OCSB

Out of Control Sexual Behavior: Sexual behavior that is in conflict with your goals for sexual health.

Remember my professional conference and the post I wrote, "Good Sex Is Vanilla and Boring"? Well, thank goodness for Doug Braun-Harvey, MFT, CGP, of "The Sexual Dependency Institute of San Diego", and Michael A. Vigorito, MFT, of "San Diego Psychotherapy Services".

Theirs was the last workshop I attended at this conference, and praise the lord, there is a sex positive God after all and she created these two men to deliver us from our misguided attempts at pathologizing sex and labeling those who indulge in any sexual activities beyond missionary position in bed with your lawfully wedded spouse as a sex addict. OK, I confess to exaggerating a bit but unfortunately, not much.

I didn't think I would make it through the afternoon and had a tentative plan on heading home early. I was sorely disappointed in the quality of most of workshops I had attended at this conference. The medical model of addiction seems to have lead too many therapists down a frightfully narrow path that offers limited access to therapeutic interventions that subscribe to a model of sexual health. I figured this workshop would be yet another of the lot, attempting to guide me along a "sex negative sexual addiction assessment path". I noticed that they used the term "Out of Control Sexual Behavior" which isn't uncommon language in the field.

But when I reached the conference room, my heart lightened and I felt an inkling of hope as I read the full description of the workshop, "Assessing Out of Control Sexual Behavior: Ending the epidemic of psychotherapist premature evaluation." Oh yes, oh yes, oh thank you God. I got excited at the thought that someone was actually going to confront this horrendous "epidemic" where hundreds of therapists had been herded like sheep to the sexual slaughtering of their clients all fucking weekend long.

One of the goals and objectives of the workshop was to: "Identify therapists' sexual attitudes and beliefs that interfere with a more complex conceptualization of sexual behavior problems." This is so beautiful. Concurrent with learning specific assessment protocol for assessing client's concerns regarding their sexual behavior, the therapist must learn to identify their own sexual attitudes and beliefs that will interfere with their understanding of their clients problems. Perfect. Imagine that, "Healer, heal thyself."

Lots of what was covered in this workshop related to the "Paradox of Eroticism"--that which is forbidden and pleasurable at the same time. Therapists and clients are dealing with the both the personal/idiosyncratic constructs and well as the social/ cultural constructs of sexual behavior, both the egosyntonic (that which is acceptable to the ego) and egodystonic (that which is unacceptable to the ego.) We must support our clients (as well as ourselves) in finding their way through this labyrinth.

We discussed the effects of "High and Low Inhibition" and "High and Low Excitability". Inhibition refers to the the social constructs that stop us from engaging in OCSB. For example, we might have a fantasy about running through the streets naked, or having sex with a minor but our fear of the consequences stops us from doing it. Excitability refers to any sexual behavior that excites us, such as running through the streets naked, or having sex with a minor.

Here are some various combinations of Inhibition and Excitability:
"High Inhibition/Low Excitability"
"Low Inhibition/High Excitability"
"High Inhibition/High Excitability"
"Low Inhibition/Low Excitability"

Which of these combinations would most likely lend itself to OCSB?

First consider that sexual health is rooted in a balance of both Inhibition and Excitability.

The answer is:

"Low Inhibition/High Excitability"

If a person's level of Inhibition and Excitability are balanced "High/High" or "Low/Low" there is usually no problem. If a person has "High Inhibition with Low Excitability" there is usually no problem either. On the other hand, a person with "Low Inhibition and High Excitability" needs to be mindful of this combination. This person has a tendency to get very sexually excited and their low inhibition in regards to acting out on their sexual excitement, makes it much harder to control their impulses to engage in their fantasy of running through the streets naked or having sex with a minor, or what have you.

If a person's sexual fantasies are benign (won't get them into trouble) there is no problem. But remember, we are discussing OCSB here and the erotic paradox is significant--what is forbidden is pleasurable.

Ultimately, each individual needs to define their own problems and come to terms with whether their problem is actually OCSB or not. Of course, a trained OCSB therapist who is not on a witch hunt for sexual addiction can be extremely helpful.

