Porn Addiction and the Addictive Process

 

 

“Every form of addiction is bad, no matter whether the narcotic be alcohol, morphine or idealism.” Carl Jung

Within my private practice, I work with an increasing number of clients who are struggling with what they describe as ‘porn addiction’. Despite each person’s own struggles and difficulties being specific and unique to them, there are frequent themes, and common factors that seem to feature regarding the development and maintenance of addictive cycles of behaviour generally speaking. Indeed, there is a long-standing school of thought within psychological and addictive fields that ‘addicts’ often manifest compulsive behaviours that are primarily forms of symptom substitution for overwhelming and/or uncomfortable emotion. These compulsive behaviours are effectively driven by an individual’s inability to develop and maintain healthy relationships, and therefore experience any  sustained satisfaction from their interpersonal relationships, resulting in a perpetual cycle of unmet emotional needs (1). It is certainly true in my own professional experience, that clients that I collaboratively work with around these types of issues frequently have a  history of childhood pain and trauma, and unmet emotional needs.

Many adults struggling with addictive behaviours regardless of their ‘weapon of choice’, be it drugs, alcohol, sex (including pornography), or food, in addition to a range of other potential resources or behaviours, have a history of unmet emotional and relational needs that have their roots in childhood (2). It is not uncommon for adults who struggle with porn addiction, and/or other sexually compulsive behaviours to have childhood experiences consisting of a home environment where their parents were overly strict, controlling, disengaged or emotionally unavailable for example (3). Thus, the child may experience intense feelings of loneliness, isolation, shame and guilt, that can become so emotionally overwhelming that they may develop, and ultimately turn to dysfunctional behaviours as a means of comforting, and soothing strong feelings of emotional rejection (4).  Healthy, nurturing and stimulating relationships naturally generate powerful biochemical processes in the brain and body, that are both rewarding and necessary for healthy psychosocial, psychosexual and relational development. Therefore, from a neurophysiological perspective, the lack of such biochemical reward, can make a young person hungry for their missing neurological pleasure centres, that they may turn to addictions as a means of changing the way they feel, or numbing the pain of stress hormones (5). Dopamine is a natural pleasure and reward chemical secreted by the brain and drugs, cigarettes, alcohol, porn or food are all substances and/or behaviours that both stimulate and activate the dopamine pathways. Our brains and internal chemistry naturally produces a range of powerful and stimulating chemicals in response to addictive behaviours, that are extremely habit forming when abused, and so this represents an incredibly potent neurophysiological factor of the addictive process.

Working with clients around understanding the process of addiction, whilst assisting them in exploring their own relationship history as a means of identifying any potential origins of their harmful behaviours can be an effective place to begin treatment. Understanding potential triggers, managing urges and/or cravings, whilst developing additional skills for emotional regulation and tolerance all represent essential aspects of effective treatment. Psychotherapy treatment can assist and support clients to ultimately break free of their destructive cycles, and regain control of their lives.

References:

  1. Flores, P. J., (2004), Addiction as an Attachment Disorder. Jason Aronson, Plymouth
  2. Katehakis, K., (2016), Sex Addiction As Affect Dysregulation: A Neurologically Informed Holistic Treatment. W. Norton & Company, London
  3. Skinner, K, B., (2005), Treating Pornography Addiction: The Essential Tools for Recovery. Skinner Corp, Utah, USA
  4. Skinner, K, B., (2005), Treating Pornography Addiction: The Essential Tools for Recovery. Skinner Corp, Utah, USA
  5. Allez, G. H., (2009), Infant Losses, Adult Searches: A Neural and Developmental Perspective on Psychopathology and Sexual Offending (2nd Ed). Karnac Books, London

Attachment Theory and Relationships

“The human psyche , like human bones, is strongly inclined towards self-healing.” John Bowlby

Because we are social animals our relationships represent an essential resource for our survival. However,  something important to remember, is that despite born needing to develop and maintain relationships in the interests of our survival, we are not born knowing how to do so. Relationships represent quite literally a form of communication, or a language, and are therefore not unlike any other language in that we must learn how to speak and use it effectively to communicate within the social world. Problems and issues with relationships represents an incredibly common reason why many people seek therapy, and in my professional opinion I believe that every client’s current struggles are either directly or indirectly linked to relational difficulties, whether it’s relating to themselves, the world and/or the people within it.

