The World Health Organization has listed sexual compulsion in its International Classification
of Diseases. Although not a substance, like other " process" compulsions like debting and gambling
the disorder is typified by behavior that lurches out of control despite relationship, monetary, and other personal consequences and failed attempts to stop. Despite controversy over the addiction
model, research suggests the involvement of neural pathways that mimic the same processes in the mind of addicts with substance and other addictions. Despite the controversy, the problem remains of how to help people with sexual compulsion. Some have mood disorders, others PTSD linked to traumas and abuse. There are established treatment protocols for these problems. Some co-exist with substance abuse and other addictions. Integrating treatment that involves social, biological, as well as
intrapsychic issues is important. Many people do well in supportive recovery
groups for individuals and partners. Help is available for betrayed partners whose
reality and trust are shattered by discovery of the addicts activities. Recovery and
managing to free oneself of sexual compulsion is difficult but hardly impossible.
Many have found intimacy and meaning in their lives they never felt possible.
Geoff Michaelson, Ph.D., Certified Sex Addiction Therapist
Monday, March 25, 2019
Wednesday, March 5, 2014
Managing Stress with Mindfulness and Related Techniques
1. Four Words: Body, Image, Talk, Feeling
When you feel overwhelmed and its an image that is bothering you,
say the word 'image' about every four seconds to yourself until the
intensity of your experience subsides.
If you are overwhelmed with an emotion, use the word 'feeling'.
If you are overwhelmed by a physical sensation, use the word 'body'.
If you are ruminating and its getting to you, use the word 'talk'.
Why should this simple technique work? When we are experiencing
intensity and it is over the top, whether sensation, emotion, imagery,
or the chatter of rumination, the emotional and arousal centers of the
lower brainstem are very active. Saying the applicable word stimulates
the higher order cognitive centers in the neo-cortex. This naturally
tunes down the over arousal. This technique was shared with me by
one of John Cabot Zinn's colleagues and is used in their stress clinic
for cancer patients.
2. The Ten Second Pause
At the top of every hour take a deep breath, let it out and tell yourself
that these ten seconds exist for the pure pleasure of your being alive.
Why should this work? The breath helps, but more importantly, if the
river of stress in your life is not interrupted, it does not decline, and
it may rise. When you start interrupting it, you are hitting the pause button.
Stopping even if for 10 seconds frequently helps.
3. Visualize for 1 to 3 times a day for 1-3 minutes each time your favorite
relaxing place, perhaps on the beach or wherever you can really let go and
unplug. The more days you do this the better you will feel until you feel
like you are never far away from that experience. Remember, the more
time you rhearse stressful anxious thoughts and worries the more conditioning
you give your body and mind to go in that directions. Changing the
conditioning and the mind and body will follow, and more associations
will form in the brain with these pleasant visualizations and thoughts.
4. Slow breath
We teach people with panic disorders to do controlled breathing. Breathing
3 seconds in and three seconds out is all that is necessary and keep going until
you are thinking more clearly. This breath stabilizes carbon dioxide in the blood
stream and corrects the often shallow and quick breath that they take. It is not necessary
to take huge amounts of air or to stress already sore chest muscles that are common with stress
and anxiety. Breath slowly through the nose unless you are stuffed up. As your muscles
relax your chest will expand exactly as it needs to with no effort on your part.
5. Self Suggestion
Often when we are panicked, anxious, overwhelmed, our mind is triggered by the
body to provide associations for these experiences. That's where the worries and fears and
catastrophic thinking come from. Respond to these emotional and out of proportion reactions
by telling yourself that that's what they are. Take a moment to refocus your mind on some very
happy moment, or moment of success, or other positive experience. Circle back to the
irrational out of proportion thoughts and direct your thoughts to this thought by saying
I have more positive and constructive and important things to think about and do, more
pleasurable and happy and exciting thoughts and experiences to focus on. Thank you
for the fire alarm, but there is no fire. As you continue to cycle back to the more important,
pleasurable, and happy things in your life, your mind is competing with the stressful
thoughts and sensations. Because the positive thoughts and experiences are so much more
compelling and enjoyable, the stress and anxiety loses its hold.
