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.

One big box on display, for all the world to see

Prior to computers encompassing a big part of our daily living, it was safer and easier to compartmentalize those aspects of your life you wish to be separated or private....a box for your work, a box for your family, a box for your friends, and a box for acquaintances or strangers. It was fairly easy to navigate through the boxes. If you were cool with one box knowing certain things about you, one or more of the other boxes didn't have to know about it. But then technology started infiltrating its way in, bulldozing those safe little boxes and replacing it with one big mingling social playing (or mining?) field. Boundaries started to become vague, sometimes even non-existent.

While you could once be choosy about self-disclosure with people in your various boxes, the mainstream popularity of sites like Google and Facebook opened up a can of worms regarding finding people, being found, and finding information about other people that they don't want out there for the whole world to see. This particularly hits home for me and while I cannot speak for my therapist friends or colleagues in depth, I know they go through similar thoughts and feelings on this issue. For therapists in particular this can be a thorny issue, and it's only getting harder to manage as technology continues to rapidly expand.

Let me back up to the year 2005, where the story begins for me. After graduating with an MA degree in 2005, I started working as an addictions counselor in a small office on the north side of Chicago. While it was an incredibly hard and challenging job, it also had one major perk. At this same time, I started writing blogs on the now seemingly obsolete site MySpace. My work hours were in the wee hours of the morning and there would be stretches of quiet downtime in between doing any work with clients. This allowed me the time, space, and opportunity to write about different things I happened to be thinking about or wanting to express. It was a way for me to share with my friends and also pass the time in a meaningful way. Social networking was in its infancy stages at that time. Clients rarely mentioned the importance or even functional use of computers in their everyday life, most probably didn't even have one. I felt safe with my boxes.

Several blog posts later (in 2007), a friend encouraged me to create my own blog page (this here) that would allow a potential audience of readers beyond my two small boxes of family and friends. I was apprehensive and nervous as I thought about what it would be like for the world wide web to read my thoughts and in a sense "know" me through my writing. It felt scary being perceived as a "writer" and the vulnerabilities that come with such a role, especially since I never considered myself a "real" writer. My boxes still felt pretty intact....looser, but intact. But then Facebook came along. The boxes started to disappear, or rather there was suddenly just one big box. Everyone from the various boxes were now all with me in the one box. And some lurked just right outside the box, mainly ones I never wanted to see or think about outside of work: clients.

I once had clients at my last job (2005) that didn't even have computers and now in 2011 I have clients who will frequently talk about Facebook. We no longer have private lives, but rather only private aspects to very public lives. I am now overly conscious and aware of what I put out there. It's harder to know if and when I should share or not share (Thank goodness for privacy settings that allow me to make myself invisible in some regards!). It used to be if a client asked me a personal question, they wouldn't know if I didn't tell them. I could freely pursue my photography and writing with reckless abandon. Self-expression felt liberating. I miss that feeling. It has been replaced with borderline paranoia, a neurotic feeling that likely won't disappear. I'm pretty sure my friends and family who aren't in the counseling field think I'm nuts on this particular issue, but they don't know/understand the dynamics of therapeutic relationships. They require certain boundaries and limitations you don't have or need in the relationships you have in your personal life...hence the dilemna and anxiety for what you can't control with technology rearing its sometimes ugly head.

Thinking I must not be the only therapist out there impacted by this issue, I curiously decided to do a little online research and see what has been written on the topic. Once again, I appear to be ahead of the curve on noticing this paradigm shift....I couldn't find anything written about it. The closest thing I could find was this: http://www.zurinstitute.com/internet_transparency.pdf. Even then, all this article talks about is the impact on the client not on the therapist's personal life (especially with the therapist's own creativity and self-expression).

