Quality Versus Quantity

Today I pranced into my therapist’s office, bringing with me an air of confidence. I came in with an agenda. I provided her with some quick updates on my health and family, but nothing major occurred. Then, I jumped right into it.

Sex.

You read that right. Sex. No, I did not have sex with my therapist. Get your mind out of the gutter. However, sex became the session topic. It did not come as a shocker to my therapist. This was far from the first time we talked about it. I struggled with dating, sex, and developing intimate relationships as long as I can remember.

I felt myself on the border of a “relapse” (I use that term loosely, and you will see why in a moment.). My attention focused in on sex since my last therapy session. I hooked up with three different women over the course of a week and with two of them more than once. I found myself spending any free time I had swiping on Tinder. Even the women I already had established friendships with, my conversations took on a suggestive, sexual undertone.

Although nothing detrimental happened yet, I was playing with fire. My behaviors bordered on the line between having fun and unhealthy obsession. Thankfully, I caught onto this pattern. I called it into question before it took control and could cause any real damage. This was a few days before my therapy appointment. I figured I had a perfect opportunity to chew on this food for thought and present it for discussion in therapy.

I owned up to my recent actions in session. As I plucked apart the specifics though, I grew confused. Several lingering questions arose. Was I a sex addict? How long would it take to overcome these behaviors? Would it impede my ability to have a long-term relationship? How do you overcome a behavioral addiction that is a natural part of relationships and a basic human need?

I made my therapist work for her money today, but she certainly earned my respect in the process. She helped me dissect each question. With my therapist as a sounding board, the picture grew clearer.

First things first. Was I a sex addict? Just over two years ago, I saw a new therapist after my former psychologist retired. To say the least, I only lasted three sessions with the new one. I say that because she was far too aggressive and categorized me as a “sex addict” right from the start. It sent me into a ruminating spiral of guilt after that session. I looked up the diagnostic criteria for sex addiction for clarification. It both frightened and bewildered me. My “symptoms” matched up with a majority of the criteria including using sex as a coping skill, feeling remorse for your actions later, and impairment in daily functioning. I knew I had an issue with sex, but labeling “sex addiction” did not feel right.

My therapist today agreed. We together acknowledged that I had tendencies of sex addiction, but that my behaviors matched more along the lines of an obsession and compulsion. I have gone months without urges or any kind of “relapse.” However, when the urges erupt, they come on full force.

This made more sense to me. I even pulled out my phone to Google the diagnostic criteria for sex addiction again. It was odd what came up on the top result. It was a peer-reviewed research article outlining the difference between the ICD-10 and DSM-5 criteria of sex addiction. Part of the article described how the ICD-10 (Europe’s version of diagnosing medical and mental illness) included a diagnosis for sexual compulsions/hypersexual behavior, and the DSM-5 (the American diagnostic bible for mental illness) rejected the idea. The DSM-5 solely included sex addiction. I was shocked. Even the professionals acknowledged more of a spectrum approach in differentiating sexual compulsion versus addiction. For comparison, I was more of a binge drinker versus a chronic alcoholic.

How long would it take to overcome these behaviors? Would it impede my ability to have a long-term relationship?  My therapist pointed out that these compulsions dated back nearly twenty years to when I was a preteen. The moment I realized that it felt good, it was all over. I was satisfying urges three to five times a day. I did not give getting caught by someone a second thought. The objective was to feel in control and to feel good doing it.

While talking to my therapist, I even came to the realization that a horrible joke I came up with ten years ago highlighted my internal conflict.

****Trigger warning****: I must preface this with saying that this joke was never meant to hurt others or objectify women. Looking back at it ten years later, I see how bad it sounds and can certainly where it could be interrupted that way. 

I categorized women in the dating realm into “quantity” and “quality.” Quantity described women who only wanted to have casual fun, while quality were those who I deemed worthy of pursuing a long-term relationship. It highlighted the internal discrepancy between my sexual compulsions and wanting something meaningful.

To say the least, it would be nearly impossible to rid myself of thoughts, feelings, and behaviors that have been running rampant for nearly two decades. I hate to say it, but it will always be part of me deep down. I will always have a sick sense of humor. I will always connect intimacy and emotion to sex. I will always deal with these urges to some extent. However, there is a way to keep all of these in the “normal” range without getting out of control.

How do you overcome a behavioral addiction that is a natural part of relationships and a basic human need? Unlike substance abuse, sex is an innate, biological part of who we are as human beings. Unless you have done it before, our bodies do not crave heroin, cocaine, or other illicit drugs. Our biological makeup pumps out hormones that make us want to have sex. On a societal level, it is expected that you will engage in sex with your significant other at some point.

What worried me was my skewed perspective on sex. Unfortunately, due to a long history of trauma and broken relationships, I saw sex in a different light. I often used it as a coping skill when under significant amounts of stress. With my partners, sex usually resulted in a mutual using of one another. I did not want this to carry over into a relationship. I want a relationship to mean something.

My therapist made two strong observations at this point in our conversation. She initially highlighted that sex talk often takes a back seat when I truly see myself developing an emotional connection. She was right. If I saw someone as worth getting to know and seeing where it goes, that topic went on the back burner. It would come up in conversation naturally, but I was seldom vulgar. Conversations were full of substance and developing a deeper connection.

She then asserted that I rarely challenge the thoughts behind the urges. Again, I agreed. I had no problem in acknowledging them and letting them run their course. Challenging and questioning them did not occur though. I needed to assert myself over my compulsions and maintain control.

I walked out of that session with a fresh perspective, feeling refreshed and clear direction. I thanked my therapist for her help, especially since sessions like that do not come around too often. I value insight as a powerful therapeutic tool, and this session connected a lot of dots for me. Going in with an open mind and mentally prepared allowed for that conversation to take place. I probably could not have discussed any of this two or three years ago. It was a huge step forward for my mental health recovery, but there is still work to be done. Onto the next step in my self-care journey.

-The Caring Counselor

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