Between the Covers

The ultimate treatment goal for recovery from addiction is mastering the experience of forming enduring and trusting intimate connections. And I would add to that, a connection with oneself. It has to start with knowing and believing in yourself. 
— David Fawcett, quoted in Jennifer Matesa, Sex in Recovery (2016)

For some of us, substances allowed us to avoid honesty during the most vulnerable moments of intimacy. We could use drugs or alcohol to be what we thought another person wanted rather than risk revealing ourselves. The difficulty in recovery is not a lack of desire. As Matesa explores in Sex in Recovery, the challenge is that the old pattern of self-judgment remains. Without substances, the mind can fill with worry during intimate moments—I’m not good enough, I’m too fat, I’ll fail, this relationship will fail—and those thoughts lock us out of our physical selves. We want to be present, but we get trapped in our heads.

So how do we stay present between the covers? Matesa offers several grounded, repeatable approaches.

Staying consciously present during the act is the foundation. This means focusing on what the body is physically feeling rather than getting trapped in the stories the mind constructs. When we notice ourselves drifting into worry, judgment, or putting on a performance, the task is not to force those thoughts away but to redirect attention to actual sensation. This is mindfulness applied to connection. The book emphasizes that pleasure is physical, not psychological—it is what the body feels and enjoys. As sex educator Emily Nagoski writes, pleasure is the best measure of sexual wellbeing we have: focus on sensation, and do more of what feels good, and do less of what doesn’t.

Honest speech in the moment is another suggested practice. This means speaking out loud what is actually happening internally to whoever you’re with during sex. Not confession or disclosure for its own sake, but the willingness to say something like: This really has nothing to do with you, but I want to tell you how I’m feeling. Or: I’m not fully here right now, but let’s just play around and see—I’ll get there. Before recovery, we often did not know what was going on inside ourselves. The honesty comes after awareness, not before. Naming internal experience mid-connection is not weakness, it is an act of trust that deepens the very intimacy it interrupts.

The book also mentions the importance of distinguishing secrecy from privacy. Recovery teaches rigorous honesty, and rightly so. But there is a difference between naming what is happening in the moment and feeling compelled to disclose every detail of our inner lives. The pressure to tell everything can feed the same approval-seeking and self-mistrust that addiction thrived on. Secrecy involves concealing something that has caused harm. Privacy involves sitting with a feeling long enough to understand it before choosing whether to share. Learning to trust our own perceptions, rather than compulsively checking them against someone else’s judgment, is itself a recovery skill. Recovery is not meant to keep us dependent for life on the judgments of others. It is meant to build the spiritual strength to trust our own.

The final suggestion is to have patience with the body’s timeline. Different drugs affect sexuality differently, and the nervous system does not heal on command. People who used sedating drugs like alcohol, opioids, or benzodiazepines might go months or years not thinking about sex. Those who used stimulants like methamphetamine or cocaine might have had sex compulsively, and the physical damage can be severe. For some, regaining the capacity for sensation takes only a few months. For others, a year or longer. The book recommends periods of stepping back from sexual activity entirely to focus on individual healing. This allows the nervous system to recalibrate without the pressure of performance or expectation. There is time.

During active addiction, substances allowed some of us to avoid honesty during intimacy almost entirely. One of the gifts of recovery is we can now stay present, speak the truth in the moment, and trust our own perceptions. We do not need to master intimacy. We need to practice paying attention.