The eminent psychiatrist John Bowlby (1907-1990), believed that human beings along with all other mammal species are predisposed to relational behaviours that satisfied an internal need for security. In other words, we are born with an innate internal ‘attachment system’ that propels us to try and stay close to our parents and/or carers (or attachment figures), to ensure our safety, security and survival. As babies from the moment we are born, our brains are developing a neurological map or pattern of how to relate to our environment, which will ultimately inform our ability to relate to ourselves, others and the world in general. Therefore, the initial ‘attachment bonds’ that we form with our adult parents/carers as babies and throughout childhood, are of tremendous importance, because they represent the initial ‘template’ for how we develop and maintain relationships with ourselves and others throughout the lifespan. This template then acts as a type of map to direct us in navigating our relationships, and may guide us in performing key relational tasks, such as expressing our own emotional needs, and responding to the needs of others.

The verbal and non-verbal signals we receive as children via our parents/carers interactions with us, and their ability to ‘tune in’ and respond to our needs effectively and appropriately is paramount in our learning how to communicate and interact.

The subtle and not so subtle messages we receive both verbally and non-verbally from the adults we rely on to meet our physical and emotional needs may be internalised as a part of this process, informing core beliefs about ourselves, the world and the people in it that subsequently influence our view of and sense of being in the world. Therefore, we effectively develop our sense of  identity and self-worth as a part of this complex relational activity and interaction.

If for example we had consistent experiences of our needs or expressions of distress being ignored and/or dismissed as children whenever we expressed them, the core belief that we develop and internalize could be something like “I don’t matter”, or “I am not important”. Other examples may include children of parents who may have a tendency to put their own needs before those of their child’s most if not all of the time. The child may consequently develop internal beliefs such as “other people’s needs are more important than my own”, which significantly affects self-esteem and self-worth, and may lead to difficulties asserting themselves in relationships, or feeling safe enough to express their own needs. The problem with such core beliefs are that they effectively become ‘rules for living’, that can then influence the roles we adopt in our relationships. Our earliest ‘template relationships’, teach us what role we are expected to play in relationships, and we can often then go on through life replicating those learned relationship dynamics or ‘relational dramas’ over and over, as we subconsciously recreate them in an attempt to readdress those early painful feelings of anger, frustration and/or hurt that we may have long been buried.

This piece represents a very concise and limited overview of merely ‘some’ aspects of attachment theory, and its significance for how we function in our relationships. It is an extremely expansive and complex theoretical framework that has a broad range of applications for psychotherapy, and those clients struggling with relationship issues. Therapy itself involves developing a relationship with your therapist, and so there is arguably no better way to explore and examine relationship problems than by developing a trusting relationship with our therapist, within which we may then proceed do so safely and securely.

Men and Mental Health

“A man who does not think for himself does not think at all.” Oscar Wild

According to 2016 statistics, a staggering three quarters of UK recorded suicides are committed by males, with men aged 40 to 44 representing the highest age specific suicide rate (1).

These figures are both astounding and frightening, and clearly illustrate significant problems regarding men and our mental health. It’s impossible for anyone living within the UK or the western world for that matter, to not be affected and to some degree influenced and informed by the stereotypical ‘gender norms’ still pervasive within our respective cultures and societies. Despite significant shifts in outdated perceptions of what constitutes masculine and feminine within the modern world, there are clearly still a staggering number of men feeling unable to express their pain and vulnerabilities and access help and support before ending their own lives.

The unfortunate reality is, that the social and cultural messages beamed out via music, film, television and social media, to be subsequently ‘sucked up ‘and internalised by boys and men in our society, are still predominantly old fashioned regarding males and our expression of emotion. The obvious exceptions to this are of course anger and aggression, because these are still viewed as typically ‘male characteristics’, and therefore deemed more acceptable, and in many ways even expected of men. However inaccurate, there appears to be a clear and distinct association made between vulnerability and weakness that represents a significant and formidable barrier for many men to overcome regarding our experience and expression of anything they might perceive as ‘weak’ by ourselves or others. Such gender myths clearly still hold immense power, and represent a toxic and ultimately destructive legacy of a bygone era, that is causing many men to feel increasingly trapped and isolated during times of intense mental and emotional pain and distress.

There is a cruel irony that throughout my career so far, I have had the fortune and privilege to meet and work with so many incredible men who fill me with admiration and respect. This is due to their unwavering courage and determination in embracing their individual healing journeys from all manner of personal trauma and adversity. Whether its male survivors of sexual abuse and/or rape, men who have experienced childhood abuse and neglect or men suffering with the overwhelming, painful and debilitating effects of depression, anxiety or personal loss, they are all figures of inspiration to me. Because each and every one of them has sat in a room with other men, whether alone in a room with me or in groups that I have facilitated, and taken the huge risk of sharing aspects of their most vulnerable selves.

