Doing It Until We Need Glasses (Or Not)

There are a great many statistics – not all of them obtained scientifically – regarding the frequency of sex among long-term committed/married couples. A quick Internet search will yield a surprisingly wide variation in what is thought to be a “normal” or “healthy” amount of sex for married people. So much for Internet searches. That said, the most scientifically reliable data comes from the General Social Survey, which has tracked American sexual behaviors since the early 1970s. According to the GSS, married couples of all ages have sex an average of 58 times per year. But this number lumps 29-year-old newlyweds into the same survey sample as 70-year-olds who’ve been married half a century, and I’m guessing that those in the first blush of love tend to get it on a wee bit more than couples who’ve been together for twenty-plus years with two or three kids and maybe even some grandkids to show for it. Recent GSS studies support this, finding that couples in their twenties have sex 111 times per year on average, with that frequency dropping steadily as couples age – perhaps as much as 20 percent per decade. Basically, younger married couples have sex twice per week, give or take, slowing over time to once or twice a month with the occasional extra session thrown in to acknowledge birthdays, anniversaries, and major holidays. That said, the frequency of sex varies widely depending on health, available time, and external circumstances (new kids, caring for a senior parent, etc.), not to mention each individual’s very specific sex drive.

For most of us, the holidays are a time of stress, anxiety, depression, loneliness, and a whole bunch of other uncomfortable feelings. Sure, even the most curmudgeonly among us is bound to experience the occasional, fleeting flash of peace, joy, love, and good will toward man. In these ephemeral moments we’ll pick up a few toys and drop them off at a donation center, write a check to our favorite charity, and send our mother a card – hoping she’ll assume we’ve sent everyone a card and will therefore stop bugging us about the “need” to remember friends and loved ones at the holidays, even if they’re no longer friendly or loved.

Fetish, fe•tish noun: an object or bodily part whose real or fantasized presence is psychologically necessary for sexual gratification and that is an object of fixation to the extent that it may or may not be required for complete sexual expression

—Merriam Webster, 2012

Sexual fetishes* are defined as recurrent and intensely arousing sexual fantasies, urges, and behaviors that incorporate specific roles and/or physical objects. Theses objects and roles are brought into one’s sexual life because they feel compelling to the individual and because they are a primary source of sexual arousal.

Involvement in and fascination with fetishistic sexual behavior lies on a continuum. Some individuals or couples may occasionally incorporate a fetish object or act to add a little spice into their sexual lives, while others are solely aroused by fetishistic behavior, finding sex to be neither interesting nor arousing without that element.

In other words, for some people fetishes are nonexclusive, meaning the fetish is only one element of a wider arousal pattern, whereas for others the fetish is exclusive, meaning the individual can’t become aroused without it.

While the majority of sexual fetishes are playful and harmless means of sexual arousal, some are also illegal, pathological and dangerous. This blog will focus on the less pathologic, better-known fetish behaviors. In future blogs we will discuss more profound fetish related sexual pathology.

Cross and Co-Occurring Addictions

Individuals who are cross-addicted are people who switch from one addiction to another—for instance, Suzanne stops drinking alcohol, then gains 40 pounds in three months, replacing booze with compulsive eating. People with co-occurring addictions struggle with multiple addictions at the same time—for instance, Eric smokes pot morning, noon, and night, and also plays video games for eight to ten hours each day.

Cross and co-occurring disorders are especially common with sex addicts. In one survey of male sex addicts, 87 percent of respondents reported that they regularly abused either addictive substances or other addictive behaviors. Considerable anecdotal evidence suggests that for a majority of sex addicts with a co-occurring addiction the secondary drug of choice is crystal methamphetamine. Sex addicts also use cocaine, crack cocaine, and almost any other stimulant—but crystal meth is usually cheaper and more readily available.

Consider Brad, a married, 38-year-old lawyer:

Stepping It Up in Treatment

Sex addicts, like many in early addiction recovery, are often highly resistant to the idea of attending 12-step recovery meetings. Their reasons are myriad and usually without merit, though they sure can sound convincing on first listen.

Basically, it boils down to this: individuals who hang out in adult bookstores, cruise local red light districts looking for prostitutes, download hard-core pornography on work computers and masturbate in their office during business hours, post hi-definition photographs of their exposed genitalia on dating websites, and openly announce their extramarital availability on Ashley Madison (with a face photo but without a second thought) are the same folks who become very concerned about being “spotted” at one of “those” meetings.

“What if someone sees me there and thinks I’m a pervert?” they fret. Never mind the fact that these meetings usually take place in churches, school classrooms and local businesses after hours with no neon signs announcing what’s going on. Resistance to change is what it is, and even though sex addicts invite risk when acting out, they are risk averse in terms of being seen in 12-step sexual recovery meetings like SAA, SLAA, SCA, SA, and SRA.

It is therefore up to the addiction therapist, when working with a 12-step-averse client, to bring the themes, neurobiological rewiring, and experience of 12-step recovery into the treatment arena—especially in a group therapy setting. Once the sexual behavior problem has been clearly assessed and client/treatment goals and expectations aligned, sex addiction treatment is well served by the therapist initiating discussions on themes like surrender, feeling out-of-control/powerlessness, developing personal integrity, asking for help, accepting responsibility, turning it over, establishing accountability, etc., all within the framework of cognitive behavioral treatment.

