It is a common complaint, and not just in heterosexual couples. I hear one partner complain that he watches porn when the partner wants to have sex. It can be hard to understand, so I decided to write a post to help people make sense of this common behavior.

This is my fifth in my How Sexuality Works series. Prior entries can be found at the links below:

• Sexuality Is a River
• What is Erotic and Why? Part I
• What is Erotic and Why? Part II
• Are We Sexually Compatible

Nature is efficient. Water flows in the direction of least resistance. Organisms of all kinds will adapt to their environment to conserve energy. This shows up in the sex and mating of animal species, like larger testicles and more sperm when there is more sexual competition among a species, but small testicles and less sperm when there is less sexual competition. When we get to humans, these principles apply too. This is one take on human sexual efficiency.

There’s a lot of concern about pornography among my clients. Many come in self-diagnosed or armchair diagnosed by their partners as “sex addicts” because of their masturbation and pornography viewing habits. I’ve written other blog entries (here and here) about the problems with the concept of porn addiction. Several professional organizations have come out formally against “sex addiction treatment,” including this statement from the American Association of Sex Educators, Counselors, and Therapists, of which I am a member. I also want to acknowledge that while I’ve gendered the title of this entry, men aren’t the only ones who watch porn. However, concerns about males viewing porn are orders of magnitude higher in frequency, and so I titled this post to catch that interest.

Why do some people like pornography so much?

There are some simple answers to this question. But I’ve found they don’t calm fears in concerned clients and their partners. Those answers include, “because it is pleasurable” or “because men are more visually focused, they prefer images and videos over written material”. The one answer that does seem to cultivate some compassion through understanding is this: Porn is easy to watch.

Sex, especially with a long-term partner, may include negotiation, interpersonal communication, effort to connect, associated thoughts, conversation, and experiences related to the stressors of running and maintaining a household and/or family, as well as the clean-up, cuddling, and aftercare with that partner. This is all great stuff. It is the raw material of intimacy and long-term connection. It is wonderful that sex can bond us with a partner through all of these aspects in just one encounter. But arousal and orgasm are so amazing that they have many more capacities than only strengthening the relationship.

A partner using porn alone for arousal and masturbation might be seeking a natural stress reliever, a natural sleep aid, a natural pick me up with fewer side effects than coffee, the opportunity to passively appreciate beauty, a fantasy of being desired (or many other kinds of fantasy), an erotic boost to bring into the relationship at another time, or any of the many other positive benefits that masturbation and fantasy might provide. He watched porn because it brings the promise of all of these.

But isn’t porn or masturbation like this a problem?

Like any coping skill, if it is the only one you’ve got, then having a limited set of coping tools might be a problem, but that doesn’t make the one coping skill a problem. The problem is the limited set of coping tools.

If the person lacks the ability to connect to their partner, and that kind of emotional connection is one of the relationship agreements, then yes, that’s a problem. But take note, nothing in that sentence says anything about pornography.

Here’s a tricky objection that I hear fairly often: “If my partner is watching porn and not bringing that erotic energy to me, then I’m not okay with that. If they were watching porn and still interested in me, I’d be okay with it.” In this case, the aggrieved partner sees pornography as taking something away from them that they desire very deeply. They see porn as getting in the way of their relationship needs being met. Almost every time, though, as I dig deeper into the couple’s lives and learn more, there’s a deeper issue at play, but it is hard to see. That is, there’s an imbalance in the ecology of the relationship. He watches porn because it is easier to do than have partnered sex. That requires a little explanation.

Water Seeks the Lowest Point

There is an ecology at play in our sexual lives. The water in a river seeks the lowest point. If we’re talking about the path of sexual interest as a river, then pornography offers a very low path. That is, very little energy is required for a person to find a conduit for sexual arousal through pornography. So if partnered sex is desired instead of pornography, there are three solutions. First, you could lower the energy investment required for partnered sex. You might tell your partner, “I’ll get a towel for the wet spot and take care of it later so you don’t have to” or “Let’s just go have quick hot sex and not worry about anything else going on for us for 10 minutes!” The erotic energy, like water, will flow in the direction of least resistance.

Second, try eliminating drains on energy for the relationship. If you and your partner have a history of criticism, contempt, defensiveness, and stonewalling (Gottman’s Four Horsemen of the Apocalypse), then having sex means getting enough arousal to get past those painful experiences. That requires a lot of erotic energy. Healing those communication patterns and becoming more generally loving and kind with each other will create a more conducive atmosphere for sex between the couple. Even then, individuals need enough water in the river of their arousal to get there.

Third, increase the water level of the river. Though some people experience an increase in sexual desire frequency under pressure, more people experience a decrease in sexual desire in light of stress. Stress diverts some of the energy we have for eroticism away. In the analogy, there is less water in our river. Sometimes, this depletes a person so much that they have nothing left for partnered sex. The little additional trickle of arousal created by a stimulating image or video can help a person access their sexuality enough to get the benefits of stress relief in masturbation but not enough to replenish their energy for partnered sex. Managing energy resources by working less, exercising more, eating right, sleeping more, reducing commitments, and taking care of yourself better can help if you have the capacity to make those changes.

In order for a person to have the water in their river so their eroticism can feed both the pornography watching branch and the partnered sex branch, they need to have enough energy and vitality left over so their energy can flow past the lowest point of porn to reach downriver and spill into the potential for partnered sex.

Practical Application

Does the person who watches porn work more than full-time? Most people have more energy and attention for partnered sex when they work less.

