Sunday, June 26, 2011

DSM, Epistemology, and Addictions

The DSM's are developed by mental health and medical practitioners who are guided by “current” research and knowledge. It is a clinical tool that is as good as the times in which it was written, the culture it was written for and the current understanding (the science) of mental illness. It guides our conceptualization, perception and treatment of our clients’ mental/psychological conditions. Even with its limitations, the DSM diagnostic procedures are highly “reliable” and “valid.” As the most widely accepted diagnostic resource manual in our field, we are stuck with it – at least until another one is written.

Epistemology is the study or theory of the nature and grounds of knowledge, especially with respect to its limits and validity. Epistemologically speaking, I believe we have not yet evolved enough to embrace the psychopathological elements of sexual addiction (as well as other process/behavior addictions). As I have said before, we are a part of the evolution of knowledge. What we know to be “true” now, may actually be groundbreaking stuff, or as history may have it, a laughable matter. Lest we forget that the DSM-II famously listed homosexuality as a mental disorder - specifically, it was listed under Personality Disorders and Certain Other Non-Psychotic Mental Disorders, Sexual Deviations (302.0).

The evolution of the DSM doesn’t happen because new disorders are discovered, but instead, because our understanding of mental health continuously evolves. As far as the debate on sex addiction: just because the DSM-IV has not recognized it as a bona fide disorder doesn’t mean it doesn't exist. Our field is in its infancy. Twenty-five years from now, the DSM will look differently than it looks now. Practitioners will scoff at our ignorance - as we do with former DSMs.

As Mark Twain once said, "To a man with hammer, everything looks like a nail." The writers of the DSM utilize a hammer that is “manufactured” by physicians. Their hammer can only be used with special “nails” that work with practitioners who think/conceptualize according to the medical model. Sexual addictions, as we understand them now, don’t conform to the rules of these highly evolved “carpenters.” As a tool of their trade, their hammer doesn’t work well with sexual addition. Sexual addiction, therefore, still isn’t considered a psychopathology or mental health disorder worthy of being placed in our “big book.”

What I’m trying to say is let's not take the DSM-IV (and the future DSM-V) so damn seriously. It is just a guide - a bible of sorts - to be used as we choose to use it. Many of us choose to interpret it loosely. Insurance companies live and breathe it. Some of you may choose to use it precisely without questioning its authenticity or validity. It isn't the "law of the land." Just like with laws disallowing gay marriage: just because it is a "law," doesn't make it right.

Finally, the draft version of "Hyper-Sexual Disorder" looks good to me. It is a good start and I am hopeful they will more fully develop it. I have included it below.

Ross Rosenberg, M.Ed., LCPC, CADC
Clinical Care Consultants, P.C.

Updated October-14-2010

Hypersexual Disorder [14]

A. Over a period of at least six months, recurrent and intense sexual fantasies, sexual urges, and sexual behavior in association with four or more of the following five criteria:

(1) Excessive time is consumed by sexual fantasies and urges, and by planning for and engaging in sexual behavior. [15]

(2) Repetitively engaging in these sexual fantasies, urges, and behavior in response to dysphoric mood states (e.g., anxiety, depression, boredom, irritability). [16]

(3) Repetitively engaging in sexual fantasies, urges, and behavior in response to stressful life events. [17]

(4) Repetitive but unsuccessful efforts to control or significantly reduce these sexual fantasies, urges, and behavior. [18]

(5) Repetitively engaging in sexual behavior while disregarding the risk for physical or emotional harm to self or others. [19]

B. There is clinically significant personal distress or impairment in social, occupational or other important areas of functioning associated with the frequency and intensity of these sexual fantasies, urges, and behavior. [20]

C. These sexual fantasies, urges, and behavior are not due to direct physiological effects of exogenous substances (e.g., drugs of abuse or medications) or to Manic Episodes. [21]

D. The person is at least 18 years of age.

Specify if: [22]

Sexual Behavior With Consenting Adults
Telephone Sex
Strip Clubs

Wednesday, June 22, 2011

Virtual Sex? It's Already Here

Virtual Sex? It’s Already Here
By Robert Weiss LCSW, CSAT-S

Looking beyond the sad mess of Former Congressman Weiner’s recent sexting scandal, today’s as yet under-the-radar, but evolving sexnologies are about to make texing nudie pics to strangers as old-school as focusing a 35-mm camera.

