Recognizing the Consequences of Sexual Addiction

By Robert Weiss LCSW, CSAT-S

Recognizing-the-Consequences-of-Sexual-Addictio-2Assessment Questions

It’s not exactly a clinical secret that most of the sex addicts who enter therapy do so in response to their addiction’s related symptoms—disintegrating relationships, depression, severe anxiety, inability to focus at work or in school, social isolation, and the like. Rarely do these individuals walk in the door say, “You know, I think maybe I’m a sex addict, and that’s probably the first thing I need to deal with.” Instead, sex addicts will tell you that they’re unhappy, and that they’re having a variety of life and relationship problems. In my previous blog I discussed the fact that therapists should always ask at least a few specific but non-graphic questions about sexual activity during assessment in an effort to unearth sex-related issues. These questions may include the following:

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Does Your Client Have a Cybersex Problem?

By Robert Weiss LCSW, CSAT-S

Recognizing-the-Consequences-of-Sexual-AddictionLevels of Cybersex Use

In today’s digitally driven world it can be difficult to distinguish between those whose involvement with online sexual behavior is recreational, those whose involvement is “at-risk,” and those who are cybersex addicted (those whose lives and functionality are negatively affected by repetitive online sexual activity). This is compounded by the fact that most of the people who are struggling with cybersexual activity who enter psychotherapy choose to talk about their symptoms (depression, anxiety, issues with sleep, inability to form lasting relationships, and the like) rather than their problematic patterns of cybersexual activity. Making matters worse, current therapeutic evaluation tools (standard bio-psycho-social assessments) typically do not ask clients much about their sexual lives or sexual histories, meaning these issues can easily go undiscovered and unaddressed (to the client’s detriment). This non-discovery is aided and abetted by the very nature of the Internet, which, in addition to being highly affordable and continually accessible, allows for relatively anonymous use, making it easy for cybersex abusers to keep their behaviors private and to psychologically compartmentalize what they are doing.

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Out of Control Sexual Behavior: Addiction or Offending?

By Robert Weiss LCSW, CSAT-S

Out of Control Sexual Behavior: Addiction or Offending?When It Comes to Sex, Confusion Reigns

After more than two decades spent treating both sexual addicts and the occasional offender, I’ve watched the field of sexual disorders assessment and treatment come very far in its understanding of both sexual addiction and sexual offending. Nevertheless, the general public is often wildly misinformed on both topics, as are at least a few clinicians. One of the most common misperceptions is that sex addicts and sex offenders are one and the same. This is most definitely not the case.

In reality, there are significant differences between sexual addicts and sexual offenders. Sex addicts are people who engage compulsively in one or more consensual sexual behaviors, continuing those behaviors despite directly related negative consequences – relationship woes, problems at work or in school, loss of interest in previously enjoyable activities, lack of self-care, declining physical and/or emotional health, financial issues, and more. Sex offenders often have similar symptoms, but their sexual activities are nonconsensual, violating the rights of others, breaking the law, or both.

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Addicts Just Want to Have Fun (in Recovery)

By Robert Weiss LCSW, CSAT-S

Addicts Just Want to Have Fun (in Recovery)All Work and No Play…

Jack a 52-year-old divorced high school guidance counselor, after a stint of inpatient substance abuse rehab, had nine months sober from both alcoholism and marijuana addiction. In addition to working 8 to 5 every weekday, Jack kept a journal, meditated daily, and attended at least one twelve step meeting each evening. He also met with his therapist once per week and his twelve step sponsor twice weekly. Until the eight month mark of sobriety, he was riding the “pink cloud” of early recovery – that blissful time when many recovering addicts feel so relieved to finally be addressing their longstanding problem that, no matter what comes their way, they feel generally positive and cheerful about themselves and the world.

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Another Study Links Compulsive Sexual Behavior to Other Forms of Addiction

By Robert Weiss LCSW, CSAT-S

Another Study Links Compulsive Sexual Behavior to Other Forms of AddictionStatus Quo (For Now)

In mid-July I published a blog discussing a recently released fMRI (brain imaging) study showing that the brain activity of sex addicts, when they are shown pornography, mirrors the brain activity of drug addicts when they are exposed to drug-related imagery. That research strongly suggested that sexual addiction not only exists, but that it manifests in the brain in profoundly similar ways to more readily accepted forms of addiction like alcoholism, drug addiction, and gambling addiction. Publication of this study was highly significant in light of the American Psychiatric Association’s unexplained and unexpected refusal to include Hypersexual Disorder (aka, sexual addiction) in the DSM-5 last year. This despite Harvard Professor Dr. Martin Kafka’s well-researched and elegantly presented argument, commissioned by the APA, in favor of such a diagnosis.