When you feel overwhelmed and its an image that is bothering you,
say the word 'image' about every four seconds to yourself until the
intensity of your experience subsides.
If you are overwhelmed with an emotion, use the word 'feeling'.
If you are overwhelmed by a physical sensation, use the word 'body'.
If you are ruminating and its getting to you, use the word 'talk'.
Why should this simple technique work? When we are experiencing
intensity and it is over the top, whether sensation, emotion, imagery,
or the chatter of rumination, the emotional and arousal centers of the
lower brainstem are very active. Saying the applicable word stimulates
the higher order cognitive centers in the neo-cortex. This naturally
tunes down the over arousal. This technique was shared with me by
one of John Cabot Zinn's colleagues and is used in their stress clinic
for cancer patients.
2. The Ten Second Pause
At the top of every hour take a deep breath, let it out and tell yourself
that these ten seconds exist for the pure pleasure of your being alive.
Why should this work? The breath helps, but more importantly, if the
river of stress in your life is not interrupted, it does not decline, and
it may rise. When you start interrupting it, you are hitting the pause button.
Stopping even if for 10 seconds frequently helps.
3. Visualize for 1 to 3 times a day for 1-3 minutes each time your favorite
relaxing place, perhaps on the beach or wherever you can really let go and
unplug. The more days you do this the better you will feel until you feel
like you are never far away from that experience. Remember, the more
time you rhearse stressful anxious thoughts and worries the more conditioning
you give your body and mind to go in that directions. Changing the
conditioning and the mind and body will follow, and more associations
will form in the brain with these pleasant visualizations and thoughts.
4. Slow breath
We teach people with panic disorders to do controlled breathing. Breathing
3 seconds in and three seconds out is all that is necessary and keep going until
you are thinking more clearly. This breath stabilizes carbon dioxide in the blood
stream and corrects the often shallow and quick breath that they take. It is not necessary
to take huge amounts of air or to stress already sore chest muscles that are common with stress
and anxiety. Breath slowly through the nose unless you are stuffed up. As your muscles
relax your chest will expand exactly as it needs to with no effort on your part.
5. Self Suggestion
Often when we are panicked, anxious, overwhelmed, our mind is triggered by the
body to provide associations for these experiences. That's where the worries and fears and
catastrophic thinking come from. Respond to these emotional and out of proportion reactions
by telling yourself that that's what they are. Take a moment to refocus your mind on some very
happy moment, or moment of success, or other positive experience. Circle back to the
irrational out of proportion thoughts and direct your thoughts to this thought by saying
I have more positive and constructive and important things to think about and do, more
pleasurable and happy and exciting thoughts and experiences to focus on. Thank you
for the fire alarm, but there is no fire. As you continue to cycle back to the more important,
pleasurable, and happy things in your life, your mind is competing with the stressful
thoughts and sensations. Because the positive thoughts and experiences are so much more
compelling and enjoyable, the stress and anxiety loses its hold.
Tuesday, September 22, 2009
What can Hypnosis Help?
Hypnosis can help with lots of things including
anxiety, depression, habit problems, weight control,
smoking cessation, and pain, to name just a few.
However, the most important thing to understand about
hypnosis is its power as an "adjunct" therapeutic technique
that may increase the effectiveness of other treatments.
So, in a very important sense, hypnosis is a strategic
consideration, rather than a stand alone therapy.
An example of this effect is what I have seen combining
cognitive behavioral methods with sensate focus
exercises, mindfulness, and hypnosis in the treatment
of sexual disorders. Since hypnosis is a natural way
of enhancing a relaxed state of focused attention, it
can be very useful when helping a couple attain the
benefits of sensate focus exercises when they need to
relax and focus on pleasurable experiences.
Geoff Michaelson, Ph.D., is a Fellow of the Academy
of Clinical Sexology, certified as a sex therapist by the
American Board of Sexology, and an Approved
Consultant by the American Society of Clinical Hypnosis.
anxiety, depression, habit problems, weight control,
smoking cessation, and pain, to name just a few.