You see as far as I’m concerned that’s what being a ‘real man’ is. It’s about striving to be as real and true to ourselves as we’re able, especially when we’re feeling at our most terrified, vulnerable and alone. It’s about acknowledging that as human beings we each have our vulnerabilities and weaknesses, irrespective of sex, gender or sexuality, and that once we give ourselves permission to have them, that this validation then leads to their becoming strengths by definition.

It’s not merely the social and cultural straightjacket of gender that restricts men from acknowledging our vulnerabilities, and asking for help and support when we need it. It’s not just a fear of what people think, or what they might say, it’s actually far more deeply rooted than that. It’s the fact that men can also be victims of a predominately patriarchal society, and many are literally immobilized by these immense pressures, to the point of taking their own lives rather than speaking out and accessing help and support.

If you’re a man who is currently feeling overwhelmed, struggling to cope or feel like you’re going under in some way, then please access some confidential help that’s available. Whether that’s with a counsellor, a telephone helpline or services, by doing so you are moving towards recovery and reclaiming your life.

Don’t become another statistic, because you are worth so much more!!

References:

  1. Office for National Statistics (2018, Apr 02), Suicides in Great Britain: 2016 Registrations. Retrieved from URL: https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/bulletins/suicidesintheunitedkingdom/2016registration

Avoidance and Emotional Numbing as Symptoms of Child Abuse & Neglect

“One can only remember what one has consciously experienced.” Alice Miller

Research evidence continues to highlight the strong links between adverse childhood experiences, and increased physical and mental health problems throughout the life course (1). Such links go some way to identifying some of the potential devastating long-term impacts of childhood abuse and neglect, and the difficulties and issues that many adult survivors continue to struggle with as a result.

Abuse and neglect come in many different forms, and it is not uncommon in my experience of working with many adult survivors of physical, emotional and sexually abusive experiences over the years, to hear many appearing to minimize, or trivialise their painful memories as they tell their stories. Some clients share aspects of their childhoods that may sound and feel incredibly painful and distressing to me as I hear them, but this does not necessarily correspond with the manner in which the content is delivered. What I mean is the client’s tone of voice, body language or general demeanour will not necessarily indicate any visible signs of distress. Indeed, it is quite common for clients to often speak about what may overtly appear to be traumatic, painful and/or distressing events from childhood, in very factual and somewhat detached ways. Such circumstances can represent examples of powerful psychological defence mechanisms at work that are dissociative in nature, and act  as a means of distancing ourselves from distressing and/or painful emotional content. Such Defences are viewed within psychoanalytic theory, as strategies that we may potentially develop and deploy either consciously or unconsciously, as a means of avoiding aspects of the self or self-experience that may be painful or threatening (2).

When something has the potential to make us feel things that may be painful, frightening, uncomfortable or overwhelming it makes a lot of sense to avoid it. Not only is this a natural and quite frankly, less stressful thing to do, but it also maintains our ultimate evolutionary imperative as a species, which is to survive. Avoidance and emotional numbing are not only powerful defence mechanisms, but they also represent one of the four distinct symptom clusters of post-traumatic stress disorder (PTSD).

And so, for many adult survivors of childhood abuse it is not the factual details of what happened to them that pose the biggest and most significant threat to their mental and physical health and emotional well-being, but the emotional content associated with it all. Content that for many has long been disassociated from awareness, internalised and buried away somewhere deep inside, where it has remained since they were a vulnerable, abused and defenseless child.

The processes discussed in this particular blog can represent some of the many devastating and cruel ways that childhood trauma, whatever the experiences may be, can affect people. Having experienced events as children that were so painful and overwhelming at the time, that parts of our emotional selves withdrew and locked themselves away to keep us safe and protect us, can be a huge loss to contend with, for ourselves, the people we care about and the rest of the world. For some, acknowledging and grieving for this loss may represent a part of their individual recovery journey, whereas for others this may not be the case. For adult survivors who may read this blog and have some of the content resonate with you, I do want to stress that there is always hope, because your emotional selves referred to in this piece have not died, but are merely locked away. Therefore, you can reconnect with these previously lost parts of yourself and by doing so set them free and reclaim them, before reintegrating them into your life.

