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Aug 13

What Is Sexual Addiction?


By Michael Herkov, Ph.D

Sexual addiction is best described as a progressive intimacy disorder characterized by compulsive sexual thoughts and acts. Like all addictions, its negative impact on the addict and on family members increases as the disorder progresses. Over time, the addict usually has to intensify the addictive behavior to achieve the same results.

For some sex addicts, behavior does not progress beyond compulsive masturbation or the extensive use of pornography or phone or computer sex services. For others, addiction can involve illegal activities such as exhibitionism, voyeurism, obscene phone calls, child molestation or rape.

Sex addicts do not necessarily become sex offenders. Moreover, not all sex offenders are sex addicts. Roughly 55 percent of convicted sex offenders can be considered sex addicts.

About 71 percent of child molesters are sex addicts. For many, their problems are so severe that imprisonment is the only way to ensure society’s safety against them.

Society has accepted that sex offenders act not for sexual gratification, but rather out of a disturbed need for power, dominance, control or revenge, or a perverted expression of anger. More recently, however, an awareness of brain changes and brain reward associated with sexual behavior has led us to understand that there are also powerful sexual drives that motivate sex offenses.

The National Council on Sexual Addiction and Compulsivity has defined sexual addiction as “engaging in persistent and escalating patterns of sexual behavior acted out despite increasing negative consequences to self and others.” In other words, a sex addict will continue to engage in certain sexual behaviors despite facing potential health risks, financial problems, shattered relationships or even arrest.

The Diagnostic and Statistical Manual of Psychiatric Disorders, Volume Four describes sex addiction, under the category “Sexual Disorders Not Otherwise Specified,” as “distress about a pattern of repeated sexual relationships involving a succession of lovers who are experienced by the individual only as things to be used.” According to the manual, sex addiction also involves “compulsive searching for multiple partners, compulsive fixation on an unattainable partner, compulsive masturbation, compulsive love relationships and compulsive sexuality in a relationship.”

Increasing sexual provocation in our society has spawned an increase in the number of individuals engaging in a variety of unusual or illicit sexual practices, such as phone sex, the use of escort services and computer pornography. More of these individuals and their partners are seeking help.

The same compulsive behavior that characterizes other addictions also is typical of sex addiction. But these other addictions, including drug, alcohol and gambling dependency, involve substances or activities with no necessary relationship to our survival. For example, we can live normal and happy lives without ever gambling, taking illicit drugs or drinking alcohol. Even the most genetically vulnerable person will function well without ever being exposed to, or provoked by, these addictive activities.

Sexual activity is different. Like eating, having sex is necessary for human survival. Although some people are celibate — some not by choice, while others choose celibacy for cultural or religious reasons — healthy humans have a strong desire for sex. In fact, lack of interest or low interest in sex can indicate a medical problem or psychiatric illness.

Explore More About Sexual Addiction

What is Sexual Addiction?
What Causes Sexual Addiction?
Symptoms of Sexual Addiction
Symptoms of Hypersexual Disorder
Am I Addicted to Sex? Quiz
If You Think You Have a Problem with Sexual Addiction
Treatment for Sexual Addiction
Understanding More About Sexual Addiction

Mark S. Gold, M.D., and Drew W. Edwards, M.S. contributed to this article.

Aug 12

Is It Normal to Masturbate When You’re Married?


Is It Normal to Masturbate When You’re Married?
By Michael Ashworth, Ph.D.

There is absolutely no reason to feel guilty for masturbating even though you are married. Most men and women do indeed continue to masturbate when they are in a relationship, and it does not mean that there is anything wrong. In fact, research shows that those people who masturbate more also have more (and more satisfying) sex.

People have sex, as well as masturbate, for all sorts of reasons. Often men and women feel like having an orgasm or pleasuring themselves as a quick stress reliever, as a “pick-me-up”, or just because they are very aroused but don’t want to go through the whole process of sex.

Masturbating is also a great way to learn about your own body, which invariably makes for better sex with a partner. Men can use masturbation as a way to learn how to control their orgasms, while women can learn how to have orgasms more easily.

