Transcript Caring for clients` sexual problems

Working with sexual problems &
temptations
BOKSS & YMCA
July 20, 2001
Melvin W. Wong, Ph.D.
Licensed Clinical Psychologist
www.ChristianMentalHealth.com
[email protected]
Overcoming sexual problems and
temptations in adolescents
Understanding impact of sex culture on adolescents
Common problems & temptations
Pornography, masturbation, and promiscuity in guys
Emotional dependency in girls
Homosexuality, bisexuality, transvestism & transexuality
A protocol of prevention & treatment
Sexuality and intimacy development
Counseling, support groups, accountability person &
sexual purity in dating
Psychology of Sexual Problems
Sexual problems are the manifestations but
not the causes of psychological issues
Sexual problems are the effects rather than the
causes of psychological issues
Deep-rooted psychological issues cause the
result of sexual problems
(Exception: Medication side-effects)
西方的性文化悲劇
1.錯誤的理解基礎+(和加上)
2.正確推斷 + (和加上)
3.狂熱的執行 (等于) =
不斷上演個人的家庭悲劇
西方的性文化悲劇
錯誤的理解基礎+ 正確推斷 + 猛烈行動
== 不斷上演的個人的家庭悲劇
___________________________________________________________________
n 實際問題
---- 性病
---- 愛滋病
n 兩難之局：針筒交換及安全套分派計劃 ;政府送手提電話
給妓女，防範色魔侵襲
n安全性行為：由教育變成推動？
「邦頓市男孩可以穿上女服上學」
市法庭裁決
個人身份的表達自由是最重要的优先
2000年10月13日波士頓報導：
•「法官裁定校方不准 “她”上學是有違她個人身份的
表達自由。」
•「校方將會上訴，法官為一女同性戀者，學童是 個15
年歲男孩。」
•「學校管理階層聲言男童女服擾亂秩序。」
•「醫生作證謂男孩有性別混淆問題，而衣女服是基於醫
學上須要。」
西方的性文化悲劇
東西方文化在認識上的分別
l 西方
直線形的，理性的
驗證及實踐性，故放縱自由好
像司法制度：兩方面擺事實
“如合理便對！”
l東方
歷史性的
傳統沿革的智慧，,
l 西方依靠有牌的專家
l 東方賴智者的引導
保守形的
西方的性文化悲劇
l 「性愛有大市場」: 色情電影及圖片
西方的性文化悲劇
l 「性愛有大市場」: 色情電影及圖片
l 女性被性感象徵化、玩物化、為施暴對象
n
n
性暴力：強姦（約會時，婚姻中）
連環殺手：反社會變態怪人
西方的性文化悲劇
l 「性愛有大市場」: 色情電影及圖片
l 女性被性感象徵化、玩物化、為施暴對象
n
n
性暴力：強姦（約會時，婚姻中）
連環殺手：反社會變態怪人
l 男性是孤獨的被遺棄的人
l 同居與離婚率上升
l 家庭暴力：虐童
l 學園暴力：無家庭溫暖
何謂「個人身體政治」？
•源自過去的壓迫及歧視 (同性戀)
•須要
保護自我
•須要
個人“私隱化”
─ 始於美國把墮胎合法化
─ 紐約州，加州，實行愛滋病人登記制，使減少試驗費用
•須要把個人自我“民主化”
•須要把個人自我“自由度擴大化”
何謂「個人身體政治」？
•誰作主？ “是我自己，我的官感！”
•不正常的性取向何以會主觀地被接納甚至被推祟
至身體崇拜地步？
-
生殖及性取向的私隱權
雞姦是個人的事，同性戀與別人無涉
性虐待，性痛苦是小圈子的事
戀童廦，如果對方覺得快樂，也是個人的事
後現代主義是甚麼？
“在道德領域內並無絕對”─
這是絕對真理
 絕對私隱權、自由權：個人身體民主化
－ 官感、性感覺是最高無上
－ 怪異、變態嗜好是容許的，只要你從中得到樂趣
－ 個人身體政治化：染髮、剌孔、墮胎、安樂死、同性婚


文化反叛：民主的推展
傳統的性觀念代表對別人的壓迫
Michel Foucault 的性理念
性觀念的沿革
樂趣至高
維多利亞時代性理念 =
性慾的壓制
性觀念的沿革

壓制性慾不對（維多利亞時代）
─ 性解放是好; 性的壓抑＝政治權力
性是人權 - 現在民主
弗洛伊德 (Freud) 對性及病理的假設：瘋狂

對性的討論 = 政治權力

性不是愛
─
愛是互相的，性是自我的
─
性無須有愛，也無須有對象
─
正如食慾，無須節制
後現代時代特點
學者從政 （政治研究）
有利益衝突之虞
思考封閉(Allan Bloom)。
主觀處事 客觀不再
肉身性慾神聖（墮胎、同性戀、
安樂死〈雙重標準〉）
至高至巧：進入意念市場
西方的性文化悲劇
1.錯誤的理解基礎+(和加上)
2.正確推斷 + (和加上)
3.狂熱的執行 (等于) =
不斷上演個人的家庭悲劇
Sex Education
• First impression is the most important
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–
–
–
Formative years of a child
Parents should be equipped to educate children
School should be the secondary source
Media should be the tertiary source if at all
• The church should equip parents
– Pulpit should address issues of sex education
• Do more than just condemn: Provide an alternative
– Sunday school materials and workshop training
Sex Education
Parents can talk about specific issues of sex
– Teen pregnancy: Causes and effects & solution
– Abortions and Abstinence: Peer group support
– Contraceptives: Only at a mature age
• Not in a co-ed fashion: Respect modesty of sexes
• Not given in a crass manner as if to encourage &
challenge teens to engage in immature sexual acts
– Teach EQ: Delay gratification skills (pain?)
