Hyper-Sexual Behavior (commonly referred to as sex addiction)
What defines sex addiction? This is a question that many professionals from different disciplines have tried to explain. Nonetheless, there has been very little consensus regarding the etiology of hyper-sexual behaviors and best treatment practices amongst researchers and practitioners from all over the world.

In the early stages of sex addiction research, factors that were used to define “sex addiction” included presence of Sexually Transmitted Infections, HIV/AIDS, unwanted pregnancies. As the field evolved, definitions started to include sexual health vision, sexual pleasure, consent, human rights, among others. What this tells us is that the concept of “sex addiction” can very well be defined as a social construction.

On the other hand, persons who struggle regulating their sexual behaviors, thoughts, or emotions, have a valid experience that involves distress, despair, anxiety, anger, and fear. Family members, spouses, partners, and friends, are also often affected by the person’s dysregulated sexual behaviors. It is important to acknowledge these experiences and work with clients and others affected by the “sex addiction” in ways that are validating of their experience. Whether the person feels their current sexual behaviors are culturally, socially, or pathologically rooted; it is important that they obtain clarity about how they define sexual health, and take steps that will lead them to their sexual health goals.


NARRATIVE THERAPY AND SEX ADDICTION
In Narrative therapy, the person is able to explore their story and the problem afflicting them, in this case “sex addiction” or “sexual dysregulation”, etc. The person seeking help will be able to define the problem in a way that makes the most sense to them and their experience. The person often works on changing the relationship between them and the problem, which often leads to them having more choice in their lives without the influence of the problem.

The person is guided by the therapist to identify gaps in their story, which often represent exceptions to the problem and from which alternative stories could be identified, explored, and developed.

Separation from the problem often leads to a reduction in its effects on the person’s life. This may not fully free the person right away, but it gives them space to create a more meaningful and vital experience of life. In Narrative therapy, the person will also participate in therapeutic conversation that deconstruct social and cultural discourses associated with the problem and the person’s experience of the problem. The person will also have the opportunity to explore past experiences that have shaped their experience and the life of the problem.


OUT CONTROL SEXUAL BEHAVIOR MODEL
Out of Control Sexual Behavior is a therapeutic model for treating sexual dysregulation or impulsive sexual behaviors, most commonly known as “sex addiction.” This therapeutic model is non-shaming, non-judgmental, and affirmative of people’s experiences (consistent with a Narrative Therapy approach.) The OCSB model promotes understanding of sexual behaviors and choices around sex from a values point of view. The OCSB model operates under a sexological lens that helps combat harmful societal pre-conceived notions. People struggling with “sex addiction” may have realized that their sexual behavior patterns are no longer serving them or perhaps, may have caused different challenges in their lives and in their overall functioning. People have the opportunity to explore their choices, their sexual behavior patterns, and discover the specific reasons for wanting a change.

The model focuses on personal values and utilizes these to identify a treatment plan consistent with what’s truly important to the person seeking help. This approach is non-pathologizing; therefore, persons who see me in therapy will not experience therapeutic conversations that focus on diagnosis or “deep-rooted” problems. Instead, clients will be able to identify specific patterns that presently, do not satisfy their specific needs, nor match their values and commitments.

I will make use of effective Narrative interventions and ideas that will help facilitate the process of therapy. The main purpose of our work together is to get you to a place in life that feels right to you. As referenced above, we will also explore the different messages that you may have received from society, your culture, and your socialization process; and how these may have influenced your perception of yourself, your self-esteem, and potential feelings of shame.


HOW IT WORKS
Communication between therapist and client is key. In order for us to communicate effectively, we will need to work on building trust and mutual respect. It is my main goal that you feel respected and never ashamed of what you’re going through. I view people as experts of their own life and experience; therefore, I will seek to collaborate with you to make sure your therapeutic goals are met. I don’t make any decisions about your care alone, we discuss and decide together. It is possible that we may experience barriers or challenges within our work together. It will be essential that we communicate openly about this and make sure that things are going as you desire. Regardless of the work that’s accomplished in therapy; please know that failure is never an option, we try our best together. Together, we will create a safe space for you to feel comfortable opening up and willing to explore your challenges. I will guide you through this process and help you connect with your values and meet your goals.


