Sunday, May 31, 2009

Bisexuality

Yes Virginia, there really is bisexuality.*

The recent opinion editorials and responses highlight how much of a flashpoint this topic is in the LGBT community. As fun as it is to banter about, what does the research suggest? In the case of bisexuality, the picture is “Yes, there is bisexuality.”*

Every once in a while the research makes the picture more confusing. The “*” requires us to look at the fine print. The fine print almost always requires a clarification of what we mean by the term “bisexual.” The lack of precision in understanding the term is the source of much of the confusion.

Starting with the granddaddy of psychology, Sigmund Freud defined bisexuality as the ability to get sexual pleasure from a male or female. Strictly speaking, he emphasized genital satisfaction and suggested since all of us can be sexually stimulated by anyone we are all bisexual. Obviously, this view has significant limitations.

The concept of “situational sexuality” applies Freud’s theory. This is behavior where a “straight” guy engages in same-sex behavior. This type of behavior is often present in prisons, same-same sex institutions and other times when the only available partner is the same sex. Other times include when a person is under the influence of chemicals or is engaging in compulsive sexual behavior. Joe Kort, a noted gay author, talks about 12 types of situations where this can occur. You can read more at http://www.straightguise.com/.

In a similar way, a “gay-guy” can engage in genital contact with a woman. Men who consider themselves gay have sex with women for any number of reasons, ranging from wanting children, denial of their orientation, social pressure or various other reasons. This is why researchers emphasize same-sexual behavior versus same-sex identity. Behavior is what I “do” whereas identity is how I see/label myself.

The fact that we perform sexually with anyone raises a problem. Using an analogy, simply because it looks like a duck, walks like a duck, and quacks like a duck doesn’t mean it’s a duck. If it is not a duck, what else could it be?

Many people in the coming out process misuse the term bisexual. It's their way of attempting to minimize their gay identity as they come to terms with a same-sex identity (see “identity tolerance” in the coming out process: This part of the coming out process is where I think the most damage is done to those who have a true bisexual orientation. I wonder if the reaction to the question of bisexuality is a projection of “been there, done that” assuming that anyone who says they are “bi” is “doing that” as well.

Moving away from a view of sexual orientation as an "either/or" idea, the “granddaddy” of sexuality research, Alfred Kinsey developed the “Kinsey” continuum to highlight attraction on a scale of 1-6. Typically “straights” score themselves 1-2 and “gay/lesbians” score themselves 5-6. In the middle are those who are attracted to the both sexes, the “bisexuals.” Kinsey’s research estimates about 4.1% of women and 9.6% of men are bisexual. Another major study (National Health and Social Life Study) estimates 3.3% of women and 5.8% of men identify as bisexual.

Another way to confuse the picture is to think about sexual orientation beyond simply genital expression, and look at many different variables. One researcher uses 7 different variables to define sexual orientation such as genital behavior, attractions, emotional attraction, etc. An extended conversation of the seven variables probably isn’t helpful, but you get the idea that the answer to bisexuality will “depend” on how you ask the question.

So, yes, Virginia there really is bisexuality.* But this is just the start of the conversation. It is important to read the small print.

Additional reading: For those who want to get into the details, a great summary of the research is: Rust, Paula C. Rodríguez (2002) Bisexuality: The state of the union. Annual Review of Sex Research, 13. 180-240.

Saturday, May 23, 2009

Types of Relationships

Culture is very powerful in shaping our view of what is a healthy relationship. Our current culture emphasizes that sexual behavior should occur within a monogamous relationship, and that only monogamous relationships are healthy. How much do you agree with this expectation? In fact, there are a multitude of different types of relationships. Sexual health requires that you clarify the type of relationship you want. This is a controversial opinion where other clinicians may legitimately differ. The primary approach taken in this book is that you have the responsibility to choose the type of life you want to live regarding sexual expression.

As a summary, I highlight three types of sexual relationships:

Celibacy
Celibacy is a choice to not engage in any sexual contact with anyone. How people define celibacy varies. There are opinions saying that any sexual expression including masturbation, fantasy and use of sexually explicit material would be unhealthy. Other opinions focus celibacy as not allowing any genital contact with another person. Some religious traditions impose celibacy as the only form of sexual expression for groups of people (usually LGBT individuals or non-married straight couples). Also, some religious traditions impose celibacy as a discipline in order to for a person to qualify to be a minister in that tradition.