If a spouse calls in reporting that her husband masturbates to pornography everyday and she wants him to get help, that does not constitute OCSB. The woman made need help dealing with her own issues, and whether her husband has OCSB or not, is not really the point. The fact that she has a problem is obvious because she's the one calling in for help, even if she thinks it's her husband that has the problem. If the man calls in requesting help regarding his masturbating to porn, that's another story and the therapist is then in a position to start an OCSB assessment without prematurely evaluating his actual problem. Maybe he has OCSB, or maybe his wife simply has different sexual standards than he does for what is appropriate and they lack communication skills as well as needing a more indepth understanding of their sexual selves and personal values and how to more effectively meld their differences into a loving and intimate relationship.

The Erotic Mind by Jack Morin was suggested as a good read so I googled it and found the San Diego Institute for Bioenergetic Analysis. Click on this link and scroll down just a tad for an article, Bioenergetics and a Paradoxical View of Sexuality by Diana Guest MFT, CBT where she discusses Jack Morin's "paradoxical theory". It's interesting.

My notes were obviously disorganized as I had information on the "Love Map" that I thought was related to Jack Morin's work but when I googled "Love Map" it's all about John Money Ph.D., a psychologist and sexologist known for his research into sexual identity and biology of gender. The "Love Map" is a template which pairs our idealized lover with what turns us on sexually. We only know the "Love Map" metaphorically and it is a place we visit during sex through mental imagery and fantasy. I found this link which took me to a page that was discussing some sexual stuff related to the "Love Map" and I'm offering it here because of this quote which is the perfect description of how I felt after the "Good Sex is Vanilla and Boring" workshop I attended.

"Diagnosing types of sexuality is as disrespectful as discriminating people based on race, ethnicity or religion."

Anyway, these presenters were both lovely. They worked well together and were intelligent, articulate and sex positive. I particularly appreciated their skill in helping the participants distinguish between thoughts and feelings. It's amazing how many people (including therapists who should better trained in this) will tell you what they think, or the meaning they make of something when then are asked what they feel. They also made a good point about it being a mistake for therapists to allow their clients to speak in metaphors. Talking clearly about sex is important. I also like that this model invites ambivalence and encourages contemplation.

There was lots more good stuff including criteria for assessing OCSB that I won't go into but I will say that I was incredibly relieved to experience this workshop after what I'd been exposed to in the other "Addiction Workshops" at this conference.

A few more recommendations they made:

Cruise Control: Understanding Sex Addiction in Gay Men by Robert Weiss. Disclaimer: This is a sex addiction model but is good for understanding the feelings related to OCSB.

Changing For Good by James O. Prochaska, a book on "Motivational Interviews".

This Film Is Not Yet Rated is documentary on how the MPAA rating system censors movies. This is a good link to an article about this film and what it exposes about the NC17 (No Children under 17) rating. Here are a couple of quotes from the article along with a few films that have received the NC17 rating.

"This Film is Not Yet Rated makes a compelling case for MPAA ratings system as a form of institutionalized, homophobic puritanism."

"Boys Don't Cry, a transgender teen who was raped and beaten to death; Gunner Palace, a documentary about life in the US military in Baghdad; A Dirty Shame, a gross-out sex-comedy from John Waters, one of my favorite filmmakers; and But I'm a Cheerleader, a lighthearted comedy about a sexually curious teenaged girl sent to an anti-gay rehabilitation camp."

I've seen all of these except "A Dirty Shame" and I highly recommend them--well, I don't really recommend "A Dirty Shame" because John Waters films really do tend to gross me out.

And this is my own recommendation not the presenters.
Shortbus. If I'm going to be recommending movies about sex I have to throw "Shortbus" in here because Gillette recently reviewed it, which encouraged me to watch it again and it is great. Here's a quote from the official site which I've linked to:

"John Cameron Mitchell's SHORTBUS explores the lives of several emotionally challenged characters as they navigate the comic and tragic intersections between love and sex in and around a modern-day underground salon. A sex therapist who has never had an orgasm, a dominatrix who is unable to connect, a gay couple who are deciding whether to open up their relationship, and the people who weave in and out of their lives, all converge on a weekly gathering called Shortbus: a mad nexus of art, music, politics and polysexual carnality. Set in a post-9-11, Bush-exhausted New York City, suggesting new ways to reconcile questions of the mind, pleasures of the flesh and imperatives of the heart."

One more little tidbit about an interesting thing I learned at this workshop: the term "Rapid Ejaculation" which I really appreciate over the term "Premature Ejaculation." It's somehow gentler and seems more descriptive and less of a judgment label than what "premature" implies.