#JointheConversation
In recovery, disclosure is an important and difficult undertaking for the addict, the partner, and the relationship. For the partner, disclosure is often traumatic to varying degrees. As the addict, there are things you can do to make the disclosure process easier and there are things you can do that make the disclosure process more traumatic for your partner. One thing that often makes the disclosure process more traumatic for the partner is reassuring them about the content of the disclosure.
It can seem reasonable to reassure your partner prior to a formal therapeutic disclosure that they know everything about your past behaviors and that there are no new behaviors to disclose. Couples sometimes refer to these unknown behaviors as "bombs." Sometimes this reassurance is offered by the addict when they believe there are no “bombs” coming. Sometimes this reassurance is asked for when the partner experiences anxiety about what they might not know. On the surface, reassurance seems like a reasonable thing to offer or request. So, why is providing this reassurance to your partner problematic? It is problematic because you are reassuring your partner about something is that typically untrue and, additionally, it is manipulative.
In recovery, assumptions are always problematic. If you assume your partner knows everything and reassure them that there are no “bombs,” you are playing with fire. When (not if) your partner learns something new about some of your past behaviors in disclosure and if you have reassured them that they knew everything, it will be more traumatic to your partner. In my clinical experience, partners almost always learn about new behaviors or they learn new information about behaviors. This may include behaviors that the partner genuinely did not know about, behaviors the partner knew at one time but had forgotten, or nuances of behaviors the partner was unaware of.
People forget things. And having previously known about something does not eliminate the trauma of remembering. This is similar to you, as an addict, being in an environment that beings up memories of a past addictive situation or trigger and again feeling shame, guilt, or an addictive urge. The feeling may be less intense than it was originally but it has not gone away. 
If someone who knew about your addiction had reassured you that there was nothing to be worried about, you would likely feel some level of resentment regardless of whether the person was intentionally lying or honestly believed everything was safe. Likewise, if your partner previously knew about a behavior but has forgotten about it, it will still be traumatic for them to be reminded of the behavior. Also, if you have reassured them there would not be any “bombs” in the disclosure, they will likely feel resentment toward you whether or not you were completely honest in your reassurance. A similar pattern plays out if your partner had not previously framed a behavior as part of your addiction. Again, it does not seem to matter that your partner had previously known about the behavior. Cognitive knowledge does not protect your partner from a traumatic experience. Having this known behavior shared as an aspect of your addiction can still be traumatic. If you have reassured your partner there would be no “bombs” in your disclosure, the trauma will be worse.
Sometimes the addict forgets. While working with your therapist to prepare disclosure, you might remember a behavior that was linked to your addiction that you had honestly forgotten about. Or, you might realize a past or present behavior you had never considered part of your addiction is actually important to disclosure and, for whatever reason, your partner is unaware of this behavior. This constitutes new information for your partner.
More often than addicts care to admit, they have lied about or not shared some sexual behavior with their partner, their recovery community, and their therapist. While significant omissions are not an every time occurrence, I am no longer surprised when this comes up in disclosure preparation. If the addict holds onto secrets and does not include them in disclosure, they undermine the point of disclosure, minimize the potential healing disclosure offers to them and their partner, or, worst of all, further damages their partner and their relationship. Disclosing hidden behaviors is essential. This is one of the reasons we recommend a polygraph in conjunction with a formal therapeutic disclosure. If you have reassured your partner they know everything only to disclose something you have been holding as a secret, you have just further traumatized your partner.
Part of the reason we recommend disclosure is that by providing your partner with a full account of your past behavior, you are providing them with all the information available to choose what to do with the relationship. Repairing the attachment bond in your relationship can only happen with rigorous honesty. Withholding information or refusing to provide a disclosure leaves doubt, which interferes with rebuilding trust and healing the relationship attachment. Reassuring your partner that there are no “bombs” creates the potential for further damage to your relationship’s attachment and your partner’s trust.
