TODAY'S GUEST: Doug Braun-Harvey

I'm extremely happy to welcome Doug Braun-Harvey to Hard Conversations!

Douglas Braun-Harvey is a Licensed Marriage and Family Therapist, Certified Sex Therapy Supervisor, Certified Sex Therapist, Sexual health author, and trainer. He teaches and trains nationally and internationally on sexual health principles within drug and alcohol treatment, group psychotherapy, HIV prevention and treatment, and child maltreatment.  

Since 1993 he has been developing and implementing a sexual health based treatment approach for men with out of control sexual behavior (OCSB). His book “Treating Out of Control Sexual Behavior: Rethinking Sex Addiction” was written with co-author Michael Vigorito and published in 2015. In 2013 Doug Braun-Harvey and Al Killen-Harvey co-founded The Harvey Institute, an international education, training, consulting and supervision service for Improving health care through integration of sexual health. 

He is an Adjunct Assistant professor in the Center for Human Sexuality Studies at Widener University and Faculty for The University of Michigan Certificate Program in Human Sexuality. He also wrote “Sexual Health in Recovery: Professional Counselor’s Manual” and “Sexual Health in Drug and Alcohol Treatment: Group Facilitator’s Manual” (2009).

• WEBSITE:

  https://www.theharveyinstitute.com/

• Instagram:

• Treating Out of Control Sexual Behavior - Rethinking Sex Addiction

YOU'LL LEARN

• The difference between sex addiction and out of control sexual behavior

• The importance of language when talking about sex

• The trauma that can occur when there is sexual betrayal and infidelity

• How erections are impacted by impulsive sexual behavior

• The detriments of sexual shame

• Insights on sexuality

• The impact of sexual imagery and porn on relationships

• The impact of anxiety on sex

• The benefits of online sex therapy

• And more!

THANK YOU FOR LISTENING to my male sexuality and sex therapy podcast!

To get more hard conversations sent directly to your device as episodes become available, you can subscribe on iTunes or Stitcher!

Also, reviews on iTunes are extremely helpful and greatly appreciated! I read each and every one of them, and feel free to share your URL there so I can contact you later on and say thanks!

And lastly, if you have any questions (or would like answers to previously submitted voicemail questions!), head on over to Tim’s website.

About the Show

Introducing Hard Conversations, a podcast about male sexuality, and all things erectile, from the latest natural erectile dysfunction treatment to the best ed medical treatment. Therapist Tim Norton expands the conversation about male sexuality, adds context to why we struggle as a society to have hard conversations and breaks down how in a sex-positive environment there really is no room for taboos, judgment, or shame when it comes to penises.

YOUR online sex therapy and couple’s therapy HOST:

Tim Norton is a sex positive sex therapist working in private practice. He offers online therapy, online sex therapy, online sex coaching, and therapy and coaching for somatic symptom disorder.

Tim obtained his bachelor’s and master’s degrees from the University of Southern California. Tim is a proud member of American Association of Sex Counselors, Educators, and Therapists (AASECT), the Los Angeles Sexological Association, and works part-time with the Pain Psychology Center in Beverly Hills.

Hard Conversations Podcast Transcript

Tim Norton: Hello and welcome to Hard Conversations. Really excited for my next guest Douglas Braun-Harvey, a licensed marriage and family therapist, certified sex therapy supervisor certified sex therapist, sexual health author, and trainer. He teaches and trains nationally and internationally on sexual health principles within drug and alcohol treatment groups,  psychotherapy, HIV  prevention and treatment and child maltreatment. Since 1993, he has been developing and implementing a sexual health based treatment approach for men with out of control [00:01:00] sexual behavior. His book treating out of control sexual behavior, rethinking sex addiction was written with co-author Michael Vigorito and published in 2015, a couple of years before that Doug Braun-Harvey Co-founded the Harvey Institute and international education training, consulting, and supervision service for improving healthcare through integration of sexual health. He is an adjunct assistant professor in the center for human sexuality studies at Weidener university and faculty for the university of Michigan certificate program in human sexuality.

He also wrote sexual health and recovery, professional counselors, manual, and sexual health and drug and alcohol treatment group facilitators manual. Welcome to the show, Doug. 

Doug Braun-Harvey: Thank you. It's going to be here. 

Tim Norton: Yes. So excited for this interview.  You know, I, I worked in,  [00:02:00] well, we'll, we'll, we'll just jump right into it.

I worked at a clinic that, that branded itself as a sex addiction clinic for a few years. And, you know, I spent so much time in that world. And then, then when I got into ASAP, I was, you know, learning your model, honestly, learning the out of control, sexual behavior model and, and, and working with that population for so long that I kinda got.

Burned out on it, but I've, I've had a bunch of requests from people who want to hear, you know, how does, how does this impact erections and sexuality? And it's such a germane issue to, to male sex in 2019. So I'm just really excited for this interview. And thank you so much for 

Doug Braun-Harvey: appearing, Tim. It's great to hear about your background.

I don't often. Do podcasts or interviews of this kind of nature with people who've had their own professional direct work in, in providing sex addiction treatment and then, you know, moving into the sexual health model. So this is a rare opportunity. Thank you for letting me know that. I didn't know that.

[00:03:00] Tim Norton: Okay. Yeah, no. Fantastic. So let's, let's jump right into it. You developed a model for the treatment of out of control sexual behavior. He wrote a book,  

Doug Braun-Harvey: Michael Figueiredo and I co-wrote a book. Yes, 

Tim Norton: yes. The two of you. Yeah, a really important book in, in my world and in the world of, of sex therapy and sex therapy treatment.

So can you just tell us,  tell us a bit about 

Doug Braun-Harvey: that? Well, I think I would start with. Why there needed to be a book written like this,  and that, that th this, this human behavior. Which I'm going to call from a general perspective for this interview, sexual dysregulation, for whatever reason, somebody is not feeling like they're regulating their sexual behavior very well.

And there has been a significant controversy since the eighties about what exactly we call this. And for the most part. Everybody has been trying to figure out what to call this. And I'm going to emphasize this word [00:04:00] disease. The idea is, is that this human behavior is some sort of a disease, a psychiatric disorder, addictive disorder.

This has been the story since the eighties, that, that that's how people have been wanting to understand it. So is it compulsive sexual behavior? Is it a sexual addiction? Is it a hypersexual disorder? Is that,  impulsive compulsive sexual behavior disorder. I mean, these, these have all been sort of bandied about, but the, the, the, the one thing they have in common, As they've all viewed this behavior as a form of mental illness, a kind of disorder.

 and, and what people have been, you know, really kind of debating is what, what kind of disorder it is, but they've all believed it's a disorder. The one thing that stands out. In the sexual health model that Michael and I have developed without a control sexual behavior is that we do not believe this human behavior is a mental illness or a psychiatric disorder or an addictive disorder.

That is the most significant kind of [00:05:00] cleave here that we're going to be talking about today.  is that everything we're talking about in our model is we're not saying that somebody has a disorder.  and that's, that's really why this book was written. And that's why Michael and I spent so much time elucidating, a model that I eventually, you know, grew out of my work.

I started my first group for men and how to control sexual behavior. I didn't even use that term. Then the term out of control sexual behavior, didn't come come about until a journal article for John Bancroft and.    in 2004, where they recommended that until we have a better idea of this behavior, we call it out of control sexual behavior.

Before that I called it a variety of things, but I never believed in a sex addiction model. So since 93 I've been providing outpatient group and individual therapy without a disease model. Hmm. And, and having to kind of figure out, well, what is this? And so eventually, Michael and I really, really put together this model and built this book.

