We talk a lot in treatment about compulsive behaviors functioning as self-soothing mechanisms. In the 5-Day Intensive Outpatient Program, we construct a genogram of each participant’s family history. Invariably, someone will say “Yeah, whatever. I don’t want to waste time blaming my parents for my being a sex addict.”
It’s always tough at this juncture. As clinicians, we want clients to accept responsibility for choices made. Yet we also want to present some explanations (not justifications and not excuses!) for how these coping mechanisms might have come into being: What emotionally dysregulating material is present, and how does sexually compulsive behavior obliterate those intolerable feelings?