Therapy Notes

Coming to therapy is a little daunting to many of us. As a therapist, I am constantly aware of how difficult it can be to enter into the commitment of therapy. And while main stream media has popularized the idea of therapy and we watch characters like Tony Soprano going to therapy, the idea of going to see a stranger, telling them all of our negative thoughts and feelings and actually having to work on our issues can be very overwhelming and scary.

I often tell my clients that going to therapy is like looking in the mirror: you get to see the good, the bad and the ugly. While most of us know exactly what the bad is (you know all those repetitive thoughts, negative self talk, the fights with our significant others, the drinking too much, and bad relationships we keep getting into) and we are afraid to admit the ugly (any self harming thoughts or behaviors, thoughts of hurting others, sexual thoughts and behaviors and abusing drugs and alcohol) we often are completely unaware of the good. The good are skills, strengths, abilities that you may be unaware of or may be having difficulty seeing. Therapy helps clients to identify what is positive in their lives, what positive attributes they have, and to accentuate the positive feelings they have. So while what generally brings us to therapy are those dark thoughts, what we tend to discover as we continue on in treatment are the positive within us.

We often see the most distorted images of ourselves.  And coming to therapy can correct those distortions bringing us closer to a more realistic image.  To work on the distorted images we initially start with correcting the distorted thoughts.  I ask clients to challenge their distorted thinking by asking themselves “Where is the evidence that I am ____?  Sometimes clients will ask me what if I AM ugly, fat, mean, etc.  I always tell them I have no problem if that is reality.  If the thinking isn’t distorted we look at it too but we don’t need to correct the thinking.

As I tackle the negative thinking I also have to assign affirmations.  Now those of you who are old enough remember a spoof that SNL did called “Daily Affirmations with Stuart Smalley”

“I’m good enough, “I’m smart enough and doggone it people like me.”

As silly as it may be affirmations work but here is the trick – you cannot lie to yourself.  So while you may want to say “I like myself” if that isn’t true it won’t work.  So you’ve got to start with affirmations you believe in otherwise they won’t work.

So good luck and have fun looking into the mirror!

Although some of you are just welcoming yourselves to the world of twitter (even though there still may be some of you who have no idea what twitter is – thank goodness I’m not the only one), I am welcoming you to my blog!  Why a blog?  I wanted a place to share some of my musings, commentary, and a place to record some of my ideas.

I am a licensed clinical social worker specializing in the field of sexual abuse and trauma.  I have worked in this area for over fifteen years starting with female adult survivors of sexual abuse and sexual assault.  I have dedicated much of my work to the specialties of sexual abuse, incest, perpetration and sexual acting out.  I also have extensive experience working with depression, anxiety, trauma, addictions, anger, violence and abuse.

This blog will focus on my thoughts regarding psychology & social work,  treatment, psychotherapy,  and my specialty of sexual abuse.  It will also explore other areas of interests for me such as spirituality, addictions, sexuality, sexual offending, forensics and relationships.  I may also from time to time venture off topic to discuss other varied interests.

What is normal sexual behavior in children?

I don’t know how many parents have asked me, “How do I know what is normal sexual behavior in my children?” or “What did I miss?” or “How did I not notice that something was wrong?” It is so hard for parents to know today what normal sexual behavior is when navigating through the sexualized media and the over sexualized public figures that all of our children seem to idolize. And if your child has acted sexually inappropriate, many parents struggle to understand this behavior and often blame themselves.

For most children they develop sexual behaviors in much the same ways they develop other non-sexual behaviors. In other words, it is through normal exploration, an information gathering process as they begin to discover their bodies, act out different roles and sexual behaviors. However, it should be noted that all exploration should be with same age children and should not be confused with sexual abuse. It is important to understand what is normal and what is not normal sexual behavior in children and adolescents. It is also important to talk with your child and let them know what acceptable behavior is and what is not acceptable.

What is typically seen in normal sexual behavior in children (under age 10)?

• Looking and touching same aged children’s bodies (i.e. playing doctor)
• Exploring gender roles (i.e. playing house)
• Touching and rubbing of own genitals
• Curiosity about sexual things and sexual talk
• Curiosity about others’ bodies and genitals
• Interest in how people make babies
• Curiosity about urinating, defecating and other bodily functions
• Talking/asking about their own genitals
• Looking at others genitals

Adolescent Sexuality (ages 10 – 18)

Puberty brings increased interest in sex. This is the time that you will generally see more sexual behavior. In addition to the above behaviors of younger children you will also see:

• Masturbation – almost all boys masturbate and many girls begin to masturbate at the onset of adolescence.
• Voyeuristic behavior may occur in the form of viewing pornography or looking at others.
• About half of all boys and a third of all girls have sexual contact with same aged peers in early adolescence. They may begin with kissing and touching and eventually evolve to sexual intercourse.
• Increased interest in opposite sex or same sex peers.

What are behaviors that are of concern and require professional intervention?

• Sexual knowledge beyond biological/developmental age
• Public masturbation after being told it is not ok and consequenced
• Continually talks about sex
• Wants to play games with younger children such as doctor or house
• Draws people having sexual intercourse
• Asks people to take off their clothes
• Touching of genitals of adults either through force or manipulation
• Talking or acting in over-sexualized way
• Touching of genitals of other children through force or manipulation
• Extreme fear of having someone observing them undress
• Hurting of one’s own genitals or rectum
• Sexual behaviors or contact with animals
• Forcing or manipulating others to touch their genitals
• Forcing or manipulating others to show their genitals
• Exposing their genitals after being told it is not ok and consequenced
• Hates their own genitals
• Hates their own gender/sex
• Refuses to leave people alone when they are in the bathroom
• Smearing of feces or urinating purposely in areas outside the bathroom
• “Humping” the furniture, animals or other children
• Forcing or manipulating others to have sex
• Inability to stop themselves from engaging in sexual behaviors

If you see any of the above behaviors, you should seek out professional help. Or if you are experiencing any of the above behaviors or have feelings of wanting to do these behaviors, please contact a professional.

References:
Johnson, Toni Cavanaugh, (1996). Understanding Children’s Sexual Behaviors: What’s Natural and Healthy: New Harbinger Publications: South Pasadena, CA.