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Failing without Falling

You and I are on a great climb. The wall is high, and the stakes are higher. You took your first step the day you confessed Christ as the Son of God. He gave you his harness — the Holy Spirit. In your hands he placed a rope — his Word.

Your first steps were confident and strong, but with the journey came weariness, and with the height came fear. You lost your footing. You lost your focus. You lost your grip, and you fell. For a moment, which seemed like forever, you tumbled wildly. Out of control. Out of self-control. Disoriented. Dislodged. Falling.

But then the rope tightened, and the tumble ceased. You hung in the harness and found it to be strong. You grasped the rope and found it to be true. You looked at your guide and found Jesus securing your soul. With a sheepish confession, you smiled at him and he smiled at you, and the journey resumed.

Now you are wiser. You have learned to go slowly. You are careful. You are cautious, but you are also confident. You trust the rope. You rely on the harness. And though you can’t see your guide, you know him. You know he is strong. You know he is able to keep you from falling.

And you know you are only a few more steps from the top. So whatever you do, don’t quit. Though your falls are great, his strength is greater. You will make it. You will see the summit. You will stand at the top. And when you get there, the first thing you’ll do is join with all the others who have made the climb and sing this verse:

“To him who is able to keep you from falling and to present you before his glorious presence without fault and with great joy — to the only God our Savior be glory, majesty, power and authority, through Jesus Christ our Lord, before all ages, now and forevermore! Amen.” (Jude vv. 24–25 NIV)

Today’s devotional is drawn from Max Lucado’s Next Door Savior.

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Sex Addiction as Affect Dysregulation: An Interview with Alexandra Katehakis, MFT

For an interview on our Purity Podcast with Alexandra Katehakis, please follow this link: https://castimonia.org/resources/castimonia-purity-podcasts/episode-47-interview-with-dr-alexandra-katehakis-certified-sex-addiction-therapist-on-sexuality-in-recovery/

Recently, my colleague Alexandra Katehakis, founder of the Center for Healthy Sex in Los Angeles, published a research-based book entitled Sex Addiction as Affect Dysregulation: A Neurobiologically Informed Holistic Treatment. Her thorough understanding of the neurobiological underpinnings of sexual addiction along with ways to address these underlying issues in the treatment process is impressive. Recently, I was able to speak with her about both her book and her theories on treating sexual addiction. A partial transcript of our conversation is presented below.

Right now there is a lot of debate about what qualifies as “addictive” sex. What are your thoughts on this?

 I conceptualize addictive sexual behavior as adaptive. Sex addiction is an adaptive strategy, because humans are incredibly adaptive. Our brains are highly automatic. If somebody has an experience when they are quite young that relieves some pain or some stress and it is functional for them, it becomes adaptive. So that person will repeat that experience over and over again. Automaticity in that way is a component of dissociation, and that is what we see in sex addicts. So I would say that sexually compulsive or addictive behavior is adaptive, not necessarily a choice as some would argue. It’s a result of the automatic brain. And, as such, it is often a repetition of trauma—not in an attempt to rectify what was done, which is an old definition of trauma repetition, but as a neurobiological construct, a pattern of behavior. And these are patterns of behavior that create stress and problems in people’s lives over time. So what was once pleasurable becomes problematic. Sometimes it remains pleasurable, but it also becomes problematic. Sex addicts report that they cannot stop their behaviors, even though they’re problematic.

So sex addiction is, basically, an adaptive response to early-life relational trauma?

Yes. That’s the aspect of sex addiction that I’m most interested in—what happens when people don’t get proper attunement, usually starting in infancy, so their systems aren’t brought to fruition in the way that the brain and the body are designed to develop and operate optimally. If there’s any kind of chronic unrepaired disruption, you’re going to get distortions in the organism. If you have a mother who is highly depressed or highly anxious, or is under some sort of duress where she’s traumatized, she’s not going to be able to attune to her infant in a way that’s going to bring its systems up optimally, and therein lies the intergenerational transfer of trauma. So it’s not just psychological, it’s biopsychosocial. And it’s all environmental. In other words, part of the environment is the mother’s psychology and another part of the environment is her neurobiology. So you have this problematic attunement, and if there is any sort of trauma after that, whether it’s bullying, beating, sexual, neglect, or anything else, then you are going to have problems.

