Transcript Gender Identity Formation Stages

Gender Identity Formation
Theoretical and Treatment Issues in Clinical Practices
Copyright © 1997-2002 Melvin W. Wong, Ph.D. All Rights Reserved
Melvin W. Wong, Ph.D.
黃偉康博士
Licensed Clinical Psychologist
ChristianMentalHealth.com
220 Montgomery St., Suite 1098, San Francisco, CA 94104
1357 Mowry Avenue, Fremont, CA 94538
Tel (510) 794-8898
Fax (510) 475-1473
Video Presentation
Formation of Gender Identity
And
Homosexuality
Fairchild Television
Vancouver, Calgary & Toronto, Canada
(Used by permission)
Resource & References
www.ChristianMentalHealth.com
Handbook of Child and Adolescent Sexual Problems,
George A. Rekers, Lexington Books, 1995
The Psychological Birth of the Human Infant,
Margaret S. Mahler, et al, Basic Books, 1975
Comprehensive Textbook of Psychiatry/IV 4th ed.
Harold I. Kaplan & Benjamin J. Sadock, Williams & Wilkins.
Homosexuality: A New Christian Ethic, Elizabeth R. Moberly.
The Diagnostic and Statistical Manual of Mental
Disorders, (DSM-IV) 4th ed. American Psychiatric
Association. 1994
Gender Identity Formation Stages
• Stage 1 (Birth to Four years old)
– Parental Same-Gender Attachment
• Stage 2 (Kindergarten to Elementary School)
– Social Same-Gender Attachment
• Stage 3 (Elementary to Middle School)
– Social Opposite-Gender Attachment
• Stage 4 (Middle to High School)
• Stage 5 (High School to College)
• Stage 6 (Beyond College & Marriage)
Stage 1
(Birth to Four years old)
Parental Same-Gender Attachment
– Separation & Individuation
– Same-Gender Attachment Failure
– Opposite-Gender Attachment
Family Tree Diagram
Father
Mother
Daughter
Son-1
Son-2
Healthy Relationship
Father
Mother
Daughter
Son-1
Son-2
Son separates from mom
for psychological
individuation successfully
Healthy Relationship
Father
Mother
Daughter
Son attaches with dad
for Gender-Identity
formation sucessfully
Son-1
Son-2
Healthy Relationship
Father
Mother
Daughter
Son-1
Son-2
Son separates from mom
for psychological
individuation successfully
Healthy Relationship
Father
Mother
Daughter
Son attempts to attach
to father for GenderIdentity formation
Son-1
Son-2
Unhealthy Relationship Begins
Father
Mother
Daughter
Son’s attempts to attach
to father was rebuffed
and he experiences
rejection and hurt
Son-1
Son-2
Unhealthy Relationship
Defensive Detachment Begins
Father
Mother
Daughter
Son’s attempts to defend
against more pain from
rejection by defensively
detaching from father’s
relationship emotionally
Son-1
Son-2
Gender-Identity Development
Separation-Individuation
• Successful Gender-Identity develops after
an early dynamic relationship (SeparationIndividuation) of child with Mother & Father
• Both Mother and Father are important for
healthy gender development of their kids
• Dynamic psychological relationship begins when
child walks & talks (Separation-Individuation)
– Where Gender-Identity Imprinting begins
Gender-Identity-Imprinting Stage
Copyright © Melvin W. Wong, Ph.D.1999
Object-Relations
Separation-Individuation
theory suggests there is a critical phase
when a child will have to separate from
mother to attain gender individuation
For gender identity to be formed, child
must successfully attach to the same-sex
parent emotionally
Reference
The Psychological Birth of the Human Infant
Symbiosis and Individuation
Margaret S. Mahler,
Fred Pine & Anni Bergman
(1975 308 pages)
Published by
Basic Books, Inc. Publishers, New York
(Hardcover USD $45 Paperback $22)
The Psychological Birth of the
Human Infant Symbiosis and Individuation
• Beginning of Gender Identity is 21 months
– Boys turn to fathers to gender identify (p. 106)
– Boys struggles with castration anxiety
• Task of becoming a separate individual for
little girls are more difficult than boys
– Girls turn to mother upon discovery of sexual
difference
– Girls blame, demand, ambivalent toward mom
Gender-Identity-Imprinting Stage
Copyright © Melvin W. Wong, Ph.D.1999
• Defensive Detachment theory
– Dr. Elizabeth Moberly
• Defensive Attachment theory
– Dr. Melvin Wong, Licensed Psychologist (Calif)
• Father-Son Separation: Emotional Detachment
• Mother-Son Enmeshment: Close emotional
attachment, results in imprinting of
mother’s gender-personality characteristics
Healthy Relationship
Father
Mother
Daughter
Son-1
Son-2
Son separates from mom