When you reassure your partner that there will be no “bombs” in your disclosure, you are performing a manipulative act. This is true no matter how altruistic you claim your reassurance is. You are an addict. Your behavior has had an impact on your partner. And, your partner has a right to their emotions about this, which may very well include anger, pain (sadness), and fear. These emotions may be uncomfortable for your partner but are almost assuredly uncomfortable for you. When you reassure your partner there will be no “bombs,” you are taking away their right to have their own emotional reaction about your addiction, the information in the disclosure, or the disclosure process itself. Your partner may experience positive growth from having and exploring these emotional experiences. Your reassurance robs your partner of this potential growth. In reality, when you reassure your partner there will be no “bombs,” you are actually manipulating your partner so their emotional experience is more comfortable for you.
If your partner is angry, afraid, hurting, or overwhelmed, please do not reassure them there will be no “bombs” in your disclosure. Instead, tell them you are committed to making sure they get all the information about your addiction and your behavior in order to support them in their own healing process. Tell them you are committed to seeing this full therapeutic disclosure process through to the end. Then dig in with your therapist and work to provide your partner with a full therapeutic disclosure as soon as possible so your partner can continue their own healing process with a clear understanding of the reality of your addiction. You cannot eliminate your partner’s trauma. That was created by your past behavior, which you cannot change. But, by committing to provide a full therapeutic disclosure as soon as possible instead of reassuring your partner about the contents of the disclosure, you can minimize their disclosure trauma.
Tim Stein is a well-known expert in the field of sex addiction. His work as a clinician, lecturer, consultant, supervisor and author keeps him on the cutting edge of sex addiction treatment. Tim is a regular presenter at national and international conferences and is dedicated to offering information, providing clinical and recovery guidance, and advocating for the understanding and treatment of sex addicts and their partners. Tim’s professional life is guided by his passion to heal the lives and relationships of individuals and families impacted by sex addiction. Through his writing, lecturing, and clinical work, Tim strives to help those impacted by sex addiction to find self-love, emotional resilience, integrity and joy in recovery whether this is through personal insight or information and tools Tim provides to other professionals. Tim is a co-founder of Willow Tree Counseling in Santa Rosa, CA and was integral in the development and evolution of their treatment programs for sex addicts and partners of sex addicts.
Blog Disclaimer
The Society for the Advancement of Sexual Health (SASH) sponsors this blog for the purpose of furthering dialog in the field of problematic sexual behaviors and their treatment. Blog authors are encouraged to share their thoughts and share their knowledge. However, SASH does not necessarily endorse the content or conclusions of bloggers.
Information in blogs may not always be complete, up-to-date, accurate, relevant, or applicable to all situations. Legislation, case law, standards, regulations, descriptions of products and services, and other information are often complex and can change rapidly. Always double-check and confirm that any information you find on the internet is accurate, current, and complete in regard to your specific situation, question, concern, or interests.
This website and its agents make no promises, guarantees, representations, or warranties, expressed or implied, and assume no duty or liability with regard to the information contained herein or associated in any way therewith. No legal or other professional services are being rendered and nothing is intended to provide such services or advice of any kind. The inclusion of external hyperlinks does not constitute endorsement, recommendation, or approval of those sites or their contents. This website bears no responsibility for the accuracy, legality or content of the external sites or for that of subsequent links. Those who visit or use this website, links or any other information assume all risks associated therewith.
The client is a 15-year-old girl referred by her guidance counselor. “Amber” has been disciplined by her high school for sending naked selfies to her boyfriend, which came to the attention of a teacher as the sexts were liberally shared around the sprawling suburban campus. Her horrified parents initially labeled the behavior a momentary judgment lapse fueled by “bad influences,” until a search of her phone revealed a couple of well-hidden hook-up aps. Her laptop browser history added to their concern.