One of which could be sex addiction.

Yes, because sex addiction is an auto-regulatory strategy. Because the child isn’t getting proper and appropriate co-regulation from its caregivers, the organism itself will find ways to auto-regulate. And as an adult that can manifest as an addiction.

That’s what you’re talking about when you discuss addiction as a chronic brain disorder.

Yes, the brain will adapt. It’s highly malleable. It will organize itself according to what it needs in order to function. The organism is always trying to right itself. It’s always going to try to move toward some kind of healing, so it will adapt and do whatever it needs in order to function.

So a sex addict’s brain looks different and functions differently than a non-sex addict’s (or at least a non-addict’s) brain?

Well, I would say that’s likely, but we’d have to do more research to say that for sure. But there is already some evidence to that effect, and it’s clear that clinically and phenomenologically sex addicts present differently than non-addicts. There are many different examples. Some have to do with perception, some have to do with relatedness. With perception, sex addicts perceive all kinds of distortions because they’re only focused on getting into the sexual experience. That is where their attention is all day, every day.

It’s a little like magic. You see a magician who uses sleight of hand, and the reason that works is because our attention is on one thing that the magician wants us to see, instead of what he’s doing to fool us. We don’t have our attention on other things that the magician is doing. That’s how magic works. For sex addicts, they’re only looking for the sexual experience. If you ask a sex addict how many massage parlors there are in LA, and where they are, they’ll tell you that they’re everywhere. But if you ask a 35 year old soccer mom, she’ll tell you she’s never seen one. It’s an issue with perception.

For evidence of this we might look at the Mechelmans/Voon attentional bias study, which showed that sex addicts are similar with their focus to, say, a cocaine addict. For instance, if you put a cocaine addict in a room with a pile of cocaine on the coffee table, that’s all he will see. He won’t notice the color of the couch, or the carpet, or the walls, or anything else that a normal person would typically notice.

Yes, sex addicts are the same.

In your book you write, “Once addictive sexual behaviors have been arrested, the work of repairing and supporting neurophysiological structures through human relatedness must begin.” Can you explain what you mean by that?

That means that therapy has to be a two person relational system, where the therapist is actually engaging in a real relationship with the client. Historically, psychoanalysis has been more of a symbolic relationship with the client, where the client authentically projects onto the therapist that they’re the mother or the father or some problem figure and the therapist makes interpretations about that. With sex addiction, I believe the addict and the therapist need a real relationship. And together they work through whatever their issues are, so both of their subjectivities are being worked through simultaneously. It’s a coregulatory process where both parties are engaged, both parties are changing. There are ruptures, there are repairs. There’s a slipperiness to the process, but that’s what changes brain structure and function. In the same way, 12 step meetings are enormously valuable. It’s the fellowship, the coffee, the relationship that has addicts starting to trust other human beings again. That’s what starts addicts toward feeling they’re not alone. Twelve step recovery is a come as you are program and all are welcome, so people start to recognize that they can trust other people and they can get their needs met.

So you’re saying these hardwired reactive pathways that we build very early in life need to be rebuilt or worked around with new pathways, and that happens through relatedness?

Yes, we’re rebuilding pathways that were blighted, or that were never formed to begin with. Obviously, with people who are severely dissociated you’re talking about long-term therapy that requires resonance, closeness, safety, and trust between client and therapist so that the client’s uncoupled circuits can recouple. This is the work required for neural integration; this is the process of recovering dissociated self-states. And we really do see profound changes in people over time when they’re working in this way.

I had a guy who came to group last night who’s been in recovery for a long time who has some very serious psychological problems. But he’s worked very hard for years to restore his life. Recently, he lost his job, and he started slipping with pornography, and he felt a tremendous amount of fear about coming into group and talking about it because he didn’t want to be shamed, and he has a hard time with confrontation. To his credit, he came back anyway, and the group was really compassionate with him about what he’s struggling with. I saw a distinct shift in his level of defensiveness and fear, so that he was able to be more compassionate with himself. His pornography use was inconsequential to the group because it was clearly an auto-regulatory coping mechanism and, therefore, a regressed move he made to soothe his many anxieties. What mattered most was the relationship between the men in the group.