Sometimes people feel that if everything was perfect in a sexual relationship, then neither partner would “need” to masturbate. Nothing could be further from the truth. Simply put, good sex begets more good sex — in all its forms. In fact, many couples masturbate together and find it a very enjoyable part of their relationship. Honestly, there is no need to feel guilty. Listen to the good doctor: Masturbation is good for you!

Aug 11

The 5 Stages of Loss and Grief


By Julie Axelrod
The stages of mourning are universal and are experienced by people from all walks of life. Mourning occurs in response to an individual’s own terminal illness or to the death of a valued being, human or animal. There are five stages of normal grief. They were first proposed by Elsabeth Kubler-Ross in her 1969 book “On Death and Dying.”

In our bereavement, we spend different lengths of time working through each step and express each stage more or less intensely. The five stages do not necessarily occur in order. We often move between stages before achieving a more peaceful acceptance of death. Many of us are not afforded the luxury of time required to achieve this final stage of grief. The death of your loved one might inspire you to evaluate your own feelings of mortality. Throughout each stage, a common thread of hope emerges. As long as there is life, there is hope. As long as there is hope, there is life.

Many people do not experience the stages in the order listed below, which is okay. The key to understanding the stages is not to feel like you must go through every one of them, in precise order. Instead, it’s more helpful to look at them as guides in the grieving process — it helps you understand and put into context where you are.

1. Denial and Isolation

The first reaction to learning of terminal illness or death of a cherished loved one is to deny the reality of the situation. It is a normal reaction to rationalize overwhelming emotions. It is a defense mechanism that buffers the immediate shock. We block out the words and hide from the facts. This is a temporary response that carries us through the first wave of pain.

2. Anger

As the masking effects of denial and isolation begin to wear, reality and its pain re-emerge. We are not ready. The intense emotion is deflected from our vulnerable core, redirected and expressed instead as anger. The anger may be aimed at inanimate objects, complete strangers, friends or family. Anger may be directed at our dying or deceased loved one. Rationally, we know the person is not to be blamed. Emotionally, however, we may resent the person for causing us pain or for leaving us. We feel guilty for being angry, and this makes us more angry.

Remember, grieving is a personal process that has no time limit, nor one “right” way to do it.

The doctor who diagnosed the illness and was unable to cure the disease might become a convenient target. Health professionals deal with death and dying every day. That does not make them immune to the suffering of their patients or to those who grieve for them.

Do not hesitate to ask your doctor to give you extra time or to explain just once more the details of your loved one’s illness. Arrange a special appointment or ask that he telephone you at the end of his day. Ask for clear answers to your questions regarding medical diagnosis and treatment. Understand the options available to you. Take your time.

3. Bargaining

The normal reaction to feelings of helplessness and vulnerability is often a need to regain control–

If only we had sought medical attention sooner…
If only we got a second opinion from another doctor…
If only we had tried to be a better person toward them…

Secretly, we may make a deal with God or our higher power in an attempt to postpone the inevitable. This is a weaker line of defense to protect us from the painful reality.

4. Depression

Two types of depression are associated with mourning. The first one is a reaction to practical implications relating to the loss. Sadness and regret predominate this type of depression. We worry about the costs and burial. We worry that, in our grief, we have spent less time with others that depend on us. This phase may be eased by simple clarification and reassurance. We may need a bit of helpful cooperation and a few kind words. The second type of depression is more subtle and, in a sense, perhaps more private. It is our quiet preparation to separate and to bid our loved one farewell. Sometimes all we really need is a hug.

5. Acceptance

Reaching this stage of mourning is a gift not afforded to everyone. Death may be sudden and unexpected or we may never see beyond our anger or denial. It is not necessarily a mark of bravery to resist the inevitable and to deny ourselves the opportunity to make our peace. This phase is marked by withdrawal and calm. This is not a period of happiness and must be distinguished from depression.

