Licensed marriage and family therapist Jill Vermeire was on hand during the filming of Sex Rehab with Dr. Drew, bringing her clinical expertise to the world of reality TV. She’s agreed to lend us her perspective on the show’s shoot, as well as the rehabilitation of the cast. Below, Jill talks about the show’s third episode: the rivalry between Kari Ann and Kendra, the concept of enmeshment and the philosophy behind having the female patients remove their makeup in group.
The main focus of this episode is Kari Ann and Kendra’s rivalry. What do you think about that situation?
I can only go back to what my original thoughts were when that note exchange happened. I told Drew that I predict they’ll end up being great friends, because you can not fight like that, and feel that angry and that intensely about something, if you don’t care about the person. So what it really shows me is that they actually did care for each other and that’s why it was so frustrating for each one of them to feel like they weren’t being heard or being supported.
I guess that’s why they say that there’s a thin line between love and hate, right?
Yeah. It’s the same thing in any relationship. If you don’t care about the person, you’re not going to invest the time and energy to even fight with them or come up with some kind of a defense. When you do care, that kind of thing is important to you. A lot of time the hurt comes out as anger, but you look underneath that and you’re going to find that they are people who are feeling betrayed, feeling scared, feeling fear.
As a viewer, I found it in possible to be anything but on Kendra’s side.
I completely understand why people have such a hard time sympathizing with Kari Ann, because she makes it hard to sympathize with her. She puts up that wall in such an extreme way. She actually sets it up so that people will prove her right in [her belief ] that you can’t trust people. She has this core belief that the world is not safe, people will betray you, that people are going to hurt you; that you have to fend for yourself. She actually creates a self-fulfilling prophecy. She makes the situation so that it’s going to fit her belief system. That way later she can say, “See: every body leaves. Nobody’s trustworthy, everyone betrays me,” without being able to look at her part in it. The biggest thing for Kari Ann is that she has a very difficult time really being accountable for her actions and really having any insight into her behavior.
Exactly how disruptive was Kari Ann? Because the show is so centered on her, I can only assume she took up a lot of the discourse and thinking time.
Yeah, it was extremely disruptive. It was hard to get the rest of the group to focus on themselves, because she was such a bright neon light grabbing all of the attention. But again, this is how she operates in the world. And one of the interesting things about the group process is that people are going to show up and represent something from your life, or push buttons that usually get pushed in the real world anyway. But being in a treatment center and being in a group therapy process really gives you the opportunity to learn how to deal with them in a more productive way, so that you’re not going to let this person who’s self-sabotaging their treatment take all of the energy out of your treatment. You know, it’s learning how to have the boundaries and state needs. And it is frustrating. If you go to any treatment center anywhere, there’s always going to be a Kari Ann. You go out into the world and there’s always going to be a Kari Ann. So it’s learning how to deal with that.
Kendra was mad that the covers were pulled off of her and she was made to get up and have breakfast, whereas Kari Ann was allowed to stay in bed and was brought orange juice. Do you think Selma was doing everyone a disservice by treating everyone differently?
You have to work with what’s in front of you, and I wasn’t privy to how everybody was woken up, specifically. If Kendra’s experience was that the covers were thrown off and she was told to go to breakfast, then I’m gonna believe that was her experience. Is it OK that Kari Ann was brought juice and candy (or whatever it was) to get her out of bed? In my opinion, no. Did it work? Maybe half the time. What started to emerge was that it wasn’t about the juice. It wasn’t about how she was woken up. She was just resistant. You try and accommodate her here, and then she’ll go over to another place and create drama. Her resistance would show up wherever it could. If I had my way, everybody would be treated exactly the same, and then the differences between where they’re at as far as readiness for treatment would be addressed in individual and group therapy only. Because really, Selma is not a therapist. Unfortunately she was put into a position to do some work that she didn’t have the background to do. And these were really, really challenging patients. So I don’t blame the rest of the group for being upset at the preferential treatment of Kari Ann. If I were a patient going through that and witnesses it, I probably would have been upset myself.
I wonder if you have any thoughts on the makeup challenge during therapy?
I, in no way shape or form, am saying that girls shouldn’t wear makeup. I believe that girls should use those things on the outside that help you feel confident and help you feel beautiful. I often tell girls, “Do your hair, put on some make up, find an outfit that makes you twirl.” In this particular group, the majority of them are very heavily made up. From what I was told, they would spend up to an hour doing their makeup. That’s pretty extreme. The goal was not to have them feel comfortable without make-up, or to expose all of their flaws, but it was to see what comes up when they have to take it off, to see what’s behind the mask. Sex addicts, and especially female sex addicts, are really used to using their outside appearance to get attention, to get validation, to get a hit. There’s a healthy relationship to their make-up, and then there’s the unhealthy relationship to their make-up, and I knew that there would be one or two who would have an extreme reaction to exposing and being that vulnerable. Part of that experiment was to see if the guys would notice, because I think that there’s this belief that they don’t look good without it, they look way better with it, it’s the only way people look at them, and nobody would like [them] if they didn’t wear it. So it was really cool to have the guys come in and actually not notice that the girls weren’t wearing make-up at all.
During one on one with Kendra, it comes out that her husband is her drug, kind of.
Not “kind of.” “Is.”
Isn’t there a slippery slope from the societal ideal that is “being in love” to “enmeshment?”
In the honeymoon phase of a relationship, it’s understandable, acceptable, and even biologically and anthropologically proven that we become completely obsessed with our romantic partner. A healthy relationship means that you maintain your individuality while also learning how to be together. It’s called “interdependence.” And interdependence is really a concept of learning over time how to figure out which of my needs I can meet on my own, or with the help of somebody else outside of my relationship, and which of my needs I need to bring to the relationship and get support from my partner. “Enmeshment” is that extreme, suffocating, it’s-all-about-the-other-person type of situation, which is really unhealthy. It’s different than having a really great, loving, healthy relationship. Kendra and Lukas are so enmeshed, she feels like if she stops taking care of him, he won’t survive. And he is so enmeshed with her that, even though he probably can’t list off the things he loves about her, he knows he loves her and has to be with her all the time. And he lets her take care of him. And I’ve talked about this with both of them, and they agree. They agree that this enmeshment is what’s killing the relationship. They have to learn how to be apart and create individual lives for themselves so that you have something to bring back to the relationship. If you become too dependent on the relationship and that’s all you have and that’s your food, air, water and everything, you’re going to suffocate. Eventually you will self destruct.
Finally, with the Nicole one on one, it comes out that she’s kind of a loner. And I thought it was a little ironic to have a loner in group therapy.
Well, it’s not unusual. And again, that’s one of the things that the group therapy process can bring that part of her out and have her work on it with other people. Really, the label “loner” means “inability to connect and be intimate with other human beings.” That’s really what it boils down to with her. Nicole is much more of a love addict than a sex addict, so really it’s an intimacy and attachment disorder. She truly wants to be in a relationship, but she doesn’t know how to connect and be vulnerable and have the healthy intimacy, so it’s easier to just shut it all down. She talks about the revolving door: people come in and out of her life, and it’s really painful for her. I think Nicole really did want to connect with people, but her whole life has been about surviving on her own and taking care of herself. So it’s really scary for her to trust other people and open up and be vulnerable. And I don’t know what shows up in future episodes, but her fear of being intimate and not feeling safe and letting her guard down comes out as anger at certain points also. I don’t know if that’ll show up, but it did come out.