Certain concepts get entrenched in popular as well as professional psychology. They remain in common usage long after the field has come to a better or fuller understanding of the phenomenon. It seems to me that in becoming clichés these ideas prevent us from understanding the psychological processes involved and from approaching them in a truly constructive way. Here are some of the concepts that most obviously cause me trouble in sex addiction treatment.
Self-esteem is probably my all-time biggest pet peeve. There is such a thing as low self esteem, or poor self concept. And so it seems logical that we would strive for “high” self esteem as a solution to the problem. But the problem is not simply one of changing our assessment of our own worth from “low” to “high.”
First of all the problem of low self worth is tied into the process of judging oneself. Whether we judge ourselves to be inadequate or marvelous we are engaged in evaluating how we measure up, usually compared to someone else. So instead of being able to feel confident and unselfconscious, we are looking at ourselves (usually from the outside, as someone else would look at us) and making an assessment.
Regardless of what the verdict is, the process is one that is built on insecurity and that takes us away from functioning freely in the moment. Rather than placing the emphasis on whether we admire or despise ourselves, I like to talk about things like “self-efficacy” and “self-activation.” These are the strengths that allow us to stick up for ourselves, pursue our goals, and not be hamstrung by worrying about how we are doing or what others think of us.
Anger management is another misleading concept. It sounds good—so good an entire industry was built on it which promises to remedy dangerous and destructive behavior patterns. I am referring of course to the “traffic school” programs for people with aggressive acting out problems like hockey dads and spouse abusers.
The misleading part is that, as it is commonly used, the idea of anger management suggests that we can learn how to “handle” our anger. This may be true in some ways but it can lead us to ignore what most people now believe: that anger is never the primary emotion. Anger is itself a way to manage another emotion, such as pain, fear, shame, etc.
When someone experiences undue anger, we should be working with the whole person including their underlying wounds and insecurities, rather than with just this one type of overt expression or action. If we try to “manage” it we forfeit a chance to look at it as a symptom of something and use it in a way that will help the person grow.
I prefer to approach anger by working through the reactivity that comes from early trauma as well as the more behavioral techniques of assertiveness training and learning healthy communication skills.
Child abuse is a serious concept. It is only misleading because it is popularly used in a narrow way to mean physical, sexual or verbal/emotional harm inflicted on a child.
Many of my clients cannot understand why they have sex addiction or other problems when they can’t identify any kind of abuse in their childhood history. In other words they can only see childhood trauma and abuse in terms of these very overt and extremely visible kinds of harm.
In fact we now have a much broader understanding of the concepts of child abuse and childhood trauma. In current thinking, a relationship with a caregiver can be seen as abusive when that caregiver is emotionally unavailable or unresponsive, is not able to be appropriately nurturing, supportive and validating, or induces abandonment fear or other severe stress. All these things can traumatize a child and lead to serious problems in the child’s learning normative developmental competencies including distress tolerance, behavioral control, self protection, learning, attention and empathy.
We all get lazy in our use of words and reach for the word that comes most easily to mind, myself included. But as our understanding of psychological phenomena changes I think it is important to occasionally go back and look at how we use concepts and whether they are continuing to serve a useful function or are due for an overhaul.