Loved ones that are terminally ill or aging appear to go through a final period of withdrawal. This is by no means a suggestion that they are aware of their own impending death or such, only that physical decline may be sufficient to produce a similar response. Their behavior implies that it is natural to reach a stage at which social interaction is limited. The dignity and grace shown by our dying loved ones may well be their last gift to us.

Coping with loss is a ultimately a deeply personal and singular experience — nobody can help you go through it more easily or understand all the emotions that you’re going through. But others can be there for you and help comfort you through this process. The best thing you can do is to allow yourself to feel the grief as it comes over you. Resisting it only will prolong the natural process of healing.

Aug 10

By Rick Nauert PhD Senior News Editor
Reviewed by John M. Grohol, Psy.D. on August 16, 2013

Exercise Relieves Insomnia — But Effects Take Some Time A new study explains the method by which exercise can improve sleep showing that while effective, exercise is not a quick fix.

Researchers from Northwestern University say that although exercise is a common prescription for insomnia, spending 45 minutes on the treadmill one day won’t translate into better sleep that night.

“If you have insomnia you won’t exercise yourself into sleep right away,” said lead study author Kelly Glazer Baron, Ph.D., director of the behavioral sleep program at Northwestern University Feinberg School of Medicine.

“It’s a long-term relationship. You have to keep at it and not get discouraged.”

The current study is meaningful because it is the first long-term study to show aerobic exercise during the day does not result in improved sleep that same night when people have existing sleep problems.

Most studies on the daily effects of exercise and sleep have been done with healthy sleepers.

The study also showed people exercise less following nights with worse sleep.

“Sleeping poorly doesn’t change your aerobic capacity, but it changes people’s perception of their exertion,” Baron said. “They feel more exhausted.”

The study is found in the Journal of Clinical Sleep Medicine.

“This new study shows exercise and sleep affect each other in both directions: regular long-term exercise is good for sleep but poor sleep can also lead to less exercise. So in the end, sleep still trumps everything as far as health is concerned,” says senior author Phyllis Zee, M.D.

Baron decided to analyze the daily effect of exercise after hearing her patients with insomnia complain the exercise she recommended didn’t help them right away.

“They’d say, ‘I exercised so hard yesterday and didn’t sleep at all,’” Baron said. “The prevailing thought is that exercise improves sleep, but I thought it probably wasn’t that simple for people with insomnia.”

Why does it take time for exercise to impact sleep?

“Patients with insomnia have a heightened level of brain activity and it takes time to re-establish a more normal level that can facilitate sleep,” Zee said.

“Rather than medications, which can induce sleep quickly, exercise may be a healthier way to improve sleep because it could address the underlying problem.”

In the current study, participants were older women – the group that has the highest prevalence of insomnia.

Despite the delayed effects, exercise is an optimum approach to promote sleep in an older population because drugs can cause memory impairment and falls.

Baron thinks the results also could apply to men because there is no evidence of gender differences in behavioral treatments for insomnia.

For the study, Baron performed an analysis of data from a 2010 clinical trial (by the same group of Northwestern researchers on the current paper) that demonstrated the ability of aerobic exercise to improve sleep, mood and vitality over a 16-week period in middle-age-to-older adults with insomnia.

She and colleagues examined the daily sleep data from 11 women ages 57 to 70.

The key message is that people with sleep disturbances have to be persistent with exercise.

“People have to realize that even if they don’t want to exercise, that’s the time they need to dig in their heels and get themselves out there,” Baron said.

“Write a note on your mirror that says ‘Just Do It!’ It will help in the long run.”

Source: Northwestern University

Aug 9

ADHD Tip: 5 Tricks to Manage Time Wasters


By Margarita Tartakovsky, M.S.

ADHD Tip: 5 Tricks to Manage Time Wasters For many of us, managing time is tricky, especially thanks to the pull of technology. Everything is simply a click or keyword away. Maybe you even do what I do: You decide to be strict with yourself, and pledge to hyper-focus on your project.

You close Twitter and email on your computer. Maybe you use a program that blocks the Internet in hopes of getting at least 30 minutes of work done, distraction-free.

But then your mind starts to wander, and so does your hand. Before you know it, you’re checking said Twitter and email on your smartphone. Somehow Instagram and Feedly get checked, as well.