SEXUAL HEALTH PLAN:
Nobody is the same and I make sure to maintain awareness of this in all my clinical work with clients. As an essential part of the OCSB model, we will create a sexual health plan. The sexual health plan is a unique process that will help us understand the direction we should take in treatment. Your sexual health plan will be developed based on your values, your purposes, and what’s truly important to you in life. Once we have this, it will be much easier to identify short-term and long-term goals, not only in terms of your sexuality, but also any other areas of your life.


GETTING STARTED

If you are experiencing any distress or interpersonal challenges as a result of your sexual behavior patterns, you can call me at 303-736-9311 to determine if my services can help. I would be happy to answer any questions you may have and schedule an initial meeting. You can also send me an e-mail at mauricio_yabar@narrativedenver.com or contact me on here with any questions you may have and I would be happy to respond within at least 48 hours. This is not easy by any means; but remember, it isn’t just because of you. Instead, asking for help is most likely difficult as a result of the shame and judgment that our society places on those who are different or may have made choices that others do not fully understand.


References:

Braun-Harvey D. and Vigorito M. A. (2016). Treating Out of Control Sexual Behavior: Rethinking Sex Addiction. New York, NY: Springer Publishing Company.




PEDOPHILIA

​One of the most important things to be said regarding Pedophilia is that it is often misunderstood and misconstrued. A person who fits the definition of the word “Pedophile” is someone who is sexually attracted to and interested in prepubescent children. Meeting criteria for a diagnosis of Pedophilia in the DSM5 is not the same thing as committing a crime. Sexual molestation of a child/minor is a criminal sexual offense and therefore, punishable by law. Pedophilia and Child Molestation do not carry the same definition and must be addressed and treated differently.

There are many people out there who may experience sexual attraction toward children, and are afraid to seek help due to the social stigma and misconceptions about Pedophilia. Many men who identify as Pedophiles do not desire to act on their fantasies or urges. Several of these men understand that their sexual interest in children must never be acted on because of undeniable harm this would inflict on a victim. 

For a lot of Pedophiles, managing and coping with their sexual feelings can be extremely difficult. They would benefit from psychological treatment; however, many will refrain from seeking professional help because of shame and stigma. The reality is that leaving these folks without professional help or emotional support can actually put children at higher risk of being sexually abused. People who identify as pedophiles and who do not want to harm any child must be able to find a safe space to explore their sexual interest and learn effective ways to regulate their fantasies and urges.


HEBEPHILIA
Similarly to Pedophilia, adults who identify as hebephiles experience sexual attraction toward adolescent boys or girls. They may never act on their sexual interests, and some of them may benefit from professional guidance. Many people who identify as hebephiles may also understand that acting on their sexual interest would be harmful and considered a criminal offense.


DIFFERENCES BETWEEN PEDOPHILIA/HEBEPHILIA AND SEXUAL OFFENDING
Most people in our society neglect to differentiate between the diagnosis of Pedophilia and the act of sexually offending. A sex offender is someone who has acted on their sexual impulses and caused harm to a victim or victims. Similarly, a child molester is someone who committed a sexual crime against a child or children. It is important that we understand the differences between these in order to identify the most appropriate treatment and services. Many states offer “Offense-Specific” treatment to people who have been convicted of a sexual offense. This treatment is mandated by law and is usually offered in conjunction with probation, jail, or other forms of punishment. Treatment offered to someone who identifies as a pedophile or hebephile is not necessarily mandated nor guided by the justice system.


RESEARCH ON PEDOPHILIA
There have been several studies that try to explain Pedopholia, why it happens, and how to treat it. Recently, a lot of research has found significant differences in the brain development of people who identify as Pedophiles. Research suggests that Pedophilia could be categorized a sexual orientation. The research findings suggest that Pedophilia is something people are born with and not something they can simply turn off. In terms of psychological treatment, it is therefore more effective and appropriate to enhance skills to cope and manage urges. The findings come from neuroscientific studies that have identified specific differences between the brains of Pedophiles and non-Pedophiles. Most recently, neuroscientific research in the area of Pedophilia found that when compared to the general population; more Pedophiles develop certain characteristics such as left-handedness--related to the differences in brain development. There certainly is much work that needs to be done to fully understand Pedophilia and Hebephilia; particularly in the areas of assessment and treatment.