Ever since my graduate school days I have had a way of picking topics that have never been written about, at least publicly/no research can be found on it. I'm compelled with curiosity to start talking to more of my therapist friends and colleagues about this now. Maybe I've had it all wrong on what my first book could/should be about. haha. If I were rich and had ample time, I could write books on all the issues or topics that haven't been written about and are incredibly relevant to the mainstream even though they don't know it yet.

Time to buy that lotto ticket and go back to my one big box of public living....

Technology and detriment to relationships

I've been thinking about this alot lately, and more so...I feel increasingly frustrated about this....

It relates to a blog I wrote about quite awhile ago ("Connecting in a Postmodern World", or something along those lines of a title), only this time around I feel like it extends beyond the realms of trying to navigate through a confusing realm of dating. No, this is so much broader and potentially detrimental to human relationships as a whole.

Can anyone remember a time pre-Internet and social networking sites? Remember when having a relationship (of ANY kind, whether with a friend, family member, significant other, neighbor or coworker) with someone was done the "old fashioned" way of talking to the person on the phone, spending one-on-one/face to face time, and/or doing community based activities? How often does this happen now? Unless you're living in a poor, rural area (aka third world country), I would venture to say that a majority of relationships in the 21st century do not look like this anymore. Instead, direct interpersonal contact has been replaced by indirect impersonal, disconnected contact more often than not. By this, I mean relationships have become negatively dependent upon technological mediums (whether texting, emails, and especially social networking sites) to develop and maintain relationships. I can much more easily tell you who was the last person to text me, email me and communicate with me via a social networking site and how frequently this occurs in a given day than I can recall the last time I received a phone call or meaningful "in person" contact with someone in my personal life.

While I cannot speak for everyone, my keen psychological observations lead me to the prediction that this is more the norm for a majority of people than the exception.

In some ways, technology has made communication incredibly expansive and it definitely has its positive aspects...don't get me wrong. Taken to the extreme, as with anything else in life, it has become toxic to human relationships in many ways. When an individual seems to be having more of a relationship with a computer than a real, live person...there's a problem. It can have profound effects on one's capacity to engage in meaningful dialogue, demonstrate critical thinking skills, social skills, and developing genuine intimacy in relationships. It can also affect one's mental, emotional, and physical health.

It also extends to impacting one's ability to be "real," vulnerable, authentic and raw in expressing oneself with another in "real life." I saw a clip for a PBS special recently. It was a program about differences between the generations and they had people of various ages talking about what is different about Gen Xers, baby boomers, and the current generation (Gen Y'ers?). One mid 30 to fortysomething woman said something about how young people are so consumed with communicating via technology (texts and social networking) that they have a hard time even making eye contact when face to face with someone. I could not agree with her more, although I don't see it quite so specific to just that generation.

What bothers me (and what I haven't quite figured out yet) is, how does one come to terms with this in their relationships when this is the cultural norm? I don't know how many times in the past couple of months I have genuinely yearned to talk on the phone and/or spend time with someone I care about (too many instances to count), only to find the individual doesn't want to talk/chooses to be "distant" in their contact with me (but is definitely more accessible to communicate with online or through texts) or is too busy to hang out. Granted, things happen in life and I don't expect someone to be available at the drop of a hat. If you know me, you know I am not demanding in my relationships with people. At the same time, human beings are social animals who need to be stimulated by all of their senses (seeing, hearing, tasting, touching, and that 6th sense we call our intuition) and this includes our relationships.

I want more personal mediums in which to interact and communicate in my relationships. I want less of the current norm. Am I the only one who wants a return to this "old fashioned" way of having relationships? Do I put up with it, taking a 'this is better than nothing at all' attitude? Do I mourn the loss of the kind of relationship I would like to have with a particular person that just won't happen if he/she isn't willing to take it to the level I would like? And where do I find those that want more than a technologically based relationship?

It's pretty sad when the most meaningful conversation and face to face contact I have on a daily basis (on average) is with my clients...a surreal juxtaposition against my personal relationships that rely heavily on technology for a certain degree of staying "connected" in some way.