– Practice good judgment skill in decision making
Sexuality & Gender
Gender Identity Disorder
An Introduction
© ‘99 Melvin W. Wong,
Ph.D.
Licensed Clinical Psychologist
www.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
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
What Is Gender Identity Disorder?
• GID is a psychological condition where a
person prefers to be the opposite gender.
• Most experts in the field tend to agree this
condition is psychological and not biological.
• There may be a maternal hormonal influence.
• More males than female GID problems.
• A person may experience Gender Identity
Confusion without GID.
Gender-Identity-Imprinting Stage
© 1999 Melvin W. Wong, Ph.D.
• Object-Relations theory suggests there is a critical
phase when a child will have to separate from
mother to attain individuation.
• For gender identity to be formed, must
attach to the same-sex parent, emotionally.
• Defensive Detachment theory: Dr. Elizabeth Moberly.
• Defensive Attachment: Dr. Melvin Wong, Psychologist.
– Father-Son Separation: Emotional Detachment.
– Mother-Son Enmeshment: Close emotional attachment,
resulting imprinting of mother’s personal
characteristics.
GID Age of Onset
• Onset of Cross-Gender Interests and activities is
usually between ages 2 and 4 years
• Average age for a clinical referral is 3.5 yrs(Rekers, G.)
• Only a very small number of children with Gender
Identity Disorder will continue to have symptoms
that meet criteria for Gender Identity Disorder in
later adolescence or adulthood.
• Most children with GID display less overt crossgender behaviors with time, parental intervention,
or response from peers.
GID Age of Onset
• By late adolescence or adulthood, about threequarters of boys who had a childhood history of
Gender Identity Disorder report a homosexual or
bisexual orientation, but without concurrent
Gender Identity Disorder.
• Most of the remainder reports a heterosexual
orientation, also without concurrent Gender
Identity Disorder.
• The corresponding percentages for sexual
orientation in girls are not known.
GID Manifestations in Boys
• In boys, the cross-gender identification is
manifested by a marked preoccupation with
traditionally feminine activities.
• They may have a preference for dressing in girls'
or women's clothes or improvise such items from
available materials when genuine articles are
unavailable.
– Towels, aprons, and scarves are often used to represent
long hair or skirts.
• There is a strong attraction for the stereotypical
games and pastimes of girls.
GID Manifestations in Boys
• They particularly enjoy playing house, drawing
pictures of beautiful girls and princesses, and
watching television or videos of their favorite
female characters.
• Stereotypical female-type dolls, such as Barbie,
are often their favorite toys, and girls are their
preferred playmates.
• When playing "house," these boys role-play
female figures, most commonly "mother roles,"
and often are quite preoccupied with female
fantasy figures.
GID Manifestations in Boys
• They avoid rough-and-tumble play and
competitive sports and have little interest in cars
and trucks or other non-aggressive but
stereotypical boy's toys.
• They may express a wish to be a girl and assert
that they will grow up to be a woman.
• They may insist on sitting to urinate and pretend not to
have a penis by pushing it in between their legs.
• More rarely, GID boys may state that they find their
penis or testes disgusting, that they want to remove
them, or that they have, or wish to have, a vagina.
GID Manifestations in Girls
• Girls with GID display intense negative reactions
to parental expectations or attempts to have them
wear dresses or other feminine attire.
• Some may refuse to attend school or social events
where such clothes may be required.
• They prefer boy's clothing and short hair, are often
misidentified by strangers as boys, and may ask to
be called by a boy's name.
• Their fantasy heroes are most often powerful male
figures, such as Batman or Superman.
GID Manifestations in Girls
• These girls prefer boys as playmates, with whom
they share interests in contact sports, rough-andtumble play, and traditional boyhood games.
• They show little interest in dolls or any form of
feminine dress up or role-play activity.
• A girl with this disorder may occasionally refuse
to urinate in a sitting position.
• She may claim that she has/will grow a penis and
may not want to grow breasts or to menstruate.
• She may assert that she will grow up to be a man.
Such girls typically reveal marked cross-gender
identification in role-play, dreams, and fantasies.
GID Associated Features and Disorders
• Many individuals with GID become socially
isolated.
