Porn Addiction Help NYC

Porn Addiction in NYC: How to Get Help

Does everyone look at pornography on-line. No, not everyone, but the majority of men admit to it, and a lot of women admit to it as well.

Based on the surveys, as many as 3.5 million New York City residents look at porn on-line and close to 700,000 people in Manhattan alone. Now not everyone that looks at porn regularly has a problem.

But, if you find yourself spending hours, and find it difficult to stop, you are not alone. Based on one study, it is likely that there are more than one million people in NYC that meet the criteria for problematic sexual compulsivity and watch porn on-line regularly.

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Diagnosing Porn Addiction

While you may not know what to call it, “Porn Addiction,” “Porn Compulsivity,” “an impulse control disorder,” “OCD attached to porn,” or something else, you know what it looks and feels like.

• Do you find yourself watching porn and trying to set a time limit that you push past?

• Or say “Only one more site,” and then end up going to another porn site, and another?

• Do you lose hours to on-line pornography that you wish you could get back?

• Do you feel empty?

• Do you feel guilt? Shame? Embarrassment?

• Has it made sex and intimacy less satisfying in the real world, less appealing?

• Have you had any difficulty performing sexually or getting as aroused?

• Are you afraid your partner may find out and judge, or even reject, or break it off with you, if what you’ve been watching was revealed?

• Have you put yourself at risk at work by viewing things on work computers or devices, or by not getting enough sleep, or getting your work done because of hours viewing pornography on-line?

While there is not yet an agreed upon label, i.e., porn addiction, or compulsive porn viewing, it is clear that it is difficult to stop, takes up many hours per week of time, and there is a lot of emotional suffering that goes along with it. There are certainly intense positive feelings at times, but there can also be plenty of lows, accompanied by guilt, shame, and embarrassment, and even self anger afterwards. You may even feel hopeless, since quitting has seemed so impossible.

Is Porn Addiction Bad for You?

For some New Yorkers, viewing porn may not have a negative impact on their relationships, sexual performance, emotional or psychological life, or career.

There are many people addicted to viewing porn on-line who may be wrecking their lives in various ways. Take the case of Greg. Greg’s use of porn started at home on his computer. While he manages to find a way to do it privately, his wife certainly has been impacted since he seems exhausted, distracted, and a lot less interested in initiating sex with her. He tells her he is doing work late on the computer, but something seems to be different to her. Lately he has been starting to use his phone to see porn as well. And he’s even slipped and used his work computer as well—that really scared him. Controlling this habit feels impossible. Now he’s worried he could get into trouble at work, not for being behind because he isn’t as productive since he’s missing sleep, but because he’s visited those sites on a work computer, while he’s on the clock. This is all feels out of control, scares him, and is making him feel anxious, embarrassed, ashamed, and angry at himself. All of these emotions can be overwhelming.

For many, the suffering can be intense, the time lost can be long, and the potential risks and costs to one’s family and career can be incredibly high. Whether or not there is scientific consensus on generalizing about pornography being good or bad, I think the most important question for you is, “Does the way you view pornography increase or decrease your quality of life?”

If your answer is that it decreases it, then who cares what the scientific community thinks the impact is overall on the population, and who cares if the psychiatric community hasn’t decided what to call it? You have something that is causing you to suffer and that is stealing satisfaction from your life. And, if you are like most people with this issue, it has been incredibly hard to get control of it on your own.

Porn Addiction Treatment in New York City

Treatment for porn addiction does exist. There have not been many controlled trials. On-line pornography hasn’t been around as long as alcohol or many drugs, so coupled with the lack of a diagnosis, many studies have not been done yet. But, on-line porn is more accessible than illicit drugs, and even easier to get than a beer—anyone with a smart phone can pull it up 24 hours a day, no matter where you are, you can get it, no dealer other than AT&T or Sprint needed.

Fortunately, there is hope. Specific techniques in Cognitive Behavior Therapy (CBT) can work to help you suffer less. You can learn how to decrease the number of hours you spend watching porn on-line, decrease your guilt, shame, embarrassment, frustration, depression, and helplessness. Reduce the risks that you may get into trouble at work, a fight with your partner, and increase your satisfaction and performance in your sex life.

If you have questions about treatment for porn or sex addiction, or want to schedule an appointment, please call my office.

While we may not know what to call it, we know it hurts, and we know there is help.

