Download Religion and Internet-Based Compulsive Sexual Behaviors

Religion, Internet Pornography, and Sex Addiction
A discussion of how the Internet bypasses religion’s filters
Dan Drake, MFT, CSAT Candidate 3
Objectives
1. Intro
2. Religiosity as a Protective Factor
3. Religiosity / Spirituality and Internetbased Compulsive Sexual Behaviors (ISAC)
4. Applications
5. Discussion
Introduction
Defining Terms
1. Sex Addiction
2. Internet-based Sex Addiction /
Compulsivity (ISAC)
3. Religion / Religiosity
4. Spirituality
5. Religion as a Protective Factor
Religion as a
Protective Factor
Religion in the U.S.
• About 2/3 of Americans claim to be a member of a
church or synagogue (Shafranske, 2011)
• How important is religion (national sample as quoted
in Shafranske, 2011):
• 58% - Very Important
• 30% - Fairly Important
• 11% - Not Very Important
• 1% - No Opinion
Religion and Spirituality as Distinct Factors
•
3 Constructs:
• Spiritual and Religious
• Spiritual but not Religious
• Neither Spiritual nor Religious
•
Hodge, Andereck, & Montoya (2007):
• Spiritual AND religious lifestyles leads to lower addictive
behaviors than none or also just spiritual – this is the most
protective profile
• Spiritual but not religious had LEAST protective influence
(spirituality linked with self-esteem, and higher levels of
unmoored spirituality can increase substance use, particularly
if peers also use substances).
Religion as a Protective Factor
•
•
•
•
•
•
•
•
•
•
•
•
Means of social support/socialization
Physical illness
Coping with surgery
Health behaviors
Suicidality
Depression
Crime
General protective factor
Substance abuse / addictions
Sexual behavior among teens / adolescents
Sex addiction
Sexual attitudes / behaviors
Why Religiosity is a Protective Factor
•
•
Moral, Mental, Psychological development
•
•
•
•
Builds character (Sanchez, Garcia de Oliveira, & Nappo, 2008)
Norms internalized from religion (Barkan, 2006; Hodge, Andereck, & Montoya, 2007)
Teaches moral behavior (Barkan, 2006)
Builds sense of coherence, meaning, and control (Larson & Larson, 2003)
•
Enhances self-esteem (Barkan, 2006; Larson & Larson, 2003)
Religious / Subjective Experience
•
•
•
Belief in supreme being whose laws are for the benefit of the individual and who is a source of
strength (Barkan & Greenwood, 2003; Sanchez, Garcia de Oliveira, & Nappo, 2008)
Socialization / Social support
•
Less likely to choose friends who use substances (Hodge, Andereck, & Montoya, 2007)
•
•
Positive peer relations (Larson & Larson, 2003)
Familial support often correlated with religiosity (Sanchez, Garcia de Oliveira, & Nappo, 2008)
•
Increases social ties (Barkan, 2006; Barkan & Greenwood, 2003; Trinitapoli & Regnerus, 2006)
Promotion of Positive Behaviors / Discouragement of Risk-Taking Behaviors
•
•
(Burris, Smith, & Carlson, 2009)
Discouragement of risk-taking behaviors (e.g., unsafe sexual activity, gambling, use of drugs, etc.)
(Barkan & Greenwood, 2003) and positive behaviors (Trinitapoli & Regnerus, 2006)
•
Exclusionary practices among non-members (Trinitapoli & Regnerus, 2006)
Religion and InternetBased Compulsive Sexual
Behaviors
Prevalence of ISAC among people of faith
•
A poll of thousands indicated that 50% of Christian men and 20% of
Christian women are addicted to pornography
(http://christiannews.christianet.com/1154951956.htm)
•
Approximately 33%-40% of clergy in the U.S. report that they have
struggled or are currently struggling with the use of pornography, largely
through the internet (e.g., Abell, Steenbergh, & Boivin, 2006;
Christianity Today Leadership Survey, 2001; Laaser & Gregoire, 2003;
King, 2003, etc.).
•
57% of pastors say that addiction to pornography is the most sexually
damaging issue to their congregation (Christians and Sex Leadership
Journal Survey, 2005).
•
A 1996 Promise Keepers survey at one of their stadium events revealed
that over 50% of the men in attendance were involved with pornography
within one week of attending the event
•
20% of calls (in 2000) to Focus on Family were related to online porn
(Ferree, 2002)
Religiosity and ISAC
Why Internet-Based Compulsive Sexual
Behaviors among religious population?
1.
2.
3.
4.
5.
6.
7.
8.
9.
