Introduction to Problematic Sexual Behavior

Speaker 1 0:01

Welcome to the Husband Material podcast , where we help Christian men outgrow porn . Why ? So you can change your brain , heal your heart and save your relationship . My name is Drew Boa and I'm here to show you how let's go . Today , we get to hear from Bill Herring , who is a certified sex addiction therapist and certified clinical partner specialist , who won the Carnes Award for his contributions to advancing our understanding of sexuality and sex addiction and problematic sexual behavior , which is what we're talking about today . Welcome , Bill .

Speaker 2 0:41

Thank you , Drew , Glad to be here . I really appreciate you having me on Welcome .

Speaker 1 0:44

Bill . Thank you , Drew , Glad to be here . I really appreciate you having me on In your work as a sex addiction therapist . What problems were you beginning to find with this concept of sex addiction ?

Speaker 2 0:53

I appreciate that question . I may give a sequential answer to that because there's more than one sentence to that one . Let's start with obviously I believe in sex addiction . I believe in porn addiction . Let's start with obviously I believe in sex addiction , I believe in porn addiction . I believe in their reality , their legitimate entities , processes that so many people get involved in and literally cannot control their behavior once they get into that loop . So I want to start with an absolutely solid foundation and acceptance and support and advocacy for the phrases sex addiction and porn addiction . All right , start with that .

Speaker 2 1:28

With that said , over the years and I've been in private practice for a long time , about 35 years and I became a c-set certified sex addiction therapist I think it was back in 2002 .

Speaker 2 1:42

So I've been doing this work for a long period of time and what I noticed really for a good while back is that some men who came to see me who were having just intense problems with the consequences of their sexual behavior you know , having been discovered by a spouse or having had some sort of crisis at their work or maybe a legal crisis or just typically going to be discovery when men come in they're just devastated and looking at the consequences of their behavior and wanting to know what to do about it , because they wanted to no longer engage in that behavior , and typically outside of therapy . There was one resource that I would recommend almost consistently , which is one of the 12-step groups related to sex addiction , and , as I know that you know , I typically explain to clients that if you had an alcohol problem , there's one 12-step group that I would refer to you , and that's AA , or if overeating , there's one OA , or gambling , there's one GA . But in the sexual arena , there's several 12-step fellowships that I'll highly recommend , as you know SA , SAA , SCA .

Speaker 1 2:58

There's probably more and more emerging .

Speaker 2 3:01

I typically say if it starts with an S and ends with an A go to that one and I found that that was really beneficial . You know , life transformational for so many people and not so much for others . And there was obviously the traditional barriers that some people can have against the phrase sex addiction or going into 12-step programs , that you just kind of have to typically help people to get by if they have some reluctance . Years ago I wrote an article called 12 Objections to 12-Step Programs and 12 Responses . I generally found that if people did not want to go there were some reasons that would come up a lot .

Speaker 1 3:44

One of the reasons why people are reluctant to identify with some of those programs is because of the language of saying I am a sex addict .

Speaker 2 3:52

You're absolutely right , and that's where I started to realize that the paradigm and the language that we had was not sufficient to help everybody who needed help . Obviously again , as you know , the language and the concept of sex addiction came basically in the 1980s as sort of a drag and drop from alcohol and drug addiction treatment , with all of the parallels from sexual behavior to those it was a natural fit to just put 12-step programs as the primary modality to help people .

Speaker 2 4:31

So the first language , the first words that got to this field were sex addiction and were 12-step languages . And so it was almost a given that if you came in to have help with your sexual behavior , you were going to be referred to a 12-step program , and you're going to have to acknowledge that very phrase that you say , rightly , so many people resist having .

Speaker 2 4:52

I am a sex addict , which as you know it's a difficult , one of the most difficult five words for some folks to be able to say , because it means so much , there's so many implications . Those words cannot be taken lightly . It is sometimes spouses or people may say oh , you're hiding behind the excuse of addiction . No , it's not . It's taking absolute responsibility for your life and your behavior and your choices and consequences in dealing with that . But as you said , those five words I am a sex addict often became a terrible barrier initially in my treatment with that . But as you said , those five words I am a sex addict often became a terrible barrier initially in my treatment with clients and I found myself just spending inordinate amount of time trying to convince a person that sex addiction is a concept that he ought to look at for himself .

Speaker 1 5:41

In other words , yes , you are a sex addict .

