Treating Sexual Compulsivity in Sex Therapy - Is It a Sexual Addiction or Out of Control Sexual Behavior (OCSB)?

Language matters, especially in the field of mental health.  When mental health professionals pathologize compulsive sexual behavior by defining it as a "sexual addiction," they do clients a disservice.  

This article will focus on the difference between treating sexual compulsivity as out of control sexual behavior (OCSB) as defined by Doug Braun-Harvey, LMFT and Michael A. Vigorito, LMFT in their book Treating Out of Control Sexual Behavior: Rethinking Sex Addiction and treating the problem as a "sexual addiction," as in the work of Dr. Patrick Carnes (see my article: What is Sexual Health?).

Treating Sexual Compulsivity in Sex Therapy

What is Sexually Compulsive Behavior?

Let's start by defining sexually compulsive behavior.

Sexually compulsive behavior is an excessive preoccupation with sexual thoughts, urges and behavior where this behavior is disruptive and has a significant negative impact on a person's health, relationships, work and other important areas of life, including (but not limited to) the following issues:

• Recurrent sexual thoughts, urges and behaviors take up a lot of your time.

• These thoughts, urges and behaviors feel out of control to you.

• Despite repeated attempts, you have been unable to reduce or control these thoughts, urges and behavior on your own.

• Despite serious consequences, you continue to engage in out of control sexual thoughts, urges and behavior.

• You have problems establishing and maintaining relationships, jobs or other important areas in your life because of your sexually compulsive behavior.

Sexual Addiction vs Out of Control Sexual Behavior (OCSB)

As of this writing, there is a heated debate in the mental health field about whether sexually compulsive behavior should be seen as a sexual addiction or as out of control sexual behavior (OCSB).

Treating Out of Control Sexual Behavior in Sex Therapy

Proponents of the sexual addiction perspective see compulsive sexual behavior as similar to other forms of addiction, including alcoholism and drug addiction.  In this model people who engage in compulsive sex are seen as "powerless" over their behavior.  Dr. Patrick Carnes, who has written extensively about "sexual addiction" is one of the biggest proponents of this view.

The main proponents of the out of control sexual behavior (OCSB) perspective are Doug Braun-Harvey, LMFT and Michael A.  Vigorito, LMFT.  They define six principles of sexual health in their book, Treating Out of Control Sexual Behavior: Rethinking Sex Addiction.  Instead of viewing this behavior as an addiction, they see it as sexual behavior that is out of control.  In their view it is a sexual problem but not a sexual disorder or an illness.

Treating Out of Control Sexual Behavior in Sex Therapy

Other proponents of the OCSB view, like Dr. Neil Cannon, see sexual compulsivity as being related to unresolved trauma, unresolved mental health issues, relationship issues and problematic habits.

Treating Out of Control Sexual Behavior in Sex Therapy

OCSB is not a diagnostic term.  The term OCSB refers to problems with self regulation of sexual thoughts, urges and behavior despite negative consequences.

Why Does It Matter How Compulsive Sexual Behavior is Labeled?

In my opinion (and the opinion of many others in the sex therapy field), labeling someone who engages in compulsive sexual behavior as an "addict" is harsh and shame inducing.  

Treating Out of Control Sexual Behavior in Sex Therapy

People who are labeled in such a shame-inducing way are often too embarrassed to admit they have a problem or to get professional help.

Unlike drug and alcohol misuse, people who engage in sexually compulsive behavior cannot be expected to give up having sex so labeling behavior as a sexual addiction is counterproductive to resolving the problem.

Getting Help For Sexually Compulsive Behavior

If you are struggling with sexual compulsivity, you're not alone.  Help is available to you.

Depending upon the particular circumstances, sexually compulsive behavior can be treated in individual sex therapy or in couples therapy with a sex therapist.

Working with a sex positive sex therapist who treats sexual compulsivity as out of control sexual behavior (OCSB) rather than as an addiction is affirming to your sexual health and overall well-being.

About Me

I am a licensed New York City psychotherapist, hypnotherapist, EMDR, AEDP, EFT, Somatic Experiencing and Sex Therapist.

I am a sex positive therapist who works with individual adults and couples (see my article: What is Sex Therapy?).