General addictive potential of the Internet
Emotional coping
Misunderstanding of addiction
Concerns around masturbation
Bifurcation of public/private
Rigidly held beliefs from family of origin
Shame
Impacted behavior, not attitudes
Unique issues among clergy
The addictive potential of ISAC
1. General addictive potential of internet-based sexual
behaviors:
• The Triple A Engine (Cooper, 1998)
• Accessibility
• Affordability
• Anonymity
• Acceptability (King, 1999)
• Approximation (Ross & Kauth, 2002)
• Escape (Young, 1999)
•
Cybersex as the crack cocaine of sex addiction
(Carnes, 1996): Addiction (amount and variety)
escalates extremely rapidly (Carnes & Scheider,
2002).
Religiosity and ISAC
2. Emotional Coping:
• Many use the Internet for sexual arousal or providing a
sexual outlet, but also use the Internet for:
• To cope with negative emotions
• Difficulty sleeping
• Out of habit
• Because of low self-esteem
• To feel more relaxed
• Sexual outlet where do not have to deal with others
(Baltazar, Helm Jr., McBride, Hopkins, Stevens Jr., 2010)
Religiosity and ISAC
3. Misunderstanding of Addiction:
•
Common misunderstandings of sex in Christian circles (Ferree,
2002):
•
•
•
•
Confusion of terminology (addiction vs. “sin”)
Addiction equated to moral failure
Addiction implies pedophilia or offending behavior
Mistakes among clinicians from communities of faith:
•
•
•
•
•
•
•
Encouraging to get help only from clergy
Not utilizing supports in the secular community
Only emphasizing spiritual component
Encouragement only to repent
Ignoring 12-step groups
Failing to understand systemic nature of the disease (IP)
Encouraging partners simply to comply sexually (rather than realizing
ISAC is an intimacy disorder)
Religiosity and ISAC
4. Masturbation:
• Emphasis on sexual purity and historical position on nonmarital sexuality creates guilt around developmentally
normative behaviors
• Furthermore, sin-based vocabulary and no clear Biblical
ethic on masturbation creates confusion, shame, and
further secrecy (See Kwee & Hoover, 2008)
• Many stuck in compulsion to stop masturbating, which
leads to vicious cycle and continued/escalated
masturbatory patterns (Kwee, Dominguez, & Ferrell,
2007).
Religiosity and ISAC
5. Bifurcation of public/private and splitting of sexual
behaviors:
• Reaction Formation
•
•
Maintaining rigid doctrinal attitudes, public fervor and
outward appearances while ignoring private practice (Levert,
2007)
Publically presenting a performance-oriented religiosity while
hiding personal weakness or problems – Leads to
perfectionism and shame/inadequacy (Nelson, 2003).
• Less cognitive dissonance with online sexual behaviors
than intercourse
•
Involvement more solitary and permissible / less
objectionable than premarital or extramarital sexual activity
with a partner (Abell, Steenbergh, & Boivin, 2006)
Religiosity and ISAC
6. Rigidly held beliefs from Family of Origin:
• Rigid religious rituals employed to gain control of
unmanageable behavior (see Laaser, 1992)
• Rigidity from family of origin
• Rigid and disengaged family systems already linked to
SAC
• Religious origins, messages, and rigid family structures
can set up further public/private bifurcation (see
Levert, 2007)
Religiosity and ISAC
7. Shame:
• The shame hook:
+
+
+
+
=
Rigid notions of morality
Negative view of sex
Natural biological urges
Addictive power of Internet-based sexual behaviors
Delayed adolescence
Bifurcation of self (moral outward appearance /
sexual secrecy, shame, and escalating online behaviors)
• Secretive compartmentalized sexuality creates shame and
breeds continued isolation/fragmentation rather than
seeking help.
Religiosity and ISAC
8. Impacted Behavior, NOT attitudes:
• Religious behavior associated with sexual
behavior, not as much in regards to sexual
attitudes
• E.g., Lefkowitz, Gillen, Shearer, & Boone
(2004); Lo and Wei (2005)
Religiosity and ISAC
9. Unique issues of clergy:
Special consideration for pastors struggling with Internet addiction
(see Laaser & Gregoire, 2003; King, 2003; Nelson, 2003, etc.):
• Role
• Vocational
consequences
• Isolation
• Narcissism
• Spiritual maturity
• Anger
• Accountability
• Entitlement
• Relationship
• Presence of other
addictions
• Caregiving
• Issues around
discovery
• Sexual anorexia
• Issues around
disclosure
Consequences
• Consequences specific to religious population
(i.e., Christians):
• Worsened relationship with God
• Increase in sexual behavior
• Increased negative emotions
• More permissive attitudes concerning sexual
behavior (Baltazar, Helm Jr., McBride, Hopkins,
Stevens Jr., 2010)
Implications /
Applications
Language / methodology
• There are too many ambiguities/equivocations around
terms. We need a more coherent conversation around
the terms “religiosity” and “spirituality” within the field
of psychology
• Because “spirituality” has become so vague we need to
utilize more robust language for it (e.g., Roof’s (1999)
“lived” religion)
Incorporating BOTH religiosity and spirituality
• We can’t simply bifurcate religiosity / spirituality
• Spirituality and religiosity are intertwined, and most
people experience them together (Sanchez, Oliveira, &
Nappo, 2008; Shifranske, 2011)
• Making religion=bad and spirituality=good can confuse
the terms
• Spirituality that is not rooted in the concrete life of
communities is in danger of drifting toward
disembodied vagueness or general religiosity or
unrestrained individualism" (Wendel, 2003, p.158).
