Tuesday, May 1, 2012

A Book I May Be Writing

I have been offered an opportunity to write a book for CMI/PESI, the organizations that sponsor some of my training seminars. I will find out in a few weeks if we are moving forward with the book plans. But in the meantime, I wanted to share the introduction on my blog.


Don’t Dance: Breaking Free from Emotional Manipulators
By Ross A. Rosenberg, M.Ed., LCPC, CADC

This book is about real-life relationships – common everyday relationships – relationships that many of us have experienced but wished we didn’t. In this book, I will explain the very human ache to be understood, connected and loved; the innate emotional, physical and sexual drive to find our “dream” romantic partner. This “love drive” motivates us to seek our perfect mate, who we hope will instinctively comprehend our struggles, validate our pain, affirm our dreams and, most of all, co-create an explosion of emotional and sexual excitement. We can’t help it; we are naturally designed to seek someone who will share with us our desire for everlasting love.

Since the dawn of the first romantic kiss, men and women have been magnetically and irresistibly drawn into romantic relationships, not so much by what they see, feel and think, but more by an invisible and irresistible force. When individuals with healthy emotional backgrounds meet, the result is a loving, reciprocal and stable relationship. However, when Codependents and Emotional Manipulators meet, they are enveloped in a magnetic and seductive “love force,” it begins like a fairytale, but later unfolds into a painful “seesaw” of love/pain and hope/disappointment. The soul mate of the Codependent’s dreams becomes the Emotional Manipulator of his/her nightmares.

It is my belief that we all fit somewhere on my “Continuum of Self.” All of us have a “self-orientation,” which is a personality type that is either oriented toward the care and needs of others or the care and needs of self. My model accounts for the full range of relationship possibilities, from healthy to dysfunctional. On the farthest ends of my continuum lie the Codependents and the Emotional Manipulators. In this book, I will tie together my continuum-of-self concept and the ubiquitous “love force” that affects each and every person who desires to find the romantic partner of their dreams.

I will explain why patient, giving and selfless individuals (Codependents) are predictably attracted to self-centered, selfish and controlling partners (Emotional Manipulators). Like “clockwork,” Codependents and Emotional Manipulators find themselves habitually and irresistibly drawn into a relationship that begins with emotional and sexual “highs,” but later transforms into a painful and disappointing relationship (the “dance”).
In this dance, Codependents and Emotionally Manipulators are naturally and unconsciously attracted. This dance is paradoxical in nature because the two disparate, but perfectly matched, people participate in a dance that begins as thrilling and exciting, but ends up rife with drama, conflict and feelings of being trapped. Within the comprehensive understanding of the nature of this dysfunctional relationship dance lies the hope for a sustainable and life-affirming romantic relationship.

This unique, fresh and innovative relationship model will explore the traits, symptoms and origins of both Codependency and various Emotional Manipulation Disorders (Borderline, Narcissistic and Antisocial). Both mental health professionals and the layman alike will learn what drives and sustains the Emotional Manipulator and Codependent relationship.

In this book, I will examine the intricacies of relationship dynamics shared by the Codependent and the Emotionally Manipulative personality types. The attraction dynamic will be illustrated through my Continuum of Self model, as well as through other theoretical examples. The model ties together the complex web of underlying psychological forces that inescapably draws the Emotional Manipulators and Codependent into an enduring relationship. The reader will gain an appreciation for the nature of these binding relationships, which are often immune to personal or professional assistance.

The Codependent reader will learn that they may have a broken “relationship picker.” They will learn about their propensity to pick Emotionally Manipulative partners, while also learning how to disengage from their destruction relationship pattern. Armed with an understanding of this “magnetic” relationship force, the corrective psychotherapy process can be empowering, focused and effective. At the end of the day, the reader will have a deeper understanding of Emotional Manipulation, Codependency and the relationship dynamic that keeps them tied together.

Sunday, April 1, 2012

Female Sex Addiction: Understanding Gender Differences

Female Sex Addiction: Understanding Gender Differences

Ross Rosenberg, M.Ed., LCPC, CADC
Clinical Care Consultants
Arlington Heights, IL

Unlike alcohol or drug addiction, there is still no formal diagnosis for sex addiction. To make matters worse, female sex and love addiction is similarly not recognized as a bona fide addiction disorder. However, most addiction specialists agree that it has risen to epidemic proportions (R. Weiss, 2011).
The term sex addiction was coined by Patrick Carnes. Carnes first used the term in his 1983 seminal book on the topic: Out of the Shadows: Understanding Sexual Addiction. Carnes is largely responsible for popularizing the study and treatment of sex addiction, as well as establishing a valid and commonly used diagnosis.

