We all have known a villain or two. Even the sex addiction treatment community has villains. Why are these people villains?

Because they question the validity of sex addiction.

Two, in particular, come to mind, though upon reflection they are not the same.

Villain Introduction

The first villain, Dr. David Ley, is a rather publicly outspoken opponent of the idea of sex addiction. He is a clinician, writer, and sometimes public debater of Dr. Rob Weiss.

The second villain is Dr. Prause. She is an academic and researcher from the University of California with a prolific CV. Her publications appear in peer reviewed scientific journals. Her argument against sex addiction as a concept is more theoretical and based on the scientific concept of validity.

Listening, Not Just Hearing

Imagine my surprise, after spending three hours in an Association for the Treatment and Prevention of Sexual Abuse (ATSA) training on Compulsive Sexual Behavior Disorder (CSBD), that the first plenary speaker of the ATSA conference was Dr. Prause making her case against sexual addiction.

To be completely honest, I have not read much of her scientific work.

My knowledge of her is second hand from a community that does not consider her a friend.

I had two choices:

1. Sit and listen to the talk from a position of defensiveness based on my belief in CSBD.
2. Sit and listen from a place of openness and process her information with an open and clear mind.

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.

Giving the Villain a Chance

I put on my open-minded researcher hat and listened to her talk entitled Psychophysiology and the Failure to Discriminate Sexual Compulsion as a New Disorder. Her talk focused on two key components of proving the construct validity of a theory.

Particularly, she focused on convergent and discriminant validity.

Research Methods

As a recap for those who did not endure lots of research methods in school:

• Convergent validity is a type of construct validity that tests whether things that should be related are related.
• Discriminant validity, on the other hand, tests whether constructs that should not have a relationship do not have a relationship.

In looking at these two types of construct validity, Dr. Prause is addressing whether our measures of assessing sexual addiction are related and whether sexual addiction is different than other things such as depression.

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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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Determination of a New Disorder

We often point to Voon et. al (2014) as a neuroscientific study that lends support to sexual addiction because the results of the self-determined sex addicts in the study had similar results to those of substance abusers.

Prause argues that when you look at the brain imaging studies of sexual desire you see the same reactivity, suggesting that Voon et. al very possibly just studied sexual desire as opposed to sexual addiction.

In terms of discriminant validity, Dr. Prause looks to the many studies that look at sexual addiction and its comorbidity with other mental health issues like major depressive disorder, obsessive compulsive disorder, alcohol use disorder, etc. The point she made is that if a diagnosis has so much overlap with other diagnoses, it is likely not its own separate diagnosis but symptoms of some other construct.

The Villain May Not Be a Villain After all

What I found most interesting: despite not believing that sexual addiction is its own separate diagnosis, she treats people who come in with problematic sexual behavior similarly to a clinician who does believes sexual addiction is valid. For example:

• Assess for other mental health conditions
• Engage in behavioral analysis of the sexual behavior they are concerned about
• Then treat them with shame reduction work and ACT

Final Thoughts

She agrees that people struggle with sexual behavior sometimes.

Dr. Prause thinks we should help them get a handle on the things they find to be a problem.

She does not believe in using a 12-step model or forced abstinence.

My personal take is that she believes that what some of us would call compulsive sexual behavior disorder is not its own thing but that the same behaviors are likely a symptom of some other mental health issue.

My other take away… I don’t think she is a villain at all. She is just someone who wants us to really think critically about our work.

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!

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

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

The post How to Un Villain: Listening with an Open Mind first appeared on Dr. Jen's Recovery Readings.

Based on science and clinical experience that there are individuals who acknowledge an attraction to children, also known as minor attraction. 

What do we Really Know About Minor Attraction?

The most recent science about minor attraction suggests that the age of the people we are attracted to is influenced by our brain structures and not a choice. Many people who have this attraction also have NOT engaged in any behavior with a child. Because they realize that acting on their attraction is never appropriate.

Where can those afflicted by these urges go for help? How do they ensure they never act on these urges or to process their feelings?

Preparing a sentencing report for a minor attracted person? Get the data you need, quickly, with Mitigation Aide.

• Characteristics of Male Internet Only Child Pornography Offenders
• Comparing Child Pornography Offenders to Child Contact Offenders: What’s the Difference?
• Updated Review of Online Child Pornography Offender Research

Where can they go?

Most of the time they do not seek help for fear of what may happen if they disclose this attraction. Because the fear of stigmatization is a real and justified fear. 

Many therapists are not trained to help process this form of sexuality. And, worse yet, many refuse to do so. 

There have been a few scientific studies of therapists. These studies have found that they hold the same stigma against pedophilia as the general public. So much for non-judgmental!

Where might someone go for treatment who wants to process their minor attraction? While there are therapists out there who are trained to help people process this attraction, these resources are few and far between.