For Clinicians
How important is religion to our clients:
Very
Important
Fairly
Important
Not Very
Important
No Opinion
National
Sample
58%
30%
11%
1%
MDs /
Psychiatry
38%
19%
42%
1%
MDs /
Rehabilitation
47%
30%
22%
1%
PhD / PsyD /
Counselor
26%
22%
51%
1%
PhD /
Rehabilitation
41%
29%
29%
1%
For Clinicians with Religious Clients
1. Tap into the protective resources clients are already
utilizing
2. Recognize own personal biases
3. Know what to look for and what questions to ask
4. Look for other potential addictions / risk factors
5. Education
6. Be aware of damage / impact from prior attempts at
help
7. Importance of shame reduction
8. Utilize client’s religious framework
9. Importance of building other coping resources
10.Help nuance understanding of religiosity/spirituality
For Clinicians
1. Tap into the protective resources clients are
already utilizing
• Design and implement programs to include religious
components
• Enlist support of religious leaders (e.g., clergy,
chaplains, priests, rabbis, etc.) – collaborate
• Utilizing clients’ already established religiosity for
protective factors listed above
• Continue referring to 12-step groups
For Clinicians
2. Recognize own personal biases
• There is no consensus among mental health professionals
about the dangers of porn or the use of the term
"pornography addiction” (Singel, 2004).
• Avoid mistakes among clinicians in communities of faith
(Ferree, 2002)
• Need to be aware that psychotherapy is a values-based
engagement in which “religious, spiritual, and moral
values implicitly embedded within clinical theory and
expressed through the personal commitments of the
clinician (Shefranske, 2011)
For Clinicians
3. Know what to look for and what questions to ask
• There are a significant portion of religious
individuals struggling with ISAC
• Potentially even MORE individuals struggling with
ISAC in religious communities than non-religious
(Abell, Steenbergh, & Boivin, 2006).
For Clinicians
4. Look for other potential addictions / risk factors
• Excessive work
• Food restriction / overeating
• Gambling
• Alcohol use
• Drug use
•
Etc.
For Clinicians
5. Know what religious clients might’ve experienced
before coming into your office
• Some clients might come to session with shame/damage
from prior attempts at help
• Rigid/abusive dynamics from Family of Origin
• Might’ve experienced trauma, shame, and loss from faith
community for “sexual sin” that has been exposed or
disclosed (King, 2003)
For Clinicians
6. Importance of shame reduction
• Creating a safe place where client can engage religion
and psychology when might be client’s first time ever
coming to a “secular” therapist
• Importance of conceptualizing shame as a driver for selfperpetuating addiction cycle (kwee & Hoover, 2008)
• Shame reduction to promote further honesty of sexual
behaviors in therapeutic relationship and reduce splitting
• Know that many from faith community will experience
shame, which keeps them isolated, fragmented, and
resistant to help
For Clinicians
7. Utilize client’s religious framework
•
Compulsive sexual behaviors most likely will look different than
general population of sex addicts
•
Be open and non-prescriptive around masturbation – helps
individuals arrive at own informed conclusions (Kwee & Hoover,
2008)
•
Need to challenge reaction formation but be careful not to
disenfranchise client
•
Be aware of nuances of addiction as affected by faith (Levert,
2007)
•
Be sensitive and understanding of potential losses – identity,
relationships, and/or vocation
•
Don’t have to share client’s faith to be effective (Larson &
Larson, 2003)
For Clinicians
8. Importance of building intimacy, social functioning,
and coping resources
•
Deepen relationships / intimacy
• Importance of Group Psychotherapy
• Teach functional relationship patterns that satisfy (Carnes,
2001)
• Explore cognitive distortions / faulty belief systems that
interfere with capacity for intimacy (Boies, Knudson, & Young,
2004)
• Build support network, relationships, and intimate connection
in the offline world. Teach social skills where needed (Boies,
Knudson, & Young, 2004)
•
Help build more adaptive skills than sexual coping, increasing
capacity for gratifying relationships (Kwee & Hoover, 2008).
