The Search for Solutions

“Chemsex,” the use of psychoactive drugs to enhance sex, is a recognized public health concern due to its association with increased risks of HIV and other sexually transmitted infections (STIs).

In response, a range of programs, from counseling to medication, have been developed to address these risks. The common assumption is that the primary goal of these programs is to help individuals reduce or stop the drug use associated with chemsex.

However, a major new systematic review and meta-analysis that synthesized the results of 12 different studies challenges this assumption, revealing a more nuanced and surprising picture of what “success” actually looks like in this area. 

Takeaway #1: Chemsex Interventions Target a Specific Risk, Not the Drug Use Itself 

The single most effective outcome identified by the review was a clear and significant victory for public health: bio-behavioral interventions were found to substantially decrease the number of episodes of unprotected anal intercourse (UAI) with serodiscordant partners, or partners with a different HIV status, a result so strong it was highly statistically significant (p<0.001). 

However, in what may be the most counter-intuitive finding, the review also concluded that the interventions did not lead to a reduction in the use of psychoactive substances during sexual activities.

This is a significant finding because it reframes the goal of these interventions from one of drug abstinence to one of harm reduction. The data shows that the programs are succeeding at reducing a primary risk factor for HIV transmission, even if they don’t stop the underlying drug use itself.

They are making a high-risk behavior safer. 

Bio-behavioral chemsex interventions reduce the risk of UAI with serodiscordant partners, a high-risk factor for HIV seroconversion. 

Takeaway #2: The Evidence is Narrower and More Fragile Than It Appears 

While the primary finding is promising, the review also reveals critical limitations in the current body of research, suggesting the evidence is not as robust as it might seem. 

• Geographic Bias: All 12 studies included in the meta-analysis were conducted in the USA. This raises what the review calls “concerns regarding the generalisability of these findings to other countries” in Europe, Asia, and Australia where chemsex is also practiced.
• Drug-Specific Focus: Chemsex is known to involve several drugs, including mephedrone and GHB/GBL. Yet, 11 of the 12 studies focused exclusively on methamphetamine use. The review notes this highlights a “dearth of research” for interventions targeting other relevant substances.
• Risk of Bias: The quality of the evidence is a concern. The majority of the studies (67%) were rated as having a “high risk of overall bias.” Key issues included a reliance on participants self-reporting their behaviors and high drop-out rates, which tempers confidence in the overall conclusions. 

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Are you exploring your trauma? Do you feel your childhood experiences were detrimental to your current mental or physical health? Utilize this free, validated, self-report questionnaire to find out.

Take the Adverse Childhood Experience (ACE) Questionnaire

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Takeaway #3: Beyond a Single HIV Risk Factor, the Benefits Remain Unclear 

While the interventions successfully reduced UAI with serodiscordant partners, their impact on other risky behaviors was more ambiguous.

The review found that interventions led to a decrease in the total number of sexual partners and the number of partners with whom UAI occurred, but these reductions were not large enough to be statistically significant.

Specifically, the review could not establish a statistically significant link between the interventions and outcomes such as the total number of sexual partners, the number of partners where UAI took place, the overall number of episodes of UAI, or the frequency of sex involving substance use.

This finding does not mean the interventions are failures. Rather, it suggests they are highly targeted in their effect, acting on one very specific, high-stakes behavior rather than serving as a “magic bullet” for all behaviors associated with chemsex. 

Conclusion: Reframing the Success of Chemsex Interventions

This comprehensive review sends a clear message: chemsex interventions show tangible promise for reducing a critical HIV risk behavior, even if they don’t reduce drug use itself.

At the same time, the scientific evidence supporting these interventions has significant gaps, including a narrow geographic and substance focus and a high risk of bias in the underlying studies. The review presents a paradox: the most successful interventions are the ones that ignore the most obvious target: drug use and, instead, focus on mitigating its most dangerous consequences. 

As we move forward, should the goal of public health be focused less on abstinence and more on providing tools that demonstrably make risky behaviors safer?

Are you a professional looking to stay up-to-date with the latest information on, sex addiction, trauma, and mental health news and research? Or maybe you’re looking for continuing education courses? Then you should stay up-to-date with all of Dr. Jen’s work through her practice’s newsletter!

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Are you a Licensed Professional Counselor seeking engaging, unique Continuing Education courses? Dr. Weeks offers accredited courses on her practice website on the effects of Pornography Abstinence and other unique topics!

Do you feel your sexual behavior, or that of someone you love, is out of control? Consult with a professional.

Are you looking for more reputable, data-backed information on sexual addiction? The Mitigation Aide Research Archive is an excellent source for executive summaries of research studies.

The post Chemsex Interventions Succeed by Not Targeting Drug Use first appeared on Dr. Jen's Recovery Readings.

Introduction: The Illusion of Choice

For many, gambling is seen as a form of entertainment, a voluntary activity where personal responsibility is paramount. We’re told to gamble responsibly. But, if things go wrong, the blame is often placed on the individual’s lack of self-control. 

But what if that entire narrative is a dangerous fiction?

A new public health study reveals gambling harm is not an unfortunate side effect of a few people’s poor choices. Instead, it is the calculated outcome of a powerful and deliberate “gambling ecosystem” designed to maximize profit at a severe human cost.