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Learn more about Primary Prevention and its benefits in these articles:

• How to do Primary Prevention and More
• Help for Minor Attraction
• Research: CSAM on the Dark Web
• You Are Not a Monster: Review of a Long Dark Shadow
• Search: Primary Prevention on Dr. Jen’s Recovery Readings

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Enter: Troubled Desire

Doctors at The Institute of Sexology and Sexual Medicine at Charite-Universitatsmedzin Berlin created Troubled Desire specifically for this purpose. The website provides an anonymous online self-management program for individuals who experience an attraction to children. The University acknowledged that there was a great need for services for individuals who could not find a suitable therapist near them.  

The University is practicing Primary Prevention. By providing resources and support for individuals who are attracted to children who have not offended. This means helping people not offend against children in the first place. 

Unfortunately, the normal state of affairs is that we engage in secondary prevention. Therefore we help someone not offend AGAIN.

Know someone struggling with minor attraction? I suggest they check out the free, anonymous online course from Troubled Desire. 

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

Do you feel your sexual behavior, or that of someone you love, is out of control? Then you should 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 Help for Minor Attraction first appeared on Dr. Jen's Recovery Readings.

Protect Children is a non-governmental not-for-profit organization, based out of Finland that recently published the results of their survey related to the ReDirection Project which looked at CSAM on the Dark Web. 

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

Article originally appeared on the Mitigation Aide Research Archive on June 23, 2022.

About the ReDirection Project

The project aims to help consumers of Child Sexual Abuse Materials (CSAM) by providing them an anonymous and self-directed program designed for individuals who view CSAM. The ReDirection Project is the organization’s effort to provide primary prevention of child sexual abuse and exploitation.  

In 2020, they had two surveys on their website. The main survey, Help Us Help You, was for individuals who felt they needed some help with their CSAM production. The second survey was for those who felt they did not need help but were consuming CSAM materials. 

Preparing a sentencing report for a minor attracted person? Get the data you need, quickly, with Mitigation Aide.

• Characteristics of Male Internet Only Child Pornography Offenders
• Comparing Child Pornography Offenders to Child Contact Offenders: What’s the Difference?
• Updated Review of Online Child Pornography Offender Research

The Report about CSAM on the Dark Web

The recently published report is the result of over 8400 responses to the surveys. Survey respondents were all users of the dark web to consume CSAM materials.

The authors provide 6 main bullet point results from the survey:

1. A large number of individuals who consumed CSAM materials want to or have tried to stop using it in the past but have been unsuccessful in their attempts to stop.
2. 70% of the survey respondents stated that they had first been exposed to CSAM materials before they were 18 years old. Almost 40% were first exposed to CSAM prior to the age of 13. 
3. Almost half of the respondents (45%) view CSAM materials of girls aged 4 to 13 years old. 
4. More than half of the survey respondents have feared that their viewing of CSAM materials might lead them to a contact offense with a child. 
5. Nearly half of the survey respondents have watched actual child abuse on a livestream feed.
6. More research is needed.  As most research is conducted with individuals who are convicted of CSAM crimes, knowledge from those not arrested can be informative.  

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Learn more about Primary Prevention and its benefits in these articles:

• How to do Primary Prevention and More
• Help for Minor Attraction
• Research: CSAM on the Dark Web
• You Are Not a Monster: Review of a Long Dark Shadow
• Search: Primary Prevention on Dr. Jen’s Recovery Readings

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Specific Results of the Survey

• 70% of survey respondents first saw CSAM prior to the age of 18. Nearly 40% were under the age of 13.
• 51% first came across CSAM material by accident.
• 43% of survey respondents have been watching CSAM material for 1 to 4 weeks.
• 55% view illegal material occasionally.
• 45% view CSAM of girls between the ages of 4 and 13.
• 50% would like to stop viewing CSAM materials.
• 62% have tried to stop viewing CSAM materials at some point.
• For those who have stopped viewing CSAM, the main motivator was the negative feelings of guilt and shame.
• 45% have seen live streamed CSAM material.
• At some point in their CSAM use, 62% of respondents felt they were unable to control their use.
• 48% did not feel that their CSAM use made them afraid of a contact sexual offense.
• 56% reported that they never thought about direct sexual contact with a child after viewing CSAM.
• 63% of the CSAM users stated that they never sought direct contact with a child with the remainder seeking said contact anywhere from rarely to every time.
• About half the respondents had thought about or attempted suicide or self-harm.
• 58% never thought about telling anyone about their CSAM use.
• 54% of CSAM users stated they never had (29%) or never wanted (25%) contact with other CSAM users.

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.

Limitations of the Study

First: it is a survey of dark web users. 

It is possible that the survey results are not generalizable to other populations. 

Second: inherent in any voluntary survey, there is the possibility that there are characteristics of those willing to take a survey that are different from those individuals who chose not to, again possibly affecting the generalizability of the results. 