Because most statistics are based on sex addicts who seek treatment, statistical representation of this disorder is considered to be low. Women are less likely than a man to seek help for her problem sexual behavior for a variety of reasons – mostly related to shame. (Weiss 2011). Research and treatment fields have directed little attention to women’s struggle with this addiction. Other than an early treatment by Charlotte Kasl (author of Women, Sex, and Addiction: A Search for Love and Power) and some writings by Carol Ross and Jennifer Schneider, sex addiction in women has been largely ignored (Feree, 2001).
According to Patrick Carnes, 3% of the total U.S. population is female sex addicts. In other words, of all American sex addicts, 37.5% are female. Carnes’ research also indicates that approximately 20% of those seeking help are female. This statistic is consistent with similar statistics regarding females seeking alcohol treatment (Carnes, 1983). According to Robert Weiss (2011), an international sex addiction expert, author, educator and founder of the Sexual Recovery Institute, 8 to 12% of those seeking sexual addiction treatment are women.

Over the last 30 years multiple nationally recognized researchers have studied, validated and come to agree that sex addiction is indeed a legitimate compulsive disorder (Coleman, 1995; Goodman, 1993, 1998; Irons & Schneider, 1999; Kafka & Hennon, 1999; Money, 1986; Orford, 1978; Schneider, 1991; Schneider & Irons, 1996; Finlayson, Seal & Martin 2001; Goodman 1992.

Statistical support for the prevalence of sex addiction is starting to build. According to Dr. Patrick Carnes, a nationally known speaker and expert on sex addiction issues and recovery, estimates that 5-8% of Americans are sex addicts. The National Council on Sexual Addiction and Compulsivity estimates that between 6-8% of Americans are addicted to sex. Mary Ann Miller, a psychologist who founded the Chicago chapter of Sexual Addicts Anonymous (SAA), estimates that up to 6% of Americans are (sex) addicts. Robert Weiss, another well-known expert and founder of the Sexual Recovery Institute, guesses that 3-5% of the U.S. population suffers from sexual addiction. The Mayo Clinic estimates that 3-6% of adults in the United States are sex addicts. It is estimated that in the U.S. there is between 9,200,000 (3%) and 24,500,000 (8%) individuals who are sexually addicted.

Sexually compulsive behavior has existed at all times in human history. Sexual excess and debauchery have been described and documented at the beginning of written history. Ancient Greeks used the term nymphomania to describe uncontrollable and excessive female sexual behavior. In the 17 century, the legend of Don Juan described a rogue and a libertine hypersexual man who was famous for seducing women. Don Juanism, after Don Juan…has since denoted male hypersexuality (Finlayson, Seal, & Martin 2001).

In 1886 Richard Krafft-Ebbing wrote the seminal work Psychopathia Sexualis, in which he documented cases of pathological hypersexual behavior. In this book Krafft-Ebbing described cases of hypersexual men and women who were powerless over their compulsion to engage in sexual activity. He described this hyper-sexuality as a “dreadful scourge for its victim, for he is in constant danger of violating the laws of the state and of morality, of losing his honor, his freedom, and even his life.”

Our societal gender bias significantly affects the accurate statistical representation of female sex addiction. A society that regards male hyper-sexuality in positive terms has created a shameful backdrop and societal prejudice for women. Hypersexual men are commonly considered virile or studs” whereas hypersexual women are considered sluts, whores or nymphomaniacs. These unfair and egregiously incorrect conceptions of sex hyper-sexuality and addiction have marginalized and minimized the seriousness of female sex addiction. Gender bias is also found in addiction-related research. In most addiction studies, females are underreported; underdiagnosed and overlooked (S. O’Hara). For example, the American Medical Association recognized male alcoholism as a disease in 1956; but it was not until the late 1980s that significant findings regarding female alcoholism was represented in research studies.

