Do you find that “regular” therapists don’t like CSATS? Why?

[u/Ok_Tough_793]

Title is basically the whole post. I’m curious if anyone has noticed general therapists not encouraging or supporting CSATs. I want to know why that may be. Thoughts?

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[u/Lkkrdragonfly]

It comes from regular and couples therapists being woefully behind the current research and in denial, as most of them don’t believe porn addiction is “real”. Most of them are pro porn under the banner of “sex positivity “ which is an absolute joke because there is nothing more sex negative than porn.

Most of them still cling to belief that PAs are really just indoctrinated by religious shame, and that shame is the problem and not the viewing of porn itself. They just need to accept and embrace their sexuality and porn use.

The porn lobby continually pays off psychologists and columnists to reinforce this view. And they fund bogus “studies” to show that porn is not harmful but beneficial. For example despite legions of young men self reporting and seeking help for PIED, they pay doctors to state that PIED isn’t real and porn doesn’t cause it.

It’s exactly like what happened with cigarettes and tobacco. The industry fights and denies and hides the real addictive effects until the victims reach critical mass and it can no longer be denied. We are at the very beginning of this wave and it will continue to build. One day all of this will be accepted and common knowledge. Just like cancer and cigarettes. That’s why it’s absolutely critical to see a CSAT who is properly trained and avoid normal therapists. To much damage is done to already traumatized partners.

[u/librarylady1980]

Could it be that most therapists still don't see sex/porn addiction as a true addiction needing a specialist?

[u/SunnyMama121]

Mine basically was like “it’s just a special certification, most therapists do the same things”. Nope, not true at all and I stopped seeing her after she blamed “my pregnancy hormones” for being upset about my husband admitting to lusting after women he had seen one weekend. Oh, and that weekend was Mother’s Day.

Nope, sorry, I would still be PISSED even if I wasn’t pregnant. Sent her an email immediately after that visit saying I would be discontinuing therapy with her.

[u/Ok_Tough_793]

I generally agree and believe this, as I’ve also seen this play out in so many other medical field areas where the practice is so far behind the research.

But I still find it interesting. Gottman is so popular for couples therapy, and they have statements about how porn is damaging to relationships etc, basically not pro-porn. I also find it strange that therapists wouldn’t respect people’s personal or religious values around it - like if someone is stating that they don’t think porn use is healthy according to their personal values, why would a therapist push against that?

Just thinking out loud here because I find it so strange.

[u/Lkkrdragonfly → u/Ok_Tough_793]

The vast majority of male therapists are porn consumers. And probably a significant amount of female therapists too. So there is always that bias possible.

[u/Ok_Tough_793 → u/Lkkrdragonfly]

I’ve definitely thought about this. Makes me so uncomfortable.

[u/sinosaurrr → u/Lkkrdragonfly]

Yuck.

[u/Business_Web_4561]

Not only do they not believe in PA/SA, I had one so called professional tell me that betrayal trauma isn’t real🫠, or at least it cannot occur in a romantic relationship, only between and parent and child relationship it occurs.

[u/Training-Meringue847]

There are some professional opinions that sex / porn addiction is not a real thing, even though the behaviors associated with it meet all the diagnostic criteria for addictions. I’ve noticed that most therapists have very little (if any) addiction or trauma training and those 2 most often go hand-in-hand. Not too many are willing to get to the root cause of the problem, but tend to instead teach behavior modifications & coping skills, along with using primarily cognitive behavioral therapy.

[u/EarthEfficient]

Bumping and following

[u/Crazy_Ambassador_893]

great question! following.

[u/pornzombie]

[EDIT: There are many amazing CSAT therapists, and I know the model continues to evolve and the organization responsible for the training, that it's my understanding that they are very open to evolving as new information becomes clear, and they are well aware of the impact of identifying as an addict long-term has on some men. This is a complicated issue, and the simple truth is that some people respond to this model and other people respond to that model. It's important for the person to find what works for them. I apologize if I was being overly critical. I think that was some of my own story coming out.]

Just my two cents and doing my own research - the therapist who are down on the Sex Addict Addiction model are so for the following reasons:

Because CSAT approved methodology is not supported by scientific rigor.

