Sexual Addiction Treatment: Male Vs Female

There are significant differences in the ways that men and women think, act and relate. Many of these differences are neurobiological in nature. Generally speaking, men are more “left brain” (logical and objective) and women are more “right brain” (creative and intuitive). In short, men tend to be stronger systematizers, women stronger empathizers. 

Not surprisingly, these inherent biological differences come into play in sex addiction treatment settings. As such, even though male and female sex addicts typically arrive with relatively similar acting out histories, they often respond in very different ways to the same treatment modalities, meaning techniques that work well with one gender can sometimes be counterproductive with the other. This is one of the many reasons that gender-separate treatment is nearly always recommended for recovering sex addicts.

Men in Sex Addiction Treatment

Sex addicted men typically struggle with the idea of giving in to treatment, as doing so means admitting weakness and lack of control. This goes against their neurological wiring (not to mention their upbringing and social conditioning), making them difficult to engage with in treatment. After all, the primary qualities asked for in therapy are vulnerability and emotionality, which are both counterintuitive for many men.

As such, some traditional forms of talk therapy—uncovering past trauma and processing it in ways that reduce its power—are typically not effective with male sex addicts in the early stages of recovery. Usually, therapists appeal to the male sex addict’s straightforward, logical, problem-solving nature through use of Cognitive Behavioral Therapy (CBT)—a highly directive, solution-focused methodology. For the most part CBT focuses on:

• Helping the client understand the nature and consequences of his problem (reducing denial)
• Helping the client identify and learn to anticipate triggers that set his addiction in motion
• Helping the client develop and implement healthy coping mechanisms (teaching him to “do something else” when triggered to act out sexually)

Women in Sex Addiction Treatment

Usually women are much more willing than men to enter treatment and to share openly and honestly about their sexual issues and the related consequences. They also tend to adapt better and faster to the social aspects of group therapy, 12-step support groups, and the like. As such, female sex addicts are usually much easier to engage with in treatment settings. However, directive methodologies like CBT can be less useful with women, especially early on, as female sex addicts sometimes question assignments and suggestions to the point where the directive approach simply breaks down and becomes counterproductive. When this occurs, therapists typically opt for more traditional forms of talk therapy, with a focus on relationship and empathy building. Later, once trust is established, therapists can subtly work in assignments and directives as part of the larger “feelings oriented” therapeutic conversation.

Different but the Same

The simple truth is the above information is based on generalizations. In reality, some men respond quite well to traditional psychotherapeutic approaches, and some women readily accept directive approaches. Every person is different, and no sex addict ever fits neatly into any clinical package. Factors like age, race, sexual orientation, culture, class issues, attachment issues, and the impact of early-life trauma all come into play. However, in general, and once again this is a matter of nature (neurobiology) as well as nurture (social conditioning), males tend to be less willing to make themselves emotionally vulnerable, while females tend to question the need for therapeutic assignments and direction.

Either way, sex addicts ultimately need liberal doses of both methodologies. Regardless of gender, recovering sex addicts need the directive approach, which helps them to understand the nature of their addiction, to identify the triggers that set it in motion, and to respond in ways that short-circuit the process. They also need the traditional approach, which uncovers their early-life trauma and attachment deficit issues (both of which are nearly always underlying conditions of sexual addiction) and processes them in ways that reduce their present-day power, thereby reducing the desire to engage in addictive sexual behaviors. The good news is that therapists at the best sexual addiction treatment centers are able to tailor their approaches to each individual, regardless of gender, developing the best possible treatment mix for any particular sex addict.