What a difference a week makes. As recently as last weekend, the internet was awash with another tiresome round of sensationalized stories proclaiming that sex and porn addiction aren’t “real”. This latest flare up owed in large part to the release of a “Position on Sex Addiction” by the American Association of Sexuality Educators, Counselors and Therapists (“AASECT”) disputing the foundations of longstanding sex addiction therapy methods. The content of these stories wasn’t anything new. But the response to them sure was.
Spurred on by some surprisingly candid revelations by one of the AASECT statement’s architects, a chorus of sex addiction therapists, advocacy organizations, and commentators (including yours truly) responded with pointed criticism of the AASECT statement and the stories it had generated in the popular press. We pointed out the questionable motives for the statement, the logical fallacies it contained, and the dumbed-down reception it received. We questioned its seeming ignorance of a body of scientific research on sex addiction. And, most of all, we decried the shame and confusion the statement sowed among the very people AASECT claimed to want to help - those suffering from compulsive, addictive behavior involving sex and porn.
On December 14, one of the most notable responses to AASECT’s statement appeared on the web site of the International Institute for Trauma and Addiction Professionals (“IITAP”). IITAP is the organization principally responsible for developing sex addiction therapy methods and training sex addiction therapists. We described IITAP (accurately, we think) in our most recent blog post as AASECT’s rival in the sexuality practitioner certification marketplace.
In its response, IITAP struck a remarkably conciliatory tone. It praised AASECT for advancing sexual rights, particularly among LGBTQ, kink and polyamory populations. It acknowledged AASECT’s criticisms of IITAP’s historic deficiencies in training therapists on issues of sexual diversity. It also noted that AASECT’s “Position on Sex Addiction” constitutes a softening of AASECT’s historic stance on sex addiction, reflecting AASECT’s own acknowledgement of deficiencies in its curriculum. For instance, IITP observed that AASECT has recently introduced training for AASECT members in treating out-of-control sexual behaviors.
Most significantly (in our view), IITAP lamented the “unnecessary intellectual rock throwing” that has emerged over time between IITAP and AASECT members, resulting in “fractionalization” that prevents “integration of knowledge between groups that could easily learn from each other”. Echoing the criticism others had leveled at AASECT’s statement, IITAP noted that this needless “rock throwing” contributed to sensationalized stories in the press that do nothing but confuse and stigmatize people suffering from out-of-control sexual behaviors. In a full-throated call for a ceasefire, IITAP urged “the various sexual health organizations to come together in the best interest of [their] clients—working to legitimize and de-stigmatize this issue, so the people suffering will know there is hope and help.”
We are thrilled by IITAP’s statement. Then again, in PornHelp IITAP is preaching to the proverbial choir. What matters more is whether folks on AASECT’s side of the fence heard our collective criticism and IITAP’s call for “cross fertilization of theory and knowledge”.
Happily, it seems that at least one prominent AASECT member did. The same day IITAP’s position appeared, AASECT Board Member Dr. Ian Kerner penned this article for CNN. Though the article avoided any mention of AASECT or Dr. Kerner’s leadership position, it read like a point-by-point acknowledgment of many of the biggest criticisms IITAP and others leveled at AASECT’s “Position on Sex Addiction.” Among other things, Dr. Kerner acknowledged that many people suffer from compulsive, addiction-like sexual behaviors, that therapists from both the IITAP and AASECT camps provide valuable and valid help for those people, that IITAP rejects harmful “reparative” therapy, and that scientific evidence exists of links between out-of-control sexual behaviors and addiction.
Of course, the article wasn’t perfect. Its title, “Is sex addiction real? Depends on whom you ask” had an unhelpfully reductive ring to it. And, Dr. Kerner devoted column space to some questionable tropes (“sex addiction is about avoiding responsibility”) and suspect voices (including Dr. Michael Aaron, whose column crowing about how he used “guerrilla tactics” to push AASECT to issue its “Position on Sex Addiction” is a shining example of “unnecessary…rock throwing”). But, on the whole, we find Dr. Kerner’s recognition that many of his clients experience compulsive sexual behaviors as addictions, and his resolve to help them despite his personal doubts about the “addiction model,” refreshing. This, to us, feels like the sort of “coming together” that IITAP’s statement encouraged.
So, what’s next? We’ve seen a week of attention (finally) being paid to helping, instead of belittling, people who struggle with sex and porn addiction. Will this nascent detente between the IITAP and AASECT camps endure? We hope so. But, even if the cessation of hostilities proves short-lived, let’s hope it serves as a lasting reminder of how calm and reasoned voices of criticism and conciliation, when they speak frequently and widely enough to be heard, can lower the temperature of a heated conflict. For all of us who share the mission of helping people with out-of-control behaviors involving sex and porn, (re)learning that lesson is a victory in itself.