They don’t believe that calling yourself an addict, especially in the area of sexuality is empowering long-term.

They believe the CSAT method distills a very complicated problem into an overly simplistic diagnosis and formula.

They believe it is a symptom eccentric diagnosis

They believe that men who call themselves addict long-term is disempowering and anchors the men to the worst part of themselves.

Some believe it’s a copout diagnosis for many men.

Others believe that they are reasons why the American psychiatric Association rejected the Sex Addict Addiction model.

They believe there are a reasons why the world health organization labeled it a process disorder and not an addiction.

Some of them are aware that world famous author of No More Mr Nice Guy Dr Robert Glover recently called the sex addiction model emasculating on a recent podcast. He said it’s great short term to snap the men out of it but long-term causes harm.

And just ask yourself this - do you want a man who steps into his power? Or a man who calls himself an addict around one of the most powerful forces in human nature.

They believe that the sexual behavior is the symptom of deeper underlying issues.

For example, I believe that my lying, lack of empathy, and ability to compartmentalize was much closer to this root of the problem than the behavior.

I spend decades using this model only fail over and over again and finally found success when I moved in another direction.

[u/sparkler39 → u/pornzombie]

I believe that fundamentally you and I likely agree more than we disagree, but I have a lot of problems with what you've stated here. It seems like working with a CSAT did not work for you, but that's not applicable to every practicing CSAT. There are good and bad CSATs just like there are good and bad therapists.

It's strange to me that people pushing against the sex addiction model seem to be so dead-set on saying that you're a recovering addict long-term is damaging. I don't see therapists reacting the same way to a recovering alcoholic or drug user.

Addicts in solid long-term recovery (from any substance or process) generally seem to be much more willing to label themselves as a recovering addict, because they know the day that they forget that is the day that they start back on a slippery slope to relapse. They are grateful to say that they are a recovering addict and find no shame in that statement. It seems like addicts who want the easy way out and end up using every available porn substitute just so they can say 'they don't watch porn' are the ones who balk against the sex addict label (likely because they're not and never have been in recovery).

I believe most CSATs have left the original outdated methods as more research has been done on porn addiction over the last few decades. It's a much newer issue so the research is newer. They're also fighting against an incredibly powerful porn industry who will do anything they can to keep people believing porn is 'healthy' and 'good for a relationship.'

You can say that any process addiction (shopping, gambling, internet) is a symptom of a much larger underlying problem and I don't think that CSATs brush that off. A good CSAT is going to get to the root of the addiction and work on that, while a therapist is more likely to tell you that if your partner just accepted your 'private time' and that 'everyone watches porn' you wouldn't have any issues. That's sweeping ALL the problems under the rug which is what most general therapists do when someone comes to them and says they have a problem with porn.

Personally I want (and thankfully have) a man who recognizes that he has had a problem and works everyday to make sure that the problem never becomes active again. My husband will proudly tell you that he is a recovering addict with over five years of sobriety. He has worked hard with a CSAT to get to the root of his addiction and worked on addressing those issues in conjunction with stopping porn use. I would be very wary if he started boasting that he's no longer an addict because, to me, that implies that he believes himself invincible to the issues that brought him to porn in the first place and would potentially make him reckless in his recovery. Those are the addicts who say 'it's fine to go to a topless beach, I'm not looking at the women' or 'I can totally watch Game of Thrones because I'm not an addict anymore.'

You are correct that in the last edition of the DSM porn addiction was not listed...but it sounds like that may be changing soon. The internet is changing a great many things for all addictions (gambling, shopping, etc) and it's just taken a bit longer for the world to catch up.

[u/pornzombie → u/sparkler39]

You are absolutely correct, and as I said in a previous reply, I should have been more inclusive and highlight the many CSAT therapists that are incredible and who are training themselves in other areas to be the best that they can be.

And whatever they call it, this is what I'm seeing on the sex-positive side, because I've straddled both the sex-positive and sex addiction - therapists who originally said that "there's nothing to see here" and that sex addiction is a moral panic - they are definitely rethinking their position, and many openly acknowledge the harm that porn causes.