Speaker 2 5:43

No , I'm not , yes , you are . And of course I boil it down . It wouldn't be that directly , but just intense reluctance for some people to use those words . And secondarily , Drew , I came to appreciate that there was a fairly substantial number of people who came to me with those same dire consequences , but it was not readily apparent to me that diminished self-control was the primary driver of their behavior . They looked that their consequences would be the same as a person who identified as a sex addict , but the reasons behind that might be different . When I had a client that would come in

Evolution of Sex Addiction Therapy

Speaker 2 6:25

and he would say he did not think that addiction was his primary driver , I went from initially thinking , oh , this man's in denial to thinking he's kind of got a point . Maybe there's more characterological issues that are going on .

Speaker 1 6:43

Maybe he doesn't fit cleanly in that old model .

Speaker 2 6:46

And then to try to put a square peg in a round hole , to try to put a person who's multidimensional and a human being into a predetermined slot , is when it works it's beautiful , and when it doesn't work we can often say , well , the person was resistant and the person wasn't really committed . Well , the person was resistant and the person wasn't really committed . And you know , sometimes that's the case , but sometimes it's just a lack of fit between what's really going on inside that person and the resources that they need to address that . So at times I would agree with a person . You know , maybe addiction is not the primary driver of your behavior , maybe it's more . And then we start talking about the different reasons and I'll come back to that in a little bit . You did it because you could . You did it because you started doing it and you got away with it . And there's something in your character that got hooked and you started repeating the same behavior because it was successful for you . You were feeding a sense of narcissism and entitlement and a very myopic vision and had not really considered the consequences of your behavior or engaged in some sort of self-delusion about what you were doing or all these more emotional or cognitive reasons , and I would generally say that to clients I'm pretty direct . I don't mean to be judgmental , but I do have judgments and I do tell clients many times and I remember that to myself that having a judgment does not mean I'm judgmental . It means I have discernment over what I believe is better than something else and that's what clients pay me to give them . So I do give them my recommendations and my opinions and then they can do what they want to with that . So even people who are coming in for help who are maybe not so much addicts as much as there's no really good word to say it jerks Even those people many of them when they go to 12-step groups , get tremendous benefit from it . Because , as you know , any 12-step program is a life transformational tool that achieves much more than just the cessation of that behavior but really involves a transformation of the person's character through all the spiritual steps and those 12 principles that can really solve any problem . I'm a firm believer in the 12 steps can really solve any problem . I'm a firm believer in the 12 steps . And so I say you know , if the essay meeting was actually called , you know , ja , for you know jerks anonymous , you know , yeah , that would fit me . So it's just , it's the same thing .

Speaker 2 9:14

There's so much overlap between folks who do have a solid addiction , can engage in all of those other behaviors that I just talked about . They can have entitlement , they can have unprocessed self-reflective abilities , what I call just a sort of reflective insufficiency they just didn't really think enough about it or moral ambiguity with all of that , because it's built upon honesty and transparency and humility and enormous restitution and continued self-reflection and healing from the damage that you've caused and helping to grow in all levels of your being so that you can be available to other people who could not benefit from that . So I would tell folks go to the meetings , don't think so much about the language , about it . You know there's the classic take what you need and leave the rest , and that worked for some people , but again , for other folks it just didn't fit into that slide , like you said . So I would have people who were not getting in my mind the full help that they needed , because what was getting in the way was the language , the full help that they needed because what was getting in the way was the language .

Speaker 2 10:30

A good number of years ago I started , you know , cogitating on all that and talking with colleagues and say you know , do you think that all your clients actually , you know , addiction fits ? And I would have some clients , some sex addiction therapists , who didn't even question it Absolutely , are all sex addicts . And to me that's an example of the old saying said . I think it was Mark Twain who said if you give a boy a hammer and everything , it looks like everything needs to be nailed and you give a therapist a theory and everything needs to fit in that theory , because it's just the mindset that we have , and so in the kind of behavior we're talking about , lends itself very well to confirmation bias , and confirmation bias is , I'm looking for the signs and symptoms of this paradigm of sex addiction and oh , look what he's done many , many times and look at that behavior and the hiddenness and the consequences that have caused .