The parents are college educated professionals, who responded to their daughter’s difficulty by grounding her for two weeks and taking away her phone and tablet indefinitely. They banned her boyfriend from the house and insisted she talk with her female church youth leader. Mom and dad were relieved when they got through the two-week home arrest with Amber “just being angry at first, then sullen and often disrespectful, but it could have been a lot worse.” They added, “We were sure she’d learned her lesson and everything would be fine. We just wanted to put this whole sorry mess behind us.”
And it seemingly was, until a few weeks later when they discovered Amber had gotten another phone and was exchanging explicit texts with a guy who claimed to share her interest in soccer and just wanted to get to know her better. The parents asked their pediatrician what they should do, and he said he had no idea other than finding a therapist. The school social worker also was unable to provide an appropriate referral, but she was aware of a local program for adult males who used pornography compulsively, and she gave the parents our number
“Please help us!”the mom wailed. “Our beautiful, talented daughter has gone off the deep end. We taught her better than this, but she won’t listen when we tell her how terrible she is. We need to send her to your facility and have you straighten her out. We’re so embarrassed and want this fixed before it further damages our family reputation.”
Yes, indeed. “Straightening out” is exactly what needs to be done with teen females struggling with problematic sexual behavior, right? And labeling an acting teen as “terrible” is sure to motivate her positively. Not.
The reality is that untold numbers of teens, both males and females, are engaged in potentially problematic sexual behavior. According to Statistics Brain (https://www.statisticbrain.com/sexting-statistics/), the numbers are staggering. In an online survey with 1280 respondents ages 13-19:
Perhaps it’s reassuring that 71% of teen girls and 67% of teen boys say they’ve sent or posted sexually suggestive content to a boyfriend or girlfriend. Less comforting, 21% of teen girls and 39% of boys say they’ve shared such content with someone they wanted to date or hook up with. Most frightening, 15% of teens in this age group (not broken down by gender) report they’ve sent nude or semi-nude pictures to someone they only met online- in other words, to a stranger.
Our sexually-saturated culture has far outrun most families’ - and counselors’ - ability to protect or even adequately inform and guide their children. The information presented by Dr. Gail Dines and Culture Reframed provides overwhelming evidence that pornography, not parents, are providing sex education for today’s kids. (https://parents.culturereframed.org/).
The culture is swamped with gender and sexual messages, images and values - most of them unrealistic and unhealthy.“Pornland,” as Dr. Dines calls it, increases early sexual awakening before the child is developmentally able to process what’s happening. It further encourages objectification of self and others, often in a violent form.
Recent research shows that early exposure to pornography is more predictive of later problematic sexual behavior than overt sexual abuse. If that finding proves true over time, the impact will only mushroom exponentially. Sadly, the pornified culture is unlikely to reverse itself any time soon, if ever.
Typically, teens won’t recognize their sexual behavior is a problem. They think they’re engaging with their friends and romantic partners like “everyone else.” Unfortunately, they may be right, since sexting and promiscuity are more the norm than the exception, including for teens raised in “good” homes
Teens usually don’t have the maturity to realize the impact of their sexual and relational behavior, which might affect the rest of their lives. Problematic sexual behavior can interfere with education, health, self-esteem, and social and spiritual development. It can also be extremely dangerous when girls (and sometimes guys) put themselves in risky situations.
Attachment theory illuminates the importance of healthy bonding between parents and children, yet more and more, today’s teens seem adrift in a technology wasteland. Many parents are similarly engulfed in their devices or work, or are themselves struggling sexually or relationally. Most parents label the acting out teen as the problem, and they miss the attachment wounds that may be driving his or her search for connection, however exploitive or fleeting. As Amber’s mom expressed it, parents want the teen “fixed,” and they may be unwilling to be involved in that solution beyond carting the teen in for therapy.