He may also have learned that he can come back to group any time he has a problem.

That’s exactly right. When I asked him what he needed from the group, he said, “I need for everyone to tell me that I should keep coming back.” Which is not what he learned in early life, when he was shamed and ostracized. This is exactly the type of relational work that he desperately needs.

How does your PASAT treatment model, as discussed in your book, differ from the cognitive-behavioral approach that most sex addiction therapists rely on in the early stages of treatment? Or does PASAT simply formalize the process of moving, over time, from cognitive-behavioral work to trauma and relational work?

It’s different than the traditional model of using CBT first, and then moving into deeper dynamic therapy, which is a bifurcated model. With PASAT, the actual relational work is happening during the cognitive-behavioral treatment protocol. Sex addiction therapists in general tend to ascribe to Patrick Carnes’ CBT model, which lays out a road map on how to help people get sober. But therapists have to simultaneously be working on the relational aspects. So it’s not just about giving somebody an assignment and processing the assignment with them, it’s about co-regulation—tracking all the nonverbal cues of the client while the therapist is also paying attention to his or her own somatic countertransference, and tracking the client’s affect, gesture, and autonomic cues. So the therapist is in an “experience near” relationship with the addict, meaning both parties have a felt sense of each other, are processing their experience of each other while also processing cognitive material.

So it’s an integration of the relational work with the behavioral work?

Correct. It’s a holistic model. It brings everything in at the same time. Historically we’ve had addiction therapists and then we’ve had psychodynamic therapists, and never the twain shall meet. I’m proposing that we play all those notes at the same time, requiring the therapist to bring all of himself or herself into the mix. When we do this, we’re affecting and changing both parties’ neuropsychobiology. We’re working the left brain and the higher cortical functions, but we’re also working from the body up. It’s a much more integrated model that’s geared toward regulation and integration. We might also call it the affect regulating “cure” for addictive trauma.

Alex Katehakis’ book, Sex Addiction as Affect Dysregulation, is available on Amazon.com at this link.

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Why Is Your Partner’s Smartphone Use an Issue?

Smartphones have now been with us for 10 years, and play a huge part in our lives. We use them to take selfies, connect on social media and dating apps, read the news, and play interactive games. Many people check their smartphones as the last thing they do at night and then first thing in the morning. Train and bus passengers constantly gaze at their phones; people even stare at them when walking down the street, oblivious to others. There is no doubt that phones have changed the ways we behave and live.

Smartphones provide a way for people to stay closely connected with family and friends, and the array of options arguably create feelings of connectedness with others, but excessive use means that users forgo face-to-face interactions. Diverting one’s attention to a smartphone while in the company of another is a behavior known as phubbing, a portmanteau of phone and snub, and generally considered to be impolite or inappropriate in the context of social interaction.

If phubbing is impolite and inappropriate, what is the effect of such behavior on romantic relationships? Is it tolerated because of the closeness of romantic partners, or is its impact exacerbated because of it? Further, are there gender differences in emotional reactions and responses to phubbing?

McDaniel and Coyne (2016) suggest that smartphones can be intrusive and interfere with face-to-face interactions, with one partner feeling upset if the other becomes too absorbed in their phone when they are spending time together. Any distraction or intrusion when partners are together might cause upset, but are intrusions caused by smartphone use more of a problem? Does phubbing merely cause one partner to feel upset because they feel ignored? Or does it go further and cause them to be upset due to a feeling of jealousy as their partner is possibly connecting with a third party via their phone? Remember that one aspect of jealousy is the perceived threat to a relationship from another party.

Hanna Krasnova and colleagues investigated jealousy in partner phubbing and relationship outcomes (Krasnova, Abramova, Notter & Baumann, 2016). In their study, they employed participants between the ages 26 and 40, an age group they argue are most likely to use smartphones, while at the same time likely to be seeking sustainable romantic relationships.

The researchers asked participants to think of the last time their partner used their smartphone for too long in their presence. Participants reported that this happened:

  • When they were at home together (33.6 percent).
  • In bed before going to sleep (19.6 percent).
  • When they were home having a meal together (10.8 percent).
  • In the car or on public transport (9.8 percent).
  • When going out (4.5 percent).