So [00:06:00] I think that's the most important thing. We're not talking about somebody who has a disease, and that's why the book is written. It's a sexual health model rather than a disease model. 

Tim Norton: Right. Absolutely. And, and I, I remember when I was first learning about the, the sex addiction model was one thing that I really didn't like about it was, it, it kind of felt like we threw the baby out with the bath water.

We threw out. Everything, you know, if we had a client who came in, nobody was asking, well, is this client depressed, bipolar and anxiety disorder, like that suddenly became secondary. And a lot of personality disorders, a lot of narcissism,  and borderline, and, and, and, and that was such a distant thing to talk about, but.

It's really different to work with bipolar than it is, you know,  just depression without mania or, or just anxiety and, and, and the clients would present much differently. And there was just [00:07:00] so many things that were getting lost. And, and I like not thinking of this as a disorder. It's, it's really. It's an aspect of something else that's going on.

Wouldn't you say? Or it's, 

Doug Braun-Harvey: it's a coping, it's a, it's a problem out of control. Sexual behavior is a problem, but many people can have problems and also have disorders. But that, that co-worker th th th th th that are happening at the same time, or ha or inter it affect each other interact together. What you're seem to be commenting on is that at least in your experience in a sex addiction treatment program, the, the, the psychiatric conditions that might be present,  we're, we're, we're not given as much prominence in the overall case conceptualization, but it sounds like you thought they needed to have.

And it, it seemed like a kind of an omission of priorities that, that,   that, that this wasn't somehow really looked at [00:08:00] in a more critically thought out way,  that the sex addiction model was really the model in which their behavior was viewed.  and,  that this is what can happen with disease conceptualizations or disorder conceptualizations.

It all has to kind of, every patient is supposed to fit within that sort of. You know, kind of narrative that's been designed around the particular disease.  and it sounds like you saw all that in your experience. 

Tim Norton: I did. And if somebody, I remember a couple of times where somebody might,   present.

With suicidality and I'd have to chime in and say, look, we're not that kind of clinic. We don't, we don't treat highly suicidal people here. We're not that that's a whole system that there's a whole way of handling that. And we, you know, we, we're dealing more with,  Long-term married people in an affluent neighborhood.

And the guy had acted out four years at a time. And there was a sudden,  a [00:09:00] fare that was revealed and which is tough work in its own. Right. But it's very different than somebody who is actively suicidal. And I'm just saying like, we have to work with this first and we probably are going to have to refer this person out to somebody who's accustomed to dealing with suicidality on a regular basis.

And those kinds of things.  yeah, it's, it's tricky in those settings. And I've seen that in a couple of different,  sex addiction, focused centers. Yeah. 

Doug Braun-Harvey: You also used a word of a phrase that I really like to highlight. You use the phrase acting out. In your sentence. And I wondered about that. 

Tim Norton: Yeah, you 

Doug Braun-Harvey: may have, you may have read my work enough and Michael's, and I work at it to know that he emphasized language and we think language is very important.

And I think the language of acting out that phrase is really also comes from,  you know, disease models and mental illness models that this sort of idea that a behavior. Is representational of, you [00:10:00] know, some more deeply,  you know,  kind of underlying psychological or psychiatric conditions. And so that's just sort of acting out of an unaddressed mental illness.

And I really, I really take umbrage at the use of the word acting out when we're dealing with out of control sexual behavior.  it, I find it a kind of.  when I train therapists,  I talk about how that, that you're really avoiding detailed and specific language about a person's sexual life. So whenever I'm working with a therapist or in a case, conceptualization with somebody, and they say, well, so-and-so acted out.

I didn't want to interrupt you with your podcast, but I would normally, I would normally say, wait, wait, let's want to stop you there. What do you mean by acting out? I don't know what that word means. And oftentimes a clinician or a therapist or somebody who's talking about it, or even a client, a client's is acting out well.

What do you mean? What do you, what do you want me to know about you? That you're telling me when you say acting out and let me get an idea of what are some of the common stories. Some people say when they say acting now, one of the most common is I'm not keeping my [00:11:00] relationship agreements. I've agreed to a certain kind of boundaries or certain agreements of how we're going to conduct our sexual life in this relationship.

And I'm not doing that. I'm not keeping those agreements. And I have unilaterally changed the agreement and I've not told the person I have the agreement with that. I've unilaterally changed the agreement. Now that's a lot to say. So what people will just say, they'll say they're acting out because who wants to say all that that's painful.

That's taking a lot of responsibility for decisions that are injured and hurt people and exploit people. You know, these are hard things to say, so. Acting out is often a shortcut way for people to avoid saying detailed and specific descriptions of their behaviors that are painful and difficult to acknowledge and be accountable for.

Yeah, 

Tim Norton: that that is a painful sentence. I've I like how you said that too. I unilaterally have changed our relationship agreement [00:12:00] and not 

Doug Braun-Harvey: told you. Yeah. And I told you here's the exploitive part. I'm going to keep acting like I have kept the agreement. Yeah. Now I've called that, you know, failure to keep our sexual health relationship agreements is one of the most common,  you know, behaviors as, as to why somebody says their behavior sexually on our control.

Hmm. 

Tim Norton: What would you say is the most. Typical or what your, your, did you just stop doing private practice work? 

Doug Braun-Harvey: I'm I'm PR Tim I'm actually in December. I will be ending all of my work as a psychotherapist after 40 years of mental health work.  I ended my individual psychotherapy work a year ago, and I've been doing my groups now for 27 years, but I'll be Andy and my outpatient group leader work.

The end of December. And my work now [00:13:00] is it's about generativity training and teaching other people,  sort of returning all the knowledge I've been given and passing it on and letting other people do more with the knowledge we have and writing books. So I'm going to be teaching training, writing books,  training other therapists in how to work with sexual health and those CSP, but I'm not going to be providing direct client services anymore.

 and they actually have five weeks. Oh,  five weeks. Wow. Okay. Well,  December 17th is my last day. 

Tim Norton: Alright. And I'd want to save this for the end of the interview, but in case we get so mired in this conversation, but thank you for the work that you've done.  and that's you, you've made an incredible and really important contribution to the field.

Thank you.  yeah. So in the, in the, in the individual work and group work that you have done in these last 40 years, and once you. Kind of, I don't know, developed a reputation as the CSP guy.  what would be the more, a typical two or three [00:14:00] different case presentations that would come through your door?

Yeah, I think 

Doug Braun-Harvey: we've already covered one of them there. Somebody in a,   a coupled relationship. They have agreements as to how their, what their boundaries are within their relationship agreement. And, and I've, I've only worked with man. This is the CSB model is really specifically developed for men of all sexual orientations.

  and I'm going to say cis-gendered men, we've not had a trans,  male client who's presented for therapy. So a cisgendered men of all sexual orientations is really what we're speaking of here.  And, and, and adults 18 or older, the youngest client I ever had was 23. The oldest was 78. So, you know, quite a wide age range.

 and what we're really speaking of here is some people will just not keep their relationship agreement. That's very common.  another common one is their relationship with sexual imagery.  you know,  oftentimes,  [00:15:00] couples or individuals themselves,  have not figured out what is a relationship with sexual imagery that they can feel good about.