Pride and Problems

June is unofficially “Gay Pride Month,” when major cities around the world host gay and lesbian focused celebrations and events featuring parades, parties, festivals and forums. In Los Angeles (home of The Sexual Recovery Institute), Pride takes place this weekend, June 8th – 10th, in the form of a huge parade and a weekend-long outdoor festival.

And there is much to celebrate. Without doubt, the GLBT (Gay, Lesbian, Bisexual, and Transgender) community has come an incredibly long way since the American Psychiatric Association was labeling homosexuality as a diagnosable and treatable pathology in the 1960s and early 1970s.

In most American urban areas, gay people now can adopt children and openly build lives together without fear of repression or overt discrimination. Gay marriage is now legal in many countries (Canada, England, and Spain, to name just a few), and the topic is being addressed in the US.

Most notably, last month, for the first time, a US President spoke out in favor of marriage equality. But for every step forward, we slide a half-step back, and gay and lesbian people remain in many ways marginalized, stereotyped, and highly susceptible to prejudice, negative bias and oppression.

Just Go to a Meeting!

Sex addicts, like many individuals in early recovery, are often highly resistant to the idea of attending 12-step meetings. And, like all addicts, they often have clever and insightful but typically unproductive reasons for not going.

Some examples include: “That’s where the really sick people go, right, not people like me?” or “I can’t talk openly to a bunch of strangers. What will they think of me?” or “What if someone sees me there and tells someone I know?”

And it’s not like the urban or online sex addict is limited in terms of sex and relationship addiction 12-step meetings, as today numerous groups can be found both in-vivo on and the Internet—each with a slightly different focus and population (SA, SLAA, SCA, SRA, SAA, etc.). Yet for a variety of reasons, mainly fear of the unknown, attending therapy often seems a more palatable option than going to a 12-step recovery meeting. So be it.

Mark’s Story

Mark is a married, 35-year-old realtor. His wife, Janet, is a pharmaceutical sales rep who spends several days each week on the road. Both report that their sex life was great until just a few years ago, and Mark is not sure what happened. He used to look forward to the days Janet was home because he knew the first thing they were going to do was hop in bed and make passionate love. Even after the birth of their first child, the two always made time late evenings and weekend mornings for lovemaking. But no longer. These days when being sexual with Janet, Mark struggles to reach orgasm. He’s even started faking orgasms, just to get things over with. What Mark can’t understand is why he’s ready, willing, and able when he logs on to his favorite porn sites—something he does regularly when Janet is on the road—but he can’t function when he’s got the real thing right there in front of him. Mark is quite clear in saying he is not “bored” with his wife, and he continues to find her “sexy, exciting, and arousing.”

Is Porn Ruining Sex?

Mark is suffering from Delayed Ejaculation (DE), a problem that is more common than most people realize. Symptoms of DE include: taking longer than normal to reach orgasm; only being able to reach orgasm via masturbation; and not being able to reach orgasm at all. At first Mark didn’t mind because “lasting longer” is generally viewed as a sign of virility. He chalked it up to maturing as a lover, thinking he was now better at pleasing Janet. Unfortunately, as he and many others have discovered, there really is such a thing as too much of a good thing.

As with all sexual dysfunctions, there are numerous possible causes of DE, including: physical illness/impairment; the use of SSRI-based antidepressants, which are known to delay and in many cases eliminate orgasm; psychological factors with stressors like financial worries or family dysfunction—all of which can mentally distract men during intercourse. But one increasingly documented cause of both delayed ejaculation and erectile dysfunction is an over-involvement with—for some, addiction to—pornography and masturbation as a primary sexual outlet. This seems the most likely culprit for otherwise healthy men in the prime of life such as Mark.

Betty’s Story

Betty has been referred into treatment for a binge eating disorder (BED) by her long-time psychotherapist, who sees out-of-control patterns emerging that need to be addressed outside of the outpatient frame. Betty arrives 75 pounds overweight and has a number of health problems, but with the right combination of therapy and self-care she starts looking and feeling better than ever.

Once home and attending support groups and meetings, Betty finds that men are now taking note of her “improved look.” Betty finds herself both feeling sexy and wanting to be seen. So out she goes, looking for “the one” but settling instead for a lot of romantic attention and casual sex.

Eventually she finds “the one” and settles down into a committed relationship. Sadly, within a few short months of playing house Betty begins to gain weight and within 18 months, Betty has gained back 60 pounds, but also loses her new romantic partner who walks out the door not having gotten the woman he bargained for. This pattern plays out not once or twice, but nearly every time Betty gets into a serious relationship. It has never been identified.

Behind closed doors, millions of couples are harboring a not-so-dirty little secret: We still love each other, but we don’t have sex anymore.

Can a romantic relationship exist without sex? For an estimated 40 million people in the United States, the answer is yes. Whereas the average married couple over age 30 has sex 58 times a year (just over once a week), 15 to 20 percent of couples are “sexless,” according to national surveys.

What Does ‘Sexless’ Mean?

There is no shortage of opinions about what constitutes a sexless marriage. Some couples aren’t having sex at all, while others do the deed multiple times per week but would still describe their relationship as sexless. So how does a couple earn this dubious distinction?