Becoming Open and Honest

A common theme apparent across many clinical settings is the struggle with being open and honest to the important people in your life. I consistently see how people avoid talking with others, disclosing their sex history, or reaching out to others to help break the isolation, fear and shame. In the 12-step tradition, there is a saying "Our secrets keep us sick." As a treatment approach, anything you're not able to talk about is the treatment issue you need to be talking about.

The treatment assignment is to identify the major issues you are keeping secret. I recently asked one client to list the top 25 secrets he hasn't revealed. The assignment scared him, but by the end realized that the isolation he feared didn't come about.

Given the level of struggle with becoming open and honest, I'm interested in hearing from readers about what they found helpful in starting the process of breaking secrets.

Weston

Online Community Talking about Sexual Health: An ending opens a new door.

All of the material in this blog (previous to this date) has been used in the development of a workbook addressing sexual health issues to facilitate recovery for individuals experiencing sexual compulsivity. The purpose of the blog was two-fold. First, clients were provided the information quicker than waiting for the workbook to be completed. (The initial content was written over a period of one year.) Second, the blog held me accountable. I was responsible to others to get something done regularly. An embarrassing reality is that this workbook was started in 2005. Without the accountability created by the blog, I simply languished in moving forward.

After completing the workbook, the purpose of the blog is now a place for individuals to engage in an ongoing conversation regarding the material, the workbook, or general questions. Too many people are too isolated and have no place to engage in these conversations. For the safety of all, all posts are moderated. And all posts will be made anonymous unless you give me explicit permission to use your name.

Body Image

1. In general, I like how my body looks.

2. I like the look of my genitals.

3. I feel I am too thin.

4. I like how my breast/chest looks.

5. R. I am uncomfortable with several parts of my body.

6. It is important for me to make my body look good.

7. I have had cosmetic surgery to change my looks.

8. Overall, I feel my body is attractive.

9. FOR MEN: I like the size of my penis. FOR WOMEN: I like the size of my breasts.

10. R. I want to look more masculine.

11. R. I want to look more feminine.

12. R. I feel I am overweight.

Score 1 point for each no to questions 1-4, 6-9.

Score 1 point for each yes to questions 5, 10-12.

The higher the score, the bigger the concern with body image issues.

A component of sexual health is body image. This involves challenging the notion of one narrow standard of beauty and encouraging self-acceptance. Sexual health requires a development of a realistic positive body image. The necessary work in moving toward sexual health suggests that this is a major issue for all people and may be the last issue resolved according to professions who treat eating disorders. Body image incorporates so many parts of our perceptions, internal messages, external messages, and feelings that it is difficult to address.

Culturally what is considered beautiful changes across time and circumstances. The key to addressing body image is that it is COMPLETELY cultural. The objectification of women has been occurring for a while; recent developments have started the objectification of men as well. Given the cultural emphasis on unrealistic images of the body, the negative messages both genders face are tremendous. The impact of sexually explicit material also raises concerns in the role it has in shaping a person’s view of their body.

While a lot of people struggle with cultural body, there is a mental health diagnosis that reflects significant body image issues. Body dysmorphic disorder is characterized by constantly compare your appearance with others, possibly refusing to let your picture be taken, or are extremely self-conscious in photos, keep checking a certain body part that you think is flawed (e.g., your nose or belly) as well as measure the flaw frequently, feeling anxious and self-conscious around other people, calling yourself names, completing plastic surgery, and often dissatisfaction with the results of plastic surgery,

Developing a Healthy Body Image

Here are some guidelines (Adapted from BodyLove: Learning to Like Our Looks and Ourselves, Rita Freeman, Ph.D.) that can help you work toward a positive body image:

1. Listen to your body. Eat when you are hungry.

2 .Be realistic about the size you are likely to be based on your genetic and environmental history.

3. Exercise regularly in an enjoyable way, regardless of size.

4. Expect normal weekly and monthly changes in weight and shape

5. Work towards self acceptance and self forgiveness- be gentle with yourself.

6. Ask for support and encouragement from friends and family when life is stressful.

7. Decide how you wish to spend your energy -- pursuing the "perfect body image" or enjoying family, friends, school and, most importantly, life.

One assignment I will sometimes give clients is to list 100 negative messages they say about themselves, their body, or hear from the culture. The reason I do this is to help the client become aware of the negative self talk. You can’t change what you don’t recognize. Next, for each negative message, I have them review and investigate the source of the message. Was it TV, family, culture, sexual minority culture? Finally I encourage them to identify positive messages to balance the negative messages.

Examine your sexual history. How has messages regarding body image impacted your sexual behavior. What behaviors have you done or not done in response to the messages? How do you feel about your body now? Describe a realistic and healthy body image.