The novel Fifty Shades of Gray has attracted enormous attention since its recent publication. The popularity could be attributed to the characters’ scandalous sexual trysts laid out in vivid detail. Or it could be due to the fact that women really do want more sexual pleasure in their relationships. In a recent article, clinical psychologist and sex therapist Dr. Stella Resnick explains why she believes the public has such a voracious appetite for this type of literature. Resnick practices Gestalt therapy, which integrates body and mind presence and awareness. Her experience has taught her that every form of physical contact, including touch, kissing, and even eye contact, increases overall sexual pleasure. She believes that intimate play is an integral part of a healthy sexual relationship.

Resnick has been working in her field for more than two decades and says that contrary to popular belief, men seem to lose interest in sex more quickly than women. This could be a result of the pressures men feel to provide financially and their sense of responsibility as the head of the family. The natural progression a partner makes from lover to family member can actually undermine sexual attraction and excitement for men and women alike. In fact, Resnick says that these feelings of “love” for each other can create barriers to healthy sexual fun. Resnick says that maintaining a sense of playful sexual activity is important for many reasons. “New brain research has shown that what’s essential for enhancing new learning is to keep the brain engaged and attentive and that playfulness is one of the best ways to do that,” she says. Learning about each other’s wants in and out of the bedroom helps broaden the bond between partners both physically and emotionally. Resnick suggests couples engage in conversations about sexual desires and act on them. Taking time to relax and enjoy a sexual encounter, including play, can create a sexual experience that will satisfy both partners and keep both brain and body engaged.

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If you haven’t read the novel yet, you might be 50 shades of curious about why Fifty Shades of Grey is the most-talked-about tale in print currently.

A quick search will reveal that the romance between the main characters, Mr. Grey and Miss Steele, revolves around bondage, discipline, dominance, submission, sadism, and masochism (BDSM). In fact, Christian Grey appears to really only get satisfaction from sex when it involves inflicting pain or dominance over his partner, which, following criteria from the Diagnostic and Statistical Manual of Mental Disorders (DSM IV-TR) used by mental health professionals to make diagnoses, could be considered a mental disorder called sexual sadism.

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The DSM IV-TR states that “sexual sadism involves acts (real, not simulated) in which the individual derives sexual excitement from the psychological or physical suffering (including humiliation) of the victim.” In order to officially be diagnosed with sexual sadism, individuals must meet the following criteria:

1)    “Over a period of at least 6 months, recurrent, intense sexually arousing fantasies, sexual urges, or behaviors involving acts (real, not simulated) in which the psychological or physical suffering (including humiliation) of the victim is sexually exciting to the person.”
2)    “The person has acted on these sexual urges with a nonconsenting person, or the sexual urges or fantasies cause marked distress or interpersonal difficulty.”

In the first novel of the series, Christian Grey appears to engage in sexual sadism only with consenting participants (like Anastasia Steele, the main female character), but he openly admits to being abused (including sexual abuse) as a child and teenager and appears to be at least somewhat distressed by the fact that it’s difficult for him to have a “normal” relationship. He even explains to the character Anastasia Steele at one point that this is just the way he is, almost with sorrow. And although he does have “normal” or “vanilla” sex with Anastasia, he makes it obvious that he prefers sex that involves pain and pleasure at the same time, always with him dominating.

Anastasia also admits to herself that there is something unusual about Christian and his sexual preferences, but she lets her desire for him take over, and she hopes that she can make him want a “normal” relationship with her. She herself has issues with low self-esteem and confidence, which is perhaps why she is so drawn to the seemingly overly confident Christian. Both characters appear to function as well as the average person in their fictional world, but both have issues that could potentially need to be addressed by a professional if they lived in the real world.

So it appears that one of the main characters of Fifty Shades of Grey may have a diagnosable disorder related to sexuality, or at least has abnormal sexual preferences and a traumatic past that hasn’t been resolved yet. He has major difficulties maintaining any lasting romantic relationship, and yet the relationship between Christian and Anastasia seems to have been received in a somewhat positive light, considering the large following of readers.

The Experts Weigh In
Several mental health experts have offered their insight into the unusual relationship found in Fifty Shades of Grey (and the two other novels in the series). Reef Karim, a board-certified psychiatrist, the founder and medical director of the Control Center for Addictions, and author of Why Does He Do That? Why Does She Do That? and host of the new show Broken Minds on the Discovery channel, said that the novel is definitely making people think about normal and abnormal sexuality and possibly changing some people’s minds.

He said in an e-mail that the main question people are wondering is, “What is normal and abnormal sexual behavior, and when is aberrant sexual experimentation and behavior considered a mental health diagnosis?” “The really interesting part of psychiatric diagnoses is that many are based on a behavioral spectrum where the interruption of an individual’s social, relational, occupational, and functional life is a key factor in making the diagnosis,” Karim said. “This book has become a literary piece of pop culture that is challenging many to review their thoughts on normative and ‘out of the box’ sexual behaviors.”

He said that there could be concerns about a link between sadomasochism (S&M) and childhood abuse as well, since that is mentioned in the novel. “There is definitely a connection, but many people with no psychiatric or psychological history report enjoying BDSM primarily as a novel and alternative way to connect with each other,” Karim said.