That they feel,  pleased with,  that is pleasurable,  and is aligned with their values,  and is something that they can speak openly about to new partners or to their current partner.  the, the, you know, masturbation and the solo sex life using imagery for arousal or desire. Orgasm or increased excitement or,  access to an unconventional turn on that you may not be experiencing in person, but is very rousing and pleasurable to look at.

 these are all reasons. People look at sexual imagery,  for their solo sex life or their partner in sex life. And th this is a very common conflict is, is the whole relationship with, with masturbation solo sex and use of sexual imagery.  and the last one. I would say, I'm going to put under the con the category, the [00:16:00] Michael Figaredo and I speak about in our book, and that's an erotic conflict that somebody has a, a turn on a sexual interest, a fetish unconventional kind of turn on something that might be stigmatized or judged.

If it were to be known that this really turns me on, or I need this particular thing in order to have an orgasm,  People have a lot of conflicts about these,  unconventional turn-ons. They may have hidden them, keep them a secret.  and I'll mention here. One other aspect of the LCSP model is,  we only work with consensual sexual behavior.

So it if I'm talking about an erotic conflict in somebody,  has minor attractions,  or somebody is exhibitionistic, a voyeuristic or fraud or derision is in other words, they. In order to gauge and have this turn on, they have to non consensually engage with another person. And that person hasn't agreed to be part of this.

Uh that's non-consent [00:17:00] and this model is not a nonconsensual model. So, so those are the three would be not keeping agreements,  one's relationship with sexual imagery and solo sex,  and having,  an unconventional or unresolved conflict about how one gets aroused erotically in a very kind of unusual way.

Tim Norton: Okay. Wonderful. So let's unpack those with not keeping the relationship agreement.  what would the, the, the spectrum look like? So the guy who had,  one long-term affair, one short term affair, and what would be on the other end of that 

Doug Braun-Harvey: split? Well, you know, I tend not to use the word affair, so here's what I would say.

A guy. Maybe had a sexual relationship with somebody else. And it was not in the agreement of the relationship. The key factor there is. Did they fall in love with that person or not?  and you know, we, I think we have to reserve a fairs for the line, which a falling in love. Then somebody actually [00:18:00] not only broke the monogamy agreement of the relationship.

They had sex with somebody other than their partner, but they also broke the emotional. Monogamy relationship agreement, which is you're not going to fall in love with somebody else. Other than me, those are two different agreements and relationships that often get merged as if they're one in the same thing.

 so,  you know, I th so I think the bigger issue. Is,  you know, if they're having sex outside of their relational agreement, are they falling in love or not? That's a big, big issue right there.   how frequently her, how often are they having,  sex with other partners that are not within the agreement?

 you know, how frequency, how frequently it is and more importantly, what are the consequences?  you know, are people losing their job? Are they going to lose the ability to raise their children? Are they going to have a divorce?  you know, are they going to,   you know, have a high [00:19:00] conflict divorce?

Are they going to pass a B, maybe have to no longer be part of their religious community?  there, there are just so many consequences that people get concerned about,  and the amount of shame and embarrassment and humiliation that might bring to them.  So I think what, what, what really separates the, the, the spectrum of that first one, the relationship agreements is not so much the behavior they're engaged in it's.

What are the consequences? How severe are the consequences?  that's usually what gets people to come in for help is they've experienced a terrible consequence, or they are really scared, a terrible consequences going to happen. And, and. It's so interesting for one person, the terrible consequence might be my partner will find out for the other person, the terrible consequences isn't that the partner will find out it's that I might not get to raise my children in an intact family.

And they're really not concerned about injuring their partner. I mean, It's hard for therapists to hear this, but they may not really care that their partners that injured, [00:20:00] they think they're going to get away with it. They just don't want to be raising their kids in a divorced family. And that's why they that's what they're worried about.

So sometimes we have to be prepared to hear a consequence from a client that in our moral system, we're going, Oh man, those are crummy morals.  but you know, that's their conflict, right? No, 

Tim Norton: that's a really good point. What I was thinking about. With regard to the other end of that spectrum is in, in the media.

When we think of this idea of a sex addict, there is, there are stories of, you know, somebody who's gone to multiple sex workers and on dating apps,  while married and, and, and, and, you know, and the other partner has an agreed to that. And just going to strip clubs all the time and, and. Clinic or your treatment facilities, would you see that kind of presentation 

Doug Braun-Harvey: as well?

Absolutely. Any of these, you know, any of these sexual activities might be part of what's happening? I think what's different in some of the particularly sex addiction [00:21:00] models. Notice how, as you described the more severity of the behavior, your focus was on the sex acts. That they were engaged in, you know, and I think in particular, many people will see the severity be about how judged those sex behaviors are, how much they're stigmatized, how much they might be morally disapproved of,  how much they might be seen, you know, in a.

In a negative light. So I think in some models, the focus of severity is actually more on how judged the behavior is. The section behavior, our model focuses on consequences, not the sexual behavior itself. Any of these sexual behaviors could have these consequences. And some may not. For example, we have men in our, in our treatment program who it's on their sexual health plan.

 that,  they're single.  and they like to have erotic feelings in their body and they might go to a,  let's [00:22:00] say,   a place where people undress and are nude for entertainment and that that's part of their pleasure in their life.  and that in they're sitting in a group with another person with that exact same activity is what's torn their life apart and destroyed it.

So it's the consequences rather than the, the, the judgment of the sex act itself, that it really differentiates the sexual health model from some of the other models. Okay. 

Tim Norton: And that, that puts it in a really good perspective for someone like me and, you know, in terms of how to approach a case. But I'm also thinking about the partner, you know, who just might get really overwhelmed by, Oh my God, you did all of those things.

And you're saying at the end of the day, really the, the consequences are going to stand out, but I've, I've met those partners who. Want to just make this who want to pathologize, who want to make it a mental condition and who want to [00:23:00] send this person somewhere and say, you know, fix this and there, nobody could do all of those things if they were quote unquote normal.

Doug Braun-Harvey:  but yeah. Yeah, I think I, you know, one of the things I've, I've, I've learned over the years, it's a crisis for somebody to. To kind of question, who am I, what does this mean about me? If I love somebody like, like you, and now I know things about you that I can't unknown and what am I doing with this? How do I understand how I feel about you?

What, what does this mean about how our relationship has been over all these years? These are enormously, and I don't mean to overdramatize this, but these are existential crises in a relationship. And these are crises that happen over the, over the course of many relationships that may not be about not keeping a sexual agreement and exploiting a partner.

But I think what you're describing most important it is hurtful is how do I [00:24:00] reconcile somebody saying they may have loved me or do love me. And they've also exploited me. Hmm. This is, this is a very difficult thing for people to understand. And it's very painful. And so. That sentence is so difficult to understand, but it's, it's, it's, it's,  appealing to see it as a disease.

There's, there's something soothing about, there's something hopeful about seeing it as a disease rather than we have to talk about the fact, but you have explained it to me and I have been exploited by you. Where do we have conversations like that?

And it, 

Tim Norton: would you use the word traumatizing 

Doug Braun-Harvey: if the client needs to use that word? We have to assess it. I think we move a little fast. If we put that narrative on that experience [00:25:00] as a generalized story for clients. You know, we know from the child sexual abuse field, we know people who've engaged in non-con.

Who've been the target of non-consensual sex as minors. That some people that's an enormously, terribly traumatizing experience. And for other people, it is not a traumatizing experience. But they've had the same human experience and I'm very concerned about models that impose those narratives of trauma,  without a good assessment of trauma, you know, w what I, what I think is the word that I hear missing too often is hurt.

Hmm, this is what some people look like when they've been terribly hurt or in shock, or are,  you know, again, existentially they're completely disoriented, right. You know, [00:26:00] you know, you know, those are real time experiences for some people. Those experiences may activate historical trauma. And it may, and this experience may actually maybe be a trauma for them.