Does the person watching porn take care of household duties for other people often? We are often less ready for partnered sex when we’re overwhelmed with taking care of others.

How much verbal processing, interpersonal processing, negotiation, or planning does the person have to do on a daily basis? Often, people in cognitively or interpersonally demanding jobs feel too exhausted to use those skills at the end of the day. Can you work out simplified or gentle sexual invitation, acceptance, and consent negotiations to ease the process? Can you identify when the times for low demand at work are and coordinate partnered sexual time for those periods?

If These Ideas Don’t Apply to Your Situation

There may be some other situations that cause the barrier to partnered sex, too. First, if there are mental health issues like depression, ADHD, or OCD, these may play a factor in why he watches porn or does not engage with his partner. Treatment for that underlying mental health challenge may change the behavior, and because of that, porn isn’t the problem; the mental health is the problem. Second, sometimes even when there is adequate time and energy for sex, no interpersonal problems, a person might still pursue the easiest course of action. Porn is still easier to look at. In those cases, consider increasing the challenge to view pornography in non-shaming ways. For example, create an impossibly complex password on the internet router and then keep that password inside a difficult-to-access part of the home, like a box high up in a closet. If the person wanting to view pornography has to work to get access to it, they may find that today it would be easier to hit on their partner instead.

Just keep in mind, the problem isn’t pornography. In order for me not to eat a whole bag of chips, I need to do something like this, too. I keep the chips in the cupboard, and if I want some, I have to put a predetermined amount in a bowl, then put the bag back in the cupboard. Chips aren’t the problem. I’m just naturally inclined to eat fats, salts, and sugars as much as I can for evolutionary reasons. Since I have ready access to them, if I want to stay healthy, I need to limit how many I eat. Since we’re also inclined to preserve energy, a little inconvenience can go a long way to discourage unhealthy behaviors.

If this section still doesn’t cover your situation, reach out by writing a comment or sending me an email. I’d be curious to know what I’ve missed.

Conclusion

Rather than looking at pornography as an easy source of shame or blame, notice the ecology of the watershed for your sexual river and try to figure out how to get more water into that river in the first place. The energy we have for eroticism can only be used for eroticism after the other necessary needs are met. Our energy is a limited resource. We need to manage our lives well in order to preserve energy for watering the flowers in the fields downstream.

• Sexuality Is a River
• What is Erotic and Why? Part I
• What is Erotic and Why? Part II

How Can We Talk About Our Desire Differences?

At the beginning of a relationship, the question of sexual compatibility is an exciting one to explore as anticipation mingles with the newness of the relationship. You wonder if this new person could fulfill all of your wildest fantasies. In a long-term relationship, you may approach the question with feelings of dread. What if you aren’t compatible? What do we do then?

I’m going to use the metaphor of a river again to present a tool for opening a conversation about sexual compatibility with nuance that goes beyond a simple “yes” or “no” answer. First, I’m going to invite you to identify the sexual behaviors and interests you do and don’t have. Before you can identify whether you and your partner are compatible, you each need to understand your own sexuality. Second, I’m going to present you with a way to compare your sexual interests with your partner’s. So, print off the Sexual Compatibility Record (.pdf here), give one sheet to your partner and keep one for yourself, and read this entry and fill out the sheet. This is an interactive blog entry.

Your Sexual Compatibility Topography

Essential Sexuality (Dark Blue)

The first task is to identify the essential elements of your sexuality and write those down in the dark blue Essential Sexuality section. Don’t make this just the bare minimum that would prevent you from depression. Do identify what behaviors or partners make you feel like your sexual expression is full and complete.

Some Elements to Consider:

• Sexual Orientation: Most people cannot be healthy and happy if they are not able to find a way to express their sexual orientation. If that fits your experience, write it down in the Essential Sexuality column.
• Love: You may need a loving relationship with your sexual partner, and without that, even if they are doing all the right sexual things, the sex would feel stale. Write that down.
• Sexual Frequency: Maybe if you have sex less than once a month, you feel like something is dying inside of you. Write that down.
• Kinks: For many people, there are certain kink dynamics, roles, or practices that feel as essential to them as a sexual orientation.
• Relationship Styles: For some people, monogamy is essential. For others, there are non-monogamous relationship forms that are important.

The only caution I have is that if you are considering putting something here that you are also ashamed of, you may have a different experience of the central nature of that desire if you ever remove that shame. It may feel less essential without shame supercharging the eroticism.

Good for Vibrancy (Light Blue)

Many people have sexual fantasies, desires, positions, roles, or partners that they enjoy but which they don’t feel are essential. Maybe a dominant partner feels essential, but spankings are a bonus. Maybe a loving relationship is essential, and romantic words would be gravy, but not necessary. Write down anything that feels like a joyful abundance on top of an already full and vibrant sexual life.

Interested but Unnecessary (Dark Green)

Beyond the joyful abundance of the prior category, there may be a group of sexual behaviors that you aren’t quite sure what to think about, but you’d like to try. Whether this is a sexual position that looks compelling if you could just get your ankle to the right place, or that toy at the adult store that you keep thinking about with curiosity, “What does that feel like?” This category is probably the one that is the easiest to change. When you try something, and you like that experience, the sexual behavior will probably go into one of the earlier categories; if you don’t like it, the behavior may land in a category below.

Uninterested but Willing (Light Green)

There’s a great set of scenes in the movie “Analyze That” where Billy Crystal’s character, a therapist, is working with a couple. The man wants the woman to do some sexual-cowboy roleplaying because it turns him on. At the end of the movie, Billy Crystal says something like, “What’s the big deal? You put on the hat and the chaps and give it a try. It isn’t going to kill you.” This is the category of things that just don’t do much for you sexually. Though they aren’t a turn-on, if a partner was really into it, you could be a good sport, be generous, and do that for them.

