TALKING SEX: BRITISH FT’S LAST FRONTIER?!

1. TALKING SEX: BRITISH FT’S LAST FRONTIER?! DAFT and ASPENS Conference, Thursday 16 May, 1:45 – 3:15 Dana Mills-Powell

2. The context we’re in:paradoxes at the heart of this issue • Sex talk is everywhere but often not where it needs to be. • Sex is a foundational narrative about an adult relationship, but is often not spoken. • Sex should be brought in to couple therapy, but how, if the couple themselves do not? • Sex is both idealised on the one hand, and a method of abuse or control on the other • Is there any question why this topic is hard to talk about??

3. My own story of systemic training: does sex matter? What is your training story?

4. The historical context: how did this all come to be? UK: Non-statutory sector took on marriage counselling in the 1930s Relate, Marriage Care, TCCR. Some systemic input: • Robyn Skinner , One Flesh Separate Persons (1976) and (1980) article, Journal of Family Therapy. • Dallos and Draper (3rd ed.) 2010, added a chapter on couple therapy (but it’s all drawn from the USA). • UKCP’s systemic college adopted the new name of College of Systemic, Family, Couple Therapy (CFCST) • 2012 special issues of Context and JFT on couple therapy but very little drawn from the UK.

5. “In the USA, when did who knock couple therapy out of psychoanalysis and into family therapy? “(Nick Child)

6. Jay Haley (1963) Marriage Therapy, when with Bateson’s original schizophrenia project in Palo Alto, CA • Alan Gurman, professor of psychiatry and director of family therapy training at Univ of Wisconsin. Clinical Handbook of Couple Therapy (4th ed.) (2008) Described Haley’s work as “undoubtedly the defining moment at which family therapy incorporated and usurped what little was left in the stalled-out marriage counselling and psychodynamic marriage therapy domains • James Framo, professor of psychology and family studies, San Diego CA (1996). Journal of Marital and Family Therapy,“Haley wanted to make sure that psychoanalytical thinking be prevented from ruining the newly emerging field of family therapy.” • AAMFT (American Association of Marriage and Family Therapy)

7. Sex therapy: UK and USA • We can summarise that early UK family therapy with its lack of focus on the couple relationship had little interest in the emerging field of sex therapy with the exceptions provided previously. • The study and practice of sexology and sex therapy took off in the late 1960s with first the work of Alfred Kinsey who was first to study and publish material on the sexual behaviour of Americans between 1938-1952. • Others followed including William Masters and Virginia Johnson who pioneered the work on the human sexual response cycle starting in the late 1960s—still in use today by sex therapists and in creating frameworks for sexual disorders in the DSM: excitement/ plateau/ orgasm/ resolution. • Later on in 1970 they wrote the text, Human Sexual Inadequacy which described sexual disorders and their treatment. Overall, research and practice of psychosexual therapy (or PST) has been largely driven by the USA.

8. The emergence of Systemic Sex Therapy. • Two texts published in 2009 (Systemic Sex Therapy and A Clinician’s Guide toSystemic Sex Therapy) have crafted the ‘intersystems approach to sex therapy’. • Fundamentally, it is looking at sexual difficulties and DSM-defined disorders from all of the following vantage points: • Individual and Biological • Individual and Psychological • Dyadic/Couple Relationship • Family of Origin • Society, Culture, History and Religion

9. Practice: facilitating sex talk in couple therapy

10. Body, mind and spirit connections • Tom Andersen: Therapy as Social Construction: • “When life comes to me it touches my skin, my eyes, my ears, the bulbs of my tongue, the nostrils of my nose. As I am open and sensitive to what I see, hear, feel, taste, and small I can also notice ‘answers’ to those touches from myself, as my body ‘from inside’ lets me know in various ways how it thinks about what the outside touches, what should be concentrated on, and what not. “

11. Working with the spirit/body connections • James and Melissa Griffith in their book Encountering the Sacred in Psychotherapy speak of the body as a “door” to the sacred or spiritual. • “Even religions that discourage gratification of bodily passions strive to access states of the body that are associated with reverence, awe, and communion with God or Spirit. This access is sought through spiritual practices—fasting, ritual dieting, ascetic practices, or other activities that place a check on physiological arousal from fear, anger or shame. All this suggests that the sensations of the body play a larger role in the perception of spiritual experience than many of us in Western culture had supposed.” (2002, p. 42).

12. Meaning as context: Coordinated Management of Meaning (CMM) • CMM: practical tool with a theoretical framework. • There can be no meaning without context. • Human experience is embedded in levels of context (hierarchical model) • Every conversation is in fact a cluster of conversations (atomic model) • Sex as a form of communication between persons

13. References • Gergen, K. & McNamee, S. (1992) Therapy as Social Construction. London: Sage. • Griffith, J. and Griffith, M. (2002) Encountering the Sacred in Psychotherapy. New York: Guilford. • Gurman, A. (2008) Clinical Handbook of Couple Therapy (4th ed.).   • Haley, J. (1963) “Marriage Therapy”. Archives of General Psychiatry, Vol. 8, March. Available from www.forallthat.com (Nick Child’s website).   • Hertlein, K., Weeks, G., & Gambescia, N. (2009) Systemic Sex Therapy. New York, London: Routledge.   • Hertlein, K., Weeks, G., Sendak, S. (2009) A Clinician’s Guide to Systemic Sex Therapy. New York, London: Routledge. • Pearce. WB (1994) Interpersonal Communication: Making Social Worlds. New York: Harper Collins.

14. Case example • Case example: a Christian couple coming to me due to difficulties in their sex life. • The atomic model for each of them in one session, which brought out their stories of faith (“off limits”, “never heard a Christian speak positively about sex”), family scripts (“taboo in my family”), gender stories (“men want it and girls go along with it”), and specific episodes which were influential . • It also brought forth the woman’s issues with her body and links to an eating disorder in her younger years: “I should not be allowed to enjoy sex.” It is this broad, systemic approach which this tool assists us in.

15. Exercise • Working with another person. Draw an atomic model on a sheet of blank paper, putting sex in the centre as a “speech act”. Use this model as a framework for your conversation—the interviewer will then use different levels of context to shape their questions and briefly summarise the responses in each of the loops. The model will show the multiple levels of meaning of sex for your interviewee. Swap roles.