The field of treating problematic sexual behavior has evolved positively to include effective models for helping partners as well as addicts. Resources for teens, though, are woefully lacking. As far as I’m aware, only two in-patient treatment programs that accept adolescent males are equipped with clinicians who have specific certification or training for treating problematic sexual behavior. None of the programs I’ve found for adolescent girls have a specialized PSB program with therapists who are specifically trained in the field. A few outpatient support or therapy groups exist for teen males with PSB, but a group for teen females is rare. The need is huge for clinically informed, excellent resources, especially ones based on attachment theory and a family systems perspective.
Real change for a hurting teen happens within a systems framework, which means the whole family engages in the healing process. Parents need and deserve personal help to address their own emotional struggles and learn how to help their teen through altering their parental attitudes and behaviors. It’s vital that the whole family be involved in a coordinated process of understanding, growth, and change. The therapeutic environment should be non-judgmental, non-adversarial, and engaging for all involved.
Today, adolescents are probably the largest under-served population of those struggling with problematic sexual behavior. If you’re like me, the prospect of treating a teen is a bit terrifying. Yet we need more specialists in this area who can offer prevention and intervention, so that teens are spared some of the pain experienced by addicts and partners in adulthood.
by Marnie C. Ferree, M.A., LMFT, CSAT
Marnie C. Ferree, M.A., is a licensed marriage and family therapist in Nashville, Tennessee, where she directs Bethesda Workshops, which provides Christian-based treatment for sexual addiction in an intensive setting. The workshop she established for female sex addicts in 1997 was the first of its kind in the country. Her book, No Stones: Women Redeemed from Sexual Addiction, is one of the earliest books to address sexual addiction in women. She is also the volume editor and a contributing writer for Making Advances – A Comprehensive Guide to Treating Female Sex and Love Addicts.
Bethesda Workshops has launched a new Healing for Teens & Their Parents Workshop, which offers gender-specific clinical intensive workshops (four-days) for adolescent females and males. The first workshop, June 13-16, 2018 is for teen females. Later dates, August 8-11 and September 26-29, will provide services for teen males. Parents accompany their teen and are required to attend the workshop. Visit http://www.bethesdaworkshops.org/workshops/healing-for-teen-females-and-parents/for complete information or call Bethesda Workshops at 615-467-5610.
Blog Disclaimer
The Society for the Advancement of Sexual Health (SASH) sponsors this blog for the purpose of furthering dialog in the field of problematic sexual behaviors and their treatment. Blog authors are encouraged to share their thoughts and share their knowledge. However, SASH does not necessarily endorse the content or conclusions of bloggers.
Information in blogs may not always be complete, up-to-date, accurate, relevant, or applicable to all situations. Legislation, case law, standards, regulations, descriptions of products and services, and other information are often complex and can change rapidly. Always double-check and confirm that any information you find on the internet is accurate, current, and complete in regard to your specific situation, question, concern, or interests.
This website and its agents make no promises, guarantees, representations, or warranties, expressed or implied, and assume no duty or liability with regard to the information contained herein or associated in any way therewith. No legal or other professional services are being rendered and nothing is intended to provide such services or advice of any kind. The inclusion of external hyperlinks does not constitute endorsement, recommendation, or approval of those sites or their contents. This website bears no responsibility for the accuracy, legality or content of the external sites or for that of subsequent links. Those who visit or use this website, links or any other information assume all risks associated therewith.
In 2013 the editors of the Diagnostic and Statistical Manual (DSM-5), manual of mental health diagnoses, declined to add a disorder called “Hypersexual Disorder.” This has caused major problems, according to experts:
This exclusion has hindered prevention, research, and treatment efforts, and left clinicians without a formal diagnosis for compulsive sexual behaviour disorder.
The World Health Organization (WHO) publishes its own diagnostic manual, known as the International Classification of Diseases (ICD), which includes diagnostic codes for all known diseases, including mental health disorders. It is used worldwide, and it is published under an open copyright.
The APA promotes the use of the DSM instead of the ICD. Elsewhere in the world, however, most practitioners rely on the free ICD. The code numbers in both manuals conform to the ICD.