The Real Value of the Study

The authors are correct in that most of our knowledge of individuals who consume CSAM materials comes from people who have been arrested for its possession. Therefore, all data misses a huge segment of people, those who are viewing the material and not getting caught. Additionally, the more we know about the consumers of CSAM, the better able we are to create prevention programs to help decrease the use of CSAM at a primary prevention level.

Reference: Insoll, T, Ovaska, A & Vaaranen-Valkonen, N. (2022).  CSAM users in the Dark Web.  https://protectchildren.fi/2021/09/23/redirection-survey-report/

Article originally appeared on the Mitigation Aide Research Archive on June 23, 2022.

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

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.

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

The post Research: CSAM on the Dark Web first appeared on Dr. Jen's Recovery Readings.

I read Overcoming Unwanted Intrusive Thoughts for several reasons: 

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

The first is that we sometimes have individuals referred to us for potential sexual addiction who have intrusive sexual thoughts. Frequently these individuals are not dealing with a problematic sexual behavior, but intrusive sexual thoughts and we refer them out to a great area clinician who specializes in treating Obsessive Compulsive Disorder. 

Second, we do have a lot of clients who have some version of intrusive thoughts. So, I thought: the more I could learn about it, the better.

The subtitle of the book is A CBT based guide to getting over frightening, obsessive or disturbing thoughts. 

My initial assumption was that the book was going to more traditionally CBT focused, but I did not find it so. It reads more like a book that is advocating some level of mindfulness-based practice. 

This is perfect for me as we often use this in our practice. 

One helpful part of this book is how much it normalizes intrusive thoughts. Many people have thoughts that pop into their heads that are about violence, sexualized content or doing or engaging in what the author calls “disgusting” acts. 

Anytime we can work to reduce shame it is a great thing! 

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.

The Six Steps to Overcoming Unwanted Intrusive Thoughts

I want to focus this review on the authors six steps to reduce distress over a thought. They are very mindfulness based and are also extremely applicable to dealing with urges and cravings in any type of addiction. 

The steps are: 

Recognize

The first step is to just recognize that an intrusive thought is just a thought. To adapt this to addiction recovery, a craving is just a craving. We can recognize it for what it is. That means we pause and label it. Thought. Craving, etc.

Just Thoughts

The next step is to remind oneself that it is just a thought or craving. 

Accept and Allow

From there we Accept and Allow the thought or craving. The author says that this means we actively allow the thoughts to be there. We don’t act on it, but we also do not need to give the thoughts or cravings attention. For example, someone in recovery might say to themselves, this is just a craving.

Float and Feel

The Float and Feel step requires perhaps a bit more explanation. The author says to float above the fray and allow the feelings to just stay there. This is described as an attitude of “non-active, non-urgent, non-effortful observation.” This is also called the Wise Mind. Float and Feel is to passively allow the thought or craving to be and not engage with it. 

Let Time Pass

Perhaps one of the hardest steps is to just let time pass. This is to learn to sit with the feelings that come up and not try to immediately do something to get rid of them. Recognize that a thought or a craving is just a false message from our brain. 

Proceed

The last step is to Proceed or just keep going. Continue with whatever it was that you were doing. 

Of course, as with most difficult things we need to change, this process is much easier said than done.  These steps take time to learn and even more time to master.  A good first step is to just be able to recognize a thought or a craving and label it for what it is. I am having a craving.  I am just going to try to sit with it as long as I can without judging it.  Thoughts and cravings pass.

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!

Conclusion

Overcoming Unwanted Intrusive Thoughts is a nice primer to help individuals start to understand their intrusive thoughts. 

It also helps them come to understand if the thoughts are simply intrusive thoughts or indicative of something else, such as OCD, that might require professional help to master.

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.

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 Book Review: Overcoming Unwanted Intrusive Thoughts first appeared on Dr. Jen's Recovery Readings.

One of the unfortunate, but predictable, outcomes of the horrific Georgia shooting at the massage parlors is the rash of news articles talking about how Sex Addiction isn’t real. Most of what people are saying tends to focus on the lack of inclusion in the DSM-V. It never occurs to many how sex addiction can be confused with moral incongruence. What we need is a thorough discussion of the massive body of sex addiction research.

A full blown narrative of the research on sexual addiction conducted since the publication of the DSM-V in 2013 would be beyond the scope of this blog. I will, however, leave you with a few paragraphs regarding the topic that I recently included in a sentence mitigation report.

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.

Diagnostic and Statistical Manual of Mental Disorders– V: (DSM-V)

In the current edition of the DSM, there is no stated mental disorder that encompasses the concept of sexual addiction. Be that sexual addiction, sexual compulsivity, hypersexual disorder, etc. To simply negate a mental health phenomenon because it is not in a version of the DSM that is currently almost 8 years old is to negate both the history of the disorder with the DSM and the body of research that has been conducted since the DSM-V work group decided against including Hypersexual Disorder. 