Speaker 2 11:23

Look at all the shame that he's gotten . A lot of typical diagnostic indicators can be right there for therapists to say well , of course , this is a sex addict , Don't worry about it , let's move on . Now . I want to talk about what I think supports that , which is the way that so many of the sex addiction screening tools are worded on the sex addiction inventories . Are you a sex addict ? Take these five questions , 10 questions , I think . The SAST sexual addiction screening test is the long version , is like 44 questions or something like that , and I did an experiment once and just created a scenario of a man who could answer enough of the questions that he would meet the criteria and it would say you're probably a sex addict . And yet those questions could be met . That threshold could be met primarily if the person endorsed two types of behaviors One was shame and the other was secrecy . Are you ashamed of your behavior ? Do you feel like that ? Your behavior causes you to hide yourself to other people ? Do you live a double life ? Do you regret what you've ?

Speaker 2 12:39

done after you've done it . That can absolutely be reflective of addiction , but it's clear it can also be reflective of just shame . And I would use an example of a person who may have some sort of a fetish that they were subject to or that they had , which from no quote fault of their own . People have fetishes for all kinds of reasons , often rooted in early experiences and so forth . But a person who is engaging in fetish behavior and this

Labels and Their Limitations

Speaker 2 13:10

is just one example who's not living in an arrangement in which that works and maybe has had such a shame about it then he never even talks about it and a classic example of falls in love with a person , with a woman , and man , I'll just go ahead and be heterosexual right now .

Speaker 2 13:29

Falls in love and says well , this is going to change me , this is going to save me , this is going to stop . Very sincere , and oftentimes that works for a long period of time or a short period of time , and maybe sometimes always . But those are not the ones who come to see me . It's the ones who try that and it does not work . In examining it , what becomes evident is that this was an essential part of their sexual nature , their sexual character . It didn't fit in their moral code , so they repressed it , but it was there and because of that , once they started engaging in it again , they would be secretive about it , they'd feel terrible about it , they would have great shame about it . And , presto chango , they're a sex addict . Sometimes yes , but sometimes no . That's the confirmation bias . No , that's the confirmation bias .

Speaker 2 14:28

I did not feel in my own case that the phrase addiction fully captured what I considered something to be my core issues that caused me to engage in my behavior . So in a little bit it was a personal journey of me looking in the mirror and saying who am I ? What am I ? Who determines what I am ? What language is used ? What are my choices for being able to determine what you got ? Well , we kind of have one suit of definitions off the rack and need to fit within that . So you put those two together and just for the way that I work , I realized there was a need in some way to expand the scope of how we you know , just being professionals , really just society can bring in a wider range of people who are suffering from sexual behaviors . Because , as you know , it's way more than the people that we see , it's way more than in 12-step groups . Those groups are not for everybody who needs it . It's for everybody who finds their way to it .

Speaker 2 15:27

It's a tsunami of sexual problems , especially with the introduction of the internet , which happened in my generation . And now there's folks in your generation who are digital natives and it's all that's been there . And Gary Wilson , who has the tagline evolution , did not prepare your brain for today's . Who has the tagline evolution did not prepare your brain for today's pornography delivery system , and because of that , we live in a techno world that facilitates and really turbocharges addiction . There's a whole lot of people who come to see me and I'm really clear that if it was 50 years ago , they wouldn't one . There wouldn't be seasats to come to , but there wouldn't be that language and there wouldn't be as much of a problem , because sure people can get addicted to looking at magazines and other still images and so forth , or maybe going down to the movie theater in the seedy part of town and so forth . But it took a lot of work to do all that . And then the internet came and we're in a brave new world .

Speaker 1 16:28

Yeah , anonymous , affordable , accessible .

Speaker 2 16:32

Yes , I was trying to think of the name of the person who coined that phrase , but that's it . It's anonymous .

Speaker 1 16:38

You don't have to be identified .

Speaker 2 16:39

It's right there , it's accessible two clicks away . I often tell my clients a lot of compulsive behavior is downstream of impulsive behavior , and what's more impulsive than the phone , whether you're looking at sports or doom scrolling , or there's three clicks and I'm into a whole realm ?

Speaker 2 17:00

that did not exist until this century . And so we live in a society , a techno society , that is creating addicts , creating addictions , and of course we're in a whole addictive culture . It's almost inevitable that there would be this tsunami . I do tell a good many of my clients , especially younger guys , you didn't stand a chance . There's just no way the odds were stacked against you to not be exposed to pornography during a very early age . So often how kids can get access .

Speaker 1 17:31

As porn has become a bigger problem , we need new frameworks . We need new ways of talking about this , so more people can get more help .

