Healthy Sexuality and Sexual Addiction: Two Ideas Worth Exploring

Unhappy couple in bedroomI was recently contacted by a student who was writing a paper about ‘sexual addiction’ for a college course on sexuality. As a counsellor and therapist in private practice, I’m not usually in a position to offer so much assistance to students (I receive many requests and my time with people is my livelihood) but my curiosity was drawn to the theme of his particular course: Healthy Sexuality.

Sexual Addiction and ‘Healthiness’

To date there has not been so much written about the idea of sexual addiction from a narrative therapy perspective. When I saw the course title, what immediately struck me was the lens of healthiness through which sexuality was being judged. I know this is a very common way to consider sexuality because I hear it all the time. And I began my career working in the field of sexuality as a ‘health educator‘. In a state, culture and era when public dialogue about sex was largely taboo, health (and specifically HIV) provided an entry point to talk more openly. The rules were that our sex talk had to be the interests of public health.

When people consult me about sex addiction, they are often describing their actions in terms of whether they are ‘healthy’ or not. These days the concept of healthy human sexuality has become such a norm it is a cliche. It seems to me that, particularly since the onset of AIDS, ‘healthiness’ is the primary lens through which we tend to view sexuality. It is taken for granted that sex and sexuality must be ‘healthy’ first and foremost. And this makes me curious about the division that is made between ‘healthy’ and ‘unhealthy’ sexuality. How useful is this binary? And who determines what is ‘healthy’ and what is not?

It also has me wondering about what happened to other perspectives or lenses through which we might view sexuality. What does sexuality look like, for instance, through a lens of Pleasure? Or a lens of Community? Or a lens of Power? Or Spirituality? Or – dare I say it – ‘Fun’?! What does your sexuality look like if you view it through those lenses instead? Or how about through the lens of Self-Knowledge, finding out about yourself?

Exploring Sexualities and Alternatives to ‘Addiction’

It does strike me that when we start looking at sexuality through a lens of ‘healthiness’ we might also be standing firmly within the disease model. It’s no wonder these fears about addiction figure so strongly when we are viewing ourselves with the presumption of a deficiency or possible health disorder. We lose the context. In the stories I hear, people tell me about the steps they are taking in exploring desire. They describe themselves acting on urges they have had for 30 years but done nothing about due to shame or fear of ridicule. Others tell me about strategies of using pornography for stress relief, or to relieve boredom or to escape from grief that has overwhelmed them. Some people tell me how good they feel when they have sex but say they can’t share this with others because of taboos around discussing sex. I find myself engaged and interested in the courage, skills and abilities of those who consult with me and we draw on all of these in our work together.

history of sexualityIn his book series The History of Sexuality, the French philosopher Michel Foucault claims that the concept of Sexuality itself was developed to ensure power remained with certain people. Sexualities are proscribed in the same way that particular activities or behaviour might be regarded as disordered or pathological or unhealthy. In narrative therapy there is an idea that people can be experts in their own lives. This certainly challenges the standard model supporting doctors, psychologists and psychotherapists as the experts, but it is a way of thinking I personally find exciting and empowering.

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About Forward Therapy

Ash Rehn is a counsellor and narrative therapist with over 20 years experience. He specialises in therapeutic conversations and collaborative therapy for anxiety, burnout, depression, midlife crisis, sex and relationship issues, pornography use problems and counselling for lesbians and gay men.

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