This system operates using tactics that public health experts call the “commercial determinants of health.” The same strategies used by the tobacco and fossil fuel to drive profit by undermining public wellbeing. 

This post will reveal five of the most impactful insights from the study, exposing the hidden truths of an industry that has mastered the art of engineering harm.

1. The “Responsible Gambling” Slogan is Designed to Blame YOU

The familiar phrase “gamble responsibly” is not a genuine public health message but a strategic discourse meticulously promoted by the industry. The primary function of this narrative is to shift the focus, and the blame, onto the individual consumer.

By framing harm as a personal failing, it deflects attention. It deflects it from:

• Predatory industry practices
• Unsafe products
• A system that profits from addiction

This blame-shifting has severe consequences, creating a culture of shame that prevents people from seeking help and isolates them when they are most vulnerable. As the study’s authors note: 

This emphasis on individual responsibility diverts attention from the practices of the industry. It generates stigma and shame for those harmed. It downplays serious harms caused by gambling. Worst of all: it contributes to the suicide toll. 

This psychological framing is so damaging because it convinces individuals that their suffering is their own fault, making it harder to recognize the external forces at play and seek the support they need. 

Are you a professional looking to stay up-to-date with the latest information on, sex addiction, trauma, and mental health news and research? Or maybe you’re looking for continuing education courses?

Stay up-to-date with all of Dr. Jen’s work through her practice’s newsletter!

2. The Gambling Industry’s Goal is For You to “Play to Extinction”

Behind the glamorous advertising and messages of entertainment lies a stark and chilling internal objective. The study highlights a term used by gambling industry representatives to describe their core aim: “playing to extinction.” 

This isn’t an exaggeration; it’s the industry’s own vocabulary for its business model:

“…gambling industry representatives describe their aim is to maximise revenue per available customer (revpac), and encourage ‘playing to extinction’, the point at which a customer has exhausted all available funds.”

The phrase has a chilling double meaning.

It refers to the financial extinction of a customer’s funds, but in the context of gambling-related suicide, it acquires a much darker significance.

The industry’s profit model depends on pushing customers into the exact states of financial ruin and profound despair that are known precursors to suicide. It is a business model that treats human crisis as a key performance indicator. Rather than a tragic crisis.

3. Products are Engineered to Undermine Your Control

Modern gambling products, especially digital ones, are not simple games of chance. They have been intentionally intensified with features like:

• Increased speed
• High complexity
• “Frictionless” transactions

All designed to encourage extended use and bypass a person’s executive function. 

The industry also employs digital tactics like sludging. Deliberately designing interactions to make it difficult for customers to act in their own best interest. Such as withdrawing funds or closing an account. This tactic also manifests physically. For 15 years, the Australian industry has resisted modern, universal pre-commitment systems that allow users to set binding loss limits. Instead, it has relied on a form of physical sludging: “manual, paper-based self-exclusion” that requires a person to fill out separate forms for every single venue they wish to avoid. 

Product design also deploys psychological tricks to encourage overspending.

The study points out that a single ticket in the Australian “Powerball” lottery can be priced as high as AUD$46,249.65. This serves as a psychological anchor. While few would buy it, its existence makes spending smaller—yet still exorbitant—amounts like hundreds or thousands of dollars seem reasonable by comparison.

Need support and not local to the Lehigh Valley? Check out the LGBT National Help Center.

4. “Good Causes” are Used as a Smokescreen

A common defense of the gambling industry is that it funds worthy causes, from sports teams to community charities. The research argues this is a calculated strategy to create an “‘alibi’ to legitimise gambling operations” and procure a “social license” to operate. 

This linkage creates a “symbiotic, reflexive relationship” where community groups become financially captured. Reliant on gambling revenue, these beneficiaries become powerful allies in resisting reforms that could threaten their funding, even if those reforms would reduce harm. This insidious dependency creates a powerful barrier to reform. 

As one researcher observed, the dynamic is inescapable: 

… at first the lottery was primarily dependent on the good cause and then, gradually, the good cause became increasingly dependent on the lottery. 

5. The Gambling Industry Distorts Science and Influences Policy

Like the tobacco and fossil fuel industries before it, the gambling ecosystem actively works to control and distort the scientific evidence base to protect its interests. The study identifies two key tactics: 

• Funding “safe” research: The industry funds and promotes research focused on the individual, such as the influential “pathways model.” This model frames gambling harm as an artifact of pre-existing conditions like “antisocial personality disorder,” thereby shifting blame from the addictive product to the flawed consumer. 
• Discrediting effective solutions: The ecosystem publicly casts doubt on proven harm-prevention tools. The paper cites an industry-linked researcher who claimed that universal pre-commitment systems might have a “detrimental effect and may aggravate the problem.” Crucially, the study notes that a subsequent review of the evidence cited for this claim found “no support for this conclusion,” noting the studies had significant “methodological limitations.” This reveals a pattern of distorting weak evidence to undermine effective public health measures. 

This distortion of science is coupled with political donations and the “revolving door”—where politicians and staff take industry jobs after leaving office—to block or delay meaningful reforms that could save lives.

