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Paradigm Shifting from an outdated sex addiction model to a new sexual health model

Debate within my profession:

Sometimes the public isn’t aware of nor even concerned with the idea that different professionals treat the same issue from different perspectives. The public or consumer is usually my first concern and your understanding and knowledge is paramount to me. It bothers me when clinicians in my profession state theory in terms of fact. It bothers me when closed minded people push their value systems on to others in an attempt to control and shame them.

There is a new gold standard of treating Out-of-Control Sexual Behavior and my profession is currently in a huge internal struggle some might say fight. This shift will be and is currently profoundly troubling to clinicians who are entrenched in the sex addiction paradigm. I personally have empathy for them because they will have to change and grow. Growth is painful at times so in that I do have empathy. It doesn’t change that when we know better we must do better.

Doug Braun-Harvey and Michael Vigorito have laid out a model of treating individuals who struggle with feeling out of control in their relationship to sexual thoughts, urges and behavior.

We have many many years of viewing sexuality through an act-centered lens by which treatment models have evolved and been refined. Much like when individuals thought the world was flat and then we found out it wasn’t it made for a great deal of discomfort. But once you are aware of and have the knowledge that sex addiction really isn’t scientifically prove-able as a matter of record the sex addiction model has actually been falsified.

What to do now that a new model exists?

The new model challenges clinicians with concepts of ethics and professionalism in ways that can at times feel like a struggle. None the less it is our professional ethics that should drive us to continue to assess our own knowledge and competence around an area we treat that should propel clinicians to revisit the way they view clients who feel out-of-control.

Recently there was position statement by AASECT here it is:

AASECT Position Statement – Sex Addiction

Founded in 1967, the American Association of Sexuality Educators, Counselors and Therapists (AASECT) is devoted to the promotion of sexual health by the development and advancement of the fields of sexual education, counseling and therapy. With this mission, AASECT accepts the responsibility of training, certifying and advancing high standards in the practice of sexuality education services, counseling and therapy. When contentious topics and cultural conflicts impede sexual education and health care, AASECT may publish position statements to clarify standards to protect consumer sexual health and sexual rights.

AASECT recognizes that people may experience significant physical, psychological, spiritual and sexual health consequences related to their sexual urges, thoughts or behaviors. AASECT recommends that its members utilize models that do not unduly pathologize consensual sexual problems. AASECT 1) does not find sufficient empirical evidence to support the classification of sex addiction or porn addiction as a mental health disorder, and 2) does not find the sexual addiction training and treatment methods and educational pedagogies to be adequately informed by accurate human sexuality knowledge. Therefore, it is the position of AASECT that linking problems related to sexual urges, thoughts or behaviors to a porn/sexual addiction process cannot be advanced by AASECT as a standard of practice for sexuality education delivery, counseling or therapy.

AASECT advocates for a collaborative movement to establish standards of care supported by science, public health consensus and the rigorous protection of sexual rights for consumers seeking treatment for problems related to consensual sexual urges, thoughts or behaviors.

This statement calls for clinicians to revisit their own conceptualizations.  I am cautiously hopeful that both clinicians and consumers will find help so that we may all grow in our understanding of sexual health.

My best,

Chuck Franks, LCSW, CST

Bibliography and Suggested Reading for GKCPA 10.30.2015

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Sexual Integrity in porn use.

There is a big debate about is sex and porn addiction. I recently was lucky enough to be a witness to two intelligent, passionate men discuss the common ground in the middle of the debate. The two men I speak of are Dr. David Ley and Dr. Robert Weiss. Today, I read an article that I resonated with in a different context. For me it was a very eloquent definition of sexual integrity. It was written by Dr. Ley. It sparked an interest so I googled Sexual Integrity and guess who’s article came up, Dr. Weiss’s. Was it fate? Or just google feeding me relevant information by relevant individuals? It didn’t matter cause I was off to the races defining sexual integrity for myself. It’s not like this is a new topic for me. I think integrity is a life long endeavor and we are all sexual beings our whole lives.

Dr Weiss wrote this about Sexual Integrity:  “If you are completely open and honest about these things with yourself and with your long-term intimate partner/spouse, and in a boundaried way with new sexual/intimate partners, then you probably have sexual integrity.”

I really like the inclusion of boundaries. Remember, I found this quote after reading an article about porn addiction. Dr. Ley writes about personal responsibility.

Dr David Ley wrote, “requires a man to stand up for himself and his sexual desires, to be willing to negotiate for those needs, to be willing to compromise, but stay true to himself, while asking for the same in return.”

Staying true to one’s self is something I think that is crucial to life satisfaction. I tend to use the phrase authentic truth. However, authenticity and honesty can often involve a lot of fear around rejection. My own work in Kansas City Missouri often involves exploring a unique experience I share with many of my clients. The local culture of our City and geographic area. Kansas City is a unique blend of large city and small town experience. Kansas City on the surface is a progressive city. The bible belt and religious undertow though is always but an unspoken word away. Our unique blend of Kansas City “niceness” often leaves that unspoken word as a space used for judgement.

