Quote from AStubbs on April 19, 2021, 7:06 pm

1. Why would we as sex therapists sometimes work toward “imperfect solutions” for our clients? What might an imperfect solution look like?

Quote from lpernoud on April 23, 2021, 7:08 pm

As sex therapists, imperfect solutions are the only solutions we can work towards with our clients. This is true for any realm of counseling (for example, with addictions, no one ever achieves perfected “recovery” – rather, they remain in a constant state of imperfect “recovering”). As fallible beings living in a fallen world, it is impossible to strive for perfection. If we give our clients the expectation that we can endeavor to have a “perfect” solution, we will inevitably fail them, which may lead them to an even deeper sense of despair or hopelessness.

This, however, does not mean that we are without hope for our clients’ capacity to heal and grow within their imperfect solutions, as well as live their lives more fully in the present day. They may still have an emotional “scar” at the end of the process, but they will no longer suffer from a gaping wound, and the pain will be significantly lessened.

An example of what an imperfect solution could look like is this: we cannot undo a client’s sexual trauma, but we can support them in how they respond to and engage with their traumatic experience. Many clients wish that their trauma could be reversed or undone, or that they could simply forget about their traumatic experience. However, as a past supervisor once told me, “you can’t un-pickle a cucumber once it’s been pickled!” Instead of striving towards the perfect solution of returning to a state of being a cucumber, the imperfect solution is to appreciate the pickle. In other words, we as sex therapists can support our clients in finding their strength, meaning, and restored narrative in who they are today rather than futilely relishing (no pun intended) in the person they were before their trauma.

The only perfect solutions come from God, and we have faith and joy that we will be made perfect in Him one day. We can offer our clients hope in rebuilding a better – albeit imperfect – life on earth while looking forward to the perfection that is to come.

Quote from haley.bryant on April 26, 2021, 8:55 pm

Quote from lpernoud on April 23, 2021, 7:08 pm

As sex therapists, imperfect solutions are the only solutions we can work towards with our clients. This is true for any realm of counseling (for example, with addictions, no one ever achieves perfected “recovery” – rather, they remain in a constant state of imperfect “recovering”). As fallible beings living in a fallen world, it is impossible to strive for perfection. If we give our clients the expectation that we can endeavor to have a “perfect” solution, we will inevitably fail them, which may lead them to an even deeper sense of despair or hopelessness.

This, however, does not mean that we are without hope for our clients’ capacity to heal and grow within their imperfect solutions, as well as live their lives more fully in the present day. They may still have an emotional “scar” at the end of the process, but they will no longer suffer from a gaping wound, and the pain will be significantly lessened.

An example of what an imperfect solution could look like is this: we cannot undo a client’s sexual trauma, but we can support them in how they respond to and engage with their traumatic experience. Many clients wish that their trauma could be reversed or undone, or that they could simply forget about their traumatic experience. However, as a past supervisor once told me, “you can’t un-pickle a cucumber once it’s been pickled!” Instead of striving towards the perfect solution of returning to a state of being a cucumber, the imperfect solution is to appreciate the pickle. In other words, we as sex therapists can support our clients in finding their strength, meaning, and restored narrative in who they are today rather than futilely relishing (no pun intended) in the person they were before their trauma.

The only perfect solutions come from God, and we have faith and joy that we will be made perfect in Him one day. We can offer our clients hope in rebuilding a better – albeit imperfect – life on earth while looking forward to the perfection that is to come.

LPernoud,

Your response is very well put. We are working in a fallen world. This goes along with Dr. Sytsma’s point in class that there are times are not trying to heal the “cancer.” My model of treatment is MRI, so my foundational belief is that the client knows what they need. Their solutions are often better than what my goals for them would have been. When I step back and accept what might seem “imperfect” to me, I can see the entire picture at the end of treatment or years down the road when I see where God was leading them as ideal, with my own solution actually being imperfect. Jesus talks about a “restoration of all things,” there will always be imperfection until that happens.