Unwilling (Brown)

This is the category for sexual behaviors that you do not want to do. It might include words you don’t want to use or to be used for you, as well as positions that would hurt, things an old lover did that you now have bad associations with, or things that are just on your “no” list because that’s how you work.

Squick (Black)

The term “squick” comes from the BDSM community and refers to sexual interests or behaviors that gross you out or give you the creeps. This category is for behaviors that generate that feeling in you. This category is not a way for you to shame your partner for their interests. It is a subjective experience. When someone has a squicked-out reaction, it is probably hard to even have a discussion about the possibility of bringing it into your sex life together. If one partner squicks to another’s essential sexuality, the squicked partner probably doesn’t want to hear about that interest.

Compare For Sexual Compatibility

Now that both partners have filled out their own sheets, sit together and put Partner 1’s sheet on the left and Partner 2’s sheet on the right so the two dark blue “Essential Sexuality” columns are next to each other. You might want to note which sexual interests are on your partner’s sheet but not on yours, and then add that interest to your sheet in whichever column it fits for your interests. What I want you to do now is to imagine that you are looking at a topographical map of a river valley from the air. The two dark blue columns are the river’s baseline level. If the river doesn’t fill this river bed, there’s a bit of a drought in the sexual relationship. If the river is full, like the spring flow of a river, it will reach the light blue areas. In that case, there is a lot of erotic water in the river for nourishing the members of the couple in this case, and gratitude and abundance result. Sometimes, a couple might be able to foray into the “interested but unnecessary” dark green territory, like a river that branches out and supports copses of trees and forests. Maybe in very good times, a couple is even able to explore areas of “uninterested but willing” like branches of a river that reach all the way to plains and fields. But if the river is flooding the “unwilling” or “squick” areas of the map, there will be difficulty living in harmony with the river. Many times, sexual conflicts between couples come when one member is trying to push their partner into that brown or black territory, and they haven’t understood that their partner is different from them sexually. Your partner is always very different from you sexually because our sexuality is so unique.

Difference, Sexual Compatibility, and Incompatibility

Keep in mind that the two sides of the river valley for any couple almost certainly aren’t the same. One person’s side might get more easily flooded, the other person’s is harder to fill up. One person’s dark blue “essential sexuality” could be enough to flood the green areas of the other partner. Conversely, one person’s “good for vibrancy” might not be enough to fill the other partner’s “essential sexuality” river basin. But an apparent difference does not equal incompatibility. In fact, I can’t imagine any two people having the same map.

There’s good news if you are seeing differences when looking at these two maps. The first is that you have been honest enough to share the truth of the differences. The second is that you may begin seeing the adaptability of sexuality as you talk. One person might say, “Well, I did list that as essential, but actually, I’ve done fine without it for years. I guess it really is just ‘good for vibrancy’”. The other partner might say, “Oh, wow, I didn’t know that sexual behavior was so important to you. I’d like to talk about it more. I know that I put it under ‘unwilling,’ but now that I know how important it is to you, I guess I can at least learn more about it. Maybe in time I can shift it to ‘willing but uninterested’ or even more.” Maybe you work out a kind of seasonal flooding agreement where something special to one partner in the essential sexuality column gets filled on a birthday as the other partner allows the erotic waters of the couple to reach their “uninterested but willing” plains.

There’s even more good news: these sexual topographies can and often do change across the lifespan. Whether we’re talking about sexual orientation fluidity as identified by Lisa Diamond (link to her book) and others, or the way that experience and aging change our interests, you need not view either your own or your partner’s map as a fixed given. If you want to have a conversation about it, especially if you are interested in finding out whether it might be possible to shift something for your partner from a brown or black column to another, I recommend a simple process. Start by separating any actual or potential sexual activity from the discussion. So, maybe at a coffee shop or in the dining room alone, you ask, “Hey, I was wondering if I could ask you some questions about your ‘unwilling’ category from the sexual compatibility exercise we did. Would that be alright?” Then you try to do some active listening to understand more about the reason the behavior is there. Was there a bad experience with it in the past? Does your partner not understand something about it? Then, rather than shifting from listening to becoming a sudden apologist and advocate for the behavior(s) in question, ask if they have any willingness to change the category of that behavior. If yes, then ask how they would like to go about the process and if you could help or participate. Maybe somewhere in the conversation, you find a place to identify why you are asking by pointing out that it would mean a lot to you because that behavior is “good for vibrancy” for you, and then restate your desire to respect their boundaries and needs about it. Remember, it is a conversation. A dialogue. Not an opportunity to harangue your partner into giving up their sexual boundaries.

In the end, maybe the title of this post is a little deceptive. This tool doesn’t tell you whether you and a partner are sexually compatible or not. It is really a conversation starter. With this tool, you can find the inevitable differences between your sexual topographies and begin to figure out how to consciously direct and navigate the sexual energy in your relationship, the flow of the water in your collective river, to create compatibility.

Now that you have your maps, do you feel like you could use some help bridging the differences in your erotic maps? If you live in California, contact me. Otherwise, you can find referrals in your state here.

This is the third post of my Sexuality is a River series and my second post applying the analogy of a river to Morin’s theories of eroticism. You can find the first post in the series here: Sexuality Is a River. That post describes the perspective I write from and some caveats about what this analogy does and does not apply to.

