While the typical American couple would identify themselves as monogamous and/or vanilla, more and more couples are looking for alternative ways to explore their sexuality. What is out there? In the image below, you can learn about a variety of styles of non-monogamy. Some of the types include swinging, casual sex, polyamory, BDSM play and Dominant/Submissive non-monogamy, open relationships and relationship anarchy, and many more.
As therapists, we need to take a sex positive approach with our clients regardless of whether or not we are comfortable with their life choices. What this means is that we respect the lifestyle and encourage people to take a positive and educated approach to sex. We are avoiding attaching shame to sex or sexual expression. How do we do this without knowing much about what is out there? How do we do this if our own values are vastly different from the clients we work with?
I often teach a model of sexual health first created by Michael Vigorito and Doug Braun-Harvey. In their 2015 book, “Treating Out of Control Sexual Behaviors,” they developed a great tool to teach individuals to make sexually ethical choices. These ethical rules include: consent, non-exploitation, honesty, mutual pleasure, shared values, and protection against unwanted STIs/HIV and unwanted pregnancy. This sexual health model is a helpful reference for clients across the spectrum.
Let's look at each part. The first and most important rule is consent of all parties. With the recent #metoo movement, it is becoming clear that people all across the country need education in consent.
In relationships where couples are exploring sex outside their marriage, they need to have direct conversations about consent. In kinky communities, they will talk in depth about sexual acts they like, sexual acts that are not okay with, and sexual acts that are somewhere in the middle—it depends on the context. In some lifestyle communities such as Sex Positive St. Louis, they are even educating their participants about both verbal and non-verbal consent-that someone may hesitantly say yes to something, but their body language may be showing hesitation. As clinicians, we can educate our clients about how to read non-verbal communication and build a deeper trust through consent even in monogamous relationships.
For the next rule, non-exploitation, you may need to describe what an exploitative relationship is with your clients. The easiest way for me to describe it is a one-down relationship. We discuss this in systems theory. As therapists, our clients are in a one-down relationship with us. We have some power in our position which is why it is important for us to have ethical codes to protect our clients.
In our own AAMFT ethical codes 1.4 and 1.5, it states that clinicians are not supposed to engage in a romantic relationship with our clients. That is because the relationship would be exploitative in nature. Other relationships that have a similar one-down situation include adult/child, manager/employee, prison guard/prisoner, and doctor/patient. In each of these relationships, the person in the higher position has more rights, more privileges, and/or more power. Clients need to be aware of this dynamic and try to find relationships that are on more equal footing. In actual dominant/submissive relationships, the couple is typically on equal footing and has consensually created this power dynamic for the purpose of mutual pleasure.
The next rule is honesty. Since sex can be a shameful topic, it can be difficult for clients to share honest feelings about sex, sexual desires, and even kinks. As a sex therapist, I have found increasingly that people are more similar than different. A lot of our shame comes from society and the way we were raised. If as a culture, we could encourage sex positivism, it might be easier for clients to be direct about their needs and desires with their partners.
In the case of my clients, I always try to help them express their honest feelings about sex. I also encourage clients to take a curious, non-judgmental approach to their partner's sharing so that people can build trust. Remind your clients that talking about sexual fantasies does not necessarily mean acting on them. There are many people who like the fantasy of a threesome but would not be comfortable with the actuality. If we can encourage honesty up front, then couples can make conscious decisions about who to couple with and who to break up with if their sexual interests are too different.
Another helpful rule is to make sure there is mutual pleasure (among all participants involved). Pain can be involved in pleasure. For people who have never explored sadism or masochism, it can be difficult to understand why getting a serious spanking could be pleasurable. When I speak with clients who explore this, they state they get a lot of pleasure out of the experience. To be helpful to clients, clinicians need to develop a non-judgmental approach to what it can mean to have mutual pleasure.
Many vanilla couples aren't paying attention to the mutual pleasure rule. Sex can become all about male pleasure while women are having sex “just for him.” As a sex therapist, I try to make it a point to ensure that both partners (or more), are getting something pleasurable out of the situation for themselves. Even in a situation of polyamorous lovers, all parties often describe the feeling of compersion, which is defined as getting pleasure from a partner's romantic relationship with another person. This suggests that even in cases where partners are having sex outside of their primary relationship, they are still getting mutual pleasure out of the situation.
Another important rule is for the partners to have shared values. People involved in swinging communities have similar values. They may have their primary partners, husbands or wives, and then they share and act on sexual fantasies with the bigger group. If all parties involved have a similar value of, “Couples who play together stay together,” then the group can have a great time and enjoy various sexual encounters.
Problems can occur when one person in a relationship wants these things and is trying to strong-arm the other person into situations counter to their values. Going back to the previous rule, if we can help couples be honest, we can help them decide how to incorporate alternative sexual expression safely or guide them in how to respect each other’s differences without harming the relationship.
The final suggestion in the model is that all parties be protected against unwanted STIs and unwanted pregnancy. This is a great rule for all individuals to have with new partners. Recently, I have had a great number of divorcees who are newly dating and concerned about this conversation. The reality is that many people do not have great sex education, so the idea of asking a partner if they have an STI or if they could use a condom may be terrifying.
I have interviewed people in the polyamory community about safe sex practices who state that they get regular STI checks and have very upfront conversations about STIs with potential partners. In fact, in one interview with Kevin Patterson, author of the book, “Poly Role Models,” he stated that the STI conversation is sexy because you know if you are talking about this, you are about to get busy! I find this both hilarious and deeply respectful. As long as your clients are having similar conversations and protecting themselves, they may be in a better spot than some of our clients whose spouses are cheating on them non-consensually.
As long your clients are following these guidelines, then they should be free to explore whatever sexual interests they desire no matter how wild or out of our comfort zones as their clinicians. I hope you will join me for my upcoming webinar An Advanced Look at Polygamous and Kink Lifestyles, in which we will go into a more in depth discussion of various non-monogamous and kinky sexual lifestyles and how we can be helpful as their clinicians.
Angela Skurtu is a Licensed Marriage and Family Therapist in the state of Missouri and an AASECT Certified Sex Therapist. She is also a speaker and author of two books, Helping Couples Overcome Infidelity: A Therapist's Manual, and Pre-Marital Counseling: A Guide for Clinicians. She runs a YouTube channel and is cohost of the About Sex Podcast.