Speaker 1: Welcome to smart sex, smart love. We’re talking about sex goes beyond the taboos and talking about love goes beyond the honeymoon. I’m dr Joe Kort. Thanks for tuning in.
Speaker 1: Hello everybody, and welcome to the show. Welcome back. Um, today we’re having a topic that’s near and dear to my heart. It’s helping clients recover from the trauma of sex addiction treatments. This week’s episode looks at how therapists help clients recover from the trauma of sex addiction treatments. My guest is Silva nievus, a C O, S R T accredited psychosexual and relationship psychotherapist and clinical supervisor. He works in the private clinic in central London, UK. He works with individuals and couples presenting with many psychosexual and relational problems. One of Silva’s expertise is the treatment of compulsive sexual behaviors and sexual trauma. Silva was one of the featured therapists in the BBC series sex on the couch. He believes there are treatments available for compulsive sexual behaviors that are more effective than traditional sex addiction therapies. Welcome Silva.
Speaker 2: Hi. Thank you for inviting me.
Speaker 1: Yeah, thank you for coming. I’m so happy to have you here and as you know, and many of my listeners would know if they followed me that you know, for 25 years I was a sex addiction therapist and I was also self identified as one. And the recovery from getting out of that was so hard and slow and long and so I’m so glad you’re going to flush it. Flush this out for people.
Speaker 2: Yes, thank you. I was the same too. I was first trained as a sex addiction therapist too and I worked with the sex addiction model for a long time. So, um, you know, I understand how difficult it is to come out of this model and to find other ways to help our clients.
Speaker 1: I did not know that about you.
Speaker 2: Yeah, I did the [inaudible] training.
Speaker 1: Oh wow. Same here. Wow. Okay. No, that’s even better than you really know the ins and outs of this.
Speaker 2: Sure. Yes.
Speaker 1: I have to be honest. In some ways I feel like clients who’s to tell me that, uh, how hard it was for them to come out of conversion therapy, you know, because you know, helping them, uh, realize that being gay was okay. I feel like sex addiction treatment is like conversion therapy for sex. That you learn that the kind of sex you like is okay. It’s not pathology. Would you, would you see it that way or differently?
Speaker 2: Yes, exactly. I’m glad you say, because this is exactly how I feel. Um, I think it’s, it’s the accepted conversion therapy at the moment is the success of addiction, you know, because they actually, uh, there’s a lot of pressure, ology and, and encouragement to stop normal, healthy, you know, functional sexual behaviors because it doesn’t sit with what the therapist think.
Speaker 1: Yes. And what the maybe partner things or the religion things or society things. Right, exactly. I like what you saying.
Speaker 2: One of the things, the, uh, that we
Speaker 1: have now in the ICD 11 of the criteria for the disorder of composite sexual behavior is that it have to not be, um, thoughts of a problem because of external sources. So you have to be the clients themselves thinking there is a problem rather than thinking they have a problem because the partners think they have a problem or because they’re religious ministers think they have a problem or because they read a book about it and then they think they have a problem. Right. That’s very well that said that. So that most of our clients that come in really are coming in because of other people’s problem with their sexual issues or sexual behaviors or fantasies. And then they internalize them. Right. And they think, well, then I have this problem too, rather than sorting all that out.
Speaker 2: Yes, exactly. And one of the, one of the things about, uh, one of the strong philosophy of the 12 step programs and also in the sex addiction treatment is to accept what they call, uh, accept powerlessness. And I think this is the one thing that really, uh, one of the things that keep people feel like they have a disease. Because if you are powerless, it’s feels like it’s something that happens to you and then you’re going to be chronically diseased. Whereas in fact, I think the is is true that if you, if you think that there’s some sexual behaviors that you’re questioning or that you’re not happy with, the first thing to do is to own it and to then think about what to do about it.
Speaker 1: Absolutely. And then empower yourself on how to manage it rather than what Doug Brown Harvey always says is giving yourself an erotic ectomy. Right. Our clients come here.
Speaker 2: Okay.
Speaker 1: Right. You have that clients come in and like, can you just be racist part of my brain? No, I can’t. That’s impossible.
Speaker 2: Exactly. Yes. [inaudible] and Douglas Brown, Harvey and makeover [inaudible] writing the book, treating out of control sexual behavior I think is a fantastic addition to literature because it really is, um, you know, challenging that sex addiction model and really offering a different way to treat it that is more six solid Jabez. You know, and one of the things when I was training as a sex addiction therapist that I was really surprised about is that there is so much time and hours taught about addictions and hardly anything taught about human sexuality and yet it’s about sexual behaviors. So that was always kind of weird to me, you know, from the start, you know?
