On Not-Acting-out and What to Do Afterwards: A Two-Step Guide for Clinicians

Abstract

Helping someone consider what it might be like to desist from an ingrained, highly-prized, sexually-compulsive behavior is challenging. To help a client move toward such a goal, it may be helpful to break down the process of refraining into two parts or subsequences: first, the moment of choosing not to engage in the pleasure-seeking behavior(s); and second, the moments after one has chosen not to engage. This “second moment” is not often addressed granularly in intervention models because in a sense, it seems like a negative space, a void. It presumes the hard work and mental energy of desisting has already occurred. But we may conceptualize the “moment(s) after” as forming a temporal, affective, and psychological space in which the client needs specific help, support, and tools. This article uses theoretical and casework material to demonstrate how such a “two-step” model can help clients envision and prepare for the challenges of ceasing sexually addictive behaviors by also getting them in touch with what may follow an episode marked by inhibition.

Keywords:

• Sex addiction
• acting-out
• containment psychoanalysis

Compliance with ethical standards

The author hereby states that this writing in no way contains, facilitates, or may reasonably lead to a substantive conflict of interest which would compromise the ethical standards of the publisher or of generally-accepted standards. Furthermore, because the “individual” depicted in this article is a composite with no identifying details pertaining to an actual person, and because all clients of the author are in any case informed that some information from sessions may be used for research or consultation purposes—and for which purposes written consent is obtained—the author attests that no rights of human participants has been violated nor is such a framework generally applicable herein. No animals were involved in preparing this article.

Notes

1 “Erik” is a composite personage, rather than a single individual. The behaviors I describe here give an accurate and detailed reflection of my work with a number of sexual addiction/compulsivity clients; other potentially identifying details are wholly fictitious.

2 Some clients have reported that a low dose of antianxiety medication, such as clonazepam, to be helpful when feeling high tension and urges to enact temporarily-relieving but addictive behaviors.