Conclusion: Shifting from Individual Blame to Systemic Accountability

The evidence is clear: gambling harm is not a simple story of poor individual choices. It is the predictable and profitable result of a commercial system meticulously designed to addict users, shift blame, and protect its revenue streams at all costs. From manipulative product design to the distortion of science, the gambling ecosystem functions as a commercial determinant of health, actively generating and sustaining harm. 

This reframing moves the problem from one of personal responsibility to one of systemic accountability. Seeing the deliberate system that drives these harms, what does real responsibility—from our governments, communities, and the industry itself—truly look like?

Are you looking for more reputable data-backed information on sexual addiction? The Mitigation Aide Research Archive is an excellent source for executive summaries of research studies.

Do you feel your sexual behavior, or that of someone you love, is out of control? Then you should consult with a professional.

Have you found yourself in legal trouble due to your sexual behavior? Seek assistance before the court mandates it, with Sexual Addiction Treatment Services.

The post 5 Hidden Ways the Gambling Industry Engineers Harm first appeared on Dr. Jen's Recovery Readings.

The Surprising Psychology of Sports Gambling 

Are you thinking about placing a little wager on a football game this holiday season? With the rapid growth and normalization of sports gambling across the United States and Canada, betting on a game is more common than ever. But what are the real reasons people gamble?

Most would assume it’s simply for fun, to make a game more exciting, or for the chance to win money. But what if the most important metric for gambling risk isn’t on a bank statement, but in the unseen emotions driving the bet? 

A recent study of over 900 sports bettors reveals a more complex picture, uncovering deeper psychological motivations that separate casual fun from problematic behavior. The findings challenge our basic assumptions about gambling risk. This article will break down the five most impactful takeaways from this research, revealing that the “why” behind a bet is far more important than the “how much.” 

1. Your Reason for Betting Matters More Than How Much You Spend 

One of the study’s most unexpected findings was the relationship between mental health, betting habits, and gambling problems. The research showed that greater anxiety and depression were strongly linked to the severity of a person’s gambling problems. However, these emotional states were not significantly related to the total amount of money a person spent or the total number of bets they made. 

This insight reframes how we should think about risk. It’s not just about the financial footprint of betting, but the emotional impetus behind it. 

According to the study, the true indicator of risk isn’t found in a bettor’s bank statement, but in the emotional state that drives them to bet in the first place. 

This is a critical distinction. It shifts the focus from a purely financial view of problem gambling to a psychological one, suggesting that the “why” you bet is a more telling sign of risk than the “how much” you spend.

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Are you exploring your trauma? Do you feel your childhood experiences were detrimental to your current mental or physical health? Utilize this free, validated, self-report questionnaire to find out.

Take the Adverse Childhood Experience (ACE) Questionnaire

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2. The Crucial Difference: Gambling for Fun vs. Betting to Escape

The study identified two key motivations that drive people to bet, each with vastly different outcomes: 

• Enhancement Motives: Betting to increase positive emotions. This is the classic reason—placing a wager to add to the thrill and enjoyment of watching a game. 
• Coping Motives: Betting to reduce or escape from negative feelings, such as anxiety, stress, or depression. 

The results linked to each motive were counter-intuitive.

This revealed a fascinating paradox: while betting to enhance the fun of a game was linked to placing bets more often, it was simultaneously associated with fewer gambling problems. This suggests a clear psychological dividing line between frequent, low-risk engagement and problematic, high-risk behavior. 

In stark contrast, betting to cope was the single strongest pathway linking pre-existing anxiety and depression to serious gambling problems.

Crucially, this connection held true even when the researchers accounted for other potential drivers like betting for social or financial reasons, isolating ‘coping’ as the most dangerous motivation. This finding strongly supports the “emotionally vulnerable pathway” model of problem gambling, where individuals use gambling as a maladaptive strategy to manage emotional distress. 

3. “In-Play” Gambling Is a Different Beast Entirely

“In-play” sports betting, defined as making wagers during a live game, has exploded in popularity. The study’s findings on this specific group were stark. Compared to bettors who only place wagers before a game starts (single-event or traditional bettors), in-play bettors reported: 

• Significantly higher levels of problem gambling.
• Significantly higher scores for both anxiety and depression.
• A higher frequency of betting.

This raises a critical question for researchers: does the high-speed, constant-feedback nature of in-play betting actively create psychological distress, or does it primarily attract individuals already struggling with anxiety and depression who are seeking a powerful distraction? 

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As professionals, our time is valuable. Dr. Weeks created the Mitigation Aide Research Archive because there isn’t enough focused, data-backed research available in easily digestible formats.

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4. For Sports Bettors, Anxiety and Depression Are Often Intertwined 

The research observed that in this sample of sports bettors, depression and anxiety were “highly correlated.” In simple terms, participants who scored high on one tended to score high on the other. 

The researchers noted that this suggests these conditions are more likely to be comorbid—or occur together—in people who bet on sports. The connection was so strong that the effects of anxiety and depression on gambling behaviors often overlapped. This reinforces the concept of a combined “emotional vulnerability” that can fuel problematic gambling, rather than a single, isolated mental health issue.

5. The Psychological Blueprint Is Surprisingly Consistent Across Genders

The study also examined differences between men and women, revealing a nuanced picture. On the surface, there were clear differences in behavior and emotional states: 

• Men engaged in sports betting on significantly more days than women.
• Women reported significantly higher levels of anxiety, depression, and betting for social and coping reasons.