I have helped many clients to overcome psychological trauma (see my article: What is Trauma Therapy?

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.

What is Sexual Health?

According to Doug Braun-Harvey, LMFT, co-author with Michael A. Vigorito, LMFT of Treating Out of Control Sexual Behavior: Rethinking Sex Addiction and co-founder of The Harvey Institute, sexual health is comprised of six principles which include safety as well as pleasure.  

These six principles will be the focus of this article.

Sexual Health includes Safety and Pleasure

The concept that sexual health includes both safety and pleasure is different from what is taught in most sex education programs in the United States.

Unfortunately, most education programs limit sex ed to protection against sexually transmitted infections and unwanted pregnancy.  

But sexual health is so much more than that--it includes sexual pleasure.

The Six Principles of Sexual Health

The Harvey Institute identifies six principles of sexual health:

• Consent: Sexual health must be consensual.  Consent means that sex is voluntary between willing partners who are of age and able to give enthusiastic consent to sex.  Non-consent involving children often occurs in the home with relatives or family friends in the form of sexual abuse, sexual assault and rape.  With regard to consenting adults, it's important to establish consent at each step of sexual activity so that there can be safety and pleasure for everyone involved (see my article: What is Sexual Consent?).

• Non-Exploitative: Sexual exploitation is when someone uses their power and control over someone else to have sex.  Exploitation includes unwanted harsh behavior to dominate and take sexual advantage of someone who is unable to give consent, including children and people who have physical or cognitive disabilities.  Exploitation often involves alcohol or drugs to coerce people to have sex.

• Honest: Sexual health requires honesty between sexual partners. Communication is open and direct with all sexual partners.  Honesty involves being open about sexual pleasure, health, sexual experiences and sexual education. 

• Shared Values: Sexual values identifies a person's ethics and sexual standards which can differ based on a person's culture.  For instance, a person's values can differ with regard to the first sexual experience based on their particular culture.  When people get involved sexually, each person can have different values regarding particular sex acts or sexual turn-ons.  Sexual health involves people having open and honest communication about their sexual values.  It's also important for children and teenagers to get accurate answers to their questions about sex without adults communicating shame or discomfort.

• Protected Against Sexually Transmitted Infections (STIs), HIV and Unwanted Pregnancy: Anyone engaging in sexual activity needs to be protected from STIs, HIV and unwanted pregnancy.  Protection includes the use of condoms, birth control, adherence to HIV medication, taking PrEP (pre-exposure prophylaxis). Sex education about these issues needs to be medically accurate (fewer than 20 states in the United States requires sex education to be medically accurate).  

• Pleasure: Whether sex involves solo activity or partnered sex, sexual pleasure is a primary motivator to have sex.  Throughout the lifespan sexual health is a matter of balancing safety/responsibility with pleasure.  Sexual pleasure includes remaining curious about different ways of enjoying sex.

About Me

I am a licensed New York City psychotherapist, hypnotherapist, EMDR, AEDP, EFT, Somatic Experiencing and Sex Therapy.

I am a sex positive therapist who works with individual adults and people in relationships.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.

Relationship Skills: How to Develop Self Awareness Skills to Improve Your Relationship

This is the third in a series of articles about developing self awareness as a relationship skill 

See my articles: 

Relationship Skills: What is Self Awareness?

Why is Self Awareness Important to You as an Individual and in Your Relationship?  

In this article, I'm focusing on how to develop these skills.

Developing Self Awareness Skills to Improve Your Relationship

How to Develop Self Awareness Skills

There are many ways to develop self awareness skills.  Here are some tips:

• Get Curious About Yourself: Becoming curious about yourself is the first step in developing self aware.  This is the best way to get ready to explore your inner world and to become more psychologically aware.  By getting curious, you're also opening up to self discovery.

• Allow Yourself to Open Up to New Experiences: Whether the new experiences include taking an improv class or traveling to a country where you've never gone before, allowing yourself to try something new and interesting can provide you with the kind of experience where you learn about yourself.  You can share these experiences with your partner or you can experience them on your own (see my article: Being Open to New Experiences).

