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.

Developing Sexual Health

This process of developing your sexual health consists of five phases of understanding. Think about these phases as tools to help you understand what you need to do, and where you are in the particular topic of choice. For example, everyone “knows” what sexual health is, or do we. Picking up this workbook is the process of moving forward to start gathering information. Struggling with this information and coming to a basic understanding is later followed by a sense of awareness of commitment to your values in the realm of sexuality. These phases are:
1) Unexplored commitment reflects the fact that many people simply don’t think about the topic of sexuality.
2) Active exploration refers to the process of seeking information regarding sexuality. This dimension addresses the six tasks below. The person actively seeks information via the Internet, therapy, friends, family, society, etc.
3) Diffusion reflects a time of struggle and confusion. “What I thought I know is no longer the case.” This is a time of rejecting social norms about what I should be, and a time of exploration sometimes through trial and error.
4) Deepening and commitment of the identification of the individual’s likes and dislikes and an increased level of comfort with the self. For many people who identify of “straight” this may be occur without the exploration and diffusion dimensions.
5) Synthesis is a process of integration of all aspects of the self. There is an internal congruence between the self, values, behaviors, likes and dislikes. There is also an integration of the sexual identity with all other aspects of the person’s life including gender, racial, religious, and familial.

The Pain of Sexuality

I am keenly reminded of the pain many people experience in the realm of sexuality. This pain is from a variety of sources including the typical sources of abuse, shame, and guilt. But, the sources of pain can include social, familial, cultural or religious messages. A major concern is when the external messages become internalized and the individual replicates and reinforces the painful messages in a tighter and tighter circle within him or her self. Once this pattern begins, the pain takes on a life of its own, leading to feelings of hopelessness, desperation and profound isolation. For me, this is perhaps the saddest part of the pain.

The process of healing this pain is beyond the scope of a simple blog entry. The short summary is the process requires much work, and support. My clinical work, and blog writing is about helping people in the healing process. To highlight three starting points, I would encourage you to:

1) Give yourself permission to be a sexual being. Sexuality is a normal, vital, and positive aspect of your life. Having an experience of sexual health is remarkably liberating and affirming.

2) Reach out for support. Using your support network best facilitates the process. The network can include friends, family or professionals such as your therapist, spiritual guide, or other providers.

3) Feel the pain. You cannot avoid the pain; this only intensifies the pain. Paradoxically, the only way to resolve the pain is to go through the pain. A recent encounter involved working with someone in the healing process. At one point, the release of the pain resulted in surprisingly intense sobbing session. The level of wailing can best be described by imagining a 4-year-old toddler who wails after his/her finger has been accidentally slammed in a car door. Witnessing this from a normally stoic grown adult highlights the profound pain.

There is a saying in the workout/gym/weightlifting community: No pain, no gain. Not so surprisingly, this platitude applies to healing the pain of sexuality. When this process is complete, you can experience peace and acceptance. And, you have the potential for great love.

The power of story

When we think about who we are, we essentially come up with a story. When you string enough of the stories together, you develop a sense of self. Some of our stories have a profound role in shaping our identity; other stories have a minimal impact. Sometimes there is a story we deny, avoid or otherwise minimize. Sometimes we simply forget our stories. In a few cases, we’ve never thought about a particular story line. When prompted, however, thinking about the story can lead to profound change.

I encourage you to think of all of the stories about yourself and others. One place to look at is phrase that comes after because. “I do that because….. I’m that way because…… This is important because….. “ These are the stories that shape your life.

As you will find, some of the stories may be helpful or unhelpful. Some stories may suggest topics to review with your support network or therapist. A few of the stories may be a source of profound joy or emotional pain. As you understand the stories, there is no right or wrong story. What is important is that this is your story.

Believe it or not, it is possible to change the story. This is a process of growth and development. Taking a new perspective on a story can lead to new insights. Gaining additional information changes the content of the story. Feedback from peers can facilitate a reframe of the story. This process of change requires us to know and understand the stories in our life.

Sin is doing something wrong; Hell is staying in something wrong.

As individuals move forward in recovery, I hear enough stories of being not being able to stay clean. In psychological terms, we might describe this as failure and make reference to the stopping the acting out cycle as we move forward. In 12-step language we might describe this as relapse, and highlight the powerless needed to stop the addiction. In spiritual language, we might recognize this as sin and the need to seek forgiveness. Each of the different frameworks helps us understand the same behavior through a different lens.