As clinical psychologist Ari Tuckman, Psy.D, writes in his excellent, comprehensive book More Attention, Less Deficit: Success Strategies for Adults with ADHD, “Fortunately and unfortunately, technology has given us constant and immediate access to all sorts of fun distractions.”

For adults with ADHD, managing time effectively is especially difficult, he says. On some days, it might even feel utterly impossible. If you have ADHD, you’re probably easily distracted and struggle with impulsivity. In his book Tuckman shares five ways individuals with ADHD can resist impulsive time wasters.

1. Reduce wasteful temptations.

“The fewer temptations, the fewer you need to resist,” Tuckman writes. So make it your goal to “eliminate potentially exciting stimuli before they occur.”

For instance, you might unsubscribe from email alerts and magazines you don’t read. You also might block specific websites. And if you’re out and about, you might avoid the stores you spend too much time and money in, he says.

2. Build in downtime.

Build downtime into your schedule. As Tuckman writes, remember that “you can only run at a breakneck pace for so long before crashing … slow and steady wins the race.”

Making downtime part of your days decreases the chances that you’ll take that time when you really can’t afford to.

3. Post visual reminders.

When an impulse strikes, it helps to remind yourself of your priorities, so you stay on track. Keep visual reminders front and center.

For instance, you might make your computer wallpaper the image of the tropical getaway you’re saving for. Or you might write the date of your work evaluation on a whiteboard in your office.

4. Use helpful self-talk.

It can help to talk yourself through your tasks. For instance, according to Tuckman, “tell yourself things like, “Write report first, check email second.”

5. Return to your task without flogging yourself.

Sometimes, some days, you can try your best to resist time wasters. But before you know it, you’re knee deep in email or Twitter or Facebook or some other activity that pillages your productivity.

If so, simply get back to what you were doing. Avoid disparaging yourself. As Tuckman writes, “No knocking yourself, no giving up hope — just do it.”

Time wasters can be hard to resist, especially if you have ADHD. Fortunately, you can reduce distractions and employ other tips and tricks to help you stay on task and on track.

What have you found to be helpful in managing time wasters?

Aug 8

Depression and Your Sex Life


By Dennis Thompson Jr.
Medically reviewed by Christine Wilmsen Craig, MD

Depression drains the color out of life’s pleasures, robs enthusiasm, and makes everything feel bland and flat — including your sex life. About 35 to 47 percent of people dealing with depression find the mood disorder interferes with their sexuality. That percentage jumps even higher based on the intensity of the condition — more than 60 percent of patients with severe depression report sexual problems.

Why Sex and Depression Don’t Mix

The old adage about how the brain is the biggest sex organ in the body is a truer statement than you might realize. The brain controls sexual drive, arousal, and sexual function through the release of hormones and nerve impulses.

Depression stems from a chemical imbalance in the brain, and that imbalance can cause interference with a person’s ability to enjoy sex or perform sexually. Depression has been linked to:

A decrease in libido. A study of depressed patients showed that more than two-thirds of respondents reported a loss of interest in sex. The decrease in their libido grew worse as their depression grew more severe.
Erectile dysfunction. Depression and anxiety are leading psychological factors interfering in a man’s ability to have and sustain an erection.
Inability to enjoy sex. Depression can limit or eliminate the pleasure normally drawn from sex, says David MacIsaac, PhD, a licensed psychologist in New York and New Jersey and a faculty member of the New York Institute for Psychoanalytic Self Psychology. Depressed men, he says, “feel disconnected from any sexual experience. It’s a dehumanization kind of situation.”

Another adage holds that the cure can be worse than the disease, and this too can be true when it comes to depression and sexuality. Antidepressants are part of the first-line treatment of the mood disorder, but one of their chief side effects can be sexual dysfunction. Decrease in libido is most often reported, but patients also have found that antidepressants can cause erectile dysfunction and inhibit sexual pleasure. Some people taking antidepressants also report a loss of sexual desire or trouble reaching orgasm.

