15. Supports a collaborative approach between egalitarian emotional/sexual/domestic/social primary partners (dyads/triads/etc.) where EACH partner’s needs and desires have EQUAL value (not just valuing the partner who has the most conservative POV).
  16. All services pass the muster of EBP, research, being open to study, subject to outcomes studies and the scientific method, as if that were relevant to personal human experience; free of polygraph or “criminal justice”/crime-and-punishment perspective among equal consenting adults.
  17. Utilizes only mainstream, EBP mental health practice interventions that would pass muster in accredited clinical training programs of mainstream mental health practice training programs in major academic institutions, nationwide or globally.
  18. Not making claims that manipulate the public by being factually incorrect.
  19. Focusing on promoting the well-being of the client, not the propagation of a lucrative practice (that’s not even a consistent “model”) among a network of similar-minded peer professionals all selling an insular commercial practice.
  20. Focus on personal liberty versus gender and social “expectations”.
  21. Socially challenging the capitalistic notion of “partner as property”.
  22. Professionalized services in accordance with state mental health practitioner laws, accordance with the mainstream Codes of Ethics, accordance with academic standards
  23. Clinically, we have our clients identify your ideal sex life in terms of how it meets your emotional and physical needs by:
    1. Accepting responsibility and self-empowerment to act in accordance to your needs and desires
    2. Self-empowerment in terms of how to spend resources of Time, Energy, and Money, according to their Values, Priorities, and Goals
    3. Develop communication skills, put words onto feelings, assert needs to partner(s), communicate from a position of self-validation and equal self-advocacy, even for “unpopular” points of view about activity among consenting adults
    4. Have couples’ conversations facilitated by the therapist from a standpoint of egalitarian negotiation, free of aggressive countertransference bias
    5. Actively challenge, via discussion and Critical Thinking, conscious or unconscious “expectations” and “influences” of Society, Church, Culture, Era, Family, Partner, Peers vs. the client’s needs/desires; applying the Person-in-Environment Theory from Social Work
    6. Develop a Support Network (Social Work Social Support System)
    7. Address Personality Disorder issues – Narcissistic, Histrionic, Avoidant, Dependent, Antisocial traits
    8. Challenging the notion of Gender Roles & Expectations with Critical Thinking
    9. Exploring Family History that consciously or unconsciously guides behavior – that either causes Repetition or Avoidance
    10. Exploring ambivalence about being in a Relationship vs. Single
    11. Identifying behavioral options, Evaluating options, Implementing options, Re-evaluating options, Re-Identifying options
    12. Identifying ways to cultivate self-control and Affect Regulation
    13. Incorporate CBT, Developmental, Existential concepts
    14. Incorporate the role of Feminist Theory
    15. Incorporate gay-affirmative therapy and LGBT equality and dignity
    16. Practice fair and sound economic exchange policies among primary clinician, client, and associate clinician staff; avoiding self-interest beyond a fair fee for a competent service
    17. Start where the client is, not where the proscribed “social ideal” is
    18. Practice in good-faith collaboration with other providers; no “poaching” of clients among competitive private practices
    19. Collaborate in good faith with MDs or other professional disciplines
    20. Avoid “debate” that is about competing commercial interests instead of moving the clinical discourse forward
    21. Publish from an academic, client-helpful perspective, not a “sales job” of promoting an entreneurial, transient, commercialized product of a model that supports the therapist regardless of its impact on clients or the field

If you have been affected by sexual issues and behaviors in your relationship, with you or with your spouse/partner, and the situation is causing you emotional distress, you owe it to yourself, your partner, and the health of  your relationship to get help.  For more information on the Sexual Self-Empowerment program of GayTherapyLA, call of text Ken Howard, LCSW, at 310-339-5778, or email  

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