Category: mental health

  • 7 Questions Wives of Porn Addicts Ask

    ella hutchinson photoPornography addiction is a form of sex addiction. Wives of porn addicts are baffled by this addiction and feel like they are partially responsible for their husband’s behavior. The reasons for this are numerous and include the shame associated with this addiction for both the addict and the spouse, the sense of betrayal, and stereotypes linked to the addiction. Ella Hutchinson, a counselor from Katy, Texas, specializes in counseling wives of sex addicts. She sees women who haven’t told anyone about their husband’s addiction, sometimes for months, years and often, they never disclose. The lack of support available to spouses, and often inaccurate information being put out about partners of sexual addicts can cause a wife to suffer additional trauma. Ella has formulated 7 questions wives of porn addicts ask.

    #1: How can my husband love me and look at porn when he knows it hurts me?

     It is possible for your husband to love you, even though he is looking at pornography? In fact the two are completely unrelated. Men are better than women at compartmentalization. A man’s brain can be compared to a waffle. There are many different compartments so that he can divide his life up into separate components that don’t touch each other. His marriage and family can be in one compartment, his job in another…you get the point. This is a benefit when a man is fighting in a war and able to focus on the task at hand without worrying about his family back home. But it also makes a man able to look at pornography without thinking about how it may hurt you or his marriage. Women’s brains are more like spaghetti where everything is connected. Women are more likely to be worrying about our kids when we are at work and thinking about work when we are at home.

    When a man becomes addicted to pornography, it can become a perceived need rather than a choice for him until he becomes willing to reach out for help. His use of porn causes a release of the same chemicals involved when a drug is ingested. At the height of his addiction, nothing, not even the risk of losing his job or his marriage, is enough to stop him. This explains how a politician or celebrity can make such risky, career-destroying moves without stopping to consider the consequences.

    Later Ella will discuss the kinds of consequences that can catapult an addict into reality.

    #2: Why does my husband prefer porn and masturbation to sex with me?

     Norman Doidge, psychiatrist and author of the acclaimed book, The Brain That Changes Itself, studied porn addicts. He stated,

    They reported increasing difficulty in being turned on by their actual sexual partners, spouses, or girlfriends, though they still considered them objectively attractive. When I asked if this phenomenon had any relationship to viewing pornography, they answered that it initially helped them get more excited during sex but over time had the opposite effect.

    Your husband had this addiction, or the proclivity toward it, before he ever met you, regardless of what he says. In spite of what you think or even what he might have said, nothing you could do could be enough to sexually satisfy your porn addicted spouse. Pornography presents an unrealistic reality that damages a person’s brain. They become engrossed in this fantasy world where they don’t have to worry about pleasing anyone but themselves and no emotional connection is required.

    While a porn addict desperately craves love and intimacy (something he is probably unaware of), he seeks it out in the exact place that will cause him to become less and less able to experience it. As a counselor, Ella hears sexual addicts talk about their past, it becomes apparent why they are so uncomfortable with the idea of intimacy. This topic is beyond our scope here, but it is important for a wife to be aware that there is a reason her husband became addicted to porn, and that reason is not her.

    #3: Why am I not enough if I am sexually available to him?

    Beyond the intimacy issue, pornography offers the thrill of what is forbidden. The more taboo, the more exciting. This is why a porn addict may progress to looking at more hardcore porn and even pornography involving aspects that a healthy person would consider offensive and grotesque.

    Gary Wilson, human sciences instructor, and Marnia Robinson, author of Cupid’s Poisoned Arrow: From Habit to Harmony in Sexual Relationships, state:

     The uniqueness of Internet porn can goad a user relentlessly, as it possesses all the elements that keep dopamine surging. The excitement of the hunt for the perfect image releases dopamine. Moreover, there’s always something new, always something kinkier. Dopamine is released when something is more arousing than anticipated, causing nerve cells to fire like crazy. In contrast, sex with your spouse is not always better than expected. Nor does it offer endless variety. This can cause problems because a primitive part of your brain assumes quantity of dopamine equals value of activity, even when it doesn’t. Indeed, porn’s dopamine fireworks can produce a drug-like high that is more compelling than sex with a familiar mate.

    #4: He says he looks at porn because I don’t have sex with him enough, am I not pretty enough, am I  too fat, etc. What can I do?

    Ella hears this a lot and it is called justification. Your husband doesn’t want to believe he is sick. If he is not ready to admit he is an addict and take responsibility for his own behavior, he will say anything to convince you, and even himself, that he does not have a problem. Blaming you is an easy way to save face.