We have written about the public “debate” over sex and pornography addiction, and have been especially critical of news stories that attempt to reduce complex issues into simplistic headlines. Intentionally or not, news articles blaring “Porn/Sex Addiction Isn’t Real” perpetuate the stigma of problematic sexual behavior. By dumbing down highly complicated and emotional issues, they confuse people in pain who want - need - to find help.
Late last month, an announcement by the American Association of Sexuality Educators, Counselors, and Therapists (“AASECT” for short) kicked up the dust storm yet again. In what was billed as a “historic position statement”, AASECT rejected addiction-centered treatment methods for problematic sexual behaviors. Specifically, as of today “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.”
Predictably, media outlets translated this as confirmation by “experts” that sex and porn addiction aren’t “real," or worse, that they're a "hoax." Absent from these stories was much (if any) analysis of the nuance in AASECT’s announcement. For instance, AASECT acknowledges that people do suffer from out-of-control behaviors involving sex and porn, and that those people do need help. But, AASECT believes there is insufficient empirical evidence to establish these behaviors as addiction-type “mental health disorders”, and therefore believes it’s inappropriate to use addiction-focused therapies to treat them. Finally, and perhaps tellingly, AASECT claims that therapists who do follow the “addiction model" lack “accurate human sexuality knowledge”.
Journalists also failed to point out an important omission from AASECT’s statement. Lost in the attention-grabbing hoopla over whether sex and porn addiction are “real” was AASECT’s tacit admission that it has no clear recommendation for how therapists should counsel people with problematic sexual behaviors. Instead, stealing a page from the official Paul Ryan “Repeal and Delay” Playbook™, after trashing the longstanding “sex addiction model” of treatment, AASECT offered only its support for a “collaborative movement to establish standards of care supported by science, public health consensus and the rigorous protection of sexual rights.” That sounds to us like AASECT kicking the can down the road.
So what are we to make of this? And, by “we,” we mean the people struggling with problematic porn use who are the consumers of the therapy services AASECT’s announcement covers. Should we use it as guidance in choosing a therapist? If so, what good is a therapist if he’s waiting for a “collaborative movement” to tell him how to go about helping us? Some background might help us answer those questions.
AASECT is a certifying body for sexual health practitioners, most notably for the “Certified Sex Therapist” (“CST”) certification. AASECT competes for prominence in the sexuality practitioner certification marketplace with the International Institute for Trauma and Addiction Professionals (“IITAP”). IITAP was founded by Patrick Carnes, the godfather of “sex addiction” treatment methodology, and a founder of the Society for the Advancement of Sexual Health (“SASH”). IITAP is the certifying body for the Certified Sex Addiction Therapist (“CSAT”) certification.
In other words, AASECT and IITAP are rivals. The "sex addiction model" AASECT has rejected is the method of therapy promoted and taught by IITAP. When AASECT took a poke at addiction-centered therapists who purportedly lack “accurate human sexuality knowledge”, it was undoubtedly referring to IITAP-certified practitioners. Seen in this light, AASECT’s announcement looks a lot like a shot fired in a (highly niche) turf war between competing professional certification bodies.
An article published on the website Psychology Today by one of the practitioners behind the AASECT announcement, Dr. Michael Aaron, gives credence to that view. Dr. Aaron holds a Ph.D. from the American Academy of Certified Sexologists, and has been certified by AASECT as a CST for “over three years.” In his Psychology Today article, he describes how he led an effort to combat “hypocrisy” within AASECT surrounding sex addiction treatment. Dr. Aaron believes the “sex addiction model” of therapy is “extremely destructive to clients” in that it purportedly addresses “sexuality concerns from a moralistic and judgmental perspective.” For this reason, he sees “the sex addiction model as directly at odds with the sex-positive messaging that AASECT ... [is] trying to project.”
Finding AASECT's tolerance of the "sex addiction model" to be "deeply hypocritical", in 2014 Dr. Aaron set out to eradicate support for the concept of “sex addiction” from AASECT’s ranks. To accomplish his goal, Dr. Aaron claims to have deliberately sowed controversy among AASECT members in order to expose those with viewpoints that disagreed with his own, and then to have explicitly silenced those viewpoints while steering the organization toward its rejection of the “sex addiction model.” Dr. Aaron justified using these “renegade, guerilla [sic] tactics” by reasoning that he was up against a “lucrative industry” of adherents to the “sex addiction model” whose financial incentives would prevent him from bringing them over to his side with logic and reason. Instead, to effect a “quick change” in AASECT’s “messaging,” he sought to ensure that pro-sex addiction voices were not materially included in the discussion of AASECT’s course change.
