ࡱ> b( v/ 0DTimes New RomanNbbv 0b( 0<De0}fԚ New RomanNbbv 0b( 0< DjwiԚ New RomanNbbv 0b( 0<A0DMonotype SortsNbbv 0b( 0t@DWingdingsortsNbbv 0b( 0<PDArial BlacktsNbbv 0b( 0<"`DArialBlacktsNbbv 0b( 0<"pDSymbollacktsNbbv 0b( 0<DArial Unicode MSbbv 0b( 0" ` .  @n?" dd@  @@`` nf ru+Gn *gi mjklf]a`dbc^eop_(GH   )*+,-./01234KI6789:;<=>?@ABCDrstuv F5Ehqwxyz{|}~#$% L  S ~1? f3f@g4<d<dv 0bnppp@  uʚ;Mgʚ;<4!d!db{ 0bb<4ddddb{ 0bb<4cdcdb{ 0bbH@___PPT9"{b20 +/( ,H$Pho ors? 5O =l<6*Working with sexual problems & temptations +*@BOKSS & YMCA July 20, 2001 Melvin W. Wong, Ph.D. Licensed Clinical Psychologist www.ChristianMentalHealth.com Students@ChristianMentalHealth.com3F=P#Zdfdfdd dd#f  J9Overcoming sexual problems and temptations in adolescents&:Z9` 9 nUnderstanding 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 datingtQo%oob9bbn ^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) P ev'`eS`R c6  l/vtWy+(TR N) ckxce + (TR N) rqvWL (I{N) = Ne No PNv[^`R+ lZ xc6c,c c<c$c<cBc(cBc0 c07 ev'`eS`R c6   /vtWy+ ckxce + spLR == Ne Nov PNv[^`R___________________________________________________________________ n [OUL ---- '`u ---- anu n iQKN@\ݑR{NcS[hQWYR>mR ;?e^Kbcqf}YsY 2{rTOr n[hQ'`Lp1uYebcRvZr<<<c c(c c(Dgc aa a  a  a  c  a  a acct/ D     '   R 0^7ui[SNz NsY g Nx[ 0 ^l^zl PNNvhT1u/fg͑vOHQ*Zg$g g g$gc$*   2000t^10g13elX1X\ 0l[[!he NQ  yY Nx[/f gUyY PNNvhT1u0 0 0!he\g N4 l[pNsY T'`b x[z/f P15t^rk7ui[0 0 0x[!h{td\r7uzsY gdNy^0 0 0u\OI7ui[ g'`%RmmOUL csY g/fWex[ N0 0rcccqcc  ev'`eS`R c6   qgeeS(WX NvR%R l e v}b_v t'`v WIS['` Ee>e1~1u}Y PSl6R^iQebdN[  YTtO \ lqge wkS'`v Pq}livzfga , O[b_v l eO` gLrv\[ l qgezfv_\ &  c e eacaa& a ag geec a a cg gcv  6        ev'`eS`R c6  , l 0'`a g'Y^4X 0: r`q_SWGr laccca@     !ev'`eS`R c6 l 0'`a g'Y^4X 0: r`q_SWGr l sY'`'`aa_S0sirS0pef \a n '`fR7_Y}gBf ZZY-N n #tkKbS>ygKa*`Nccccccccc cch         (ev'`eS`R c6 l 0'`a g'Y^4X 0: r`q_SWGr l sY'`'`aa_S0sirS0pef \a n '`fR7_Y}gBf ZZY-N n #tkKbS>ygKa*`N l 7u'`/fd[hsvzhvN l TE\ZZs NGS l [^fRPz l x[WfR!q[^nfJccccccccc ccc$c cc$c cccc c                    )UO 0 PNԚ?el 02 c0g0   nNSvXSgk ( T'`b)  Owb  PN yS % Ye WbX΀TlS % }}] R] [LanuN{v6R On\fW(u b PNb l;NS b PNb 1u^d'YS %5c ccccc-ccw * UO 0 PNԚ?el 0H g0 c0g0  \O;N  /fb] bv[a Nck8^v'`STUONg;N0Wc }u󁫈c_y󁫎Ԛ]b0Wek - ukS'`STvy k - ޖY/f PNvN T'`b%RN!qm - '`P_ '`u/f\WP[vN - bz^ Yg \e__j _N/f PNvN1$.c cc cc$c.c +_sN;N/fu@ c0ae   (WS_WgQ&N!qU} \ % /fU} \wt U} \y k01u k PNԚl;NS 0[a0'`a/fgؚ!q N 0*`pu0KaU}Y/f[1v S`O_-N_0Rj 0 PNԚ?elSg0LRT[0X΀0[j{k0 T'`ZZ eSSSl;NvcU\ Pq}v'`_Nh \%RNvXnBnKcccccAa ccca .(Michel Foucault0v'`t_a  >'`_vli jؚ }Y)RNBfN'`t_ = '`~avX6RD  c,c,c(  / '`_vli2c6g6 . X6R'`~a N \}Y)RNBfN %0'`>e/f}Y; '`vXb?el kR '`/fN k - s(Wl;N _m O_ (Freud) \'`SutvGP- vr \'`v֊ = ?el kR '` N/fa % a/fNvv '`/fbv % '`!q ga _N!q g \a % ckYߘ~a !q{6R F nZ@Z nZ0Zg f3cac$9aaac cac cac,c(A  P 0_sNBfNyrޞ2c0g0  x[_?e ?elxvz g)Rv]zKN^ `\(Allan Bloom)0 ;NUN [ NQ '`~a^yVX΀0 T'`b0 [j{k0ٖ͑jn 0 ؚ]2eQa_^4XZ\Zc& c&c&c&c&c&c& c&c&c&c& c&4!   9 -ev'`eS`R c6  l/vtWy+(TR N) ckxce + (TR N) rqvWL (I{N) = Ne No PNv[^`R+ lZ xc6c,c c<c$c<cBc(cBc0 c07 1 Sex EducationrFirst impression is the most important Formative years of a child Parents should be equipped to educate children School should be the secondary source Media should be the tertiary source if at all The church should equip parents Pulpit should address issues of sex education Do more than just condemn: Provide an alternative Sunday school materials and workshop training'ZZ Z.Z2Z.Z' .2.2 Sex EducationParents can talk about specific issues of sex Teen pregnancy: Causes and effects & solution Abortions and Abstinence: Peer group support Contraceptives: Only at a mature age Not in a co-ed fashion: Respect modesty of sexes Not given in a crass manner as if to encourage & challenge teens to engage in immature sexual acts Teach EQ: Delay gratification skills (pain?) Practice good judgment skill in decision makingj.].