for psychological
individuation successfully
Healthy Relationship
Father
Mother
Daughter
Son attempts to attach
to father for GenderIdentity formation
Son-1
Son-2
Unhealthy Relationship Begins
Father
Mother
Daughter
Son’s attempts to attach
to father was rebuffed
and he experiences
rejection and hurt
Son-1
Son-2
Unhealthy Relationship
Defensive Detachment Begins
Father
Mother
Daughter
Son’s attempts to
defend against more
pain from rejection by
defensively detaching
from father’s
relationship
Son-1
Son-2
Unhealthy Relationship
Defensive Attachment Begins
Father
Mother
Daughter
Son-1
Son-2
Son has no choice but
to re-attach with mom
for emotional security
Unhealthy Relationship
Defensive Attachment Continues
Father
Mother
Daughter
Son-1
Son-2
Son has no choice but
to re-attach with mom
for emotional security
Forming Defensive
Attachment
Unhealthy Relationship
Defensive Attachment Intensifies
Father
Mother
Daughter
Son-1
Son-2
Son generalizes
defensive detachment
to defensively attach to
girls and women: Nonaggressive & softer
Unhealthy Relationship
Defensive Attachment Intensifies
Father
Mother
Daughter
Girl 1
Girl 2
Son-1
Son-2
Generalization
intensifies. Father
becomes a stanger
Unhealthy Relationship
Defensive Attachment Intensifies
Father
Mother
Daughter
Girl 1
Girl 2
Son-1
Son-2
Generalization
intensifies. Men are
unfamiliar
Girlfriend
Unhealthy Relationship
Defensive Attachment Solidifies
Grandma
Father
Mother
Daughter
Son-2
Son-1
Men are objectifiedcurious-sexualized
Girl 1
Girl 2
Girlfriend
Unhealthy Relationship
Defensive Attachment Solidifies
Aunt 1
Grandma
Father
Mother
Daughter
Son-2
Son-1
Men are objectifiedcurious-sexualized
Girl 1
Girl 2
Girlfriend
Gender-Identity-Imprinting Stage
Copyright © Melvin W. Wong, Ph.D.1999
• Mother-Daughter Separation: Individuation
• Father-Daughter Attachment: Gender-Identity
“Confirmation” process
– “I am not mother, but I am myself as a wanted girl”
• Father-Daughter Detachment: Confusion
• Mother-Daughter Attachment-Enmeshment
– Defensive Attachment: “I am wanted as a girl”
– “I am not mother, so I must not be like her”
• Rejects Gender-Identity with mom for Individuation
Gender-Identity-Imprinting Stage
Copyright © Melvin W. Wong, Ph.D.1999
• Imprinting: An Opportune-Window of time
for Gender Identity to take place
– Successful attainment: Secure Gender Identity
– Attainment failure: Incomplete Gender Identity
• When Imprinting period is passed, child
becomes more vulnerable in Gender Identity
• Non-Gender-Imprinted child: Seeks attainment
indiscriminately due to desperation: Mother
Fathers’ Characteristics
• Inexperience-Distracted: “Teenage Dads”
– Dads’ orphaned, fostered, disconnected
– Dad’s role was insignificant: “ego-centric”
• Having children “Out-of Wedlock”
• Physically abusive
– Fear-Shame-Blame based “Parenting”
– Sexual-Genital based teasing: “Put-Downs”
• Survival: Dads’ Identity at expense of son
Mother’s Characteristics
• Inexperience: “Teenage Moms” Immature
– Husband unable to meet her Emotional Needs
– Her role is not involved enough: “Grandma”
• Having children “Out-of Wedlock”
• Emotional Enmeshment: “Favorite Child”
– Unable to help sons-daughters detach from her
– Sexual-Boundary Exposure: Intended or not
• Survival: Mom’s identity at expense of kids
Stage 2
(Kindergarten to Elementary)
Social Same-Gender Attachment
• Polarization-Strengthening Process
– Gender Identity
• Opposite Gender seen as a threat
– Clear Limits Boundaries across gender lines
• Gender Stereotyping: Hair-cut, clothes, toys,
• Same-Gender familiarity preferred
Picture Credit: Janelle Ching, used by permission (Dr. & Mrs. Stephen & Lisa Ching, 2002)
Stage 3
(Elementary to Middle School)
Social Same-Gender Attachment
• Physical Gender Identity Differentiation
– Pre-Puberty Gender Ambiguity
– Masculine Features: Security vs. Insecurity
– Feminine Features: Security vs. Insecurity
• Acceptance vs. Rejection of Body
– Body Discomfort of troubled children
Stage 3
(Elementary to Middle School)
Social Same-Gender Attachment
• Physical Gender Identity Differentiation
– Pre-Puberty Gender Ambiguity
– Masculine Features: Security vs. Insecurity
– Feminine Features: Security vs. Insecurity
• Acceptance vs. Rejection of Body
– Body Discomfort of troubled children
– Gender Identity Disordered children