Dr. Aaron’s boast comes across as a little unseemly. People rarely take pride in, much less publicize, suppressing academic and scientific debate. And it seems odd that Dr. Aaron spent the time and money to become CST certified by an organization he deemed “deeply hypocritical" barely a year after joining it (if not before). If anything, it is Dr. Aaron who appears hypocritical when he criticizes pro-“sex addiction” therapists for having a financial investment in the "sex addiction model", when, quite obviously, he has a similar investment in promoting his opposing viewpoint .
And that, to us, is the key to understanding the real significance of the AASECT announcement. Dr. Aaron’s pride in suppressing debate and driving AASECT to reject the “sex addiction model” of therapy makes sense if we think of his efforts as an exercise in brand differentiation. Commercial motive is a common denominator for all professional therapists to some degree. AASECT-certified therapists trade on their CST certifications the same way IITAP-certified therapists trade on their CSAT credentials. But for would-be consumers of therapy services, it’s hard to distinguish between the two certifications. Both require adherence to strict sets of ethical guidelines, including non-discrimination and acceptance of sexual diversity. Both also stress the importance of promoting client sexual health. Heck, the abbreviations for the certifications are even confusingly similar.
Could it be that Dr. Aaron recognized this, too? Without a clear distinction between his CST certification and his competitors’ CSAT certifications, Dr. Aaron may have recognized that he was trading on a poorly-defined brand that could easily be confused with a viewpoint with which he disagreed. That could explain why he joined up with AASECT (“deeply hypocritical” though it was), and promptly undertook an unpopular and controversial effort to drive a wedge between AASECT and IITAP over the headline-grabbing issue of “sex and porn addiction”. Seizing on the stigma attached to the word “addiction”, Dr. Aaron pushed AASECT to discredit the longstanding methods of its competitor, IITAP. It was a clever stroke of political and marketing insight: no one wants to be labeled an “addict,” so why not define AASECT-certified therapists as people who will treat your out-of-control sexual behaviors without calling you one?
All of which would be fine and dandy if AASECT managed the rest of its message a little better. But, by endorsing the reductive message that “sex and porn addiction aren’t real”, AASECT allowed its statement to be communicated as a categorical rejection of the fact that people actually do suffer from problematic, compulsive sexual behaviors that feel, to them, like addictions. AASECT also compounded its error by punting on the most important question: how AASECT-certified therapy would be different from addiction-centric therapy. And then there's the baffling refusal of the folks on the AASECT side of the turf to so much as acknowledge the body of scientific evidence that supports an addiction-based approach to out-of-control sexual behaviors. In short, in making a big deal of its rejection of the “sex addiction model,” AASECT (inadvertently, we hope) sowed still more confusion and shame for the people it purports to want to help.
For what it's worth, those of us who have consulted therapists trained in the “sex addiction model” (CSATs certified by IITAP, mostly), have found that they are not moralizing or judgmental in the main. Our collective experience has been that CSATs do not use shame to address our behaviors. They show a great deal of empathy, in fact. CSAT therapy, in our experience, aims at helping us understand how and why our behaviors are unwanted, and at coming to terms with those behaviors that have been most destructive to things we care about. In that respect, we suspect we’d find a similar approach used in AASECT-certified therapy (and we invite anyone with experience in that regard to comment below). Yes, IITAP-certified therapists may use a vocabulary of addiction to address our issues. But frankly, by the time most of us seek help, we don’t really care about labels all that much. We just want help controlling a personally destructive cycle of behavior, guilt and shame that has taken over our lives. Many of us have even found comfort in giving our problem a name - even if the name is "addiction".
Bottom line: AASECT’s announcement may be “historic” for AASECT-certified practitioners, but to those of us who may consume their services, it doesn’t feel particularly enlightening. If AASECT really wants to make a meaningful difference in the therapy marketplace, it should advertise exactly how its therapists are trained to approach treatment of out-of-control sex and porn use issues. Instead of telling us how “bad” the “sex addiction model” treatment we’ve been receiving is (contrary to the experiences of the vast majority of us), it should tell us how its alternative treatment model will be better. And, instead of completely ignoring the body of scientific research that appears to run contrary to its position on the links between out-of-control sexual behavior and addiction, AASECT should explain why it disagrees with that research.
Until then, we're going to be wary of buying whatever it is AASECT is selling.