Sunday, June 20, 2010

What is positive sexuality

Defining positive sexuality requires understanding sexuality in a brand new way. In this approach, sexuality is a normal, vital, and positive aspect of your life. Too many people suffer pain when they think about sexuality. Give yourself permission to be a sexual being. Rather than repressed, hidden or shamed, positive sexuality celebrates your sexual energy and being. Yes, this includes sexual behavior but it includes much more.

Your task in this section is to challenge most, if not all of the messages you have heard about sexuality. This doesn’t mean you have to discard the beliefs. Instead, understand both the letter and spirit of the messages. Sexual Health is a journey. Today’s thoughts are for today. What you like today is for today. What you want is for today.

The key to this section is discovery. When you watch a child in a playground, they meander through all of the play areas. They might stop at the swings, or the merry go around. Next the may check out the slide, and perhaps build something in the sand. When they like something, the child stays in the area. So to is the role of discovery in the realm of sexuality. Check out what you like or don’t like. Enjoy the positive experiences, and let go of the unpleasant experiences.

Balance is important in the journey. You can change your mind on this journey. I place good/bad sexual experiences on a different continuum then the continuum of healthy/unhealthy. You can have a sexual encounter that feels good but is unhealthy (think meth/sex), and a bad experience that is healthy (think too tired to function, but emotional intimacy).
Enjoy your journey in sexual health. My hope is that you have great experiences along the way. Sometimes the only way we know what is sweet is because we can compare it to what is sour.

Saturday, June 19, 2010

Disclosure of Sexual Compulsivity to Partners

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We recommend sharing this section with your partner sooner than later.

When a person is addressing sexual compulsive behavior, one person it impacts is the partner. For a partner, a variety of issues need to be addressed, including emotional, physical and sexual issues. It is our recommendation that the partner obtain therapy/support for himself or herself. Through individual therapy, we recommend each partner clarify his or her commitment to the future of the relationship before disclosure occurs. Coping with a partner’s disclosure has a parallel process for the partner. Treatment issues include getting information, including “understanding” the language of people in the field. Therapists and those involved in the 12-step movement often use a jargon for shorthand communication. Learning the meaning of these terms is important. As you move away from crisis/shock, it is important to stay focused on your emotional and physical health. Incidentally, family members may have access to pornography because of another member’s behavior. Addressing basic safety issues and setting boundaries to maintain safety of others is important. As you cope with your partner’s compulsive behavior, you need to identify how you will take care of yourself. It is important to identify what you need to do today, what you can do in the next month, next three months, or the next year. Partners typically may have feelings of despair, hopelessness, confusion, and anger. Additional feelings of shock, depression and grief may be present. Sometimes the individual blames himself/herself, either due to ignoring signs or simply not knowing. Part of the healing process is to gain support from professionals, peer networks (groups) and family or spiritual support.

When an individual has multiple sexual contacts, the partner is also at increased risk for HIV/STIs. It is my recommendation that you be completely open and honest about the purpose of the visit with your healthcare provider. Some providers will assume that since you are in a relationship, you are not at risk. You will need to be explicit and say, “I found out my partner has multiple sex partners and I’m worried about being infected with a sexually transmitted infection.” A partnership will need to determine safer-sex guidelines in light of the risky behaviors.

Once both individuals address their respective issues, couples therapy can facilitate the healing of the relationship. Relationship issues can include addressing blaming statements by the partner. Often there is a sense of powerlessness that comes with not knowing what to do and how to get your partner to stop the behaviors. Treatment for the individual and the partner includes clarifying what you both need and want in a relationship and assessing honestly where the current relationship is going. This is a chance for you to clarify your boundaries and develop the skills to protect those boundaries. Some partners may feel pressured by their support network to leave the relationship. Unfortunately, no guidelines are available for the decision you and your partner may need to address. Some relationships can continue while others should end. In some cases, this is an appropriate response. If you know you are not going to stay in the relationship, disclosure is not necessary. If you know you want to stay in the relationship, disclosure can occur. I will not work with couples who use the process of disclosure as ammunition against each other. In my approach, disclosure is about repairing, reconciling and taking full responsibility in order to foster an ongoing relationship.
One issue rarely addressed is the disclosure of your history to any future partners. The timing and level of detail in regard to your future disclosures are important to consider. Again, I have the bias of full disclosure. You wouldn’t necessarily avoid disclosure of a chemical addiction or health issue, and I see the issue of sexual history as similar. I also recommend working with a couple’s therapist to help you and your partner through the process.

What do you share?

After discovering that his partner was engaging in sexual behavior outside of the relationship, a client commented that coping with identity theft was easier than coping with the loss of his image of the relationship. He reported that he felt like a part of his identity was ripped away. I think the metaphor is accurate. One of the biggest issues in addressing sexual health is the question of disclosure to the partner. Not everyone agrees, but my bias is toward full disclosure or at least giving the partner the right to set how much disclosure he or she would like. I do not recommend that disclosure happen outside a couple’s therapy process. Again, we recommend sharing this with the partner sooner than later. Your treatment process is designed to help you respond to the needs of your partner as identified in this section.

• These questions are for your partner to answer.
• Who is your primary support network? What is your plan to reach out for support when disclosure is complete?
• What work have you done to address your treatment issues triggered by the partner’s acting out behavior?
• What are your feelings and thoughts about disclosure?
• Are you committed to staying in the relationship? If not, we do not recommend disclosure. If you are ambivalent, why do you want disclosure at this time? What work do you need to complete in order to strengthen your commitment to the relationship before disclosure?
• What is your goal of disclosure?
• How much detail do you want to receive? Consider the following:
o Your partner completed a sex history and timeline? Review the questions. Which of these questions would you like answered? The sex history is very detailed (about 4 pages) and includes questions addressing frequency, intensity, consequences (legal, medical, financial), duration, location, types of behaviors, number of partners, online behaviors, etc.
o Your partner completed a timeline? Would you like to see this timeline? At what time in your partner’s history do you want him to start (Since dating? Last disclosure? Lifetime?)
o Often there are additional acting out behaviors, would you like to know about these compulsive/addictive behaviors?
o Is there any information you DON’T want disclosed to you?
o Your partner has identified a continuing care plan addressing the major high-risk situations, thinking errors, and feeling triggers related to his/her acting out behaviors. Would you like your partner to share this plan?
• Are you prepared to respond to your partner with your own disclosures? Why or why not?

Monday, June 7, 2010

Life, Liberty and the Pursuit of Sexual Health

I argue that all of our life is built on sexuality. Simply look and it is possible to see connections to sexuality that may have been unrecognized. A great deal of the advertising is built on sexuality. “If I buy this thing, I will get the right partner, perfect job, or woo the person of my dream.” The funniest jokes are often based on sexual innuendo. The biggest social issues of the time are related to sexuality. Many of our fears about the future are based on the question of whether or not I will find someone to love. Some of the biggest fears we have are about trusting our partner. Our biggest pains often connect to relationship failures. For some people, our biggest joys are children.

All of these examples highlight how important sexuality is in our life. But almost no-where do we have any discussion about sexuality that fosters growth and understanding. Much of our discussion on sexual health is unspoken, or if spoken it is fear based. What would it look like to take a moment to expand the discussion and uncover all the messages we hear about sexuality? What would it look like if we sat down and discussed our sexual beliefs? What would it look like if I identified what is healthy in my life and actually took the responsibility to assertively get my needs met?