• Isolation and ostracism contribute to low selfesteem and may lead to school aversion or
dropping out of school.
• Peer ostracism and teasing are especially common
sequelae for boys with the disorder.
• Boys with GID often show marked feminine
mannerisms and speech patterns. (Hand-wrist
inflections, Limp-Wrist, Hand-Clasp, Hyperextension)
Homosexuality
Failure in (Father) Male-Attachment
“Defensive Detachment”
• Object-Relations: Separation-Individuation
– Self-Identity Development: Who-What am I?
– Mom-Son: Physical-Emotional Detachment & Attachment
– Son-Dad: Bonding (Attachment failure: rejection)
– “Rejection = Pain; Detachment = No Pain”
• Son-Dad relationship Disturbance
– ‘Sour Grape’ Syndrome as a defense against more hurts
– Avoids father: No “Aggressiveness-Toughness, etc.”
Failure in (Father) Male-Attachment
“Defensive Attachment” to Mother
(Copyright © Melvin Wong, Ph.D. 2000)
• Homosexuality primarily an Identity Disturbance
• A Disturbance of a person’s Gender Identity
• A Disturbance of the Masculine Identity Development
• Upon failure to Attach (Separation-Individuation task)
– Defensive Detachment from Father
• Son’s resultant yearning for Male attention and affirmation
• Curiosity for the unfamiliar: “Male aspects” of Masculinity ID
– Causing a Defensive Attachement to Mother
• Son’s Masculinity Development became frustrated & stops
• Over familiarity-socialization with females: No “Intrigue”
Masculinity Identity Disturbances
• Victim of sexual abuse: Molestation-rape
• Pre-mature same sex sensitivity & curiosity
• Mixed emotions: Attention-Getting, Pain-Pleasure reversal
• Over-Identification with Mother-Sisters-Aunts
– Over-familiarity: “Know them (women) too well!”
– Suffocation: Enmeshment-Limits & Boundary
– Dislike-Anger-Rage: “family’s emotional baronmeter”
– Role Reversals: “My mother’s keeper!” Misogynist
• Labeling that turns to a “Self-fulfilling prophesy”
– “I am gay” “I behave gay” “Once gay, always gay”
Masculinity Identity Deficits
• “Body Discomfort” Dissatisfaction-rejection: own body
– Self insecurity: Emotional over-sensitivity “cave-ins”
• Rejection of the “Real Self” (Peer dependence)
• Yearning (craving) for the “perfect man body”
• Attraction (obsessing-preoccupation) of Men
• Neurotic need for “Symbolic Union” with
“Man”, “Manhood”, “Symbols of Men”
– Military, Police, Uniform, Power-Predation, Bondage
Treatment Issues
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Factors affecting prognosis
Therapist/Client match
Transference/Counter-transference issues
Object Relations
Nonsexual male relationships
Group therapy
• The role of father and religious support groups
Specific Male Treatment Issues
(Copyright © Melvin Wong, Ph.D. 2000)
Ideations: Reduction of Intrusive Thoughts
• Explain thought origin, validation not encouragement
– Desperate crave for intimacy and acceptance
• Develop insight into precusors of thoughts: HALT
• Re-interpret to reframe the meaning of the thoughts
– Neediness and affirmation needs
• Re-direct thoughts with more competitive thoughts
– Accountability partner-tell a friend
• Medication: SSRI’s (Selective-Serotonin-Reuptake Inhibitors)
– Fluoxetine:Prozac, Sertraline:Zoloft, Paroxetine:Paxil
Specific Male Treatment Issues
(Copyright © Melvin Wong, Ph.D. 2000)
Behaviors: Reduce Mastubation & Acting-Outs
• Goal is to reduce frequency and intensity
• Check-in with client weekly: Accountability
– How did it feel afterwards? “Good but bad!”
• Reduce stimuli: No Cyperporn, chats, media
• Positive-Negative reinforcements
– Commendations, Loss of spouse, rubber-bands
• Medication: Prozac, Zoloft, Paxil help
Specific Male Treatment Issues
(Copyright © Melvin Wong, Ph.D. 2000)
Relational: Increase Male non-sexual friendships
• Reduce same-sex pedestal effect of males
– Develop insight of over-adulation and devaluation
• Develop courage to befriend attractive males
– Sexual-attraction desensitization, ego-stability
– “I’m one of the guys!” “I can’t believe I belong!”
– Learn to keep relationships: reduce jealousy
• Group meetings-activities with guys
– Attend regular self-help groups: EA, SA’s, Exodus
Femininity Identity Crisis & the
Development of Lesbianism
• Great hurts and pains from males
– Fathers who failed or abused them
• Believes mother is weak as a woman
– Rejects self as women; Rejects
womanhood (Pain) as being unsafe
• Sexual abuse-promiscuity resulting in men-hating
• “If I can be a man I will be safe from harm!”
– Multi-layered-loose clothes, “Walk like a man, talks
like a man” “I hate make-up” “It’s oppressive-sexismslave!”