Despite (or because of) the unusual relationship involving pain and pleasure (and emotional issues), many women appear to be captivated by the novels. Karim suggests this is because women enjoy having sexual fantasies, but that doesn’t necessarily mean they want the type of relationship found in the novel to become more than a fantasy. If anything, women might be more prone to sexually experiment during or after reading the novels.

However, he doesn’t think the novel is capable of completely changing sexual norms, so sexual sadism and sexual masochism will most likely still be considered mental disorders according to the DSM in the future. “I believe the novel opens up the conversation of BDSM, kink and sexual norms, but it’s much more in the curiosity range than actually changing research-driven professional medicine,” Karim said. “Expecting an increase in sex shop purchases is different than changing a clinical manual.”

Karim explains further why the novel is so appealing to women (and men), even with the dysfunctional (and sometimes even depressing) personalities of the characters. “In regards to sexual research, many women fantasize about submission, and many men fantasize about dominance,” he said. “Even though men and women are more equal than ever in regards to occupation and finances, we are still very different sexes, and definitive gender and role-based fantasies do exist,” he added. “Many people in our society have hidden (or not so hidden) fantasies involving kink, S&M, or altered sexual behavior. 50 Shades of Grey has opened up the conversation of previously hidden sexual desires and fantasies of many women.”

He said the novel could help couples become more creative in their sex lives, but going to any extremes is generally not beneficial. “The introduction of BDSM can add to a couple’s sexual tool box, but occasionally it can get out of control,” Karim said. “When extreme behavior leaves the bedroom or involves extremes in the bedroom, it can negatively impact the relationship. I’ve treated couples who use BDSM as a novel, fun experience in a healthy and intimate way, and I’ve treated other couples or individuals who became obsessed with the act or re-created a previous abuse history with a lot of painful markings.”

Overall, the BDSM series is encouraging men and women to discuss sexuality more openly with each other. “The book mentions childhood abuse and difficulties with self-esteem that contribute to the psychological make-up of these characters, but it has also found a way to tap into the S&M lifestyle curiosity shared by many men and women,” Karim said. “It may actually normalize the behavior, when done in moderation, as not something strange but perhaps just another form of sexual expression. Life isn’t always black and white; sometimes it’s fun to live with a little grey.”

Kari Tabag, a licensed clinical social worker, works with adolescents and college-age men and women and has read the series. She said the novel has passages that hint at mental health issues like posttraumatic stress, codependency, BDSM, and alcoholism.

Although she agrees that the novel can improve people’s sex lives through fantasy, role play, and experimentation, the sexual expectations people might have after reading the series might be set too high, leading to disappointment. Also, she emphasizes that the actual relationship depicted in the series is very unhealthy in many ways. “Christian and Anastasia’s relationship is not a healthy one. They are codependent and are too enmeshed with each other,” Tabag said. “A lot of women are codependent and are what I call ‘daddy hungry.’ This novel depicts two people who have abandonment along with trust issues.”
There are even more unhealthy aspects of the fictional relationship, according to Tabag:

• When Anastasia finds out that Christian only dates women with brown hair, it is a dead giveaway of his childhood abuse and abandonment. In fact, Anastasia refers to him as her “boy,” which is not healthy.
• Anastasia repeatedly feels that she is not worthy of Christian and vice versa.
• Christian is obsessed with Anastasia and even follows her to another state when she visits with her mother.
• They both are looking for someone to take care of rather than focusing on healing themselves. A healthier relationship involves two people who have their own separate, independent personas, making them well-established, well-rounded, self-reliant individuals.
• Christian wants Anastasia to give in to him and give up all control, and he lavishes her with gifts as a reward.

Although the relationship in the novel is not healthy, BDSM is not necessarily as terrible as it’s made out to be. Tabag suggests our society is not necessarily mature when it comes to accepting and understanding sexual preferences outside of ‘man on top.’”

Viewpoint From a Submissive
Kasi Alexander, the author of several books and short stories about alternative lifestyles, such as Becoming Sage and Saving Sunni, has herself been involved in the lifestyles of polyamory, BDSM, and power exchange. She currently identifies herself as a “slave,” and the partner in her polyamorous relationship is the “master”; she could also be referred to as a submissive. She said in an email that the relationship between Christian and Anastasia is not necessarily a model of the typical BDSM or power exchange relationship. The characters themselves are also not typical. For example, Christian Grey was abused as a child and became involved in BDSM at 15, and he now avoids “vanilla” sex and relationships.

“Very few people in the lifestyle immerse themselves so deeply that they have no desire for a relationship outside the parameters of power exchange,” Alexander said. “The ones who do are using the lifestyle to mask other personality defects, not the other way around. Accepting your dominant or submissive tendencies does not kill the desire for intimacy, closeness, or connection.” Also, the character of Anastasia Steele is low in self-esteem, self-worth, and confidence, which is not usual for submissives, Alexander said.