Despite these differences in emotional states and motivations, men and women reported statistically similar levels of overall gambling problems. 

The more profound finding was that despite these surface-level differences, the underlying psychological model was the same for both groups.

The core pathways showing how anxiety, depression, and motives lead to gambling problems did not differ between men and women. This suggests that when it comes to the fundamental emotional drivers of problem gambling, gender may not change the blueprint. Interventions, therefore, can likely focus on these consistent psychological drivers for everyone. 

Conclusion

This research cuts through the noise of wins, losses, and dollar amounts to deliver a clear message:

Understanding the motivation behind gambling is the key to understanding the risk of it becoming a problem.

While many people bet to enhance their enjoyment of a sport with few negative consequences, the data points to a clear red flag:

The strongest pathway to serious gambling problems isn’t rooted in how much money is spent, but in whether the bettor is motivated by a need to cope with or escape from negative emotions. 

Before placing your next bet, it might be worth asking: am I doing this to enhance my fun, or to escape my feelings?

Drop a comment and let us know if you were able to identify any motivations you may have for acting out this holiday season.

Are you a professional looking to stay up-to-date with the latest information on, sex addiction, trauma, and mental health news and research? Or maybe you’re looking for continuing education courses? Then you should stay up-to-date with all of Dr. Jen’s work through her practice’s newsletter!

Do you feel your sexual behavior, or that of someone you love, is out of control? Then you should consult with a professional.

Have you found yourself in legal trouble due to your sexual behavior? Seek assistance before the court mandates it, with Sexual Addiction Treatment Services.

The post Holiday Gambling: Why You Bet Matters More Than How Much first appeared on Dr. Jen's Recovery Readings.

I had the pleasure of hearing Dr. Fawcett give a presentation on Sex Under the Influence at the 2023 IITAP conference. 

This post contains affiliate links. The author or blog owner may earn a commission if you make a purchase using these links.

It was one of the more enjoyable discussions I caught while at the conference. He has a vast amount of experience working with dual chemical and sexual addictions. He is very clearly passionate about helping people work through these issues. 

So, when he published a book on the subject, I was eager to read it.   

Sex Under the Influence is aimed at Individuals

While this book’s target audience is individuals who are struggling with sexualized drug use, it will also be useful to clinicians who are not as familiar with the pairing of sex and drugs in a compulsive manner. 

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Do you believe your sexual behaviors are compulsive or harmful to you or others? Then you should take the CSBD-19 free, validated self-assessment tool.

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The first chapter does a nice job with the following points:

• What sexualized drug use is
• How people use sex and drugs together and why
• The biology of the addictive process and the consequences when pairing sex and drugs gets out of hand

Chapter 2 is either a nice primer or recap about what addiction is and how it can be experienced by people. 

Chapter 3 looks at addictive behaviors in a variety of demographic groups. 

I really enjoyed this chapter. It did something few books on addiction do: it discussed what addiction can look like for men, women, and transgender individuals. 

We know from the scientific literature that men and women experience addiction differently both socially and biologically. Dr. Fawcett also discussed how addiction may differ based on one’s sexual orientation. 

An entire chapter looking at the diversity of the addictive process was appreciated.  

Recovery Tools from Sex Under the Influence

Starting in Chapter 5, the book provides tools and information for recovery. For clinician’s reading this book, particularly those who are trained in treating problematic sexual behavior, a lot of this work will be familiar. 

For people struggling with addiction who are thinking about or entering into recovery, the second half of the book provides valuable tools such as:

• The three-circle exercise
• Emotion regulations tools
• Relapse prevention planning

Subsequent chapters delve into the long-term process of recovery. It implicitly and explicitly acknowledges this is a long-term or lifelong process. 

Recovery, particularly from issues with sexuality, require us to deepen connections. It requires us to delve into intimacy and our own sexuality.   

Are you a professional looking to stay up-to-date with the latest information on, sex addiction, trauma, and mental health news and research? Or maybe you’re looking for continuing education courses?

Stay up-to-date with all of Dr. Jen’s work through her practice’s newsletter!

My Favorite Part

One of the things I particularly like about Sex Under the Influence is the author’s discussion of harm reduction. 

So often, recovery is seen as an abstinence-only model and harm reduction is not discussed. 

Abstinence-only models can drive away those thinking about recovery but feel full abstinence is impossible. 

Additionally, abstinence-only models often are not realistic for problematic sexual behavior. Sexuality is part of who we are as humans. 

The author spends a chapter discussing harm reduction and how it can be applied to sexualized drug use.

This post contains affiliate links. The author or blog owner may earn a commission if you make a purchase using these links.

Do you feel your sexual behavior, or that of someone you love, is out of control? Consult with a professional.

Have you found yourself in legal trouble due to your sexual behavior? Seek assistance before the court mandates it, with Sexual Addiction Treatment Services.

The post Book Review: Sex Under the Influence first appeared on Dr. Jen's Recovery Readings.

Why might you block porn?

1. You might want to block porn if you’re a parent of young children.
2. Pornography is a drain on time, money, and computers.
3. You or loved one has a compulsive desire to view pornography.