However, the most important thing to understand about
hypnosis is its power as an "adjunct" therapeutic technique
that may increase the effectiveness of other treatments.
So, in a very important sense, hypnosis is a strategic
consideration, rather than a stand alone therapy.
An example of this effect is what I have seen combining
cognitive behavioral methods with sensate focus
exercises, mindfulness, and hypnosis in the treatment
of sexual disorders. Since hypnosis is a natural way
of enhancing a relaxed state of focused attention, it
can be very useful when helping a couple attain the
benefits of sensate focus exercises when they need to
relax and focus on pleasurable experiences.
Geoff Michaelson, Ph.D., is a Fellow of the Academy
of Clinical Sexology, certified as a sex therapist by the
American Board of Sexology, and an Approved
Consultant by the American Society of Clinical Hypnosis.
Saturday, January 31, 2009
How Does Coaching Work?
How often do we say, "Someday I'll get around
to..." followed by one of our cherished dreams:
write a novel, find a mate, learn a language,
find a new career, succeed in business, spend
more time with my family, and the list goes on.
While coaching doesn't substitute for counseling
when it comes to serious emotional blocks and
problems, it has helped many people achieve
their goals.
How does it work? By crafting a coaching plan
with a clear set of step by step goals, meeting
and dedicating time to this plan on a regular basis,
creating an accountability that matches the client,
challenging the coaching client and supporting
them in moving outside their comfort zone, very
wonderful things can happen. People may get
past obstacles, procrastination, and uncertainty,
and the fear of acting on what they really want.
The relationship with the coach is another key.
A professional or executive coach is like a partner
on your team who helps you craft your plan, but
you retain all the profits or benefits. The process
is akin to a personal seminar on the most important
things in your life.
******************************************
Geoff Michaelson, Ph.D. has been a professional
and executive coach since 1995. He was a member
of the Mentor/Coach LLC Trainers Team, coaching
numerous coaches on how to help their clients. He
has coached CEO's and COO's in the financial and
manufacturing sectors, published authors, music
company executives, literary agents, actors, among
many others.
******************************************
to..." followed by one of our cherished dreams:
write a novel, find a mate, learn a language,
find a new career, succeed in business, spend
more time with my family, and the list goes on.
While coaching doesn't substitute for counseling
when it comes to serious emotional blocks and
problems, it has helped many people achieve
their goals.
How does it work? By crafting a coaching plan
with a clear set of step by step goals, meeting
and dedicating time to this plan on a regular basis,
creating an accountability that matches the client,
challenging the coaching client and supporting
them in moving outside their comfort zone, very
wonderful things can happen. People may get
past obstacles, procrastination, and uncertainty,
and the fear of acting on what they really want.
The relationship with the coach is another key.
A professional or executive coach is like a partner
on your team who helps you craft your plan, but
you retain all the profits or benefits. The process
is akin to a personal seminar on the most important
things in your life.
******************************************
Geoff Michaelson, Ph.D. has been a professional
and executive coach since 1995. He was a member
of the Mentor/Coach LLC Trainers Team, coaching
numerous coaches on how to help their clients. He
has coached CEO's and COO's in the financial and
manufacturing sectors, published authors, music
company executives, literary agents, actors, among
many others.
******************************************
Tuesday, January 13, 2009
Pain Management
Here are 5 tips to managing pain from a psychological
perspective.
1) Since muscle tension around a pain area can increase
the perception of pain, finding a way to relax despite
the felt pain can help. Everyone is different regarding
what can help in a painful situation. Some strategies:
a) Diaphragmatic breathing( can be taught in minutes}
b) Hypnosis (can be taught for muscle relaxation in a
single session).
c) Mindfulness training (simple techniques taught in minutes)
d) Visualization (designed with individual preferences for
analgesic imagery) . There are many more simple
techniques for relaxation.
2) We have good and bad pain days. Take a break every day
from worry and thinking about symptoms. Call your doctor
if need be and let him/her worry or think about it. Mentally
practice this rest from fear or worry for as long as you want
or can. Its your moment or time to reclaim from pain.
