Saturday, August 27, 2011


Mindfulness is the experience of being aware of your current thoughts, feelings, body state and surroundings by paying attention to your reactions, motivations and actions. Our mind is so full of ongoing chatter that it simply becomes the noise the fills up most of our life. To increase your ability to be mindful, I encourage you to become aware of your inner conversation. When someone walks into the room, we may say to the person next to us, “She’s attractive.” But our inner conversation is what we have with ourselves when no one is around. Someone might walk into the room, and we say to ourselves, “I want to have sex with her.” Various meditation techniques can also be helpful in increasing your mindfulness. The process of behavioral analysis described later in the stage is a tool of increasing mindfulness by asking you to reflect on your thoughts, feelings and behaviors when you last acted-out.

What you will find is that mindfulness is a skill. It is not possible to mindful 100% of the time. The key is to try to be mindful, and when you aren’t mindful of what you are feeling or thinking to simply and gently become mindful of what you are thinking and feeling. I know it is easier said then done. Many meditation traditions have at their core the concept of mindfulness. I have two examples that might be helpful. Consider the image of a cloud in the sky. We see the cloud, and watch it come to be right over us, and slowly move on only to have another cloud take its space. Next, think of a leaf on a river. While sitting on the bank, you see the leaf come into view, pass in front of you, only to move out of your view. So too, mindfulness is becoming aware of your thoughts as you move from thought to thought. So to when building our skills of mindfulness, we watch what we are thinking as we move from thought to thought. Given that many of our thoughts are automatic, in the healing process, becoming aware of our thought may occur we stop and ask, what where we thinking. This is a benefit of completing a behavioral analysis.

Monday, August 22, 2011

Theory, Adaptations and Recommendations

The workbook is organized in a way that could be used alone or in a therapeutic setting. If you look carefully, you see the standard therapeutic structures within the assignments. Stage 1, for example, reflects the data collection often completed in early therapy. In the clinic I supervise, for example, we use an interview process where a therapist and client complete a bio-psych social. The relevant topics in the workbook for data collection are:

• Developing Rapport (talking about sex)
• Short-term treatment plan (what brought you to treatment)
• Data Collection (sex history, timeline, logs, acting out cycle, cross compulsivity, be-havioral analysis).

After the data is collected, a client will collaborate with the clinician to complete a treat-ment plan. The treatment plan is where the client tells the clinician what are the most im-portant issues. In the workbook, this corresponds to the summary and prioritization of topics at the end of stage 1 (see page 73).
After the completion of the treatment plan, the client starts the work corresponding to the client-defined priorities. The topics in stage 2 reflect an introduction to the major issues that I believe are most important. If additional material on a topic is needed, the client is encouraged to go beyond this workbook. All of the assignments in the workbook reflect an attempt to integrate a cognitive behavioral model with a health promotion model.

In the therapy process, there comes a time when both the clinician and client recognize the process is nearing the end. Assignments in stage three reflects the termination process by helping the client clarify the major issues to be addressed after treatment (continuing care plan), and provide opportunities for the client to demonstrate the progress that oc-curred in the treatment process (personal definition of sexual health). These two assign-ments are done within a context of motivational interviewing and stages of change model (Spirituality Values, and Sexual Health). In other words, a client’s values shapes what the client thinks is most important in his or her life, and confirms what the client is willing to commit to in the future within the client’s cultural context (e.g., the first topic in Stage 2).

The reason for the extended discussion is to help either the client or professional to make changes, or adaptations to the structure. You are encouraged to use the workbook in a way that makes sense to you. The implicit structure is what makes sense to me. But in the end, a personal definition of sexual health requires each of us to define what is right with-in our world. My hope is that you found the workbook helpful.

Friday, August 19, 2011

Transference Updated content

I updated the content on Transference.

Transference is any reaction we have to another person. The individuals with whom we have the strongest reaction are perhaps the people who can teach us the most about our self. Often the experience of transference occurs so quickly, we don’t real-ize neither that it occurred nor are we mindful of the content of the transference. The reality is that transference is how we make sense of the world. We are CONSTANT-LY assessing and judging our environment based on our past experience. It is the past experience applied to the current situation that typifies transference. It is the way we “know” what to do in the current situation. The problem is that no two situations are the same, so sometimes our transference might actually be getting in the way during the current moment. Also, most of the time we focus on negative transference, or the negative reactions we have to someone, but positive transference is also helpful to understand. In any reaction -positive or negative- you can learn what you are feeling and thinking and how it relates to your acting-out cycle. It is your reaction that tells you the most about yourself. The key is to pull back the levels of reaction to focus at the core motives/thoughts. Individuals often try to hide/avoid these thoughts. Ask yourself the following questions: “Why am I having this reaction? Who does this re-mind me of? What memory does this person trigger? Why do I like or dislike this person?” Whatever the response, you can gain insight into your internal thoughts and feelings. As highlighted, transference can occur in positive and negative ways. What I don’t like about a person may often be expression of the things I don’t like about myself. What I do like about a persona may also be an expression of things in my life that I like about myself, or I want but don’t have. What we like and dislike in others reflects our inner core. This is a classic psychological principle that also applies to sexuality. That to which we are drawn reflects an inner craving that we must address. That to which we are rejecting also reflects an inner craving that we must address. Take the opportunity to discover about what moves in you in your life by becoming mindful of your reactions to others. Your strongest reactions reflect a deeper truth. An open, honest and fearless examination of those reactions might create profound transformation and possibility.