-/<Sexuality & Gender 3(Gender Identity Disorder An Introduction))  99 Melvin W. Wong, Ph.D. Licensed Clinical Psychologist www.ChristianMentalHealth.com 220 Montgomery St., Suite 1098, San Francisco, CA 94104 1357 Mowry Avenue, Fremont, CA 94538 Tel (510) 794-8898 Fax (510) 475-1473 PZ     ,43Resource & References www.ChristianMentalHealth.com 4$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. 1994ZknZ0(,-) ;$9  ,5!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.:?S \,d6?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. xZP5ZZT 4 7GID 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 cross-gender behaviors with time, parental intervention, or response from peers. \Z ""4"0 2"8GID Age of OnsetBy late adolescence or adulthood, about three-quarters 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. ZZ"k"L";GID Manifestations in BoysIn 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. PNZQPy"4"8"1"N"P"<GID Manifestations in BoysThey 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.2ZP"=GID Manifestations in BoysThey 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.6Z"k"">GID Manifestations in GirlsGirls 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. &Z"?GID Manifestations in Girls7These girls prefer boys as playmates, with whom they share interests in contact sports, rough-and-tumble 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. &8P6"@%GID Associated Features and Disorders&&"$Many individuals with GID become socially isolated. Isolation and ostracism contribute to low self-esteem 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)2ZF"A Homosexuality PtFailure in (Father) Male-Attachment  Defensive Detachment ";$('Object-Relations: Separation-Individuation Self-Identity Development: Who-What am I? Mom-Son: Physical-Emotional Detachment & Attachment Son-Dad: Bonding (Attachment failure: rejection)  Rejection = Pain; Detachment = No Pain Son-Dad relationship Disturbance  Sour Grape Syndrome as a defense against more hurts Avoids father: No  Aggressiveness-Toughness, etc. +Z"i+ *,)+"hQFailure in (Father) Male-Attachment  Defensive Attachment to Mother (Copyright Melvin Wong, Ph.D. 2000).l$("'& 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 |Z!{*s\k!{*s  w }R!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 UFhZZ4Z1ZU :.0*4041 B > SMasculinity 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, Bondage6745 6],K 4UTreatment IssuesFactors affecting prognosis Therapist/Client match Transference/Counter-transference issues Object Relations Nonsexual male relationships Group therapy The role of father and religious support groups 0VESpecific Male Treatment Issues (Copyright Melvin Wong, Ph.D. 2000).F*"& 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+5,e 2%=7+ 5,e 2  %  B+B7B,  MWESpecific Male Treatment Issues (Copyright Melvin Wong, Ph.D. 2000).F*"& 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,ZVZ,ZMZ,Z'Z,V,M,' 0XESpecific Male Treatment Issues (Copyright Melvin Wong, Ph.D. 2000).F*"& >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, Exodus1Z)Z2Z-ZZ$Z2Z1)2-$  1Y: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-sexism-slave! "P"P#P@P_ZrZ"$" # @ _r  Z&What do Lesbians say about themselves?''