For Clinicians
9. Help client find a more nuanced understanding of
religiosity/spirituality, to integrate all parts of self
including shadow.
• Process notions of religiosity and spirituality
currently and from FOO
• Learn healthy views of sexuality, nuanced from
religious tradition/teachings
• Be aware of potential resistance to a balanced
approach to recovery
For Clinicians
10. Education
•
Education of client:
•
•
•
For religious clients presenting with compulsive masturbation:
Education on criteria for sex addiction and how client’s behavior does
or does not meet criteria, as well as normalize feelings of confusion
and guilt (Kwee & Hoover, 2008).
Dangers of ISAC and other ways to cope with sexual arousal and
negative feelings (Baltazar, Helm Jr., McBride, Hopkins, Stevens Jr.,
2010; Hamade, 2009).
Education of Professional:
•
•
Become familiar with how internet works, types of sexual activities
online, implications for religious individuals; also with use of internet
filters, monitoring software (Boies, Knudson, & Young, 2004; Weiss,
2007). For example, Internet filters (e.g., K9, NetNanny, Safe Eyes,
etc.) and Accountability software (e.g., Covenant Eyes, Bsecure, etc.)
Ensure adequate training on religiosity/spirituality and to not impose
own values or beliefs (Hodge, Cardenas, & Montoya, 2001)
Education for Clinicians
Frequency of Religious / Spiritual (R/S) Issues in Treatment and in
Training (Shefranske, 2011):
• R/S issues never included:
• R/S issues often included:
•
In Treatment: 0%
•
In Treatment: 35%
•
In Training: 18%
•
In Training: 5%
• R/S issues rarely included:
•
In Treatment: 8%
•
In Training: 47%
• R/S issues sometimes
included:
•
In Treatment: 43%
•
In Training: 25%
• R/S issues included a
great deal:
•
In Treatment: 14%
•
In Training: 4%
For Churches / Religious Institutions
1. Community
2. Be careful not to disenfranchise
3. Create safe space to dialogue about sexual
issues
4. Helping clergy / religious leaders
For Churches / Religious Institutions
1. Building community
• Provide both spiritual guidance AND
community
• Helps tap into protective resources of
religiosity, particularly for those isolated
or socially stunted through the use of
internet for sexual arousal.
For Churches / Religious Institutions
2. Be careful not to disenfranchise – love, not shame
• Because of moral dimension, people can be
disenfranchised
• Don’t lose moral framework but be careful to not
perpetuate shame.
• Goal isn’t moral perfectionism (specifically in
regards to masturbation)
• Be careful with reductionistic solutions (e.g., pray
more, fast more, etc.) (see Kwee & Hoover, 2008)
• Though well-meaninged, can lead to sense of failure
• Drives addiction underground
For Churches / Religious Institutions
3. Create safe space to dialogue about sexual issues
• Creating nonjudgmental atmosphere that doesn’t
oversimplify sexual struggles (see Kwee, Dominquez,
& Ferrell, 2007)
• Address common misunderstandings of sex (Ferree,
2002)
• Ultimately recognizing that we are sexual beings,
and this comes from God as a GOOD thing
For Churches / Religious Institutions
4. Helping clergy / religious leaders
• Provide support/connection to religious leaders rather
than isolation
• Help religious leaders to know what services/resources
are available to them (Trihub, Mcminn, Buhrow Jr., &
Johnson, 2010)
• See religious people as “real people” – Resist putting
leaders on a pedestal of perfection (Nelson, 2003)
• Seeing sexual anorexia as part of the problem (Nelson,
2003)
• Treatment protocol for pastors / clergy (Laaser &
Gregoire, 2003)
Applications
Ultimately, a patient's spiritual/religious commitment is
potentially relevant to physical and mental health.
Clinicians can respectfully inquire about the role
spirituality/religion may play in a patient's life in taking
the patient's history. For patients for whom
spirituality/religion is relevant, opportunities await to
collaborate with trained chaplains or spiritual counselors
as part of the healthcare team to provide spiritual support
or deal with spiritual distress in addressing particular
patient needs (Larson & Larson, 2003).
The Institute for Sexual Health
400 South Beverly Dr., Ste 316
Beverly Hills, CA 90212
Dan Drake, MS, MA, MFT, CSAT Candidate 3
[email protected]
(310) 415-5732