The next edition of the ICD, the ICD-11, is due out sometime in 2018. Unlike the DSM-5 editors, the editors of the ICD-11 propose to include a new diagnosis that would encompass those with disorders relating to sexual behavior addictions. Here’s the current proposed language:
6C92 Compulsive sexual behaviour disorder is characterized by a persistent pattern of failure to control intense, repetitive sexual impulses or urges resulting in repetitive sexual behaviour. Symptoms may include repetitive sexual activities becoming a central focus of the person’s life to the point of neglecting health and personal care or other interests, activities and responsibilities; numerous unsuccessful efforts to significantly reduce repetitive sexual behaviour; and continued repetitive sexual behaviour despite adverse consequences or deriving little or no satisfaction from it. The pattern of failure to control intense, sexual impulses or urges and resulting repetitive sexual behaviour is manifested over an extended period of time (e.g., 6 months or more), and causes marked distress or significant impairment in personal, family, social, educational, occupational, or other important areas of functioning. Distress that is entirely related to moral judgments and disapproval about sexual impulses, urges, or behaviours is not sufficient to meet this requirement.
This new “Compulsive sexual behaviour disorder” (CSBD) diagnosis is critically important. In addition to offering caregivers a suitable diagnosis for those who require treatment, the existence of a formal diagnosis in the world’s premier medical manual will facilitate future research. Without a formal diagnosis, some sexology journals and professional magazines have not published related research and commentary. This has hindered mainstream recognition of the risks of this disorder.
So, has the ICD-11 “rejected” sexual behavior addictions? Not for now. In fact, experts who serve on the ICD-11 (including Geoffrey Reed who is in charge of all of the mental disorder diagnoses for the ICD-11) clarified the ICD-11 position in a new piece in World Psychiatry (the world’s top-ranked psychiatry journal).
The authors make it clear that the ICD-11 has not ruled out that compulsive sexual behaviors may indeed be addictions (by whatever name). Instead, the ICD-11 has adopted a conservative, wait-and-see approach while further research is published.
...Currently, there is an active scientific discussion about whether compulsive sexual behaviour disorder can constitute the manifestation of a behavioural addiction. For ICD-11, a relatively conservative position has been recommended, recognizing that we do not yet have definitive information on whether the processes involved in the development and maintenance of the disorder are equivalent to those observed in substance use disorders, gambling and gaming. For this reason, compulsive sexual behaviour disorder is not included in the ICD-11 grouping of disorders due to substance use and addictive behaviours, but rather in that of impulse control disorders. The understanding of compulsive sexual behaviour disorder will evolve as research elucidates the phenomenology and neurobiological underpinnings of the condition.
This is the same strategy once used with respect to “gambling disorder.” When gambling was first given a medical diagnosis it too was characterized as an “impulse control disorder” while it was further investigated. Many hundreds of studies later, gambling disorder has now been characterized in the ICD-11 as a ‘disorder due to addictive behavior’.
Who knows what will become of CSBD in the future? The important point is that when the new ICD-11 is published those with problematic sexual behavior (by whatever name) will be diagnosable using the new CSBD. How insurance companies will respond is another matter, of course.
Marnia Robinson is a former corporate attorney who writes about the effects of evolutionary biology on intimate relationships and blogs on Huffington Post.
Blog Disclaimer
The Society for the Advancement of Sexual Health (SASH) sponsors this blog for the purpose of furthering dialog in the field of problematic sexual behaviors and their treatment. Blog authors are encouraged to share their thoughts and share their knowledge. However, SASH does not necessarily endorse the content or conclusions of bloggers.
Information in blogs may not always be complete, up-to-date, accurate, relevant, or applicable to all situations. Legislation, case law, standards, regulations, descriptions of products and services, and other information are often complex and can change rapidly. Always double-check and confirm that any information you find on the internet is accurate, current, and complete in regard to your specific situation, question, concern, or interests.