Open Up to New Experiences

• Write in a Journal: People who journal on a regular basis are able to reflect on and learn about their thoughts, emotions and behavior.  Taking the time to write in a journal can help you to develop insight into yourself.  Journaling is having an inner dialogue with yourself (see my articles: The Benefits of Journaling).

• Practice Mindfulness Meditation: Observing your thoughts and emotions without judgment is a good way to develop self awareness.  When you quiet your mind and just allow thoughts and emotions to flow, you're able to enter into your inner world.  If you find yourself distracted, you can just observe the distracting thoughts and then let them go (see my article: The Mind-Body Connection and Mindfulness Meditation and The Benefits of Meditation).

• Attend Psychotherapy:  One of the best ways to get to know yourself is by attending therapy--whether it's individual therapy or couples therapy.  You'll learn about yourself in ways that no other process provides.  Experiential therapy, which focuses on the mind-body connection, is the most effective type of therapy (see my article: Why Experiential Therapy is More Effective Than Regular Talk Therapy).

Using Your Self Awareness Skills to Improve Your Relationship

Talking to your partner and sharing your thoughts and emotions with each other can increase emotional intimacy between you.  When I say talking, I'm referring to face-to-face talking--not texting, which is not intimate at all and often leads to misunderstandings.

Share Your Thoughts and Feelings With Your Partner

Although it can be frightening, especially if you're sharing more vulnerable emotions, you can strengthen the bonds between you and your partner by allowing your partner to experience you on a deeper level (see my article: Vulnerability as a Strength in a Relationship).

Sharing yourselves builds trust and strengthens your relationship in a meaningful way. 

About Me

I am a licensed New York City psychotherapist, hypnotherapist, EMDR, AEDP, EFT, Somatic Experiencing and Sex Therapist.

I am a sex positive therapists who works with individual adults and couples.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.

Relationship Skills: Why is Self Awareness Important to You as an Individual and in Your Relationship?

In my last article, Relationship Skills: What is Self Awareness?, I began a discussion about self awareness and how it begins to develop in basic ways during childhood with the help of a primary caregiver.  

In this article, I'm focusing on adult relationships and why self awareness is an important relationship skill for you as an individual as well as for you in a relationship.

Self Awareness

What is Self Awareness?

As a recap from the previous article, let's define self awareness again.

Self awareness is the ability to:

• tap into your own feelings, thoughts and actions
• recognize your own strengths and challenges
• recognize how your feelings, thoughts and actions affect how you feel about yourself and others
• recognize other people's emotional needs and feelings
• recognize how you affect others
• recognize how other people see you (seeing yourself from their perspective)

Why is Self Awareness Important to You as an Individual?

Before we discuss why self awareness is important to a relationship, let's first discuss why it's important to you as an individual--regardless of whether you're in a relationship or not:

• Being able to identify your own thoughts, emotions and behavior allows you to grow as an individual.

• Being aware of your thoughts, emotions and behavior allows you to feel responsible for your overall well-being rather than relying completely on someone else.

• Being self aware allows you to be more aware of what you want and what you don't want.

• Having greater self awareness allows you to look at your own patterns so you don't continue to make the same mistakes over and over again.  Instead, you're able to observe yourself so you can grow from your experiences and make necessary changes.

• Being aware of patterns that haven't worked before allows you to reflect on what might work better in similar situations in the future.

Why is Self Awareness Important to You When You're in a Relationship?

• Being self aware is key to being in a healthier and happier relationship.

• Being self aware helps you to be attuned to your partner.

• Being self aware and attuned to yourself and your partner will help you to be more aware of how your actions will impact your partner, yourself and the relationship.

• Self awareness will help you to be more compassionate towards yourself and to your partner.

• Self awareness allows you to set boundaries with others because you're aware of what you want, what your partner wants and what you think will work best for the relationship (see my article: Setting Healthy Boundaries in Your Relationship).

Next article

In my next article, I'll focus on how to become more self aware.

About Me

I am a licensed New York City psychotherapist, hypnotherapist, EMDR, AEDP, EFT, Somatic Experiencing and Sex Therapist.

I am a sex positive therapist who works with individual adults and couples.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.

Relationship Skills: What is Self Awareness?