This post contains affiliate links. The author or blog owner may earn a commission if you make a purchase using these links.

You’re a Parent of Young Children

Give Your Kids a Chance to be Kids and Block Porn

We all know kids will get into things they shouldn’t, it’s part of growing up.

With no guidance it’s very easy for them to fall down the rabbit hole.

But with the right mindset, frequent, open discussions with them, and some technological barriers you can help your child navigate the pitfalls of adolescence, defining their own sexuality, AND the internet.

Pornography is a Drain on Time, Money, and Computers

Pornography has always been a pervasive presence on the internet. From the early days of newsgroups through the modern “work-from-home revolution” that OnlyFans has brought, it can be tough to escape.

Blocking pornography for yourself and/or your loved ones can have a lot of benefits:

• Simply put you’ll utilize your time better if you don’t lose time being tempted by and indulging in an idle pass time.
• You won’t be tempted to spend money on memberships to pornography sites.
• You’ll avoid the hassle of potentially infecting your computer with malware.

There are lots of other reasons to avoid viewing pornography too. Risk of divorce. Desensitization. Erectile Dysfunction. Just to name a few.

Do you believe you have an online pornography addiction? Then take this free Cyber Pornography Addiction Test (CYPAT) and have the results to speak with your therapist.

You Might Want to Block Porn if You or a Loved One Has a Compulsion

This one can be difficult, whether it’s you or a loved one.

If you recognize you have an addiction to online pornography it can be difficult to curb the behavior on your own. We’ll have some suggestions in future installments for handling this particular situation whether you’re truly alone in handling the compulsive behavior or whether you just need some tips in asking your significant other, partner, or parent for help.

If you know a loved one is compulsively viewing pornography it can be a difficult and frustrating conversation to have but having some technical solutions in hand will be helpful.

Are you a professional looking to stay up-to-date with the latest information on, sex addiction, trauma, and mental health news and research? Or maybe you’re looking for continuing education courses?

Stay up-to-date with all of Dr. Jen’s work through her practice’s newsletter!

Pornography Induced Erectile Dysfunction

I know, I mentioned Erectile Dysfunction above, but it’s important enough that I felt I should mention it again. This is a subheading that could definitely be it’s own reason for curbing your mature material intake. Consuming too much erotica can have severe effects on your brain and the way your body responds to stimulus; I’m not the expert though, so I’ll let Dr. Jen explain the details of Pornography Induced Erectile Dysfunction (PIED).

Conclusion

There’s lots of reasons to want to block pornography, these are the most common in our experience, but, what reasons do you have for wanting to block pornography? Let us know in a comment below!

In future installments in the series, we’ll cover:

• The technology to block pornography.
• What IS pornography?
• How to discuss viewing pornography with your spouse/partner/significant other.
• How to bring up discussions with parents or guardians if you’re a teen needing help with pornography habits.
• And more!

This post contains affiliate links. The author or blog owner may earn a commission if you make a purchase using these links.

Do you feel your sexual behavior, or that of someone you love, is out of control? Consult with a professional.

Have you found yourself in legal trouble due to your sexual behavior? Seek assistance before the court mandates it, with Sexual Addiction Treatment Services.

Are you looking for more reputable data-backed information on sexual addiction? The Mitigation Aide Research Archive is an excellent source for executive summaries of research studies.

For an in-depth guide on talking to your adolescents about cybersex and pornography, check out Dr. Jen’s book. Amazon | BookBaby

The post 3 Reasons You Might Want to Block Porn first appeared on Dr. Jen's Recovery Readings.

For me, the concept of sex dolls is fascinating and when my web guy told me that some people were searching for more information about it, I jumped at the chance to write about them again.  

The first thing to do when talking about sex dolls is to forget that image of the plastic blow up doll with a permanently gaping mouth. Today’s sex dolls are high tech, sometimes robotic, really life like and nothing like what most people imagine.  

Let’s talk about some of the controversies.

Child Sex Dolls and Sex Offenders

This one is a hot button issue with some people falling in either camp. Child sex dolls are manufactured outside of the United States and they are extremely realistic looking. This is pretty uncomfortable for a lot of people. 

The two sides of the argument are as follows. 

For individuals who have an exclusive attraction to prepubescent children, child sex dolls might be a way for them to have some sense of sexuality without harming children. 

The other side of this camp thinks that allowing people who are attracted to children to have child sex dolls will actually increase their risk of harming a live child. 

The trouble is, there is hardly any research on the topic to help people make an informed opinion.  

For more thoughts on the topic, check out Prostasia Foundation’s blog on the topic.

Do you believe your sexual behaviors are compulsive or harmful to you or others? Then you should take the CSBD-19 free, validated self-assessment tool.

Sex Dolls and Adults

If we are talking about adult sex dolls, we can avoid the controversy that comes with child sex dolls, but you still get the stigma. 

There are many reasons why someone might want a sex doll. 

Perhaps they have difficulty meeting people, forming relationships, or hooking up with others for sex. 

Perhaps they have a trauma history that makes sex with another person something they can’t engage in. 

Or maybe, they just want to. 

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Interested in more information about sex dolls and their owners? Here’s all of our posts about them:

• Sex Doll Owners and Contact Offenses: Correlations?
• Why do people own sex dolls?
• Let’s Talk About Sex Dolls
• Sex Doll Use: Is it Deviance, Addiction, or Something else?