3) Make a practice of focusing your mind on something that
is pleasurable whether or not your pain is significant. Realize
that a pleasure can co-exist with pain. Practice focusing
on the pleasureable sensation whether it involves touch, taste,
sound, sight or any other sense.
4) We sometimes think we know how a day will go depending
on how it starts. Practice letting go of knowing. Your muscles
may let go as well.
5) Watch your self talk. Telling yourself that your pain is horrible
may be true at times and sometimes continuously, but drop the
emotional adjective. "Its a 9 on the scale" is enough. It can
add to a lower sense of self. Our pain can feel bad, but we are
not our pain. It is something we have and we need not feel
bad about ourselves by remembering we are so much more
than the feeling od pain.
perspective.
1) Since muscle tension around a pain area can increase
the perception of pain, finding a way to relax despite
the felt pain can help. Everyone is different regarding
what can help in a painful situation. Some strategies:
a) Diaphragmatic breathing( can be taught in minutes}
b) Hypnosis (can be taught for muscle relaxation in a
single session).
c) Mindfulness training (simple techniques taught in minutes)
d) Visualization (designed with individual preferences for
analgesic imagery) . There are many more simple
techniques for relaxation.
2) We have good and bad pain days. Take a break every day
from worry and thinking about symptoms. Call your doctor
if need be and let him/her worry or think about it. Mentally
practice this rest from fear or worry for as long as you want
or can. Its your moment or time to reclaim from pain.
3) Make a practice of focusing your mind on something that
is pleasurable whether or not your pain is significant. Realize
that a pleasure can co-exist with pain. Practice focusing
on the pleasureable sensation whether it involves touch, taste,
sound, sight or any other sense.
4) We sometimes think we know how a day will go depending
on how it starts. Practice letting go of knowing. Your muscles
may let go as well.
5) Watch your self talk. Telling yourself that your pain is horrible
may be true at times and sometimes continuously, but drop the
emotional adjective. "Its a 9 on the scale" is enough. It can
add to a lower sense of self. Our pain can feel bad, but we are
not our pain. It is something we have and we need not feel
bad about ourselves by remembering we are so much more
than the feeling od pain.
Wednesday, December 24, 2008
Five Most Important Questions About Good Sex
People ask me all the time in my role as a sexologist,
"How can I have good sex?" Their number one question
is simply "What's the most important thing in having good
sex?" Here's the answer: It's all about your capacity to focus
on physical sensation and pleasure. Your body knows how to
become aroused.
Question 2: "If its so natural and simple, why do people have
so many problems?" The answer: Everything else besides sensation
is a distraction.
Question 3:
What are the top distractions? " Performance anxiety is king or
or queen. When people worry about what will happen and how
they perform they tense their muscles and breathe less deeply.
Tense muscles decrease blood flow and this is critical for sex.
When there is less blood flow to the pelvic region it's a kind of
"reverse-Viagra" effect. If they are in a relationship other emotions
from the relationship can enter in and provide distraction.
Interestingly the next most problematic distraction is an over
preoccupation with partner pleasing that dampens personal pleasure.
Question 4: So how do people overcome these problems? The
Gestalt therapist Fritz Perls had a saying: "Lose your mind and
come to your senses". I use a combination of relaxation and
self-hypnotic techniques to enhance muscle relaxation and blood
flow. I teach visualization and mental practice techniques to enhance
the focus on sensation. These are combined with cognitive or thinking
strategies that relieve the individual of irrelevant preoccupations.
Behavioral exercises for partners are used for practice and homework
to enhance their sense of sexual competency and to encourage them
to play and have fun. Then they are more able to put aside distraction.
Question 5: Why not just have people take a pill? Medications don't
work for everyone, some people don't like the side effects, and some
people simply don't want to use medication. The truth is that for some
people medications are a "godsend"when other measures don't work.
There are also situations in which combining medical treatment and
sex therapy may work best. The main point is that people should have
the available options for treatment so they can make informed
choices based on their needs.
"How can I have good sex?" Their number one question
is simply "What's the most important thing in having good
sex?" Here's the answer: It's all about your capacity to focus
on physical sensation and pleasure. Your body knows how to
become aroused.