$ I m unhappy with being a woman; it s weakness  When I discovered the gay bar, I finally came home  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! .g06[LSpecific Treatment Issues for Lesbians (Copyright Melvin Wong, Ph.D. 2000)"M'%& HAcknowledge-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 groupsn$Z.Z_Z.ZFZ$._.F\New Male BehaviorsSelf-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. |{Z4Z(ZPjZ{3(j]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 -PgP#PPZ,/8# P</6  4  ;  ^What is Healing & Recovery?@TPresence 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*F{PF-F!<h<2<*D+DOFDD,FD!DhD2F_Religious Support GroupsLExodus International (North-America) ExodusNorthAmerica.org ChristianMentalHealth.com National Association for Research & Therapy for Homosexuality 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%P1P?Z PP<% 1F ?BF FBBLB F"BF>zZPhysical-Emotional Intimacy Stages`aNSOvяvk2."f( e("    jJ)Y (`O}Y )Yl N/) NcOo` (eh`O) Y g>yg NcSvSOc ([ \e!) 2NekSOvc (xdKb, Ɂ, -, U, p) '`c '`ܕ| (7u\Ovܕ|YƖ-N(W'`)& "  " ff%f ff f f fff f3f3ffff6     bv Acting-Out Cycle Copyright Melvin Wong, Ph.D. 2000-2001*<( Compulsivity ImpulsivityzcThe Physical Intimacy-Orgasmic Cycle Copyright Melvin W. Wong, Ph.D. 1997-200 All Rights Reserved$d%%?v Intimacy Always Feels Good!  Emotional Intimacy Leads to Physical Intimacy!  Physical Intimacy Can Lead to Orgasm!  Orgasm Always Feels Good!  Orgasmic Feeling is Intimacy? Physical Intimacy is an Antidote for Loneliness, Low-Self Worth, Boredom, Aggression, Anger, Despair, Abandonment  H.A.L.T. Defeated TZFPbZCQuestions & Answer Time. End of Morning session Thank you for coming!0/((T  Afternoon Session Begins$(O*Working with sexual problems & temptations +*@vMelvin W. Wong, Ph.D. Licensed Clinical Psychologist www.ChristianMentalHealth.com Students@ChristianMentalHealth.comF=F#Zdfdd dd#f w N6Overcoming sexual problems and temptations in marriage&7Z6` 6 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 faithfulnessT[o%eob _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) P Types of Adult Sexual IssuesAttempts in Narcissistic Self-Repair Active;NR (Pre-meditated, Planned) PassiveR(Not Consciously-Planned) YGJ%H " Z%+>+!)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 myselfP*\s*\s3Types of Adult Sexual IssuestAttempts in Narcissistic Self-Repair Active;NR (Pre-meditated, Planned) PassiveR(Not Consciously-Planned) YG Neediness: Push-Pull effect ZZY`(b) Pain Reduction: Escape from suffering Opportunistic: Put self in vulnerable situation Object of  love obsession: Your  fan b  Trapped to be destroyed: Revenge drivend%H " Z " %+b+!+DActive ;NR (Pre-meditated, Planned) # $Pedophiles (Child-Molesters) azoW Exploitative-Oppressive Expressions Can be seen in early teenage years Two groups Married with children: Socialized other problems (Money: borrowing, embezzle) Single: Isolated & under-or-unsocialized The most dangerous group if smart & charismatic Have serial marriage, as rapists & serial killers|!ZRFOF)ZbZ!$R$O )  b-6Passive R (Not Planned) YG,Neediness: Push-Pull effect ZZY`(b) Pull Effects (External factors) YbbRϑ Post-modernism in the 21st century Sex culture in post-modernist life Media: TV, movies, video programs, advertising Why?  