The ability to be self aware is an important skill.  It's a necessary skill in all relationships, and it can be especially challenging in romantic relationships because there are so many emotional layers in terms of what's going on between the two people.

What is Self Awareness?

There is what's happening now between the two people as well as what each of them bring from their family history, history in other relationships and other significant emotional experiences, including positive as well as traumatic experiences.

What is Self Awareness and How Does It Develop?

Self awareness is the ability to:

• tap into your own feelings, thoughts and actions
• recognize your own strengths and challenges
• recognize how your own feelings, thoughts and actions affect how you feel about yourself and others
• recognize other people's emotional needs and feelings
• recognize how you affect others
• recognize how other people see you

    Early Childhood Experiences

Self awareness starts in childhood when parents and other people close to the children reflect back to them the emotions they are experiencing.

Let's start by looking at an early childhood example in Scenario 1 when parenting goes well i and Scenario 2 when it goes wrong.

Example:

For instance, a child of three or four, who is experiencing a temper tantrum because their mother just told them that they can only choose one toy and not two in the toy store, is not at a developmental stage yet to understand their emotional reaction.  

They don't have the ability yet to self reflect or have self awareness in this situation where they're upset, so they depend on the parent to help them.

Scenario 1:

The mother responds to the child, "I know you're really sad and angry that you can't have this other toy and that's why you're so upset." 

She is doing more than just trying to calm the child down.  

The Parent Helps the Child with Overwhelming Emotions

She is helping the child to identify what they are feeling by putting words to the child's emotions. 

By framing the child's experience with words, she is also providing a metaphorical container for the overwhelming emotions the child is experiencing so they can feel more manageable.

Let's say, as part of comforting the child, she is holding the child so she is physically soothing the child.  

At the same time, she is also letting the child know that, even though they are upset now, things are going to be okay.  She is also letting the child know that, even though they might be angry with the mother at that moment, she still loves them.  Their relationship remains stable.

She is also normalizing the child's reaction at the same time she is still setting a boundary with them.  So, she's not changing her mind and giving the child the other toy just to get the child to be quiet, which would be inconsistent parenting.  She's communicating in a way the child can understand by comforting the child at the same time she sets limits with the child.  

Over time, with the help of the mother (or whoever is the primary caregiver), this child learns that they can get upset and survive the upset.  This is an internal experience of knowing from many prior similar experiences.

This isn't a concept the child can put into words at such a young age.  Instead, it's something they internalize at a deep level that will continue to develop over time throughout their life if they are parented in this way.

Over time, if all else goes relatively well, this child will develop the ability to name their emotions as well as a tolerance for frustration in ways that are manageable.  

When this child becomes an adult, they will have internalized this self knowledge many times over.  It will be a comfort during challenging times ("I've gotten through other hard experiences") and contributes to their self awareness.

Scenario 2:  Same Situation (Child is upset about not getting a second toy)

The mother responds, "I'm only buying you one toy! Stop being such a baby!  Don't be selfish! You're driving me crazy!"

How Problems With Self Awareness Begin

Obviously, this isn't an appropriate or helpful way to respond to a child.  But more than that, this child isn't being soothed.  Instead, the child is being criticized and made to feel like an emotional burden ("I'm not lovable").

In Scenario 2 the child is left on their own to fend with overwhelming feelings of sadness and anger.  

On top of that, the child not only has to cope with their own feelings alone but the child is also being told indirectly that they are responsible for the mother's feelings.

There is no emotional support, no emotional containment or framing of the experience for this child.

If this is an ongoing experience, the child will grow up without developing self awareness. They would probably also feel they are an emotional burden to people who are close to them, including romantic relationships (see my article: What is Your Attachment Style?).

They will also probably suppress uncomfortable emotions because they never learned how to tolerate these feelings in manageable ways when they were younger with the help of a caregiver.

This second scenario isn't about blaming parents.  Usually when a parent responds in this way, it's because their own feelings were also dismissed when they were younger.  This is what they internalized and, without any other mitigating factors, this is how they parent their own children.

Next Article

This article is the first in a series about self awareness. 