Last fall while researching the effect of social network and smart-phone technologies on sexual addiction, I came across what appear to be some of the first products specifically designed and mass-produced for purchasers to engage in virtual sex. Called Teledildonics, these white plastic gadgets are described by the manufacturer as “hardware components that can, when hooked up the Wii platform, allow remote partners to simultaneously enjoy each others physical stimulations.”

Privately developed as adult accessories for the Wii, Teledildonics consist of a pair of unassuming generic looking rods, one with a ring shaped end designed to fit over the penis, the other more appearing more solidly structured with a wide smooth vibrator-like tip. Again per the manufacturer, “by connecting the two“Wii-motes” to pre-existing Wii hardware, wiggles and thrusts on Wii-mote A are detected and sent via Bluetooth to a nearby computer. From there this information is sent over the Internet and reproduced by Wii-mote B. which acts as a Wii-brator at the other end (virtually reproducing genital movements occurring either next door or half-way across the world).”

At first glance these somewhat plain and generic appearing sex toys, readily available over the Internet for about $300.00, hardly appear to represent the leading edge of the next sexual revolution yet the implications of their development and sale are profound – as they intertwine real-time sex, the Internet and computer technology together in as yet unexplored ways, Teledildonics may represent one of the earliest attempts to mass market sex that is mutually experienced long-distance.

Whether in working in Dubai or visiting the family in Vancouver as long as you and a partner can hook-up to a compatible hardware program with fast-enough Internet service – you can share a rudimentary physical experience of mutual sex in real time. As long as demand and interest remains strong there seems little doubt that virtual sexual will inevitably become more and more sophisticated. Using a bit of imagination by picturing the near full or partial body suits yet to come, individually sized and shaped to fit both in and outside our genatalia, you’ll get the idea of what virtual sex is about to offer.

As with all evolving technologies, virtual sex has the potential for both positive and destructive experiences. The good will likely involve those married military and other long-distance working spouses, separated for long-periods of time, who long to feel the (virtual) caress and intimate strokes of distant loved ones. However as with all developing tech, challenges to relationship intimacy and fidelity will again show up, as they did with web based porn, web-cams, virtual chats and smartphone sex – and we will once more be faced with the question of what actions and behaviors define infidelity and relationship adultery – especially when the virtual sex partner of the future is thousands of miles away.

Robert Weiss is Founding Director of The Sexual Recovery Institute and Director of Sexual Disorders Services at The Ranch Treatment Center and Promises Treatment Centers. These centers serve individuals seeking sexual addiction treatment and porn addiction help.

Wednesday, June 15, 2011

Clinical Care Consultants Welcomes Its Newest Clinician: Catherine Ness

Catherine Ness, M.A., LCPC
Licensed Clinical Professional Counselor
(847) 749-0514 ext.15

“No one understands what an individual is experiencing better than that individual.” With this in mind, Catherine utilizes client-centered and cognitive behavioral techniques in working with her clients. Catherine has an exceptional ability to connect and empathize with her client’s experiences and struggles, creating a collaborative relationship in which client and therapist journey together to find a resolution.

Catherine has dedicated herself to her clients and helping them better define where they are in life and where they would like to go in the future. Recognizing that each person is an individual and has personal strengths and struggles is an integral part of her therapeutic technique. Catherine believes that by focusing on known and perhaps “undiscovered” strengths, everyone has the ability to improve personal happiness and over-come life obstacles.

Catherine began her career working with adult survivors of childhood assault and incest. These individuals not only had to work through past traumas, but deal with the depression, anxiety and self-doubt that accompanied these early memories. Motivated by the strength and courage that she saw in these men and women, Catherine developed a therapeutic technique that allowed her clients to discover “unrecognized strengths” and build the self-esteem needed to be confident in life.

Catherine has also had extensive experience working with individuals struggling with substance abuse both as an inpatient and outpatient counselor. These experiences have led to a thorough understanding and development of effective therapeutic treatment of the physical, psychological and emotional consequences of substance abuse.

Catherine has had great success working with adolescents and adults who have struggled with anxiety, depression, OCD (obcessive compulsive disorder), relationship difficulties, grief and psychosis. Despite the particular difficulty one is experiencing, Catherine believes that everyone has the right and ability to find happiness in life.