Reconnecting With Your Sexuality

The best way to eliminate sexual problems associated with depression is to treat and cure the illness. As patients begin to feel better about themselves, they begin to see their lives improving in all sorts of way, including their love lives, MacIsaac says.

While receiving treatment, you can better cope with your sex problems if you discuss your depression and its effect on your sexuality with your doctor and your partner. It can be very difficult to open up about these sorts of problems, but if your partner understands that the issue lies with an illness and not the relationship, he may be better able to support you through treatment.

If the antidepressant you take is interfering with your sexuality, your doctor can switch your prescription to another drug. There are many antidepressants on the market now, and each has different effects on different people. You and your doctor can work together to find the right treatment for your depression with the least impact on your love life.

by Lisa Frederiksen
Parents of a child with a drug or alcohol problem need support, too – and there are millions of parents – there are millions of children who need treatment.

Nine million young people between the ages of 12 and 25 need treatment for substance abuse or addiction. Of those nine million, two million are 12 – 17. Of the two million, ninety percent are not getting the help they need.*

Lorraine McNeill-Popper, Mom and Parent Advisory Board Member of The Partnership at Drug, says of The Partnership’s new online resource, Time to Get Help:

“Receiving support from others who have been through what you are going through can be very powerful and often one of the most effective ways to stay hopeful, inspired and sane. You will find out that you are not alone in this fight against addiction. You can learn from other parents. And even though your child may be different than theirs, you’ll discover there are many similarities.”

According to The Partnership’s introductory email regarding this new online resource, “By listening to parents and working with experts in the field of teen substance abuse and treatment, we’ve developed Time To Get Help.

“Time To Get Help [is designed to] help parents of teens and young adults gain a better understanding of adolescent alcohol and drug abuse, dependence and addiction; get support from experts and other parents who have been there; and find the right treatment for their child and family.”

Claudia M. Gold, MD | Conditions | August 16, 2013
A study published in the Journal of Developmental and Behavioral Pediatrics showing a connection between hours of sleep and childhood behavior problems has received a lot of media attention. Children who slept less than 9.4 hours of sleep had more impulsivity, anger, tantrums and annoying behavior. The obvious conclusion-more sleep, better behavior. If only it were that simple.

If one takes the time to look closely, one will discover that what is correctly described as an “association” in the original article is in fact two interlinked phenomena that have a common underlying cause. Sleep problems are behavior problems. To know the cause, one must know the family story.

Sleep is a developmental phenomenon. In infancy a child learns what is commonly called “sleep associations.” The breast, a pacifier, a lovey or even a parent’s hair may be what a child associates with falling asleep. Frequent night wakings, expected by parents in the early weeks and months, can become a problem if that sleep association requires a parents’ physical presence. As the months wear on parents become severely sleep deprived, and often find that this pattern is not so easy to change. In toddlerhood as a child in a normal healthy way begins to assert his independence, he may resist bedtime in the way he says “no” to many things. Further complicating the picture is the fact that sleep represents a major separation. A child who handles the first day of preschool with grace may suddenly refuse to go to bed, or begin waking during the night.

Given the complexity of this process, there are many ways it can get derailed. If parents do not agree about teaching a child to sleep independently, a child in the bed can cause significant marital discord. When parents struggle with depression, and this includes both fathers and mothers, they will have aggravation of symptoms, which often includes irritability. in the setting of sleep deprivation. When a parent is quick to lash out at a child, he may become anxious. Sometimes this anxiety leads to “acting out” in the form of oppositional behavior. It seems illogical, but a two-year-old doesn’t know how to say “I need you to be with me and I feel sad when you are angry.” He may simply see that when he is “difficult” his parents are more engaged with him. Separation anxiety is common in these situations, and sleep is a major separation. Bedtime refusal and frequent night wakings are common in this setting. This leads to a vicious cycle as both parent and child become increasingly irritable.

These are some examples, and there are as many different stories as there are families. By the time parents come to see me at the Early Childhood Social Emotional Health Program with behavior problems, which in my experience always include sleep problems, they may be hard pressed to describe moments of joy with their children.