I'll continue this to discuss this topic in my next article:

Relationship Skills: Why is Self Awareness Important to You as an Individual and in Your Relationship?

About Me

I am a licensed New York City psychotherapist, hypnotherapist, EMDR, AEDP, EFT, Somatic Experiencing and Sex Therapist.

I work with individual adults and couples.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.

What Does Fear of Abandonment and Fear of Engulfment Look Like in a Relationship?

In my prior article, Relationships: What Are the Underlying Issues With the Cat-and-Mouse Game?, I discussed the relationship dynamics of emotional pursuers and withdrawers and the underlying issues involved, including the pursuer's fear of abandonment and the withdrawer's fear of engulfment.

In the current article I'm focusing on what fear of abandonment and fear of engulfment look like in the same relationship.

Fear of Abandonment and Fear of Engulfment in a Relationship

What is Fear of Abandonment?

Fear of abandonment is an overwhelming worry that people who are loved and cherished will leave. Although anyone can develop a fear of abandonment at any time, most of the time it's rooted in childhood trauma.  For instance, it could mean the loss of a parent who moved out or who died.  

This fear makes it difficult to have adult romantic relationships because this person feels vulnerable to being left in the same way s/he was left as a child (see my article: Fear of Abandonment).

What is Fear of Engulfment?

Fear of engulfment in a relationship is a fear of being trapped and smothered as well as a fear of losing independence.  

People who fear being engulfed show their fear by behaving emotionally indifferent, withdrawn, or distant.  They might cheat on their partner as a way of distancing themselves and creating emotional distance in the relationship. They might also find other ways to punish the partner who is an emotional pursuer.

This fear develops during childhood within an enmeshed family where family members were intrusive with each other and did not respect each other's personal boundaries (see my article: Learning to Develop Healthy Boundaries in an Enmeshed Family).

Clinical Vignette

People who fear being abandoned often choose people who fear engulfment and vice versa.  These are not conscious choices.  These choices occur unconsciously.  

The clinical vignette below illustrates how this dynamic between the emotional pursuer (the person who fears being abandoned) and the emotional withdrawer (the person who fears being engulfed) plays out and how Emotionally Focused Therapy (EFT) for couples can help (see my article: What is EFT Therapy For Couples?).

This is just one way that fear of abandonment and fear of engulfment manifest in a relationship.  There are many other ways it can show up in a relationship.  However, the scenario presented below is a common example of this dynamic.

This vignette is made up of many different cases with all identifying information removed to protect confidentiality:

Meg and Todd

Meg and Todd, who were both in their mid-30s, met and they felt immediate chemistry for each other. They began dating soon after they met.

During the first few months, they spent a lot of time together, which was fun, and sex was passionate, which they both enjoyed.  

As the relationship got serious, problems arose.  Meg realized how much she cared for Todd and she worried he might end the relationship and she would be devastated.  She was familiar with her fear of abandonment from psychotherapy sessions she attended in the past.  

Meg knew from her prior therapy that her fear of abandonment was related to a real abandonment that occurred when she was five when her father walked out of the house and he was never to be seen again.  

Although she knew about the origin of her fear, she didn't know how to stop it from happening whenever she developed deeper feelings for someone.  So, her insight about her fear didn't help her when she felt worried.

During this same time, as Todd developed stronger feelings for Meg, an old fear of his surface--his fear of being engulfed in the relationship.  

Initially, he liked spending a lot of time with Meg, but now that their relationship was much more serious, he felt trapped.  Todd wanted to spend less time with her and have more time to himself.  

He felt annoyed whenever Meg told him about plans she wanted to make with him.  Outwardly, he went along with it, but inwardly he felt like screaming that he cared about her, but he needed his independence.  

He also sensed how fearful she was that their relationship wouldn't work out and he would leave, which he secretly thought about whenever he felt especially trapped.

Things came to a head six months into the relationship when Meg told Todd she wanted to talk about the relationship.  From her earnest look, Todd knew Meg was going to ask him where he thought the relationship was going and if he was thinking of a future with her.  He was also aware that Meg wanted to get pregnant in the next year or two and this added to the pressure (see my article: Is It Time For "The Talk"?).

