Sexual compulsion and the internet

As a mental health therapist working in the community mental health system, I'm constantly challenged by a myriad of presenting problems clients would like to work on in therapy. While I've been working in the field of co-occurring disorders (ie, addiction and mental health) since 2005, there are certain disorders I'm very skilled in and others I have very little knowledge or experience to draw from.

I'd venture to guess that an individual presenting to therapy is confident that their therapist can help them tackle any and all presenting clinical problems. Unfortunately, this is not always realistically possible. Sometimes the problem is totally out of the scope of a clinician's educational or professional competence. In these instances, referral to a more appropriate professional specialist is warranted. In a majority of cases, however, it is important for clinicians to take the initiative to seek either (or both) supervision, case consultation with trusted colleagues, and self-motivated professional development via continuing education classes/workshops or reading professional literature on the particular subject.

With that said, I was recently presented with a case involving compulsive masturbation and addictive online sexual behavior. I found myself (internally) floundering within this extremely sexually revelatory session with my client....not out of discomfort of the subject matter being discussed, but out of not knowing how to specifically help someone with this particular issue. Especially given how vulnerable my client felt telling me and wanting the client to continue feeling confident or courageous enough to proceed with treatment.

I found myself both intimidated and intrigued by this newfound clinical challenge, that of sex/cybersex addiction. Immediately and somewhat ironically, I searched various sites online for well-written and highly rated professional books on the topic. Much to my surprise, it was a disappointing and difficult search. While there are a plethora of books promoting "healthy" sexuality and how to explore one's sexuality in healthy/safe ways, books on sexual addiction are few and far between. The book I ended up getting wasn't even one I thought would be very helpful, but it ended up being decent.

"In the Shadows of the Net" by Carnes, Delmonico, and Griffin explores and analyzes the dangerous allure of the Internet on one's sexual proclivities, especially given the technologically dependent society we live in. Although certainly not to be used by any means as an excuse to act out compulsive sexual behaviors, the availability of sexual content and ease of anonymity online makes it that much easier for an individual to get sucked into a downward spiral of unhealthy and unmanageable sexual behavior. Chapters in this book include identifying problematic behavior ("Do I Have a Problem with Cybersex? and "Understanding Problematic Sexual Behavior on the Internet"), analyzing sexual arousal and intimacy ("What Turns You On? The Arousal Template" and "Courtship Gone Awry"), and how to change/recover from sexually addictive behaviors ("Boundaries," "Taking That First Step," "Changing the Way You Live," "Preventing Relapse: Maintaining the Changes You've Made," and "Family Dynamics and Cybersex"). I found "Understanding Problematic Sexual Behaviors on the Internet," "What Turns You On?," "Courtship Gone Awry," and "Boundaries" to be most helpful.

Upon reading the second half of the book, I realized recovery for sex addiction is very similar to alcohol and drug addiction. The author posits that there is a stronger propensity for relapse with sexual addiction than other addictions. Not sure I agree with that, though the relapse prevention model is very much akin to those used in alcohol/drug recovery programs and seeing that made me feel more confident in my professional capabilities to help a client seeking recovery for sexual addiction. I might even take it one step further and pursue a training to become a Certified Sex Addiction Therapist.

Who can say their work is never boring or that they're always learning more about the human condition?

Therapists.

Ramblings of a therapist

Today I realized that I need to do more for myself, at least as far as self-care goes. I am constantly taking care of everyone else; my need to be nurtured tends to come secondary a majority of the time....and that's just not right. I'm not sure how that translates in my life exactly, but I'm working on exploring that more. Maybe it means more spontaneity.....like doing something I really want to do on a whim. Having this realization today, I decided to do something I haven't done in awhile: have some Thai food, my favorite ethnic meal. It was delicious. :)

I had class today and while alot of it was quite common sense to my level of education and work experience, I am always able to extrapolate some kind of newfound knowledge, insight,etc. What did I glean from today's discussion? (Aside from realizing I need to take care of myself more....)

The attachments we form in childhood with our parents are more significant and incomparable to that of any other social relationship from then on. If that attachment isn't there early on, an unhealthy form of attachment to a substance of some sort (drugs, gambling, food, ad infinitum...take your pick of the proverbial non-human variety) is more likely to occur. One is more apt to have increased insecurity and an inability to form intimate relationships (aka, healthy attachments in adulthood, specifically in regard to romantic relationships).

It never occurred to me that choosing a substance in a way is a SUBstitute for the absence of a significant bond of attachment. The substance becomes the 'relationship' of attachment. When seen in such a systemic framework, it becomes clear how an addiction can become so seemingly impossible to let go off from one's life. It's a safety net, a security.

If someone told you that in order to make a change in your life, you had to let go of your relationship to your parent(s)....the only attachment(s) you've ever truly connected with, how would you respond? Just how open or resistant might you be to change?