    There is nothing you could do to be appealing enough to make your husband stop looking at porn. We see very beautiful women whose husbands no longer desire them, couples where the wife looks like she belongs on the cover of Cosmopolitan magazine or on a model runway, and the husband has admitted to her that he is physically repulsed by her. Ella speaks of another couple who has sex every day, yet she still catches him looking at porn and frequenting adult bookstores. There is simply no credibility to the argument that a wife causes or contributes to her husband’s use of pornography.

    #5: My husband says all men do it. Am I making too big a deal out of this?

    It is unfortunate, but true, that pornography use is overwhelmingly common. This does not make it okay or mean you should turn a blind eye. Ella often hears women say that their husband’s porn use makes them feel cheated on. This makes sense. When a man uses porn he is finding sexual satisfaction from someone other than his wife. So the betrayal a woman feels is natural. God created sex to be between a man and his wife. The Ten Commandments interpret looking at a woman with lust is the same as committing adultery with her in his heart. Looking at porn is purposely choosing to lust.

    #6: My husband refuses to get help or admit this is a problem. How can I make him stop? What are the risks if he doesn’t stop?

    In short, you cannot make him stop. It usually takes something significant to get a man to the point where he is ready to admit his porn addiction. This is what they call “hitting rock bottom”. Sometimes, for a man who has hidden his porn use for years, just getting caught is enough. But more often, it takes losing his job, his wife leaving him, or another monumental event to shake him to the core and wake him up to reality. It may be his porn use progressing to acting out with another person or other people and facing the multiple possible consequences of this, to cause him to recognize his need for help.

    You can insist your husband stop his porn use and you have every right to do so. The compulsive use of porn will, without exception, do damage to your marriage and your family. It affects a person’s sense of right and wrong. It can cause your husband to lose respect for you. You will likely feel him pulling further away from you and your family as he gets more entrenched in this sinful lifestyle. If he refuses help, it will only get worse. Your pleading that he stop will fall on deaf ears if he isn’t ready to hear it. This is a harsh reality, but one too many women just do not get. Some women beg and plead for decades until they grow cold and bitter. Then they tell me that they wish they had left years ago and feel they have wasted most of their life.

    When porn is an issue, it is likely that extramarital affairs are or will become an issue. This means you are at risk of more than the heartache of discovering your husband has been sexual with another person. You are also at risk of STDs or your husband fathering another woman’s child. Additionally, your children are almost guaranteed early exposure to porn, something that was likely a contributing factor in your husband’s addiction.

    #7: Is there hope? Can a man like this change?

    Recovery from sexual addiction is very much possible. Men who get out feel a sense of freedom, as if a huge boulder has been lifted off their chest. It is such a liberating feeling that many men forget that their wives are still grieving from his actions and likely will be for some time.

    For some men, simply the threat of their wife leaving is enough to cause them to get help. But for many others, they need something more. This can cause you, as the wife, to feel helpless. You are not helpless. You can’t control your husband’s recovery, but as the injured spouse, you can control your own. The fact that you need recovery does not mean you are sick or that something is wrong with you, but that you have likely been traumatized by your husband’s behavior. Your recovery includes building up a support system for yourself. Don’t keep silent. Reach out to a trusted friend, your pastor, or a therapist. Keeping this secret will cause feelings of shame, loneliness, and isolation. Finding a support group for wives of sex/porn addicts can be very helpful. If there is not one in your area, there are phone support groups available, led by trained life coaches and therapists who have been in your shoes. Finally, learn to recognize your unmet needs and what it will take to meet them. A skilled therapist can help you with this. The absolute best book written for wives is Your Sexually Addicted Spouse, by Barbara Steffens and Marsha Means. Ella strongly encourages you to find a therapist (individual and marriage) who is familiar with this book and subscribes to the treatment model described in it. If your therapist isn’t familiar, ask if they’d be willing to read it.

    Beyond self-care, Ella recommends that you take some time to come up with some clear, firm boundaries for your marriage. While this may not result in the desired outcome, it is worth it to put in the effort. At the very least, this is a first step toward helping you get to a place where you can make an informed decision about the direction of your relationship. This means bottom-line behaviors you will not tolerate and actions you need to see happening in order for you to feel safe in your marriage. Your list of unacceptable behaviors may include viewing pornography in the home, inappropriate conversations or relationships with other people, and other possible abusive behaviors toward you that are often present in a sexual addict. The actions you need to see your husband take might be installing a filter on computers and phones, open discussions about where all the money is going with you having access to all accounts, attending sexual purity or sexual addiction support groups, counseling, and talking to a pastor.