It may be the most traumatic thing that's ever happened to them in their lives. But we w I think the dilemma is we, we place this narrative in a general way to describe the experience of two people in a relationship where exploitation has been a solution to a problem, and it's injured somebody deeply.

Yeah, 

Tim Norton: I really appreciate you saying that,  regarding the assessment of trauma. And so maybe for the listeners who don't know how to assess for trauma, could you, could you highlight a couple of trauma symptoms that you'd like to see before actually, you know, using that word? Well, you 

Doug Braun-Harvey: know, you know, I can speak to this for many years of working with men with those CSB who have their own trauma histories, right.

I'm not going to [00:27:00] speak to the partners because I'm not treated the partners, but you know, trauma is when you have. Intrusive thoughts about past experiences in your current everyday life, that something something has happened in, in your environment something's happened in your own emotional state something's happening in your relational experience, where all of a sudden your body biophysiological is having an experience that is in some way, a component of some historical event that was highly traumatic.

You know, somebody might have a body memory that was, that had to do when they were, you know, physically assaulted and beaten on a street, you know, and, and, and, and they're sitting in a group talking about something and all of a sudden, they're, they're flooded with a memory of that. And their body's actually having sensations that are similar to that expense.

And it's terrifying for them because they don't, they don't know how to understand this. How can I be feeling this way? City here. And if they don't know that that's a trauma recall experience, they're going to think something in the room is [00:28:00] highly dangerous and this attribute what's going on and get terrified that somehow they're in danger.

Yeah. 

Tim Norton: Okay. Perfect. And that's, that's such an important point. I mean, not that you know, I don't want to get into semantics when, you know, people use words differently than clinicians do, but it, it, it can be hyper pathologizing if somebody is not dissociating or having flashbacks or nightmares and things like that, like they, like you said, there was a ton of it.

Doug Braun-Harvey: Yes. Yes. Pain. They're having pain. They're remembering something painful. When we remember something painful, that's not trauma. That's remembering pain. Yeah. Yeah. And I don't mean to minimize people who experienced trauma, but I also don't want to dilute the intensity of people who do experience trauma by, by overgeneralizing that word to people who are in a different spectrum of pain than trauma.

Yeah. Yeah. 

Tim Norton: And so [00:29:00] just to clarify before, I want to, I want to get into the, the imagery stuff, but I also just want this to be clear to the listeners that you know, everything that you talked about with the, the, the man who's not keeping.  his relationship agreement. It's w regardless of the details of that, regardless, even of the consequences of that, there's not, I don't want to think that there's somebody out here you're saying, well, that doesn't really apply to me.

No, I'm just an addict. Like you're talking about this and an all encompassing way that this is, there's not somebody, there's not some level of pathology that somebody gets to where, where you're calling them a sex addict ever 

Doug Braun-Harvey: me. Yeah, well, we don't have any science yet that establishes a kind of clear, agreed upon consensus, among many different people who understand this behavior.

We have no [00:30:00] agreement as to when this might be actually a disease or a disorder. I mean, there are people who believe it is. There are people who treat it as it's a disorder, but we still have no agreement,  as a mental health field to say, here's this here's the standards. Here's where you cross a threshold.

Here's where you've now really in the arrange of having a disease. Each attempt to do that,  in the psychiatric manual,  has been now eventually completely rejected. It's just been rejected because the science isn't there. Now we have the international diagnostic manual, which is called the ICD it's the international classification of diseases.

It's actually what every other country in the world uses to classify their diseases except the United States for their psychiatric diseases.  and that has just now come out with an actual disease idea. Of compulsive sexual behavior is what they call it, compulsive sexual behavior. And they [00:31:00] think it's a part of people who have impulse control problems.

There's a psychiatric disorder classification called impulse control disorders.  and,  they think some people might have compulsive sexual behavior who have difficulty controlling their impulses,  in, in, and the difficulty is reflected in their sexual behavior parents. Now, this is an idea it's in the classification.

We don't have it. Studies, we don't have anything. They actually say, yep, we've now studied this. And we've determined. There is a condition called compulsive sexual behavior, but the reason they included it in the classification was let's check it out. Let's, let's call it what it is. Describe what we think it is.

And now let's do some research to see if there's anything to support it. So that that's the closest thing we have. 

Tim Norton: Okay. And the distinctions, I suppose, have to do with, you know, when we're talking about,  drug addiction, when we're talking about withdrawal and we're talking about [00:32:00] tolerance and we're talking about consequences and all that good stuff.

So, and when you say the research hasn't been. Great on that, that it's, it's really hard for them to establish an actual physical withdrawal like you would get from a hair. Well, the, the 

Doug Braun-Harvey: sex addiction field has moved away from tolerance and withdrawal as their defining characteristic for the disease.

They've really put much more emphasis as well as many other, you know, addictive disorders have on the brain.  component of a deduct disorder and looking at changes in brain functioning and neuro-biological changes in the brain. We've looked at this with drugs, of course, and the changes in brain with different drugs, you put in your body how to fix the brain.

But this is a very important area of study.  and those brain studies, neurobiology and key neuro-biological studies,  neuropsychiatric and psychological studies around how the brain functions in the state. Of different aspects of sexual arousal and changes in the way the [00:33:00] brain functions in sexual arousal based on a kind of addictive process developing is really what the sex addiction field is invested a great deal in.

Now the dilemma with as most of the studies that I, and this is a perspective, I find credible as a critique. Is most of the studies that have been done, the FMR eye and the brain imaging studies on how the brain functions in States of sexual arousal,    have been done primarily by people looking at sexual imagery on a computer, you know, these sorts of situations, and then measuring the brains of people who.

Identify as sex addicts and measuring the brains of people who don't identify as sex addicts and see if their brains are wired differently. Based on the fact that they've now entered into an addictive process, that's the idea. And they have seen some differences and based on where the brains light up, however,  none of these studies have been done while people are having sex.

Right. So [00:34:00] the dilemma with all of these studies is it's based on how the brain functions while having sexual imagery or sexual activity being activated by viewing. But we know the brain functions enormously differently while we're having sex. We don't have any measurements of what somebody who's been diagnosed with sex addiction, what their brain looks like while they're having sex.

Yeah, 

Tim Norton: no. I had a Dr. Nicole Prouse on this show,  some months ago and she was very eloquent about that point and speaking from experience cause she actually does do research with people. It's it? 

Doug Braun-Harvey: It's Dr. Process research that I really rely on to make that statement. And I was going to say her name in a minute.

So thank you for saying that because it is Dr. Price who has taught me,  through her studies that, you know, we have to really look at the science. Yeah. And I'll just say one more thing about FMI studies. FMRI studies are where you look at the brain and where it lights up in these, in these [00:35:00] kinds of the technology, Rory Reed, who's a brain neuro-psych researcher as well told me this story, where they were doing some FMRI studies on fish.

And they were seeing if fish's brains lit up differently under these FMR machines, if they showed the fish different colors, so they would show Brad or Baloo and see if the brains lit up differently. And they did. But here's the most important thing about that study? All of the fish in the study were dead.

Oh my God. Now think about that. All of the fish were dead, but they did get some dip. Maybe get reactions on the machine. Huh? What this teaches us is the machines are not infallible. We think when we do research with machines, that the machine is so infallible, the only reason for any data to be a significance is the human subject that's being measured.

We have to remind ourselves these machines have their own fallibility. And so it's an interaction of the [00:36:00] technology limitation and the limitations of the scientific design that I think leads to some of these conclusions that I think are inaccurate. 

