Couples Therapy and Sex Therapy

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Check out this New York Times article by Amy Sohn: First Comes Sex Talk With These Renegades of Couples Therapy (July 1, 2015). It highlights some interesting views about couples therapy as it relates to sex and sex therapy. Apparently, there are some “renegades” out there that are suggesting that sex talk may need to precede talk about attachment bonds. And, it is implied that sex talk in mainstream couples counseling may be lacking or off-base in terms of kink, polyamory, gender-queerness, sexual orientation, and/or pornography.

In my opinion, this article may cause some confusion about how gender and sexuality are treated within the EFT process and thus provides an opportunity to explain some things that, in my view, may be misinterpreted or misunderstood about EFT. Please note, the points below are not the official views of ICEEFT, the oversight organization for EFT certification:

  • EFT does strive to build a foundation of safety and secure attachment, but I’ve never heard the word loyalty specifically mentioned as a basic building block other than the role it may play in safety and security. I suspect loyalty is being used as a code word in the article to mean strict monogamy. If that is the case, I submit that EFT is not inherently monogamy-based even though some EFT proponents may be.
  • The field of “marriage and family” therapy seems to have a history (as suggested by its name) of bias toward “traditional marriage” and the thought that only married people have legitimate families. It also seems there are vestiges of this bias in current therapists, but EFT is not restricted in my experience to any one population in theory or in practice even though EFT practitioners all have their own personal views about gender and sexuality.
  • While EFT does give emotional safety primacy, this does not exclude general sex talk as an important component of romantic relationships. EFT is based on the idea that deep, authentic intimacy and vulnerability are made possible only in the presence of both emotional and physical safety. Likewise, the kink and BDSM communities (as well as some pornographers) use safe words and periodic checks as preconditions to any activity so that participants are free to relax into the vulnerability of being dominated or to dominate without fear of harming another and free to enjoy the endorphin-generated high brought on by measured amounts of pain without fear of injury or trauma.
  • Couples counseling is different than sex therapy even though the two can coincide or overlap. It may be tempting to assert that the two should be combined; however, some couples who need to work on their emotional safety do not need to work on their sex lives. Conversely, some couples who want to work on their sex lives do not necessarily need to work on emotional safety and intimacy. So, it makes sense that the two therapies would be separate and have different priorities as well as educational and certification requirements.
  • Most responsible practitioners of either field will strive to gain some working knowledge of the other field; however, it is important that all therapists practice ethically and within the limits of their expertise, education, and experience. An EFT therapist who is not also a sex therapist, will not likely engage in therapeutic sex talk because it may be irresponsible even if it is appropriate to the clients’ needs. That is not the same as valuing attachment talk over sex talk so much as it is being ethical. If clients do not feel their concerns are being adequately addressed, that should lead to a discussion of what type of treatment will best suit their needs and whether the current therapist is qualified.
  • Because it strives to attain the universal need for emotional safety as a prerequisite for openness and vulnerability, EFT leaves the particulars of one’s gender, orientation, views on monogamy and pornography, fantasies, and proclivities up to the clients to define. EFT is concerned about these topics when the navigation of them interferes with the establishment of security and safety and is seen as an impasse on the partners’ road to connection or intimacy.
  • EFT is not inherently blind to (although some practitioners may not be comfortable with) how safety and attachment can come in different shapes and sizes in accordance with gender and sexuality diversity. The EFT language and dynamic framing needs to match the clients’ world, and the therapist must accept that clients decide what is best for them according to their reality and values. Only if the participants feel disconnected or unsafe around these topics does it enter the true EFT process. When partners can safely discuss their feelings and needs around these topics, then they can decide for themselves how it will look in their lives and bedrooms, unless they need the guidance of a sex therapist at that point.
  • Openness to porn use within a relationship is not the same subject as concern about porn addiction; therefore, comments about porn addiction should not be perceived as negative views on porn use in general. Porn addiction is a possible outcome of the over-reliance on porn, and a symptom of porn addiction can be that it takes over the intimacy in a relationship.
  • Having an affair is not the same subject as non-monogamy because an affair includes dishonesty and displaced intimacy. Non-monogamy, for those who practice it, is typically honest and intended to add to intimacy. Harmful affairs can happen in non-monogamous relationships. Affairs may be a catalyst to needed change, but they are not on par with the option of honest and consensual non-monogamy as a path to added intimacy for those who see it that way. Affairs hurt and risk becoming an irreconcilable injury in some relationships.
  • EFT does not look to feminize men, as in taking away something manly and replacing it with something feminine. It strives to free men (and women) who happen to fear vulnerability with their intimate partners which in turn may affect their ability to participate effectively in relationships in ways that work for all involved (as opposed to an entitled stance that requires one partner to compensate for the insecurity of the other partner). The process is more about letting go of an ineffective position that’s based on fear, which is not the same as manliness.

I welcome any discussion, questions, corrections, or further clarifications about these statements concerning the treatment of gender and sexuality in the EFT process. Comments debating the morality, validity, or politics of diversity will not be accepted as that debate is not the point of this post.

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