Monday, August 8, 2011

Healthy Masturbation Exercise

Moving toward integrating masturbation into healthy sexuality means moving away from the typical form of masturbation. It is also about moving from shame to self-exploration and discovery. To do so, the following exercise will help expand your experience of masturbation from a quick and dirty activity (on average, lasting 3-5 minutes) to a sensual self-affirming opportunity. This applies to both men and women.

Make sure you have the time for the following exercise. What follows is one example, but you can adapt to your personal interests. For this example, I assume you are in your bed (but experiment with other locations/positions). Start by making sure you’re comfortable, including any music, candles, aromatherapy, oils, bath, or any activity that can help you relax. The fun is in the experimenting.

First, start by being aware of your breath. Breathe in-and-out, slowly and steadily. As you move through the experience, it is important to maintain your breathing. Sometimes as a person becomes aroused, he/she may forget to breathe. When you sense that you are holding your breath, gently remind yourself to keep breathing.

Next, continue by touching your body with your hands (without lubricants). At this point, don’t focus on your genitalia. Touch your face, ears, massage your neck, arms, fingers. Feel your chest, moving to your stomach. Massage your thighs, and include your legs and feet (and toes!). The slower you move through ALL of your body parts, the better. Vary the intensity, and type of touch. You can use your thumbs, palms, fingernails, back of the hand, tips of the fingers, back of the fingers, etc. Repeat the touch and be mindful of what you enjoy. Perhaps gently tug at your hair, or pinch your skin. Each of us has erogenous zones that vary in sensitivity. Find the zones and types of touch that are most pleasurable to you.

As you continue touching your body in different ways, include touching your genitalia, nipples, and buttocks. Continue varying the touch. Move back and forth between all your body parts. You may find that your genitalia will change in the level of arousal throughout the experience.

Optional activities might include using other pieces of clothing or items. Various items might be different fabrics, cold/hot items (not too hot!), feathers, or sticks (such as a dowel). The key here is to experience a range of touch.

As you go through the experience, vary the type of touch of your genitalia (for example, the grips of the penis, or the massage of the clitoris, etc.). Each type of touch will lead to different experiences. Experiment and enjoy. If you don’t like something, or it feels unpleasant, do something else.

Remember to breath.

After you’ve felt your body, repeat the full body touch but this time you might consider the possibility of adding lubricants such as oils, waters, water based or silicon-based lubricants. Each will create different experiences. Some might be sticky, slick, sensual, etc.

Continue to breath.

Your body will increase in excitement simply due to the stimulation. Depending on how long your want to prolong it, you will notice that if you are very genitally stimulated moving the touch to other body parts will extend and slightly decrease the overall stimulation thereby prolonging the experience.

At some point in the experience, particularly if you are focusing your touch on the genitalia, you may get to the point where you might experience an orgasm. Continue to breathe. But remember that orgasm isn’t necessarily the goal. Understanding what you like and providing self-pleasure is the goal.

Practice and repeat.

After your experience, review how you felt, what you liked, and talk about the experience with your support network. Often in the struggle with sexual compulsivity, we have to UNLEARN unhealthy patterns of masturbation (often associated with shame, guilt and frequently linked with problematic behaviors)

Friday, August 5, 2011

The transforming power of community.

A powerful instrument to help individuals move toward sexual health is the support of a community. Often in the early stages of addressing sexual health issues, the isolation a client feels is profound. With so many fears and secrets, the expectation that a client share his or her secrets in the sexual timeline is the first hurdle to overcome. But often, it is the sharing of the secrets that leads to the beginning strands of connection and community. By sharing secrets an individual deconstructs the illusion that he/she is alone. Yes, breaking the silence starts with one disclosure, and leads to additional disclosures. Slowly what was experienced in isolation disappears in the developing connections that occur through the sharing of secrets. As the process of disclosure continues, a community develops. Believe it or not, what was once a secret is joyfully acknowledge in community and leads to a sense of transformation. From this transformation, powerful new opportunities are created. All of which starts with sharing a secret with one person.