Speaker 2 17:37

That's it . That's it , spot on . And I'm a little surprised that there's not a robust pornography anonymous movement yet . And so I have a whole lot of people who are porn addicts and not sex addicts and I am one of the CSATs professionals who do this work who firmly believe that those are two separate , related but separate entities , that many sex addicts look at porn , but porn addicts look at porn . They're not going out and having affairs , they're not going out and doing all these other things . It's strictly porn , and to conflate porn addiction with sex addiction can get really messy . I see you nodding your head with that . Oh yeah , in many ways I think sex addiction has a more grave meaning to it than porn addiction . With porn addiction , it's one thing okay , there's porn , sex addiction , oh gosh . What does that mean ? Is he a pedophile , is he a rapist ? Is he a sex addiction ? People just project all of their fears into that phrase sex addiction .

Speaker 1 18:34

But porn addiction , okay , porn , I know what that is yes , and porn is so disembodied and it's so disconnected from from other people . It's a completely different experience than a sexual encounter .

Speaker 2 18:52

Oh , absolutely Just no comparison between the two . True sexual intimacy from watching porn is like learning how to play baseball by watching the highlights of the World Series . You'll see all the dramatic plays and you'll see all the jaw-dropping catches and triple plays and all that . But that's not what the game of baseball is about . I mean sure it gets there , but most of it is about fielding grounders and striking out . And just brought over to pornography , people see images and have this idea of what sexuality is like and sexual intimacy is like and get into the real world and find that does not fit . Very often does not fit . So back all the way around porn addiction .

Speaker 1 19:40

I know that there is .

Speaker 2 19:41

I think there is a burgeoning PA group , pornography Anonymous . Small handful of meetings and , oh gosh , I would love to have that expanded , but until then we work with what we have .

Speaker 1 19:56

And you have created a newer framework called PSB Problematic Sexual Behavior Sure and everything that I said up to this point is really setting the stage for that .

Speaker 2 20:08

So I wanted to find a different way to assess people for these issues without relying upon labels . I'll give one more little tee up Professionally . There has been tremendous controversy about the phrase sex addiction . You know , is it real , Is it not ?

Speaker 2 20:27

And whole organizations pit themselves against each other . I think it's better , but there's still a lot of sex therapists who feel that sex addiction is nothing but a moral way of pathologizing people who are engaging in sexual behavior that doesn't fit into a norm . They're wrong , but they still are very powerful with that . So in dialoguing with people who did not agree with the concept of sex addiction , I started to hear the phrase problematic sexual behavior as a judgment-neutral way of just saying it's a problem . But there was no agreement about what that meant . Everybody had a different idea about problematic sexual behavior , and I'm a former board member of the Society for the Advancement of Sexual Health , sash , which used to be , up until 2004 , the National Council on Sex Addiction and Compulsivity , and so , which was before that , just the National Council on Sex Addiction National Council on .

Speaker 2 21:26

Sex Addiction . Well , there's another theory base that says this is compulsion , not addiction and man . To me the difference is minuscule , but just like schisms can happen with minuscule doctrinal differences or so forth . So we added in the compulsivity , slightly different way to put it . But then there's other frameworks as well . Hypersexuality has a slightly different view to it . So do we call it the National Council on Sexual Addiction and Compulsivity and Hypersexuality ? And how many initials are we going to put behind that phrase ? So I was on the board . It was back in 2004, .

Speaker 2 21:57

I was a real strong advocate for changing the organizational view from the problem to the solution . And the solution is sexual health . So that leaves the question of what does sexual health mean , and can that ? How does that ? It seems to be culturally different . Some cultures over here it's this way , some it's that way . How do you come up with a definition of sexual health that's not culture bound .

Speaker 2 22:23

Putting that together , I set about the task of trying to figure out . Okay , let me see if I can crack the code and find a way to identify the core concepts of problematic sexual behavior in grounded sexual health theory without using labels . Now I'm finally ready to get to it . I feel like everything was a tee up to the problematic sexual behavior framework or the PSB framework .

Porn Addiction vs Sex Addiction

Speaker 2 22:54

Sexual Behavior Framework or the PSB framework this is a simple five-question method for helping a person identify whether their pattern of sexual behavior is problematic for them , and it looks at five different categories of how could something be a problem ? If it's a problem , why is it a problem ? And so I sussed out that there's five different reasons that behavior is problematic . Either F and I'll just tick them off .