Speaker 1: Right. I remembered that’s actually how I got out of sex addiction treatment was because there was nothing in my day. Nothing. I mean in like you said, there’s still hardly anything on sexuality and sexual health that I hate to go outside the organization to a sex therapy organization to learn. And when I learned about how the nuances and complications of sex, the, then I saw how harmful and abusive I really believe the sex addiction model really is.
Speaker 2: Hmm. Yes, exactly.
Speaker 1: So some people are going to listen to that.
Speaker 2: Going back to the conversion therapy, a conversation, you know, the, the, a lot of ’em now in the UK and I’m sure in parts of the USA too, uh, we all agree that it should be banned because it’s harmful and it’s actually traumatizing. Um, and, but you know, it’s important that we don’t keep it just for the LGBTQ, uh, community. I’m very glad that the LGBTQ community now is protected from those kinds of therapies. But, um, we have to now look further and see how other people, um, you know, do conversion therapy with, you know, the, the larger population. And I think that, uh, in the UK anyway, a lot of well-meaning therapists that have been trained in sex addiction will do accidental conversion therapy.
Speaker 1: Oh gosh. Oh my God. I love the way you’re saying that. Well, first of all, I like that you’re saying sex addiction is the, uh, current, uh, acceptable way of doing conversion therapy. And that sex addict, well-intended sex addiction therapists are doing exit dental conversion therapy. Can you explain what conversion therapy is to listeners who are like, what the hell is that? Hmm.
Speaker 2: Yes. Conversion therapy really broadly is, um, to think that there is, uh, one sexuality pattern that is not normal and the rest is abnormal. And, and it’s an attempt to change what people perceive as abnormal sexuality into something of normal sexuality. So in the Covisint conversion therapy is really about the belief that the being, uh, having, uh, same sex, uh, sexual attraction or romantic attraction is wrong. And a Domo and the therapy is an attempt to, uh, convert people into heterosexuality and does it work? It does not work. It never worked who have now studies that says it doesn’t work. But more than not working it actually traumatizes people.
Speaker 1: Yes, absolutely. Traumatizes people and there, there’s no such thing as going from gay to straight any more than there is from going to straight to gay. And there’s, and what would happen in sex addiction is people would be a pressure to move away from their erotic orientation, the things that get them off because they would say that was the problem rather than managing it as the problem.
Speaker 2: Exactly. And when, when people go to, um, a 12 step program or a sex addiction treatment within the first few sessions, um, it will be, uh, the clients will over already be encouraged to stop all sexual behaviors. It’s kind of like 90 days, so brightly things that actually doesn’t have this no clinical evidence at all that that 90 days should be recommended or not. But people just do that. Uh, anyway. And, and, and that in, in the first place on top of being sex negative, is that actually quite harmful to start with because there is no curiosity about the client’s unique sexual arousal template or what it means, what the sex, sexual behaviors mean. Um, people are not interested in investigating that. You know, they go straight into, Oh, that messed up and you’ve got you, you got to do sobriety. That’s your goal. Um, and that really for me is really counter productive because, you know, as a therapist, if a client comes with an issue, the first thing that therapists should be thinking about is to be curious about it and to find, to find what, what the meaning and the functions of that behavior have for the client.
Speaker 1: Yes. You know, what kills me
Speaker 2: and somehow some of how we do it with all of the other clients, but we don’t do it with sexual behaviors.
Speaker 1: That’s well said. That’s so true. We do it with all the other clients cause we do, but when it comes to sex, the therapist’s bias interferes because they haven’t done their own sexual health work and uh, and professional learning around it. Right? Yes, exactly. It kills me.
Speaker 2: If the therapist, if the therapist thinks that it’s wrong to go to a sex club every Saturday night when they meet a client and said, Hey, uh, you know, I’m going to six clubs every Saturday night, I’m really questioning this, the therapist will automatically think, well there’s a problem here. We’ve got to fix that.
Speaker 1: Yes. And you know, what bothers me the most is I went into treatment for sex addiction at 24 years old. I’m almost 57 years old and there’s still the, the model is the same 90 day sobriety, you know, I’m here, you know, pathologizing the actual sexual behavior. It hasn’t moved, it hasn’t grown. It hasn’t learned from any sexual health models at all. It just stays the same. I don’t understand.