Sexual addiction in women rarely receives the same research and popular media attention received by men, so it continues to be underreported and minimized. Moreover, media and news coverage seems to cover female and male sex addiction differently. Female sex addicts are often portrayed as manipulative, power hungry, sex crazed and shameless individuals. On the popular VH1 reality series, “Sex Rehab with Dr. Drew (Pinsky),” female sex addicts are mostly porn stars. On the other hand, media reports on male sex addicts include powerful celebrities whose sex drive has led them astray (Tiger Woods, Michael Douglas and David Duchovny). At the end of the day, men seem to remain famous, while the “famous” female sex addicts’ careers crumble and end in shame and disrespect.

There seems to be a mistaken assumption that sexual addiction is a “one size fits all” disorder. This could not be further from the truth. Female addiction is often misunderstood, incorrectly diagnosed and inappropriately and ineffectively treated. Although female and male addiction shares many similarities, female addiction is distinctly different.

In actuality, sex addiction tends to parallel our society’s gender stereotypes. For example, men tend to prefer face-to-face anonymous contact and are more aggressive and dominant. They typically favor sexually explicit chat, cyber-porn and interactive sexual play - virtual and in person. They gravitate toward the voyeuristic forms of sexual behavior, i.e., chronic masturbation, Internet pornography, strip clubs and the use of real-time videos (webcams). The goal for most male sex addicts is to seek sexual stimulation – not the sexually stimulating relationship. To the male addict, the euphoric fix is in the act, not the relationship.

Another gender difference in sex addiction is found in the relational boundaries of the acting out behavior. Men tend to maintain distinct and clear emotional boundaries with the object of their compulsive and lustful desires – not as often seeking a romantic or personal experience. They seek sexual opportunities that come from discreet, anonymous and disconnected hookups. To the typical male sex addict, the relationship is the vehicle by which his lustful obsessions and compulsions are satiated. If there is a relationship, it is often fantasy based – lasting just long enough to satisfy his out-of-control pursuit of sexual contact. For the typical sexually addicted male, at the conclusion of the sexual act – usually at orgasm – he becomes disconnected, disinterested and even repelled by the object of his lust.

It is important to note that females can also look like stereotypical male sex addicts, as males can also look like stereotypical female sex addicts.

Female Sex Addiction Myths
Female sex addiction has been largely underrepresented because of misunderstandings and the subsequent development of myths. Such myths or commonly-held erroneous beliefs have contributed to the ignorance, fear, shame and consequent silence concerning female sex addiction (Ferree 2011).

Myth One: Females Cannot Be Sex Addicts.
Within the addiction treatment field, it is a well-known fact that women, like men, can be addicted to sex. However, the general public believes that sexual compulsivity is mostly a male phenomenon. The belief that women do not struggle with sexual compulsivity comes from societal prejudices, double standards and ignorance rooted deeply in the American culture. A female sex addict, like her male counterpart, is addicted to uncontrollable compulsive sexual behavior. Even with the similarities, women tend to use sex for power, control and attention. Women score high on measures of fantasy sex, seductive role sex, trading sex and pain exchange (S. O’Hara).

Prior to the mid 1950’s, women who had sex outside of marriage were subjected to harsh and unfair judgment. Female sexuality outside of marriage, especially masturbation, was viewed as the closest thing to moral bankruptcy. It was with the 1953 Kinsey study, Sexual Behavior in the Human Female, that normative data regarding female sexuality was made available to the public at large. The Kinsey Reports played a significant role in changing the public perception of female sexuality. Fifty-eight years later, women with aberrant sexual behavior, such as sex addiction, are still viewed through the lens of hypocrisy and condemnation. That which was acceptable for men was considered ugly and perverted for women.

A myopic society that scorns rejects and unfairly judges female sex addiction (while being more tolerant with men) places roadblocks for support, education and counseling/treatment. A fear of being disparaged, blamed, shunned and, ultimately, isolated by their loved ones prevents many women from feeling safe enough to seek help. It is no wonder that women sex addicts maintain their silence and secrecy about their addiction.