Sex sells! Visual stimulation of men Push Effects (Internal factors) gQ(WcRϑ Unsatisfied marital relationship: Mid-life crisis Career Disillusions: Sense of failure Children s birth & growth: empty nest#" Z&F " F&F~ " F#    , /,      L >$6Passive R (Not Planned) YG$"Pain Reduction: Escape from suffering Neediness: Push Effect ZZY`(b) 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 Novelty extra-marital relationship: No history, NewVD" ZN " Z&$4=R6Passive R (Not Planned) YG$Opportunistic: Put self in vulnerable situation Unaware of limits & boundaries Adult-child of dysfunctional family Physically, emotionally or sexually abused Unhealthy emotional limits; greed 2k Too much disclosure of personal-marital issues Unable to say  no to women excessive self disclosure Tangled in dual relationships:  church secretary Can t say no to pretty women: Pedestal effect Wife has a bad history: This woman does not This woman is younger & prettier:  There s hope O " P$ " P " P. " P] " P0$F `/72.  \*  #6Passive R (Not Planned) YG$Object of  love obsession: Your  fan b Secret admirer: Relationship in the  mind You are object of an emotional transference An  ideal husband that should be or have been An  ideal father who is loving and warm An  old boy friend who was nicer than spouse She  loves you to avenge your wife for  it is not fair because  she s too lucky N "  " S " S$(/!6Passive R (Not Planned) YG$ Trapped to be destroyed: Revenge driven Woman is a  men-hater : Conquer them! Power & control expressed by woman Usually very attractive, show-off & intelligent Casual & easy sex: To  catch you Uses relationship as black-mail Uses relationship or  pregnancy to black-mail  Part-time relationship better than no relationship Unusual reason: Spiritual warfare?*" ZI " P0 " P" " Z " Z# " P* I0"  /5#Types of Adult Sexual IssuesReduced 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`gZ2* " 2ZPhysical-Emotional Intimacy Stages`aNSOvяvk2."f( e("    jJ)Y (`O}Y )Yl N/) NcOo` (eh`O) Y g>yg NcSvSOc ([ \e!) 2NekSOvc (xdKb, Ɂ, -, U, p) '`c '`ܕ| (7u\Ovܕ|YƖ-N(W'`)& "  " ff%f ff f f fff f3f3ffff6     cThe Physical Intimacy-Orgasmic Cycle Copyright Melvin W. Wong, Ph.D. 1997-200 All Rights Reserved$d%%?v Intimacy Always Feels Good!  Emotional Intimacy Leads to Physical Intimacy!  Physical Intimacy Can Lead to Orgasm!  Orgasm Always Feels Good!  Orgasmic Feeling is Intimacy? Physical Intimacy is an Antidote for Loneliness, Low-Self Worth, Boredom, Aggression, Anger, Despair, Abandonment  H.A.L.T. Defeated TZFPbZThe Physical Intimacy-Orgasmic CycleSOvя'`Nؚnov_t (Copyright Melvin Wong, Ph.D. 2000)pZ$f% eg%f%&f @$    % [a/fgz}Yv SOvя_~a_n ~a__'`vؚno '`ؚno_naCN}Y '`vؚnoa[ܕ|a/fgz}Yv '`ؚnoS!qaX0Wzl d[[ bNO NUN u&P ;ed'` a` 1Yg zha +cWea|>Z,P de.d d"di  TPercentage of Those Seeking Sexual Fulfillment on the Internet (Zogby International):U?b b bFocus 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 sitejninIb#b"Df"hbBTPercentage of Those Seeking Sexual Fulfillment on the Internet (Zogby International):U?b b bThe 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 response4*b"*b  TPercentage of Those Seeking Sexual Fulfillment on the Internet (Zogby International):U?b b b0Of 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 online6Z8Z>4bb 8f*>f b  B 0 N,NZZY`(b)v_tyrrF*$^7u'`: bv P'` (b!qPS) sY'` :  } v P'` (_t&qnaN|^y)]pov})F6F6F6F,F6F6 F6F,~ mNarcissism 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 & Introspectionb/6'7"I'Dealing with unhealthy defenses Intellectualization `S :  If I can think about it and it is logical, it must be right Rationalization TtS :  It is reasonable, therefore it must be right Spiritualization l\HS :  There is a Biblical support, therefore it must be right Justification wS :  Therefore, it is right and no one can challenge me! Accountability & Counseling:  Check reality "eZSPQCKf(Over-Coming The PitfallsaBuild 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: ConfidentialityTQQ9O(a!