“Many people assume that submissives give up all responsibility for themselves, are doormats that cannot stand up for themselves, and so are taken advantage of by predatory dominants,” Alexander said. “That couldn’t be further from the truth. Submissives are stereotypically extremely strong, capable people. Many of them crave submission as a way to temporarily escape the huge responsibilities they take on in their “vanilla” lives.”

Alexander adds that the BDSM lifestyle can even be considered therapeutic in different ways. “In my own relationship, we have used our power exchange to work on my self-image and body issues, increase my self-confidence, and achieve many goals, including writing and publishing three books (so far),” she said. “Other kinky people that we know use sensation play as therapy or catharsis to work through feelings of inadequacy, childhood abuse issues, and various kinds of mental health issues.”

The BDSM element of 50 Shades of Grey just takes the typical romance/erotic novel a little further. “Women have a genetic inclination toward alpha males, so we love our fictional heroes to be large, powerful, and a little scary—someone who has the ability to hurt us but doesn’t,” Alexander said. “And almost all BDSM play is based on the intensification of physical experiences. So the fantasy of the physical ‘danger’ (intensity of experience) goes along with the mental domination of having a strong alpha male taking over your life. It’s erotic, even if it’s not what we want in our actual day-to-day lives.”

She said BDSM and power exchange have the potential to make relationships more sexually fulfilling, but just like in any relationships, it’s a matter of communicating wants and desires. And just like in other bad relationships, abuse and manipulation can happen, but that is a matter of individual personalities and relationships, not a characteristic of BDSM as a whole. She said it’s important to make a distinction between mental conditions and different sexual preferences and alternative lifestyles. “The most important aspect of the mental disorder consideration is the difference between true sadism and kinky sadism,” Alexander said. “A vast majority of ‘sadists’ in the BDSM community derive no pleasure from inflicting pain unless the recipient is enjoying the experience, whereas a true sadist is not concerned with the benefit of the other person.”

She believes that people will eventually become more accepting of these types of lifestyles and realize that they can be beneficial to people who can learn how to make them work.

“More education is needed to show people that polyamory is not cheating, BDSM is not abuse, and power exchange is not manipulation,” Alexander said. “The important thing to keep in mind is the benefit for the people involved. BDSM and power exchange can be done badly and for the wrong reasons, but they can also be used for personal, professional, and spiritual growth and for the enhancement of relationships.”

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George W. Bush created the Healthy Marriage Initiative based on research showing that healthy, strong marriages make a positive contribution to communities. The program, funded by the federal government, was designed to help unwed parents living in socioeconomically deprived neighborhoods reap the benefits of marriage. Most of the targeted families were minorities and faced challenges with keeping and maintaining employment, adequate housing, and earning enough income to supply the basic needs of their families. They also dealt with crime and safety issues. The government believed that this vulnerable group was the most in need of programs designed to help couples develop healthy marriages. The program was implemented during Bush’s administration and fully supported by Obama when he became President.

It is only recently, however, that the results of this program are coming to light and being fully analyzed. And, as outlined in a recent article, they are not encouraging. According to data gathered by Matthew D. Johnson, an associate professor of psychology at Binghamton University, the programs were based on scant research from higher income, nonminority couples. Johnson reviewed assessments from thousands of couples who participated in the program and discovered that the framework, which was based on individuals from different socioeconomic environments with fewer challenges, did not provide a relevant foundation from which minority couples could build a strong marriage. The couples that need the Healthy Marriage Initiative most do not consider marriage more important than finding employment, meeting basic needs, and ensuring the safety of their families. “When faced with a myriad of social issues, building intimate relationships is just not high on their priority lists,” says Johnson.

The Healthy Marriage Initiative costs slightly more than $9,000 per couple to implement and has become more of a burden, both economically and socially, to the very communities that it was designed to help. Johnson believes that the intention behind the program was the right one but that the whole initiative needs to be restructured in order to achieve positive results. Specifically, Johnson believes that the program should be fully examined and reformatted based on accurate research, and if it still cannot meet target goals, it should be eliminated altogether.

Did you know that most individuals who have experienced sex addiction and have taken their recovery process very seriously and remain committed to it for life can be some of the healthiest individuals, despite their past challenges?

Relationships in general take a lot of hard work, but many people are not willing to engage in the hard stuff to make their relationships easier down the road. If people do not feel that they have an addiction or struggle with any kind of sexual integrity issue, it is more challenging for them to understand the need to have boundaries around their relationship to protect it from anything that can cause it to weaken.

Here are THREE REASONS individuals need not be afraid to date someone who has recovered from or is in active recovery from a sex addiction:

STRONG BOUNDARIES: Most individuals recovering from sex addiction who have worked hard in a program, such as outpatient therapy, along with being a part of a support group or in-patient program with a solid outpatient support system know the importance of having strong boundaries to first protect themselves from relapse or slipping back into old habits. For example, a person who has abused alcohol needs to stay away from bars and heavy drinking venues to avoid temptation. The same goes for people with sex addiction; they have certain places they cannot visit, movies they cannot watch, and websites to stay clear of, and even conversations with other individuals that may trigger certain thoughts or feelings.