Prior to the publication of the newest edition of the DSM-V in 2013, the Sexual and Gender Identity Disorders Workgroup (Kafka, 2014) considered the inclusion of Hypersexual Disorder into the upcoming edition of the DSM. The suggested diagnostic criteria were as follows:

The “Almost Officially” a Disorder

1. Over a period of at least six months, recurrent and intense sexual fantasies, sexual urges, and sexual behavior in association with four or more of the following criteria:
   1. Excessive time is consumed by sexual fantasies and urges and by planning for and engaging sexual behavior.
   2. Repetitively engaging in these sexual fantasies, urges and behaviors in response to dysphoric mood states (e.g., anxiety, depression, boredom, and irritability).
   3. Engaging repetitively in these sexual fantasies, urges and behavior in response to stressful life events.
   4. Repetitive and unsuccessful attempts to control or significantly reduce the sexual urges, fantasies, and behavior.
   5. Repetitively engaging in sexual behavior while disregarding the risk for physical or emotional harm to self or others.
2. There is clinically significant personal distress or impairment in social, occupational, or other important areas of functioning associated with the frequency and intensity of sexual fantasies, urges or behavior. 
3. These sexual fantasies, urges and behavior are not due to the direct physiological effects of exogenous substances (e.g., drugs of abuse or medication), a co-occurring general medical condition or to a manic episode.
4. The person is at least 18 years of age.

Specify if masturbation, pornography, sexual behavior with consenting adults, cybersex, telephone sex and strip clubs.

It was ultimately decided that Hypersexual Disorder would not be included into the DSM-V. The main reasons cited for the lack of inclusion were concerns around diagnostic accuracy, moral and cultural confounds and a lack of research supporting the concept (Kafka, 2014).

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

What’s changed in Sex Addiction Research since 2013?

In the nearly 8 years since the publication of the DSM-V, a vast body of scientific research in peer reviewed journals has been published seeking to understand the concept of sexual addiction and compulsivity which has also been termed hypersexuality.

A recent metanalysis was published by Grubbs et. al. (2020) that systematically reviewed the scientific research on the topic. Research on the topic, alternatively called sexual addiction, sexual compulsivity, hypersexuality, and compulsive sexual behavior began in the mid 1990’s. Research increased during the time that the DSM-V was in development. Knowledge on the topic continues to expand. The Grubbs et. al. (2020) metanalysis included 371 papers published in peer reviewed scientific journals documenting the results of 471 individual scientific studies. 

The Grubbs et. al. (2020) meta-analysis yielded several findings. On the negative side, the study found that there was a lack of rigorous outcomes studies for the treatment of Compulsive Sexual Behavior. Therefore, to date, there is no gold standard approach to treating the issue. The study did reveal that the Hypersexual Behavior Inventory (Reid et. al., 2011) is a well validated and clinically useful tool to assess Compulsive Sexual Behavior. The main finding pertinent to this case is that there is “clear evidence that CSB is a real phenomenon with clinical implications.”  (Grubbs et. al., 2020, p 11)

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!

International Classification of Diseases – 11 (ICD-11) and Sex Addiction Research

The ICD-11 is the international equivalent of the DSM-V in the United States. The International Statistical Classification of Diseases is published by the World Health Organization and its most recent version was published in 2019 (WHO, 2019). Like the DSM, prior to any condition being accepted into the ICD there is a process of extensive debate and consideration. The ICD-11 does include a diagnosis of Compulsive Sexual Behavior Disorder (CSBD) which is classified under impulse control disorders. The diagnostic criteria share some traits with the proposed DSM-V diagnostic criteria for Hypersexual Disorder.

The Diagnostic criteria for Compulsive Sexual Behavior Disorder (ICD-11)

            Essential (required) features for compulsive sexual behavior disorder:

1. A persistent pattern of failure to control intense, repetitive sexual impulses or urges resulting in repetitive sexual behavior, must be manifested by one or more of the following:
   1. Engaging in repetitive sexual activities has become a central focus of the person’s life to the point of neglecting health and personal care or other interests, activities, or responsibilities.
   2. Person has made numerous unsuccessful efforts to control or significantly reduce the repetitive sexual behavior.
   3. The person continues to engage in repetitive sexual behavior despite adverse consequences (repeated relationship disruption, occupational consequences, negative impact on health, etc.).
   4. Person continues to engage in repetitive sexual behavior even when the individual derives little or no satisfaction from it.
2. The pattern of failure to control intense sexual impulses or urges and resulting repetitive sexual behavior is manifested over an extended period of time (e.g., 6 months or more.)
3. The pattern of repetitive sexual behavior causes marked distress or significant impairment in personal, family, social, educational, occupational, or other important areas of functioning   NOTE:  Distress that is entirely related to moral judgments and disapproval about sexual impulses, urges or behaviors is not enough to meet this criterion.

