Dermod Moore interviews Dominic Davies in Dublin

This is an interview Dominic gave Dermod Moore when in Dublin earlier in the year where they discussed sex, sexuality and psychotherapy in the social context of Ireland. 

Dermod Moore: Thinking back to the time the Pink Therapy books were first published – a lot has changed since then!

Dominic Davies: Yes, Pink Therapy as an organisation has been around 14 years. It feels like it’s gone in the blink of an eye.

DM Do you have a sense that what you are doing is more mainstream, now?

DD I think that’s true. It’s now becoming a legitimate source of study and to work in. It’s being recognized by the professional associations too, which is really good. They’re not doing very public or explicit things regarding GSD issues, but I have a sense now that my voice will be heard, that, for example, my letters tend to be published in full. It’s quite a nice degree of power to have.

For example, the European Association for Psychotherapy has a draft document which is proposing the necessary professional core competencies for psychotherapists – it managed to avoid mentioning awareness of sexuality in its requirements.

I mean, how did you miss that out in the first place, people? What is going on? You list all these other “-isms” but you don’t list sexuality? Is that heteronormativity? Or is that homophobia? Because it should be ingrained in people’s awareness by now. When this was pointed out to me, I sent off a few emails to various people saying how appalling it was, and then someone in UKCP drafted a correction,* which was submitted to the EAP competency committee. It makes me think – it’s not benign for that to be missed out. The situation for European queers is pretty appalling, especially for some Central and Eastern Europeans – and for therapists practicing there, if it’s not enshrined in the competency codes that they need to account for sexuality, they could easily not do so, or pathologise, or institute reparative therapy. Given how Russia is treating gays at the moment, the fact that the EAP is meeting in Moscow is important.

One of the things that was coming out of today’s workshop was a sense that it was the first time that such a workshop was held in Ireland. Why did the professional associations not do this sort of thing?

DM Actually, Stephen Vaughan has presented workshops for IAHIP (Irish Association for Humanistic and Integrative Psychotherapy) and IACP (Irish Association for Counselling and Psychotherapy) over the years, with others doing work for the HSE/GMHP.

I know, Dominic, that you’ve been working recently on emotional and psychological safety for sex workers in London, can you say a bit more about this aspect of your work?

DD Clearly, there are people who are exploited and trafficked, and that needs to be stopped, that goes without saying. For people who want to make a conscious choice to go into it as a profession, or as a part-time occupation, or as a way to pay their way through college, earning good money, and if they’re comfortable doing that, then I don’t think the state should be intervening in that. I think it’s their body and it’s their right to do with it as they want to. I also think there are also issues around access to sex, – for example, people with disabilities who might want to have sex. Sex workers often play a really vital role in the psychological and mental wellbeing of disabled people. Whether that’s just company, or self-esteem, or sexual touch, it seems to me that they are providing a compassionate service – and to criminalise it is appalling. I was lucky enough to meet sex workers in Australia and helped inspire an organisation that is largely staffed by sex workers to work with disabled people; training them how to safely lift people, how to deal with catheters etc; how to work with people with cerebral palsy, or speech impediments, or those who might spasm. How to help them practice their kissing skills, learn to flirt – sex workers are fantastic at flirting! They are very proficient teachers of the art of lovemaking. That was a really exciting project to be involved in.

A lot of the people using sex workers are very big into power play and degrading and using, and they may be nervous, difficult, trying to get it on the cheap, or try to exploit in other ways – and if you’re on the receiving end of that you may end up feeling quite contaminated with all this baggage. I was teaching them – both practicing and aspiring sex workers – Thought Field Therapy, an energy psychology, which is one of the most effective psychological treatments I’ve ever come across.

DM – I can hear, listening to you, how you are always de-problematising sex – always asking, “what’s wrong with sex?” In the Irish context, there’s often a long journey to leave behind a lot of shame about matters sexual, there’s such a strong message of “you’ve got to be careful, protect yourself”.