This website and its agents make no promises, guarantees, representations, or warranties, expressed or implied, and assume no duty or liability with regard to the information contained herein or associated in any way therewith. No legal or other professional services are being rendered and nothing is intended to provide such services or advice of any kind. The inclusion of external hyperlinks does not constitute endorsement, recommendation, or approval of those sites or their contents. This website bears no responsibility for the accuracy, legality or content of the external sites or for that of subsequent links. Those who visit or use this website, links or any other information assume all risks associated therewith.
The majority of individuals who experience out of control sexual behavior are men. Why? This question is complex as is the answer. The ecological model of clinical social work (Pardeck, 1988) provides a frame in which we can understand the contributing factors that have resulted in men’s vulnerability to out-of-control sexual behavior (OCSB). This model provides a frame that includes social, cultural, familial and intrapsychic factors that result in a phenomenon and it is particularly useful in understanding men and OCSB.
Over 30 years ago, Haviland and Maletesta (1981) looked at the differences between male and female infants and their emotional expressiveness. In their review of 12 infant studies, they found that male infants often displayed more emotional reactivity, tended to cry and be startled more often, and that their emotions changed more rapidly than did those of female infants. Olesker (1990) found that male infants show a slower achievement of emotional stability than did females, are more invested in the outside, material world, and show less inner processing. According to Levant (1997), males are more emotional in infancy; however, there is a reversal by the age of 2, which he believes occurs due to a socialization process that is supported both by parents and by society at large.
Olesker (1990) stated that boys had less awareness of maternal separation and often did not display as much clinging behavior as did girls. She noted that boys often turn to the object world to cope with their anxiety, whereas girls turn to their caretakers to help assuage their distress. According to Pollack (1998), this process continues into adulthood and leaves men more apt to cope alone rather than turn to others. He referred to this as defensive autonomy, which he believed was a result of the early emphatic separation from their maternal caretaker that left men with a continued yearning for closeness that simultaneously threatened their autonomy. This notion is in keeping with Pleck’s (1981) theory of a gender-role strain that posits that, when men conform to the male role, for which the embracing of feelings is scorned, it results in a disconnection from their feelings and needs.
Fonagy, Gergely, and Target (2008) noted that the infant’s ability to reflect on feelings and cognitions is directly related to the caretaker’s ability to understand his or her own history with his or her own parents. Further, the ability to mentalize and reflect is directly linked to secure attachment and competence in affect regulation. Insecure attachment often leads to defensive functioning and affect dysregulation. These theories all have relevance to an understanding of the etiology of OCSB. Studies have shown that those with OCSB often present with insecure attachment (Crocker, 2013, Gilliland, 2015, Zaph, 2008).
Goodman (1998) hypothesized that alexithymia is related to OCSB. The term alexithymia was developed by Sifneos (1967), who observed individuals with psychosomatic complaints and felt that the complaints were related to their difficulties in recognizing, naming, and verbalizing their feeling states. Sifneos believed that alexithymic individuals with psychosomatic complaints typically experienced their feelings as bodily states rather than as identifiable emotional states and that these individuals lost the benefit of having identifiable emotions that could be used to direct their thinking and actions. Sifneos observed that this alexithymic condition often was accompanied by impairments in self-care, object relations, empathy, and affect regulation. Goodman felt that individuals with OCSB also presented with alexithymia. He believed that these individuals often did not know what they were feeling and often experienced their feeling states in their bodies and, as such, were prone to use bodily action to address them.
Levant (1990, 1997a, 1997b) theorized that there is a normative male alexithymia due to familial and social processes. He theorized that this male-patterned alexithymia results in an impaired ability to put feelings into words and, instead, an inclination to act out feelings. He noted that one acting-out strategy is nonrelational sex. Similar to Goodman (1998), Levant believes that men may use sex to address myriad feeling states, including sadness, fear, and anger. In support of this ideology, Katehakis (2016) has theorized that OCSB is an affect regulation disorder directly related to early attachment trauma.