Rightfully understood, however, celibacy is less about telling yourself “you can’t do that” and instead emphasizing something greater in a person’s life. Celibacy allows a greater commitment to the major focus in a person’s life. In this approach, celibacy is believed to facilitate other types of intimate relationships. Many religious traditions have identified celibacy as a “gift of the Spirit” referring to it as a gift from God. In my opinion, a healthy expression of celibacy is possible. It does take a bit of work and self-understanding. And celibacy doesn’t “turn-off” the sexual energy within a person. If you choose this, you must find healthy ways to channel your sexual energy. It is very important for celibacy to be chosen for the right reason. In my experience, I’ve run into many individuals who “choose” celibacy out of fear, a history of abuse, or low self-esteem. If these are the motivating factors for choosing celibacy, it is only a matter of time that any commitment to or vow of celibacy will be broken.

Monogamy
Most of this workbook is built on the assumption of monogamy that is typically defined as sexual contact exclusively between two individuals within some type of committed relationship. Even this definition has different interpretations resulting in confusion and conflict. For some people, monogamy is expanded to prevent any emotional relationships with anyone but the primary partner. Some opinions of monogamy also see any use of sexually explicit material as a violation of the monogamy rule. As expected, in these examples monogamy is less about an expression of love but an expression of fear and attempts to control the partner. There is a decided lack of trust.

Healthy monogamy, in my opinion, is about trust and commitment. It’s working with your partner to put the other first. And paradoxically, in putting the other first, your needs are simultaneously met (partially because the other is putting you first). Monogamy isn’t passive, but requires tremendous amounts of work. The workbook is designed to start the necessary conversations regarding healthy monogamy.

Open Relationships
A final type of relationship discussed here is open relationships (typically defined as a relationship where there exists a primary sexual and emotional partner followed by a secondary partner or partners). Even within this concept there is a variety of definitions and expressions. If you choose an open relationship it is important for you and your primary partner to clarify ground rules and expectations. When, where, with whom and how often are all topics to be addressed. What are the plans for communicating and coping with fear, jealousy and insecurity? What are the safer-sex rules?
If you want an open relationship, examine what unmet needs (if any) exist within your primary relationship. Significant reflection should occur within your support network to clarify the reasons you want an open relationship. In particular, be careful that you are not simply trying to get out of the primary relationship. If the primary relationship is not healthy, it is important to address the issues first. If it should end, do this with integrity instead of forcing a rift that ends the relationship. One requirement is that all partners be open and honest in the conversation. Both partners must agree with a sense of internal integrity with any decision. It might be better to end a relationship than agree to a type of relationship that is inconsistent with your values.
Sexual satisfaction is a major component of overall relationship satisfaction. Research has repeatedly stressed overall health is connected to relationship satisfaction. If you continue to struggle in this area, I strongly recommend seeking additional help from a qualified professional.

Can I choose to be gay?

I have a question I know is sure to be controversial but I have to ask. Based on my experiences as a gay man and from relationships I have been in with men identifying as gay, I have often wondered if it is possible that some people CHOOSE to be gay. I was recently in a relationship with a man who said he was gay but had a previous relationship with a woman. One night while we were dating, he revealed to me that he had been violently raped by his older brother when he was growing up. He said he believed he was always gay and the traumatic event did not make him gay. Nonetheless the story disturbed me and left me questioning the idea that some people may become gay as a result of some kind of childhood trauma. To add to my confusion, the man I was dating called me one day to tell me the woman he was previously dated asked him to come back to her and that he decided he wasn't really gay after all.


This a great question; it’s a the real-life “hot-potato” question that leads to intense conversations and much confusion. The causes of sexual orientation are unknown. Any theories as to why a person might be gay usually don’t work for another person. A great analogy is what causes “left-handedness.” We simply don’t know what causes a person to be left-handed. What we do know about left-handedness is that people are this way from birth, usually have a stable predominant hand, and can use their other hand as well.

This analogy can be helpful in many ways. Just like a kid starts to use his left-hand more often, and sees that he is different, people with a gay orientation recognize something is different. Sexual orientation is stable from an early age. What appears to change is our awareness of our orientation.

For some people who are left-handed, they are trained not to use that hand. So too, many people are taught not to express any same-sex orientation and play it straight.

In some cultures, giving something to another person using your left hand is a cultural insult. There is a lot of pressure to conform to the cultural expectations and use your right hand. In a similar way, gay people have a lot of pressure to “play straight.”

A few people are ambidextrous, meaning they can use both hands with equal dominance. So it is with sexual orientation; there are some people genuinely attracted to people of both genders.

When someone experiences damage to the dominant hand, they can learn to use the other hand to compensate. Given various circumstances, a straight guy can have sex with a guy, and a gay guy can have sex with a woman. This is simply an expression of sexuality; it doesn’t change the initial orientation.

The left-handed community has experienced significant stereotypes over the years. As a result, there is “left-handedness pride” (seriously, there is!). You can see the analogy to gay pride. (link: http://www.anythingleft-handed.co.uk/)

All in all, I don’t know what’s up with your friend. It would be unethical for me to even guess. What I would say is that there are many different factors that impact a way a person chooses to express sexuality. This is the key. My orientation is stable, but I choose to engage in a variety of different behaviors.