(The remainder of the answers were watching TV, walking, and shopping.)

When asked to describe their emotions on these occasions, participants reported the following:

  • Loss of attention (28.6 percent).
  • Anger (19.4 percent).
  • Sadness/suffering (11.1 percent).
  • Boredom (3.2 percent).
  • Indifference (38.1 percent).
  • Happiness (4.4 percent).

The only notable gender difference was in happiness, with males reporting more happiness than females. However, compared to males, females reported more anger, sadness, and indifference.

The researchers then asked about participants’ coping strategies to phubbing. Reactions included:

  • Voicing intervention, such as making a request to stop using the phone (27.1 percent).
  • Showing curiosity by either looking at the other’s screen or voicing suspicion (7.3 percent).
  • Mirroring; for example, doing the same as a partner (6.9 percent).
  • Doing something else (13 percent).
  • Loyalty, such as showing tolerance, waiting, and understanding (22.3 percent).
  • Feeling negative—being annoyed or angry (7.3 percent).
  • No reaction (22.3 percent).

In terms of gender differences, males reported coping more in terms of loyal reactions compared to females. Further, males were twice as likely to exhibit mirroring behavior compared to females. Overall, it seems that males report more positive emotional responses and coping with phubbing behavior compared to females.

Finally, the researchers tested the relationship between partner phubbing, feelings of jealousy, and relational cohesion (the feeling of togetherness or emotional bonding). They found that it was not just annoyance or the feeling of being ignored when their partner used their phone that impacted on cohesion. Rather, it was more likely affected by an individual’s feeling of jealousy at their partner using their smartphone.

While jealousy is often discussed within the context of partner rivalry, jealousy is often experienced in other ways, such as a partner spending time with friends, or time at work; overall, jealousy can be associated with relationship deterioration. Previous research on jealousy revealed that not all interruptions to a social interaction are perceived equally; even from an early age we experience more intense feelings of jealousy towards social objects than inanimate ones (Hart et al, 2004).

The research of Krasnova et al. seems to suggest that we tend to see smartphones more as social objects—not just phones or computers—because they enable connection with others. Overall, it seems that it is not the process of phubbing itself (merely being ignored), but the feeling of jealousy (a partner connecting with another person) that phubbing triggers which ultimately leads to relationship dissatisfaction.

Visit my website and follow me on Twitter @martingraff007 and YouTube

References

Hart, S. L. Carrington, H. A., Tronick, E. Z. and S. R. Carrol (2004).’When infants lose exclusive maternal attention: Is it jealousy?’ Infancy 6 (1), 57-78.

Krasnova, H., Abramova, O., Notter, I.,Baumann, A. (June 2016) ‘Why phubbing is toxic for your relationship: Understanding the role of smartphone jealousy among ‘generation Y’ users’ (Unpublished). In: 24th European Conference on Information Systems (ECIS). Istanbul, Turkey.

McDaniel, B. T. & S. M. Coyne (2016). ‘Technoference: The interference of technology in couple relationships and implications for women’s personal and relational well-being.’ Psychology of PopularMedia Culture, 5(1), 85-98.

 psychologytoday.com · by Martin Graff Ph.D.

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Child Sexual Abuse Prevention Goes to TEDMED

Source: Stephanie Neal

Last year culminated in a once in a lifetime opportunity—the chance to give a TEDMED talk to a curated, attentive and influential audience about child sexual abuse prevention. TEDMED is the independently owned and operated health and medicine edition of the world-famous TED conference. This annual event is dedicated to “ideas worth spreading.”

The theme for 2016 was “What if…?” and speakers were asked to imagine new possibilities for advancement in medicine, public health and biomedical sciences.

I asked the question: what if we stopped treating child sexual abuse as solely a criminal justice problem and instead treated it as the preventable public health problem that it is?

In my talk, I told the story of the fateful day I met with the journalist who would break the story about non-offending pedophiles and my research in finding a public health approach to ending child sexual abuse. Luke Malone brought the idea of child sexual abuse prevention into the living rooms of millions of Americans who listened to his story on This American Life.