What is Erotic and Why Section II

What is Erotic and Why? Part I sets up Morin’s theory of eroticism which provides context for the final three Cornerstones of Eroticism which you will find below. If you want to just keep reading, the important thing to know about the theory so far is that there are some characteristic patterns that describe why we find things erotic. Recognizing those patterns, can help us remove shame about our turn-ons. Below you will find three more of those patterns. I highly recommend Morin’s book which you can find here.

Violating Prohibitions: Breaking the Dam

When there is no place for a person’s sexuality to flow (or when the allowed expressions aren’t the ones desired) because of restrictive sexual mores of the community or religion people often find that breaking those taboos is itself a source of erotic energy. For people who support or even reinforce the sexual mores in other roles in their lives, the obstacle and therefore the erotic payoff can be even higher. It is in this cornerstone, that the power of the metaphor really lives for me. What happens if there is nowhere for a river to flow? It doesn’t just stop. It builds pressure. The reservoir behind the dam gains volume. Though downstream it may appear that there is a desert and the sexuality has stopped flowing, the river is waiting to express itself again. Then, whether there is a tempting stimulus (a downpour) or an expression opportunity that just catches the person off guard (an earthquake that cracks the dam) suddenly all of the force of the river previously held in abeyance by the dam, rushes forward flooding the river valley.

When breaking taboos is expressed in ways consistent with the sexual health principles, it can feel like a liberation. For example, a person from a previously restrictive background might feel empowered to engage in sexual behavior, they might become proud of their sexual expression, or they might feel an increased sense of self-esteem as they shed restrictive limitations on who they are or who they can love.

Sometimes, like all of the other cornerstones, breaking taboos can show up in some ways that don’t align with the sexual health principles. Sometimes for example, having broken a taboo the person feels shame and the fear of losing community connections. This shame and fear leads to commitments to not engage in the behavior again. The paradox of this of course is that it rebuilds the dam and the river begins building up force again. The shame which rebuilds the dam can fuel a compulsive and potentially destructive cycle. Please note how I phrased this last sentence. It is the shame, not the breaking of taboo itself that fuels the compulsive behavior. When clients come to me with this challenge, normalizing their desire for sexual expression and pointing out the nature of the expression-shame-avoidance-arousal cycle often helps them decrease the compulsive nature of their behavior in just a session or two. While there may be more work to do, the core treatment element was removing the idea that the river shouldn’t flow. It will flow somewhere and in treatment I help clients develop their plans for where they do and don’t want it to flow.

Searching for Power: The Whirlpool

A third cornerstone of eroticism that Morin’s research identified is Searching for Power. That is, in fantasy or behavior, the person eroticizes a power differential between them and their sexual partner(s). For some people, they desire a feeling of power and control relative to their sexual partners. They are freed to be more erotic when their partner is submissive, inexperienced, or worshipful for example. Other people have erotic rivers that flow in the opposite direction. They more easily access their eroticism through having a powerful, sexy, experienced, or dominant partner. In one case the freedom to sexual expression is found through the force of your eroticism, in the other the eroticism of the other sweeps you into it. Using the concept of the river, these powerful currents can sweep the participants past any self-consciousness or fears. Flowing in opposite directions but always towards each other, these erotic currents create a whirlpool. The opposing currents bring the people rushing towards each other for an erotic consummation that leaves everyone feeling a little dizzy.

In alignment with the sexual health principles, this whirlpool could look like a protective and a nurturing partner, a consensually kinky dominant-submissive couple, or a high-powered roleplay between a “nurse” and “patient”. There are many other possible expressions and honestly, the details don’t matter that much. The thing to remember about that the erotic charge is intensified through partners occupying polarities.

When searching for power takes place out of alignment with the sexual health principles several complications can arise. I’ll offer one example, but keep in mind that the content of the example is less important that maintaining sexual health can allow this cornerstone to flow abundantly and happily. One challenging expression of the searching for power cornerstone takes place when one or the other person engages in taking the stance of the polarity without the engagement or participation of the other partner. When one person sets their current in the direction of another person, for example trying to be dominant when the partner hasn’t agreed to it explicitly, the person receiving the energy might feel violated and the one sending the energy might feel shocked, guilty, or ashamed when their energy is rebuffed. Therapy can help in this case too. I help clients navigate sexual negotiations, clear invitations, and finding and choosing partners who have matching erotic styles. Therapy can help clients who eroticize power dynamics without judgment.

Overcoming Ambivalence: Rapids

Sometimes a person doesn’t quite know where they want their erotic energy to flow. My favorite example of this is that person that you find attractive despite yourself. One part of you wants them, another part of you abhors the idea of being with them. The erotic river flows towards them and the next thought redirects the energy elsewhere. In my analogy, this is the erotic rapids. Coursing through narrow canyon passages, directed and redirected around boulders and obstacles, the river churns up a froth and noise that can become a massive feature of the erotic landscape. There are more everyday examples of the eroticization of ambivalence too. For example, there are times when I recommend that a client try a new sexual behavior to aid them with their therapeutic goals. In the process of trying something new sexually many people feel some reservation. They might think, “If I do this does it make me a slut?” or “If I try this will I be able to stop?” physiologically the anxiety and the excitement mingle together to create a potent form of sexual energy. When the person then finally dives in and tries the form of expression they were ambivalent about, the newness, the emotional release of the unknown, can leave them feeling like they just shot the rapids of a river and emerged charged with adrenaline and a little more alive for the experience.