What do Lesbians say about themselves?
• “I’m unhappy with being a woman; it’s weakness”
• “When I discovered the gay bar, I finally came home”
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•
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“I feel like I am a man in a woman’s body”
I don’t need men, I hate-despise them!”
“I am more “homo-emotional” than homosexual”
“Smoking, alcohol and drugs are cool!”
“You don’t understand how we love, it’s better!”
“Women is a stronger sex! Men are weak!”
Specific Treatment Issues for Lesbians
(Copyright © Melvin Wong, Ph.D. 2000)
• Acknowledge-resolve sexual abuse(s)
– Work through pain to develop male-trust again
• Reconciliation with Mother and Father
• Say goodbye to girlfriends
• Attempt to embrace femininism
– Put on a dress? Try cosmetics. Try high heels
• Have feminine affirmation by male-females
• Involve with women’s groups
New Male Behaviors
• Self-Acceptance: Body-Comfort: I’m okay!
• Male-Resocialization: I am one of the guys!
• Mother will be okay if I let her go!
– Mom, do you want a son or a nurse? I can’t be both!
• Accountability Person: No more secrets!
• Female-Resocialization
– From “I want a masculine woman who is not
dependent”
– To “Women can be feminine and they are attractive.”
Emergence of the New-Self
• Overcoming the Expectations of Old Community
– Change always unstablizing: Courage to move on
– Rejection of others: “You have Changed! What happened?”
• Establishing a New Social Paradigm
– Relationships are Neutral-Mutual: Non-Shame based
– Male Non-Sexual Relationships
– Female “Non-Default” Relationships: No more “Safe-Retreats”
– Female Emotional-Physical-Sexual Relationships
• Overcoming Fears: Enmeshment, Physical-Sexual “Space”
• Dependency vs. Initiative Behaviors: “Take a Lead!”
• Making a Commitment: Litmus Test of Enmeshment Resolution
What is Healing & Recovery?
• Presence or Absence of SSA “Orientation”?
– Realistic Expectations: Some Traces of SSA
– Memories Can’t be Completely Obliterated, But
Emotions Can Reduce Significantly
• Degree or Intensity of SSA’s?
– Overwhelming vs. “In Passing” “Non-Dwelling”
• The Recovered vs. The Strugglers
– Addiction Cycles: Presence or Absence?
– Intrusive Thoughts
– Preoccupation & Obsessions
– Secret vs. Honesty
• Litmus Tests: Stressful Times, Unstructured Times
Religious Support Groups
• Exodus International (North-America)
ExodusNorthAmerica.org
ChristianMentalHealth.com
• National Association for Research & Therapy for Homosexuality
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narth.com
Regeneration Books (Exodus Member) 410-661-4337
Courage (Catholic) 212-268-1010
Parents and Friends of Ex-Gays Pfox.org
Evergreen International (Mormoms)
Evergreen-intl.org
Physical-Emotional Intimacy Stages
情感与肉体的親近的階段
1.
2.
3.
4.
5.
6.
7.
8.
聊天 (你好，天气不錯！)
交換信息 (眼光的接触: 電話號碼；地址)
透露喜好及主見 (喜歡吃面條? 米飯？餛飩?)
透露個人情感愛好 (眼神的接触: 我喜歡你！)
承諾:自己開始接受對方(我愛你！不會放棄你！)
開始有社會上接受的身体接觸 (肯定對方!)
較進一步身体的接觸 (摸：手, 臉, 頭髮, 唇, 腰)
性接觸－性關系 (男：將來的關系多集中在性)
“Acting-Out Cycle”
Copyright © Melvin Wong, Ph.D. 2000-2001
Compulsivity
Abuser-Victim
Blame-Shame
Impulsivity
The Physical Intimacy-Orgasmic Cycle
Copyright © Melvin W. Wong, Ph.D. 1997-200 All Rights Reserved
“Intimacy Always Feels Good!”
“Emotional Intimacy Leads to Physical Intimacy!”
“Physical Intimacy Can Lead to Orgasm!”
“Orgasm Always Feels Good!”
“Orgasmic Feeling is Intimacy?”
Physical Intimacy is an Antidote for
Loneliness, Low-Self Worth, Boredom,
Aggression, Anger, Despair, Abandonment
“H.A.L.T. Defeated”
Questions & Answer Time
End of Morning session
Thank you for coming!
Afternoon Session Begins
Working with sexual problems &
temptations
Melvin W. Wong, Ph.D.