The inclusion of the rule out relating to erotic conflict or moral incongruence is a necessary criterion to address historical concerns about pathologizing sex with a label of addiction or compulsivity. Simply engaging in a sexual behavior that is non-normative or outside of a person’s religious or moral belief is not sufficient to diagnose Compulsive Sexual Behavior Disorder according to the ICD-11.

Check out my more recent article about Compulsive Sexual Behavior Disorder for more information about CSBD and its classification.

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.

References

Bothe, B., Potenza, M.N., Griffiths, M.D., Kraus, S.W., Klein, V., Fuss, J., & Demetrovics, Z. (2020). Journal of Behavioral Addictions 9(2), 247-258.

Gola, M., Lewczuk, K., Potenza, M.N., Kingston, D.A., Grubbs, J.B., Stark, R. & Reid, R. (2020). What should be included in the criteria for compulsive sexual behavior disorder. Journal of Behavioral Addictions published online November 25, 2020.

Grubbs, J.A., Hoagland, K.C., Lee, B.N., Grant, J.T., Davison, P, Reid, R.C. & Kraus, S.W. (2020). Sexual Addiction 25 years on: A systematic and methodological review of empirical literature and an agenda for future research. Clinical Psychology Review (82), 1-15.

Kafka, M.P. (2014).  What happened to hypersexual disorder?  Archives of Sexual Behavior, 43(7), 1259-1261.

Reid, R.C., Garos, S. & Carpenter, B.N.  Reliability, validity, and psychometric development of the hypersexual behavior inventory in an outpatient sample of men.  Sexual Addiction and Compulsivity, 18(1), 30-51.

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 The Importance of Sex Addiction Research first appeared on Dr. Jen's Recovery Readings.

Last night, after my final session ended at 8 pm, I looked at the news quickly before I packed up to leave the office. The biggest piece was the horrific murder of eight people in a massage parlor shooting. Many of the victims were women of Asian descent. 

These stories were followed by news that the shooter said he did this because of his sex addiction.

In a moment of full transparency, I will acknowledge that my thought after seeing sex addiction being brought up as a motive for a mass shooting was, “oh no, we don’t need this.” 

The legitimacy of sex addiction continues to be hotly debated in some circles and when horrible things happen and sex addiction is spoken about in conjunction with these horrific acts, it can add fuel to the debate fire.

Condolences

I would like to start this post by saying that I am deeply saddened for the victims and their families. The tragedy is compounded by the fact that many women who work in these massage parlors are victims of sex trafficking. I am also very sorry that the man who committed these crimes felt such despair. This extreme violence shouldn’t ever be the only option.

Much of my work is in forensic psychology, that is the lens through which I am viewing this. When a person commits a crime, there are both aggravating and mitigating factors. As I have no knowledge of the specifics in this case, I am going to speak in generalities. 

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.

Mitigating Factors

Mitigating factors are things that may influence the person to commit the act. They are in no way, shape or form an excuse for the commission of the crime. They are the things that can explain the underlying factors that drove the person to the final criminal act. 

It is well established that addiction is frequently a mitigating factor in many crimes. We know that there is an association between drug addiction and crimes such as forgery, theft, etc. Other crimes may be influenced by a person’s untreated mental health issues.

In this case, it may well be that a mitigating factor was sexual addiction. 

This would mean that the perpetrator felt he had an addiction to sexual behaviors and that he could not control them.

Per newspaper reports, he sought treatment for these issues. At some point, his behavior continued to feel out of control and he likely had deep feelings of shame around his sexual behavior; news reports have claimed that his religious beliefs fueled this shame. 

Obviously, there may be other mitigating factors as well.

Aggravating Factors

On the other side of mitigating factors are aggravating factors. These are issues that make the crime particularly heinous. 

Again, not having reviewed the case, I can speculate that an aggravating factor here is the fact that many women who work in massage parlors are victims of sexual trafficking. Research from many nonprofit advocacy groups that work to stop sex trafficking has shown that many of these women  are often from China or South Korea. These women are often under extreme financial pressure, have limited resources and are recruited to work by fraudulent means and often do not know that they will be expected to perform work of a sexual nature. 

If the victims in this case were also victims of sexual trafficking, it makes them even more of a vulnerable population.

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.

The Realities

In this case, we can speculate that this man’s feelings of despair over his inability to control his sexual behavior overrode his sense of right and wrong. As I stated before, mitigating factors are explanations and not excuses. A person who has been to treatment has knowledge of coping skills and resources that could have been used instead of resorting to an act of violence. 

There were other options. 

There are two major takeaways from this horrible act of violence in Georgia. 

1.  Sex trafficking is a major problem in the United States.  If you are unaware of this, please do some research on the topic.  Please also support the many great nonprofit organizations that work to stop the trafficking and help the victims of sex trafficking. 
2. Problematic sexual behavior is treatable.  Violence is NEVER an acceptable answer. 

