What the Out of Control Sexual Behavior (OCSB) model allows for in the Individual and Group Psychotherapy phase, and what the Sex Addiction model fails to address, is healing focused on identifying and attending to the underlying causes of compulsive sexual behavior. As one example, I believe the impact of sexual trauma–including sexual abuse, incest, unwanted sexual encounters, etc.–can last long after the threat has ended and frequently underlies compulsive sexual behavior (among other symptoms such as anxiety and depression). I have also observed how addressing the trauma rather than only attacking the related compulsive sexual behavior or related symptoms can be a more effective approach. As a result, the integration of Contemplative Psychology, Commitment and Acceptance Therapy (ACT), and Somatic Experiencing (SE) has been instrumental in my work with healing the effects of trauma and compulsive sexual behavior.
Commitment and Acceptance Therapy (ACT) in Sexual Abuse Counseling
ACT is a way of working with the client in which acceptance of whatever arises in the present moment, including difficult thoughts and emotions, is cultivated through awareness. Hayes, Strosahl, and Wilson (2011) describe human suffering as a “kind of allergic reaction to our own inner world” (pp. 18-19).” As a result, “a goal of healthy living is not so much to feel good as to feel good (Hayes, Strosahl, & Wilson, 2011, p. 23). In other words, it is to build the capacity to feel and tolerate all that arises. This is because it “is psychologically healthy to have unpleasant thoughts and feelings as well as pleasant ones, and doing so gives us full access to the richness of our unique personal histories” (Hayes, Strosahl, & Wilson, 2011, p. 23). It is my experience that ACT provides the latitude to explore these sometimes difficult histories in a way that does not solidify around them, so they can be better understood and integrated.
Somatic Experiencing (SE) in Sexual Abuse Counseling
SE a way of working with the client in which awareness is brought to the body, particularly the level of activation and deactivation of the nervous system, rather than focusing on the narrative of the trauma. Levine (2010) states, “Trauma occurs when we are intensely frightened and are either physically restrained or perceive that we are trapped. We freeze in paralysis and/or collapse in overwhelming helplessness” (p. 48). As a result, he concludes that trauma is not a disease or an event, but rather a sympathetic state of arousal that continues to live (in an incomplete state) in the nervous system well after the event has completed (Levine, 2010). In order to confront past trauma, Levine constructed the SE framework that includes: (1) establishing an environment of relative safety, (2) exploration and acceptance of physical sensation, (3) using pendulation (i.e., movement that cycles between activation and deactivation) and containment to initiate a rhythm of activation/deactivation in a titrated manner, (4) providing a corrective experience that empowers defensive responses that were not able to complete, (5) decoupling the associated helplessness/maladaptive responses from the biologic immobility response that occurred, (6) resolving hyperarousal states through guided discharge/release, (7) engaging self-regulation, and (8) orienting to the here-and-now by contacting the environment and reestablishing the capacity for social engagement (Levine, 2010, p. 74). It is my experience that this approach provides an opportunity to process and integrate trauma, which may include sexual trauma, in a way that reaches beyond the narrative to include the body.
Hayes, S., Strosahl, K., & Wilson, K. (2012). Acceptance and commitment therapy: The process and practice of mindful change (2nd Edition) [Kindle Edition]. New York, NY: The Guilford Press.
Levine, P. (2010). In an unspoken voice: How the body releases trauma and restores goodness. Berkeley, CA: North Atlantic Books.