DD Of course I want people to protect themselves, while they are having incredible sex! I want them to be emotionally healthy! I’d want them to feel that what they are doing is liberating and exciting and a healthy and positive way of expressing themselves. And if they manage to remember the name of the person that they’re having sex with, and leave them both with a smile on their face, that counts as healthy sex!

DM There are regular radio ads in Ireland for a clinic offering treatments for all sorts of addiction, including sex addiction.

DD I don’t buy it, sex addiction. I don’t believe sex, which is a natural biological drive and urge, can be classified as an addiction. I think it’s dangerous and foolish to do so. I think Dr David J. Ley’s new book, The Myth of Sex Addiction spells out the case very eloquently, and if there is anyone who thinks there is such a thing they really ought to read his book. Yes, there are some people who have a problem with sex, who use it in a compulsive way, whose sexual activity masks other, more serious psychopathologies, such as bipolar depression, or borderline personality disorder, or narcissistic personality disorder. But if you are diagnosed as a sex addict, the treatment is perhaps to go on a chastity contract, or work The Steps; it focuses entirely on sex and your sexual history, that fits you in to a paradigm that says you were abused, or traumatised in some way. Who has not had a childhood that could not be seen as traumatic, through a particular lens? The sexual acting out is likely to be a symptom of something else that’s going on. It’s just a symptom, like a tic; and that will go away if you deal with the other stuff. In over 30 years of practice, I’ve never yet met a “sex addict.” I don’t think other people diagnosing you is ethical. The APA, doesn’t accept sex addiction exists; the DSM-V committee refused to include hypersexuality as a disorder. There’s no agreement that the diagnosis exists.

It is, basically, shame. And I have a paper in mind, that I want to write. It’s framed in DSM language: a diagnostic criteria for a new sexual disorder. And it’s called Sexual Shame Disorder. It would mean that these clinics could continue to charge money to treat people for something – but they might have to change the framework they’re using!

People who are presenting with sexual shame need treatment for it. And if they are calling themselves sex addicts, then, as long as we screen out the disorders I’ve mentioned, then what’s left is sexual shame. And that is treatable! I treat that all the time!

DM Someone from that clinic was on the radio recently with a client talking of how he had become addicted to porn, and broke his wife’s heart.

DD I’ve not fully formed my ideas on porn. The impact of porn on young people, particularly on young men, can be quite damaging. Clinically, there are more reports of erectile dysfunction, young men who have been masturbating to porn all the time, and then they find that real sex, when they finally get laid, doesn’t match up. It’s not as fast, it’s not as intense, they can’t find the fast-forward button on their partner to get to the exciting bits! So, their erection diminishes, and they feel shame, and they feel bad. It can all be undone and relearned. But it takes time. The neurochemistry of the brain is that they’re harnessing all the dopamine and the adrenaline, but what they’re not accessing is the oxytocin. And if they withdraw from 2-4 weeks, from all of that intensity, and understand more about the process, psycho-education, and then are given some opportunities to do other horny activities, the body and the brain reprogramme, and you can have a more balanced sex life. But I think porn has its place, it’s a great way for people to get sex education, you can become more creative in your imagination, with things that you find hot.

DM But isn’t (heterosexual) porn all about viewing, from a feminist point of view, women as objects, there for the pleasure of men?

DD There are plenty of women who like porn. Plenty of women who like sex, the carnality of it, who like sex without any connection, or romance, who just want a good hard orgasm and plenty of them. And they want someone with the stamina and the skill to give it to them. And let’s celebrate those women too, and not marginalise them and play into a stereotype that women don’t like sex and it’s men’s sexual desires that give them some sort of exclusive biological privilege that they should do whatever they like. They shouldn’t do what they like! It’s too convenient for a man to say “I couldn’t help myself because I’m a sex addict” – that’s the ultimate cop out. It’s much better to say “I did it because I wanted to.” “I did it because I’m horny.” Or, “I did it because you haven’t wanted to have sex with me for the last three months.” Whatever the reason, men are responsible for their sexuality and women are responsible for their sexuality. We need to take responsibility. Sex itself is not a bad thing. It’s how it’s used, what people do with it. That’s where the conversation needs to begin.