Licensed Clinical Psychologist
www.ChristianMentalHealth.com
[email protected]
Overcoming sexual problems and
temptations in marriage
Understanding impact of sex culture on marital relationships
Common problems & temptations
Pornography, masturbation, sexual addiction and promiscuity
in husbands
Emotional dependency in wives
Psychodyanmics of extra-marital affairs: Narcissism &
borderline issues
A protocol of prevention & treatment
Sexuality and intimacy development
Counseling, support groups, accountability & marital
faithfulness
Psychology of Sexual Problems
Sexual problems are the manifestations but
not the causes of psychological issues
Sexual problems are the effects rather than the
causes of psychological issues
Deep-rooted psychological issues cause the
result of sexual problems
(Exception: Medication side-effects)
Types of Adult Sexual Issues
Attempts in Narcissistic Self-Repair
1. Active主動 (Pre-meditated, Planned)
2. Passive被動(Not Consciously-Planned) 外遇
Narcissistic Self-Repair in Sexual Issues
• Self-Esteem Issues: I am Important-Worthy
– I am lovable
– I must not be ignored or abandoned
– I enjoy (crave) attention from pretty women
• Control–Mastery Issues
– It hurts too much to be unloved
– I must love myself (Egotism-Narcissism)
– I will succeed in intimacy striving myself
Types of Adult Sexual Issues
Attempts in Narcissistic Self-Repair
1. Active主動 (Pre-meditated, Planned)
2. Passive被動(Not Consciously-Planned) 外遇
1.
2.
3.
4.
5.
Neediness: Push-Pull effect 婚外情(戀)
Pain Reduction: Escape from suffering
Opportunistic: Put self in vulnerable situation
Object of “love” obsession: Your “fan” 迷戀
“Trapped” to be destroyed: Revenge driven
Active 主動 (Pre-meditated, Planned)
Pedophiles (Child-Molesters) 愛童坯
• Exploitative-Oppressive Expressions
• Can be seen in early teenage years
• Two groups
– Married with children: Socialized other
problems (Money: borrowing, embezzle)
– Single: Isolated & under-or-unsocialized
• The most dangerous group if smart & charismatic
• Have serial marriage, as rapists & serial killers
Passive 被動 (Not Planned) 外遇
Neediness: Push-Pull effect 婚外情(戀)
Pull Effects (External factors) 外面拖力量
1. Post-modernism in the 21st century
2. Sex culture in post-modernist life
3.
Media: TV, movies, video programs, advertising
4. Why? “Sex sells!” Visual stimulation of men
Push Effects (Internal factors) 內在推力量
1. Unsatisfied marital relationship: Mid-life crisis
2. Career Disillusions: Sense of failure
3. Children’s birth & growth: empty nest
Passive 被動 (Not Planned) 外遇
Pain Reduction: Escape from suffering
1.
2.
3.
4.
5.
6.
Neediness: Push Effect 婚外情(戀)
Doubted marriage decision was a good one
Wife is not supportive: Source of frustration
Marital relationship maintained: But unhappy
Conflicts are denied: No skill to resolve or repair
With increased responsibilities: More frustration
Unassertive husband bears pain & wished it ends
7.
Novelty extra-marital relationship: No history, New
Passive 被動 (Not Planned) 外遇
1. Opportunistic: Put self in vulnerable situation
2. Unaware of limits & boundaries
1. Adult-child of dysfunctional family
1. Physically, emotionally or sexually abused
2. Unhealthy emotional limits; greed 貪欲
3. Too much disclosure of personal-marital issues
4. Unable to say “no” to women’ excessive self disclosure
5. Tangled in dual relationships: “church secretary”
3. Can’t say no to pretty women: Pedestal effect
1. Wife has a bad history: This woman does not
2. This woman is younger & prettier: “There’s hope”
Passive 被動 (Not Planned) 外遇
1. Object of “love” obsession: Your “fan” 迷戀
2. Secret admirer: Relationship in the “mind”
3. You are object of an emotional transference
1. An “ideal” husband that should be or have been
2. An “ideal” father who is loving and warm
3. An “old boy friend” who was nicer than spouse
4. She “loves” you to avenge your wife for “it is
not fair” because “she’s too lucky”
Passive 被動 (Not Planned) 外遇
“Trapped” to be destroyed: Revenge driven
1. Woman is a “men-hater”: Conquer them!
2. Power & control expressed by woman
1. Usually very attractive, show-off & intelligent
2. Casual & easy sex: To “catch” you
1. Uses relationship as black-mail
2. Uses relationship or “pregnancy” to black-mail
3. “Part-time” relationship better than no relationship
3. Unusual reason: Spiritual warfare?
Types of Adult Sexual Issues
• Reduced sexual desires for spouse: Age vs. health
• Spouse unwilling to satisfy sexual desire
• Pornography preoccupies your life
• Masturbation into marriage: Spouse unaware
•
•
•
•
Sexual attraction to female other than your wife
Sexual experience with woman in your church
Sexual experience with your wife’s best friend
Same-sex feelings that do not go away with prayer
Physical-Emotional Intimacy Stages
情感与肉体的親近的階段
1.
2.
3.
4.
5.
6.
7.
8.
聊天 (你好，天气不錯！)
交換信息 (眼光的接触: 電話號碼；地址)
透露喜好及主見 (喜歡吃面條? 米飯？餛飩?)
透露個人情感愛好 (眼神的接触: 我喜歡你！)
承諾:自己開始接受對方(我愛你！不會放棄你！)
開始有社會上接受的身体接觸 (肯定對方!)