Tim Norton: Yeah, then I don't know if I've ever soap boxed about this on this podcast. I could probably fill an hour with the very large conclusions that a lot of people draw from those, those FMRI studies and, and. They're they're very compelling and you know, and I, I love, I would love it if the sex addiction camp would speak in those terms, like there's some compelling information that we've found where there's some similarities between these two brains, we're still going to research it.

We still I'd like to see a thousand subjects in just one of these studies. I'd like to see, like you're saying people while they're having sex, they that's really hard research to get funded. By the way, Dr. 

Doug Braun-Harvey: He probably told you on her program that she had to leave the campus. Have you sail to conductor studies because the university was uncomfortable with people in research labs, on campus, having [00:37:00] sexual activity and orgasm.

Totally. 

Tim Norton: Totally. So there are only a handful of places around the world that are doing that kind of research on a regular basis and incredible basis. So we're a long way from speaking definitively about that. Right. And while there. At the same time you speak, you spoke earlier about the hope that people receive when, when they, they, they have this medical diagnosis or a disease disease diagnosis.

And then there are places that will charge you $30,000 a month, based on that hope that you have telling you they're going to cure this. Yeah. Well, that's another 

Doug Braun-Harvey: thing they're going to cure, but they certainly saying they can help you and they can give you hope. But I, you know, I. I think we have to bring this to a human level.

All of us go to the doctor when we're, when something's wrong. And we want them to tell us what's wrong, right? I mean, that's human, right? This is, this is just something we want. And so to [00:38:00] have the kind of. Pain and, and, and, and fear and shame and,  threat of all sorts of consequences in front of you. And you walk into an office with somebody who's going to help you understand this sexual behavior.

It's enormously relieving to be told you have a disease. And here's exactly what we're going to do. Whether it's, whether it's a useful or accurate or pertinent to that client, clients feel relieved when a medical practitioner is sitting across from them, says, this is the story. And we've got an answer.

Damn. But 

Tim Norton: I've, I've seen this process on you. You have to, I'm sure at still there's two things happening there. There's one, there's the doctor. Who'd probably get sick of saying, I really don't know what to do with this. And once he starts saying, and you're a sex addict, you're a sex addict, sex addict. He gets [00:39:00] rewarder.

She gets rewarded for. For saying that and gets a thriving practice as a result. But two, I've seen that couple experience that relief and no, thank God. It's just this he's, he's got the sex addiction thing and we're going to go, we're going to, and you've got the answers 

Doug Braun-Harvey: for us. You've got tasks to do.

You've got a sequence of things to do. You've got people we're going to meet. Who've done the same thing. This is enormously hopeful for people who are scared and have no idea what's going to happen. Right. 

Tim Norton: And then. 30 days later, 45 days later, he gets out. And what he really has is narcissistic personality disorder.

And he has, you know, he's, he's using maybe he's just doing all kinds of things and 

Doug Braun-Harvey: that could take years, you know, 

Tim Norton: but not a lot of people will say, there's nothing you can do about that. And he's just spent a month and a half meditating and going to groups and doing all these things and in a really lovely place, but he could be years from being even slightly different.

And [00:40:00] if ever, and there's such a, almost like another level of hurt for the partner in that situation, he was like, what did we just do? You know, what did we just pay all of this money for? He's the same guy. He's actually a little worse now he's the same guy, but he has a narrative explaining. All of the things that, you know, the reasons why he's doing things and he's blaming me for stuff.

 yeah. And that that's been, that was, that was eventually what chased me away from that was just watching that several 

Doug Braun-Harvey: times in our model for treating out of control sexual behavior. We see the out of control sexual behavior as a problem, not a disorder, but that doesn't mean we're not assessing and looking at real diagnosable conditions that might contribute or actually explain why they're feeling sexually out of control.

For some of the people we look at, are they in a situation of fit they're not safe, there's violence or lack of safety in their home, or you mentioned earlier another, another aspect of physical safety. That [00:41:00] makes,  sexual behavior possibly feel less regulated or not a control is somebody who might be suicidal.

That's another form of violence, you know?  you know, I, I, I, I approach life that I could eventually just end my life as a, as a treatment plan for the distress in my life. You know, that that's, that may impact or impair somebody's motivation to change, or it may regulate their sexual behavior more effectively because they hold out the idea.

I can just end my life as things get too bad. But for some people that have medical conditions, I mean, we, there's lots of research out there that shows real medical illnesses and conditions that you are medications can cause hypersexual behavior or certain psychiatric,  medical conditions, Parkinson's disease, other things.

These actually have hypersexual disorder things. So you have to look for. Are there medical conditions that could explain this,   and then, and then we also have to look at,  medical conditions related to sexual functioning. Might somebody have an unaddressed erectile dysfunction or orgasm difficulties or, you know, or maybe they're, again, maybe you have a conflict about who they are sexually [00:42:00] and they don't, they're alone with this.

Men, oftentimes they're isolated alone with these problems. They come up with these treatment plans all on their own. And so what looks like out of control sexual behavior actually is some sort of an attempt to address a medical or physical condition related to their sexual lives.  and, and,  it's not a great treatment plan, but if they're trying to do something about it, Many people as you've alluded to have mental mental illnesses,  they may, you know, have you mentioned bipolar disorder, they might have personality disorders that might have depression, anxiety disorders, ADHD.

They might have PTSD.  there's there's so many range of the kinds of mental health issues that could be in the office when they're walking in. But yes, there are sexual behaviors out of control, but they might have an,  not significantly a well-treated enough anxiety disorder conditions. It's just not being treated well enough.

Or they've never been diagnosed for depression and they've been living with kind of, you know, depression their whole life, and it's never really been identified. And the last area we look at is their relationship [00:43:00] with drugs and alcohol, a significant number of people who have sexual dysregulation feel out of control sexually in their wives.

There. Using substances in a dependent and out of control manner, they might, they may have alcoholism that's so out of control,  you know, that there's really no hope for regulating the sexual behavior until they treat their alcoholism. A subset of men who have sex with men.  is a, is a it's called chem-sex.

This is really term. We came out of the United Kingdom, but there's a certain series of drugs on GBA, GHB, and, and other kinds of club drugs that people use. Men who have sex with men will gather together in large group settings, either in homes or in sexual venues and use these drugs have prolonged sexual experiences sometimes for days at a time.

And that's called cam sex. And so some men might who have chem sex patterns. I think that, you know, they have out of control sexual behavior or sex addiction and, and it's really this interesting Kim sex issue. So, you know, [00:44:00] all have to be looked at before you even begin to think, Oh gosh, maybe they have out of control sexual behavior.

We gotta, we gotta figure this out first to make sure we're not jumping to conclusions. Or as I like to say that our field suffers from premature evaluation. And there's help for them. 

Tim Norton: Yeah, that's really well put it is a premature evaluation and when you're kind of looking for. Yeah. The, the thing that we've been talking about this whole time, then a lot of that gets missed.

Doug Braun-Harvey: I think the idea you're talking about, and there's research for this, this is where this is a real human behavior. You're talking about confirmation bias. Confirmation bias is when somebody has a particular idea of something and how they understand things to be, or they need to see or want to see a particular way.

But. They, the human brain will do this. They'll filter out information, then it contradicts,  the, the idea they, they, they think explains the situation.  this is true for, this is just a [00:45:00] human behavior. Yeah. And so the LCSP model as Michael and I, but when you have a sexual behavior, that is so little understood.

There's no consensus about exactly what exactly the nature of this is, how to best treat it. It's something we know very little about. You know, the mental health field has a terrible track record of doing well in those situations. They've they've they thought they understood something only to 20 years later have to say, no, that's not the case.