Dermod Moore is a psychotherapist in Dublin and  teaches the ‘Sexuality and Gender’ modules at the Psychosynthesis Education and Trust http://dermod.tel

Dominic Davies, a fellow of the BACP, lecturer, supervisor, psychotherapist, sex therapist, co-editor of the Pink Therapy series of books (with Charles Neal, 1996-2000), writer and activist, spoke to Dermod Moore on his recent visit to Dublin. He was co-training a workshop “Working with Gender and Sexual Diversity” for  Oakleaf Counselling, for 26 counsellors and psychotherapists working with Lesbian, Gay, Bisexual or Transgender clients or anyone who would like to improve their understanding of working with Gender and Sexual Diversity. (GSD).

PS:   Amanda Middleton and Dominic Davies will be off to Dublin in February 2014 with their Introduction to Psychosexual Therapy. Check out the link for the syllabus

Again, Anita Furlong is producing the event and dealing with admin. Places are limited and it’s booking up fast! http://www.oakleafcounselling.com/workshops-and-seminars.html

My curious paradox about sexual addiction

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I’m finding myself in a curious paradox regarding ‘sexual addiction’ and it’s one that I feel the time has come to speak out about.  I’m increasingly frustrated at seeing people claim expertise in something which most mental health professionals dispute exists.

How does one claim to be a sex addiction expert when even the expert psychiatrists of the American Psychiatric Association recently revised DSM V were not persuaded to include Hypersexual Desire Disorder, let alone recognise sexual addiction as a diagnosis eligible for treatment?

I’ve been working as a therapist with gay and bisexual men for over 30 years and I would say I have never met anyone I considered to be a “sex addict.”  I’ve met many men who have found themselves out of control with sex, or who have used sex compulsively, or even recklessly, but I wouldn’t call them “addicted.”  I’m also not happy to collude with their self pathologising and self diagnosing.  It just feels unethical to agree to treat someone for something that I don’t believe exists.  If the client is sure they are addicted, then I tend to refer them to others who are happy to collude with this belief.  I readily acknowledge many people feel their lives have been saved by 12 Step Programmes and Sex Addicts Anonymous and I don’t want to stand in the way of someone seeking that kind of help if they feel it’s going to fit their world view better.  However, I feel I have a different view and wish to reflect on the meaning and circumstances of someone’s behaviour through a less pathologising and more personally responsible lens.

For about a decade, I’ve been co-facilitating a workshop for therapists which reframes ‘sexual addiction’ in a variety of other less shaming and more sex positive ways and offers ways of working with this.  I think sexual shame is often at the heart of presentations from gay and bisexual men who present for help thinking they are sexually addicted.  In fact  shame is often at the heart of many presentations for gay men, and since we’re men who choose to love other men, then often this gets focussed around sexual behaviour.  But it’s not the sexual behaviour that needs treating – this is only symptom of other things.  Sex is NOT an addiction. It is a natural biological drive, which is as natural as breathing or eating.

Many years ago I was heartened to come across Marty Klein’s article and we made this core reading for our workshop.  More recently the excellent The Myth of Sex Addiction by David Ley makes a cogent argument and debunks the hype and faux science and covert religious dogma which has been responsible for compounding the shame and guilt of many gay and bisexual men.

Heterosexual men are of course also affected by the myth of ‘sex addiction’ but I think there are some unique features that mark heterosexual men and men who love other men as different that I am choosing to focus my energy and objections to tarring gay and bisexual men with this spurious diagnostic brush.  Both Klein and Ley dismantle ‘sex addiction’ as a concept for everyone anyway and I think they are extremely persuasive.  I just think at Pink Therapy we have some new paradigms to offer and some interesting ways to understand and work with people who are using sex compulsively and so it’s worth focussing on just that group in our training workshop.