    Before you present this to your husband, make sure you are prepared to follow through with consequences if he refuses or does not stick to what he agreed to do. Consequences can be anything from insisting one of you move to a separate bedroom (an in-house separation) to one of you moving out of the home. Your husband will likely be resistant to you setting these boundaries and may accuse you of being demanding and giving him an ultimatum. Do not engage in any kind of manipulative or accusatory conversations with your husband. Learn to recognize this behavior and refuse to participate. It is important that you wait to address your new boundaries until you are able to do so in a calm manner. A therapist’s presence (and guidance beforehand) is a good idea. A good book on this topic is The Gaslight Effect by Dr. Robin Stern.

    If your husband does not follow the boundaries you set, you now have a choice to make. You can choose to accept that your husband is simply not ready to stop his porn use. This means letting go of the nagging, criticism, and efforts to control (which should have stopped already by this point since you have learned they don’t work). If you choose to to not follow through with the consequences, even though he has made it clear through his words or actions that he is not willing to stop, you are choosing to accept his behavior. This will probably require a good deal of emotional detachment on your part. It may be a marriage that looks more like you are roommates. Ella says she has not yet met a woman who has chosen this arrangement and found any kind of long-term life satisfaction in it, but it is an option.

    Your choices may need to include making the necessary preparations in case you need to leave. This may mean getting a job if you don’t work and starting to put money aside. Separation does not mean divorce, but it can be a prelude to it. Ideally, that should not be the goal for separation. The purpose is to show your husband that you are unwilling to share him with pornography. Once he sees you are serious and can no longer be placated with words and half-hearted attempts that don’t last, he is also more likely to take his addiction seriously. Also, getting physical space between you and him can make it easier for you to clear your mind, spend more time in prayer and God’s Word, and make objective decisions about your future. A good Christian counselor can guide you through a therapeutic separation where rules are put in place for you both to follow during this time.

    Many men have escaped the chains of sexual addiction. Here is an important truth to be aware of. Your husband has probably tried to stop more times than he can count. He is not deriving pleasure from his lifestyle. He keeps going back, trying to fill a void that porn will never fill. Willpower is not enough. Recovery from sexual addiction is multifaceted, but includes reaching out to other men who have been there, and often requires professional help as well.

    God must be the central focus in recovery. However, many men have learned the hard way, in the words of author, speaker, therapist and recovering addict, Dr. Mark Laaser, “You can’t pray it away.” If prayer was all we needed then we wouldn’t have to have jobs or pay bills. We could just pray about it and our bank account would never run out and the bills would get paid. If prayer was enough we could eat and drink whatever we want and every check-up would reveal a clean bill of health. But God wants us to do the work, and keep doing it.

    Once a man has decided to become serious about recovery from sexual addiction, there are more steps to take to help the marriage heal. After all, just because the behavior has stopped, it doesn’t mean the damage that has been done will go away. Marriage counseling with a skilled sex addiction therapist is important. Couple’s Intensives are a great way to get a jump start on recovery for the couple. Ella recommends the book Hope and Freedom by Milton Magness to learn more about recovery for you, your husband, and your marriage and to learn about intensives. You can also read about intensives and other issues surrounding marriage and sexual addiction on Ella’s website, Comfort Christian Counseling.

    . . . .

    Ella Hutchinson, is a Licensed Professional Counselor with a Bachelor of Science degree in Psychology and a Master’s degree in Counseling from St. Edward’s University in Austin, TX. She is also a member of the American Association of Christian Counselors. In addition, Ella is certified in treating sex addiction and specializes in counseling partners of sexual addicts. She practices at:

    Comfort Christian Counseling,

    2900 Commercial Center Blvd #101, Katy, TX 77494

    You can contact Ella at:

    http://comfortchristiancounseling.com/

     

     

     

     

     

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  • Believe Change is Possible

    Believe Change is Possible

    Melissa Killeen
    Melissa Killeen

    As a recovery coach, I work with people trying to change a habit. We work on finding different ways of responding to a trigger. For some seeking recovery, they want to find an easier, softer way. Others think willpower is all they need to get sober. But that doesn’t always work. As Charles Duhigg describes in his book, the Power of Habit, for a habit to be changed, people must believe change is possible.

    Where does this belief come from? Habit change can emerge from a tragedy or from some kind of adversity. Many addictions have been successfully abandoned when an individual hits bottom and finally seeks treatment. Many people give up smoking after a diagnosis of heart disease or when a family member is being treated for lung cancer.