Speaker 2: Right. I know, and especially now that we have so much, so many studies and so, so much knowledge in with the science of sexology, it’s really baffling to me that people are really staying stuck in the 80s with these things.
Speaker 1: So people tell people, how does it mess people up? So that, like you say, and I do this too in my work, but I want you to just talk about how do you help somebody recover from sex addiction therapy?
Speaker 2: Hmm. Well, first is, uh, for me, I look at the, that, that Gnostic criteria of the ICD 11 because I think that’s a helpful one. I mean, so people, uh, you know, have problems with it. It’s not perfect, certainly, but at least it gives us a guide. And with the ICD 11 and the world health organization, what is very clear is that they say scientifically that’s, uh, sexual problems. Compulsive sexual behaviors is not an addiction and the terms should not be inter interchangeable. So it’s compositive sexual behavior is not a synonym of sex addiction. Sex addiction is a completely different framework than composite sexual behavior. So when clients, when clients come and say, Oh, maybe I’m a sex addict, which is normal that they would say that because it will be, you know, that’s the kind of popular language that they will have read in magazines and so on.
Speaker 2: I don’t say to them, while you’re wrong, you know, you’re not a sex addict. But at the same time as a clinician, I have the duty to inform them what actually, you know, scientifically the, it’s a, it’s sexual compulsivity um, is not an addiction. And my treatment follows sexual compulsivity not an addiction treatment. Because I want to give clients the right to consent to my treatment or notes, you know, to start with. And that’s really how we have, have I setup my sessions to start with to say, you know, this is what I do. Are you consenting to this treatment? Because if they want an addiction treatment, I’m not the right guy.
Speaker 1: Ah, that makes sense. And then what’s the difference? So then if you’re not doing addiction, what are you doing?
Speaker 2: So I do, um, festival, uh, proper assessment. I look at their erotic template. And with that I use that, the helpful book, the erotic mind by Jack Morin.
Speaker 1: Yup. Can you define, define erotic templates so people know what that means?
Speaker 2: So, so that’s, that’s basically all the things about you, uh, that is unique to you, that turns you on. So it just, things that can turn you on either based on behaviors that you’ve done in the past that you’re currently doing, but also sexual fantasy that you have no interest in acting on two behaviors. And so for some people, for example, they might say, um, when I was, uh, you know, 23 years old, I had a threesome that was really, really arousing that was really erotic. And when I remember this memory, I have lots of, uh, sexual feelings, uh, coming back to me. So that will be part of the erotic template. Now it doesn’t mean that, you know, say it now the satisfied, it doesn’t mean that they want to be keeping doing threesomes when they’re 75, but surely that can be a really helpful memory to have to connect with their sexual selves. And that is not a pathology in any way. And that will be part of their arousal templates.
Speaker 1: And so then, yeah, go ahead. Yeah, carry on. Oh, so, so what, then what do you do? So they come in as you say, first thing you do consenting to, we’re going to look at this as a compulsive problem, not as an addiction problem. And then you look at their erotic template and then what?
Speaker 2: And then we, uh, with the clients and that can, that can be quite a few sessions because it’s just in collaboration with the client or with the clients. We talk about it. And through that process of investigating the erotic mind and the erotic template, they start to really understand and piece things together about, you know, uh, the reason why they do something is because actually it’s, it’s a big turn on and it’s special, but it might not fit with the current relationship set up they have or it might not fit with their other values or religious beliefs or whatever. But at least it actually, if they start, they’re starting to piece things together and they starting to see that the sexual landscape is a lot more complex than just a behavior that’s right. Or behavior that’s wrong.
Speaker 1: So you help them, you help them look at the erotic tension, right, the tension between the values in other parts of their lives and the values that they hold for their sexual selves.
Speaker 2: Exactly. Because that is part of your sexual self. You know, we can’t, we can’t, uh, act on all of our sexual impulses all the time because we are socialized and we have to, we have to find the appropriate place, the appropriate time, the appropriate people. So we do it all the time, but we do it without really a conscious thoughts. A lot of the time. Um, you know, we don’t have the conscious thought of, Oh, I’m in the museum right now so I should not masturbate, although I want to write. We just don’t because we, we’re in the museum. Um, but when you, uh, when you think of people thinking that they have a composite sexual behavior, suddenly they lose the capacity of thinking rationally and consciously about it. But if they say, you know, I’m seeing a sex work, uh, once a month because that’s the only time where I can feel sexual pleasure with anxiety, then that’s fantastic piece of a separate collection.