So here I am claiming expertise and experience in working with something which I don’t really believe exists!  I too am a sex addiction expert!

Dominic Davies – Founder – Pink Therapy

Addendum 26 Jan 2016
One of the contributors to the discussion below requested their comments be withdrawn.  I hope this doesn’t detract from your making sense of all the other contributions who respond to her.

Comparing arguments for and against classification of ‘sex addiction’

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The official release of the DSMV has happened and there is more than enough material to begin a discussion upon. For Pink Therapy, the reframing of GID – Gender Identity Disorder  as Gender Dysphoria- seems a good decision, given the DSM needs to have this as a treatable condition for insurance purposes.  We’re hoping the WHO ICD committee will be bolder.

Something that has won our attention has been the debate that has raged over Hypersexual Desire Disorder (aka ‘sexual addiction’), and whether it can be advised to be a disorder.

The APA has, for the moment, left it out of the new DSM. It is worth clarifying Pink Therapy’s position on ‘sexual addiction’, which is that it is a not an appropriate classification for people who experience problems they find relate or stem from their sex lives.

The APA have said there was not enough evidence to suggest that sex, the thought of/act of etc, could be addictive in the way analogous with addictive substances (such as cocaine) or gambling. Therefore, it could not be included.

While sexual addiction (or hypersexual disorder) does struggling toward a definition at the best of times, it often requires that a person wants ‘it’ too much, sexual gratification. And that this wanting can make itself apparent in behaviours directly sexually or indirectly linked to sexuality.

There is a profound abundance of literature exploring these topics. Two of interest, both for the writers and as a means of comparison, are ‘Understanding and Treating Sex Addiction’, by celebrity relationship and sex therapist Paula Hall. The other is ‘The Myth of Sex Addiction’, by David Ley, a clinical psychologist based in New Mexico whose career has often dealt with issues of sexuality.

Hall’s book is, overall, an extremely negative take on sex, and provides case studies driven in trying to reveal the potential for sex to break apart relationships. There is a profligacy of models and labels for the different dangers posed by sex, and the routes to recovery, however the essential point comes across as time and time again as: deny your libido, or be subject to runaway lust.

While Hall herself might deny this claim (“no, that’s not the point, the point is: if your sex is destructive, then deny it”), it seems she offers only the correlative relationship between sex and ‘pathological’ (be always wary of that word) behaviour, and not causative.

Considering some things known of sex – that it releases torrents of happy chemicals into your body, that it establishes emotional intimacy with other people – Hall’s detailing of ‘symptoms’ of sex addiction such as ‘loneliness’ and ‘unhappiness’, seems to argue against more evidence-based understandings of our relationship with sex. She doesn’t once mention that, for many, sex can be a healthy coping mechanism for a stressful job or lifestyle.

Ley’s book offers these arguments, certainly, and more to the sex addiction conversation. However, the two key things this writer took out of the book from first read were: Western society takes a moral perspective on sex, which is often pathological (that is not to say only the West does this, however), and this has meant we find it easier to understand that something so evil as sex could be in fact unhealthy in real, diagnostic terms. The corollary of this is that we shouldn’t be too trigger-happy when labelling a behaviour as ‘bad’, especially when we know the benefits and importance of that behaviour (sex).

One of Ley’s most convincing argument is, of course, the one from evidence. He talks about the ancient civilisations that hosted orgies (mixed sex, same sex, whatever!) these orgies took place across continents, and included the Greeks, who  so often are described as the founders of Western civilisation. And not one account of the Greeks suggests that relatively uninhibited sex had anything to do with anything wrong in those societies.

Jack Flanagan

Reference

‘Understanding and Treating Sex Addiction’, Paula Hall, http://www.amazon.co.uk/dp/0415691915
‘The Myth of Sex Addiction’, David Ley, http://www.amazon.co.uk/Myth-Sex-Addiction-David-Ley/dp/1442213043