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Saturday, January 19, 2013

Addictive Relationships

The following might seem like a very general article on addictive relatiosnhips, something that many of us have seen/ been a part of. It may be an interesting read in terms of identifying whether you are in one currently. As counselors, one of the main issues that most clients come with is 'being stuck' in an unhealthy relationship and not being able to come out. This article from a popular psychology source might help you better understand this vicious cycle.

Addictive Relationships

It is often very hard to end a love relationship even when you know it is bad for you. A “bad” relationship is not the kind that is going through the usual periods of disagreement and disenchantment that are inevitable when two separate people come together. A bad relationship is one that involves continual frustration; the relationship seems to have potential but that potential is always just out of reach. In fact, the attachment in such relationships is to someone who is “unattainable” in the sense that he or she is committed to someone else, doesn’t want a committed relationship, or is incapable of one. Bad relationships are chronically lacking in what one or both partners need. Such relationships can destroy self-esteem and prevent those involved from moving on in their careers or personal lives. They are often fertile breeding grounds for loneliness, rage, and despair. In bad relationships the two partners are often on such different wave-lengths that there is little common ground, little significant communication, and little enjoyment of each other.Remaining in a bad relationship not only causes continual stress but may even be physically harmful. An obvious harm is the physical abuse that is often a part of such relationships. In a less obvious way, however, the tensions and chemical changes caused by the constant stress can drain energy and lower resistance to physical illness. Continuing in such bad relationships can lead to unhealthy escapes such as alcohol or drug abuse and can even lead to suicide attempts.

In such relationships, individuals are robbed of several essential freedoms; the freedom to be their best selves in the relationship, the freedom to love the other person through choice rather than through dependency, and the freedom to leave a situation that is destructive.

Despite the pain of these relationships, many rational and practical people find that they are unable to leave, even though they know the relationship is bad for them. One part of them wants out but a seemingly stronger part refuses or feels helpless to take any action. It is in this sense that the relationships are “addictive.”

Are You Addicted?

Listed below are several signs of addiction. Consider whether they apply to you:

  1. Even though you know the relationship is bad for you (and perhaps others have told you this), you take no effective steps to end it.
  2. You give yourself reasons for staying in the relationship that are not really accurate or that are not strong enough to counteract the harmful aspects of the relationship.
  3. When you think about ending the relationship, you feel terrible anxiety and fear which make you cling to it even more.
  4. When you take steps to end the relationship, you suffer painful withdrawal symptoms, including physical discomfort, that is only relieved by reestablishing contact.

If most of these signs apply to you, you are probably in an addictive relationship and have lost the capacity to direct your own life. To move toward recovery, your first steps must be to recognize that you are “hooked” and then try to understand the basis of your addiction. In this way, you gain the perspective to determine whether, in reality, the relationship can be improved or whether you need to leave it.

The Basis of the Addiction

There are several factors that can influence your decision to remainin a bad relationship. At the most superficial level are practical considerations such as financial entanglement, shared living quarters, potential impact on children, feared disapproval from others, and possible disruption in academic performance or career plans.

At a deeper level are the beliefs you hold about relationships in general, about this specific relationship, and about yourself. These beliefs may take the form of learned societal messages such as “Love is forever,” “You are a failure if you end a relationship,” “Being alone is terrible,” and “You should never hurt anyone.” Also relevant are beliefs about yourself such as “I’ll never find anyone else,” “I’m not attractive or interesting enough,” or “If I work hard enough I should be able to save this relationship.”

At the deepest level are unconscious feelings which can keep you stuck. These feelings develop early in childhood, often operate without your awareness, and can exert considerable influence on your life. Children need to be loved, nurtured, and encouraged in their independence. To the extent that parents are successful in doing this, their children will be able to feel secure as adults in moving in and out of relationships. To the extent that these needs are not met their children may be left feeling “needy” as adults and may thus be more vulnerable to dependent relationships.

Strategies for Overcoming Relationship Addictions

Robin Norwood, in her excellent book “Women Who Love Too Much” outlines a ten step plan for overcoming relationship addiction. While this book is directed toward women, its principles are equally valid for men. Stated here (reordered and sometimes paraphrased), Norwood suggests the following:

  1. Make your “recovery” the first priority in your life.
  2. Become “selfish,” i.e., focus on getting your own needs met more effectively.
  3. Courageously face your own problems and shortcomings.
  4. Cultivate whatever needs to be developed in yourself, i.e., fill in gaps that have made you feel undeserving or bad about yourself.
  5. Learn to stop managing and controlling others; by being more focused on your own needs, you will no longer need to seek security by trying to make others change.
  6. Develop your “spiritual” side, i.e., find out what brings you peace and serenity and commit some time, at least half an hour daily, to that endeavor.
  7. Learn not to get “hooked” into the games of relationships; avoid dangerous roles you tend to fall into, e.g., “rescuer” (helper), “persecutor” (blamer), “victim” (helpless one).
  8. Find a support group of friends who understand.
  9. Share with others what you have experienced and learned.
  10. Consider getting professional help.