Using the spiritual framework, my personal definition of hell builds on the concept of sin. If sin is doing something wrong, hell is staying in something wrong. I encounter individuals who after a relapse, enter into shame spirals, emotionally abuse themselves, and forever put themselves in negative place. For many of these individuals, they punish themselves much more than I or anyone else could ever punish them. And in my mind, the individuals are in a self-imposed hell distinguished as helplessness, frustration, and hopelessness.

When I met an individual in this self-imposed hell, I encourage them toward self-forgiveness. I ask them to if they would treat others they way they are treating themselves (a reverse Golden Rule). And I encourage them to “be gentle with yourself.” Recovery from drugs and stopping the sexual acting out cycle requires accountability that is respectful and leads toward forgiveness and healing versus shame, fear, and the ongoing experience of a personal hell.

Why does a person stop at a stop sign? The role of discovery in sexual health.

One of my favorite exercises is to ask a client: Why does a person stop at a stop sign? After a moment of confusion often based on the thought “what is the purpose of that stupid question” the client will usually respond with a nice answer that is sometimes punctuated with an attitude (and for drama, a nice roll of the eyes) of “that is so obvious.” My enjoyment is to follow-up with “Why ELSE might a person stop at a stop sign?” And the exercise continues until the person exhausts all of the answers; usually this is about 2-3 responses. Then I ask them to think of a funny reason, a silly reason, a stupid reason, an absurd reason etc. In one group setting, the group eventually identified 41 reasons why a person might stop at the stop sign. My point had been made. Until you think outside the box, your options are limited.

So often in the realm of sexuality, we assume we know the answer to the question. We’ve been taught, told, indoctrinated, forced, or otherwise encouraged to “know” the right answer that we haven’t thought about what is our response to the question “what is sexual health for me. The movement toward sexual health is a process of discovery and thinking outside the box. Your purpose in this process is to ask, “Why do I think this?” What else may be an answer, response, thought, issue, concern associated with the topic? This process is about unfolding, uncovering, and discovery. A great concept from my experience is the concept of discernment. Discernment is the exercise of discovering, uncovering, and revealing the truth within you (for those with a religious faith, this truth within is believed to be the Spirit acting in your life.).

I want to provide three simple examples where the concept of discernment helps us understand the movement toward sexual health.

In my opinion, staying in or leaving a relationship is a process of discernment. It is uncovering, revealing and discovering the health of the relationship. It requires an honest evaluation of your contribution to the state of the relationship, and assessment whether you are capable or willing to help build, repair or develop the relationship. It requires assessing whether the relationship can be transformed or declaring it should end.

What does it mean to live as a LGBT individual is my second example. There are many cultural factors (religious, family, community) that affect this process. In the end, the individual is charged with discovering what it means for him/her to live as an LGBT individual. I’ve seen it all. From an individual who knew at age 12 they were LGBT and appeared to have little difficulty in the process of living as an LGBT individual to a 70-year-old man coming out and choosing to stay with his wife of many decades.

My third example is to link discernment to sexual behavior. Ultimately it is up to you to determine what behaviors are sexually healthy. In other words, what behaviors help me grow as an individual, foster respect in my life and the life of my partner and the health of my community? As you see in the previous blogs, it is a process to discovery the behaviors that reflect and protect the values you use to shape your life.

Two notes of caution.

Discernment is a process. While the first response to what is healthy may “seem” like the “correct” response, sometimes discovering your personal truth needs time. Many times we edit or limit our thoughts, beliefs and desires. Uncovering sexual health requires you to challenge the thoughts, beliefs and values you assume to be true. Sexual health is about integration resulting from many trials and errors, experimentation, successes and trip-ups. And sexual health is about continuing the process when all seems dark.

Discernment is about responsibility. It requires you to step-up and say, “This is important to me. This is what I believe.” Too often, people avoid this responsibility for any number of fears including fear of judgment, or disapproval. Paradoxically, when you step-up and take responsibility for your journey, freedom is possible. It is also communal in sharing your choices with others. Should you say, “Yes this is me!” but fail to talk with your primary support network, I would say that you are avoiding the responsibility of your choice.

More on my therapeutic approach

The past few days have been a light work load. As I result, I’ve had time to read and reflect. I am currently reading a book by Irvin Yalom, The Gift of Therapy: a letter to a new generation of therapists which serves as the catalyst for this post. (In my studies, Irv Yalom is considered a “classic.” His work on group theory and therapy was a must read.)