Integration with the 12-steps

I'm still adding a few ideas now and then in the new workbook (so much for being done!). This was a requested topic. "How do the 12-steps and the workbook overlap."

All of the topics listed here are in the blog...the order is a bit confusing. The page and topic numbers refer to how the new workbook has been reorganized.

One of the more common ways that people address sexual compulsivity is using the 12 steps. I see the workbook and 12-steps as complementary. In fact, I created the first draft of the workbook for a 12-step chemical dependency program where I work as the Director of Program Development. The first task was to develop a Sexual Health Program within a residential and outpatient CD program. The following is how I think the 12 steps overlap with some of the topics in the workbook.

1. We admitted we were powerless over sexuality—that our lives had become unmanageable.
Topic 1: Immediate Short-Term Prevention Plan, page 11.
Topic 3: Sex History, page 15.
Topic 5: The Acting-Out Cycle, page 23.

2. Came to believe that a Power greater than ourselves could restore us to sanity.
Topic 37: Spirituality, Values and Sexual Health, page 144.

3. Made a decision to turn our will and our lives over to the care of God as we understood Him.
Topic 39: Creating Your Future, page 160.

4. Made a searching and fearless moral inventory of ourselves.
Topic 3: Sex History, page 15.
Stage 2: Primary Treatment: Related Topics, page 57.
Topic 24: Abusive Behaviors Toward Others, page 106.

5. Admitted to God, to ourselves, and to another human being the exact nature of our wrongs.
Topic 2: Talking About Sex, page 13.
Topic 40: Toward a Personal Definition of Sexual Health, Component 1. Talking About Sex, page 165.

6. Were entirely ready to have God remove all these defects of character.
Introduction to the Workbook, page 1.
Defining Sexual Compulsivity, page 2.
Topic 7: Thinking Errors, page 28.
Topic 8: Primary Thinking Error, page 33.
Topic 9: Feeling Triggers, page 36.
Topic 10: High-Risk Situations, page 38.

7. Humbly asked Him to remove our shortcomings.
Defining Sexual Compulsivity, page 2.
Topic 37: Spirituality, Values and Sexual Health, page 144.
Topic 38: Continuing Care Plan, page 150.

8. Made a list of all persons we had harmed, and became willing to make amends to them all.
Topic 3: Sex History, page 15.
Topic 24: Abusive Behaviors Toward Others, page 106.

9. Made direct amends to such people wherever possible, except when to do so would injure them or others.
Topic 36: Disclosure to Partners, page 140.

10. Continued to take personal inventory and when we were wrong promptly admitted it.
Topic 1: Immediate Short-Term Prevention Plan, page 11.
Topic 13: Logging your Sexual Behaviors and Fantasies, page 48.
Topic 38: Continuing Care Plan, page 150.
Bottom Line Behaviors, page 158.

11. Sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only for knowledge of His Will for us and the power to carry that out.
Topic 6: Power of Thought, page 25.
Review and Repeat, page 174.

12. Having had a spiritual awakening as the result of these steps, we tried to carry this message to others, and to practice these principles in all our affairs.
Topic 39: Creating Your Future, page 160.
SexualHealthInstitute.blogspot.com, page 174.

Friday, May 22, 2009

Updated screen of Sexual Compulsivity

The link connects you to my most recent post on Gay.com/Planetout.com



Weston

Wednesday, May 13, 2009

Are you really over your ex?

She's packed her bags, gotten a new apartment and you've both moved on with your lives but have you really gotten "over" your ex? Many people think they have but if you read the comments to my last article "Do All Gay Men Cheat?" you quickly see an enormous amount of pain and anger people in the responses.

When a relationship ends, for whatever reason, there is going to be some amount of 
"garbage" of hurt and anger that needs to be actively dealt with. If you don't clear it away many of you will find some major barriers to having successful future relationships.

Impact Today
First thing you need to do is to take a good look at your current situation and try to figure out how the relationship relates to your life today. Specifically you're looking to identify how your past relationships impact your sexual behavior and also how your sexual behavior impacts your relationships.

Ask yourself the following questions:

* Do you do things you know are wrong because of something your partner did? Why?
* Was your partner’s behavior a response to something you did? Why?
* Are you avoiding relationships? Why?

Identifying Barriers

When a dog bites a child, there is a very good chance the child will have a negative reaction to dogs in the future. This is an example of transference. When you have a reaction to a current partner, it is often based on your past experiences. When these experiences are positive, your reactions are typically helpful. However, when they are negative they can create a barrier that may possibly doom a new relationship. What barriers are you experiencing today?