More recent research indicates that biological factors, specifically testosterone, may cause male vulnerability to OCSB (Alexander & Saenz, 2010), yet not due to the assumed idea of a high sex drive, but actually increases in affect dysregulation. Alexander and Saenz found that male infants with high testosterone levels showed lower levels of frustration tolerance as well as externalizing behaviors, which is often seen in OCSB (Goodman, 1998).
Testosterone appears to impact the amygdala, the region of the brain often associated with emotional reactivity. Both Ledoux (1998) and Goleman (1995) refer to the amygdala activation as “emotional hijacking,” stating that this activation can hijack an individual’s ability to be reasonable and logical. Hamann, Herman, Nolan, and Wallen (2004) found that, when presented with visual sexual stimuli, men experienced more activity in the amygdala than did women.
All these issues help to explain the speculated higher prevalence of OCSB in men and why men may corner the market on OCSB. With this in mind we must think creatively about how to treat men that are struggling with these behaviors. It is essential to take into account that many men may struggle with the typical therapeutic question of “how does that make you feel?”. Not only may they not be able to answer the question but they could also feel shame about the fact that they have no idea how they feel. As clinicians we need to take this into account and find ways to help our male clients find their feelings. As noted men often experience their feelings in their bodies without the necessary process of mentalization and for this reason run the risk of turning to bodily means to address the feeling state. If we can help these men locate the feeling states in their body and begin to help them describe their experience then we can help them move towards reflective function. This approach needs to address both somatic and emotional literacy (Linden, 1994, Goleman, 1995). With men we often have to start with their bodies. If we help men find words to describe what they are experiencing in their bodies we can move them towards increased emotional intelligence. As emotional intelligence is improved, our clients start to be able to describe their feeling states in nuanced ways, which includes blends of emotional experience.
As attachment theorists have noted, increase in reflective function provides an additional interpersonal benefit. In increasing reflective function and mentalization in our male clients we improve their ability to understand another person’s subjectivity. In the couples we treat it is often a challenge to help our male clients to have empathy and compassion for their partners. This is directly related to emotional literacy. The more our clients understand their own emotionality the more they will understand the emotional experience of others. Helping men understand their feelings also helps them to know and understand the feelings of others. They are able to identify in themselves and in others hurt, sadness, anger, fear, joy and all the derivatives that come along with these emotional states. In helping men to know their feeling, we help them to be relational and most importantly we help them to connect both to themselves and others. Lastly, we help these men to understand that in knowing what they feel they will then begin to know what they need. Through this process we help men to honor their feelings and to care for themselves and others. In short, we help them to love.
Michael M. Crocker, DSW, LCSW, MA is the founder and Director of the Sexuality, Attachment & Trauma Project in New York City. He is an expert on sexual addiction, trauma, and attachment disorder. As an advocate for children Dr. Crocker serves as a State Education Department Approved Trainer on Child Abuse Identification and Reporting. For more information about Dr. Crocker visit www.sexualityproject.org or email him at mmcrockercsw{at}gmail.com
References
Alexander, G., & Saenz, J. (2011). Postnatal testosterone levels and temperament in early infancy. Archives of Sexual Behavior, 40, 1287–1292.
Crocker, M. (2015) Out-of-control sexual behavior as a symptom of insecure attachment in men. Journal of social work practice and the addictions. Vol 15, issue 4, pp. 373-393.
Fonagy, P., Gergely, G., & Target, M. (2008). Psychoanalytic constructs and attachment theory and research. In J. Cassidy & P. R. Shaver (Eds.), Handbook of attachment: Theory, research and clinical application (pp. 783–810). New York, NY: Guilford Press.