It’s not uncommon to have a conversation that includes actively putting words to the experience when one’s authentic truth makes someone else uncomfortable. Exploring  the way people talk about this uncomfortable feeling and who’s responsibility it is to resolve it. We explore what it takes to maintain their truth while being vulnerable.

The opposing position is when someone is uncomfortable it’s their own responsibility to deal with that feeling. This is the stuff individuals have to work through with their partner/spouse. These are the topics and obstacles we have to explore in order to have sexual integrity. Does my porn watching affect my relationship? How does my partner feel about me watching porn? How do they feel about me masturbating? How will we as a couple compromise our sexualities including and respecting each other?

Many are being labeled sex addicts or porn addicts solely by their partners feeling uncomfortable with some aspect of their sexual expression. As opposed to discussing, respecting, accepting, and compromising and seeking support and help. Taking personal responsibility for one’s self is part of integrity. Taking responsibility for your sexual expression, self esteem and staying true to self are all parts of sexual integrity.



Sexual Health Matters

I recently finished a year long comprehensive program at the University of Michigan focusing on sexual health as it relates and presents in psychotherapy. I am so amazed at some of the work people are doing regarding pelvic pain, attachment, trauma, intimacy and desire, sexual performance and specifically how it relates to relationships and helping couples come together and understand how their intimacy and sexual health is impacted.

June is Men’s Health Month: The purpose is to heighten the awareness of preventable health problems and encourage early detection and treatment of disease among men and boys. This month gives healthcare providers, public policy makers, the media, and individuals an opportunity to encourage men and boys to seek regular medical advice and early treatment for disease and injury.

We are so used to not talking about anything related to sexual health we have done ourselves, and our children a disservice. One of the analogies I often use with clients is, “if your hand wasn’t working you’d go ask for help, right?” They always respond affirmatively. Why is it that we are so embarrassed to talk to doctors about our sexual health. Compounding the problem is doctors aren’t given adequate training on sexual health. Some of the work I do is basic education. Then together we explore and have conversations about how not being able to talk about sexual health has prevented couples from fully understanding the dynamics of the intimacy issues they often face through different stages of their lives.

Feel free to reach out to me to maybe set up time to discuss where you and your partner are. So during this month of men’s health I want to talk to the ladies. You know your man really doesn’t want to talk to anyone about feelings especially about sex. But what would your relationship look like if together we can get him to open up and be more comfortable sharing what he is thinking and what he is feeling.

Feel free to reach out to me at:


Sex Therapy: Is it for you?

I recently came across an article I thought was really well written.  Here are some of the highlights:

Many couples find it hard to fit sex into their busy schedules. And it is perfectly normal for people to go through periods when they are just not in the mood for love making. However, if you lack desire for sex for emotional or physical reasons, you may want to consider sex therapy.

“There are probably a lot of people out there who could use therapy but do not come because they’re embarrassed. They may go through years of needless pain or dissatisfaction,” says Alexandra Myles, MSW, a sex therapist in Massachusetts.

  • Learn more about sexuality—In spite of the greater openness about sexuality today, many people have little understanding of their own bodies and sexual functioning. Informational and self-help books and educational sex videos, which are widely available, can be very helpful. Becoming better informed will help you decide whether you really need therapy.

Many people come to sex therapy after individual psychotherapy fails to help them with their sexual problems.

“The obvious thing is that you are dealing with the human body so you cannot just talk about how you feel. You have got to work on the physical level as well,” says Myles. Sex therapy generally addresses the emotional issues underlying sexual problems and employs behavioral techniques to deal with the physical symptoms.

One popular technique used in treating many sexual problems is called sensate focus, in which couples caress or massage each other without sexual contact. The goal is to help both partners learn to give and receive pleasure and feel safe together. As the partners become more comfortable, they can progress to genital stimulation.

As a result of performing this exercise, many couples discover new ways to experience pleasure other than sexual intercourse. “Some of my patients find that they become better lovers,” says Dennis Sugrue, PhD, a sex therapist in Michigan.

Other exercises treat specific problems such as women’s inability to have orgasms and men’s erectile problems. Performing these exercises often evokes strong feelings that are then explored through psychotherapy. People who have experienced sexual trauma or are confused about their sexual identity may need to spend more time working through their feelings. For couples, who make up the majority of clients, the focus is on improving communication and developing greater intimacy.

In looking for a sex therapist, it is particularly important to find someone who you trust and respect. Do not be afraid to ask questions about the therapist’s background, philosophical orientation, and experience with your problem.

“A sex therapist can be very influential,” says Gina Ogden, a certified sex therapist in Massachusetts, “because there are fewer people who you can talk with about your sexual issues.” She warns against therapists who have rigid ideas of what human sexual response should be. Myles agrees, “Sex is such a subjective experience. You cannot impose your own beliefs on a patient.”

Most sex therapists today, according to Dennis Sugrue, “look at the whole person and try to help men and women redefine what it means to make love.” The effects of aging or physical problems “do not mean that a couple cannot experience the pleasure and joy of being physically intimate with each other.”

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