KEEPING CHILDREN SAFE
Pedophiles experience stigma and shame that stems from public intolerance and ignorance. Oftentimes, it is this stigma that keeps people from accessing therapeutic support. As previously mentioned, If these folks can’t access professional help; they may not be able to manage their sexual interest for too long (although some may.) I define my work with this population as proactive. I understand that they wish to never act on their sexual attraction to children. If I am able to work with them and help them develop strategies to manage sexual urges; chances are they will be able to regulate and never commit a sexual offense against a child.

I also acknowledge that anyone who comes to see me because of their sexual attraction to children is already showing a commitment to maintaining the safety of children and to avoid sexually offending. I owe it to them to provide the therapeutic support they are seeking and help them navigate their struggles.


MANDATED REPORTING AND RISK
As a Licensed Clinical Social Worker, I am mandated by law to report all cases of child sexual abuse. This means that I will make a report to Child Protective Services if a person discloses having committed a sexual offense.

I am also mandated to report suspicion of sexual abuse. When I am treating a client who may disclose specific fantasies that involve a real person with whom they have significant contact, I may need to report this due to the risk. This is obviously determined after carefully assessing the client and the situation. Nonetheless, experiencing sexual attraction DOES NOT indicate a crime.

As part of this work, I must assess risk for potential future sexual offense. The level of risk can be determined by obtaining information regarding potential access to children, history of criminal behavior, existence of previous sexual offense, support system, evidence of self-regulation, current marital status, etc.


ADDITIONAL INFORMATION
Someone who identifies as a pedophile or hebephile may still find age appropriate persons attractive, and be able to establish healthy sexual (or non-sexual) relationships with them.

Adolescents who experience attraction to younger peers may or may not be pedophiles. A diagnosis of Pedophilia is not appropriate until the adolescent is old enough and there is evidence that they continue to experience attraction to significantly younger children.

Ages of consent differ by state. Many young adults have been convicted of a sexual offense against a minor due to their lack of knowledge on consent laws, and not necessarily due to sexual interest or attraction toward children.

Pedophilia and Hebephilia definitions can be significantly influenced by cultural ideas, politics, and other social discourses.


It is imperative to highlight that abuse against a child (sexual or non-sexual) is never appropriate.

Although research continues to lack specific information, sexual exploration between younger persons does not meet criteria for Pedophilia and oftentimes, it also is not considered a sexual offense. This varies according to the laws of each state and often defined on a case by case basis.

Phallography is an assessment tool that is used to measure sexual attraction to children. This assessment was originally created to measure homosexuality to prevent homosexual people from servicing in the military. I do not conduct this type of assessments as it is not consistent with my therapeutic approach. I prefer to hear from my client through their account of their experience.


References:

Araji S. Finkelhor D. (1985). Explanations of Pedophilia: Review of Empirical Research. Bull Am Acad Psychiatry, 13, 17-37.

Bering J. (2013). Perv: The Sexual Deviant in All of Us. New York, NY: Farras, Strous, and Giroux.

Blanchard R. et. al. (2009). Pedophilia, Hebephilia, and the DSM-V. Arch Sex Behav, ​38, 335-350.

Finkelhor D. (1984). Child Sexual Abuse: New Theory and Research. Florence, MA: Free Press.

Hall R. C. W. and Hall R. C. W. (2007). A Profile of Pedophilia: Definition, Characteristics of Offenders, Recidivism, Treatment Outcomes, and Forensic Issues. ​Mayo Clinic Proceedings, 82, 457-471.

Herzog R., Humphries S., Maddocks N., and Vance P. (Producer), & Herzog, R. and Humphries S. (Director). (2014). The Paedophile Next Door [Motion Picture]. United Kingdom: Chanel 4.

Laws R. and O'Donohue W. (1997). Sexual Deviance: Theory, Assessment, and Treatment. New York, NY: The Guildford Press.

Stever B., Saunders J., and MacGillivary T. (Producer). (2016, June 6). The Science of Pedophilia Episode. Sickboy Podcast [Audio Podcast]. Retrieved from http://www.sickboypodcast.com/episodes/




Human Sexuality

​​Narrative Conversations Denver

720-577-3619 / mauricio.yabar@narrativedenver.com