Stage 4
(Middle to High School)
Social Same-Gender Attachment
• Self-affirmation & acceptance:
– Girls: Make-up & clothes
– Boys: Power & strength: Sports & work-out
• Interest & Curiosity over opposite gender
– “Puppy Love”: Dating begins
• Affirmation through opposite sex peers
– Comfort with opposite sex peers
Stage 5
(High school to College)
Social Opposite-Gender Attachment
• Security in self-affirmation & acceptance:
– Girls: Less self-conscious & preoccupation
– Boys: Power & strength: Sports & work-out
• More matured interest over opposite gender
– Steady Dating begins
• Affirmation through opposite sex peers
– Comfort with opposite sex peers
Stage 6
(Beyond College & Marriage)
Navigate a mutually nurturing committed
relationship through Marriage & Parenting
• Marital Relationship
Can merge without threat of over-crowding
Can be autonomous without fear of abandonment
• Parenting Relationship
Can affirm gender of same-sex children
Can affirm gender of opposite-sex children
Therapeutic Approaches to
Treatment of GID
• Gender Identity Disorder is an Identity
problem and not a sexual disorder per se
• While sexual issues are symptoms; the key
to treatment is not only sexual in focus
• The focus is in the area of Gender security development
• Males: Masculine Identity Security
• Females: Feminine Identity Security
Therapeutic Approaches to
Treatment of GID
Intervention strategy is different for each age
group
Younger the child
The easier & more effective is the treatment
It is most important to diagnose early
Average referral is three and a half year-old
Remember: Most are victims of sexual abuse
Video Presentation
Rather Be A Woman
Jenny Li, M.Div.
Exodus Taiwan (Taipei)
Taiwan
(some religious references)
Used by permission
Therapeutic Approaches to
Treatment of GID
Stage 2
(Kindergarten to Primary School)
Parents and teacher need to be in cooperation
Prevent GID child from ridicule & bullying
No cross-dressing for Halloween
Same-Gender Parent influence: Acceptance
Dad: Spend more time with son: Gender specific
Mom: Spend more time with daughter: Gender specific
Therapeutic Approaches to
Treatment of GID
Stage 3
(Elementary to Middle School)
Boys: Dads aligns with son to protects them
Girls: Dads able to relate to daughters, Mom
is considered strong person, avoid being
victims of sexual abuse by close family
members
Nickelodeon’s “My Family is Different”
Discusses homosexuality & growing up in a gay family
Linda Ellerbee & Rosie O’Donnell
Need to include following items in their discussion
• Frank discussion about the harm that comes to those who
engage in homosexual activities
• Firsthand testimonies of children of gay parents who are
adults: What consequences from parents’ homosexuality?
• Medical information: Why homosexuality is so detrimental?
– Increased risks of STD’s: Hepatitis, Chlamydia, Syphilis & HIV
– Increase mortality rate of homosexuals vs. heterosexuals
Therapeutic Approaches to
Treatment of GID
Stage 4
(Middle to High School)
Focus is with the children, not only parents
Same-gender peer acceptance is important
Boys: Athletics potential, self-acceptance of
body, reduce individual sports, team work
Girls: Make-ups practices, dresses, girl-play
Therapeutic Approaches to
Treatment of GID
Stage 5
(High school to College)
Boys: Reduce Same-sex sexual fantasies,
increase same-sex non sexual relationships
Girls: Reduce codependent same-sex
emotional relationships, find a male mentor
(teacher, coach), resolve conflicts with dad
and mourn abuse issues with self or mom
Therapeutic Approaches to
Treatment of GID
Stage 6
(Beyond College & Marriage)
Refer to mental health professional
Specific personal addiction issues
Men: Sexual addiction (Internet, gay sex)
Women: Emotional-Relational addiction
Therapeutic Approaches to
Treatment of GID
Specific Hong Kong Issues
• Absentee Fathers & Depressed Mothers
–
–
–
–
Detachment-Rejection of Father & significant males
Detachment-Rejection of Mother & significant females
Increased of Gender Confused male & female children
Increased of GID boys and girls
• Filipina maids: At-risk-boys
– Women’s emotional dominance: Detachment
– Ambivalence toward male gender: Teasing & touching
– Intentional or “casual” sexual exploitation & abuses
Sexual Addiction
& Treatment
Patrick Carnes, Ph.D.