Myth Two: Female Sex Addicts Are Only Addicted to Relationships or Love - Not Sex.
Even though most female sex addicts are relationship or love addicts, many others are addicted to sex, masturbate compulsively, use pornography, engage in a variety of Internet sexual activities, have affairs with multiple partners, engage in anonymous sex or phone sex and are exhibitionists. According to Kelly McDaniel, licensed professional counselor and author of Ready to Heal: Women Facing Love, Sex and Relationship Addiction, therapists have recently seen more women with (sex addiction)…in connection with Internet porn, which has become a gender-neutral addiction. According to Ms. McDaniel, until recently, female sex addicts generally tended to have affairs or become sex workers.

Most female addicts avoid the term sex addiction because it carries negative connotations of sexual perversion, nymphomania and promiscuity. When given a choice, women prefer the romantic and nurturing connotations of loveor relationship addiction. The sex addiction label is resisted because women are often not motivated by the pursuit of sex only – but instead by a deep and insatiable desire for love, acceptance, affection and affirmation. Naturally, female sex addicts prefer a term that represents their femininity.

Myth Three: Women Who Are Sex Addicts Know About Their Problem.
Rarely do women identify themselves as sex addicts. Similarly, when a sexually addicted female seeks mental health services, it is likely that the clinician will misdiagnose her. It is common for untrained clinicians to only diagnose a comorbid (co-occurring) mental health problem, while completely missing the sex addiction diagnosis. As a result of a scarcity of research, training and effective screening protocols, the female sex addict who is in denial of her problem is likely to interface with professionals who share her ignorance and denial systems.

If sex is the core addiction, it may be hidden beneath a more obvious and less shameful concurrent addiction. Having more than one addiction, women are prone to only seek professional help for the addiction that is more obvious and socially acceptable. Shame, embarrassment and fear of consequences, i.e., divorce or social alienation, may push the sex addiction – the primary or core addiction - to the addict’s unconscious. Simply, sex addiction is easier to deny than another addiction such as alcohol or drugs.

Myth Four: Consequences Are the Same for Females and Males.
Although female sex addicts experience the same consequences as men, a societal sexual double standard also creates more painful and harsher consequences. Additionally, women are more prone to suffer health concerns such as unwanted pregnancies or sexually-transmitted diseases. Because of the power and strength differential of men and women, women face a higher probability of physical harm such as rape or aggravated battery. Women suffer unique and agonizing consequences because they often feel responsible for the shame, embarrassment and punishing social judgment that their male partner and children endure.

A Sexual Double Standard

Our culture/media encourages women to be sexually provocative and available, while holding them in contempt if they cross the boundary of society-determined rules concerning sexual decency. Male sex addicts are afforded greater tolerance and freedom than females. The belief that women and men are held to different standards of sexual conduct is pervasive in contemporary American society. According to the sexual double standard, men are rewarded and praised for heterosexual sexual contacts, whereas women are derogated and stigmatized for similar behaviors. (Kreager & Staff, 2009)

Sexual double standards date back to earliest recorded history. Biblical archeologists and religion historians point to frequent sexist and misogynist references in religious documents and art. These scholars believe that references to sexism in religious texts were at least partially influenced by patriarchal, tribal, violent and intolerant societies. The sexual double standard also can be traced back to the 13th century during the crusades when a knight required his lady to wear a chastity belt to ensure her sexual fidelity. As hard as it may be to believe, this punishing and humiliating device is still in use today; in 2004, the USA Today reported that a 40-year old British woman set off a security alarm because of her steel chastity belt. This woman said her husband had forced her to wear the device to prevent an extramarital affair while on vacation in Greece.

Yet another historical reference of sexual double standard is illustrated in Nathanial Hawthorne’s classic novel,“The Scarlet Letter, which was written in 1850. The main character, Hester Prynne, was placed in prison with her infant daughter for conceiving a child through an adulterous affair. Hester struggled to redeem herself in a society that was harshly judgmental and punishing to females who defied the sexual mores of her time. Hawthorne’s The Scarlet Letter has become a symbol of modern society’s harmful, harsh and punishing sexual double standard.

Fifty-eight years after the publishing of the The Scarlet Letter, Sigmund Freud further perpetuated the myth of sexual inequality in his 1908 article On the Sexual Theories of Children, in which he introduced the concept of penis envy. According to Freud, the defining moment of gender and sexual identity for a woman occurs when she realizes that she doesn’t have a penis. Freud believed that girls wished they were born with penises instead of vaginas. Critics of Freud’s work argue that he was a patriarch, anti-feminist and misogynistic. One could argue that Freud was merely a product of the sexually repressed Victorian society in which he lived.

