By Stephen C. Schultz
As an executive in a Residential Treatment Center (RTC) that works with students who are demonstrating Problematic Sexual Behavior (PSB), I regularly get calls and emails from the media. Some are legitimately interested in learning more about the issue… others are only looking for a few controversial or humorous sound bites.
I recently had a conversation with a journalist from the UK by the name of Trisha R. It was obvious through her questioning that she had some preconceived notions and ideas about sexual issues in general. I would like to share with you some of her questions and some of my responses. My reason for this is that I’m sure many parents probably have some of the same questions, even if they are not discussed personally with allied health professionals.
She asked some very general questions that leaned toward a simplistic view of sexual issues, so I tended to answer her questions with more refined questions. Most parents want to avoid having to deal with their teens’ sexual issues. However, things can go from embarrassing to litigious in a heartbeat.
Here is a portion of our interaction:
Question: “Is porn okay?”
Answer: It may be best to reframe this question into a few questions to gain a deeper understanding.
“Is it possible for porn to be harmful?”
“Can there be a negative physiological response to watching porn?”
“Can porn be abused?”
“Is it okay for children to watch porn? If not… why?”
“At what age is it okay to have kids watch porn—8? 12? 16? 18? Why or why not?”
“If certain porn is okay… what kind and when? Soft-core? Hardcore? Child? Mature? Animals? Fetishes? Anime?”
The issue ends up being less about the porn and more about childhood development. The majority of students at Oxbow report being exposed to porn as early as four years old. When a four-year-old is viewing porn, how do they integrate that information at such a vulnerable developmental stage? If the student is developmentally delayed and struggles with ASD, NLD, ADHD, or attachment issues, porn can complicate an already difficult developmental process.
Question: “Is masturbation okay?”
Answer: It may be best to reframe this question into a few questions to gain a deeper understanding.
“Is it possible for masturbation to be harmful? When?”
“Are there times when masturbation is inappropriate? When?”
“Is public masturbation okay? What constitutes public masturbation?”
“Is it okay for a child or teen to watch a sibling, parent, neighbor, or friend masturbate? Why or why not?”
“Masturbation usually includes fantasy. Are some fantasies inappropriate?”
“Is it okay for a teen to masturbate to fantasies of siblings, parents, children, or a family pet? Why or why not?”
The question isn’t whether masturbation is okay or not. The question becomes: is there an unhealthy use of masturbation, and is there ever a need for a therapeutic intervention? It’s important to assess fantasies when dealing with sexual issues. A student who fantasizes about siblings or a mom’s underwear will still be “at risk,” even if behaviorally he is a model student in a traditional therapeutic setting. Thoughts and fantasies generally lead to some kind of action.
Question: “Do you believe in porn addiction? Do you believe in sex addiction?”
Answer: Once again, it may be best to reframe the questions.
“Can someone abuse porn? Can someone abuse sex?”
“Can someone become emotionally dependent on porn? Sex?”
“Can someone develop tolerance to porn? Sex?”
“Can someone develop compulsive thoughts about porn? Sex?”
“Can the use of porn or sex become chronic?”
“Would it be compassionate to provide assistance and relief to someone who is burdened with these concerns?”
When discussing the issue of addiction, it is not so much a “belief” as it is a clinical observation. There is still a raging debate about whether addiction is a disease or not. There are certainly elements of the disease model in substance abuse as well as sexual issues. In both instances, chronic and compulsive behaviors over time lead to societal as well as medical concerns that can be fatal.
When treating an alcoholic, the client may have a genetic predisposition. The drinking may be manifesting itself in a chronic, disease-like state. However, when working with an alcoholic, we don’t treat the genetic predisposition; we assist them in managing the emotional thoughts and compulsive behaviors surrounding the chronic use. When working with students who enter our care with sexual concerns, the same is true. We assist them in managing compulsive sexual thoughts and behavior in an age-appropriate way.
With substance abuse, long-term abstinence can be a treatment option. When dealing with teenagers and sexual issues, long-term abstinence isn’t realistic or recommended. Thus, it is clinically complicated and requires specialization.
I hope this has been helpful in framing these issues in a way that promotes healthy discussion of very sensitive and emotionally laden topics. When teen sexual concerns rise to the forefront and are noticed in a treatment setting, it is not a phase. These students are already outliers by virtue of the fact that they are in treatment. Further evaluation should be a top priority.
If you are interested in learning more, below is a link to my blog, where I share an experience I had speaking to a group of young men in a a traditional Residential Treatment Center about appropriate sexual behavior:
The Rocky Landscape of Teen Sexuality
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