We were wrong. So.  the LCSP model is based on the ethical principle of protecting the client as best we can from us. That we need to be trying to not, you know, prematurely place ideas or narratives on,  within a client's situation of having out of control sexual behavior,   in a way that,  doesn't really, really slowly and carefully help the client understand their situation and their [00:46:00] individual situation without applying a broad brush generalization to their situation that may.

Actually be inaccurate and could actually be even harmful. And that's 

Tim Norton: so important when we're dealing with 

Doug Braun-Harvey: sex. 

Tim Norton: Yes. There's such a tendency to stigmatize, as you've mentioned earlier as stigmatized sex and so many different aspects of culture and life and society, and to down to governmental policy,  that if you tell somebody they have a thing, their sexuality may never recover.

Or may, maybe really detrimentally effective for decades. Yes. 

Doug Braun-Harvey: Yes. The, these, these ideas of a, of a diagnostic, you know, kind of label for one sexual behavior sexual activity,  is, it needs to be thought of very carefully. And so if, if at some point [00:47:00] the science actually does come through and we have a consensus yet there is a disorder, there is a disease of some factor of how to control or, you know, set.

We're going to call it dysregulate sexual behavior. There actually comes into great, but there's still going to be many people. Who do not meet that diagnostic threshold who are going to have problems with feeling out of control, not everybody who has that is going to have the disease. So our model can still help the people who don't cross that diagnostic threshold.

And they, and we are this, this sexual health model can be quite useful for them. Even if a disease gets established. 

Tim Norton: Let's shift over to the second kind of client that you said would,  come into the practice a lot at the one who's really struggling with his relationship. Yes. Sexual imagery. Yes. Sexual imagery in, and some people might.

Call that a porn addiction, 

Doug Braun-Harvey: actually 99% of the people at 0.9% of the people in the world call that porn. [00:48:00] You know, you know, I th my, our sexual health languages, we use the word sexual imagery. We describe what the media is without trying to use a pejorative or judgemental language pornography is, is not,  it really has a pejorative history to it, a judgment.

Yeah. 

Tim Norton: So tell me about working with this population. So these, when they're coming into for treatment, is it more often that it's somebody who's just worried about. His relationship to it while he's not in a relationship or is it was most of your clients actually, their partner was taking issue with what they were doing or is it a little bit 

Doug Braun-Harvey: of both?

You know, I think there's three circumstances that come to mind. One is somebody who has recently lost a relationship that they hold held. Dear. There's been a real loss,  as a re  in, in their, in their understanding of that [00:49:00] relationship ended, they lost that relationship, having something to do with their masturbation life and sexual imagery, whatever it may be.

Again, some people are single, not in a current relationship, and they're concerned that their relationship with sexual imagery is, is so out of control or is so worrisome to them. That they believe it's actually interfering with finding loss and that they believe that that they're actually going to not find a love in their lives.

They're not going to find a part or there they're, there they're dooming themselves because of their relationship with sexual imagery. Some people are very concerned about that.  and then other people are very concerned,  about,  the secretive sexual life they have with imagery,  within their partner relationship.

It's either been discovered or it's been discovered many times and they've made promises and there's, you know, to change. And those changes haven't happened.  you know, th th th those are the three most common [00:50:00] relationships with sexual imagery. Some people come in, you know, and they're, they're conflict with sexual imagery.

They could be in any of those situations, single partner, whatever.  and they're very disturbed about the images they're looking at. Hmm. You know, th th th it's like, I can't believe this turns me on, Oh my God. I, you know, they're, they're, they're just like, they're just mortified or they're thrilled that it turns them on.

They love it. And somebody else hates them because it turns them off. Or is disgusted by them because it turns them off or, you know, thinks they're perverted. I hate to use that word, but that's an allegation that'll be used.  you know, so you know that those are big deals and they, and they all come in and say, I have a sex addiction.

Right. They all say 

Tim Norton: that. Yeah. Which is,  do you have just [00:51:00] recordings that you refer that you must, must've gotten sick of having to explain that? 

Doug Braun-Harvey: No, I don't get sick of explaining it because I don't want to take this away from people for their use of the word sex addiction. First of all, that's what the culture has given them.

That is the language they know.  and then quite frankly, that phrase might be what gives them hope. You know, so I, you know, I, it doesn't bother me that a client uses that language as, you know, as part of their early relationship formation with me.  they're just not going to hear me say it.  you know, so, you know, I, I, it's really important.

You don't want to take hope away from people and, and, and certain words and certain times, so,  you know, I think there's an interesting. You know, kind of responsibility of, even if you, you know, don't think that language is accurate because this is a human behavior. We know so little about, I can't just say absolutely that that's not true.

That doesn't exist.  you [00:52:00] know, there are, cause there are heat. They could walk right down the street and meet another professional who says right on that's exactly what you have. So, you know, I can't like just hold it like with other diseases, we have agreement to what they are. And so somebody uses the word and it's inaccurate.

They could probably go to 10 other people. And they'd all say the same thing. It's not an accurate word. So we, we have to be careful with this languaging of this in our offices.  letting people come at their own pace and coming to terms with. You know, when they're exposed and learn about the sexual health model, how they eventually might possibly begin to think about different language.

Hmm. I don't think it's an emergency because somebody uses that word in my office. Yeah, no, definitely 

Tim Norton: not.  W we've kind of started to, to wander into this area to a couple of different points. This is a podcast about erectile issues. So let's just segue from what you were just talking about there, of those three typical kinds of [00:53:00] presentations.

You didn't mention the guy who comes in because all the sexual imagery that he was taking in had led to an erectile malfunctioning. 

Doug Braun-Harvey: It happens.  in other words, what I mean by it happens is people say, this is their story. That's what happens.  you know,  again, this is premature evaluation. Somebody is having difficulty with their erectile functioning and they have come to the conclusion that it's correlated or completely linked with the fact of their relationship with sexual imagery and their masturbation practices.

 the science is beginning to reveal. There's many explanations for this.   one of the least likely explanations is that they have a biophysiological erectile dysfunction that can be measured.  I did have a couple of clients that however, who came in and said I was a porn addict.  and what the situation was is they actually [00:54:00] had low blood flow.

To their penis, which was a biological condition from birth.  and they had adapted to looking at sexual imagery as a way to kind of as their own kind of erectile therapy, thinking that if they masturbated,  they could. You know, gauge their penile tumescence, or they could gain confidence in how they could have orgasms while masturbating.

So they might have more confidence during partnered sex,  you know, all of this, but they, but they began to somehow think that their erectile difficulty was because of watching sexual imagery when actually their use of sexual imagery. What's that such high frequency, because they had an existing erectile dysfunction that was biophysiological caused, right?

Yeah. So it was, the imagery had nothing to do with it. Yeah. So there's a lot of thinking anger's here. Another,   porn addiction,   kind of narrative will be that somebody has a very [00:55:00] unconventional turnout.  and the only way they see it as can turn on is through going to,  imagery online. Let's say they,  you know, they like,   they, they like,  somebody being tied up and being restrained and they imagine they're the person being restrained when we're watching this.

And that fantasy state is very highly arousing for them. And they learned that this is actually their most preferred way to have. You know,  highly pleasurable, you know,  you know, sexual fantasy and arousal and body sensations that gives them the most pleasurable orgasms. And then they're in the middle of partner and sex and they th this fantasy isn't accessible to them.