Even today, the double standard continues to be inexorably entwined in our culture - so much so now that women themselves are guilty of discriminating against their own gender. A significant percentage of women judge highly sexually experienced women more negatively than men (Milhausen and Herold, 1999). It is still commonplace for women's sexual histories to be used against them in workplace harassment cases or in cases of sexual assault (Valenti, 2009). The double standard creates a dangerous backdrop for women who are considering getting help for their sexual addiction.

Concurrent Addictions

Especially with sex addiction, addictive disorders tend to coexist or fit together (Carnes, 1983). Concurrent addictions, which are multiple addictions that are simultaneous expressed and/or ritually connected, are quite common for female addicts. Examples include smoking marijuana before going online, drinking alcohol before an Internet date to lower inhibitions and taking stimulants in order to surf the net all night. Concurrent addictions, like alcoholism, may have been started to hide or numb the pain or shame caused by out-of-control sexual compulsions. Alcohol, especially, lowers inhibitions and alleviates anxiety – making the sexual acting out more pleasurable and easier. Rarely does a sex addict have just one addiction (Carnes, 1983). Carnes’ research on sexual addictions revealed that 83% of sex addicts reported multiple addictions:

• Chemical dependencies - 42%
• Eating disorders - 38%
• Compulsive overworking - 28%
• Compulsive spending - 26%
• Compulsive gambling - 5%

Four Categories of Female Sex Addiction (Feree, 2001)
Female sex addicts may be categorized (in order of prevalence) into four groups: Relationship Addict, Pornography or Cybersex Addict, Stereotypical Sex Addict and Sexual Anorexic.

Category One: The Female Love or Relationship Addict
Female love addicts compulsively seek total immersion in a relationship – real or imagined. The lust for an intoxicating relationship becomes a dramatic obsession that may be stronger and more compelling than the overwhelming desire for sex. Love addiction creates an illusion of power, control and even dominance. Love addicts compulsively seek exciting, exhilarating and mood-altering relationships, which by definition are unstable. They practice serial monogamy: seeking multiple relationships, which begin with intense passion but end relatively quickly. These unhealthy relationships become the organizing principle of the love addict’s life. According to a renowned expert on love addiction, Pia Mellody, it is dependent on, enmeshed with and compulsively focused on taking care of another person (1992). Like any addiction, the drug or process, in this case the relationship, persists despite the addict having no control over it and suffering obvious negative effects.

Female love addicts are habitually preoccupied with romance, intrigue or fantasy. They are driven by an insatiable desire for a romantic “fix,” which requires a steady stream of new and exciting short-term romantic monogamous relationships. They rely on their exhibitionistic and seductive “powers” to “feed” their addiction. They are entranced by the intoxicating “high” initiated at the point when they meet their love object. Beginning with hope, excitement and a huge desire, these relationships usually devolve into disinterest; disillusionment and conflict. The euphoric “fix” escalates and then maintains until the relationship does not deliver the drug-like euphoria anymore. Like with other addicts, female love addicts try, but never succeed in satisfying their insatiable and compulsive need of romantic euphoria – their drug of choice.

Signs of Love or Romance Addiction:
 • Thinking you are in love despite just meeting (love at first sight)
• Valuing the time spent with love object over time and attention needed for self
• Relationships create feelings of safety, happiness and optimism
• Mistaking sexual or romantic intensity for healthy love
• Constantly “on the prowl” for a romantic partner
• Short, intense and conflict-based relationships
• Pattern of failed relationships
• Using sex, seduction and intrigue to hook or hold onto a partner
• Using romantic intensity to hide, cover or “medicate” emotional pain, conflict or problems
• Pattern of “dating” abusers, narcissists and addicts (emotionally unavailable, distant and harmful)
• Flirting and/or having an affair while in a relationship
• Pattern of broken promises to stop the behavior/addiction
• Sacrificing time with friends or family to act out
• Avoiding relationships to control the addiction

Unlike sex addicts, love addicts tend to act out within a relationship. Often, they are unable to avoid or let go of toxic relationships, even if they are unhappy, depressed, lonely, neglected or in danger. Typically, love addicts are disinterested in the sexual aspect of the romance, including orgasm. The pull and the power of the “love” in love addiction almost always exceeds the addict’s sexual desires. It is not unusual for the female addict to report apathy or even dislike of sexual activity, including orgasm. Love addicts tend to use sex to manage their feelings or to control their partner – the co-addict. To the love addict, the sexual experience is a means to the end. According to the Love Addiction Anonymous (LAA) website, unlike sex addicts, love addicts crave an emotional connection and will avoid, at any cost, separation, anxiety and loneliness.