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>&<&<aTPercentage of Those Seeking Sexual Fulfillment on the Internet (Zogby International):U?b b bFocus 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 sitejninIb#b"Df"hbBbTPercentage of Those Seeking Sexual Fulfillment on the Internet (Zogby International):U?b b bThe 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 response4*b"*b  cTPercentage of Those Seeking Sexual Fulfillment on the Internet (Zogby International):U?b b b0Of 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 online6Z8Z>6b 8f*>f b  B 0 d!Root Causes of General Addictions""*Dysfunctional-Abusive family Rigidity & perfectionism: Can t fail,n%n%"Family Tree Diagram ,DF( #!Casts of the Dysfunctional Family""F+D $!Casts of the Dysfunctional Family""F+D %!Casts of the Dysfunctional Family""F+D &!Casts of the Dysfunctional Family""F+D '!Casts of the Dysfunctional Family""F+D (!Casts of the Dysfunctional Family""F+D )iCasts of the Dysfunctional Family Adapted from: Sharon Wegscheider-Cruse, 1985, Health Communications, FLdj!F+fFfFF!FREnabler: Tries to control to make things OK Hero: Be perfect & problems will go away Scapegoat: Rebel against family problems & then finally believing that s/he is the problem Lost Child: Retreats, withdraws & isolates self from meaningful relationships Mascot (Clown): Desperately makes everyone laugh admist the family tragedy. PamperedtSZ%$ Q CF.7!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 relationshipspnGnnBn1nGB189:;<=>?@ABCDEFGHIeAbuse & AddictionsChemical Dependency 42% Eating Disorder 36% Compulsive Work 27% Compulsive Spending 26% Gambling 5% Sexual Addiction ?x$f#Proximal Causes of Sexual Addiction"$&&rPremature 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 WZ.x)F!.F -= /.g$Immediate Causes of Sexual Addiction"% &&Child was a victim of sexual violation Molestation-Fondling: Culture specific (Sexual curiosity of adults in Asian ethnic groups) Men s sexual curiosity over self: Projected on children Men exposed self to children: To satisfy  something about themselves Servant-Maid:  Bathing a toddler Sexual arousal as a way to soothe a childZ'Z%n'F$'48h#Direct Causes: Biology & Psychology"$&&Behavioral: Stimulus-Response Cycle Boredom: Social-Interpersonal Isolation Excitation: Immediate Gratification Stimulus-Response: Emotional Reminders Habit-Forming Behaviors Cigarettes smoking Rage: Temper Tantrums Relaxation Cycles Physiological Arousal & Rest States$ZMZ'PP)PP$P$F$M  F$)   F $$  iWhy Sexual Addiction?QNeeds for Arousal Life is Boring Gambling Sex Stimulant Drugs High-Risk Behaviors@!1 1jWhy Sexual Addiction?Needs for Satiation Life is Not Satisfying-Unhappy Sex Over-Eating (Bulimia-Binging) Depressant Drugs (Marijuana) Narcotic Drugs (Anesthetic effect) Alcohol@3j  jkWhy Sexual Addiction?Needs for Fantasy Reality is too Hard: Need a Quick Escape Voyeuristic Sex: Intelligent fantasy & Routine Psychedelic Drugs: LSD Marijuana Mystic/Artistic PreoccupationV;n ) ?lUnhealthy Signs (Mild-Moderate) +Husband demands wife to be in a certain physical position for intercourse Re-enactment (replay) of pornographic materials Have X-Rated (XXX) video on for sex Husband demands wife to wear a certain kind of lingerie ( To seduce-tease him ) He buys specific pieces of underwear, stockings Husband is distracted by flash backs of pornographic images while love-makingJZUZPZ0ZNZJD0%7D0NDm"Unhealthy Signs (Moderate-Serious)##(Masturbation after marriage (Decreased desires) Sexual  Anorexia  