較進一步身体的接觸 (摸：手, 臉, 頭髮, 唇, 腰)
性接觸－性關系 (男：將來的關系多集中在性)
The Physical Intimacy-Orgasmic Cycle
Copyright © Melvin W. Wong, Ph.D. 1997-200 All Rights Reserved
“Intimacy Always Feels Good!”
“Emotional Intimacy Leads to Physical Intimacy!”
“Physical Intimacy Can Lead to Orgasm!”
“Orgasm Always Feels Good!”
“Orgasmic Feeling is Intimacy?”
Physical Intimacy is an Antidote for
Loneliness, Low-Self Worth, Boredom,
Aggression, Anger, Despair, Abandonment
“H.A.L.T. Defeated”
Percentage of Those Seeking Sexual
Fulfillment on the Internet Zogby International)
(
• Focus on the Family recently conducted
a survey with Zogby International
• Indicating that 1 out of 5 American adults
may have looked for sex on the Internet
– 20.8% of respondents to a March 8-10,
2000 survey admitted they had visited a
sexually-oriented Web site
Percentage of Those Seeking Sexual
Fulfillment on the Internet Zogby International)
(
• The percentage of those viewing sex sites
was higher among males and young
adults.
• 31% of men surveyed said they had
visited sex sites and
– 37% of 18-24 year olds gave that response
Percentage of Those Seeking Sexual
Fulfillment on the Internet Zogby International)
(
• Of interest to Focus on the Family was the fact that
–17.8% of those who claim to be
"born again" Christians
– and 18% of those who are married have also
viewed sex sites.
• In a follow-up question, nearly two-thirds of
American adults thought it wasn't likely that
sexual fulfillment could be found online
一般華人婚外情(戀)的心理特色
男性: 自戀的個性
(自我無限化)
女性 : “邊緣” 的個性
(心理焦慮与精神崩潰的邊緣)
Narcissism Features
•
•
•
•
•
•
•
Over Self-Evaluation: “False Self-Confidence”
Exploitation of others in name of ministry
Entitlement: Self-expectations of special treatment
Narcissistic Injury: Rage when criticized
Lacks Empathy: “Bad Taste Humor” Can’t comfort
Preoccupation with Envy: “They compare”
Absence of Guilt & Introspection
Dealing with unhealthy defenses
• Intellectualization 思考化 : “If I can think
about it and it is logical, it must be right”
• Rationalization 合理化 : “It is reasonable,
therefore it must be right”
• Spiritualization 屬靈化 : “There is a
Biblical support, therefore it must be right”
• Justification 辯護化 : “Therefore, it is right
and no one can challenge me!”
• Accountability & Counseling: “Check reality”
Over-Coming The Pitfalls
• Build Friendships: Dual Relationships &
Boundaries. Can you have a church buddy?
– Learn to establish intimate relationships: Vulnerability
– Variety of friendships, no dual relationships
– Friend to your Spouse & Children
• Balance of Rational-Emotional Awareness
• Accountability Group: Other pastors, counselor
• Get Personal Counseling for self: Confidentiality
Understanding Sexual Addiction
Gender Differences in Sexual Addiction
• Predominantly more males than females
– It is true that this is a “Men’s Problem” of the millennium
• Men are more visually-oriented: Response
to visual cues
• Men are more Goal-Task oriented: Quick
fixes; Immediate gratification
• Reversal of “Love” with “Sex” Intimacy as
always sexual
Percentage of Those Seeking Sexual
Fulfillment on the Internet Zogby International)
(
• Focus on the Family recently conducted
a survey with Zogby International
• Indicating that 1 out of 5 American adults
may have looked for sex on the Internet
– 20.8% of respondents to a March 8-10,
2000 survey admitted they had visited a
sexually-oriented Web site
Percentage of Those Seeking Sexual
Fulfillment on the Internet Zogby International)
(
• The percentage of those viewing sex sites
was higher among males and young
adults.
• 31% of men surveyed said they had
visited sex sites and
– 37% of 18-24 year olds gave that response
Percentage of Those Seeking Sexual
Fulfillment on the Internet Zogby International)
(
• Of interest to Focus on the Family was the
fact that
–17.8% of those who claim to be
"born again" Christians
– and 18% of those who are married have also
viewed sex sites.