PTSD Veteran

PTSD and Veterans

Veterans risk their physical safety, and that is only the beginning. Many veterans exposed to combat suffer with behavioral health issues as a result of their service. The suffering can be intense. Posttraumatic Stress Disorder (PTSD) may impact as many as 20% of Iraqi war veterans. While it may not seem possible, there is help. PTSD is one of the most intense and debilitating issues one can have, but there is very effective treatment that works very quickly and the results last.
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Anger Management

Top 3 Causes of Anger

I am Ryan Fuller. I am a clinical psychologist. I have done anger research and I treat a lot of angry clients in New York City. I’ll talk to you a little bit about the top causes of anger. So oftentimes when we’re talking about the causes of anger, we refer to them as anger triggers. And frequently, triggers are the external events, usually other people that, in fact, precede an anger episode.
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Anger Management

Anger Expression Styles

So there are a number of different anger theorists who have talked about different kinds of anger styles. But the one I’ll mention breaks anger styles into three forms of expression. So there is “anger out”; and “anger out” typically looks like the kinds of behavior we see with someone that we consider to have a temper. So they become very angry and then they are going to be doing things like yelling, they may be using profanity, they may smash cell phones or pound their fist on a desk, or something along those lines, destroy property.
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Anger Management

What is anger?

What is anger?

Anger is a negative feeling and when it comes in frequencies and intensities and durations that are in the normal range, it can be quite healthy. Unfortunately, when it becomes really intense or really frequent and it is paired with behaviors that are problematic that are aggressive or uncooperative, it can cause big problems and people can run into anger management issues.
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REBT: The Elegant Solution

Cognitive Behavior Therapy: REBT, The Elegant Solution

Cognitive Behavioral Therapy (CBT) is a term bandied around a lot in news stories or any conversation about therapy. There is a lot of scientific support for its efficacy in treating issues such as Obsessive Compulsive Disorder (OCD), Post-traumatic Stress Disorder (PTSD), unipolar depression, anger, and bulimia. But there is still not perfect consensus among researchers, theorists, and clinicians about what exactly CBT is and what it isn’t. While some disagreements are about whether or not cognitive changes or learning principles (behavioral) are responsible for someone with depression feeling less depressed, some of the confusion is simply due to the variety of cognitive behavioral treatments.
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Anger Management and Aggression

Cold Anger

Anger and Aggression in the Harsh Winter

Anger management is important year round. I haven’t seen evidence that there has been more aggression or anger outbursts this year because of a harsh winter. But there are good reasons to suspect that could be the case as our nerves become frayed.

Hot temperatures are frequently thought of as putting us at risk for violence. But there is a great deal of scientific evidence that any environmental factor that makes us uncomfortable can lead to aggression. Certainly bitter cold temperatures can do just that.

Anger is often thought to precede aggression, and many times it does. But most of us do not realize that other emotions put us at risk for aggression too. There is ample scientific evidence that any negative emotion, e.g., anxiety, guilt, loneliness, etc. make the likelihood of aggression more likely. So a difficult winter that may lead to less social contact or make us more nervous because of driving conditions could certainly put us at risk for becoming aggressive.

Another predictor of aggression is frustration. In the social science literature frustration occurs when a goal is being blocked or a desired outcome is prevented from occurring. Big snowfalls can lead to just that. People are stuck in their homes or can’t get their cars out their driveways and are prevented from completing all kinds of goals. And it is easy to see how those situations can also lead to more and more negative emotions, putting us at greater risk of becoming aggressive.

Rational Emotive Behavior Therapy

REBT-Rational Emotive Behavior Therapy

Rational-Emotive Behavior Therapy (REBT) was developed by Albert Ellis. Dr. Ellis  who was originally trained in psychoanalysis. After completing his doctoral work he began treating patients in New York City. He became frustrated by the limited progress his psychotherapy patients were making in psychoanalysis.

He then decided to turn to one of his earliest interests, philosophy. He went back and read Stoic philosophy as well as eastern philosophy. He based a new system of psychotherapy on much of this work. The hypothesis that made the most sense to him was that our emotional pain is not the product exclusively of the situation, but also our thinking about the situation, ourselves, life, and the future.

From this view of human emotion, he developed the ABC model, which is used by many Cognitive Behavior Therapists (CBT) today. In REBT, “A” stands for activating events. These are the situations, real or imagined, that trigger, or activate, our beliefs. “Bs” are these beliefs, which can be rational (or helpful) or irrational (unhelpful). Over the years the kinds and number of irrational beliefs he identified changed. The most refined version of REBT beliefs includes four core irrational beliefs and four alternative rational beliefs.