When they sat down to talk, they were both silent at first.  Meg seemed to be waiting for Todd to speak and Todd was silent and dreading this conversation.  Finally, Todd broke the silence by telling Meg that he cared for her a lot, but he had mixed feelings about whether they had a future together.

Fear of Abandonment and Fear of Engulfment in a Relationship

This was exactly what Meg feared and she broke down crying uncontrollably.  Her fear of abandonment was being triggered. 

Seeing her reaction, Todd wasn't sure what to do.  On the one hand, he felt he should comfort her.  But, on the other hand, he felt like running away because he felt overwhelmed by her reaction.  Todd's fear of being engulfed was being triggered.

So, they were both triggered.  Meg sat crying on the couch and Todd suppressed his urge to run out of the room.  It was almost as if he was paralyzed.

At Meg's insistence, they started couples therapy with an EFT (Emotionally Focused Therapy for couples) therapist (see my article: How EFT For Couples Can Improve Your Relationship).

Todd just went along with it at first to please Meg.  But as time went on, he became curious and more engaged in couples therapy.

Over time, the EFT therapist helped Meg and Todd to look at their negative cycle together.  Rather than blame each other, she helped them to get curious about their dynamic.  

As they continued to attend couples therapy, Meg learned that she was an emotional pursuer and Todd learned he was an emotional withdrawer and their dynamics were rooted in their childhood experiences (see my article: Emotional Pursuers).

Todd learned that he developed his fear of engulfment due to the dynamics in his enmeshed family.  Both of his parents were strict disciplinarians.  They were highly critical and imposed their will on him until he got fed up and moved out after he graduated college.  Even after he was on his own, his parents refused to respect Todd's personal boundaries.  

Even now that he was in his mid-30s, they expressed their strong negative opinions about almost everything he did.  So, he had a lot of pent up resentment towards them and these experiences created a fear of being trapped and overwhelmed.

Gradually, Tom came to see how his emotional withdrawal with Meg was related to his unresolved childhood experiences (see my article: Understanding a Partner Who Withdraws Emotionally - Part 1 and Part 2).

Unlike her prior therapy, which was cognitive behavioral (CBT), Meg experienced EFT, which is a type of experiential therapy, in an embodied way.  Instead of having just intellectual understanding about her fear of abandonment, she felt the insight emotionally as well as viscerally.

Their therapist explained to them how people often make unconscious choices when they choose someone to be in a relationship.  She explained that these choices often bring up what they fear the most.  

In other words, an emotional pursuer often unconsciously chooses an emotional withdrawer and vice versa for an emotional withdrawer.

As Meg and Todd learned to turn towards each other to work together to change their negative dynamic, they grew closer together.  

EFT Helps Couples to Develop a Healthier Relationship

By the time they completed EFT couples therapy, Meg and Todd changed their negative cycle into a healthier dynamic.  

There were still times when Meg still feared being abandoned and Todd still feared being engulfed, but they were able to talk about it and get out of that negative cycle based on what they learned in EFT (see my article: Overcoming the Negative Cycle in Your Relationship That Keep You Both Stuck).

Eventually, Todd and Meg each got into their own individual therapy to work on their own. unresolved childhood trauma that created their fears.  Working through the trauma enabled them to free themselves of the fears that manifested in their relationship.

Conclusion

It's not unusual for a person with a fear of abandonment and a person with fear of engulfment to unconsciously choose each other for a relationship.

A couple with this dynamic can get stuck in a negative cycle indefinitely because they don't understand the dynamic they are in and they don't know how to stop it.  T

Emotionally Focused Therapy for couples, which is an attachment-based therapy, helps couples to understand their dynamic and then work together to change it so they can have a healthier relationship together.

About Me

I am a licensed New York City psychotherapist, hypnotherapist, EMDR, EFT, AEDP, Somatic Experiencing and Sex Therapist.

I work with individual adults and couples (see my article: What is a Trauma Therapist?).

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.

   

Relationships: What Are the Underlying Issues in the Cat-and-Mouse Game?

The origin of the phrase "Cat-and-Mouse Game" dates back to 17th Century England.  This phrase refers to actions involving the constant pursuit, near capture and repeated escapes of two people stuck in this dynamic. 