• In a follow-up question, nearly two-thirds of
American adults thought it wasn't likely that
sexual fulfillment could be found online
Root Causes of General Addictions
• Dysfunctional-Abusive family
– Rigidity & perfectionism: Can’t fail
Family Tree Diagram
Father
Mother
Daughter
Son-1
Son-2
Casts of the Dysfunctional Family
Addict
Adult-child:
Man with
problems;
Gambling,
affairs, rage &
irresponsibility
Enabler
1
2
3
4
Survival for me
5
Mother who
helps hide
husband’s
serious
problems
Casts of the Dysfunctional Family
Addict
Enabler
1
2
3
4
5
Keep the peace: Survival for me
Mother who
is trying to
be the UN
PeaceKeeper:
Hoping
things will
not go out of
her control
Casts of the Dysfunctional Family
Addict
Enabler
Win-Lose
1
2
3
4
5
Rivalry
Detach
Hero
Be Perfect: Problems will go away
I want to be hero too! I am worthy
Casts of the Dysfunctional Family
Addict
Enabler
1
2
3
4
5
Scapegoat
Rebel: Believing I am the problem
Casts of the Dysfunctional Family
Addict
Enabler
1
2
3
4
5
Lost Child
Withdraws from Relationships: Numb
Casts of the Dysfunctional Family
Addict
Enabler
1
2
3
4
5
Clown
Makes laughter admist family tragedy
Casts of the Dysfunctional Family
Adapted from:
Sharon Wegscheider-Cruse, 1985, Health Communications, FL
Enabler: Tries to control to make things OK
Hero: Be perfect & problems will go away
Scapegoat: Rebel against family problems &
then finally believing that s/he is the problem
Lost Child: Retreats, withdraws & isolates
self from meaningful relationships
Mascot (Clown): Desperately makes everyone
laugh admist the family tragedy. Pampered
Root Causes of General Addictions
• Dysfunctional-Abusive family
– Rigidity & perfectionism: Can’t fail
– Enmeshment between family members
• Can’t talk about emotions
– Denial of feelings
– Re-labeling-Minimizing your feelings by adults
• Ineffective, non-satisfying social relationships
循環型家庭分配圖
低
凝聚力
高
循環型家庭分配圖
High
A
d
a
p
t
a
b
i
l
i
t
y
Low
低
凝聚力
高
循環型家庭分配圖
High
A
d
a
p
t
a
b
i
l
i
t
y
Low
低
凝聚力
彈性地
連接
高
循環型家庭分配圖
High
A
d
a
p
t
a
b
i
l
i
t
y
Low
低
凝聚力
彈性地
連接
結構地
連接
高
循環型家庭分配圖
High
A
d
a
p
t
a
b
i
l
i
t
y
Low
低
凝聚力
彈性地
分離
彈性地
連接
結構地
連接
高
循環型家庭分配圖
High
A
d
a
p
t
a
b
i
l
i
t
y
Low
低
凝聚力
彈性地
分離
彈性地
連接
結構地
分離
結構地
連接
高
循環型家庭分配圖
High
A
d
a
p
t
a
b
i
l
i
t
y
Low
低
凝聚力
混亂地
連接
彈性地
分離
彈性地
連接
結構地
分離
結構地
連接
高
循環型家庭分配圖
High
A
d
a
p
t
a
b
i
l
i
t
y
Low
低
凝聚力
高
混亂地
連接
彈性地
分離
彈性地
連接
結構地
分離
結構地
連接
彈性地
纏結
循環型家庭分配圖
High
A
d
a
p
t
a
b
i
l
i
t
y
Low
低
凝聚力
高
混亂地
連接
彈性地
分離
彈性地
連接
結構地
分離
結構地
連接
硬化地
連接
彈性地
纏結
循環型家庭分配圖
High
A
d
a
p
t
a
b
i
l
i
t
y
Low
低
凝聚力
高
混亂地
連接
彈性地
分離
彈性地
連接
彈性地
纏結
結構地
分離
結構地
連接
結構地
纏結
硬化地
連接
循環型家庭分配圖
High
A
d
a
p
t
a
b
i
l
i
t
y
Low
低
凝聚力
高
混亂地
分離
混亂地
連接
彈性地
分離
彈性地
連接
彈性地
纏結
結構地
分離
結構地
連接
結構地
纏結
硬化地
連接
循環型家庭分配圖
High
A
d
a
p
t
a
b
i
l
i
t
y
Low
低
彈性地
脫離
凝聚力
高
混亂地
分離
混亂地
連接
彈性地
分離
彈性地
連接
彈性地
纏結
結構地
分離
結構地
連接
結構地
纏結
硬化地
連接
循環型家庭分配圖
High
A
d
a
p
t
a
b
i
l
i
t
y
Low
低
彈性地
脫離
凝聚力
高
混亂地
分離
混亂地
連接
彈性地
分離
彈性地
連接
彈性地
纏結
結構地
分離
結構地
連接
結構地
纏結
硬化地 硬化地
分離 連接
循環型家庭分配圖
High
A
d
a
p
t
a
b
i
l
i
t
y
Low
低
彈性地
脫離
凝聚力
高
混亂地
分離
混亂地
連接
混亂地
纏結
彈性地
分離
彈性地
連接
彈性地
纏結
結構地
分離
結構地
連接
結構地
纏結
硬化地 硬化地
分離 連接
循環型家庭分配圖
High
A
d
a
p
t
a
b
i
l
i
t
y
Low
低
彈性地
脫離
凝聚力
高
混亂地
分離
混亂地
連接
混亂地
纏結
彈性地
分離
彈性地
連接
彈性地
纏結
結構地
分離
結構地
連接
結構地
纏結
硬化地 硬化地
分離 連接
硬化地
纏結
循環型家庭分配圖
High
A
d
a
p
t
a
b
i
l
i
t
y
Low
低
混亂地
脫離
彈性地
脫離
凝聚力
高
混亂地
分離
混亂地
連接
混亂地
纏結
彈性地
分離
彈性地
連接
彈性地
纏結
結構地
分離
結構地
連接
結構地
纏結
硬化地 硬化地
分離 連接
硬化地
纏結
循環型家庭分配圖
High
A
d
a
p
t
a
b
i
l
i
t
y
Low
低
混亂地
脫離