Many female love and relationship addicts report that they are addicted to the intoxicating, intense and all-consuming feelings experienced in the attraction phase of a relationship. This “rush” is described in Dorothy Tennov’s 1979 book, “Love and Limerence: the Experience of Being in Love.” Tennov coined the term “limerence,” which she described as an involuntary state of mind that results from a romantic attraction to another person, combined with an overwhelming, obsessive need to have one's feelings reciprocated.

Symptoms of Limerence (Tennov, 1979):
• Intrusive thinking about the limerent object (‘LO’)
• Acute longing for reciprocation
• Mood fluctuations based on LO's actions
• Can only feel it with one person at a time
• All-consuming obsession that the LO will relieve the pain
• Preoccupation (fear) with rejection
• Incapacitating and uncomfortable shyness in the beginning
• Intensification through adversity
• An aching `heart' (in the chest) when there are doubts
• Buoyancy (walking on air) with reciprocation
• Intense obsessions demotivate the person from other responsibilities (friends, family, work)
• Emphasis is placed on positive attributes of the LO, while ignoring the negative

Category Two: The Female Cybersex Addict
Cybersex is virtual sex where sexually explicit material is viewed or exchanged to evoke a sexual response. The cybersex addicts act out their sexual compulsions through the use of and involvement with the Internet. Cybersex requires vivid, visceral and sexually evocative sexual stimuli. Female cybersex addicts typically do not meet in person, but in virtual places, i.e., email, chat rooms, with video cams, prolonged email interactions and role-playing activities. While creating a safer experience, anonymity often enhances the sexual excitement for the female cybersex addict. Cybersex addicts usually act out together in virtual places through masturbatory activities. Female cybersex addicts are more prone to have phone contact or seek relationships through their activities (Schneider, 2011).

Cybersex Addiction Activities
• Viewing and masturbating to Internet pornography (photos or videos
• Live webcam sexual interaction
• Sexual membership sites (Swingers, BDSM, etc.)
• Membership in cyber affair sites (AshleyMadison.com)
• Seeking sex through personal sex ads (Craigslist or Backpages)
• Participating on sex-related chat sites
• Adult dating sites (Adult Friend Finder)
• Cell phone hook-up applications
• GPS hook-up applications (Grindr)

Category Three: The Female Sex Addict
Female sex addicts can fit the stereotypical male pattern of sexual addiction. This is an addiction driven by a lustful and compulsive preoccupation with a sexual activity. Sex addicts typically engage in chronic masturbation, with or without pornography, and have anonymous sex with individuals who they either met online or picked up in a bar or other public place. To the female sex addict, the relationship is less important than the thrill of the sexual experience. While female sex addicts are less voyeuristic, they are more exhibitionistic. Typically, they are exotic dancers or strippers, prostitutes or women who sell sex or trade it for something desired.

Female sex addiction occurs with the same 11 behavioral forms of sexual addiction that Patrick Carnes outlined in his breakthrough book on sex addiction, Out of the Shadows. It should be noted that despite the commonalities, there are clear gender differences and gender behavior preferences.
Behavioral Forms of Sexual Addiction
1. Fantasy Sex – Sexually charged fantasies, relationships and situations
2. Seductive Role Sex- Seduction of partners
3. Anonymous Sex — High-risk sex with unknown persons
4. Paying for Sex – Purchasing of sexual services
5. Trading for Sex – Selling or bartering sex for power
6. Voyeuristic Sex – Visual arousal
7. Exhibitionistic Sex – Attracting attention to the body or sexual parts of the body
8. Intrusive Sex – Boundary violations without discovery
9. Pain Exchange – Being humiliated or hurt as a part of the sexual arousal
10. Object Sex – Masturbating with objects
11. Exploitive Sex — Exploitation of the vulnerable

