A relational model of therapists’ experience of affect regulation in psychological therapy with female sex addiction

This study investigated how therapists work with female sex addicts on affect regulation from a relational perspective in psychotherapy. I used a grounded theory approach, embedded in a social constructionist epistemology, and implemented a relativist constructionist methodology (Bryant & Charmaz, 2010). A total of twelve experienced psychotherapists and psychologists who worked in the sex addiction field participated in conversational, semi-structured interviews. Analysis revealed seventeen central properties, which organized five reciprocal, interactive categories. Four of these – namely, Forming Relationship, The Therapist’s Edge, Managing Risk and Safe Surprises and Finding a Shared Frequency – are cohered by the fifth category, The Multiversal Space. Findings demonstrated affect regulation as a therapeutic method with female sex addicts to be inextricably bound up with the therapist’s subjective response as well as their capacity for conceptualization, and theory of mind. Central to the work is an attendance by the therapist to both the implicit unconscious and somatic communication and explicit, cognitive and narrative aspects, as these were shown to influence the quality of relationship and the therapeutic action of change (Boston Change Process Study Group, 2010). The contribution of this research added to that of the small number of empirical studies considering female sex addiction. The originality of the study concerned the conceptualization of psychological therapy with female sex addicts as a two-person endeavour, thus positioning it in the field of relational and counselling psychology.