Speaker 2 23:16

A it's breaking commitments . If you're violating your promises and breaking commitments , that's a problem . B is values conflicts If you're not okay with what you're doing . If you do have regret and shame and so forth about what you're doing , that's a problem . Third is diminished self-control , and this is where all the sex addiction and porn addiction comes in . If you don't have full ability to guide your own behavior , it's a problem . The fourth is lack of responsibility to others .

Speaker 2 23:45

And this was a tricky one for me , drew , because the word responsibility first it was just dripping with moral relativism . I'd say responsible can seem like a real judgment and I wanted to get away from that . And what I found was , in reviewing the history of how the phrase sexual health has developed is that just about . At the start of the century some writers started to include behavior that was not responsible to others , and what I found fascinating is a lot of sex therapists . They kind of pushed that off to the side because I think they felt like , well , here's that morality piece again . But I wanted to take that idea of responsibility and make it really clear about what that means , and I came up with three subsets of that .

Speaker 2 24:31

Responsible behavior is behavior that has full consent of everybody , that protects everybody from unwanted negative consequences and that doesn't exploit anybody . So everybody's got a consent , nobody can be harmed and nobody can be exploited . That is our responsibility to other people , and part of a component of sexual health is to be responsible to other people . And so I took those categories , reviewed them commitment violations , values , conflicts , lack of control , lack of sexual responsibility . Oh , I forgot the fifth one . The fifth one is kind of a catch-all negative consequences . Maybe a person is engaging in behavior that they're not breaking any commitments sometimes because they're so isolated they don't even have commitments or they're not breaking their values because maybe they're personally , okay with what they're doing .

Speaker 2 25:26

Maybe they're not engaging in diminished self-control , they're just doing it because they like to do it . Maybe they're not violating anybody else's rights , so it's not irresponsible to them , but they still have negative consequences from what they were doing . Pick somebody who maybe goes to see a sex worker and then wants them getting arrested for that and they were single and they were okay with it , and they were wearing condoms , and so the only category that that would catch would be this fifth category that I put in negative consequences .

Speaker 2 26:01

Problem is as problem does . If your behavior is causing problems , it's problematic . A equals A . I attached a question to each one of these categories , and the questions are ones that I give to the folks that I talk with , and I wanted them to be so simple that anybody could both understand them and use them Not just professionals , but people in their personal life . You want to talk to somebody that you care about , or you want to self-examine yourself without having to decide is this sex addiction or is it not ? It's simply asking these five questions . The first is are you keeping your promises ? There's a whole conversation that comes with that . Then we can talk about explicit promises and implicit promises .

Speaker 2 26:46

I use pornography as an example . Maybe the husband's been looking at porn and the wife finds it . There's a whole crisis with that , and I'll ask well , had you ever talked as a couple about your mutual stance on pornography so often ? No , we never talked about it , but in many marriages people don't talk about it because it's just understood , or maybe the spouse thinks it's just understood , like you don't have to say to your partner I'm going to make a commitment not to rob banks , he would say well , of course , pornography is cheating , it's off limits . And the man might say well , you know , we never talked about that . Say , yeah , but it's very implicit . You can't really say well , I just thought it was going to be okay . You knew you were hiding the behavior . That's why she caught you .

Speaker 2 27:25

Now , if you had said you know , honey , I'm going to go upstairs and look at porn now , and she said I don't want you to . And you said I appreciate that , I respect that , but I want to do that and we can disagree and I'm going to go do this myself . Actually I

The Five-Question PSB Framework

Speaker 2 27:38

would consider that's not problematic sexual behavior , because if a person engages , does that and says I'm going to go watch porn and I know you don't like it , but it's important to me , I'm just making up a situation Then they're not breaking a commitment because they're not making a commitment . And if they're okay with what they're doing , they're okay with what they're doing and all the others are not being flagged . So it's certainly causing I guess you could say that category is causing problems . But the problem is really about the disparity between the couple . One person's okay with it , one person's not okay with it . This is a relational issue and we need to look at it that way in order to then look at whether the behavior is truly problematic .

Speaker 2 28:18

So the first question are you keeping your promises ? Second question is are you okay with what you're doing ? And a lot of folks will say I'm going to get right down to it . I hate that . I like this . I hate that this is what I'm doing . It goes against who I want to be . And so , again , classic values conflict . And again , as you know , about pornography , because dopamine feeds on novelty and pornography is all the novelty you could ever want . Person starts with just looking at something and then over time that template can wind them up in someplace very different from where they they intended to . How did I get here ? And so they have tremendous values conflicts . So first question are you keeping your promises ? Second question are you okay with what you're doing ? Third question is are you in control of yourself ? And of course that can be up to interpretation , but these are all jump off questions . Each one of these primary questions . They're conversational starters and they can lead all sorts of fine-tuned questions that come after that .