 

 

Quote from Hal on April 27, 2021, 12:00 am

I agree, there are no perfect solutions and I like the way you discuss having a frank conversation about this with clients up front.  While you say, "As fallible beings living in a fallen world, it is impossible to strive for perfection"  I can say that, while I totally agree with you that it is unobtainable, it has been my experience that, unfortunately, many of my clients can and do strive for perfection.  And therein lies the problem.  It is one of the ultimate victim roles for clients.  They are striving for that which is not possible and therefore constantly setting themselves up for failure and possibly reinforcing old shame narratives that are not only non-productive but actually harmful for them.   Shame and healthy sex do not pair well.  Patrick Carnes says that shame is at the core of sex addiction.  Striving for perfection feeds the dragon.  I love the pickle remark in regards to trauma.  I think your example is a good example of when to address the use of imperfect solutions.  The way you talk about it brings grace and a sense of redemption to the topic.  When I think of "perfection" with sex therapy, I also think of Metz and McCarthy's concept of "good enough sex" and helping clients come to their own understanding of what that means and looks like for them.  It addresses the idea of having a "perfect solution" and brings it more to a continuum of excellence as opposed to perfection.  It also takes the focus off of "performance" in sexual encounters.

Quote from ggeorgina29 on April 27, 2021, 3:36 pm

As sex therapists, we would sometimes work towards imperfect solutions for multiple reasons. First of all, we live in a fallen, broken world full of imperfect people, situations, conditions, and sin. There will be many situations and conditions that are not solved easily, but are layered and therefore require a solution that is a best fit or an "imperfect solution." As sex therapists we are also for the most part working in the arena of couples and relationships, meaning more than one person and client. No two people are the same and what could be seen as "perfect" solution for one person is not a solution for the other person. With the complexities of being unique finding solutions for the couple may sometimes mean compromising or finding an imperfect solution.

An imperfect solution may look like having to take a fast/break/time-out from sex for a period of time while the client (either working with an individual or the couple) is working through the issues that brought them to sex therapy or the goals that they have made. This is definitely an imperfect solution because as sex therapists we want our couples and clients to have a fruitful and joyful sexual relationship with their spouse. We also know full well that there is much more to a fruitful relationship than sex. There may be past traumas including a sexual assault, affair, etc. that needs to be dealt with before returning to sex. Part of this imperfect solution can include the couple choosing what they want to call their break, empowering them to determine the time period, label, boundaries, etc. and work together with the ultimate purpose of starting, returning, and experiencing sexual intimacy with one another.

In this world we can only work with imperfect solutions, Christ is the only one with perfect solutions and who can solve anything perfectly. There are times though that sometimes an imperfect solution is just what we have been called to work through and gives an opportunity for Christ to work through it perfectly.

Quote from ggeorgina29 on April 27, 2021, 3:45 pm

Quote from lpernoud on April 23, 2021, 7:08 pm

As sex therapists, imperfect solutions are the only solutions we can work towards with our clients. This is true for any realm of counseling (for example, with addictions, no one ever achieves perfected “recovery” – rather, they remain in a constant state of imperfect “recovering”). As fallible beings living in a fallen world, it is impossible to strive for perfection. If we give our clients the expectation that we can endeavor to have a “perfect” solution, we will inevitably fail them, which may lead them to an even deeper sense of despair or hopelessness.

This, however, does not mean that we are without hope for our clients’ capacity to heal and grow within their imperfect solutions, as well as live their lives more fully in the present day. They may still have an emotional “scar” at the end of the process, but they will no longer suffer from a gaping wound, and the pain will be significantly lessened.

