In my opinion, long-term psychodynamic therapy is the most efficient way to cultivate healthy personality development. The most comprehensive therapy for sex addiction combines the empathy, insight and relational abilities of a psychodynamic psychotherapist with the 12-step orientation and cognitive-behavioral strategies of an sex addiction therapist.
What IS Psychodynamic Psychotherapy?
The primary focus of psychodynamic treatment in treating sex addiction is on patients’ internal structural deficits rather than on their addictive symptoms. Besides compensating and repairing deficits in the self stemming from childhood lack of atunement with early caretakers, it may also be the most appropriate treatment to help individuals cope with life stressors and painful emotional states that contribute to urges to engage in addictive sexual behavior.
The focus of this type of therapy is to enhance individuals’ self-regulation and self-care, and to foster their capacity for meaningful interpersonal connections. Quality sex addiction therapy serves these goals by facilitating the development of healthy ways to regulate emotional self-states, for getting appropriate needs met in reality, for resolving inner conflicts, and for taking care of oneself in a spectrum of areas.
Integration of the patient’s personality is an important element of psychodynamic therapy. Sex addicts live in two worlds; the “normal” world of work and love and the “secret world” of sexual acting out. This split in the personality results in the addict having different value systems and goals for each part of the personality. Psychodynamic treatment promotes personality integration by bringing together under the light of consciousness the split, denied, dissociated and repressed aspects of the person’s mental functions. Dr. Jekyll and Mr. Hyde finally become one.
Some General Principles of Psychoanalytic Therapy
Focus is on affect and expression of emotions. The therapist helps the patient describe and put words to feelings, including contradictory feelings, feelings that are threatening, and feelings that the patient may not initially be able to acknowledge.
Knowing, but not knowing at the same time is the result of various defenses the person uses to remain unaware. One aspect of this type of therapy is actively focusing and exploring these avoidances. Patient and therapist chip away at defenses so unconscious material can be brought to consciousness where there is a chance of changing and adapting to reality.
Identification of recurring themes and patterns. Self-defeating patterns in patients’ thoughts, feelings, self-concepts, relationships and life experiences are put under a microscope.
The past is alive in the present. Past experience, especially early family-of-origin issues, affects our relation to, and experience of, the present. The goal is not just to dwell on the past for its own sake, but rather to help people free themselves from the bonds of past experience in order to live more fully in the present.
Focus on Interpersonal Relationships
Psychodynamic therapy emphasizes patients’ interpersonal experience. Problematic interpersonal patterns interfere with a person’s ability to meet emotional needs.
Exploration of the entirety of mental life. Patients are encouraged to say whatever comes to mind. Thoughts can range over various aspects of mental life, including desires, cravings, fears, fantasies, dreams and daydreams. All of this is a rich source of information about how the person views self and others, interprets and makes sense of experience, avoids aspects of experience, or interferes with potential capacity to find greater enjoyment, ease and meaning in life.
The goals of this type of therapy extend beyond healing the symptom (compulsive sex) but also foster the positive presence of inner capacities and resources. These might include more fulfilling relationships, more effective use of one’s talents and abilities, maintain a realistic sense of self esteem, tolerate a wider array of strong feelings without acting out, have more satisfying sexual experiences, greater understanding of self and other and face life’s challenges with greater freedom and flexibility. These goals are explored through self-reflection, self-exploration and self-discovery that take place in the context of a safe and deeply authentic relationship between the sex addiction therapist and patient.
Personality Factors Treated in Psychodynamic Therapy
The Fruits of Treatment
Psychoanalytic therapy can help sex addicts to develop:
The ideal result of being in psychoanalytic treatment is, of course, a cessation in sexually destructive behaviors, but rather an essential change in the entire personality so that sexing, objectifying women, experiencing overwhelming feelings, lack of impulse control and low self-esteem and shame are completely things of the past.
Shedler, J. (2011) “The Efficacy of Psychodynamic Psychotherapy”
Goodman, A. (1998) “Sex Addiction”
Bean, M. and Zinberg, N. (Eds) (1981) “Dynamic Approaches to the understanding and Treatment of Alsoholism”