When to Seek Professional Help

Some counseling may be called for when any of these four circumstances exist:

  1. When you are very unhappy in a relationship but are unsure of whether you should accept it as it is, make further efforts to improve it, or get out of it.
  2. When you have concluded that you should end a relationship, have tried to make yourself end it, but remain stuck.
  3. When you suspect that you are staying in a relationship for the wrong reasons, such as feelings of guilt or fear of being alone, and you have been unable to overcome the paralyzing effects of such feelings.
  4. When you recognize that you have a pattern of staying in bad relationships and that you have not been able to change that pattern by yourself.


Thursday, January 17, 2013

In light of the recent rape incident that shook the country, I was asked to write an article trying to better understand Pedophilia as one of the sexual deviancies/ sexual disorders. I wanted to share it in the forum in case it was useful to anyone.
Write back if you have any queries :).
Pedophilia is a psychiatric disorder that is used to describe an individual 16 years or older who has a primary sexual interest in prepubescent children, 11 years or younger.
According to the International Classification of Diseases (ICD-10), in order to make a diagnosis of pedophilia, the person initiating the sexual relationship must be at least five years older than the prepubescent child. The ICD- 10 describes it as a ‘disorder of adult personality and behavior’.
          The Diagnostic and Statistical Manual (DSM-IV TR) describes it as a paraphilia- a sexual attraction to something out of the norm.
Pedophilia as a practice is a punishable offense in most parts of the world. In the light of the current story that’s making the news- the story of Nirbhaya- the girl in Delhi that lost her life recently; we pause this New Year to ask ourselves- how much do we know about sexual offenses and sexual disorders. Further, how prepared are we to handle something like this?
          In order to better understand a concept like pedophilia, that seems so bizarre and unacceptable to all of us, a metanalysis conducted by Finkelhor and Araji proposed a four factor model to explain why adults get attracted sexually to young children. The first explanation they propose is called Emotional Congruence Theory developing from the psychoanalytical school of thought. This model proposes that people with pedophilia have arrested psychological development. Thus Pedophiles experience themselves as children with child like needs and thus wish to relate to other children.
A theory of symbolic mastery suggests that a relationship with a child helps the pedophile have a sense of mastery of shame, humiliation and guilt encountered as a child at the hands of an adult. Thus one of the ways in which the pedophile combats the childhood sense of powerlessness is by reversing the roles in adulthood and overpowering another child.
          A second model called sexual arousal to children comes from the point of view that the act is not sexual in nature at all. Like rape is a crime of violence, pedophilia is a crime of power and dominance.   
          A third group of theories called the blockage theories try to understand why pedophiles cannot get the same amount of sexual stimulation or satisfaction from heterosexual adults. Individual psychology theories claim that the individuals have an extremely high sense of castration anxiety that makes it impossible for them to function normally with adult women and have sexual relations with them. A more practical explanation from the same theoretical orientation claims that pedophilia is a reaction or an outcome to earlier experiences with failed sexual attempts- like impotency, abandonment by the first lover etc.
          A final explanation of this disorder is a group of theories called disinhibition theories. A number of studies conducted along these lines discovered that pedophiles generally have lower impulse control, neurological deficits, alcohol abuse or senility contributing to this behavior. Similar studies have also found pedophiles to have lower intelligence levels than normal people.
Further, they may have situational factors like unemployment, losses etc that are major stressors for them. This leads to another related factor that in the diathesis stress model, pedophiles have a lower threshold of stress tolerance making even small triggers very difficult to handle. A study also showed that early incidence of child molestation led to a cycle reaction inducing pedophilic behavior later on.
          A study conducted in 2008 identified a neural imbalance or a deficient mechanism in the amygdala of the brain which is responsible for arousal and emotional valuation. The normal regulating mechanism is absent in pedophiles thus reversing the mechanism and resulting in deviant sexual behavior.
          Clinical psychologists and researchers primarily use three methods to diagnose pedophilia- sexual behavior (history), self reports and psycho physiological behavior responses. Some of the tests used to measure psycho physiological behavior responses include polygraph tests and viewing time. In crime related questions, polygraph tests show an elevated rate of heartbeat, skin conductance, respiration etc. Further in viewing tests, pedophiles ‘linger’ on images of children longer than normal people.