I feel for the parent who reads an article with the title More Sleep Might Help Tots’ Tantrums, with its recommendation to have a child get more sleep to improve behavior, and is unable to change the situation because the underlying cause is not addressed. This is where our culture of advice and quick fixes can lead parents to be overwhelmed by feelings of inadequacy and guilt.

The key to treating these complex problems is to give parents space and time to tell the full story. When parents themselves feel heard and understood, they are in a better position to be curious about the meaning of their child’s behavior.

This study is important because it calls attention to the need to address sleep in the setting of behavior problems. However, when a child and family are struggling, simple recommendations have a child get more sleep are not only not helpful, but may make parents feel worse. A downward spiral of sleep deprivation and behavior problems will likely persist.

If a family and clinician has the time, then it is possible to make sense of the situation and take steps to set the whole family on a better path; to bring joy back in to relationships. The younger the child, the easier this is to do.

Claudia M. Gold is a pediatrician who blogs at Child in Mind and is the author of Keeping Your Child in Mind.

Aug 3

Fixing your marriage is like losing weight


The two have much in common. Not just because they both can be frustrating, confusing, and sometimes ugly, but in a number of other ways.

First, in both fields there are lots of gurus and information. Go to your nearest bookstore or check out Amazon and you will see tons and tons of books on weight loss. From the grapefruit diet to Atkins, you name it, someone made a diet about it. The same can be said about relationships.

Like losing weight, you have got to pick the healthy ones to follow, not fads. Diet or relationship advice that has you doing weird unhealthy things should be tossed out the door. Look for the pattern in the respected experts. In study after study it has been found the reason the fad diets “work” is calories are ultimately less. (The bottom line is calories in versus calories out.) The relationship experts often boil down to some simple ideas of healthy self, communication skills, good boundaries, and respect.

Sometimes a person starts a diet and it backfires. They either go to extremes and restrict uncontrollably, or they feel so starved they begin binging. The same happens in relationships. Someone learns about the importance of talking about their feelings, and they overwhelm their partner and anyone who will listen. On the opposite side is the person who learns the motto “pick your battle” and decides never to talk about things because “they aren’t important.” Both extremes are unhealthy in relationships.

If you are using a healthy format for weight loss, chances are the lifestyle change will also include exercise. I’ll share a story: many years ago I bought an elliptical because I loved them at the gym. I thought, “I’ll work out at home daily and take off those excess pounds.” Fast forward a year; I had been working out for 45 minutes 6 times a week and hadn’t dropped a single pound! Why? I hadn’t watched my food intake. You have to do both.

The same is true in fixing a relationship. You have to work both yourself individually as well as yourself in the relationship. Self health and relationship skill; do both.

Some parts of the work seem easier for one or the other of you. Anyone who has lost weight with someone else will agree; remember the old commercial where they do the same thing and he loses 5 pounds while she gains 10? It’s because some parts are easier; my husband is just naturally good at numbers and so counting calories is a breeze for him- I hate it. I love exercise; he could do without.

In the relationship this may seem more subtle but it is very important. Often women are “better” at the communication of feelings while men are better at thinking things through to a solution immediately. When you are working on a relationship it is important to acknowledge both strengths and weaknesses of each of you. It will help you realize the work your spouse is doing even if you think it should be easy.

Weight loss and relationship change- both need to be attended to daily. Intimacy is a practice that requires regular choices (the way choosing a salad at lunch may help you keep those pounds off.) They both take a long term commitment or you will backslide. However, if you practice them both daily they can become habitual and feel less like “work”.

Lastly, healthy eating and healthy relating are often not supported by those around you. You know what I mean: a culture of fast food and cheating (in both senses of the word.) You will run into saboteurs who will tempt you will “just one piece of cake” or “how will he know?” On a more subtle level it will be the normalcy of divorce as a first line choice instead of a last option. Like you need to surround yourself with people who support you new eating habits, you need to surround yourself with those who support healthy relating (even if you have to educate people on your choices in both venues.)

So what do you think? Are they similar or am I pushing my metaphors too far?

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