Speaker 2: And often they don’t do this kind of reflection at side of the therapy room and they need somebody that can be really open to invite them in their own exploration of the erotic mind because it’s very hard for people to do it on their own. And that will be my first, you know, it’s an assessment, but also is the first part of treatment is to, to own your erotic mind, to understand it, to know what it’s made of. And then then you look at the tension between your erotic mind and your Oh, your sexual self and you know, the world out there and the things that you believe your values, what you have asked of your relationship and so on and so on.
Speaker 1: Right? So what you’re doing is helping, cause I always say we don’t need a sex addiction label. The uh, what’s cause sex addiction would always say, well, it isn’t a sex. It’s not about sex. It’s about all the drivers and the behaviors that are, um, causing the person to do this. Like you said, this person would say, well, I do it because I can relax and I get whatever I get out of it. Well then let’s just stay with that. That’s, that’s the reason he’s doing it. And he might be attention intense having tension around that because he’s married because of his religion. And that’s the work. Right?
Speaker 2: Exactly.
Speaker 1: Exactly. Okay. So, but what if somebody says, you know, I’m doing this and it’s an an a, I’m doing it for hours and hours and hours. It’s interfering with work. It’s interfering with my marriage. I, you know, sometimes I hurt myself because I’m masturbating too much. What do you do with that?
Speaker 2: Well, that’s another part of the assessment. Sometimes the, the, the other part of the assessment, that side of the sexual self and understanding of sexual self is all the other areas of life that you need to also get the clients to understand about themselves. And one of the big thing about compulsive sexual behavior, the true sexual compulsivity often stems from some childhood trauma. And so when, you know, if it’s started, you have to learn from parents or primary caregivers how you can celebrate your successes and also SUSE yourself through adversities. And if you have a parenting that doesn’t teach you that, then the child is going to try to find their own ways of celebrating the successes or soothing the adversities. And, and, and, and often one of the first thing that defines is, uh, touching the genitals or masturbating because that smells nice. Um, and over time, if they haven’t learned any other process of self care, they would use, uh, sexual feelings to, uh, manage all of their other emotions.
Speaker 2: So that’s why it’s really common for people that say, you know, Oh, I’ve, I’ve achieved this big piece of work, uh, you know, in my work as a great success. And the first thing I wanted to do was, you know, go online and speak to a sex worker. Or they might say, Oh, I felt really sad about, uh, you know, a, a friend passing away. And the first thing I wanted to do was to, you know, have sex or another common one. Um, my wife just gets birth and the first thing I wanted to do was to visit the sex worker. It’s because whether it’s a happy emotion, an unhappy emotion, um, celebrate a celebratory, uh, event or a sad event, it’s through sex because that’s all they know. So, um, another piece of the work is to teach clients how to self sooth, how to celebrate their successes in different ways. Um, and that is really unlimited because the more tools you have in your toolbox on how you can manage all sorts of different emotions, uh, the better you are in life generally whether you have a problem with sexual problem or not.
Speaker 1: What I love about what you’re saying is one size treatment doesn’t fit all, is that what you’re saying?
Speaker 2: Excellent. Absolutely. Absolutely. Everybody’s different. And so the treatment will look different for everybody. Some people it will be just a psychosexual treatment. You know, uh, like the example previously when it’s somebody that we did sex workers because they feel too anxious having sex with people that they love, but they can feel they can have sex, uh, with anxiety with somebody they pay. So that could be an anxiety, psychosexual treatments mostly for other people it would be a trauma treatment mostly for other people it will be all sorts of different things. So, um, so it’s never just one thing. It’s never just, you know, step one, step two, step three. For everybody. It’s just being human with another human being and being there for them and, and, and guiding them through understanding their own process.
Speaker 1: What have you got? I was kind of shocked you. So you’re over the, um, the pond, right? You’re over in the UK. And I thought, I remember learning there was some bigger names that would be in the field that would say, Oh, we’re here and we’re S we’re sex therapists and then we learn about addiction so we don’t do the same kind of thing. And then I’d read their work and hear their, about their work and they are doing exactly the same thing as we were doing here, even though they’re trained in sex therapy. So how do you, do you see that and how do you deal with that with your colleagues?
