Over the years, I’ve worked with a number of individuals who have presented with out of control or compulsive sexual behaviors. In the past, these folks may have been designated as “sex addicts,” but the field is currently in transition and moving away from this perspective. A number of other models have sprung forth to fill in the void, and I have written about some of them previously. In this article, I will focus on what I feel is the most fundamental shift in the discussion around this issue, which is a move from abstinence only (the addiction model) to harm reduction.
Harm reduction? What is that? In essence, harm reduction is nothing new; it has been a staple of public policy and social programs for years. Indeed, I got my start in the field as a harm reduction outreach worker, going to local parks and other hangouts in and around NYC, exchanging clean needles for dirty ones with intravenous (IV) drug users or providing condoms and other necessities to transgender street sex workers. There are a number of harm reduction centers in many large urban areas around the country, funded both by charities and grants, as overwhelming evidence supports the efficacy of this kind of approach. It is only recently though that harm reduction has entered the psychotherapy office as a foundation for understanding human growth and psychological change. Indeed, I am proud to be at the forefront of this movement, hosting workshops on integrating harm reduction with sex therapy and speaking at major conferences on this issue.
At its root, harm reduction is both humanistic and culturally libertarian. No, […]