Gilliand, R., Blue Star, J., Hansen, B., Carpenter, B. (2015) Relationship attachment styles in a sample of hypersexual men. Journal of Sex & Marital Therapy, Volume 41, 2015 - Issue 6 pp. 581-592
Goleman, D. (1995). Emotional intelligence: Why it can matter more than IQ. New York, NY: Bantam Books.
Goodman, A. (1998). Sexual addiction: An integrated approach. Madison, CT: International Universities Press.
Hamann, S., Herman, R., Nolan, C., & Wallen, K. (2004). Men and women differ in amygdala response to visual sexual stimuli. Nature Neuroscience, 7(4), 411-416.
Haviland J. J., & Malatesta, C. Z. (1981). The development of sex differences in nonverbal signals: Fallacies, facts and fantasies. In C. Mayo & N. H. Henley (Eds.), Gender and nonverbal behavior (pp. 183–208). New York, NY: Springer-Verlag.
Katehakis, A. (2016) Sex addiction as affect dysregulation: A neurobiologically informed holistic treatment. New York, N.Y.: W.W. Norton & Company,Inc.
Katehakis, A. (2009). Affective neuroscience and the treatment of sexual addiction. Sexual Addiction & Compulsivity, 16(1), 1–31. doi:10.1080/10720160802708966
Ledoux, J. (1998). The emotional brain: The mysterious underpinning of emotional life. New York, NY: Simon and Schuster.
Levant, R. (1990). Psychological services designed for men: A psychoeducational approach. Psychotherapy, 27, 309–315.
Linden, P. (1994) Somatic literacy: Bringing somatic education into physical education. Journal of physical education, recreation and dance, Volume 65, Issue 7, pp 15-21.
Levant, R. (1997a). The masculinity crisis. Journal of Men’s Studies, 5(3), 221–231.
Levant, R. (1997b). Men and emotions: A psychoeducational approach. The Assessment and Treatment of Psychological Disorders Video Series (Video and Viewers Guide). New York, NY: Newbridge Communications.
Olesker, W. (1990). Sex differences in the early separation-individuation process: Implications for gender identity formation. Journal of American Psychoanalytic Association, 38, 425–346.
Pardeck (1988) "An Ecological Approach for Social Work Practice," The Journal of Sociology & Social Welfare: Vol. 15: Issue 2, Article 11
Pleck, J. H. (1981). The myth of masculinity. Cambridge, MA: MIT Press.
Pollack, W. (1998). Real boys: Rescuing our sons from the myths of boyhood. New York, NY: Henry Holt.
Sifneos, P. E. (1967). Clinical observations on some patients suffering from a variety of psychosomatic diseases. Acta Medicina Psychosomatica, 7, 1–10.
Zaph, J. L., Greiner, J., & Carroll, J. (2008). Attachment styles and male sex addiction. Sexual Addiction & Compulsivity, 15(2), 158–175.
Blog Disclaimer
The Society for the Advancement of Sexual Health (SASH) sponsors this blog for the purpose of furthering dialog in the field of problematic sexual behaviors and their treatment. Blog authors are encouraged to share their thoughts and share their knowledge. However, SASH does not necessarily endorse the content or conclusions of bloggers.
Information in blogs may not always be complete, up-to-date, accurate, relevant, or applicable to all situations. Legislation, case law, standards, regulations, descriptions of products and services, and other information are often complex and can change rapidly. Always double-check and confirm that any information you find on the internet is accurate, current, and complete in regard to your specific situation, question, concern, or interests.
This website and its agents make no promises, guarantees, representations, or warranties, expressed or implied, and assume no duty or liability with regard to the information contained herein or associated in any way therewith. No legal or other professional services are being rendered and nothing is intended to provide such services or advice of any kind. The inclusion of external hyperlinks does not constitute endorsement, recommendation, or approval of those sites or their contents. This website bears no responsibility for the accuracy, legality or content of the external sites or for that of subsequent links. Those who visit or use this website, links or any other information assume all risks associated therewith.