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There is even a sex doll rental company in Houston, Texas that has lawmakers up in arms. They have tried to block it but, to the best of my knowledge, it is still up and running.

In the sex therapy community, the use of sex dolls does not carry the same stigma that it might in other circles. Fundamentally, an adult who wants to have an adult sex doll should be able to do so without worry about what other people think. 

However, some people worry that using a sex doll or a sex robot as a replacement for human interaction could be harmful.  

Check out some other’s thoughts on the topic here:  

• Using Love Dolls As a Substitute for Human Intimacy (Psychology Today)
• Sex Bot use ‘unrelated to healthcare’ (Medical News Today)

Are you a professional looking to stay up-to-date with the latest information on, sex addiction, trauma, and mental health news and research? Or maybe you’re looking for continuing education courses?

Stay up-to-date with all of Dr. Jen’s work through her practice’s newsletter!

Answering Your Questions

Some of the google searches related to sex dolls that have landed people on my website have questioned whether or not sex doll use is addictive. 

I will take this moment to remind people that when it comes to sex addiction or problematic sexual behavior issues, it is often not the behavior that is problematic but the person’s relationship to the behavior. 

A sex doll is a sex doll. If you are questioning whether your use of the sex doll is an addiction, the better questions relate to your relationship with the doll. 

Is it something that you cannot stop doing? 

Is engaging with the sex doll interfering with your life, work or other relationships? 

If your interactions with the doll do not meet the ICD-11 diagnostic criteria for Compulsive Sexual Behavior Disorder, the problem may be an issue of moral incongruence instead of addiction or problematic sexual behavior.

Do you feel your sexual behavior, or that of someone you love, is out of control? Consult with a professional.

Have you found yourself in legal trouble due to your sexual behavior? Seek assistance before the court mandates it, with Sexual Addiction Treatment Services.

The post Let’s Talk About Sex Dolls first appeared on Dr. Jen's Recovery Readings.

As a therapist, how do we determine whether a pornography problem is erotic conflict or an addiction?

When I started in this field, sex addiction was not a common term. Therapists who treated sex addiction were not that prevalent, therefore you never heard about sex addiction on the news. 

Today, it’s a different story. 

You hear the term sex addiction all the time, bandied about every time there’s a celebrity sex scandal. Therapists who treat sex addiction, whether specifically trained to do so or not, are much more common now too.

The same goes for pornography addiction.

For some reason, this feels less stigmatizing to many. There are now large numbers of therapists who treat pornography addiction. There are also many new programs popping up to help men deal with their pornography addictions. These programs are often not run by a therapist or affiliated with a 12-step program, but instead created and run by independent agents or religious institutions.

The Impact of Media Discussion of Addiction

As the visibility of pornography addiction grows, the type of clients we have coming to the office have changed. In the beginning, over 8 years ago, the (predominantly) men who were coming in to address problems with pornography were men who had struggled for most of their lives with pornography use. 

They were:

• Watching more than they wanted to
• Couldn’t stop
• Were experiencing serious repercussions in
  • Their work
  • Their relationships
  • The legal system 

I would diagnose these men as pornography or, more broadly, sex addicts.

The Changing Face of Sex and Pornography Addicts: The Pornography Problem

Today, many of the men who are coming in with self-diagnosed addictions are men who look at some pornography. 

They don’t:

• Look at it a lot; once or twice a week, sometimes less
• Look at it for hours and hours on end
• Look at anything illegal
• Often look at any pornography that is more “hardcore” 

Their pornography use is usually causing a conflict in their relationship. These are not men that I would diagnose with a pornography addiction, but they call themselves pornography addicts.

So, are these men who come in pornography addicts? Or are they men who are experiencing an erotic conflict?

Are you a Licensed Professional Counselor in need of continuing education? Learn more about Sex Addiction, Erotic Conflict, and Moral Incongruence from Dr. Weeks and Sexual Addiction Treatment Services, an NBCC ACEP™ approved provider!

Sexual Addiction Treatment Services has been approved by NBCC as an Approved Continuing Education Provider, ACEP No. 7250. Programs that do not qualify for NBCC credit are clearly identified. Sexual Addiction Treatment Services is solely responsible for all aspects of the programs.

What is an Erotic Conflict?

And how do we know what type of pornography problem it is

An erotic conflict is experienced by a person who is engaging in, or fantasizing about, a sexual behavior that conflicts with his or her moral values or religious values. 

For example, a person who is attracted to sex with the same sex might experience an erotic conflict because their religious beliefs tell them that same sex attraction is wrong. Therefore, their behavior conflicts with their religious beliefs. 

A person who uses escorts might be experiencing an erotic conflict because breaking the law is against their personal moral values. 

A man who is watching pornography occasionally, a few times a month, might feel as though he has a sexual addiction or pornography addiction because his religious beliefs tell him that lust and pornography are bad. Therefore, he equates any use of pornography with addiction.

What does the DSM-V say about the Pornography Problem?