    A Harvard study in 1994 examined people that had radically changed their lives. Some had experienced the death of a loved one, divorce or life-threatening illness. Others radically changed their life from observing a friend experience a disaster. Tragedy plays an important part of having an impact on one’s life. But equal to tragedy facilitating change, the same amount of people made change happen in their life because they were surrounded by supportive friends that encouraged change. The Harvard study sites a woman that changed the direction her life when she took one psychology course at a local college and found a group of like-minded individuals. Another man came out of his introverted shell when he joined an acting group. So for change to happen for many, it didn’t take a life shattering event, it simply took a community of believers.

    “Change occurs among people”

    Todd Heatherton, Dartmouth College Lincoln Filene Professor

    A community of non-smokers talk about how great it feels like to be a non-smoker. How nice it is not to have your hair smell like an ashtray. Your spouse commented on how fresh his clothes smell, now that you have stopped smoking. And co-workers admire you for having the strength to stop smoking. These like-minded people can also resolve some negative feelings, as well. Such as what to do after a meal, when the habit of lighting up a Marlboro is the most strong. Or how to refrain from smoking in your car. These friends are there for you to call, text or email whenever the urge to smoke becomes unbearable. Support from a community and their confidence in you, bolsters the strength you need to believe you will not pick up a cigarette.

    For habits to change permanently, people must believe change is possible. This same process makes any mutual support group very effective – the power of a group to teach individuals that they can believe it is possible to change. This belief happens when people come together to help one another to change. Whether the group is Nicotine Anonymous, a breast cancer support group or massive amounts of volunteers descending on New Orleans, post Katrina, to re-build the city to it’s former glory.

    Change is easier when it occurs within a community.

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  • Stop Calling It Behavioral Health!

    Stop calling it behavioral health! Does the term cause stigma and discrimination?

    By Robert Kent JD and Charles Morgan MD

    Reprinted from thefix.com, originally published on 11/12/15

    When somebody is treated for smoking cessation, the care will probably be provided within the behavioral health system. If that person is later diagnosed with lung cancer that will be treated over in physical health. If she becomes depressed, that’ll be managed back over in behavioral health. But if the depression causes digestive problems, that aspect of the patient’s health and health care will be treated…you get the picture. Many “behavioral” issues are driven by biological or hereditary conditions, and yet physical and behavioral health are frequently organized, paid for and managed in two entirely different systems. Two key figures at OASAS, which oversees one of the largest addiction treatment systems in the country, argue that the divide between physical and behavioral health, and the term itself, can lead to stigmatization and discrimination against people with “behavioral disorders.” Robert Kent, J.D., the general counsel at the NYS Office of Alcoholism and Substance Abuse Services (OASAS), leads OASAS’s work to implement health care and insurance reform for the Substance Use Disorders system in New York. Charles Morgan, MD, is the medical director of OASAS and a physician who has devoted over three decades to working with people and families affected by addiction. They both want you to “STOP CALLING IT BEHAVIORAL HEALTH!”… Richard Juman, PsyD.

    We believe that it is time to stop calling substance use disorder and mental health “behavioral health.” We are unabashed advocates and supporters of the substance use disorder (SUD) treatment, prevention and recovery system. We are regularly amazed by the stories of people who are now able to live their lives in recovery because of the work done by the people in our system. We need to talk about these disorders in a language that reflects their true nature; they are medical conditions, the origins of which lie in the person’s brain, and the effects of which extend into every part of that person’s life, and as with other illnesses, virtually always into the lives of the people who are touched by the patient.

    The term “behavioral health” is imprecise, since it doesn’t indicate whether one is talking about a mental health condition or a substance use disorder. More importantly, the concept of “behavioral health” as separate from the rest of health care has allowed insurance and managed care companies to create rules for managing services which have denied people access to needed services. If you follow the logic of using the term “behavioral health,” then people with type 2 diabetes, heart disease and asthma could very accurately be identified as having a “behavioral health” issue, as their chronic medical condition is aggravated by their behaviors. But we would never do that with those disorders.

    Constellations of behavior manifest from many chronic medical conditions, some of which are construed as “medical” and others as “behavioral.” The bifurcation is as illogical as it is stigmatizing. People aren’t expected to be able to shrink their own tumors or cure their own infections, but they are expected to control their own behavior. Consequently, calling psychiatric and substance use conditions “behavioral” puts the onus on the patient, often to his tragic detriment in the form of discrimination in housing and employment or the realm of criminal prosecution.

    An individual with a substance use disorder has a natural, predictable disease course, one that is responsive to treatment, allowing for recovery. While we obviously do not want these symptoms to continue, blaming a person for their “behavioral health” issues, rather than treating them, is as counterproductive as blaming a person with epilepsy for falling down when they have a seizure, or blaming the person who is allergic to bees for disrupting the annual family reunion picnic because s/he needs emergency care when s/he is stung. Since we do not want such problems to continue or to be ignored, being judgmental or pejorative about them is harmful because it impedes treatment. In the case of the person with a bee allergy, we would instead encourage him to carry an EpiPen, and we would work to remove any barriers that might prevent him from doing so. We would also remove the bees’ nest!