The Underlying Issues of the Cat-and-Mouse Game

What Are the Underlying Issues in the Cat-and-Mouse Game?

The Cat-and-Mouse Game is similar to the cartoon characters, Tom and Jerry:  Tom, the cat, always almost captures Jerry, the mouse, but somehow Jerry always manages to get away.  

The result of this pursuer-withdrawer dynamic is that they continually engage in this dance of pursuit, near capture, and flight (see my articles: Are You Afraid of Being Emotionally Intimate in a Relationship? and Fear of Abandonment).

The Cat-and-Mouse Game usually involves an unconscious fear of either fear of engulfment or fear of abandonment.  There is an ambivalent quality to the dynamics of these two people, who might want to be together. but when it appears they are getting closer together, one or both of them distance themselves.

Fear of engulfment is extreme distress or anxiety about being emotionally taken over/engulfed in a relationship with another person. The fear involves a perceived loss of independence and sense of self.  Fear of engulfment often occurs when a person feels insecure and experiences relationships as overwhelming.  This usually relates to unresolved childhood trauma where this person felt overwhelmed by one or both parents.

Fear of abandonment is an overwhelming worry that people who are close will leave.  This fear is often rooted in unresolved childhood trauma where someone close, including a mother, father or another close relative, left or died.

Although the Cat-and-Mouse Game is referred to as a "game," there usually isn't a malicious intent.  Often it's more like an unspoken dance between two people, who might be unaware of what they're doing, but who are both dealing with fears within themselves.

The person in the role of the cat fears s/he will be abandoned by the mouse, so s/he pursues but also maintains some distance so there is enough space to deal with what s/he fears will be the inevitable abandonment.  

The mouse fears being engulfed or overwhelmed by the cat, so s/he maintains enough space to feel safe but close enough to maintain contact.

On an unconscious level, the cat, who is the pursuer, is interested the in the mouse because the cat knows the mouse will run.  And the mouse is interested in the cat because the mouse knows the cat will pursue the mouse.  

As long as one chases and the other pursues, they remain in contact with each other, but they also maintain a safe emotional distance which they both need for their own psychological reasons.  

The regulation of the space between them is an unconscious defensive act so that they can have contact with some distance at the same time.

The Cat-and-Mouse Game is exhausting and can be deeply painful.  Due to their fears, the two people involved often don't get close enough to have an emotionally intimate relationship.  They might really love each other, but their earlier traumatic history of abandonment or engulfment keeps them apart and stuck in this cycle.

Even people who are married or in a long term committed relationship can get caught in this dynamic.  For a period of time their relationship can be going relatively well when one of them will pick a fight with the other.  

On the surface, the fight might seem ridiculous.  But what's really going on underneath the surface is that one or both of them gets uncomfortable with being too close because it either triggers fear of abandonment/being left or fear of intimacy/being too close.  So, the unconscious reason for the fight is that it provides psychological distance.

After a while, when the psychological distance allows each of them feel safe enough, they reengage--until fear comes over them and they begin this negative cycle again.

How to Get Out of the Cat-and-Mouse Game

As I mentioned earlier, these dynamics are often deeply entrenched in an earlier traumatic history which left an indelible mark on each person.

Getting Out of the Cat-and-Mouse Game

But there is light at the end of the tunnel if both people are willing to get help in therapy.

Insight isn't enough to change this dynamic.

Often the most effective therapeutic strategy is individual trauma therapy to work through the unresolved trauma so it doesn't get continually triggered and, if the two people involved are in a relationship, couples therapy, like Emotionally Focused Couples Therapy (EFT) to address the negative cycle in the relationship (see my articles: Overcoming the Negative Cycle in Your Relationship That Keeps You Stuck and New Bonds of Love Can Replace a Negative Cycle).

Once the couple is no longer getting triggered by their traumatic histories and the negative cycle they created together, they are free to be emotionally intimate.

About Me

I am a licensed New York City psychotherapist, hypnotherapist, EMDR, AEDP, EFT Couples Therapy, Somatic Experiencing and Sex Therapist.

I am a trauma therapist who works with individuals and couples (see my article: What is a Trauma Therapist?).

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.