Category Four: Sexual Anorexia
The term sexual anorexia has been used to describe sexual aversion disorder (DSM code 302.79), a state in which the patient has a profound disgust and horror at anything sexual in themselves and others (P. Carnes, 1998). The title of Carnes’ 1997 book, Sexual Anorexia: Overcoming Sexual Self-Hatred, describes the sex or love addict’s psychological motivation for this disorder - contempt and self-hatred – often for their sex or love addiction.
Sexual anorexia is the inverse of sexual addiction. Sexually anorexic women are as compulsive with their aversion to sex as sex addicts are trying to have sexual experiences. Sexual anorexics suppress or repress their sexually addictive compulsions by denying their own sexuality, avoiding all sexual encounters, rebuking others for any and all sexual interest and/or vehemently condemning others for their sexual proclivities or desires. Sexual anorexia includes a binge/purge cycle, during which a woman may uncontrollably sexually act out for an extended period of time, and which may be followed by a sexual shutdown – avoiding all forms of sexual expression and activity.
Symptoms of Sexual Anorexia (Carnes, 1993):
• Persistent fear of intimacy, sexual contact, sexual pleasure, sexually transmitted diseases, etc.
• Preoccupation, to the point of obsession, with sexual matters, including the sexuality, sexual intentions and sexual behaviors of others, and their own sexual inadequacy.
• Negative, rigid or judgmental attitudes about sex, body appearance and sexual activity.
• Shame and self-loathing over sexual experiences.
• Self-destructive behavior in order to avoid, limit or stop sex.


The treatment of sex addiction as a gender neutral problem has created unnecessary roadblocks to females seeking services for sex and love addiction. Although there are distinct gender differences with sex and love addiction, the problem is clearly universal. Until the popular media represents female sexual addiction in a more socially acceptable and less derogatory manner, women will be shamed out of seeking the much needed help, support and services. The mental health and addiction fields also need to overcome its own limitations regarding unsubstantiated and unsupported beliefs regarding women and sex and love addiction. Until our society's gender blindness, sexist beliefs and double standards are corrected, scores of female sex and love addicts will be deprived of timely, effective and compassionate addiction services. It is time that all mental health and addiction practitioners open their hearts, minds and offices to female sex and love addicts.

Copyright © 2011 by Ross Rosenberg. This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License.

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Friday, March 16, 2012

Why the Sprout

By Ross Rosenberg

In creating a logo for our company, we searched for a symbol that would capture the heart of Clinical Care Consultants. After considering several options, we unanimously saw our "heart" in the photo of the hand tenderly cupping the green sprout.
This image embodies both the essence of who we are as therapists and why we are invested in our work.

This photo was more than just an image to us; it represents our collective professional identity. The symbolic nature of the sprout speaks to the spirit of the counseling experience.

The hand signifies the counselor who "holds the space" where problems are solved, healing occurs and hope is revived. Counselors support and protect their clients while helping them to grow and mature into the "plants" they were meant to be.

The soil symbolizes the counseling process without which sprouts would not grow, thrive and flourish. Because of the counseling process, or fertile soil, the sprout has an opportunity to spread its roots, create stability, endure hard times and thrive. From the soil, the spout can grow into the healthy version of itself. 

The final symbol is the sprout, which represents the person seeking counseling. Each and every one is a "sprout" at one time or another. As "sprouts," clients come to therapy as tender, vulnerable and unimagined versions of their hurt, stuck or unhealthy self. At Clinical Care Consultants, we are passionate and invested in the "growth" of all our clients. To us, it is a privilege to be included in our clients' growth.

Alcohol and Anxiety a Risky Mix for Some By Anne Harding, Health.com

(Health.com) -- Many people who experience chronic feelings of anxiety about social situations, work and relationships, or other aspects of everyday life often reach for a beer or a glass of wine to quell their unease.

Alcohol may help anxious people cope in the short term, but over time this strategy can backfire. According to a new study in the Archives of General Psychiatry, self-medicating with alcohol or drugs can increase the risk of alcoholism and other substance-abuse problems, without addressing the underlying anxiety.

"People probably believe that self-medication works," says James M. Bolton, M.D., the lead author of the study and an assistant professor of psychiatry and psychology at the University of Manitoba, in Winnipeg. "What people do not realize is that this quick-fix method actually makes things worse in the long term."

