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Monday, November 13, 2017

Sexually Compulsive Behavior as a Split Off Part of the Self

Sexually compulsive behavior often involves a split off part of the self that feels like a "not me" part (see my articles:  Overcoming Sexual Addiction in TherapyOvercoming Internet and Porn AddictionSexual Addiction: Is a Compulsion For Viewing Internet Porn Ruining Your Marriage?Infidelity: Married, Bored and Cheating OnlineInfidelity on Social Media SitesThe Counterphobic Defense and Hypersexuality and Rationalization as a Form of Denial and Self Deception).  Often, although not always, that part is the result of an emotionally traumatic history.

Sexually Compulsive Behavior as a Split Off Part of the Self

People, who engage in sexually compulsive behavior, usually seek help in psychotherapy after there have been consequences for their behavior:  a spouse discovers multiple affairs, an employer confronts an employee about viewing online pornography at work, and so on.

Needless to say, there is usually a great deal of shame involved once a spouse or an employer confronts this type of behavior.  Combined with the fact that most people, including spouses and employers, don't understand sexually compulsive behavior and see it as a "moral failing," this just adds to the shame and makes it difficult for people to get help in therapy.

Prior to facing consequences and getting help, people who engage in sexually compulsive behavior often have little awareness of what triggers their behavior or the underlying psychological issues.

In therapy, people with sexual compulsions will often describe their behavior as feeling "split off" or separate from how they see themselves (see my article: Understanding the Different Parts of Yourself That Make You Who You Are and Parts Work in Therapy: Is a Split Off Part of Yourself Running Your Life?).

For the purposes of this article, when I refer to a "split off" part from the self, I'm not referring to multiple personality disorder (now called Dissociative Identity Disorder or DID), although there are people with DID who are sexually compulsive.

To clarify, it's important to understand that dissociation occurs on a wide spectrum with DID occurring at the far end of the spectrum and more common forms of dissociation, like daydreaming, which we all do, as occurring on the other end.  There are some forms of dissociation which are actually helpful (see my article: How Compartmentalization Can Be Used as a Healthy Short Term Coping Strategy).

Between a common form of dissociation, like daydreaming and the other end of the spectrum of DID, there's everything in between.  So, the type of "split off" that I'm referring to is on the spectrum--far less than DID but more than just simple daydreaming.

To varying degrees, everyone has some split off parts that are just outside of their awareness and not considered a major problem. It's a matter of degree.

One of the goals of any psychotherapy is to help clients to become more psychologically integrated in order to bring split off parts into awareness.  The more psychologically integrated a person is, the healthier he or she is.

To simplify matters in the fictionalized vignette below, I discuss a fictionalized male client; however, women also engage in sexually compulsive behavior.

Ken
Ken began therapy after his wife discovered that he was watching pornography compulsively at night and contacting women online for sexually explicit discussions after his wife went to sleep.  Based on the computer browser history, she could see that this was a regular activity for Ken.

Sexually Compulsive Behavior as a Split Off Part of the Self

Prior to this discovery, his wife thought that Ken wasn't interested in sex because they had not had sex in many months.  But after she discovered Ken's online activity, she felt very upset, hurt and betrayed by him.  She gave him an ultimatum:  Get help or she would leave him.

When Ken came for his first therapy session, it was evident that he was very ashamed of his behavior.  He could barely look the therapist in the eye, and he had a lot of difficulty communicating why he was seeking help.  After several false starts, he told the therapist that he was there because his wife gave him the ultimatum and, after 20 years of marriage, he didn't want to lose his wife.

During the early phase of therapy, Ken rationalized his behavior by saying that he didn't see anything wrong with looking at pornography online or contacting women he didn't know for "harmless flirtation."  He said that these women lived in other parts of the country and he had no intention of ever meeting up with them, so he didn't see it as cheating on his wife.

As part of his early history, Ken revealed to his therapist that he began secretly looking at his father's Playboy magazines when he was nine years old and left alone at home while his parents went out.  He remembered the first time that he looked at the pictures of naked women in sexually provocative poses and how thrilling it was for him to secretly masturbate while fantasizing about these women.

As he continued to reveal his early history, he told his therapist that his parents often left him alone and, as an only child, he was lonely.  From other details that he revealed, his therapist realized that Ken wasn't just left alone a lot--he was emotionally neglected by his parents (see my articles:  What is Childhood Emotional Neglect? and What is the Connection Between Childhood Emotional Neglect and Problems Later on in Adult Relationships? and Growing Up Feeling Invisible and Emotionally Invalidated).

