KEEPING OUR COMMUNITY SAFE – WORKSHOP

Confronting Sexual Abusers – with Dr. Gavriel Fagin

There are two people when it comes to sexual abuse. The victim and the offender. In this episode, the Klestzicks sit down with Dr. Gavriel Fagin to discuss with him how to be more aware, active and in tune with the red flags offenders have. The best protocol to help victims and the work he does with abusers to help mitigate the risk of another offense.

2015 Klal Perspectives Journal Article

Towards a Model of Self Regulation for Internet Behavior Challenges In Adulthood

This article presents research and clinical experience regarding the prevalence of “addiction” to technology, and suggests some solutions. Technology-based addiction may take a variety of degrees and forms, such as addiction to pornography, texting, shopping, and social media consumption. The word “addiction” is increasingly used rather loosely, and its meaning, and thus import, have been obscured. The term addiction, as it relates specifically to sexual behavior, will therefore be defined and clarified below, in order to conduct a more meaningful discussion.

Though this article will primarily use male sexual behavior as the example of the dominant challenge posed by technology, the discussion would apply almost identically to other technologically driven behavior. The impact of technology on male sexual behavior was chosen for two reasons. First, my clinical experience has found that the most deleterious impact of technology is on this area of behavior, even if this behavior does not rise to the level of a formal addiction. Second, and perhaps selfishly, the vast majority of my personal clinical practice relates to male sexual behavior problems. This is not to imply that females are not impacted in their sexual behavior by technology. While most researchers report that online behavioral issues relating to technology seem to have a male preponderance, there is some research that suggests that women have an equal or greater struggle.

Hypersexual Behavior vs. Sexual Addiction

Sexual addiction is best defined, in comparison to hypersexual behavior, as being greater in degree and characterized by a greater loss of self-control, while including other personality components as well. According to researchers, hypersexual behavior is characterized by a pattern of behavior, continuing for a period of six months or longer, which often includes some of the following components:

(a) an excessive or disproportionate amount of time consumed by sexual thoughts, urges, and behaviors; (b) using sex in response to unpleasant affective states or to cope with stress; (c) multiple unsuccessful attempts to reduce or control sexual thoughts, fantasies, and behavior; (d) continued preoccupation with and pursuit of sex despite negative consequences to self or others; and (e) volitional impairment in interpersonal, social, or occupational domains of life.

Sexual addiction is characterized by the presence of an increased number of these elements that are manifest in more extreme and persistent forms. For example, while individuals with hypersexual behavior use sexuality to regulate negative emotional states, such individuals commonly use other healthier coping mechanisms, as well. Sexual addiction, by contrast, is often diagnosed when sexuality is the only mechanism used to manage emotional mood states, most frequently depression or anxiety. Individuals with sexual addiction also tend to have much lower general inhibition and increased difficulty with self-regulation as features of their overall personality pattern. Low inhibition referrers to a personality pattern that can be seen as extroverted, flirtatious, overly friendly, and/or unintimidated by new situations (think: being tipsy). Additionally, individuals with low inhibition tend to treat familiar stimuli in the same manner as they would new stimuli, often leading to experiencing (and seeking) constant thrills.

Third and possibly most significant, sexual addiction is most common in individuals who tend to have a dissociative quality to their sexual behavior, and in the most extreme cases, to their overall functioning. Dissociation refers to a state of perceived detachment, be it cognitively, physically, or emotionally. Dissociation is sometimes characterized by a sense of the world as a dreamlike or unreal place and may be accompanied by poor memory of specific events. This level of dissociation is often highly correlated with a history of significant interpersonal trauma.

A final point should be made regarding efforts to distinguish between hyper-sexuality and sexual addiction. Several medical and/or psychological diagnoses have increased sexuality as part of a symptom cluster. For example, if an individual has a lesion, or experiences a stroke, in the temporal lobe or basal ganglia, hyper-sexuality might be present, as well. Similarly, bi-polar disorder often accompanies hyper-sexuality, and individuals with ADHD are at greater risk for hypersexual behavior. Therefore, it is imperative that sexual behavior be evaluated in the context of the “biggest picture” of the individual’s medical and psychological functioning.

Role of Technology in Sexual Dysregulation

What are the dynamics that might lead an individual towards hypersexual behavior, and what role does technology play in the process?