I also discussed some important statistics that everyone should know. The peak age for engaging a prepubescent child in harmful or illegal sexual behavior is 14, and about half of all sexual offences against prepubescent children are committed by other children.

Another important statistic is that nearly 98 percent of children convicted of a sexual offense are never reconvicted of a new sexual offence. This shows that adolescent sexual offending is short-lived and it strongly suggests that we can prevent the first offence.

And yet, instead of focusing on prevention, we put most of our efforts on punishment.

Children who are caught engaging in harmful sexual acts might receive treatment instead of prosecution, which acknowledges that children, even those who make serious mistakes, have the potential to be rehabilitated.

For the children who get caught, prosecuted and convicted of sex crimes, they are often treated like adults. They can face incarceration and sex offender registration and public notification, sometimes for life. Registered children can be prohibited from living near schools, parks and playgrounds—the very places where our children thrive.

And what do we make of the people who discover in adolescence that they have an unwanted attraction to prepubescent children? Our interviews with 30 young adults living with an unwanted attraction to children revealed just how hard it is to find help and cope with their attractions. Many reported that they felt isolated, depressed and even contemplated suicide. Many said that what they truly needed (and could not find) was help in dealing with the shame and stigma that can accompany these attractions.

As part of the TEDMED talk, I presented quotes from these interviews to provide the audience with a better understanding of non-offending pedophiles. (Luke Malone also moderated a panel discussion on non-offending pedophiles that was held in 2015). For children dealing with an unwanted attraction to prepubescent children, acting out might not be the only issue. Some will need our help to resist acting on strong urges some of the time.

So what needs to happen now?

We must start thinking about child sexual abuse as a preventable public health problem. This includes providing all children access to effective prevention programs that focus both on avoiding harm and on attaining health and happiness.

Good programs will teach children how to behave responsibly around younger children; they will encourage children to disclose attractions to others when it is safe to do so and they will inspire all of us to respond to those disclosures with understanding and compassion.

I’ve had positive feedback about the talk so far. A reporter from the Huffington Post called it “one of the boldest” TEDMED talks for that year.

I anticipate that TEDMED will release a publicly accessible link to my talk (and others). But for now, I’ll continue to look for opportunities to bring the idea of child sexual abuse prevention to as many diverse audiences as possible.

psychologytoday.com · by Elizabeth Letourneau, Ph D.

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The Purpose of Confronting Controllers

Mark 8:31-33 – “Jesus then began to teach them that the Son of Man must suffer many things and be rejected by the elders, the chief priests and the teachers of the law, and that he must be killed and after three days rise again. He spoke plainly about this, and Peter took him aside and began to rebuke him. But when Jesus turned and looked at his disciples, he rebuked Peter. “Get behind me, Satan!” he said. “You do not have in mind the concerns of God, but merely human concerns.”

One of the most important benefits of having boundaries is that we have the ability to stand up to others when they try to control our lives. Peter wanted to impose his own design for

Jesus’ life onto Jesus, but Jesus had good boundaries; he stood up to Peter and rebuked him.

Jesus showed that he was in control of himself and would not be defined and controlled by Peter, no matter how good Peter’s intentions might have been. The truth is that Peter was thinking, not of God’s purposes, but of his own agenda. Peter was trying to rescue Jesus instead of turning the situation over to God.

We must be on guard against anyone or anything that might take control of us. Self-control is the fruit of the Spirit (see Galatians 5:22 – 23). When we have self-control, we maintain the ability to stand up to aggressive controllers who try to tell us who we should be and what we should do. Although we are wise to listen to others and be open to their feedback, we should never allow someone to be in control of us and define who we are. Setting appropriate boundaries helps us to retain that kind of freedom and self-control.

This devotional is drawn from The NIV Life Journey Bible, which features notes based on the precepts developed by John Townsend and Henry Cloud.

The Boundaries devotions are drawn from the Boundaries book series, which has transformed marriages, families, organizations, and individuals around the world. The Boundaries series is written by Dr. Henry Cloud and Dr. John Townsend. Copyright 2015 by Zondervan; all rights reserved. Learn more at BoundariesBooks.com.