Therefore, people who have recovered from sex addiction and have moved toward a healthy outlook in life will more than likely be very respectful and aware of situations that may be uncomfortable for their partner, such as noticing attractive people in the partner’s presence or even while alone or putting themselves in a position that could be cause for concern, such as eating lunch alone with a coworker of the opposite sex.

INTEGRITY: Most people recovering from sex addiction have learned the benefits and the importance of having integrity in their life. It is essential that they share their feelings appropriately and be truthful with themselves and that they avoid anything that would cause even a hint of suspicion by others. One way that you will know that your dating partner is someone who values integrity is to watch him or her. Does this person’s behavior coincide with his or her belief system? Is he open about his life’s journey while using discernment? Does she show consistency in making decisions with integrity in all areas of her life (i.e., financial, family, work), not just in relationships?

SELF-CARE: When people who have struggled with sex addiction have worked hard on their personal recovery, one of the tools they learn is the importance of self-care. What that means is their ability to recognize that they first must take care of themselves in a healthy way before they have anything to offer anyone else. They are good at keeping things in their lives that bring value, and they do not expect someone else to fill all their needs. These individuals will have introduced specific behaviors/patterns in their life that support their recovery and reduce the temptations they will face, such as computer filters, accountability partners, continued self-improvement choices, and consistent activities that not only grow who they are but also have a positive impact on others. Most important, where their recovery plan may change along the way, they never let their guard down to say they have arrived, and they stay in the continuous mode of healthy self-care in some fashion. This not only assists them in being the person of integrity they want to be but also prepares them to be real, genuine, honest, and transparent in future relationships.

As you can see, while some may shy away from the idea of dating an individual who has recovered from sexual addiction, there are numerous reasons this can actually be a very positive experience. Keep in mind, it is not your responsibility to keep this person on track in his or her recovery, and if the person is truly taking care of himself, he will not want or expect you to do this. You actually get the benefits of being with an individual who has come face to face with a very challenging addiction and decided that he or she is worth doing the hard work to overcome it and live a life of integrity. The end result is someone who can share compassion, understanding, and love in a deeper, healthier way in relationships because that person made it a point to have tough love for him- or herself first.

Related articles:
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The word bridezilla has become an oft-used part of our lexicon, and many people who have never been married are confused by the panic and stress that seems to surround wedding planning. But a newly engaged couple quickly learns that the stress of wedding planning is not the overexaggerated fantasy of people who simply have no stress tolerance. Wedding planning is stressful for almost everyone, and yet people never stop to think about why this is. Here’s what is really going on.

Expectations vs. Reality
A wedding is a major rite of passage, and many people—especially women—have been raised to expect their wedding to be a perfect fairy tale. But nothing can be perfect, even a wedding, and the drive for perfection can be profoundly stressful and emotionally fraught. Many people use their wedding as an opportunity to take stock of their lives so far. If they can’t afford a dream wedding, they may feel like failures. Some people have a specific list of things they intended to do before they got married. No matter how unreasonable this list might have been, unfulfilled dreams can still cause stress when you’re planning a wedding.

A Stressful Engagement
The time before you get married should be one of the happiest, most romantic times in your life. Instead, many people spend this period frantically planning a wedding, stressing about finances, and fretting over guest lists. Wedding planning can cause you to pull away or turn on your future spouse, and constant planning certainly eliminates any opportunities for romantic time together. Thus some people arrive at their wedding day feeling pretty humdrum about their future marriage and pretty frustrated with the process that got them to the altar.

Finances
Disagreements about money are among the most common marital problems. When surveyed, people indicate that financial problems are one of the biggest stressors in their lives. Weddings are expensive, with the average wedding in the United States costing well over $30,000, so it’s no wonder people can be driven to a state of panic by weddings. Couples frequently must make huge sacrifices, compromise with their parents, and work extra hours to get the money to pay for their weddings, and all of this effort can take a toll.

Requests of Others
Many newlyweds report that it wasn’t the wedding planning itself that was stressful. It was the constant pressure, opinions, and criticism from other people, such as the mother who’s enraged that you’re keeping your maiden name or the father who insists on a traditional wedding ceremony. A wedding frequently puts the differences between parents and their children on full display. Many engaged couples worry about their parents making snide remarks just before their wedding, or spend the entire time they’re engaged bending over backward to please their parents, only to find out that nothing they do is enough.

Relying on Others
No matter how much you might want it to be just you and your fiancée, a wedding is a group event. From bridesmaids to florists, officiants to flower girls, you must coordinate with many people, not all of whom will be cooperative. Trying to get everyone to understand your vision for your wedding can be like herding cats. And even simple tasks such as getting your best man to finally get fitted for a tux can be extremely stressful. When people have to rely on others to get tasks done, their stress levels tend to rise. This reliance on others is made even worse by the stress most couples feel to create a perfect wedding.

So, no matter how simple you may try to keep the wedding plans, there will still be stressors that you should anticipate and plan for, just as you plan for your cake and photographer. Start thinking about the people and events that may create stress for you and your fiancé, and take steps to reduce those predictable conflicts. Acceptance of the things you can and cannot change is key, and practicing now can only help once you become a partner in a marriage.