Speaker 2 29:24

But the question of do you feel like that you're in control of your behavior ? Obviously very important . Those are the questions in those sexual addiction screening tests that I do think are valid . Do you feel like your sexual urges are stronger than you are . Are you thinking about sex in a way that feels excessive to you but that you can't stop ? You know classic addiction , compulsive , obsessive sort of behaviors . So there's a whole conversation about that .

Speaker 2 29:49

The fourth is are you protecting everybody ? Are you protecting everyone , which I'll explain ? That means do you have full consent from all the stakeholders ? Are you ensuring that you are protecting whoever you're doing what you're doing with , and are you sure that you're not exploiting people ? And this is where pornography usage that question , I think , can be really useful in helping people to look at pornography use .

Speaker 2 30:17

Because let's start with the question of do you have full consent for everybody ? Let's talk about who you're watching on the screen . I would say probably most people who are engaged in filming pornography . They are aware that that's what they're doing and they are aware that that's what they're publishing . And they are aware that that's what they're doing and they are aware that that's what they're publishing and they are aware that people are using that for their sexual purposes . As you know , there is a subset of I don't know what do you call it ? Somebody surreptitiously recorded and they don't know that they're being recorded and of course , it's just flat out unethical and illegal . I want to ask the person are you sure that everybody's operating from consent that you're looking at ? It's the other two sub-questions that can be more tricky for folks .

Speaker 1 30:56

One is .

Speaker 2 30:57

You know the question of are you protecting everyone from negative consequences ? If you're looking at pornography , are you protecting or contributing to a person's negative consequences that you're looking at ? People who do look at porn tend to underestimate the amount of porn actors or people who are appearing pornographically , who don't have much option . They don't have much power , they're economically disadvantaged , they're coming out of their own history of sexualized trauma and they're replicating that in their life . Or maybe even more physically , people are having sex without condoms . There's no barrier protection . There's a risk of if you're watching somebody who's having unprotected sex , can you say that you are not contributing to or facilitating that person engaging in behavior that's harmful to them ? And the last question , of course , is exploitation . Are you sure that you're not supporting inherent exploitation of people for the sexual purposes ? Back to what I said just a moment ago people who are maybe engaged in pornography to make money because they don't have any other way to make money or they're coerced . You know they're trafficked . They're trafficked . It's not always clearly evident when somebody's being trafficked . Oh , they seem to be into it . Well , they get inducted into that system and that's what they're doing . But you don't know their history of what comes to them . So a lot of porn users . Those are really important questions for a person to look in the mirror and say am I actually being responsible or am I contributing to the harm of other people ? So those are the five questions , and each one of those are conversation starters . Here's what you have to say in just a moment . Here A few highlights , I think , of this approach is that if you notice there's no labels used , we never have to talk about are you an addict or you're not .

Speaker 2 32:45

We're going into descriptions . After that we can decide what you want to call it . But at first let's just establish this is problematic for you , and I do distinguish . Problematic doesn't always mean pathologic . Pathology is an illness , problematic is a problem . Problem is a problem does so . Not all problems are pathologies .

Speaker 1 33:05

But when we call everybody a sex addict , we're saying they have a pathology and perhaps even an identity .

Speaker 2 33:10

So much , so much . You're spot on with that . I want people to come to that decision about whether addiction is the best explanatory language , because that's what addiction is . It's a theory of explanation . This is why the person is doing what they're doing . Addiction is a prediction about what caused that behavior . Compulsivity is another one . All the different reasons , so this avoids all the labels .

Speaker 2 33:35

It also , if you notice it , doesn't talk at all about the types or frequencies of behaviors . We're not saying well , are you involved in any S&M behavior ? Are you doing any of this ? Or how many times are you masturbating ? How many hours are you looking at porn ? Those are very important questions , but they're questions that can be really culturally distinct , that this very same behavior can be very problematic for one person and just very okay for another person . Very same behavior , how can it be as problematic for that person and okay for that person ? Well , because this person is not violating any of those five categories . This person is , and so this approach does away with all of the cultural limitations . These five questions work for anybody , whether you are the most sexually conservative person out there or the most sexually whatever you want to call it libertarian person . Those five questions go everywhere with you . So non-pathologizing , descriptive rather than labeling and sort of applies really to everyone . Let's see . Is there any other thing I want to say about it ? And theory neutral there's no theories about that , it is just sort of makes it be self-evident . So , in conclusion , I have had a lot of success with this approach . It's all on my website and I have people who come to me very regularly and say this is language that speaks to me . This is finally , you know , I can talk with you .

