I sometimes forget that I am meant to be a “sex therapist”. My journey of becoming one started in my early twenties, long before I had actually qualified. I worked as a lay counsellor in a reproductive health clinic, often finding myself holding the hand of a young woman I had only just met as she endured the termination of a pregnancy via “vacuum aspiration”. I didn’t really know what I was doing back then. I think I was simply able to effectively prostitute my need to care. I didn’t have much life experience or therapeutic skill to offer, but there was something about the willingness to stand there and bear witness to what a person was going through. Analyst, Adam Phillips, talks about the therapist as someone who “can bear what you have to say” implying that the more recent idea, that therapy should be “curative” (outcomes based) is a bit misleading. In my later years, I have realised that I made a career out of my almost pathological need to “be there” for other people. To the extent that I allowed for a certain invisibility of myself. In the end, I think we all just need a witness. We all long to be seen. As one of my favourite lines by Winnicott goes “It’s a joy to be hidden and a disaster not to be found”. For a conversation to be therapeutic it involves the experience of somehow feeling that something in you has been found or recognised. As Phillips puts it, if psychotherapy was a cure, it’s a listening cure and not so much a talking cure. It appears that there is something satisfying in hearing what you have to say, said back to you by someone listening with particular attentiveness.
I worked in the reproductive health clinic around about the same time that Viagra was launched in South Africa with much controversy. We ended up fielding a helpline for Pfiezer and every time they flighted an advert on television for Viagra, a share-call number would display at the bottom of the screen. These days, when you see a share-call number, you think of an entire call centre with disinterested administrators on the other end of the line. There was just an empty office in the clinic with a standard desk and telephone. Every time the phone rang, I would excuse myself from whatever I was busy with in the clinic and run to get to the call in time. Very few people called about Viagra but everyone wanted to hear that what they were thinking, feeling or doing sexually was entirely normal. From the young Hasidic teenage cross-dresser who had been “found out” by his parents to the woman wanting to know if it was “safe to use a wine bottle”.
By the time I had qualified, I realised that these secret sexual concerns that people had were just the starting point for conversations about their lives in general. Their “symptoms of sexual dysfunction”, as sexology so unhelpfully puts it, were just hints at a broader conversation that needed to be had. Where did the Hasidic cross-dresser find belonging? What intimacy did the woman with the wine bottle truly long for? And so, at some point, I think I deliberately forgot to be a sex therapist. A good therapeutic conversation should not be prescriptive of what should and should not be talked about.
Nevertheless, I sometimes find myself deliberately reminding clients that I am a sex therapist in the hope of permitting them to talk about the obvious – that sexuality is not a secret, separate compartment in our lives. When it comes to sex therapy; conversations about Kegel exercises, arousal patterns or Sensate Focus may be important, but they can also get in the way of a more meaningful conversation about what these struggles actually mean and how they even matter, in terms of the broader context of our lives. There is almost always an unspoken question that underlies every therapeutic conversation: What is it that you truly desire?
In the end, I sit with a great irony: the people who come to me to talk about sex usually end up needing to talk about so much more than that; and those who avoid the topic altogether are usually the ones that are most in need of talking about sex. We all have thoughts of which we feel we cannot speak; our tongues don’t seem to find their ways around the words. We either feel too much shame, we avoid the risk of judgment or rejection (even from ourselves as we hear our own words), or the thoughts and feelings have simply not found a vocabulary yet. But when we do find the words and someone does manage to hear them; giving them back to us in ways that allow us to feel understood – we feel less isolated in our struggles.
Our “symptoms” are what bring us into therapy, but they are seldom what, in the end, actually gets talked about. A teenage girl is referred to me with the courage to disclose that she is struggling with an addiction to pornography. Within a short space of time she manages to confide in me that it is “not just any pornography”. She is compulsively drawn towards watching women pee. Probably on each other, I don’t probe for the details. Not because I don’t think the details are important, on the contrary, the specifics of our secret fetishes can be deeply revealing. But, she is clearly having difficulty with disclosing this hidden struggle with herself as it is. Freud said shame was a useless emotion and, despite its uselessness, it is a deeply incapacitating emotion. It hinders expression. Shame is a deadening thing. It prevents us from becoming what we could be.
Perhaps you will find it alarming that I don’t find her disclosure overly concerning? When we take the idea of pathos out of our understanding of human behaviour, especially our more private sexual inklings, we make room for seeing them more clearly. This is not something a therapist can be trained to do, it’s a matter of belief. To believe in well-being, we must believe in sexual freedom and, ultimately, in an openness to what it means to be human. At first, she concludes that she is not gay but understands that, for some reason, she likes it. A few conversations later, she has settled on the idea that she likes both boys and girls. There is something both freeing and isolating to this realisation about herself. A coming home to herself, while at the same time acknowledging how this part of herself might never be accepted in her own home. All this happening before she has even had the chance to actually explore sex in a more tangible way. I can’t help feeling a bit sad for where she is now and yet excited, on her behalf, for what might still lie ahead of her.