Self-medication for anxiety symptoms is common. In the study, which included a nationally representative sample of 34,653 American adults, 13% of the people who had consumed alcohol or drugs in the previous year said they'd done so to reduce their anxiety, fear, or panic about a situation.

An even greater proportion, roughly one-quarter, said they had similarly self-medicated with drugs. (Detailed data on the drug use was not available, but Bolton says most people were probably using prescription sedatives -- such as Xanax -- without a prescription, rather than using marijuana or illegal drugs.)

Self-medication and anxiety proved to be a hazardous combination for some of the study participants. People with diagnosed anxiety disorders who self-medicated at the start of the study were two to five times more likely than those who did not self-medicate to develop a drug or alcohol problem within three years, the study found. (The increase in risk depended on the anxiety disorder.)

In addition, people with anxiety symptoms but in whom a full-blown anxiety disorder had never been officially diagnosed were more likely to receive a diagnosis of social phobia by the end of the study if they self-medicated. Social phobia, also known as social anxiety disorder, is characterized by pronounced fear or anxiety about specific situations, such as parties or speaking in public.

"Serious consequences can develop very quickly," Bolton says. "People can develop alcoholism and anxiety disorders within just three years, and these are illnesses that can have a devastating impact on a person's health, their relationships, and their financial situation."

Experts have long known that people with anxiety disorders are vulnerable to substance abuse, and vice versa, but they haven't been able to determine whether one problem precedes the other.

The new findings are significant because they are among the first to examine the relationship of anxiety symptoms and substance use in a group of people over time, says Kristen Anderson, Ph.D., a clinical psychologist and assistant professor of psychology at Reed College, in Portland, Oregon. Anderson was not involved in the new study.

Bolton and his colleagues reanalyzed data from a nationwide survey, led by the National Institute on Alcohol Abuse and Alcoholism, that began in 2001. Thirteen percent of the participants with an anxiety disorder who reported self-medicating with alcohol developed an alcohol problem over the three-year study period, compared with just 5% of those who did not self-medicate. Likewise, 10% of people with an anxiety disorder who self-medicated with drugs developed a drug problem, versus 2% of those who did not.

Having a glass of wine to ease the tension of a stressful day doesn't necessarily put a person at risk for becoming an alcoholic, of course. Substance abuse is heavily influenced by a person's genes and environment, Anderson says, but she adds that habitually relying on alcohol or drugs to ease anxiety at the expense of healthier coping strategies -- such as working out, talking with a friend, or taking a hot bath -- can be risky.

"I think all of us, whether we're disordered or not, need to consider the reason why we choose to use alcohol or other drugs," Anderson says. "When any of us decide to try to cope with external agents, I think it's a very slippery slope."

The shame some people feel about their anxiety and a reluctance to seek help for psychological problems are likely major factors contributing to self-medication, Bolton says.

"Unfortunately, people often do not seek the help they need because of the stigma around mental illness," he says. "People are likely to stay at home and use the resources that they have at their disposal, which in this case would be alcohol or drugs."

Maureen Carrigan, Ph.D., a professor of psychology at the University of South Carolina-Aiken who studies addictive behaviors and anxiety disorders but wasn't involved with the new research, sees widespread self-medication as a symptom of our "quick-fix society."

Talk therapy and other treatments for anxiety are effective and can even solve the problem for good, Carrigan says, but they can be time-consuming and aren't always covered by insurance. People experiencing anxiety may not even be aware of these treatments, she adds.

"The average person doesn't always know that there are good psychological treatments that exist for some of these problems," she says.

Copyright Health Magazine 2010

(Dr. Morris) Rosenberg Self-Esteem Scale

The Rosenberg Self-Esteem Scale is perhaps the most widely-used self-esteem measure in social science research. Dr. Morris Rosenberg was professor of Sociology at the University of Maryland from 1975 until his death in 1992. He received his Ph.D. from Columbia University in 1953, and held a variety of positions, including at Cornell University and the National Institute of Mental Health, prior to coming to Maryland. Dr. Rosenberg is the author or editor of numerous books and articles, and his work on the self-concept, particularly the dimension of self-esteem, is world-renowned.