Speaker 2: Yeah. Yes. I feel sad about that. Um, yeah, in America. I mean, I don’t know. My, my perception of America, I’m very fond of the USA by the way, but you know, there is, um, a Puritan history and so, and so it’s really almost understandable that there will be something like this hanging out in America. Although now of course they have moved on quite a bit since the Puritans, but you know, sometimes things, you know, link around the Victorian salmon England league lingers on. Um, but in the UK it’s surely, uh, yes, we have been, we’ve had, we’ve trained as sex therapists, so a long time. And so everybody in the UK says that they are sex positive. But actually a lot of people say that is just as a word. She feel good but they don’t practice it. And so behind closed doors, when the clients come in, they just do what America has told them. Because for a very long time there was only American literature that was available for, uh, compulsive sexual behaviors. So we took on the American can retain isn’t about that without questioning in it because there wasn’t anything else to compare between.
Speaker 1: Yeah, that’s a good point. There wasn’t
Speaker 2: no, and, but the, the sad thing is that a lot of people say, okay, I want to specialize in cobots. It’s sexual behaviors. I’m reading, you know, a book on sex addiction from Americans, clinicians. Well, they all said the same things because they all sat each other. It’s a bit of a [inaudible]
Speaker 1: which hand
Speaker 2: and then it’s like, okay, so everybody said the same things. It must be true. And then they start to do that. But whilst doing that, they actually forget the basic principles of psychosexual knowledge, which is the sadness in all of this because you can really treat compulsive sexual behaviors, um, with all of the six psychology knowledge that you have and all the psychotherapeutic knowledge that you have because that’s all you need. You don’t need an extra specialist addiction thing cause it’s not an addiction.
Speaker 1: Right. I love it. So we have a few minutes left. What’s the one thing would you like to have listeners left with by you that you want them to hear?
Speaker 2: I think what’s really important, the thing that people really, really don’t talk about enough is, uh, the harm that’s sex addiction treatment as the also 12 step programs. So one thing that I like to say to everybody, please, please, please do not encourage people to go to 12 step meetings like a SLA or S AA because, um,
Speaker 1: the sex addiction media.
Speaker 2: Yes, yes. Um, because, um, I’ve seen too many clients who have come to me traumatized by it, just like, just like conversion therapy and you know, um, people feeling depressed and suicidal. We’re talking, we’re talking that that’s range. Um, a lot of sex addiction therapists, they say, Oh, you know, when people stop their behavior, they feel depressed because that’s what was there in the first place. And I disagree with it. I think that a lot of, a lot of the time depression is induced by the treaty.
Speaker 1: I love, Oh my God, you’re so well spoken. Depression is induced by the treatment. I 100% agree. And even if I didn’t agree, you’re still well-spoken and I still think it’s right. Um,
Speaker 2: and, and I really think this is really the, the message I want you to bring home. It’s not, it’s not just about, it’s not as bad agreeing, disagreeing about a treatment model. It’s about the side effects of one specific treatment, which has one size fits all. Step one, step two, step three for everybody, not being interested in their sexual behaviors and just telling people, you must be sober from this. And that puts, that increases sexual shame. It harms people. People at the end of it all, at the end of treatment, they have never learned anything about their sexual self. They only learn how to stop or how to lie better. It’s really not. And that’s not a good outcome. Thank you. So where can people find you Silva? Um, well I’ve got a website. That’s my name’s silvana.co. Dot. UK. Um, you can find me on Twitter and you can find me on Instagram and you can also email me, you can find my email on, on the website. And I’m always, always happy to respond to emails and to help people find the right therapist for them.
Speaker 1: Good. And you’re very active on the internet, on Facebook and everything. I see you on Twitter as well, so you’re easy to find an easy to, um, you know, relate to and hopefully people will find you and read your stuff and maybe learn from you too.
Speaker 2: That’d be great. And, and it’s, and it’s me and it’s you and it’s a few of our colleagues in the UK and in America and I think we should really, really stick together and together have a stronger and stronger voice so that the public can hear that it’s not just sex addiction. There are other ways to and other doors to knock. Um, and, and so that people don’t think, you know, when people go online, the first thing they see, sex addiction. I’m hoping in the next few years people are going to go online and they’re not going to see this as their first introduction to their problem. I agree. Thank you Sylvia. Thank you so much. You’re welcome. Good to speak to you today. You too. Alright. Take care of yourself. Thank you. Bye bye.
Speaker 1: Thanks for listening to this episode of smart sex smart love. I’m dr Joel court, and you can find me on Joe kort.com that’s J O E K O R t.com. See you next time.