Fantasizing about the women in the magazine and imagining that he was with them made Ken feel less alone when his parents were out.  It was soothing to him, and he continued to look at porn from that time on with the same effect of feeling comforted and less alone.

Ken never revealed to his wife that he liked to look at pornography.  For him, it was a secret activity that belonged only to him, and he never discussed it with anyone.  He also assumed that his wife wouldn't understand and, based on her reaction, his fears were confirmed.

He somewhat resented that his wife was giving him this ultimatum to get help and he felt she was being unreasonable, "Why can't she just leave me alone about this?  I'm not hurting anyone."

Due to Ken's level of denial about his problems and the effect it had on his marriage, his therapist knew that he would probably leave therapy if she confronted him directly (see my article: When Clients Leave Therapy Prematurely and Clients Struggling With Shame Can Leave Therapy Abruptly).

Instead, initially, she took a more empathic approach and remained close to Ken's emotional experience and, at times, she made observations that she thought he could tolerate.

Although Ken stopped looking at pornography and contacting women at home, he didn't tell his therapist or wife that he used his computer at work to continue engaging in sexually compulsive behavior (although, at that point, he didn't see it as being sexually compulsive).  Ken rationalized to himself that he worked for a very large company with thousands of employees, so he didn't think he would get caught by the IT department.

But a few months later, Ken was called into his supervisor's office where his supervisor and the Human Resources director were waiting for him.  His supervisor told him that the IT department detected that Ken was looking at pornography online and this is against company policy.

He gave Ken a warning memorandum that this behavior wouldn't be tolerated and any other infractions against the company policy could result in termination.  He also recommended that Ken get psychological help.

Ken felt deeply mortified.  He tried to tell his supervisor that someone else might have gone on his computer while he was away from his office, but neither his supervisor or the HR director believed him.  They told him to take the rest of the day off.

Although he felt humiliated about what happened at work, Ken told his therapist about it.  He acknowledged that he had been keeping this a secret from her because he wanted to continue to look at porn and he really didn't see it as a problem.

But as his therapist reflected back to him the consequences of his behavior, Ken acknowledged that he was placing his marriage and career in jeopardy.  This was the first time that Ken didn't try to hide behind his usual rationalizations.

At that point, instead of feeling like he was being forced to come to therapy to appease his wife, Ken became internally motivated to understand and overcome his behavior.  He also agreed to attend a 12 Step program for sexually compulsive individuals and to get a sponsor in that program.

Once Ken became internally motivated, the work in therapy progressed.  His therapist talked to him about cross addiction so that Ken would understand that it was not unusual for people who were trying to overcome a particular addiction to form another addiction as a way to self soothe.

His therapist helped Ken to understand the various aspects that made him who he is, including the split off parts.  This is called Parts work or Ego States work.

Ken and his therapist worked on the underlying issues that triggered his sexual addiction, including loneliness and boredom (Coping With Addiction: Boredom as a Relapse Trigger).

They also did trauma work on early childhood issues related to emotional neglect.

After Ken began making progress in therapy and he was abstinent for six months, he and his wife were ready to attend couples therapy to repair their marriage.

Conclusion
With the advent of the Internet, compulsive sexual behavior has increased dramatically.

This behavior is usually difficult to overcome on your own.

The underlying roots of the problem are often (although not always) related to early childhood trauma.

Similar to any other form addiction, denial plays a significant role because it's usually too painful to acknowledge the problem.

Shame often keeps people who need help from ever seeking help.  They attempt to resolve the problem on their own but, like other forms of addiction, sexually compulsive behavior is progressive if people don't get professional help.

Although many people start therapy because they've been given an ultimatum by a spouse or an employer, the success of treatment is usually predicated on clients become internally motivated.

The work in therapy includes helping clients to develop the internal resources to remain abstinent and to deal with underlying issues, coping mechanisms to deal with triggers, and trauma work to resolve unresolved emotional trauma.

Clients, who have problems with sexually compulsive behavior, need psychoeducation from their psychotherapists about cross addiction so that they don't stop one addiction and revert to another one (i.e., stop watching pornography compulsively online and start another form of addiction like compulsive gambling, drinking excessively, abusing drugs, etc).

Getting Help in Therapy
Although people who engage in sexually compulsive behavior often feel alone and deeply ashamed of their behavior, the best chance of their overcoming these problems is to get help in therapy with a licensed mental health professional who specializes in this area.

Rather than suffering alone, if you've been unable to overcome your problems on your own, you could benefit from the help of a licensed psychotherapist.

Aside from overcoming your addictive behavior, attending therapy can help you to grow and lead a more fulfilling life.

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist who works with individual adults and couples.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during regular business hours or email me.