Sources:

1. Miller, R. S. (2011). Intimate relationships. New York, NY: McGraw-Hill.
2. Reis, H. T., Rusbult, C. E. (2004). Close relationships: Key readings. New York, NY: Psychology Press.

Related articles:
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Decision Making in Relationships: Three Important Values to Help you Know When to Give in or Dig in

“Guess what?” your best couple friends ask when you’ve just sat down at an elegant restaurant. “We have an announcement. Guess who’s not having wine?” You and your partner are jolted. You just found out an hour ago that your third in vitro fertility treatment didn’t pan out, and you didn’t even know your friends were trying.

You and your partner have a quick, furtive look. Your throat is dry, and a tear slides out before you can will it to stop. “Great news,” your husband says.

You can’t think of anything you can say aloud. You know you can’t say what you’re feeling: “Why you, not us? This is your third child, and we may never have a first. Why did you have to tell us here and ruin this expensive dinner?”

You could say, “I’m happy for you, but sad for us,” if your friends know that you’ve been trying.

With more public awareness of infertility, people announcing a pregnancy or birth are sometimes more sensitive to your needs. They might tell you in a private moment and add, “It’s hard to tell you, knowing how much you want this. I hope it happens soon for you.” You may appreciate the empathy, and elaborate on your feelings, and feel supported. On the other hand, you might be embarrassed and not want to talk about it, especially if you’re not emotionally close to the woman or you have reasons not to trust her.

First we’ll talk about dealing with your own feelings. Then we’ll talk about taking some control over how you receive news of future pregnancies.

Your feelings: handle with compassion

Mixed in with feelings of disappointment and competition, you may also feel guilty. You may even fantasize about miscarriages or complications. Your partner may add to your guilt by asking “Why can’t you be happy for them?”

Give yourself a break. You’re a good person, not someone who typically goes around with ill wishes. If you’ve been trying for months or even years to get pregnant or to carry to full term, it makes sense that you would be envious. This is especially the case if your friend is complaining of an accidental pregnancy or doesn’t have as much to offer a child as you and your partner do. A compassionate thought to say to yourself is “I’m happy for her but sad for me.” You wouldn’t expect a 24 year-old whose husband died yesterday to dance up and down about a friend’s engagement. It is understandable to have good wishes for the other person while also having feelings about your own loss or disappointment.

Controlling how you receive the information

You can’t control whether your friend gets pregnant before you do, but you can have a say in how you find out. This assumes, of course, that you are aware that someone is planning a family and that they know what you’re going through. Many of my clients have benefitted from what I call “the card trick.”

Ask your friend to send you a card. Yes, an old-fashioned greeting card via snail mail. Real envelope, real stamp. A phone call is hard, because it puts you on the spot. You need to congratulate the person right away, before you’ve had a chance to digest the information. IM is no better than phone, and e-mail is only somewhat better. Even if you don’t open the message, if its subject line reads “BIG NEWS!” you may feel that you are expected to respond quickly.

Because old-fashioned snail mail is unpredictable, your friend doesn’t know what time or even which day you receive it. This gives you time to tear up the card and stomp on it, have a good cry, or do some deep breathing before you pick up the phone and hit the keyboard. You get to feel like the loving, caring person you actually are and offer sincere congratulations. Even if you don’t have any negative feelings, you still have the luxury of time to respond when you’re ready. Everybody wins. You win because you controlled how you got the news. Your friend wins because you gave her a gentler way of breaking the news. You can both feel good about her new status and sincerely celebrate.

Even though you don’t know when or if your own luck will change, you can avoid unnecessary stress and enjoy your friend’s support and good wishes for your future pregnancy success.

Related articles:
Dealing with Fertility Challenges: Coping Tips and Resources for Parents-in-the-Making
Coping with Holidays While Trying to Have a Baby
Why Should I See a Therapist? I’m Not Crazy – We Just Can’t Have a Baby!

One of the most difficult parts of raising a child with autism is the fear of losing them. For my son, the combination of intelligence, impulsivity, and an inability to comprehend danger results in my family living in a constant state of hypervigilance and fear. When we go out, there is always the possibility he will try to run away. When we’re home, there is the fear that he will get out of the house. Our family has addressed this issue with an ability to think “outside the box” and one step ahead of our 14-year-old son, Ben.

1. Under lock and key
The most obvious way to keep a child safe at home are locked doors. We learned the hard way that deadbolt locks with a switch that can be turned by hand was only effective until he was 6 years old. One day he unlocked it and wandered out of the house while I was only one room away. Luckily, I caught him in time before he was halfway down the street. We switched to locks with keys and installed them on every door leading to the outside, my laundry room, my daughter’s bedroom, and our master bedroom. They are all master keyed so that our house key opens them all. In addition, we don’t keep our keys hanging next to the door. It’s inconvenient, but that’s the point.

2. Keeping watch: tag, you’re it
Another safety trick we use at home is something I learned from a life guard. While attending a beach outing for kids with special needs, they handed out lanyards with laminated cards that said “I’m Watching” on one side and had emergency first aid information on the other. This was to ensure that when there is a group of adults hanging out watching their kids play in the water, the parent wearing the lanyard is responsible for watching the child. This made me think about our own situation at home, where too often, my husband thought I was watching Ben while I assumed he was. This situation leads not only to missing kids but also to marital strife. So, we put the keys to the house on a lanyard, and the designated Ben-watcher wears it at all times. This way, when one of us needs to use the bathroom, we literally hand off the lanyard to the other person.