If you feel that you are suffering from a sexual addiction or are having difficulty controlling your sexual behaviors, please reach out to our office. We will be happy to direct you to treatment in your area.

Resources to learn about Sex Trafficking

Office of Juvenile Justice

Human Trafficking Hotline

Minnesota Coalition Against Sexual Assault

Valley Against Sex Trafficking

Resources for Treatment

Sexual Addiction Treatment Services

International Institute for Trauma and Addiction Professionals

Society for the Advancement of Sexual Health

The post Georgia Massage Parlor Shooting first appeared on Dr. Jen's Recovery Readings.

Rob Weiss’s latest contribution to the recovery community is his book, Prodependence: Moving Beyond Codependency. 

This book, and the philosophy of prodependence are an alternate take on the idea of codependency that has been rampant in the addiction recovery movement for decades. 

What is Codependency?

Codependence has been defined as “a psychological condition or a relationship in which a person is controlled or manipulated by another who is affected with a pathological condition, such as an addiction” (Merriam-Webster). 

In the recovery community the spouse, partner or family of someone suffering from an addiction is often labeled a codependent. 

This term came into the recovery lexicon in the 1980’s and became part of everyday language. 

A codependency diagnosis was rejected by the APA for the inclusion into the DSM but the “diagnosis” has persisted and there are 12 step meetings for Codependents (CODA). 

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.

How is Prodependence Different from Codependency?

Rob Weiss proposes the the concept of Prodependence. He, and other therapists, believe codependence is not helpful to family members. 

Family members, loved ones, or care givers of addicts, in the codependency model, are often told they’re part of the problem. However, they’re just trying to cope with a very difficult situation. 

Prodependence is a term to describe “attachment relationships that are healthfully interdependent, where one person’s strengths support the vulnerabilities of another and vice versa, with this mutual support occurring automatically and without question.” (p53.) 

Rob prefers this concept as it celebrates a loved one’s desire to help the addict in their life without shame or blame.

Distancing from the term ‘enabling’

Prodependence looks at the behaviors of those around the addict as attempts to maintain or restore healthy attachment.

Not as enabling. 

Treating prodependence is similar to treating co-dependence in terms of encouraging healthy boundaries and self care. 

However, it differs by being a strength based, attachment driven model that values loved ones of an addict.

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?

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Kindness and Empathy, Not Shaming

Another key idea behind prodependence, is that an addict has an attachment disorder and needs healthy attachment to truly heal. 

Encouraging prodependence, treating addicts and their loved ones with kindness, empathy and respect, can help repair attachment traumas. 

Intimacy Versus Codependency

Another difference between prodependence and codependence is looking at addiction as an intimacy disorder. In opposition to tough love, intimacy disorders are treated with the pursuit of healthy, intimate and ongoing connection.

While suggesting that codependence may be an outdated concept is risky, it doesn’t feel groundbreaking. Prodependence feels like the natural conclusion when you consider what we’ve learned about attachment, intimacy and shame.

As Johann Hari suggests in his TED Talk, “What if all we were taught about addiction is wrong?” 

Perhaps, instead, we should treat addicts and their loved ones without shame and blame. We might get farther modeling healthy attachment, boundaries, compassion, and empathy instead.

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 Prodependence: Moving Beyond Codependency – Book Review first appeared on Dr. Jen's Recovery Readings.

I was asked to teach the graduate human sexuality course last fall at the Moravian Theological Seminary. I was on the hunt for new books for the course and Sex, God & the Conservative Church:  Erasing Shame from Sexual Intimacy, by Tina Schermer Sellers, Ph.D. fit the bill. 

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Because this course was being taught at a seminary, I needed to at least touch on religion and sex. I found this book at the AASECT conference. 

Once I started to read the book I thought “WHERE HAS THIS BOOK BEEN ALL MY CLINICAL LIFE?”

Faith and Sex Addiction Treatment

As someone whose primary clinical practice involves issues related to sexuality (Sex addiction, sexual offending and other problematic sexual behavior), issues of faith are frequently brought into the treatment room.

It seems, that for many, faith and sex are intertwined. 

As someone who is not a Christian counselor, I didn’t always have the perspective or language to help some clients work through this as much as I could have. 

This book is an exceptional resource for clinicians, clients, or church groups!

Sex, God & the Conservative Church takes the reader first through a journey of the history of how sexuality and faith became derailed. 

Of particular interest to me, working with sexual addiction, was her discussion of Saint Augustine, who she labeled a sexually troubled soul. This is of interest to me as one of the main 12 step fellowship groups for sex addiction is Sex and Love Addicts Anonymous (SLAA). This fellowship is an Augustine Fellowship, named after the saint.