An example of what an imperfect solution could look like is this: we cannot undo a client’s sexual trauma, but we can support them in how they respond to and engage with their traumatic experience. Many clients wish that their trauma could be reversed or undone, or that they could simply forget about their traumatic experience. However, as a past supervisor once told me, “you can’t un-pickle a cucumber once it’s been pickled!” Instead of striving towards the perfect solution of returning to a state of being a cucumber, the imperfect solution is to appreciate the pickle. In other words, we as sex therapists can support our clients in finding their strength, meaning, and restored narrative in who they are today rather than futilely relishing (no pun intended) in the person they were before their trauma.

The only perfect solutions come from God, and we have faith and joy that we will be made perfect in Him one day. We can offer our clients hope in rebuilding a better – albeit imperfect – life on earth while looking forward to the perfection that is to come.

I enjoyed reading your response, thank you for sharing! I especially loved the cucumber and pickle analogy, I may need to borrow that for my clients! It painted a great mental image. I agree with you on the imperfect process of waling through with our clients to help them appreciate the pickle and what lead it to be a pickle. What a process of up and downs?!?! And yet what a gift to enter into the process with our clients. What practical ways do you think you could imperfectly walk through this appreciation process with your clients?

I also like how you brought up the focus and a goal of hope for our clients and their capacity to heal even though we are still in a fallen world.

Quote from lys_kiss18 on April 28, 2021, 2:41 pm

As sex therapist we will always be working towards imperfect solutions. I think this is a true experience of any form of counseling. We are there to firstly sit with, hold, and walk through the results of a very broken and very distorted world. We are not there to lay down “perfect” answers to incredibly imperfect and difficult experiences. The experiences of infertility, abuse, and infidelity were never supposed to be something that we as humans experienced. We were never meant to need to grieve and so we often do a poor and imperfect job of it. I think this is especially true in sex counseling work where distortions and experiences can be so damaging to an individual's perspective of God, themselves, and others.  

I think counselors in general need to go into the room with the humble perspective of seeking to help couples and individuals find imperfect solutions to where they are right now in their context of being broken people on a broken earth. This also takes into consideration that we are broken people on a broken earth too who are unable on our own fruition to create perfect solutions. I think being up front about this in counseling is a good idea as it manages expectations and relieves the pressure on the couple or individual to perform perfectly any solutions that are suggested. For the individual or couple, it allows more space for struggle, sanctification, and forgiveness. For the counselor it serves as a reminder that we are not doing and are not capable of doing the lasting impactful work, only the Lord is.  

An example of an imperfect solution is attempting to reframe the ideas around sex for a couple who has struggled with infertility. There is no ability for us as counselors to provide a couple with a child nor is there a perfect solution that will heal the pain and trauma of dealing with infertility. We can however grief with the couple and guide them in practices that will make connecting and being intimate safe and not a repetition of the trauma they are experiencing.   

We get the opportunity to hope for our clients for the perfect solutions the Lord is capable of and the ones promised to us in an eternity with Him. We also get the opportunity to build imperfect solutions with couples and individuals that help them to endure the pain and state of the world we are in presently. This is such valuable and important work.  

Quote from cindy271 on April 28, 2021, 3:43 pm

Given the degree of brokenness in our world it is surprising that we struggle so hard with accepting imperfect solutions with our clients and in our own lives.  I think that our culture has trained us that just about everything can be fixed.  “Justice will happen,” “my medical problems with be healed,” or “I really can rid my garden of weeds” are all things that I have believed at some point only to be disappointed by the fact that this world is in fact living under a curse.  If we really grasped how this world was supposed to be, I think we would find ourselves truly humbled at the small graces from our heavenly Father.

A few years ago, when I was having some health issues that puzzled the doctors, I remember feeling like I was in a double bind.  I was presented with two options as I saw it: Pursue health in a frenzy like it was my new savior or cynically decide to not pursue health at all.  Thankfully, the Lord pointed me toward the secret third option that the gospel always lays out for us: I trusted God with my health as I sought to treat my body like the temple of God’s spirit.  Since the fix to my health issues are mostly cured by lifestyle, I still fight the double bind on a daily basis.