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The Truth about Gay Conversion Therapy

By Robert Weiss LCSW, CSAT-S

The Truth about Gay Conversion TherapyTherapists are Trained, Governors are Not

A few weeks ago Texas Governor Rick Perry, speaking in San Francisco, defended his state’s Republican Party Platform endorsing gay conversion therapy (also called reparative therapy), essentially stating that homosexuality is a choice. So once again this topic is in the news and in need of intelligent discussion. Somewhat amazingly, the basic questions being asked about homosexuality and conversion therapy haven’t changed much in the last 50-plus years, despite the almost incalculable progress we’ve made in our scientific understanding of human sexuality and romantic attraction. The two primary questions seem to be:

  1. Is homosexuality a psychological disorder (or the result of a psychological disorder)?
  2. Can homosexuals be repaired (i.e., converted into heterosexuals) via psychoanalytic treatment or any other methodology?

The answer to both of these questions is a resounding NO. Yet here we are again, fighting off painfully misguided, highly moralistic efforts to judge healthy forms of sexuality.

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Wake Up California Therapists! Protecting Client Confidentiality per Proposed California Law AB 1775

By Robert Weiss LCSW, CSAT-S

therapy-sessionThe Current Situation vs. AB 1775

For a very long time, California psychotherapists have been required to break client confidentiality only when we believe a minor or dependent adult is in imminent danger of serious abuse or neglect or a life is imminently at risk (homicide and/or suicide with a clear plan). Over the years this has enabled us to privately counsel countless men and women seeking help with discontinuing illegal or potentially harmful behaviors, or with diminishing shame and self-hatred over past misconduct. Many of us have helped these individuals develop and maintain healthier, happier, and safer lives – without needing to break our vow of confidentiality.

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Discussing Casual Sex: An Interview with Dr. Zhana Vrangalova

By Robert Weiss LCSW, CSAT-S

Discussing Casual Sex: An Interview with Dr. Zhana VrangalovaZhana Vrangalova is a human sexuality researcher with a PhD in Developmental Psychology from Cornell University. Currently she teaches in the Psychology Department at NYU. Her research focuses on sexual orientation, consensual non-monogamy, and the effects of casual sex on emotional wellbeing. She is the originator of The Casual Sex Project, a forum for real stories from real people detailing their experiences with hookups, one-night stands, friends with benefits, and the like. Her recently published study, Who Benefits from Casual Sex: The Moderating Role of Sociosexuality, is generating a great deal of discussion among not just sexologists, but the general public, primarily because the research finds that casual sex, for people who are emotionally and socially “into it,” may actually benefit emotional and psychological wellbeing. (Previous studies looking into the effects of casual sex on wellbeing have been largely inconclusive.) I recently had the opportunity to speak with Zhana about her groundbreaking work, and I wanted to share the transcript of our conversation here.

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Childhood Covert Incest and Adult Life

By Robert Weiss LCSW, CSAT-S

Childhood Covert Incest and Adult LifeDashiell, a 29-year-old CPA, first came to see me after his self-described “healthy sexual appetite” went from fun to over-the-edge to addiction. In our initial assessment, Dash told me his sexual behavior had spiraled out of control, resulting in a string of reprimands at work (for downloading porn on company owned equipment) and eventually the loss of his job. Dash was also using “adult friend finder” apps, primarily Ashley Madison and Tinder, to seek out casual sexual encounters and prostitutes. Unsurprisingly, he was in deep denial about his sexual problems – justifying, minimizing, blaming, and deflecting like a seasoned addict. Nevertheless, his treatment motivation was high, even though he was hoping to not give up the escapist and highly compulsive sexual intensity that ruled his life.

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Esteemed Study Identifies Sexual Addiction as Identifiable and Diagnosable

By Robert Weiss LCSW, CSAT-S

Esteemed Study Identifies Sexual Addiction as Identifiable and Diagnosable All Highly Pleasurable Substances and Behaviors Have Addiction Potential

Led by Dr. Valerie Voon, a group of researchers at the University of Cambridge (UK) recently published a detailed fMRI study showing that the brain activity in sex addicts, when they are shown pornography, mirrors the brain activity in drug addicts when they are exposed to drug-related imagery. This study strongly suggests that sexual addiction not only exists, but in fact manifests in profoundly similar ways to other more readily accepted forms of addiction like alcoholism, drug addiction, and Internet addiction.

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