Why Sexual Addiction?
Needs for Arousal
Life is Boring
•
•
•
•
Gambling
Sex
Stimulant Drugs
High-Risk Behaviors
Why Sexual Addiction?
Needs for Satiation
Life is Not Satisfying-Unhappy
•
•
•
•
•
Sex
Over-Eating (Bulimia-Binging)
Depressant Drugs (Marijuana)
Narcotic Drugs (Anesthetic effect)
Alcohol
Why Sexual Addiction?
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•
•
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Needs for Fantasy
Reality is too Hard: Need a Quick Escape
Voyeuristic Sex: Intelligent fantasy & Routine
Psychedelic Drugs: LSD
Marijuana
Mystic/Artistic
Preoccupation
Unhealthy Signs (Mild-Moderate)
• Husband demands wife to be in a certain
physical position for intercourse
– Re-enactment (replay) of pornographic materials
– Have X-Rated (XXX) video on for sex
• Husband demands wife to wear a certain
kind of lingerie (“To seduce-tease him”)
– He buys specific pieces of underwear, stockings
• Husband is distracted by flash backs of
pornographic images while love-making
Unhealthy Signs (Moderate-Serious)
• Masturbation after marriage (Decreased desires)
– Sexual “Anorexia” “Indifference”
• Very few or no male friendships
• Gets enraged easily or numb emotionally
– Polarized emotional expression vs. full-range
• Happy to sad vs. anger to numbness
• Numbness to dissociated vs. euphoria to numbness
• Rigidity & inflexibility
• Telling half-truths and white lies to cover-up
Unhealthy Signs (Serious)
• Compulsive (Uncontrolled)“Cyperporn” use
– Chat Room visits online at work or after bedtime
– Rendezvous-meetings via chat room & email
– Sex for hire experiences: Strip joints, Prostitutes
• Compulsive (Ritualistic) “Tele-Porn” use
– Astoundingly high phone bills
• Unexplained hotel bills, condoms, wigs &
underwear found in storage or trunk or car
• Financial-legal problems: Bankruptcy
“Acting-Out Cycle”
Copyright © Melvin Wong, Ph.D. 2000-2001
Compulsivity
Abuser-Victim
Blame-Shame
Impulsivity
From Over-Control, UnderControl to Recovery
• Binge-Purge Cycles
– Impulsiveness vs. Compulsiveness
• Over-Control: The Victimizer
– Power Position: “A Mouse Click Away!”
• Under-Control: The Victim
– Not Responsible for what happened
– Don’t blame me! I can get away with it
– Rationalization & Justification: Maintains the addiction
From Over-Control, UnderControl to Recovery
• Taking Control: The Survivor
– “I don’t have to dominate to succeed!”
• “I admit I am powerless over my addiction” Step 1
– “I don’t have to be a victim anymore!”
• “I will take responsibility for myself!”
• “I will not stay in the ‘blame mode’ of helplessness!
• How to broker, balance this Power Dilemma?
– Avoid extremes by identifying feelings accurately
– Form effective intimate relationships
Healing Compulsions & Addictions
• Interpersonal: Healthy-Bonds (Safe People)
– Experiential not only rational Non-sexual intimacy
– Spiritual: Paradigm shift: Enlightenment
• Intrapersonal: Mourn loss, Spiritual renewal
– Rediscover goodness in self (false guilt)
– Rediscover meaning & significance (Help others)
• An Element of “A Loving but Firm
Structure” (Live-In programs, 12 step groups)
Change and Recovery
After a crisis then comes a paradigm shift
First Order Change
• Control: Try More
• Alienation
• Secret Keeping
• Hides Full Story
• “No one is Hurt”
Second Order Change
• Powerlessness
• Community
Involvement
• No Secrets
• Disclose full Story
Addiction is a 1st order problem:
The harder you try to control,
the worse it gets
• Accepts Self as Hurt
Self-Help Group Resources
SA: Sexaholics Anonymous
www.sa.org (615)331-6230
SLAA: Sex Love Addicts Anonymous
EA: Emotions Anonymous
(510) 471-8864
CODA: CoDependents Anonymous
(415) 905-6331
www.ChristianMentalHealth.com