As a therapist I find myself tempted to work toward perfect solutions because I get too wrapped up in the “right way” vs. the “wrong way” of doing things.  I get so focused in on the Law that I miss sight of the gospel.  The gospel always sets a path that is out of the double bind that we find ourselves in.  I remember hearing from one of my friends of a sex therapy case involving a man who had medically and surgically transitioned and had lived as a woman for many years.  I was a baby therapist at the time and had just begun working as a counselor.  The client had come to a place where she was maturing as a Christian, felt conviction over how she treated her gender dysphoria, and asked my friend if she should transition back to being a man.  I remember feeling conflict in my heart about this case because while this person had lived for years as a woman and it would be heart wrenching to detransition, something in my heart said, “but he must transition back to show his repentance!”

I am now not so sure I could possibly have the right answers for this person.  I never found out what happened to this client, but I think no matter the outcome it was certainly an imperfect solution to a very painful problem.  What I have found certainty on is that the gospel will always provide room for and point us toward imperfect solutions even when it is uncomfortable for me.

Quote from Anna Co on April 28, 2021, 4:01 pm

Ipernoud, 

True, we shouldn’t provide false hope to our clients that they would achieve a “perfect” solution to their problem.   Just like some offering prosperity gospel I had witnessed some people-helpers offering promising results in a few sessions.   In the past, I had a client with delusional disorder telling me that a counselor told her that she would be cured in just 6 months.  I was surprised to hear that the counselor was so sure of the time frame.  

“You can’t un-pickle a cucumber once it’s been pickled!”  Your supervisor is wise.  Indeed, a pickle can no longer go back to being a cucumber.   Sometimes clients are fixated with the idea of waiting for things to go back to the way they used to be as if the trauma didn’t happen or things would get resolved without facing it.  Some are wishing counselors to act like a fairy godmother or a genie to solve their troubles in one go.  I remember a client told me that her goal in therapy is for her to be happy all the time which is impossible because no one will ever have this while on earth.       

Sadly, some churches emphasize only the supernatural ways of God changing a person and don’t teach the process of sanctification.  They would promise a “perfect” solution in a fallen world which led many survivors to be disillusioned and confused when it didn’t happen to them.  God never promised us a world without pain, struggles, and trials but He promised that He is with us and we don’t need to be afraid and feel dismayed (Isaiah 41:10).  

Learning to embrace “imperfect solutions” is the only way to live in this world as we deal with our trauma.  I concur with your recommendations on how sex therapists support their clients for them to restore themselves.  They might not go back to the person before the trauma but they can come out much stronger.  James told us to “Let perseverance finish its work so that you may be mature and complete, not lacking anything.” (James 1:4).  

Quote from abostwic on April 29, 2021, 6:18 pm

As I have spent time reading everyone's posts, it brings to mind that we   are focused on how, yes we can only work towards imperfect solutions because the world is fallen, we cannot unpickle the pickle. The thought that occurred to me was that it's also about us, as the therapists being imperfect. We can only take our clients as far as we have gone ourselves. As imperfect people, and therapists, we can only do our part. But thinking of how God chooses us to help steward people’s trauma into some level of healing is the authority we have been given. I think of this quote “Fire can warm or consume, water can quench or drown, wind can caress or cut. And so it is with human relationships: we can both create and destroy, nurture and terrorize, traumatize and heal each other” (Perry & Szalavitz, 2017, p. 5). I have heard too that a relationship with parents only takes a good-enough parent 30% of the time (Karen Kranz, AEDP institute faculty, her reference is unknown). And so it is for us as therapists, in our imperfection, needing to be good enough 30% at minimum, can help lead our clients to some kind of healing. An example of this may be a client struggling with dyspareunia and although full penetration may not be obtained, the client’s sexual life with their partner may be more intimate with better orgasms than prior to therapy.

Perry, B. D., & Szalavitz, M. (2017). The boy who was raised as a dog: And other stories from a child psychiatrist's notebook--What traumatized children can teach us about loss, love, and healing. Hachette UK.