They can't have the body experience of restraint because they're in the middle of having a partner in sexual activity. And so they've been, they've learned, this is such an important arousal, and it's a secret to their partner by the way.  and all of these things are inhibitors that get in the way of sexual excitement.

And so th these inhibitors are now [00:56:00] interfering with their ability to be excited.  and so they're not sexually functioning as well, and the client will make the connection. Oh, this is because I'm looking at imagery. When actually they have a conflict about what turns them on, where do men learn? How to say I have an erotic conflict, what a men learn to say?

There's something that turns me on that I feel so ashamed of. And I, if I think about it while I'm in the middle of the partner and sex, I feel ashamed of it because I'm not present with my partner. And then I lose my erection.  and then my partner knows I just masturbated two days ago. And so it was all of us to be because you're masturbating too much.

And that's the story in the couple. Because the erotic interest can't be discussed. It's too shameful. It's too painful. So the porn addiction is the better story because then you don't have to disclose your erotic conflict. 

Tim Norton: Right? No. I love that. Where do men learn that they have an erotic conflict? What are they learning?

Doug Braun-Harvey: That's right. Where do they learn to say it? And I can tell you in, in, this is one of the criticisms I have of many of the [00:57:00] treatment approaches, notch, the sex addiction, many of the treatment approaches for this behavior.  don't have really thorough and really slow methodical ways of helping men begin to  identify an erotic conflict that they have.  without that orotic interest being seen as something wrong with them. As I like to say to the men, we work with no erotic ectomies here. We're not going to remove what erotically arouses you. That is not the point of this therapy. We're going to try to help you enjoy that erotic arousal as much as it's designed for pleasure for you.

And. Keep your relationship agreements and not violate basic fundamental ideas of sexual health. There's a way to do that. Okay. 

Tim Norton: So. What about, I think the, one of the more common tropes though is [00:58:00] so that the competition, right? So guys, and 15 year marriage, two kids, and now he's watching a couple hours of porn a night after his wife goes to sleep and he's, you know, watching college gang bangs and, and you know, his wife is not 30.

College students every night, right in that comparison. And I think our, our culture says, well, like she can't compete with that. He's desensitizing himself. To, you know, being able to be turned on and then she'll never be able to turn them on again, 

Doug Braun-Harvey: there's about five different sexual narratives in that one situation that could all be part of it.

Right, right, right. But the easiest story is all of the problems this couple is having in their sexual life is because he looks at this imagery. That's the dilemma with that story. There's so many possibilities there. The biggest word that comes to my mind [00:59:00] in that story is avoidance. This is a couple who, you know, and, you know, for all sorts of reasons, they're, they, they they're busy raising kids.

I mean, who knows? There's so many things going on. I don't know what all those circumstances are, but I know that one of the most common approaches to sexual concerns in couples is they avoid them. They don't who teaches couples, how to talk about their sexual lives with each other. I mean, I ask people when they come in, what's your masturbation agreement in your relationship?

And it's like, what is that know? They don't even know what that is. He's like, what do you mean? We don't even, they wouldn't even know each other, man. They don't even know if each other masturbates no less than what their agreement is. Right? So the dilemma with all of these avoided problems in couples around their sexual lives is they get avoided until somebody hurt.

 And that's the dilemma, the injury carries too much weight [01:00:00] for understanding the big problem. You know, that there's a couple of you described that that's a 10 year arc 2015 year. I don't know what it is, but there's a whole lot of things that could have contributed to the situation they find themselves in the sexual imagery is the easiest target.

well in her book,    the state of affairs,  and mating in captivity, both,  talks about when couples lose desire,  for each other. And they've got a Arctic vitality of couples.  it, it, you know, there's a lot of reasons why, if I were erotic, vitality can be lost in couples. And then sometimes the masturbation monies is the way a person is.

Keeping alive their erotic cell, because there's no other place for it to be on life support. Now, are we going to call that a disease or are we going to call that [01:01:00] lifesaving techniques? It's all about perspective. Yeah, no, it really is. Really is, but notice how, what I'm saying is this is hard work. This is difficult work to explore and figure out why this couple is in this situation.

Whereas the porn addiction story creates a ready-made narrative that doesn't require the kind of in-depth individualized, painful exploration of two people looking at each other and trying to figure out how we got here.

And that's, 

Tim Norton: that's very daunting. It 

Doug Braun-Harvey: is. So, you know, gimme porn addiction. All right, here we go. Yeah. Go 

Tim Norton: and stop watching this for 30 days. Join, join the no-fat movement. How do you feel about those guys? The a no fat burners and the, this is your brain on porn and all these 

Doug Braun-Harvey: things. So you've got to remember, there are [01:02:00] these sorts of ideas about sex thrive in every culture.

Hmm. You know, where eliminating certain sexual behavior is the solution to complicated conditions and situations. You know, what draws somebody to those particular interventions? What draws somebody to go to a site where you learn how to stop masturbating the motives for that can be very many and very wide.

You know, I, I wanna, I want to remind viewers that there was a time in our country. When people who had same-sex attractions,  the mental health field provided a therapy that said we could make that go away. And people came to those therapy services in droves. We live in a culture that as long as somebody offers a viable solution to sever.

An erotic interest. They'll always be a commodity of people who find that very appealing. So I have no, I don't begrudge [01:03:00] those resources. They've always been there. The mental health field for crying out loud, licensed mental health professionals in this country 40 years ago were pretty much offering the same thing.

So I w who are we to cast stones? It's, it's just that they'll always be a group of people who want this solution. Yeah, 

Tim Norton: who, who, the first thing they want to point to is it's, it's the sex 

Doug Braun-Harvey: in a, in a, in a Puritan culture, which we are, it comes from our very origins,  that, you know, in our culture,  being uncomfortable with sex,  is,  a very powerful position to be in.

You know, when you're comfortable with sex, you don't have, you don't have power in our culture. The people of the power who are walking the room and say, that makes me uncomfortable. Stop it. They have the power, the people adjust to the people who are uncomfortable about sex

[01:04:00] yeah. And this happens in families and couples. If, if one person or a couple says that's disgusting, that makes me uncomfortable. I don't want that. They assume the rest of the system will adjust to them because their discomfort should be the power. They're discussed should hold forth. Right. And 

Tim Norton: were pushing back on that a little bit.

Doug Braun-Harvey: That that is that's the ebb and flow, right? That's the ebb and flow. And it's always been in all cultures and over history. We can go back through history and see, there were times this tension always exists and it ebbs and flows. It ebbs and flows in couples and ebbs and flows and cultures and ebbs and flows and families and it, and flows over time.

And so we just have to kind of put this into perspective. I 

Tim Norton: don't know if it's just because of the world that I'm in and being around sex therapists in, on, you know, seeing your emails in a, a list serve and things like that. But [01:05:00] I do feel like we're in a, a bit of a sexual explosion right 

Doug Braun-Harvey: now.  I think for me, the number one impact on the sexual lives of everybody on the planet is the internet available by a cell phone.

Hmm, these are sexual toys that we get walk around within our pocket, 24 seven, the, the access to talking about sex in privacy with other people, the access to seeing sexual imagery and sexual activity is, is. Is is literally never been unprecedented in history of the hue of humankind.  and so, you know, I like to remind people that the, when the automobile was invented, we didn't realize we had to teach people how to drive automobiles and give them licenses until the automobile had been around 30 [01:06:00] years and people were dying in car accidents everywhere.

It's so many figured out, well, maybe we better issue driver's licenses. So we have to respect that the internet and the access to these kinds of sexual imagery is very new, very new for people to understand. And so we don't have cultural norms. We don't have you, you know, established ways of relating to this as far as sexual imagery.