Unresolved Issues

Then there may be some "unresolved issues" affecting you that are a result of past relationships. Some of these include depression, abuse (physical, mental, verbal), the coming out process or feelings of shame and guilt. Sometimes the feelings of grief and hurt are so strong, some type of grief therapy may be needed to move past them. Until these are addressed you may be stuck on an escalator trying to go the wrong way.

Forgiveness

Forgiveness is NOT about forgetting.

Forgiveness is NOT about letting the other person off the hook.

Forgiveness is about YOUR healing.



Forgiveness includes helping you heal from negative thoughts while at the same time helping you let go of painful feelings. It's an extreme act of compassion when you can forgive the person who hurt you. In some religious traditions, an example of raising forgiveness to a radical expression is offering compassion to your ex. This brings about YOUR radical transformation.

Ways to Move Forward

* Write a goodbye letter. You can be totally honest and open with your feelings because you aren't going to be mailing this letter. When you're finished show the letter to a number of close friends and family who can act as your "support network." Listen to what they have to say about it then put that letter aside and write a new one. Don't edit your existing letter but write out a brand new one. Then share this letter with your support group. Repeat writing the letter and sharing again. Repeat again. After you have done this about 10 times go back and review each version of your letter. By doing this you have really begun the healing process. If you choose, send the 10th version of the letter.

* Reach out to friends, family and professionals for the support you need.
* Establish a boundary. Your ex’s behavior is about your ex, despite what he/she may say. This is important to remember. Remind yourself of this mantra. 

* Complete an inventory and honestly assess your role in the break-up. You will need to step out of the victim role to recognize it takes two to dance.

Sunday, May 3, 2009

New version of the workbook is nearing completion.

While the content is complete, I have about 2-3 more months of behind the scenes processing to complete before the new workbook is available. I'm surprised at how long it takes to actually publish the workbook.

The new intro

I wrote a new intro to the workbook.

Too many people are struggling to live a life they love. Consider the following conversations.

Me: Hello, this is Weston. How may I help you?
Client: Hi. I need to set up an appointment for therapy.
Me: OK. Can you tell me a bit to see if I’m a right fit?
Client: I keep having sex with a lot of people. I don’t seem to be able to stop.
Or,
Client: Yeah. My probation officer told me I had to see you because I was arrested.
Or,
Client: My partner is threatening to break up because I’m on the Internet too much.
Or,
Client: I went home with a sexual partner last night, and I think I was raped. I don’t know for sure. I can’t remember everything.
Or,
Client: I’m too scared to have any type of sexual contact.
Or.
Client: Can you help me find help for my partner? I just found out he’s been having sex with other people. I don’t know what to do.
And one more.
Client: Yeah, I just found out I’m HIV positive. I’ve been drinking, drugging, and having lots of sex.

My heart breaks at the frequency of these real conversations I have on a weekly basis. In the realm of sexuality, feelings of hurt and hopelessness abound. In my opinion, it is a courageous act to pick up a book on sexuality. Simply starting this workbook is movement toward healing. This workbook is committed to helping you move forward and address the issues related to problematic sexual behaviors. In the end, my goal is you will have the freedom to say, “I’m living a life I love.” Shall we begin?

Acknowledgements for the new workbook

All authors know “the truth” that a project of this type is only possible with the support of others. I never fully understood the reality of this truth – until now. As I finish this workbook, I find I am deeply moved by the journey. As the final pieces of the project came together, I literally found myself crying in a coffee shop because of the relief due to finishing amount of work, the level of hurt and frustration I see others experience, and the struggles that so many people have with hopelessness. And like the sunrise breaking the darkness of night, I experience the birth of hope in the middle of despair.
I want to acknowledge the following individuals who provided support throughout the years.
First, recognition goes to my clients. Your journey led to the project. Your struggles, needs, hopes and failures all point to a desire for sexual health. Your cries of “help” and the lack of information available are the inspiration for the workbook. I am grateful and humbled for your generosity by including me in your journey. I hope this is another step in your recovery and movement toward sexual health. The journey can be difficult at times and I acknowledge your courage to take one-step, one-day, and one-topic at a time.
The faculty at the University of Minnesota who served as colleagues and mentors deserve second recognition. I specifically mention Drs. Simon Rosser, Eli Coleman, Bean Robinson, and Mike Miner. These four, among many others, provided an avenue that started my journey in the field of sexuality, encouragement along the way, and the occasional “special support” when I was stuck. My respect for them has grown over the 15 years.
Next, I acknowledge four individuals who contributed to the workbook: Larry S., Amanda R., James S., and Erich A. who helped me in the layout, content, and editing. I cannot tell you how many times they listened to my excitement and frustration (and all for free!). I cannot count the number of drafts they reviewed. I am grateful.
Finally, to Luis who lovingly froze not understanding the intensity of my reaction that day in the coffee shop. Your presence was the support and love I needed.
Weston M Edwards
May 3, 2009