In alignment with the sexual health principles, overcoming ambivalence could lead a client to have an expansive and varied sexual repertoire as they tackle one ambivalent behavior after another. For other clients, there’s a particular behavior they do rarely and about which they are always ambivalent but it remains a treasured feature of their erotic life which adds excitement and charge no matter how many times they try it. We certainly wouldn’t be surprised if someone wanted to go river rafting frequently and found a favorite river on which to do so.

When out of alignment with the sexual health principles, overcoming ambivalence could lead a person to feeling erotically charged with a pathway they don’t actually want to follow but uncertain about how to resolve the erotic tension. If they try to stop, they increase one side of the ambivalence dynamic and actually increase the temptation of the undesired expression. Therapy can help in those cases by helping the client notice and become more clear about what is desired within the ambivalence. What is it about that person at work that you want? Are they expressing your feelings about the company? Are they vocal about their needs in a way you aren’t? Does disrespecting them make it easier for you to think about sharing your more wild and uninhibited fantasies because you won’t value their opinion if they are turned off anyway? We can also look for the ways that because of the associated erotic charge, maybe the client is avoiding looking at important aspects of the erotic focus. For example, maybe once you examine the reasons for hesitating, there really isn’t a reason to not indulge this desire. Or maybe when you really examine the partner that you are feeling erotic ambivalence about, you will see that aside from one erotic characteristic, you don’t actually have any interest in them. You mentally thank them for showing that characteristic to you and then go looking for a more suitable partner who has that characteristic along with others that are important to you. But again, we focus on understanding and acceptance above all. The fact of the ambivalence, the fact of the desire itself is not a reason for shame and it is not pathological in itself.

Conclusion

Introducing the Cornerstone of Eroticism from Morin’s “The Erotic Mind” has taken two entries but I hope that it has done for you a little bit of what I have found useful for my clients in therapy. That is, I hope it has given you a lens for understanding that the way that your sexual river flows probably isn’t that unique. The core nature of your eroticism is not pathological in itself. I have hope that if you are finding the expressions of those energies problematic in your life, that therapy with a sex-positive therapist skilled in working with sexual issues (like me) can help you navigate the waters of your sexuality more skillfully while continuing to allow it freedom to seek expression.

Blog Posts in this Series:

Sexuality is a River

What is Erotic and Why? Part I

Once I’ve taught clients about their sexuality, they often say, “They should teach this in schools.”

This is a phrase that I hear repeatedly as a therapist. Most often this phrase comes after I have explained a principle of relationships or sexuality. It is one of the reasons that sex therapists use the PLISSIT model for therapy (which stands for Permission giving, Limited Information, Specific Suggestions, and Intensive Therapy). The PLISSIT model includes giving people information about their sexuality because that alone may be enough to resolve the problems. Even when people get accurate, value neutral information about sexuality in school, the information that we get is usually medical information but not about the subjective experiences of sexual desire, arousal, and attraction.

I’ve decided to try to write out the core principles that I have learned about sexuality. I’m going to be frank about the source and nature of these principles. Some of these principles have science behind them and where I am aware of that, I will provide citations. However, other principles here have come more through my repeated experience of providing therapy to individuals and couples about a wide range of sexual issues as well as my experience navigating and learning from the nature of my sexuality. In that sense, I have a skewed sample of people who have problems with their sexuality (people without problems with their sexuality don’t come in for sex therapy). My personal experience is also biased. As a bisexual, polyamorous, cis-presenting, white, Midwestern, male-bodied person I have an experience of my sexuality that may inform these principles in ways that won’t generalize to people with gender identities and biological sexes different from my own. Not to mention the many other biographical details that have informed my personal sexual journey. Please take these principles for what they are worth to you and discard anything that is not of service to you. They are not necessarily truths, but my truth for now. I’m going to begin with a broad metaphor for sexuality that I will use throughout this series.

I want to add a final caveat about the limits of this analogy. This analogy is not intended to help people understand sexual predation. People who engage in those behaviors work with different kinds of therapists than me. I do not know enough about those behaviors to use analogies to explain them. Moreover, what I do know about nonconsensual sexual behavior it is that the causes are less about sex than about power and violence so this analogy wouldn’t explain them. So, when I’m talking about sexuality finding expression past obstacles in this series keep in mind that I’m not talking about rape, sexual assault, or other forms of nonconsensual behavior. When a person does that it isn’t about sexual expression anymore, that is violence.

Sexuality is a River

This metaphor seems to work well for helping people understand some important elements of the nature of sexuality. Like most rivers, sexuality flows more vigorously during some seasons of life and at others, the force of the river decreases. For people who identify as sexual, the river or the potential for that river is always present. It is a constant potential energy that is a part of our experience. We identify things that are sexually relevant in the environment, we have a sense of our own sexual nature, we notice the sexual nature of others, and at least sometimes, our sexuality seeks expression. In the language of the metaphor I’m using, sexual expression is the process of the water flowing downhill. Just as rivers flow, sexuality seeks expression.

This metaphor gives us a lot of analogies for playing with how sexuality behaves. For people with out-of-control sexual behavior (see another post about treating out-of-control sexual behavior here) the river floods parts of their lives in undesirable ways. For others, the river creates fertile ground for cultivating nourishing of crops like connection, pleasure, and stress relief (see a post about sexual generativity here). Some people try to dam their rivers by limiting certain sexual behaviors. For some who do this, they are able to sublimate their sexual energy and use it for other purposes. In the language of the metaphor, they create hydroelectric power with their dam. Others find that the flow of the river is greater than their dam can sustain and the river threatens to spill over in uncontrolled ways. By comparing the flow of sexuality to the river, we can remove shame. A river is a force of nature. We can manage it with dams, dikes, locks, and spillways, we can utilize it for industrial purposes, entertainment, crops, and transportation but we are not in any of these uses ever really in control of the river; we are in relationship with the river. We cannot simply will the river to behave a different way. We must attend to understand and accept how it actually behaves in order to have a hope of living with it harmoniously and safely.