“While Augustine offered much that was foundational in the formation of Christian Theology, sexual desire and his own desire for women, which he was never able to completely escape, tortured him until the end.  His legacy of shame, fear of the body, and suspicion of its desire is with us today” p 33-34

The author suggests that a great deal of the root of sexual shame that Christians struggle with is rooted in his teachings.  I find it ironic, or perhaps a bit upsetting, that one of the main 12 step fellowships for recovery from sexual addiction is rooted in sexual shame.

Once past the history, the book delves into tangible ways to help people heal from their sexual shame and pursue sex positive messages from God and a sex positive Gospel.  Dr. Schermer Sellers frames the healing of sexual shame in a four-step process which will be very helpful for all people who are struggling with sexual shame, not just those that identify as Christian.

1. Frame – provide sexual education to a client that they did not receive
2. Name – help the client get their story heard by someone important to them.
3. Claim – the client works to accept and own their body as a wonderful unique thing to undo the harmful messages inherited from religion and culture
4. Aim – help the client write a new story of what they believe and what their legacy is to become.

Another aspect of this book that I really enjoy is the authors emphasis on normalizing childhood sexuality and the need for real, accurate and frequent sexual education being taught to children.  When families do not talk about sex and sexuality to children, they often assume it is something to be kept secret.  Worse yet is when a parent or care giver overtly shames a child for expressing normal sexual behavior or curiosity.  This can create a go to thought process of sex being dirty and bad.  If I (the child) have a sexual thought or feeling, I must be bad. Those of us who do this work know that so much of the struggle is rooted in shame and secrets.  If we normalize and teach children about healthy sexuality we can erase the shame that is often at the core of sexual problems.  To again quote the author:

“A culture that shames children for normal sexual expression plants seeds that manifest themselves in adult life in the form of disturbances in relationship, libido, and sexuality.  Sexual shame can sever the experience of sensual pleasure in a deep, loving attachment because it eclipses the person’s ability to feel seen, known, loved and accepted with and through their sensual body.  “ p. 106

I don’t think I can express strongly enough how wonderful this book is.  It should be a required reading for anyone who works with clients who struggle with sexual issues, be they sex therapists, sex educators or sex addiction therapists.  One of my strongly held beliefs is that we have to be sex positive in our work and not perpetuate sexual shame in our clients (see previous writing on being a sex positive sex addiction therapist).  Learning to integrate a sex positive Gospel for those of the Christian faith will go a long way to reduce sexual shame and reduce problematic sexual behavior.

For more information on Dr. Jennifer Weeks and her practice, head over to Sexual Addiction Treatment Services.  

The post Book Review: Sex, God, and the Conservative Church first appeared on Dr. Jen's Recovery Readings.

So far in our series of articles we have talked about finding a good attorney and a good therapist.  The next step in the process is to talk to your attorney about a psychosexual evaluation.  In most states and in Federal cases, the prosecution will have you undergo an evaluation with a therapist who works either for or on behalf of the state, county or Federal government. It is normally always a good idea to have one done by a psychologist who is not working for the organization that is prosecuting you.

First, what is a psychosexual evaluation?  The evaluation is comprised of an interview with a psychologist, a lot of psychological testing and a review of all forensic documents related to your case.  What tests you take often depends on the clinician who is doing the evaluation.  These objective measures will test for factors that may have both influenced your committing the crime you are accused of and may influence you to commit the crime again.  For example, you will likely do some type of personality test to see if you have any mental health diagnoses that influenced your crime such as depression, anxiety, bi-polar disorder, etc.  You will also likely be asked to take some test that will assess your likelihood of having a substance abuse problem, as this is sometimes correlated with certain types of crimes.

How do you find the right person to conduct the psychosexual evaluation?  If you have an attorney, he or she may have a psychologist that they work with closely and will refer you to that person.  If you are looking for this person on your own, there are a few things you should be on the lookout for.  First, you need someone who has a Ph.D. and has been trained to give the types of tests that you need.  Not all therapists have the training to be qualified to administer certain psychological tests.  Second, the psychologist who performs your evaluation needs to be experienced in performing psychological evaluations for sex crimes.  Not all forensic psychologists work with sex crimes.  Some, for example, perform evaluations for competency to stand trial.  Third, your evaluator should be a member of ATSA and familiar with the latest research related to offenders of your type of crime.

A question I often am asked is “what happens if the evaluation says something bad?”  My first response to this question is that there is nothing about an evaluation that is “bad.”  An evaluation is a combination of facts, testing results and opinion based on all those elements.  However, if you are concerned about the outcome of the evaluation, there is a solution.  If the evaluator is retained by your attorney and paid for by your attorney, the report then falls under attorney-client privilege as client work product.  This way, if your attorney does not feel that the evaluation will help you, he or she will not use it during your sentencing.