There is no DSM-V definition of sexual addiction or pornography addiction but we can extrapolate the criteria from drug and alcohol and gambling addictions. These are all use disorders in the DSM-V. This means that someone who is a pornography addict would experience at least two of the following issues: 

• Watching pornography more often than they intended and for longer periods of time than intended
• An inability to stop watching pornography
• Spending a lot of time creating opportunities to watch pornography
• Craving pornography use
• Failure to fulfill obligations at work, home or school due to using pornography
• Continuing to use pornography even after interpersonal problems resulting from use
• Social isolation due to pornography use
• The need for more pornography or more intense pornography to get the same feeling and difficulties when they try to stop using pornography or can’t access it

Here is my plea to clinicians and to society as well:

Can we please be more discerning in diagnosing sexual and pornography addiction?

What happens when we over diagnose pornography addiction?

1. We never get to the underlying issue. If someone is actually experiencing an erotic conflict, they may never get to the root of the issue. They may work a 12-step abstinence model and therefore condemn any experiences of lust as bad or problematic. This can place moral good or bad judgements on sexual behavior, in other words more psychological harm if the client continues to engage in the behavior. It can shame the normal biological process of attraction by labeling it as lust. It may prevent the client from learning about healthy sexuality and what truly arouses and attracts them. Ultimately, they may never work through the conflict between their body and their beliefs to a healthy resolution.
2. We cause more shame. Though being a pornography addict is less shameful than it used to be, being named an addict will create very shameful thoughts for most people. This shame must be worked through when the person actually has an addiction. When the person is mislabeled, it can cause more shame and isolation than necessary. This adds to the “I’m a bad person” thoughts the pornography consumer might have for looking at pornography.
3. We trivialize sexual addiction. The therapeutic community and, often, the media hotly debate whether sexual or pornography addictions are “real.” The con side often uses the argument that those who support the idea of sexual addiction are religious conservatives who are condemning normal sexual practices. When someone with an erotic conflict, often based on religious beliefs, is diagnosed with an addiction, this reinforces the argument that we are trying to morally dictate sexual practices and label them addictions

Do you believe you have an online pornography addiction? Then take this free Cyber Pornography Addiction Test (CYPAT) and have the results to speak with your therapist.

The Takeaways

My goal here and in my practice is not to condemn or judge. We all have our own set of values that we would like to live by. 

My plea is that we, both clinicians and consumers, really look at the behavior: Is the client presenting in your office who uses pornography an addict or someone with an erotic conflict? The treatment is different.

If they have an erotic conflict, the work is to process through the beliefs, sexuality and the conflict to come to a resolution that fits the client’s moral and personal compass. 

If the client is an addict, the treatment will likely follow a more traditional addiction model with 12-step attendance, abstinence from certain behaviors and recovery work.

I leave you with my plea again: CAN WE PLEASE BE MORE DISCERNING IN DIAGNOSING SEXUAL AND PORNOGRAPHY ADDICTION?

Do you feel your sexual behavior, or that of someone you love, is out of control? Consult with a professional.

Have you found yourself in legal trouble due to your sexual behavior? Seek assistance before the court mandates it, with Sexual Addiction Treatment Services.

Are you looking for more reputable data-backed information on sexual addiction? The Mitigation Aide Research Archive is an excellent source for executive summaries of research studies.

The post Pornography Problem: Erotic Conflict or Addiction? first appeared on Dr. Jen's Recovery Readings.

When I started working nearly exclusively in the sex addiction field, it was not very widely known and even less widely accepted. 

Update: Pornography and BDSM: What Americans are Really Doing

Those 7 years have brought a great deal of recognition to the addiction. The increased attention to sex addiction is, in part, a great thing. 

However, there is a down side as well. 

The moniker sex addict now seems to be tossed around rather lightly. It’s used as an excuse for sexual behavior when celebrities are caught engaging in behind someone’s back. In my opinion, this is a detrimental development. 

First, it minimizes the pain and suffering experienced by someone who truly has a sex addiction. 

Secondly, it has the potential to demonize aspects of sexuality because they are “outside the box.”

Why we don’t just say “It’s Sex Addiction”

As a clinician, supervisor, and trainer, I try to emphasize the importance of correctly diagnosing a client’s behavior. 

I do not throw the label sex addict around lightly.

I also understand there are things people do that are outside of the comfort zone of societal norms. This does not necessarily make a person a sex addict. I struggle with the idea that one can sometimes hear espoused that anything that is outside the norm of traditional heterosexual sex stereotypes is addiction. In this, and a series of writings to follow, I will take a look at behaviors that are often labeled addictive even when they may not be so. 

Just because it may make someone uncomfortable, does not make it addictive.

Are you a professional looking to stay up-to-date with the latest information on, sex addiction, trauma, and mental health news and research? Or maybe you’re looking for continuing education courses?

Stay up-to-date with all of Dr. Jen’s work through her practice’s newsletter!

Fetish and Kink Play versus Sex Addiction

The inspiration for this first article comes from my brother, Christopher Weeks, who is a professional photographer (http://black-cat-studios.tumblr.com/) in Tampa, Florida. 

He recently posted photography work he had done at an event called Fetish Divine (www.fetishdivine.com). Fetish Divine is an organization that hosts pan-sexual play parties at a club in Tampa. 

When my brother photographs these events (as an invited professional) he often gets complaints from others about the photographs being lewd or pornographic. 