And so we, we, we gotta be careful to call people who don't know how to use this as well. As the ones with the problem, you know, there's a time of an adjustment. It takes a huge amount of adjustment for these kinds of changes that only happen every now and then. And then of course the history and we're in one of them right now, right now.

Tim Norton: Yeah. Now that I love that analogy. We have to teach people to drive. I actually recently did some work with PornHub and I feel very strongly about that. Like, because [01:07:00] they have such a presence that at some level we're going to have to take a real strong look at. You know, putting out sex positive instructional porn that might be seen by a lot of people that, you know, are, are watching porn and accessing porn otherwise.

Doug Braun-Harvey: Well, there's a, there's a, there's a movement that's just beginning,  to, to even be able to be spoken just even to be said and it's, and it's called porn literacy and, and that's the phrase that is being used in the, in the, in the sex ed field.   because it's a way for people to understand they're talking about, so you have to say the word porn, just like you have to say the word sex addiction.

So people know what we're talking about. So porn literacy, you know, that, you know, just like driver's license,  you know,  you know, it, it takes a while for people to understand that this is actually not a restriction on Liberty. This is not a restraint of, of [01:08:00] expression.  th this is actually a responsible thing to do with something that has major consequences when you don't have literacy on how to use it.

Right. If 

Tim Norton: we don't offer. Porn literacy courses, it would be like, well, let's put somebody in a car without taking drivers. 

Doug Braun-Harvey: Yeah. And we did that for 30 years, by the way. So it's not like we haven't really, we did not have driver's licenses for 30 years after the car was invented. The first driver's license was issued in Pennsylvania in the late 1920s.

God. Right. So cars were around for almost 30 years.

Human to, Hey, this is what human behaviors like we have to, we have to go back to history and, and get comforted by looking at history that this is just another re you know, another cycle of the same human response to significant change. Hmm. We [01:09:00] didn't, we did like people who got into car accidents, diseased.

You've got a mental illness. You got into three car accidents in the last five years. This was 1920. Hmm. Hmm. Well, that's, 

Tim Norton: that's a hopeful point. That, that was one of the last things I wanted to talk about was I didn't mean for me or us to, you know, by challenging. The sex addiction model to say that this is hopeless.

And I was hoping that you could close with, because you've worked with also with addiction, you've worked with and alcohol treatment and drugs, where there would be sexual acting out in conjunction. Can you say that differently? 

Doug Braun-Harvey: Then sexually, I want, I'm going to channel, you can tell me what, tell me what you're saying.

Tim Norton: I would be saying there would be the sexual breaking of agreements and there would be,  erotic conflicts that happened,  while in conjunction with. Taking more [01:10:00] drugs and alcohol than they had wanted to, to your point on. And I am a big fan of looking at language and I appreciate the correction. What was your question?

I 

Doug Braun-Harvey: interrupted you. Could you say so, so 

Tim Norton: the hope for the OCS B client who actually does reach that diagnosis, who might be in, you know, and also,  struggling with just impulsivity or out of control,  Behavior in life. Like what is, what 

Doug Braun-Harvey: is the, I think, I think the first thing is is you, you need to figure out who you want to talk to about it.

If there's something you've heard me say here on this podcast that sort of excites you and interests. You see, if you can find a therapist who works with,  sexual dysregulation, that's the general term I use,  from an OCM,  you know, from a sexual health perspectives. Sees it as a problem might consider it as an out of control sexual behavior, not a disease or disorder, [01:11:00] if that's important to you, if that seems like a source of hope for you, there are people that you can find in perhaps in your region.

 there not as many of them, but you might find some people who are at least willing to work or learn or have been trained in this method. If you've listened to this podcast, And I sound like a quack,  and that this is dangerous talk and that, you know, you're gonna, you're gonna, you're gonna endanger people's lives by not calling them a sex addict.

 the, you know, that you're a fool,  then you need to call a sex addiction therapist because that's where you're going to find help.  and, and as you, as you said, sometimes you'll find people who started at the sex addiction. Stage and found themselves in your office because for whatever reason, the hope wasn't there for them anymore in the sex addiction model, but who knows, maybe they need to just start there to get where they are now.

I don't know, but I'm, I'm more interested in [01:12:00] empowering clients, empowering people to, to walk in a door where they think they're going to find hope. And the problem was there was only a one door. Primarily, and that was sex addiction. And I'm just interested in offering more doors and ours is a sexual health floor.

Tim Norton: And you could say with confidence to that person who comes in and says, I'm worried, I'm never going to have a, you know, they'll say healthy, I'm never going to have a healthy or a normal sex life ever again. And you could say what to them, 

Doug Braun-Harvey: why did you come up with that idea? This is what I'd say to them.

How did you decide this? W where did, where did you come up with that idea? This is their idea, and I'd help them figure out where it came from. Hmm. I'm not going to give them some glib answer that Sue's their fear. I don't even, I don't know enough about them. Maybe that's an accurate assessment. I don't know.

I have no idea. [01:13:00] I got to get curious. 

Tim Norton: Yeah. Okay. Very well said. All right, Doug. Well, do you feel like there was anything else that you wanted to cover in 

Doug Braun-Harvey: this? Well, I, I guess I just want to say to you, Tim, the conversation we've had today is a little different than the conversations I've had with other people in some of the media work I've done because of your experience.

I really, I just want to applaud you for having, you had your feet in several pools. Of sexual behavior concerns and that that's, you know, I just want to applaud you for that journey because that's not an easy journey for clinicians to do.  and I'm just heartening to talk to you. And the questions you've asked, show me that you have a lot of experience in this area, this, that you really, I talked to other media people and they conceptually understand these ideas.

But it's real, it, it shows in your questions that you sat in the rooms with, with these various ways of working with this population and [01:14:00] it made for a richer conversation. So thank you for that. 

Tim Norton: Oh, absolutely. I really appreciate that. You know, that, that, that this, this is what we love. This is what we do. And this is what you have loved and done. You're you're at a, you know, this is a big changing year for you, so you are going to, you're still going to work, but you're just going to focus on training, training, teaching, and writing. Okay. Training teaching 

Doug Braun-Harvey: writing. And my clients know about this decision.

My clients know my motivation for this decision. And so I can, I can say this to you on this program and it's not anything I haven't also said to the people who I'm saying goodbye to. 

Well, I can tell from your eloquence and insight and experience that you're a wonderful trainer and I I'm really glad that you're going to continue to do this work.

Tim Norton:  where can people find you?  the website for the company?

Doug Braun-Harvey: My husband and I co founded in 2013 called the Harvey [01:15:00] Institute. It starts with the, the Harvey institute.com and then you'll find all the information about. The services of education, training consulting,  and all of the books, the three books that I've written, journal articles,  media,    interviews,  a variety of resources,  and then full information about the sexual health model here that we've spoken about today.

Tim Norton: Okay, well, fantastic. Well, thanks so much for this, Doug. This was a wonderful, I, you know, when we spoke originally, I, I think we could tell, like this would be a good conversation and I'm glad that we're offering that perspective out for, for other people. And thank you so much for your work 

Doug Braun-Harvey: and your work.

Thanks Tim. It was great to be here and, and you were a good sport. Thank you. 

Tim Norton: Thanks to all my friends and family for brainstorming this show with me. Shout outs to the sex positive community, including sex educators, sex therapists, sex coaches, and other fellow sex, podcasters, sex surrogates, academics, sexual health, medical community, sex workers, the tantric community, and everybody else involved with having hard [01:17:00] conversations. Bye-bye.