In most cases, the psychosexual evaluation is used for sentence mitigation.  Your attorney may use a favorable evaluation in the plea negotiation process beforehand.  Your psychosexual evaluation will be part of the pre-sentence memorandum that your attorney files with the court prior to your sentencing.  This report will give the judge information as to some of the reasons why you committed your crime as well as provide the judge with some information about your risk of recidivism (commit another crime).  The judge will take all this information into account when they are determining your sentence.

If your attorney does not suggest an evaluation, ask them about it.  Whether or not you need an evaluation or if it may be helpful will depend on your case and your jurisdiction.  We provide these suggestions as they are helpful in our geographic area of Pennsylvania.

Dr. Jennifer Weeks is the owner of Sexual Addiction Treatment Services.  She specializes in the treatment of sexual offenders and cybersex offenders.  Through her program she provides psychosexual evaluations, treatment and expert witness testimony.  SATS also offers coaching services for those people who are being investigated but are not in Pennsylvania.

The post You’re Being Investigated for a Cybersex Crime: The Psychosexual Evaluation first appeared on Dr. Jen's Recovery Readings.

In my first blog in this series, I wrote about the fact that getting a therapist is one of the first things you need to do when you are under investigation for a cybersex crime.  I briefly mentioned that you will need a specific type of therapist in that post and I am going to expand on what you need to look for in a therapist here.

Given how expensive this entire process is, one’s inclination is to just find a therapist who takes their insurance, can help with the anxiety and depression they are experiencing, though not necessarily specializing in treating people engaging in cybersex crimes.  I understand that thought process.  However, there are some things you need to know.

1. Many therapists will not work with sex offenders. You would think or hope that someone who works as a mental health counselor would be able to work with anyone without prejudice.  Unfortunately, that is not true.  Research studies have shown that a high percentage of therapists will not work with someone who is attracted to children or has engaged in sexual behavior with a child (even if it is online).  This means that if you go to see just any therapist, you do not know if you are meeting with someone who is personally comfortable working with you.  If they are not, ethically they are to refer you to someone else.  However, not all therapists will do this.   This means that you may get advice biased by their own opinions about sexual offenders and often this is not accurate or helpful.

2. Many therapists are not comfortable talking in depth about sex and sexuality. If you are going to really get to the root of the behavior that led to you engaging in a cybersex crime, you are going to be talking in depth about sexual behaviors.  This means that the therapist you choose to work with needs to be completely comfortable in their own sexuality and able to nonjudgmentally sit with the sexual behaviors of others.  Again, just as not all therapists can work with sex offenders, not all therapists are very comfortable talking about sex and sexuality.  That might sound odd, but it is true.

3. Most therapists are not trained in treating sexual behavior that crosses into offending. In the process of graduate training to become a therapist, unless a person knows they want to specialize in treating sexual behavior problems from the get go, they are likely to receive limited training in the topic.  Normally all counseling programs make students take one course on human sexuality.  That’s it. This means that a general therapist will not have the training or knowledge to help you with the specific issues that brought you to being investigated for a cybersex crime.

What do you need to look for in a therapist?

1. A therapist who has experience working with sexual behaviors. Most therapists will have listed somewhere on their website or Psychology Today profile what types of issues they work with.  If a therapist states that they work with sexual issues such as pornography addiction, sexual dysfunction, or other sexual health problems, they are going to be comfortable talking to you about details of sexual issues.

2. A therapist who has experience working with sexual offending behaviors such as child pornography, sexting minors, online solicitation, etc. This will require a phone call or an email to the therapist and direct questioning.  Have they worked with people in your exact situation before?  If they have not, you might want to continue searching for a therapist who as at least seen a few people who are in your situation.

3. A therapist who has specific training, certification or professional membership to organizations that work with sexual behavior problems. The best thing is to find a therapist who is a member of ATSA. This stands for the Association for Treatment of Sex Abusers.  This is an international organization that is entirely dedicated to research and treatment of people who engage in sexual offending behavior.  The website atsa.com has a referral page where you can find a therapist.  A second tier choice would be to find someone who is a Certified Sex Addiction Therapist through IITAP (www.iitap.com) or trained through SASH (www.sash.net).  If you find a clinician who is experienced in treating your issue and they are not certified or a member of ATSA please make sure they stay informed of the latest treatment research and trends.

Again, if you are reading this you are in a very particular situation and need a very particular therapist to help you.  You need a therapist who is comfortable discussing sexuality in all forms, is willing to work with people who are attracted to children, has experience in treating people with sexual offending behavior and is up to date on the latest research in the field.

Dr. Jennifer Weeks is the owner of Sexual Addiction Treatment Services.  She specializes in the treatment of sexual offenders and cybersex offenders.  Through her program she provides psychosexual evaluations, treatment and expert witness testimony.  SATS also offers coaching services for those people who are being investigated but are not in Pennsylvania.

The post You’re Being Investigated for a Cybersex Crime: What to look for in a therapist first appeared on Dr. Jen's Recovery Readings.