As reflected in the diagram below, a recent study of over 200 Orthodox Jewish males ranging in age from 19 to 67, over three-quarters of whom were married and who were associated with a broad spectrum of affiliations (Yeshivish, Modern, Chassidish), yielded interesting findings. Study participants were presented with a four-question measure of hyper-sexuality, seeking to assess the potential for sexual addiction. Twenty-five percent of the respondents stated that they engage in sexual behavior that presents negative consequences, and just shy of that number reported that their sexual behavior is inconsistent with their personal beliefs. While there is no exacting formula that is applied to reach a definitive diagnosis, the more questions that are positively endorsed certainly suggest the presence of unfettered hyper-sexuality and possible sexual addiction.

Perhaps most significant, however, is the study’s finding that nearly seventy-five percent of the respondents involved in problematic sexual behavior reported that this behavior involves the use of some sort of online medium.

These statistics confirm the clinical experience of mental health professionals in both the secular and frum world: marriages are falling apart, workers are being fired, and relationships are suffering because of technology-driven hyper-sexuality. This is true even if the behavior does not meet formal criteria for sexual addiction. In the past ten years alone, I have seen a dramatic spike in the sheer number of individuals who are struggling with their online sexual behavior. This is across the spectrum of Orthodoxy, socio-economic class, and employment type. The age of onset of those that are struggling is getting younger, and some of those who are ensnared are having an unbearable time breaking free.

On the most practical level, this level of consumption is not surprising: getting online is very easy, very accessible, and very private. There is Wi-Fi everywhere, and the sheer number of devices that are capable of connecting to the Internet is staggering. Major search engines have “privacy” modes, which one teenager I treated called “porn mode.”

On a slightly more fundamental level, there seems to be a “pornification” that people are being indoctrinated into at some pretty early ages. This pornification is characterized by being able to access pornography freely and being able to view content across a colossal range of interests, fetishes and fantasies. I have found, clinically, that particularly in single men, pornification results in a highly disturbed view of both women and sexuality, a deep narcissism that is promulgated by being able to click “x” if something does not suit your fancy, and some very troublesome assumptions about the appropriate nature of a true partnership. In married men, the impact of pornification includes increased difficulty in both the physical and emotional capacity to connect to a “real other.”

As noted, most people will not meet the above-referenced criteria for sexual addiction, yet their online consumption is having a deleterious impact on their capacity to form and maintain relationships. For example, regarding shiduchim, there has always been a segment of society that has placed great emphasis on external appearance, reflected in questions that are answered in reference to dress sizes. I have increasingly found that bochrim who have had even modest exposure to pornography have an added demand for external features that are both impractical and misogynistic. Married men are increasingly making demands of their wives regarding external appearance, where women are being “pushed” to dress, exercise, groom, and perform in a manner that comports to a digital image that has been photo-shopped, hair-dressed, and body-tanned. Some women are being asked, or feel an internal pressure, to keep from having additional children for the purposes of maintaining a certain external appearance. Finally, spirituality is a connection, a relationship, to the divine. The impact of pornography on the relationship with G-d deserves an article in its own right. Suffice it to say, the spiritual broken-ness that accompanies even modest inappropriate online behavior is impacting large segments of our society.

Hypersexual behavior is advanced by technology because the very nature of online consumption breeds disinhibited behavior. The notion of disinhibited behavior applied to online sexual behavior is more fully explored in a study conducted by Suler (2004). In a most concise and simple summary, the online medium offers anonymity and privacy, thereby allowing the participant to become whomever he wishes, and to explore fantasy in an unabashed manner. As one client aptly shared with me: “Online, I can be anyone, to anyone, doing anything, anywhere.”

Is There a Solution?

The exploration of potential solutions to the problems discussed above begins with two fundamental questions: (1) Do communal rules and practices impact these types of behaviors? (2) Do individuals confronting these challenges recognize and acknowledge the nature of their difficulties?

The first question centers on the role of community rules and mandates to shape adult behavior (as opposed to children’s behavior, which seems to be positively impacted by such policies). Specifically, there has been a strong trend amongst a significant portion of our communities to strenuously urge restrictions on, and controls of, use of the Internet. In fact, many schools, Yeshivas and Shuls even mandate adherence to an internet safety policy. A comprehensive discussion of the history and implementation of filtering systems amongst unlikely partners, Orthodox institutions and secular technology companies, can be found in the work of Campbell and Golan (2011).