We do not shame nature when it behaves in ways that were unexpected or unusual. We notice that this has happened and then we make adjustments to how we relate to the river knowing what we have learned about its capacities. Similarly, when sexuality comes with an interest in something that is unexpected or expresses itself somewhere not desired by self or others, shame does nothing to resolve the challenging expression. The nature and capacities of the river do not change with shame. That your sexuality has the capacity to find that thing attractive is now know. That it might express itself in that way in this person, is now understood. This is the nature of your sexual river. We can ask, why it flooded. We can inquire about whether it is possible for this river to flow other ways. We can even identify that we don’t want the river to flow that way (in a future post I will discuss erotic conflicts). But neither these questions nor their answers will change the nature of the river. To say that it shouldn’t flow that way will not stop it from flowing that way anymore with a sexual river than an actual one.

This is not to say that we do not have choices about the flow of our sexual river. In my experience as a person and as a clinician, we can in fact divert and direct our rivers to some degree but we must do so respectful of the nature of the river or our efforts will fail. This capacity to direct our sexuality is limited though. We cannot change our sexual orientations and a future post will describe why not using the same analogy. We also cannot will our sexuality to not exist. However, if a person has not satisfied their sexual desires for a long time, they might seek sexual expression through an avenue they wouldn’t normally choose and might later regret like an affair. To prevent them from making that choice of expression in the future (i.e., have an affair), we might suggest that they not create the conditions led to that expression (i.e., maintain regular pleasurable sexual expression through desirable outlets). Using the river analogy, if the river overflowed in way that was not desirable, try to find ways of allowing the flow of the river to continue so that the force does not build, waiting for an opportunity for expression.

Over several subsequent posts, I will continue to identify new principles and to use the analogy of the river to articulate what I hope are some valuable principles about sexuality.

My first posts for this blog were a series of articles about sexual values and how they might operate in therapy for sexual issues (see the first in the series here). At that time, I was early in the development of steering my practice toward a focus on sexual issues. I knew that I needed to understand my personal sexual values, or they could interfere with treatment for clients. I decided that when personal values are difficult to avoid in therapy, it is best to acknowledge the values that you are operating under. To that end, I identified how consent, sustainability, generativity, and adaptability are values that I bring as the therapist. I wrote those posts with the intent that the transparency could allow clients to better choose whether my care would be a good fit, and as a check for me. If I can identify where my values are, I hope I can better identify when my values conflict with those of the client and therefore can be more cautious about imposing my values on my clients. I don’t know that there’s anything wrong with this approach, but I believe that I have since then learned that sexual health is a better way to guide clients who want to evaluate or change their sexual behaviors.

Treating Out-of-Control Sexual Behavior

Two colleagues of mine in the American Association of Sex Educators, Counselors, and Therapists, Douglas Braun-Harvey and Michael Vigorito, describe a treatment model for out-of-control sexual behavior (OCSB) in their book on the topic. The types of presenting issues they are treating are the same as those that may be referred to in the popular culture as sexual addictions (a term I have written about here). However, the term “sex addiction” has no diagnostic validity. Another colleague, David Ley, in AASECT has written about the problems with “sex addiction” in his book, The Myth of Sex Addiction.

One core aspect of the OCSB treatment model resolves the challenge that psychologists have in determining what defines unhealthy sexuality without imposing personal values on the client. This is a challenge in the profession because there are limited and problematic actual diagnoses for sexual behavior problems. Braun-Harvey and Vigorito resolve this dilemma by defining healthy sexuality instead of trying to define unhealthy sexuality. To do this, they utilize the World Health Organization’s definition of healthy sexuality and glean from it six Sexual Health Principles. I now use those principles extensively in my practice and will share them here with brief descriptions.

Consent

Consent refers to the willingness of all participants to engage in the sexual behavior and/or to bear witness to the sexual behavior they are engaging in. When people are engaging in nonconsensual sexual behaviors, another type of treatment (typically from a forensic psychologist).

Non-exploitation

This refers to the absence of power used to coerce consent. Some methods of exploitation include using power over (like when a boss coerces a subordinate at work into sexual favors), money (for example when someone needs money for survival so they agree to sexual behaviors to get the money), or withholding knowledge (for example, in an affair if the partner knew about the affair, they would no longer consent to the relationship with the cheating partner).

Protection from HIV, STIs, and unplanned/unwanted pregnancy

This includes allowing people to make informed decisions about the risks they take when engaging in sexual behavior with you and protecting yourself from risks to your health.

Honesty

Not everyone wants to know everything, but honesty means that everyone is informed about what is important to them. One way that I’ve learned to talk about this principle with my clients is to ask about what the explicit and implicit commitments of the relationship in question are and whether they include informing the person about the behavior in question. Most of the time, my client has a fairly clear response that helps them understand whether withheld information is more about privacy or more about secrecy.

Shared Values

This includes shared values from the community level to the interpersonal level. So, behavior abiding by shared values is legal and abides by the relationship agreements that have been made between partners. I still have some challenges with the legal aspects of the “shared values” principle, as I have described more completely in my entry on (Sexual Values That Didn’t Make The Cut). However, looking at shared values as a lens on whether the client will experience shame or other mental health consequences of their behavior, and therefore whether it will be healthful, this principle is spot on.