    With regard to the methods and rules used by the insurers and managed care companies that operate in “behavioral health,” some of our recent initiatives provide ample proof of the impact of using the term. Thanks to the leadership of New York Governor Andrew Cuomo, we now have a state law that requires insurance and managed care companies to have the decision-making criteria they use to manage substance use disorders reviewed and approved by OASAS. Our review of the criteria being used revealed that SUD level of care decisions were being significantly influenced by a person’s past failures or relapses, by whether they had “failed first” at a lower level of care before they sought a higher level of care, and by their “motivation” to seek help.

    Some insurers, and even some providers of care, use the term “motivation” to exclude people from treatment. This is in contrast to the concept of motivation as described by the stages of change model, or in motivational interviewing technique, where a patient’s level of motivation is understood in order to allow for effective treatment. These types of rules would never be allowed for other chronic medical conditions like diabetes, heart disease, and asthma. Would we deny a diabetic their insulin because they ate chocolate cake the night before? Would we deny the person with heart disease medications because they ate chicken wings and french fries? Of course not, because we do not think of those other chronic medical conditions as behavioral in nature. Unfortunately, there is a bias towards thinking of SUDs as behavioral, and then allowing the punishment of the behaviors that are symptomatic of the condition.

    Finally, and most importantly, we believe use of the term “behavioral health” plays a major role in the continued stigmatization of those with an SUD. Such terminology reflects a misunderstanding of SUD, and allows us to perpetuate the myth that the illness is volitional rather than based in biology. Critics of our stance tell us we are absolving people of responsibility for their actions, when in fact we are doing quite the opposite. By delineating the true nature of the illness, we can allow patients to get proper treatment for their illness. Blaming people for addiction would be like blaming people with irritable bowel syndrome for the symptoms of their disease. Acknowledging the disease of IBS allows for proper treatment, which then allows people to be more functional and self-actualized in a way that allows them to take responsibility for their recoveries and to get relief of debilitating symptoms. Similarly, when we treat SUD rationally in this way, rather than as a series of “volitional behaviors” that those afflicted should be able to stop if they were properly motivated, people affected by SUD can then take responsibility for their illness and get effective treatment.

    With regard to the stigmatization of people with SUD, researchers estimate that only one in 10 people who have an SUD actually seek help. While we know there are many reasons people do not seek help, we know that the stigma associated with SUD has a significant inhibitory impact.

    We should listen to the experts. The American Society of Addiction Medicine (ASAM) defines addiction as follows:

    Addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social and spiritual manifestations. This is reflected in an individual pathologically pursuing reward and/or relief by substance use and other behaviors.

    Addiction is characterized by inability to consistently abstain, impairment in behavioral control, craving, diminished recognition of significant problems with one’s behaviors and interpersonal relationships, and a dysfunctional emotional response. Like other chronic diseases, addiction often involves cycles of relapse and remission. Without treatment or engagement in recovery activities, addiction is progressive and can result in disability or premature death.

    Michael Botticelli, the director of the White House Office of National Drug Control Policy, has talked recently about the language we use impacting whether people seek help for an SUD and he has encouraged us to use different language. We know that some will disagree with our viewpoint and some will dispute the basis used for making it. We also know that we can only change what we do, and we can hope others will do the same.

    It is essential that we start thinking of substance use disorders and describing them by using the same language that we use when we describe other chronic medical conditions. The language is critical here: Let’s change the world by changing the way we think about, and talk about, the medical conditions formerly known as “behavioral health.”

    This article written by Robert Kent and Dr. Charles Morgan was reprinted with permission from the 11/12/2015 issue of theFix.com https://www.thefix.com/stop-calling-it-behavioral-health

    Robert A. Kent serves as the General Counsel for the New York State Office of Alcoholism and Substance Abuse Services. In this role, Mr. Kent provides overall legal support, policy guidance and direction to OASAS Commissioner Arlene González-Sánchez, the Executive Office and all divisions of the agency. Robert is leading the OASAS efforts to implement Governor Cuomo’s Combat Heroin and Medicaid Redesign Team initiatives.

    Charles W. Morgan, MD, FASAM, FAAFP, DABAM is the Medical Director of OASAS. He has worked in the field of Addiction Medicine for over three decades and is a Fellow of both the American Society of Addiction Medicine and the American Academy of Family Medicine. Dr. Morgan has expertise in all modalities of patient and family healthcare.

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