3. Tracking devices, helicopters and bloodhounds, oh my!
One of the most frustrating things about staying one step ahead is that we often don’t think about something until it presents itself as an obvious problem. Even after we changed the locks and donned our key lanyard, Ben’s safety was still not guaranteed. Last year, our greatest fear became a reality when Ben climbed our 6-foot privacy fence with the speed and dexterity of a tomcat. The person watching him was only a few yards away and watched him do it but could not reach him fast enough. He disappeared into the woods for 3 hours and was found with the aid of search helicopters and bloodhounds just before the sun set; he was cold, wet, and shivering.
After that incident, we obtained a tracking bracelet from our local county sheriff’s department that Ben wears on his ankle at all times. In the event that he ever goes missing, we can contact the police, who will find him using the radio signal from the device, rather than alerting the local news and calling the search cavalry. And from what they tell me, as long as the device is checked regularly and in working order, it doesn’t take 3 hours to find someone with this device.

4. Out and about
Parents of children with autism spectrum disorder know how difficult it can often be to take our children out into the world. A simple trip to the grocery store can become disastrous in no time flat. When our kids get overstimulated or can’t communicate, tantrums ensue and we often have to make a quick exit, while not making eye contact with fellow shoppers and store employees. Ben’s Houdini-like skills have also extended outside the home; school, stores, and Grandma’s house have all been settings for a “Ben Escape.” One thing we do now when going out is use a wheelchair with a seatbelt. Because of Ben’s sensory issues and difficulty transitioning, the wheelchair provides a secure, safe place for him to sit as well as the emotional stability of his seat remaining the same while his environment changes. Portable door alarms have been helpful on the rare occasion that we stay at a hotel. We’ve even been known to stack some of the hotel furniture in front of the door, from floor to ceiling, providing a barricade that would make a lot of noise if he tried to get past it. We’ve done the math, and we’re statistically more likely to lose our son than to have to evacuate in a hotel fire.

5. Vaseline
Yes, you read that right; Vaseline. Good old petroleum jelly became my best friend after Ben’s 3-hour tour of the woods. I needed a way to keep fence-hopping to a minimum, and apparently barbed wire is frowned upon by our home owners association. So, several jars and a very icky fence top later, the problem was solved. If having an autistic child in the drug-store line doesn’t solicit enough curious glances from fellow shoppers, nine extra-large jars of Vaseline is sure to.

For more information about wandering and a free box of safety materials, contact the National Autism Association at http://nationalautismassociation.org/big-red-safety-box/

Related articles:
The Difference 1 Makes: Reflections on the CDC Autism Rates
Autism on the Rise: Are We Prepared?

Whether or not we believe we should talk about sex with our therapist in treatment may have something to do with what we believe therapy is for or what the expected outcome is.

Are you going to therapy for a relationship issue? For a mental disorder such as depression or anxiety? To overcome trauma? Or because you are having a difficult time adjusting to a new situation? Therapy is useful for a multitude of issues, and no, sex may not be the most significant thing affected by a particular issue, but it definitely doesn’t hurt for the therapist to ask about it, to allow for the conversation to include some open, honest discussion not just about sex but also about sexuality, to at least let the client know it is okay to bring up the topic of sex in the therapist’s office.

Pervasive in our society is the inability to talk about sex, awkwardness, and embarrassment, which in turn leave us often bereft of the coping skills required to handle sexual issues in our relationship as they come up. When we avoid talking about sex with our partners, it can lead us down the path of avoiding talking about lots of other things as well. We all know that open, honest communication is key in successful relationships, so the absence of conversation and inability to talk about sex with our partners can be like a ripple effect in the breakdown of communication in a relationship.  And when we go to therapy and our therapist also doesn’t feel comfortable talking about sex, the therapist in turn perpetuates what society has taught us—that sex is too taboo to talk about. This may be okay for some, but not for all. Some people want a more comprehensive experience.  Some people want more than just a quick fix for their problems. Some people want to address the problems at their root. Some people want real change and real growth.

In treating relationships, sex must be addressed. Sex is not always everything, but in relationships it is definitely something. Most therapists treat some aspect of relationships. Even when an individual comes in for treatment for depression, anxiety, trauma, a new life situation, etc., if the person in therapy is involved in a relationship, or is dating, or even if they are single and celibate, a few questions encouraging open, honest communication about any concerns he/she has about sex can make all the difference in the world. Therapy should be a nonjudgmental safe haven where an individual can work stuff out, ask questions, and find answers. An avoidant therapist who is uncomfortable talking about sex sends a subtle message that can perpetuate feelings of shame, guilt, or embarrassment about sex, which in the end thwarts growth. Therapy should promote growth, not thwart it.  In couples therapy, it is absolutely pertinent to ask about sex.