          One of the surer predictors of pedophilic behavior include possession of child pornography. Further, a phallometric measure of sexual arousal to children is positively correlated to later sexual offense. Similarly, there is also a positive correlation between antisocial personality disorder and later sexually deviant behavior.
          With the above studies, we can see how pedophilia is a disorder and needs treatment and help. In terms of research conducted on how best to work with such a problem, studies show that there may be a few ways to develop insight in such individuals as they are often in denial.
          One way is to treat pedophile as an addiction and assign individuals to a de- addiction group. Another method suggests using insight oriented therapy to discuss in depth emotional and childhood concepts. Another way to work with this issue could be aversion therapy by associating the pedophilic urge/fantasy to something repulsive like an electric shock/nausea etc. Covert sensitization in which the person imagines the consequences of engaging in the activity like imprisonment may also prove to be beneficial in management of the tendencies.
          Finally, victim empathy training in which the individual is exposed to materials like audio and print material in which victims describe the horror and their experiences may help the perpetrator empathize with his victims better and check his impulses.
          With respect to medication, anti androgen medicines that reduce the sexual urges and desire are the only effectively researched drugs.
          It is important as parents and others working with such individuals that we work with the trauma of the victims first in a sensitive way. It is best to work with it like a post traumatic disorder in order to prevent uninhibited sexual promiscuity in later years or the extreme guilt and isolation (the other extreme).
          When working with such individuals, it’s important to always put the safety of the child first even if it means shifting the child away from its primary home if that is best for them at that time. The counselor or social worker is advised to work with caution and kindness but firmness to help the child understand that it is not their fault in any way.
What do we do as citizens, as social workers and counselors, as parents and people sensitizing the community? How would we ‘prevent rather than cure’ and protect our children from this evil?
          Some practical tips include,
1.    Never disclose personal information, such as your address, to strangers online.
2.    Never meet privately in person with anyone you have met online.
3.    Never get close to a car if a stranger stops and asks for directions.
4.    Never accept a ride from, or go anywhere alone with, an adult you don’t know.
5.    No adult should touch you or ask you to touch him in any way that is confusing or frightening. If this happens, refuse and tell your parent immediately.
6.    No adult should ever ask you to keep a touch or a kiss secret. If this happens, tell your parent immediately.
7.    If any of these things happens, you will not be punished even if you have broken a rule.
Teaching the children the difference between good and bad touch, having frank discussions about sex when appropriate and value based classes that constantly ingrain good values in children may help them to be better prepared for unforeseen events. They may be better equipped to say no if the situation is fishy or inappropriate. Finally, self defense must be incorporated in the school curriculum so that children are prepared to protect themselves at least early on by calling for help, stalling or buying more time. Basic things like keeping to a group, sticking to a curfew, avoiding peer pressure and substance abuse may also reduce the risk of being in a vulnerable position.
Finally, a healthy bond of trust should exist between parent and child so that in the event of any regrettable incident, the child feels comfortable sharing it with their parents without the fear of being blamed, condemned or worse yet, ignored.
Finkelhor, D. (1986). Explanations of Pedophilia: A Four Factor Model. Journal Of Sex Research, 22(2), 145.
Sartorius, A. (2008). Abnormal amygdala activation profile in pedophilia. European Archives Of Psychiatry & Clinical Neuroscience, 258(5), 271-277.
Abel GG, et al. “Pedophilia,” in Gabbard GO, ed. Treatments of Psychiatric Disorders, Third Edition.
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Fagan PJ, et al. “Pedophilia,” JAMA (November 20, 2002): Vol. 288, No. 19, pp. 2458–65.
Green R. “Is Pedophilia a Mental Disorder?” Archives of Sexual Behavior (December 2002): Vol. 31, No. 6, pp. 467–71. Commentaries and rejoinders, pp. 479–510.
McConaghy N. “Unresolved Issues in Scientific Sexology,” Archives of Sexual Behavior (August 1999): Vol. 28, No. 4, pp. 285–318.
Quinsey VL. “The Etiology of Anomalous Sexual Preferences in Men,” Annals of the New York Academy of Sciences (July 2003): Vol. 989, pp. 105–17.