Question 2: "If its so natural and simple, why do people have
so many problems?" The answer: Everything else besides sensation
is a distraction.
Question 3:
What are the top distractions? " Performance anxiety is king or
or queen. When people worry about what will happen and how
they perform they tense their muscles and breathe less deeply.
Tense muscles decrease blood flow and this is critical for sex.
When there is less blood flow to the pelvic region it's a kind of
"reverse-Viagra" effect. If they are in a relationship other emotions
from the relationship can enter in and provide distraction.
Interestingly the next most problematic distraction is an over
preoccupation with partner pleasing that dampens personal pleasure.
Question 4: So how do people overcome these problems? The
Gestalt therapist Fritz Perls had a saying: "Lose your mind and
come to your senses". I use a combination of relaxation and
self-hypnotic techniques to enhance muscle relaxation and blood
flow. I teach visualization and mental practice techniques to enhance
the focus on sensation. These are combined with cognitive or thinking
strategies that relieve the individual of irrelevant preoccupations.
Behavioral exercises for partners are used for practice and homework
to enhance their sense of sexual competency and to encourage them
to play and have fun. Then they are more able to put aside distraction.
Question 5: Why not just have people take a pill? Medications don't
work for everyone, some people don't like the side effects, and some
people simply don't want to use medication. The truth is that for some
people medications are a "godsend"when other measures don't work.
There are also situations in which combining medical treatment and
sex therapy may work best. The main point is that people should have
the available options for treatment so they can make informed
choices based on their needs.
Sunday, September 14, 2008
Hypnosis and Sex Therapy
Hypnosis can be a powerful tool in helping clients with
a variety of sexual problems. First of all there is the issue
of relaxation that has its place in treating erectile dysfunction
(ED) especially when there is performance anxiety involved.
Relaxation enhances blood flow and this is very useful
with ED.
Subjects who are able to alter sensation can apply their
training in self-hypnosis to ejaculatory control problems.
Sexual pain disorders involving muscle contraction and spasm
may respond to hypnotic relaxation along with other sex
therapy techniques.
Masters and Johnson's "Sensate Focus" techniques can
be enhanced with hypnosis since hypnosis involves a
relaxed state of focused attention. Sensate focus
requires focusing on sensation and pleasure during
lovemaking and couple exercises. Combining the
two techniques may assist couples in moving
more quickly through their learning experience.
In addition, the use of mental practice and visualization
as part of sex therapy "reconditioning" can be applied
to arousal and desire disorders as clients explore what
feels pleasurable to them. Hypnosis can help the clients
immerse more deeply in what they are experiencing.
Hypnosis also has its place in encouraging sexual self-esteem
as clients learn to appreciate their sexual selves and identity.
Hypnotizability matters. Some clients are more
talented than others with hypnosis. So, measuring this
ability is part of any initial assessment and treatment plan.
a variety of sexual problems. First of all there is the issue
of relaxation that has its place in treating erectile dysfunction
(ED) especially when there is performance anxiety involved.
Relaxation enhances blood flow and this is very useful
with ED.
Subjects who are able to alter sensation can apply their
training in self-hypnosis to ejaculatory control problems.
Sexual pain disorders involving muscle contraction and spasm
may respond to hypnotic relaxation along with other sex
therapy techniques.
Masters and Johnson's "Sensate Focus" techniques can
be enhanced with hypnosis since hypnosis involves a
relaxed state of focused attention. Sensate focus
requires focusing on sensation and pleasure during
lovemaking and couple exercises. Combining the
two techniques may assist couples in moving
more quickly through their learning experience.
In addition, the use of mental practice and visualization
as part of sex therapy "reconditioning" can be applied
to arousal and desire disorders as clients explore what
feels pleasurable to them. Hypnosis can help the clients
immerse more deeply in what they are experiencing.
Hypnosis also has its place in encouraging sexual self-esteem
as clients learn to appreciate their sexual selves and identity.
Hypnotizability matters. Some clients are more
talented than others with hypnosis. So, measuring this
ability is part of any initial assessment and treatment plan.
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