Therapy can be too intimate for a sex addict

Sex addicts present their own particular pitfalls for a therapist.  Sex addicts by definition have some kind of intimacy disability.  They have been unable comfortably be themselves in an intimate relationship and have led compartmentalized, deceitful lives.

The sex addict sitting across from me wants to avoid being open and intimate.Therapy is a frightening situation because it is supposed to be one of vulnerability and openness. 

The sex addict will typically look for a way to change the nature of the relationship.

The sex addict client wants control

The need to avoid emotional connection and vulnerability in therapy leads the sex addict to reach for his or her tried and true ways of gaining control over a situation.  I want to go one place and they want to go another.  And their strategy often reflects some version of their sexual acting out behavior.


Many sex addicts in treatment behave in seductive ways (being coy, pleasing, familiar, flirtatious, or flattering.)  The important point is that some sex addicts feel that they are only valuable for their sexual appeal.  This too is a way for the sex addict to use familiar tactics in order to feel more powerful in an intimidating situation.

The challenge for me is to get past the seducer’s self-objectification and talk to the real person underneath, the person the addict feels is “less than.”

Sexualizing communication

One sex addict dodge is to indirectly sexualize the therapy situation (most sex addicts are too smart to do something overtly sexual).  This behavior can be subtle such as using graphic sexual talk the hope of having some uninvited, intrusive impact on me.  This is a small scale sexual intrusion that can give the client a sexual “hit” and also makes him feel less anxious and more in control.  This is not unusual or alarming and can be talked about in a way that is not accusatory or shaming.

Money and power

Another way that the sex addict may use the therapy situation to “act out” is through the inherently transactional nature of the therapy situation.  I am providing a service and the client is paying for it.  For addicts whose primary area of sexual acting out involves paying for sex, the therapy situation can carry this baggage.

Some addicts who are aroused by gaining power  over another person will try to play the role of the benefactor.  This can be expressed in therapy by giving me gifts, help or advice.  As they gain confidence in recovery and through therapy most addicts let go of this.

Playing the child role

Many sex addicts have childhood histories that leave them emotionally immature and fearful of displeasing an authority figure.  They may place me in a parent role and feel that they have to be a “good boy.”  Underlying this there may be a great deal of resentment against parent figures.

Many over-compliant clients need practice sticking up for themselves, disagreeing with people including me, and learning to be assertive in expressing their needs.

Sexual shame and secrecy

Secrecy is pervasive in sex addicts in or out of treatment.  The shame that the addict feels, even with a helping professional, can be enough to cause them to lie about, minimize or hide things when talking to me.

But a therapist cannot be a detective.  I can only make it as safe as possible for the addict to be honest.   I can be non-judgmental and authentic  in the way I talk about their behavior.

All clients use the therapy relationship to act out areas of conflict like issues with women or authority.  This is not something to be dodged or stamped out.  It is part of how therapy works.  The way the sex addict deals with me is a kind of projective test in which the client’s feelings, core beliefs and thought distortions are brought out and explored.