The famous Supreme Court opinion by Justice Potter Stewart on obscene material has been quoted by the masses for years: 

“I know it when I see it.” 

However, isn’t that dependent on the viewer?

This discussion with my brother started me thinking about how we view S&M in the sex addiction treatment community. There are some that would always categorize this type of behavior as addictive. The DSM-V (the diagnostic bible for mental health practitioners) places sadomasochism in the paraphilia section of disorders. 

Sexual Masochism disorder is defined by a person:

• For at least 6 months, obtaining recurrent and intense sexual arousal from the act of being humiliated, beaten, bound or otherwise made to suffer, as manifested by fantasies, urges or behaviors. 

Sexual Sadism Disorder is defined by a person:

• For at least 6 months, obtaining recurrent and intense sexual arousal from the physical or psychological suffering of another person, as manifested by fantasies, urges or behaviors. 

The key to both of these diagnoses is the B section. 

For Sexual Masochism, the fantasies, urges or behaviors must cause significant distress or impairment in social, occupational, or other important areas of functioning. 

For Sexual Sadism, the individual has to have acted on these urges with a non-consenting person, or the sexual urges or fantasies must cause clinically significant distress or impairment in the same categories listed above. 

From a purely clinical point of view, engaging in BDSM only becomes an issue if it impairs a person’s functioning or if it is with a non-consensual partner.

Are you a Licensed Professional Counselor in need of continuing education? Learn more about Sex Addiction, Erotic Conflict, and Moral Incongruence from Dr. Weeks and Sexual Addiction Treatment Services, an NBCC ACEP™ approved provider!

Sexual Addiction Treatment Services has been approved by NBCC as an Approved Continuing Education Provider, ACEP No. 7250. Programs that do not qualify for NBCC credit are clearly identified. Sexual Addiction Treatment Services is solely responsible for all aspects of the programs.

Do you have a problem or just an interest?

From the perspective of Sexual Addiction (a diagnosis that does not exist in the DSM-V), we look at BDSM as behavioral categories or scales according to one instrument (the Sexual Dependency Inventory). This means that someone who is a sex addict may engage in behaviors involving pain exchange or humiliation and/or domination. In addiction treatment, as in the DSM criteria for SMD or SSD, we look at the effects of engaging in this behavior on the person: 

• Does it cause distress on any level?
• Has the person ever tried to stop engaging in the behavior?
• Do we see an escalation of the behavior in order to get the same feeling or high?

If the answer to these and similar questions is no, then we cannot unequivocally say that the person who is engaging in the BSDM is a sex addict.

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Check out the latest research on fetishes and criminality:

• Criminal Histories and Recidivism Rates for Juveniles Convicted of Child Pornography Possession

Read more articles about BDSM.

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Does everyone consent?

When discussing any fetish with a client, I don’t approach it as right or wrong, or addictive or not. We try to frame the fetish with the question “is it healthy or not.” Is the engagement in the fetish consensual for all parties? 

Consent is critical. Consent is different from coercion or compliance. 

Learn more about consent, compliance, and coercion from Dr. Weeks.

If a person is consenting, they fully wish to participate in the behavior. They are not doing so because they are pressured by a partner or feel they are obligated to do so for some reason. If I engage in the behavior because I fear my partner will leave me, then this is not true consent.

Psychological Distress

Another aspect we look at when discussing fetishes is psychological distress. 

• Does engaging in the behavior cause any type of psychological distress to the person?
• Is it creating strain on relationships?
• Is it interrupting normal life functioning?
• Does the person feel ashamed of the behavior they are engaging in or aroused by?

Again, if the answer to these questions is no, then it is not my place as a therapist to label the behavior as dysfunctional, addictive, or wrong.

Struggling with excessive sexual thoughts, urges, or activities that are causing you distress? Take the free, online Sexual Symptom Assessment Scale (SSAS) and get a link to share with your therapist.

Take Aways

As I move into my 8th^th year of working nearly exclusively with sexual addiction, I fear that our community, as well as the public, has a tendency to pathologize non-traditional sexuality. I also have a fear that well-meaning therapists will impose their own sexual beliefs and views onto others, particularly clients, and end up doing more harm to a person than good. 

As therapists who deal with sex on a daily basis, it behooves us to know our own boundaries with sex but also be open to other forms of sexuality that others enjoy. Can we work to re-frame sexuality, sexual addiction, and “deviance,” moving away from right and wrong, good and bad to “is it healthy for you?” 

If it is, then perhaps we don’t need to pathologize it. If it is not, then we can help our client to work through their issue.

Do you feel your sexual behavior, or that of someone you love, is out of control? Consult with a professional.

Are you looking for more reputable, data-backed information on sexual addiction? The Mitigation Aide Research Archive is an excellent source for executive summaries of research studies.

Have you found yourself in legal trouble due to your sexual behavior? Seek assistance before the court mandates it, with Sexual Addiction Treatment Services.

Are you a professional looking to stay up-to-date with the latest information on, sex addiction, trauma, and mental health news and research? Or maybe you’re looking for continuing education courses?

Stay up-to-date with all of Dr. Jen’s work through her practice’s newsletter!

The post It’s not all sex addiction: A clinical look at BDSM fetish first appeared on Dr. Jen's Recovery Readings.