Mutual Pleasure

This doesn’t always include orgasm, but it may. This doesn’t always include simultaneous pleasure, but it may. When I’m working with individuals, this principle is still relevant because sometimes, challenges arise in a person’s sexuality because they don’t allow themselves pleasure, and they don’t acknowledge and accept what does bring them pleasure. When doing relationship therapy, I make sure that each person is allowed the freedom to have an individual erotic landscape and to find pleasure in their shared activities.

Conclusion: Sexual Health Guides Treatment

After several years in practice, my personal sexual values haven’t changed, and if you are interested, you can read about them starting with this article, Sexual Values: One Therapist’s Provisional Set. I examined those values and wrote about them originally because I thought that being aware of them would help me insulate my clients from my biases. I also thought that broadcasting them would help potential clients determine whether I’d be a good fit for them. However, now that I have been exposed to Braun-Harvey and Vigorito’s excellent exposition on treating Out-of-Control Sexual Behavior, I can use a more empirically validated set of therapeutic principles for the care of my clients and their sexual health.

Sex Addiction V. High Sex Drive

One challenge with the term sex addiction is that it is very hard to objectively differentiate sex addiction from a high sex drive. Most human behaviors and characteristics, from IQ to physical skill, are distributed in normal populations along a bell curve. So when a characteristic is distributed along a bell-curve in a population, who gets to decide where the cut of line is between “normal” and “abnormal”. Clinically, the distinction between “functional” and “impairing function” is a little more useful, but in the area of sexuality, the features that define whether a behavior is functional are a complex mix of the individual’s behavior, the social-relational response from others, and the emotional response from the individual. I will use the example of two vignettes to illustrate the impact of these factors.

Imagine Farrukh and Cheng, both 32-year-old males. Barring partnered sexual activity, both men report masturbating twice a day. Both present for therapy, saying that their partner has asked them to come to therapy for sex addiction. Both report significant shame at their behavior.

Farrukh

Farrukh masturbates once in the morning. Sometimes this is after his alarm goes off, at other times, he might masturbate in the shower. Farrukh is never late to work and has enough time in his morning routine for this masturbation habit. Farrukh uses a lubricant at times and reports that he hasn’t hurt his penis with his masturbation since he was a teenager, and is still figuring out how to do it without hurting the skin. In the evening, he masturbates again. Sometimes, this is right after work, and sometimes before falling asleep in bed. He sometimes watches pornography while he masturbates in the evening. He has no trouble with foregoing masturbation in lieu of partnered sexual activity, though he says that sometimes he prefers to orgasm by masturbation because his orgasms are stronger that way. His partner is disgusted by Farrukh’s “compulsive” masturbation and feels that he is out of control. She caught him in a lie recently when he told her that he wasn’t masturbating as much, but she found evidence that he had been. Questions in the intake interview reveal that Farrukh does not masturbate at work or other compromising settings, does not view pornography that is outside his values, he goes to the same site every day, and has so far not found that he is searching for more intense pornography. Farrukh is also able to identify the differences between porn and real sex. Yet, Farrukh feels ashamed of his behavior, as it is hurting his partner, and that he is bad for masturbating. Consequently, he tries to hide his masturbation from his partner and feels even worse when he is caught.

Cheng

Cheng experiences a very different pattern for his masturbation. He masturbates whenever he can during the day, sometimes to orgasm and sometimes not. In addition to masturbating in his home in many different locations, he also reports masturbating in his car, in bathrooms at work, sometimes in secluded public spaces if he thinks he can get away with it. He reports that he has had some close calls and nearly been caught masturbating in public before. In addition, he reports watching pornography that he says is sometimes shocking to him. He says he gets bored with seeing the same old stuff. Cheng is willing to have partnered sex but says his partner is boring and not adventurous enough for him. Cheng’s descriptions show that he is clearly comparing real sex to pornography. Cheng also reports that he injured his penis a couple of years ago by masturbating in such a way that he tore his frenulum. Cheng’s partner is scared that he will get caught, but also reports being humiliated by the fact that Cheng prefers porn to partnered sex. Cheng feels very ashamed of his behavior, says that he can stop masturbating for periods of time but always seems to return to it, and that, because he fears the reactions from others, he continues to try to hide his behavior at home and at work.

Check your own assumptions at this point. Which of these men is a sex addict? Neither? Only one? Both? Both men have several signs that are supposed to indicate sex addiction, including frequently seeking sexual activity, negative impacts on the relationship, secretive sexual behavior, lying, and shame.  Yet for each person, I can identify several possible explanations for the behavior that might mitigate the impulse to call the behavior addiction.

Why Farrukh Might not Have Sex Addiction

Farrukh has had enough education and self-awareness to make sure that his masturbation doesn’t hurt his body. Second, though Farrukh hides and lies about his behavior, this is in response to a critical partner. If his partner wasn’t critical, he might continue to masturbate as a matter of daily life without hiding it. Farrukh’s shame seems to come more from believing that he shouldn’t do what he is doing than from any ability on his part to identify what the negative impact of his masturbation might be. Finally, though Farrukh masturbates more frequently than many men, I see no reason to believe that I have a right to label him an “addict” just because he occupies a certain location on the bell-curve distribution of sexual desire frequency.

Are you expecting that I will now identify all the reasons that I think Cheng is a sex addict in contrast to Farrukh?