Speaker 2 34:59

So I really wanted to start putting the word out there . So I published an article about it in 2017 . And I started doing a little bit of the workshop circuit and all that . I was really surprised when , in 2019 , I got a notification from SASH that they were giving me the Carnes Award for that . I was really surprised when , in 2019 , I got a notification from SASH that they were giving me the Carnes Award for that and maybe other things I'd done in the past . I thought it must have been just they must have run out of all the really deserving people , and so now they're down to the B team and that's just me having a hard time accepting something like that . But it was a tremendous , tremendous honor I started .

Speaker 2 35:33

One way that I apply it and I'll finish with this is I run a lot of men's groups . I actually have eight men's groups going every week and these are not sex addiction groups , they're problematic sexual behavior groups , psv groups , and within that group there are people who identify as sex addicts , there's people who identify as porn addicts . There's people who don't use those words at all and it doesn't matter , because everybody's going for the same goal , which is abide by their commitments , live within their values , be in control of their behavior , don't have negative consequences and be responsible to other folks . No matter what you call a problem , everybody's heading toward that . What has been so unexpectedly beneficial about that is that it took sex and porn addicts away from being the others . All the sex addicts go to those meetings over there and they just talk with each other and they're a little bit them . Bringing them into this group with civilians just folks who are not addicted but still have the same problem folks who are not addicted but still have the same problem brings a parity . It turns that stigma into stature because they have tremendous resources that they can bring to the non-addicted folks about . Hey , this is a three-second rule and the value of connecting with other folks , and so the non-addicts get all that benefit of the sex addicts . The sex addicts are just on the very same level with everybody else and everybody's heading toward that same goal .

Speaker 2 36:54

So it was so valuable that after I put in the first group 13 , 14 years ago , I saw the difference between men who were in groups and people who were not in groups , and his trajectory seemed so different that I put in another group because I couldn't get the guys to leave . I asked for a minimum 12-week commitment and then stay as long as you want , and everybody will say 12 weeks . They'll do that and think that well , they'll drop off after 12 . I don't think I've ever had anybody drop off after 12 weeks . My average length of stay is pushing four years .

Speaker 2 37:28

When men get together , you know , when men can get together with other men and reduce those intimacy barriers and really come to trust each other and bring that mutual male support to each other . There's just nothing like it and so many men never had the opportunity to do it . So many of us are walking around as a boy's version of what a man is supposed to be . So it's very performative , it's very exterior and all of that interior development is just not there . These type of groups , these PSB groups , really help to backfill that in . They really are . They produce men and I'm just highly grateful that this PSB framework has been so valuable to so many people that I've worked with that . I want to continue to get this

Creating Connection Through Men's Groups

Speaker 2 38:15

out into the public . I don't want this . I'm near the end of my career .

Speaker 1 38:19

I don't want this to die when I do ?

Speaker 2 38:21

I want this PSP framework because it seems to have value . I want it to self-generate . It's almost like open source code . Therapists and theorists do whatever you want to with it , because it is a way that joins all the different theories together in a very fundamental language . And so I keep saying I'm going to write the book and keep saying it doesn't make it happen .

Speaker 2 38:43

And that's why , appearing on podcasts like this , it's a great opportunity to let more and more people know about this approach and then hopefully it takes root and can bring again my ultimate goal bring the most help to the most people possible and widen the availability for people to have the opportunity to live happy , joyful and free lives .

Speaker 1 39:10

Thank you for this gift of language so inclusive , equalizing and empowering . What are your thoughts on some of the other models , such as integrity abuse disorder ?

Speaker 2 39:23

Yes , thank you for that , and in my trainings I do reference them . I love Omar Mnouala's work and any approach that can help to widen our understanding and widen our theory base . I'm very much in support of what I like about integrity abuse disorder is that it inherently involves another person . It's inherently relational . If you're violating integrity , well , integrity to who ? And that leads into responsibility . So there's , I think , a relational component to integrity abuse disorder that sex addiction doesn't necessarily capture . So with that , these five questions are just as relevant for that model as it is for the addiction model .