Feelings about our sexuality and our bodies are core in our lives. Many people walk around feeling bad about their desires or fantasies. Shame and guilt about sex are extremely common, and people have very little awareness of this. If a self-loathing, self-hating, guilt-ridden client comes to therapy, is it not best to address where the feelings come from? A client may not be that aware of the root of the problems. It is important for the therapist to open the door for exploration and discussion.

Therapists do not even have to be especially knowledgeable about sex. In fact, therapists rarely know anything about what the client has experienced, in terms of sex or any other aspects of the person’s life. Therapists are trained to ask questions in order to understand the client’s experience. The client is the expert on his or her experience. A therapist’s job is to ask questions and provide a nonjudgmental environment to foster the client’s growth.  In looking at it from this model, therapists do not need to be well-versed in something to be open about it.

Therapy is a holistic health treatment that is helpful in guiding people to lead happier, healthier, genuine, and more honest lives all the way around. In therapy we attempt to break down the road blocks that prevent us from moving forward on our life journey, whether it be in our relationships at work or with our friends, family, or partner. Many psychological issues have a physical manifestation. It is important to remember that a sexual issue may be a representation of something bigger, stemming from depression, anxiety, or a relationship problem. We cannot treat problems in a vacuum. Mind and body are connected. When you leave sex out of treatment, the client’s journey remains incomplete.

Related articles:
Sex Talk
The Importance of Addressing Sexual Issues in General Therapy
The Elephant in the Room: Why We Need Full Disclosure in Sex Therapy

Healthy conflict resolution is essential to maintaining positive and constructive adult relationships. Individuals usually learn how to handle conflict in childhood. Children watch the way adults work through disagreements and model those patterns of behavior as they develop into adults and begin to form relationships with others. The bonds that children have with their caregivers also influence the way in which they address conflicts. People who have secure attachments with their parents and caregivers are often able to work through challenges with other people in respectful, affectionate, and loving ways. They are capable of recognizing when they need to ask for forgiveness and are willing to compromise to achieve a resolution that is mutually satisfying to all involved. Individuals who have insecure attachments, however, are often unable to handle situations as amicably. Insecure attachment can be expressed through avoidant or anxious behaviors. People who are avoidant in nature tend to withdraw and shut down when faced with conflict. Anxious individuals may demand attention, even negative attention, and use aggressive and hostile tactics to engage someone in a conflict dispute.

For children who have grown up witnessing dysfunctional conflict resolution strategies, having a secure attachment with others could help them avoid making the same mistakes of their parents. Rather than continuing the negative behaviors they have seen displayed by their own parents, these secure, self-reliant, and confident people may choose to use healthier mechanisms to maintain harmony in their adult relationships. Joyce A. Baptist of the School of Family Studies and Human Services at Kansas State University wanted to better understand how attachment style affected emotional processing learned in families of origin. She enlisted 203 young adults who had been raised in families with various emotional functioning styles for a study that evaluated how the adult children managed conflict.

Baptist found that the participants who had witnessed extreme disengagement in childhood were more likely to use aggressive and antagonistic disagreement strategies in adulthood. The most anxiously attached individuals in this group were the most apt to engage in hostile behaviors as their anxiety escalated. Those with minimally avoidant styles worked through disagreements in a more civil way. Baptist believes these results suggest that secure attachments can help protect individuals from dysfunctional and destructive conflict resolution patterns. These findings could impact how professionals assist people who have communication and compromise problems in their adult relationships. She added, “Considering the interrelations between emotional processing in families of origin and insecurities in attachment will allow therapists to better identify and treat the root of the destructive conflict behavior.”

Reference:
Baptist, J. A., Thompson, D. E., Norton, A. M., Hardy, N. R., Link, C. D. (2012). The effects of the intergenerational transmission of family emotional processes on conflict styles: The moderating role of attachment. American Journal of Family Therapy 40.1, 56-73.

Childhood emotional maltreatment (CEM) can have lingering effects. Adults who suffered mistreatment as children often struggle emotionally and socially throughout their lives as a result of being neglected or emotionally abused. Although there is an abundance of literature and research that focuses on the negative impact of childhood maltreatment (CM) in general, there is little available clinical evidence documenting the devastating effects of CEM. It has been well established that CM, including sexual and physical abuse, can increase the risk for depression, anxiety, substance misuse, and a host of other emotional problems. However, for adults who experienced CEM, one of the most difficult challenges they face is cultivating a healthy romantic relationship.

CEM can significantly deteriorate one’s self-esteem and erode an individual’s ability to trust another person. Beliefs about one’s value and worth and a bond of trust are the foundation of a healthy intimate relationship. This foundation can be further compromised when CEM survivors exhibit body-image dissatisfaction, which is often manifested through disordered eating behaviors. To provide more detailed evidence of the long-term consequences of CEM on relationships, Dana Lassri of the Stress & Risk and Resilience Research Lab at the Department of Psychology at Ben-Gurion University in Israel examined the stability and satisfaction of intimate relationships in a sample of college students with a history of CEM in two separate studies. Lassri found that CEM directly impacted relationship fulfillment in the participants by way of self-criticism. Specifically, Lassri discovered that the participants with CEM had extremely low levels of self-value, exhibited difficulty coping with stress, and held negative attitudes about life events.