Indifference Very few or no male friendships Gets enraged easily or numb emotionally Polarized emotional expression vs. full-range Happy to sad vs. anger to numbness Numbness to dissociated vs. euphoria to numbness Rigidity & inflexibility Telling half-truths and white lies to cover-up0Z!Z P(Z.ZTZZ/P0! (.T  /nUnhealthy Signs (Serious)Compulsive (Uncontrolled) Cyperporn use Chat Room visits online at work or after bedtime Rendezvous-meetings via chat room & email Sex for hire experiences: Strip joints, Prostitutes Compulsive (Ritualistic)  Tele-Porn use Astoundingly high phone bills Unexplained hotel bills, condoms, wigs & underwear found in storage or trunk or car Financial-legal problems: Bankruptcy)ZZ)ZZyZ)1B)yo510 Types of Sex Addicts (After Patrick Carnes, Ph.D.) 6cFantasy Sex Seductive Role Sex (dress) Voyeuristic Sex Intrusive Sex (obscene calls) Exhibitionismn8 "  " Z " $$$$$ TSex Trading Anonymous Sex Paying For Sex (Prostitution) Pain Exchange Exploitive Sex6U " Z)%%%p 4Some Theories Explaining Addiction Dynamic To Follow&5+, $qcThe Physical Intimacy-Orgasmic Cycle Copyright Melvin W. Wong, Ph.D. 1997-200 All Rights Reserved$d%%?v Intimacy Always Feels Good!  Emotional Intimacy Leads to Physical Intimacy!  Physical Intimacy Can Lead to Orgasm!  Orgasm Always Feels Good!  Orgasmic Feeling is Intimacy? Physical Intimacy is an Antidote for Loneliness, Low-Self Worth, Boredom, Aggression, Anger, Despair, Abandonment  H.A.L.T. Defeated TZFPbZrDThe Addiction (After Patrick Carnes, Ph.D. & Steven Arterburn, M.S.) E7Craving to get emotionally intimate with others Mental-Emotional-Visual Triggers Repression of Pain with Immediate Sexual Longing Fantasy Development-Planning Begins (Thrilling) The Hunt (The Intrigue)( " Z0$sDThe Addiction (After Patrick Carnes, Ph.D. & Steven Arterburn, M.S.) E7The Connection ( Rush Altered state of awareness) The Act (Under-Control: Impulsivity: Binge) The Fulfillment (Orgasm: Feeling Dissociation) The Let-Down (Self-Blame: Numbness) The Vow (Over-Control: Compulsivity: Rigidity) The Cycle Returns again (Deprivation Sets-In)N " x3,/$ ]tv Acting-Out Cycle Copyright Melvin Wong, Ph.D. 2000-2001*<( Compulsivity Impulsivityu,From Over-Control, Under-Control to Recovery-Z-,Binge-Purge Cycles Impulsiveness vs. Compulsiveness Over-Control: The Victimizer Power Position:  A Mouse Click Away! Under-Control: The Victim Not Responsible for what happened Don t blame me! I can get away with it Rationalization & Justification: Maintains the addiction!&$! $ $$& $$$I  ;  `v Acting-Out Cycle Copyright Melvin Wong, Ph.D. 2000-2001*<( Compulsivity Impulsivityv,From Over-Control, Under-Control 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 relationshipsn'n2n'n_n+nX '2'_  +2&w 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)+\-ZO+3)-K+$x>Change and Recovery After a crisis then comes a paradigm shift ?+fFirst Order Change Control: Try More Alienation Secret Keeping Hides Full Story  No one is Hurt Addiction is a 1st order problem: The harder you try to control, the worse it getsXNZS N R kSecond Order Change Powerlessness Community Involvement No Secrets Disclose full Story Accepts Self as Hurt<X C ySelf-Help Group ResourcesSA: Sexaholics Anonymous www.sa.org (615)331-6230 SLAA: Sex Love Addicts Anonymous EA: Emotions Anonymous (510) 471-8864 CODA: CoDependents Anonymous (415) 905-6331 www.ChristianMentalHealth.comZ(!ZP2Z<Z( F(F!$(D(DF(/ATUZ[\.bcefghijknpqrstuvwxyz{|}~      *.JKLMNOPQRSTUVWXYZ[\acPb  ` ̙33` 3` 3333f` 999MMM` f` f3` 3>?" dd@,|? 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