Speaker 2 40:05

I'll say this , drew . I want to briefly share why I use the word framework , psb framework , because a framework is not a theory . It's more basic than that . It really is the foundational material that theories are built from , and I use the metaphor of construction of a house or any sort of a building . It starts with the materials . You need the bricks , you need the nails , you need the mortar and so forth . Those are the essential components that are required in order to build anything .

Speaker 2 40:34

Now , what can be built from that ? It's all kinds of things . All sorts of structures are built for their specific purposes , but they all involve the same materials . So with integrity abuse disorder , it still rests upon these five questions Are you keeping your promises ? No , that's the violation of integrity right there , full stop . It's a problem . Let's deal with that . Put those five elements together in ways that can be creative , that maybe help identify specific subtypes of behaviors ,

Different Models and Final Thoughts

Speaker 2 41:15

and can be more specific , and that's why integrity abuse disorder was so valuable to me to see get into the public and get into the literature . Highly supportive .

Speaker 1 41:29

What about the language of unwanted sexual behavior ?

Speaker 2 41:33

Well , I would put unwanted sexual behavior . That's the category of values conflicts . If I don't want it , why don't I want it ? Because it doesn't fit with who I want to be . So now we have a values conflict .

Speaker 2 41:44

One of the interesting parts or consequences of this PSP framework is that it is essentially I've used the term outcome neutral . It's not just theory neutral , it's outcome neutral , which means that some examples of problematic sexual behavior can be resolved not just by changing some sexual aspect of a person's life , but even non-sexual aspects of a person's life . Here's the two examples Commitment violations person has a commitment with someone and their sexual behavior is violating that . There's one of two options they can do . They can change their behavior or they can change their commitment and if the commitment changes , it's no longer problematic . Same with values conflicts . Oftentimes we'll think that values are immutable and changeable . That's what I've always believed , what I believe now and I always will believe , and for many people that is the case , and for other people , values can adapt and evolve over a lifetime as well . Does that answer the question ?

Speaker 1 42:43

Absolutely . It shows how value neutral this is . You can plug and play this PSB framework into any personal perspective on sexuality .

Speaker 2 42:55

I'm going to start using that phrase plug and play . I think that it's excellent , Thank you . That's exactly right , and it's not my place to tell a client which way to go . There are some doctrinaire therapists one way or the other , Sex therapists . They may not communicate it clearly , but some do . They'll take the stance that well , your values are repressive and you need to break through with that and not pathologize your behavior .

Speaker 2 43:20

Go in that direction as well as other therapists who would go in an entirely different direction , of saying you know , the problem is not your values , your values are intact , it is your behavior . For me , it's not my place to determine one way or the other , which way a client should go . I'm going to sit with them Because again , I can have two clients , very same behavior , you can almost just be twins and it goes to two very different conclusions based upon those five characteristics .

Speaker 1 43:50

Bill , thank you so much for teaching us . I feel like I just took a course by interviewing you right now . I'm glad it was helpful . What is your favorite thing about this model ?

Speaker 2 44:01

All of what we talked about sort of goes together the value-neutral piece of it , the simplicity of it that really anybody could use , regardless of education , the outcome-neutral , the theory-neutral , the outcome mutual , the theory mutual , the university applicable just a lot of aspects to it that I was very grateful to have sort of discovered in the process . It was only in the working it through that some of these benefits started to make themselves available . So , in some ways , finding a way to bring language around the phrase of responsible sexual behavior , not in a moralistic way , but in a very clearly definable way , so that we can graft the phrase responsible sexual behavior as a vital component of sexual health . I think that's one of the parts I feel most grateful and enthusiastic about Because , again , typically in standard understandings about sexual health , that one dimension of responsibility to others has always been put on the back seat and this puts it in the front seat along with everyone else . So I think that's my answer Awesome .

Speaker 1 45:04

Thank you so much for sharing out of your decades of wisdom and experience in helping people experience sexual health .

Speaker 2 45:15

Drew , it's been a real pleasure . I'm very much grateful for you reaching out to me and asking me to have this interview . It was a lot of fun .

Speaker 1 45:24

And if you want to learn more about Bill and connect with him , you can go to BillHerringcom and the other links in the show notes .

Speaker 2 45:30

Everything that I've talked about here is on my website , and there is a video on YouTube that breaks this all down into a short period of time .

Speaker 1 45:37

Well , I will include the link to that video in the episode as well . Thanks again , gentlemen . Always remember you are God's beloved son . In you he is well-pleased .