This exercise is a helpful template to facilitate full disclosure. Use/adapt as you both find necessary. After both you and your partner have completed the above questions, first confirm that you are both willing to go through the process. This starts with a confirmation by each of you to use the information to strengthen the relationship (and not as a reason to end the relationship). If you cannot confirm this commitment, please post pone disclosure and address the underlying issues. Clarify and negotiate a neutral setting for the disclosure to occur. Consider if you need someone there DURING disclosure: sometimes this may need to occur in a couple’s therapy session. Please make sure you schedule enough time. Pick a date that is NOT already emotionally charged (in other words, don’t do this on your way to holiday dinner with the in-laws!). Consider if you want a support person nearby or on standby.
Start by reviewing the receiving partner’s response to the questions on page 187. Use these questions to structure the discussion. Start by answering each of the questions, allowing the partner to ask clarifying questions. Remember to respond openly and honestly; a lie of omission is as damaging as a lie of commission. Take a break when necessary. Ether of you can call a timeout and/or suspend the disclosure if necessary. Identify a plan to resume the disclosure process if you call a timeout or suspend the disclosure.
After disclosure, debrief the experience. This includes asking each of you, “What are you thinking? What are you feeling? What are you present to? What do you need? End with a ritual to celebrate the relationship and the reaffirmed connection that occurs in disclosure. (Yes, conflict is a form of healing intimacy, see page 165). This ritual could be dinner, a walk, a date, meditation, burning the papers created to answer the questions.
Showing posts with label disclosure. Show all posts
Showing posts with label disclosure. Show all posts
Monday, September 5, 2011
Wednesday, October 20, 2010
Disclosure in the therapy process
How to talk about therapy without talking about therapy.
In other discussions, I emphasized the importance of full disclosure. I recognize the importance, however, of full disclosure occurring in a meaningful way usually near the end of the therapy process. It is also important for some type of ongoing disclosure to occur along the way that fosters healing and trust in the relationship. Below are a few ideas on how to talk about the therapy process without getting bogged down in the details of the history. Eventually the history will be shared.
1) Both individuals in the relationship have to agree to this process. I typically meet with the client and partner near the beginning of therapy to talk the process through, and clarify the guidelines.
2) Clients are encouraged to talk about their internal process, without necessarily disclosing the content. This is where the client can share feeling statements from therapy. As an example, “I realized I fell sad which is a trigger in my acting out cycle…”
3) Clients are encouraged to talk about the “lessons learned” from therapy. For example, “Today’s topic was on intimacy, and I realize I need to develop my skills in emotional intimacy.”
4) Clients are encouraged to develop assertive communication skills to express needs, desires and requests. All behavior is goal focused, including sexual compulsivity. Identifying healthy ways to get needs meet reduces the future risk of acting out.
My experience is when the client learns how to engage in these smaller disclosures, the relationship experiences healing. Occasional intermediate sessions with the partner can foster this process. It is this healing that allows the full disclosure to occur. Yes, couples therapy will still be necessary but much of that work is helped by the ongoing disclosure.
In other discussions, I emphasized the importance of full disclosure. I recognize the importance, however, of full disclosure occurring in a meaningful way usually near the end of the therapy process. It is also important for some type of ongoing disclosure to occur along the way that fosters healing and trust in the relationship. Below are a few ideas on how to talk about the therapy process without getting bogged down in the details of the history. Eventually the history will be shared.
1) Both individuals in the relationship have to agree to this process. I typically meet with the client and partner near the beginning of therapy to talk the process through, and clarify the guidelines.
2) Clients are encouraged to talk about their internal process, without necessarily disclosing the content. This is where the client can share feeling statements from therapy. As an example, “I realized I fell sad which is a trigger in my acting out cycle…”
3) Clients are encouraged to talk about the “lessons learned” from therapy. For example, “Today’s topic was on intimacy, and I realize I need to develop my skills in emotional intimacy.”
4) Clients are encouraged to develop assertive communication skills to express needs, desires and requests. All behavior is goal focused, including sexual compulsivity. Identifying healthy ways to get needs meet reduces the future risk of acting out.
My experience is when the client learns how to engage in these smaller disclosures, the relationship experiences healing. Occasional intermediate sessions with the partner can foster this process. It is this healing that allows the full disclosure to occur. Yes, couples therapy will still be necessary but much of that work is helped by the ongoing disclosure.
Saturday, June 19, 2010
Disclosure of Sexual Compulsivity to Partners
Over the last year, I've been updating the previous workbook for a new workbook to be released this summer. Here is one of the last articles that have been rewritten. Check out the website LIVINGALIFEILOVEBOOKS.COM for more information about CYBERSEX UNPLUGGEG
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.
Assignment
• 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?
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.
Assignment
• 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?
Saturday, April 24, 2010
Unsafe Sex and HIV Disclosure: Should I disclose?
>A recent request for questions resulted in someone asking what I think is one of the MOST difficult questions in sexuality/HIV prevention. “Should I disclose HIV status when I’m having unsafe sex?”
My short answer is “yes.”
My long answer is also “yes,” but probably not for the reason one would think.
Before I go into my response, I highlight the level of fear, AIDS phobia, inaccurate knowledge, and generally rude behaviors by many negative individuals toward positive individuals. The level of discrimination by negatives toward positives is sad and disappointing given that we are 25+ years into the epidemic. I also highlight all the reasons the CDC, and other prevention workers would say yes: we all have a responsibility toward stopping the epidemic.
But, in my opinion, the reason a person should disclose his or her HIV status is the expression of the individual’s own mental health. I think it is incredibly brave and courageous when an individual stands up and says, “This is me.” When an individual discloses their HIV status, I think it represents a level of self-knowledge, self-acceptance, and overall inner strength where he or she also says, “This is me, if you don’t like it, deal with it.” I recognize this level of self-knowledge and self-acceptance is a bit utopian, but then again that’s what we psychologists move toward: helping an individual claim a level of pride and integrity in all aspects of his or her life. If you’re not at that point, I think it can be a goal. Finding someone (or many someones) who will walk with you in that journey is important.
Have a question? Or an opinion, please email or post to http://sexualhealthinstitute.blogspot.com
Resources
Web: TheBody.Com
My short answer is “yes.”
My long answer is also “yes,” but probably not for the reason one would think.
Before I go into my response, I highlight the level of fear, AIDS phobia, inaccurate knowledge, and generally rude behaviors by many negative individuals toward positive individuals. The level of discrimination by negatives toward positives is sad and disappointing given that we are 25+ years into the epidemic. I also highlight all the reasons the CDC, and other prevention workers would say yes: we all have a responsibility toward stopping the epidemic.
But, in my opinion, the reason a person should disclose his or her HIV status is the expression of the individual’s own mental health. I think it is incredibly brave and courageous when an individual stands up and says, “This is me.” When an individual discloses their HIV status, I think it represents a level of self-knowledge, self-acceptance, and overall inner strength where he or she also says, “This is me, if you don’t like it, deal with it.” I recognize this level of self-knowledge and self-acceptance is a bit utopian, but then again that’s what we psychologists move toward: helping an individual claim a level of pride and integrity in all aspects of his or her life. If you’re not at that point, I think it can be a goal. Finding someone (or many someones) who will walk with you in that journey is important.
Have a question? Or an opinion, please email or post to http://sexualhealthinstitute.blogspot.com
Resources
Web: TheBody.Com
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