Human beings are fundamentally social animals, which makes our ability to develop and maintain healthy relationships of crucial importance for our mental and emotional health and well-being. Recovery from childhood trauma is about developing a healthy relationship with you, which is where it all begins. Getting to know parts of you that have been lost, neglected and criticised for so long represents a fundamental part of your recovery journey.

 

References:

  1. Jacobs, M. (2004), Psychodynamic Counselling in Action 3rd Ed, Sage Publications, London
  2. Bellis, M. A., Hardcastle, K. A. Sethi, D. Butchart, A. Mikton, C., Dunne, M. P. & Jones, L. (2017), The Effects of Multiple Adverse Childhood Experiences on Health: a Systematic Review and Meta – Analysis. The Lancet Public Health, 2, (8), 356 – 366

Understanding Trauma

“Trauma is a fact of life. It does not however, have to be a life sentence.”  Peter Levine

The deeply subjective and intimate nature of traumatic experience is such, that everyone will develop and hold their own personal meaning narratives regarding their traumatic encounters. Despite experiences of trauma being relatively common, there is an incredibly broad range of variance in people’s responses to them, indicating that it is not merely the exposure to the traumatic events that matters, but how we construct meaning and make sense of them (1).

From a neurological perspective, our brain stores whatever we experience within our lives away as memories, consisting of sensory data in the form of images, sounds,smells, taste and physical sensations related to the event. There will also be associated beliefs and emotions, and most of the time our brain can do what it needs to do, to process what’s happened and file it away as a healthy, adaptable memory that we can access when and if we need to. However, when we experience events in our lives that are too big or overwhelming at the time for our brain to carry out the neurological tasks it needs to store healthy memories, this can cause major problems. Post-traumatic stress like symptoms such as flashbacks and nightmares represent common examples of this, which are literally the brains way of trying to store the sensory data associated with the event away as a healthy memory. The problem is, that because this process is being prevented due to the overwhelming nature of the information, that parts of the brain that respond to threat, are still responding to whatever happened as if it’s happening right now, rather than in the past. Events that fall outside the realms of ‘natural human experience’ represent typical examples of traumatic events, which in other words means the types of things that don’t happen to us every day. Car crashes, physical/sexual assaults, rape, natural disasters and war traumas are all representative of such experiences, although as I mentioned earlier, there are a range of encounters that may result in traumatisation, many of which may appear less extreme, but are just as harmful and debilitating.

The terms ‘big T’s’ and ‘little t’s’ are used in much of the psychological research literature about trauma, to distinguish between specific types of traumatic events. Previously mentioned examples such as car crashes and natural disasters would undoubtedly fall into the former category, and are usually ‘single incident traumas’. Small t’s by contrast refer to the types of experiences that despite their potential to appear on the surface as less extreme, are nonetheless incredibly painful and damaging, and are often part of a complex network of other small t experiences that may have happened in childhood, and caused major distress since they happened. Typical examples might include specific arguments that we may have had with parents, carers or siblings, distressing experiences at school such as bullying, the death of a loved one or a pet or feelings of loneliness or isolation. These types of traumas can be incredibly insidious, slowly eating away at our self-image, self confidence and self-esteem, affecting our ability to develop and maintain relationships, and/or fully function in our everyday lives. I do feel it’s important to stress here, that the term ‘smaller t’s’ although maybe appearing to minimize or dismiss these types of experience, is not intended to do so. On the contrary, in my experience as a therapist working and specialising in trauma, there is nothing remotely ‘small’ about these types of experiences. Many clients I have worked with over the years however do seem to struggle in initially believing this themselves, as they’re often incredibly self-critical about the fact that they’re battling with these types of issues often years after the events took place. I am unfortunately very used to hearing clients coming out with such comments as “I should be over this by now”, or “I know this sounds stupid because it was so long ago”. Ironically, comments like this are very clear examples of the types of damage such traumatic experiences may cause to our views and perception of ourselves, which then become maintenance factors that feed the problem, and keep the vicious, destructive cycle going.

In my experience, from a clinical treatment perspective, small t’s are much more common regarding the reasons people seek and and enter therapy with me. Maybe that’s due to the types of services that I’ve worked for over the years, where clients presenting with complex trauma as a result of what are often difficult and/or distressing childhoods are typical. Big T’s in the form of ‘single incident events’ can be much simpler, and faster to treat with psychotherapy, whether that’s using evidence based, recommended psychological trauma treatments such as eye movement desensitisation reprocessing (EMDR) – (see fig 1), or trauma focused cognitive behavioural therapy (TF-CBT) – (see fig 2), or more traditional forms of talking therapy treatment. Smaller t’s can often represent a much more potentially complex and longer term type of work, although this is dependent on a broad range of factors, and each and every client is different. The good news is, that as the Peter Levine quote at the beginning of this article states, no one has to suffer with symptoms of trauma for the rest of their lives, because it is treatable, and we can recover and live healthy, fulfilling lives after trauma!