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The results also revealed that the individuals who had posttraumatic stress due to the CEM were less able to realize their self-worth and had significant problems maintaining relationship satisfaction.  This could be caused by internalizing behaviors due to the abuse or by a child’s inability to properly comprehend their circumstances. Either way, Lassri believes that even though these findings were gathered from college-age individuals, the behaviors could potentially worsen throughout adulthood. Lassri added, “Over time, this tendency might be consolidated, becoming a defining part of a person’s personality; and ultimately derailing relationships in general and romantic relationships in particular.”

Reference:
Lassri, D., Shahar, G. (2012). Self-criticism mediates the link between childhood emotional maltreatment and young adults’ romantic relationships.” Journal of Social and Clinical Psychology 31.3, 289-311.

When parents use children as pawns in their divorce, the psychological consequences can be devastating. Parental alienation (PA) is the act of deliberately alienating a child from a targeted parent (TP) by an alienating parent (AP) and can cause a psychological condition referred to as parental alienation syndrome (PAS). Although this term is relatively new, the damage this type of behavior inflicts is not. When one parent denies a child access to the TP, the child struggles with feelings of hatred and fear towards the TP. These children often live in an environment riddled with malicious and derogatory remarks about the TP, and as they age, maintain guilt over harboring these feelings toward their parent.

Research on children of divorce has shown that this pattern of behavior can cause children to have social impairments that negatively impact their quality of life as adults. But until now, no study has looked specifically at PAS and its effect on key factors of development. To address this issue, Naomi Ben-Ami of Yeshiva University in New York evaluated 118 adult children of divorce and compared the children who experienced PAS to those who did not. She assessed several areas of social and psychological well-being, including depression, trust, self-hatred/esteem, anger, guilt, marital status, and achievement and identity problems.

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Ben-Ami found that the PA participants had substantially lower levels of achievement than the non-PA group, which was demonstrated by fewer college degrees, less overall employment, lower college enrollment, and more economic hardship. They also exhibited attachment issues, impaired relationships, and decreased self-esteem, possibly as a result of the lack of attention they received from their APs. The controlling behavior of an AP was also shown to increase feelings of anger and guilt in the PA participants. These emotions, coupled with diminished self-sufficiency, elevated the risk for depression in the children who were exposed to PAS. Ben-Ami believes these findings support previous research that shows the destructive and long-term consequences that a child must bear when he or she becomes entangled in a parent’s highly fueled emotions arising from a divorce or separation. This type of evidence, if made available to parents and involved psychological and legal experts, could help prevent this type of activity and maintain the integrity of relationships, present and future. Ben-Ami added, “Ideally, the trajectory can be interrupted successfully to allow children to maintain healthy relationships with both parents, to be loved by them and loving with them.”

Reference:
Ben-Ami, N., Baker, A. J. L. The long-term correlates of childhood exposure to parental alienation on adult self-sufficiency and well-being. American Journal of Family Therapy 40.2 (2012): 169-83.

Married couples communicate in a myriad of ways throughout the world. Different countries have cultural norms that people conform to, and these norms directly influence how individuals in intimate relationships communicate. These norms also affect other behaviors and attitudes that significantly affect relationships. Chinese and American cultures are quite different, and therefore, it is assumed that couples from China might have different communication styles and beliefs about their relationships than American couples. These diverse views are important to understand in order to better address and treat the issues that plague Chinese couples in America.

To find out how attitudes and communication patterns shape the overall satisfaction of Chinese couples compared to American couples, Hannah C. Williamson of the Department of Psychology at the University of California, Los Angeles, recently led a study evaluating these factors in a sample of 41 Chinese newlywed couples and 50 newlywed couples from America. Taking into consideration that American couples are more inclined to conform to individualistic ideals and value intimacy and personal and romantic expression over the social expectations of extended family harmony and approval, as Chinese culture dictates, Williamson expected that the American couples would be more positive than the Chinese couples. This finding was not realized. Instead, all of the couples showed equal levels of positivity.

However, the results did show that the Chinese wives held more overall negative attitudes toward their husbands than the American wives. This directly impacted the levels of relationship satisfaction in the Chinese participants. Williamson believes this could be due to the collective nature of the Chinese culture, which dissuades people from directly expressing their feelings to intimate partners and family members. This nondisclosure of emotional experiences can hamper open communication and cause partners to hold on to resentments, thus negatively affecting the relationship. In contrast, American couples showed higher levels of relationship satisfaction, perhaps due to the more expressive and individualistic behaviors encouraged in American culture. Williamson believes these findings can help clinicians better understand the factors inhibiting communication in couples whose values differ with those of most Americans. She added, “The culture in which a relationship occurs therefore may be an important factor in determining how individuals behave toward their spouse and how they assign meaning to this behavior.”

Reference:
Williamson, H. C., Ju, X., Bradbury, T. N., Karney, B. R., Fang, X., & Liu, X. (2012). Communication behavior and relationship satisfaction among American and Chinese newlywed couples. Journal of Family Psychology. Advance online publication. doi: 10.1037/a0027752