Irrational Beliefs

Demandingness (DEM)
Low frustration Tolerance (LFT)
Awfulizing (AWF)
Global Evaluations (Self-downing; SD)

Rational Beliefs

High Frustration Tolerance (HFT)
Badness rating
Unconditional Self-acceptance (USA) or Unconditional Other/Life Acceptance

REBT posits that the combination of activating events (As) and beliefs (Bs) produce consequences or the “Cs.” The situation (A) is interpreted and evaluated (B), which results in an emotional consequence (C). For example, if a student receives a failing grade on her exam (A), and she believes this proves it, “I’m a failure (B).” She might then feel depressed  (or depressed and anxious) (C). That particular consequence is an emotional consequence (Ce). When feeling that way, certain behaviors become more likely than others. When we are depressed, staying in bed may become more likely than going to the gym. These are behavioral consequences (Cb).

REBT therapists target behavior change largely by identifying the events, irrational beliefs, and then emotions that precede the behavior they want to change. The most common intervention is to dispute (D) the irrational beliefs, i.e., asking challenging questions to reduce the strength of the irrational belief. Then once the client no longer believes the irrational beliefs as strongly, an alternative rational belief can be selected to rehearse (E; effective new philosophy).

In this case, an REBT therapist may help the client, through disputation, to recognize that even though she may have failed one exam, it does not logically follow that she becomes a failure. It may take a great deal of effort on the part of the therapist and even more on the part of the client to get there. The hope is, she will eventually let go of the belief that she is a failure, and can rehearse and practice behaviors to support the rational alternative. The rational alternative to the global evaluation/self-downing (“I”m a failure”) belief would be unconditional self-acceptance (USA). If she can accept herself unconditionally, regardless of what grades she receives, she can be more emotionally stable. Without the thinking that “I’m a failure” could be looming, the client can become less anxious she will become depressed again. Now if she fails at something, she can practice unconditional self-acceptance, and tell herself, “even though I fail at things, I do not become a failure– I do not become what I do.” This new attitude can inoculate her against self-defeating thoughts that “dog” her. And this new accepting attitude can reduce or prevent feelings of depression or anxiety that she may become depressed again. Without the anxiety she may be able to concentrate more when studying, hopefully decreasing the possibility of failing future exams.

REBT therefore aims to change beliefs in order to reduce not only future negative emotions, thereby making adaptive behaviors, e.g., effective studying, more likely, but also intends to reduce failures. Since intense negative emotions often lead to poor judgement, impulsive actions, or unhealthy coping, e.g., procrastination, drinking, overeating, etc… REBT aims to improve behaviors and life circumstances over time, by first changing thinking and feelings. So while it is a cognitive model of psychotherapy, it by no means ignores improving behaviors and life circumstances. REBT simply believes the closest target to emotion is cognition, and changing that link alters for the better the entire chain reaction, resulting in better behaviors and eventually improved life circumstances.

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[fontawesome icon=”fa-file-text-o” circle=”no” size=”medium” iconcolor=”#000000″ ] REBT Self-help Form – CBT Worksheet

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REBT References

A synopsis of rational-emotive behavior therapy (REBT); Fundamental and applied research. David, Daniel; Szentagotai, Aurora; Eva, Kallay; Macavei, Bianca
Journal of Rational-Emotive & Cognitive-Behavior Therapy, Vol 23(3), 2005, 175-221.

Casual Sex

Casual Sex’s Surprising Science

Science of Sex

Casual sex has been on the rise for decades. This has been concerning for many reasons.

But, did you know that 75% of casual sexual encounters may lead to a relationship?

Did you know that 45% of men hoped their last casual sex partner had turned into a steady relationship?

Or what about for those suffering from depression, casual sex may improve their mood (although for those with a healthy social life, they may feel worse)?

Ok- these are the positives, and there are clearly some negatives. Regret and shame are two emotional possibilities, and unwanted pregnancies, and sexually transmitted diseases are also serious risks.

But, this article by Pere Estupinyà sheds light on a side of casual sex that may have been overlooked. This is by no means an endorsement, only an example of how science can uncover aspects of a behavior we may not have previously understood.

In this case, more casual sex may not be a good thing. But it does seem evident the studies (and interview) he references indicate a few things in need of further investigation.

To start, it does sound as though many people are looking for steady relationships, even though they may engage in a “casual” encounter without that in mind.

Is this the healthiest and most effective strategy for initiating a long-term relationship? I believe most of us would assume the answer is no, but it is an empirical question. Perhaps it saves time.

Or perhaps there is a breakdown in our current socialization for us to understand what we really desire, e.g., a long-term relationship, and/or we don’t know how to communicate about that, so instead we end up in casual encounters. Perhaps developing greater self-awareness and effective communication skills could reduce casual encounters, while increasing the number of healthy long-term relationships if that is the goal.

In any event, we have a lot to learn (and I hope we do it quickly) about how changes in the media are impacting our sexual and relationship behaviors.