Every lover we encounter, no matter how briefly, represents something inside of us. These encounters don’t only awaken aspects of our pasts, they are the canvas upon which we project our own desires – other people serve as imagined prospects of something for us in the future. But, for this reason we don’t see our lovers for who they are, we see them for who we need them to be. This is why it, so often, does not end so well. We can be drawn to a lover for so many less conscious reasons: Because they represent something familiar yet diminishing of us; because we can provide for them what we are unknowingly wanting for ourselves; or that we are envious of a quality that we see in them. The configurations of how love can be self-serving are endless. But regardless of the configuration and no matter how briefly, a lover awakens things (past, present or future) inside of us. I think it is the work of therapy to bring awareness to these awakenings inside of us. What is it that we desire and what do these desires actually mean?
Sexual concerns are often the “canary in the cave”. It is often when sexual passion dwindles that we have a sense that something is wrong and we may find ourselves desperate enough to entrust a complete stranger (like a therapist) with our longings. Even though we don’t admit that this is the reason – at least not in our first therapy session – it is most commonly our lost or frustrated desires that compel us to seek help. Sometimes, like the flickering of a candle, we take this step just before the flame goes out completely. Most of us make the decision to come into therapy more desperate than we are prepared to admit, even to ourselves.
A couple of swingers come to see me because recent encounters with another couple have stirred things inside of each of them that they are struggling to understand. They describe it as taking them back to places in their pasts, somewhere they thought they had reached a safe distance from. They describe feelings of jealousy, anger and fear. It is my understanding that swinging is somewhat different to polyamory in that swingers treat their play partners as exactly that – objects for “play”. There is the, somewhat false, security of it being emotionally safer that way. But, is it ever “just for play”? Getting to know each other beyond just play can certainly prove to make life more complicated.
We were able to explore what the other couple had awoken in them: their unacknowledged desires, old relationship patterns and a need to “go back” into their pasts and re-script things previously gone wrong. Usually, however, we don’t manage to re-script the past. Most of the time we simply repeat old scripts with new actors on our stage. We are more likely to find healing in leaving parts of ourselves in the past. As with this couple, they had helped each other achieve this and were horrified to be haunted by previous versions of themselves. It becomes a question of who do I desire to be? And, how does this intimacy help or hinder me from becoming that? And, of course, why do they have the power to evoke this in me?
Do we truly ever get to leave previous versions of ourselves completely behind us? Therapy is an attempt at getting a clear view of who we have been and who we wish to become. Catherine Millet, famous French art curator, writes in her confessions about her lurid sex life:
“The distance we set between ourselves and the events of our past life, which reduces their scale, the backlog of things we failed to notice at the time, the logic which connects them, which back then was invisible, the light shed on them by the epoch they belong to, which mankind already considers a moribund piece of history, their ultimate strangeness, which makes us look back on the person we were as though they were a different being, all these things conspire to turn our past into a dream.”
We want parts of us to become foreign to ourselves. Lovers have the capacity to either free us from ourselves or take us back to unwelcome experiences of ourselves. This “self” is not a fixed thing, nor do we have as much control as we would like as to who or what we experience ourselves to be. We are inevitably shaped by those we share ourselves with. This starts with our dependence on caregivers but it is really made most real though the people we share our desires with, later in life. I fall in love with you because I long to experience myself in certain ways through you. I want you to reinvent who I am.
R.D. Laing offers a riddle for the intricacies of how we experience ourselves through the other:
“I cannot experience your experience. You cannot experience my experience. We are both invisible [wo]men. All [wo]men are invisible to one another… I cannot avoid trying to understand your experience because although I do not experience your experience, which is invisible to me (and non-tasteable, non-touch-able, non-smellable, and inaudible), yet I experience you experiencing. I do not experience your experience. But I experience you as experiencing. I experience myself as experienced by you. And I experience you as experiencing yourself as experienced by me. And so on.”
It takes a few reads to appreciate Laing illustration of the intricacies of how we experience ourselves through another. Ultimately, I can never truly experience you and you can never fully experience me. But, more devastatingly, I cannot even have a direct experience of my “self”. I experience myself through how I imagine you experience me. What this suggests is that it is important to bring awareness to what we are imagining. Especially how I imagine your perception of me. And, there is no greater vehicle for imagination than desire. Therapy, therefore, asks us to be honest with ourselves about “What is it that we truly desire?” Because it is our desires that colour all of our experience.
In the end my young client (who now seems to be at a more comfortable distance from her compulsion to watch porn) asked me why I think she finds “that particular genre” of pornography so stimulating. I can’t say for sure, but I remind her of how we had started to speak about her hidden shame (not just about the porn but about many aspects of herself she was feeling shame about). I proposed to her that maybe the idea of allowing natural, yet hidden, things to become visible brought her some sort of relief and, therefore, excitement. Especially given that there is so much about her that is natural and yet still hidden. Perhaps her desire is simple? Perhaps it’s a desire for freedom. I proposed that these pornographics represented a freeing of her shame? It is, therefore, unfortunate that guilt about watching pornography only served to, in the end, intensify her shame. This had kept her in a vicious cycle of feeling lousy and then seeking soothing, only to feel lousy again. The problem and the solution became one in the same – keeping her trapped.
It’s a good idea to unashamedly know what it is that we desire and why. It’s even better when we can share these desires with another. To know how our desires for another cloud our perceptions of who they actually are. One step further is to know what we imagine others are desiring of us and how that can cause us anxiety about whether we can be that for them (or even want to be). And then, to accept that desire, by definition, is something that is never ever fully fulfilled. The things we desire are always only ever just out of reach. When we satisfy a desire, it simply gives rise to something new. We, therefore, need to learn to sit, somewhat, with the burning of our own desires.