Why Cheng Might Not Have Sex Addiction

Cheng has also learned that he needs to hide his masturbation. Given that he is masturbating in public, in his car, and at work, it might be easy to label his behavior as out-of-control or potentially impairing functioning. But before I come to that conclusion, I might first explore whether he has tried to limit his masturbation to his home and what, if anything, is prohibited that. I would also want to find out how the thrill of forbidden sexual activity is a part of his erotic landscape. If it plays an important role, I might inquire about whether he has ever gotten creative about how to include playing with the forbidden in safer ways.

Cheng reports that he is bored with pornography and looks for things that are exciting and shocking. This could be seen as an indicator of sex addiction because it suggests that he has developed tolerance, one hallmark of addiction. Other possible explanations include that Cheng is intelligent enough to be easily bored, has ADHD, that most porn is repetitive, or that Cheng lacks the skills or knowledge to cultivate other ways to bring variety into his sex life. Cheng is certainly comparing his real sex life to pornography, and this is indeed a real problem with porn. But where else could Cheng learn about real sex? Who taught him about real sex? About the difference between pornography and real sex? If therapy teaches that to him, will his behavior persist in the same way?

Cheng states that his partner is boring and not adventurous, but why is he necessarily the problem? From a more kind perspective, why is this not simply a case of sexual desire discrepancy in a couple?

It is also true that Cheng harmed himself with his masturbation process. But who taught Cheng to masturbate? Who taught him how to care for his penis or warned him of the risks of tearing his frenulum? Who taught him to use lubricants when masturbating?  If he had better sexual health education, would these negative consequences have come to him? Given that he didn’t have that education, does that make him an addict?

One hallmark of addiction is that a person tries to quit but returns to the behavior. But sexuality can’t simply be eliminated. It is true that some aspects of Cheng’s behavior are challenging in his relationship, but trying to make him eliminate his sexual expression will not be a sustainable solution that allows him to retain his sexuality. This is true because it is impossible to eliminate his sexuality from him. And that fact illustrates a key difference between sexual behavior and substance use. The substance can be eliminated from the person’s life, but our sexuality goes with us everywhere

Finally, it is not only Cheng who needs to come to terms with the existence of his sexuality. His partner will also need to do that if they are to stay together. While there may be many ruptures in this relationship because of Cheng’s history of lying, secrets, and their mutual lack of sex-positive attitudes, repairing those bonds will not be complete in my opinion unless they find a way to accept Cheng’s sexuality (with more sustainable expressions) as one part of the relationship between them.

As you can see, in Cheng’s case, I would certainly recommend treatment to help him make a lot of changes to improve his mental health and relational satisfaction. But is this an addiction? The treatments I would primarily offer include education, acceptance, skill building, finding paths for expression, and open discussion with his partner. These are not hallmarks of addiction treatment. I might use some tools that I learned when I did treatment for addictions, like encouraging him to have a plan for how to channel his sexuality into healthier avenues if he is inclined to repeat behaviors that could get him arrested, like masturbating in public. Yet I might also use these tools when I have clients with other challenges that have nothing to do with sexuality or addiction.

Conclusion About Sex Addiction

Clients like Farrukh and Cheng come to treatment because something about their sexuality is not bringing them joy. Can treatment help? Yes, I believe it can. Does it matter whether we say that the treatment is for Sex Addiction or Out-of-Control Sexual Behavior (OCSB)? I believe that it does. When we talk about addiction, we think that recovery means abstinence, yet recovery from Sex Addiction does not mean abstinence from sex, though it might mean abstinence from specific sexual behaviors. In addition, because shame and self-loathing are such a toxic component of the OCSB process, I am cautious about using a label that might contribute to someone with this experience considering their body or the body of their lovers to be the “substance” of addiction and therefore a source of anxiety. I want my clients to walk out of my office embracing their sexuality in joy-generating ways.

I treat many different kinds of sexual issues for men and women, including OCSB/sex addiction. If you live in California and are interested in working with me, contact me. 

2019 Sex Addiction Update:

A consensus is emerging in the field of sex therapy against the sex addiction model. As one example, read this statement from the American Association of Sexuality Educators, Counselors, and Therapists:

Founded in 1967, the American Association of Sexuality Educators, Counselors and Therapists (AASECT) is devoted to the promotion of sexual health by the development and advancement of the fields of sexuality education, counseling and therapy. With this mission, AASECT accepts the responsibility of training, certifying and advancing high standards in the practice of sexuality education services, counseling and therapy. When contentious topics and cultural conflicts impede sexuality education and health care, AASECT may publish position statements to clarify standards to protect consumer sexual health and sexual rights.

AASECT recognizes that people may experience significant physical, psychological, spiritual and sexual health consequences related to their sexual urges, thoughts or behaviors. AASECT recommends that its members utilize models that do not unduly pathologize consensual sexual behaviors. AASECT 1) does not find sufficient empirical evidence to support the classification of sex addiction or porn addiction as a mental health disorder, and 2) does not find the sexual addiction training and treatment methods and educational pedagogies to be adequately informed by accurate human sexuality knowledge. Therefore, it is the position of AASECT that linking problems related to sexual urges, thoughts or behaviors to a porn/sexual addiction process cannot be advanced by AASECT as a standard of practice for sexuality education delivery, counseling or therapy.

AASECT advocates for a collaborative movement to establish standards of care supported by science, public health consensus and the rigorous protection of sexual rights for consumers seeking treatment for problems related to consensual sexual urges, thoughts or behaviors.