彈性地
脫離
硬化地
脫離
凝聚力
高
混亂地
分離
混亂地
連接
混亂地
纏結
彈性地
分離
彈性地
連接
彈性地
纏結
結構地
分離
結構地
連接
結構地
纏結
硬化地 硬化地
分離 連接
硬化地
纏結
循環型家庭分配圖
High
A
d
a
p
t
a
b
i
l
i
t
y
Low
低
凝聚力
高
混亂地
分離
混亂地
連接
混亂地
纏結
彈性地
脫離
彈性地
分離
彈性地
連接
彈性地
纏結
硬化地
結合
結構地
分離
結構地
連接
結構地
纏結
硬化地 硬化地
分離 連接
硬化地
纏結
混亂地
脫離
硬化地
脫離
Abuse & Addictions
• Chemical Dependency
42%
• Eating Disorder
36%
• Compulsive Work
27%
• Compulsive Spending
26%
• Gambling
• Sexual Addiction
5%
?
Proximal Causes of Sexual Addiction
Premature Sexual-Genital Familiarization
Over-exposure to adult pornographic materials
• “My dad’s Playboy magazine”
• “My uncle’s books under his bed or mattress”
• “One day I found a stash of magazine in my
neighbor’s trash”
• “I watched HBO after my parents went to sleep”
• “I watched mom having sex with her boyfriend”
Immediate Causes of Sexual Addiction
Child was a victim of sexual violation
• Molestation-Fondling: Culture specific
(Sexual curiosity of adults in Asian ethnic groups)
• Men’s sexual curiosity over self: Projected on children
• Men exposed self to children: To satisfy
“something” about themselves
• Servant-Maid: “Bathing a toddler”
• Sexual arousal as a way to soothe a child
Direct Causes: Biology & Psychology
• Behavioral: Stimulus-Response Cycle
– Boredom: Social-Interpersonal Isolation
– Excitation: Immediate Gratification
– Stimulus-Response: Emotional Reminders
• Habit-Forming Behaviors
– Cigarettes smoking
– Rage: Temper Tantrums
• Relaxation Cycles
– Physiological Arousal & Rest States
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?
•
•
•
•
•
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
10 Types of Sex Addicts
(After Patrick Carnes, Ph.D.)
1. Fantasy Sex
2. Seductive Role
Sex (dress)
3. Voyeuristic Sex
4. Intrusive Sex
(obscene calls)
5. Exhibitionism
6. Sex Trading
7. Anonymous
Sex
8. Paying For Sex
(Prostitution)
9. Pain Exchange
10.Exploitive Sex
Some Theories Explaining
Addiction Dynamic
To Follow
The Physical Intimacy-Orgasmic Cycle
Copyright © Melvin W. Wong, Ph.D. 1997-200 All Rights Reserved
“Intimacy Always Feels Good!”
“Emotional Intimacy Leads to Physical Intimacy!”
“Physical Intimacy Can Lead to Orgasm!”
“Orgasm Always Feels Good!”
“Orgasmic Feeling is Intimacy?”
Physical Intimacy is an Antidote for
Loneliness, Low-Self Worth, Boredom,
Aggression, Anger, Despair, Abandonment
“H.A.L.T. Defeated”
The Addiction
(After Patrick Carnes, Ph.D. & Steven Arterburn, M.S.)
1. Craving to get emotionally intimate with
others
2. Mental-Emotional-Visual Triggers
3. Repression of Pain with Immediate
Sexual Longing
4. Fantasy Development-Planning
Begins (Thrilling)
5. The Hunt (The Intrigue)
The Addiction
(After Patrick Carnes, Ph.D. & Steven Arterburn, M.S.)
6.
The Connection (“Rush” Altered state of awareness)
7. The Act (Under-Control: Impulsivity: Binge)
8. The Fulfillment (Orgasm: Feeling Dissociation)
9. The Let-Down (Self-Blame: Numbness)
10. The Vow (Over-Control: Compulsivity:
Rigidity)
11. The Cycle Returns again (Deprivation Sets-In)
“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
“Acting-Out Cycle”
Copyright © Melvin Wong, Ph.D. 2000-2001
Compulsivity
Abuser-Victim
Blame-Shame
Impulsivity
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”
Addiction is a 1st order
problem: The harder you try
to control, the worse it gets
Second Order Change
• Powerlessness
• Community
Involvement
• No Secrets
• Disclose full Story
• 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