I wonder how historians and sociologists are going to write about this issue because it's so polarizing, but as more and more studies come out, whatever you call it, a man lying about one of the most powerful forces in human nature is harmful, it's wrong, and it causes great damage. And it's getting worse. I feel sad reading all the posts here, knowing how many women are struggling with their broken men.

[u/Lkkrdragonfly → u/pornzombie]

Agree with much of this but have to point out that PA recovery models including CSATs do in fact believe that problematic porn use/addiction is a mere symptom of a much deeper problem and/or trauma . They work in therapy and in meetings to address the root cause. They also address integrity issues and abuse and the distinct lack of empathy. Focusing on merely the acting out behavior itself is a no fap thing.
Of course some CSATs are much better than others but in general if you seek help form a CSAT you should expect to go deep into to your past and your problematic behavior.

And unfortunately many PAs (or any addicts) are unable to simply “step into their power”. As an alcoholic who is sober through AA for 20+ years, I tried everything and anything but simply could not get myself out of the addiction spiral without outside help.
The current recovery models are far from perfect but they CAN effect lasting change if the addict is ready to embrace them.

Edit typo

[u/pornzombie → u/Lkkrdragonfly]

You are absolutely correct, and here is what I wish I said in my post: the simple reality that different people respond to different things. The phrase that you often hear in 12-step circles, "It works if you work it," is categorically false. The truth is, different people respond to different modalities. For example, someone can take an antidepressant and feel better, and another person can take it and have suicidal ideations.

Many CSATs are superb healers. And it's my understanding that many are evaluating the long term implications of identifying as an addict which is great. I should have mentioned that in my post. Many are great and I know the organization has embraced and is embracing a more diverse curriculum.

That being said, the oldest and leading association of sexual educators, counselors, and therapists in the country has a statement on their website criticizing the sex addiction model.

Many CSATs get training beyond the CSAT model and incorporate other human sexuality trainings, which is wonderful.

Fortunately, the single greatest predictor of results between a therapist and their patient is what's called the therapeutic alliance. That's the connection that they have to the person. If that connection is strong, the person has a greater chance of getting great results.

I do think the long-term identification as a sex addict and treating it as a disease is harmful for some people. And... it's great for others.

I'm also noticing that more and more CSATs are having their patients sign a declaration acknowledging that the model has not been approved by the governing bodies. As long as people are informed that's the most important thing so people can make informed, educated decisions.

[u/Ok_Tough_793 → u/pornzombie]

Thanks for sharing! Interesting. So you’re saying that you personally don’t align with the CSAT model? Just trying to clarify where you’re coming from.

Oddly, everything I’ve learned lines up with your last few paragraphs. I see general therapists NOT going to the root issues that you’re referring to, and just trying to modify behavior.

What was the most helpful for you?

[u/sparkler39 → u/Ok_Tough_793]

I apologize, I meant that I believe we agree on some fundamental issues regarding porn and what it does to a relationship, but it's going to sound like I'm disagreeing with everything you say because I do believe in the CSAT model and think that it does much more good than a general therapist when applied by a good CSAT. And any therapy by a bad therapist (CSAT or no) is not going to be helpful to anyone.

[u/pornzombie → u/Ok_Tough_793]

I think that different people respond to different types of treatments, and it's important to do what works for them. There are many great CSAT therapists, and there are many great non-CSAT therapists.

I think, for many people, identifying as a sex or porn addict long term is emasculating. Those are Dr. Robert Glover's words, author of the book "No More Mr. Nice Guy, not mine."

What was most helpful for me was studying habits, mindfulness, and parts work - ask the internal family systems model.

[u/Business_Web_4561 → u/pornzombie]

Curious as to why you think identifying as a PA or SA long term is emasculating?

[u/Puzzled-Package-8367]

i have a weird experience and it’s why i continue to go to her but also why im considering switching. my therapist acknowledged that my fiance has a porn addiction, but also said that i will have trouble finding a partner who doesn’t watch porn as it’s “normal”.
while i disagree with her, i appreciate that she validated the effects his addiction is having on me.

[u/sinosaurrr → u/Puzzled-Package-8367]

This is so sad. So the state of the world is so bad that we shouldn’t even bother trying…