The three values that shape my life and work are healing, courage and freedom. If you review the first page of the sexualhealthinsittute.org website, these three words are integrated into a mission statement. I try to use these values that shape all my relationships in my personal life as well. I thought it might be helpful to expand on these values as they relate to my work with clients.

Healing.

Nearly every client I work with struggles with a sense of brokenness, impairment in their ability to relate to others, struggle to get by in life, and otherwise simply connect with their own internal power. In some clients, the pain and brokenness is palpable: you see it in their face, the way they walk, talk, and the way they look at others in the world. My goal is to provide a space where they can experience as sense of relief from their pain and brokenness, if even for one hour. While the sources of the pain are varied, the amazing consistent struggle is that every client is struggling to experience a sense of healing. Healing might be mean relief, or awareness, or even insight as to why pain might be there. While I’d like to believe that the pain and brokenness will go away, in some cases the pain and brokenness might be permanent. Such might be the case of a loss, illness, or death; or as some theorists hold, experiencing pain and brokenness is simply a part of being human. When the pain cannot be erased, I’m committed to walking part of the journey together. Sometimes simply walking with another person is enough to ameliorate the feeling of separateness and isolation that accompanies the pain and brokenness. Sometimes the shared experience can transform the pain and brokenness into an awakening that is startling.

Courage.

Too often people minimize their own courageous behaviors. Our culture, through the movies and media, has reduced courage to acts of bravery on the battlefield. Unless you are facing a life or death situation, courage does not exist. This portrayal minimizes the infinite expressions of courage that I see in my work. For me, courage is the commitment to act in the face of fear. Courage is expressed by simply showing up in my office. Courage is expressed by disclosing to your partner the sexual compulsive behavior. Courage is expressed when a sex offender sits before his victim apologizing for his crime and asking for forgiveness. Courage is in the victim of a sex offender who confronts their abuser determined not to let the offender’s behavior destroy their life. Courage is in the individual who profoundly accepts an insight into reality; whether it is accepting the thought “I’m gay,” I’m positive,” or the addict who says “I have a problem.” Courage is when a client takes a moment where he or she is confronted and says “your right.” Courage is when a client accepts an awareness of how a particularly thinking error has shaped his/her life. In the many years I’ve been doing this work, I’m amazed at the number and types of courageous expression. And, in my own personal life, courage is when I confront a client out of a commitment to healing, even if I’m fearful the client will bolt and terminate therapy. As therapists, were taught that we’re supposed to help our clients feel better. I know I’ve created temporary pain for a client by uncovering and reflecting a painful reality. My commitment in my work is to be as open, honest, loving and courageous as possible to facilitate healing. And yes, that may mean sharing things with you that you don’t want to hear. Courage is when we struggle through the pain. That is when healing occurs.

Freedom.

Our society often equates freedom with free will. We often take a narcissistic view that freedom allows me to do what I want; and more often than not, freedom is framed as “You can’t tell me what to do.” In essence, unless I get my way, or what I want, I’m not experiencing freedom. The current rhetoric in American Politics is based on this approach. Instead, in my work, I emphasize freedom as a profound acceptance of what is. With this acceptance there is the ability to generate new possibilities to act. Hence, truth is the prerequisite for freedom. (This perhaps helps the reader understand the emphasis on confronting thinking errors.) From the profound acceptance of truth/reality, the client is better able to make choices that reflect a positive goal in their life. Two examples come to mind. First, profoundly accepting that you are manipulating others around your chemical or sexual behavior allows you to stop manipulating others. If you aren’t accepting this reality, your denial prevents you from being free. A second example is a person who profoundly accepts their same-sex sexual attraction. Avoiding this reality creates shame, depression, avoidance, and a diminished sense of self. Acceptance allows the opportunity for the individual to make free choices about what to do next. Why the emphasis of a profound acceptance? Too many times, both in my personal life and in my professional work, I see situations where someone says they accept “what is” only for the thinking errors to change to type of avoidance. Hence, for me a profound acceptance is acceptance that creates a transformation. And honestly, this type of acceptance is incremental and a process rather than an off/off switch. Therapy is the process of radical acceptance of “what is” and therefore allowing freedom. When this experience occurs, the experience is transforming, both for the individual and for me as a witness to their courage and freedom.

The three values shape my work. It is the therapeutic relationship that I commit to living these values with integrity. Now, I’m human, and I know I make mistakes. I welcome opportunities for my own growth in this process as well. While it may be your therapy hour, I know I’m touched by your transformation.