While the efforts have been extensive, and based on a desire to promote the most wholesome environment for religious homes, there is little data to ascertain whether these policies are producing actual change in internet behavior, or “only” serve as a reflection of the values of a particular community or institution. In fact, many argue that the efficacy of communal rules is secondary to the sense of shared purpose engendered by policies regarding internet and/or technology. The essential question regarding behavior, however, remains: do mandates and policies actual do anything to positively impact adult behavior?

It has been my clinical experience that the vast majority of individuals who have online behavior problems adhere to communal policies “in the home” but not at work or when using their personal devices. Additionally, in my professional discussions with clients and casual conversations with colleagues or acquaintances, I have found that most people are not content with the policies they are asked to adhere to, albeit for (often) conflicting reasons. It seems that most people feel that the policies are ineffective, too restrictive, too open, too vague, not well enforced, enforced too harshly, etc. These “goldilocks” conversations leave me with the prodigious notion that externally imposed internet policies are not doing very much to shape or control behavior, but are leading to a sense of being “disgruntled.” It should be noted that while these external policies might have a negative impact on adult feelings towards the “mandating” agent, the same policies seem to have a positive impact regarding protecting children from unwanted exposure. There certainly seems to be a balance that needs to be struck, somehow, if the same policies seem to be doing “mostly” good with regards to safe-guarding children, but might be creating negativity amongst adults. This is an area of research that is sorely needed.

The second question is whether individuals struggling with internet consumption recognize and acknowledge the nature of their difficulties. First, a word of explanation is in order, as one might naturally expect that Orthodox Jews accessing pornography online, for example, would certainly view their behavior as wrong and likely be affected immediately by feelings of guilt.

Research in the area of behavioral change – and sexual addiction specifically – makes an important distinction between feelings of “guilt” and “shame” in response to problematic behavior. Guilt refers to feelings about the specific behavior (or pattern of behavior), and tends to include a recognition and acknowledgement of the nature of the problem. Interestingly, an individual who feels guilt about sexual behavior tends to seek proactive solutions to their problem. Shame, on the other hand, refers to a general state of feeling inadequate as a person. Not “I did something wrong” but “there is something wrong with me.” In fact, many Orthodox Jews engaging in hypersexual behavior primarily experience overall shame and fail to recognize and acknowledge the nature of their specific difficulties. Therefore, they tend to revert to the very pattern of maladaptive coping to ease those feelings of shame, utilizing denial to address their cognitive dissonance. And so it is important to address whether Orthodox Jews recognize their difficulties even when they consider the behavior to be wrong.

In the late 1980’s, two researchers (Prochaska and DiClemente) introduced a model addressing an individual’s readiness to change. This model proposes that there are six possible stages that an individual might cycle through before, during, and after seeking to address undesirable behavior. The first three stages focus on the individual’s willingness and motivation for change. The chart below characterizes these stages.

The first stage, “Pre-contemplation,” is essentially characterized by the thought and feeling of “problem? What problem?” While still at this stage, the individual fails to acknowledge the undesirability of any behavior. There is, thus, no motivation for change. The second stage is “contemplation,” when the individual acknowledges that an issue might exist, but remains unsure whether corrective action is necessary or appealing. It is only when the individual reaches the third stage, “Preparation,” that a modest commitment to change is undertaken. The steps taken by the individual after this mini-commitment will dictate whether real change will occur, or whether the individual will simply revert to previous patterns of behavior.

A Proposal: Shift to a Model of Self-Regulation and Assessment

I believe that any community effort to manage technology’s impact on its members must begin with acknowledging that technology is an inescapable presence that is going to continually increase. Strategies can no longer be founded on the aspiration of isolating individuals from access to technology. It is, therefore, my view that any solution must rather be founded on the aspiration of inculcating a sense of individual responsibility to regulate one’s self, and to provide the tools by which such self-regulation can be become normative and ordinary course. That is not to suggest that communal expectations and standards not be promulgated, but rather that they be focused on developing self-regulation.