Fig 1. What is EMDR

Fig 2. What is TF-CBT

References:

  1. Cromer, L. D. & Smyth, J. M. (2010), Making Meaning of Trauma: Trauma Exposure Doesn’t Tell the Whole Story. Journal of Contemporary Psychotherapy, 40, (2), 65 – 72

Why I trained to Become a Therapist

“I am not what has happened to me, I am what I choose to become.” Carl Jung

Reading and my passion for books have always played a significant role throughout my life. As a child I would literally read anything I could get my hands on, enjoying the temporary escapism into fantasy worlds that works of fiction by such authors as C.S.Lewis, Enid Blyton, Anthony Buckeridge and Lewis Carol provided me. As a lonely, unhappy child these were precious gifts indeed, and I’m not exaggerating when I say that I genuinely do believe to this day, that these stories quite literally saved my life, during difficult times when I needed them most.

As an adult, my love for fiction has certainly continued, although it was my discovery of works of non-fiction in my mid-twenties that was to affect me so profoundly, and greatly inform my meaning in life and choice of career.

Books about philosophy, religion, mysticism and psychology captured my attention the most, and looking back, it’s clear to me that I was psychologically and spiritually lost during that time in my life, and searching for something, anything that would make sense to me, or give me answers. The truth is though, that at that point I didn’t even know who I was, what I needed or where I was going.  It was almost as if I was on some sort of ‘auto-pilot’, as I was drawn to reading anything that might provide me with some sort of direction, meaning or understanding about myself or the human condition. It was at this point that I discovered the works of Carl Jung (1875 – 1961), a Swiss psychiatrist and psychoanalyst who was in my opinion a true visionary, and quite literally living so ahead of his time that the rest of the world didn’t catch up with his ideas until after his death. Here was a man who devoted his life and career to studying the human condition, who’s powerful influence continues to affect and inform modern psychology to this day. However, it was Jung’s interest in the darker sides of human nature that I was so passionately interested in, and felt such a profound connection with. You see Jung was fascinated with those aspects of ourselves that we try to hide from the rest of the world, and even ourselves. He coined the term The Shadow to describe the things “no one has a wish to be”, consisting of our morally inferior wishes, motives, resentments. Those aspects of ourselves that we may feel ashamed of, or disgusted with, and are often not always even fully conscious or within our awareness, yet still cause us major problems.

Jung devoted a significant amount of his life’s work to exploring and trying to understand these dark parts of us, and it was this theme that initially attracted me to his work, and resonated with me on a deeply felt level. Here was a man who clearly understood what it was like to struggle with internal conflict, guilt and shame, and this made me feel less of an outsider, and less alone. Jung believed that it is only by acknowledging and ultimately accepting our shadows existence, that we can ever truly reach our full potential, and be our ‘true self’. He believed that reintegrating fragmented aspects of ‘self’ such as the shadow was necessary for life fulfilment, and that psychotherapy could assist with this process with the relationship between client and therapist representing a vessel to use to explore and investigate our difficulties and inner pain on the road to self-discovery.

This was when the initial seeds of an idea of what I might like to do with my life began to form in my mind. The idea of working with people who are struggling with life, lost, confused or in emotional pain both appealed and made sense to me, and for the first time in my life I began to conceptualise a future for myself…a purpose. For the first time in my life I had an idea of what I wanted to do, and more importantly, what I ‘believed’ I could do. Unfortunately I couldn’t afford to train in Jungian Psychoanalysis, but his work has and continues to influence my essence as a human being and a man, and undoubtedly influences my own work and relationships with clients.

I am privileged to be invited to share aspects of client’s life journeys with them for a time, which often involves their sharing some of their most painful and vulnerable parts of themselves, and I have nothing but the utmost respect and admiration for everyone who does so. I believe in therapy, and its potential for co-creating a relationship and a safe space with someone, that can be incredibly precious and valuable for self-exploration and personal growth. I also believe, having experienced my own versions of this during my own therapy, that for those of us who were not fortunate enough to have our emotional needs met as children, that an effective therapeutic relationship can become a form of ‘corrective experience’, and thus go a long way to healing painful wounds from our childhood.