Based on the two questions briefly explored above, a model should be introduced that merges self-regulation with externally mandated controls. This model would first encourage the individual to ask himself (or herself) some basic questions:

• Do I feel in control of my internet and/or technological behavior?
• Does my internet/technology behavior include viewing images or composing/viewing messages in a manner inconsistent with my beliefs and values?
• Does my internet/technology activity produce negative consequences, such as harm to relationships, difficulty focusing, or poor performance on the job or in Torah study?
• Do I need privacy and secrecy to continue my internet/technology behavior?
• Do I feel overly preoccupied with using my computer or accessing the Internet?

Once this portion of the self-assessment has been made, phase 2 is for the individual to identify the degree of his personal motivation for change. This can be accomplished by reference the model presented above, or by asking oneself: “Do I feel prepared to make any changes? If yes, when would I like to start making those changes? If not, is there a time or event that I can foresee that would cause me to reconsider making those changes?” I do not believe it is unrealistic to imagine this self-assessment process being widely encouraged and the stages of change being widely distributed – perhaps handed out along with the internet policy contract that parents are asked to sign by various institutions.

If the community is successful in empowering the individual to recognize and acknowledge the impropriety of his technology-based behavior, and there is a self-induced motivation to change, several options exist. First, having a filter on a specific device is helpful, but is often ineffective. A more effective and productive manner of filtering is by utilizing a filtered router. That way, every device connected to the Wi-Fi is filtered. But such efforts can also be circumvented since, as the adage goes, where there is a will, there is a way.

Another potential intervention is utilizing an online forum where a culture of sharing challenges and potential solutions regarding internet behavior is normalized. The Orthodox world has such a resource: a site called “Guard Your Eyes” (https://guardyoureyes.com/). Additionally, I believe that our time honored chavrusah system can be a wonderful resource for everyone, those with identified issues and those without. Would it not be wonderful if it became normative for each member of the community to have a trusted chavrusah with whom to share accountability for being honest and forthright for themselves? Such a chavrusah system can include ongoing conversations, but can also include a “monitoring” program, such as Mspy or covenant eyes (http://www.covenanteyes.com).

Certain individuals are likely to be uncomfortable sharing these issues with even a single chavrusah. For them, other, more traditional “self-help” options exist. There is a wonderful workbook called “Treating Pornography Addiction: The Essential Tools for Recovery” by Dr. Kevin Skinner. Dr. Skinner’s book offers a step-wise approach to breaking online behaviors. Additionally, Dr. Patrick Carnes has several books/workbooks that serve as a guide to behavioral change.

Finally, there are some individuals who, based on personal history and/or personality constellation, would benefit from the help of a qualified mental health practitioner. When seeking such help, it is wise to identify a practitioner who specializes in this particular area of practice. The decision to seek the help of mental health professional should, in part, be based on an honest assessment of the potential etiology (i.e., possible origins) of the problematic behavior. While the etiology of “addictive behavior” is a topic worthy of an article in its own right, the following are suggested guidelines.

First, people who have a suffered a history of sexual trauma are at greater risk of hypersexual behavior. If there is a history of trauma, the only way to fully address hyper-sexuality is often to first treat the trauma, and only thereafter any lingering hyper-sexuality. Second, if someone has genuinely tried several “interventions” without success, a qualified and experienced mental health practitioner might be able to help identify the roadblocks impeding successful and lasting change. Finally, an evaluation by a mental health professional is likely warranted if during the course of an honest self-assessment one realizes any of the following: (i) that they are utilizing technology to soothe intense emotions, (ii) they are forming one or more online relationships because their current relationships are significantly lacking, (iii) online behavior results from being constantly bored and uninterested in life, or (iv) they are unable to stop the behavior despite suffering serious consequences.

Conclusion

In summary, there is likely no solution to the challenges of “technology in modernity” if the term “solution” means “a quick, painless, universal, foolproof way to solve a problem.” The likelihood of success, however, rises considerably if the effort to address concerning behavior includes the nurturing of a culture of self-regulation, peer support, personalized interventions, and professional support. And, as noted above, where there is a will there is a way.

Dr. Gavriel Fagin is the Director of Tikunim Counseling Services (www.tikunim-counseling.com), a specialist multi-provider private practice specializing in the gamut of sexual challenges facing Orthodox Jewish men.  Gavriel is also an Adjunct Professor at the Wurzweiler School of Social Work.

Ref: http://klalperspectives.org/dr-gavriel-fagin/

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