ENQUIRY
PARTNERS OF SEX ADDICTS I

PARTNERS OF SEX ADDICTS I

My partner says his sexual behavior is normal – but he is hiding it and I know something is wrong. Am I crazy? What are the signs of compulsive sexual behavior disorder?

Partners of people with sexual compulsivity often come to the clinic in great distress.

They have just learned about the latest infidelity, daily Internet porn use, visits to Orchard Towers, massage parlors or KTV lounges. The images accidently left on the family computer may be shocking or alarming.   

Perhaps they have discovered condoms in the person’s luggage after a business trip, unexplained expenses on their credit cards, and unexplained absences from their hotel rooms late at night when they tried to call the person. Childrens’ birthdays, graduations and family celebrations may be mysteriously abandoned for “essential” business trips.

Partners may notice strange messages or nude photos on the mobiles; or perhaps odd phone calls at night, that seem to make the person excited or embarrassed. They may come home intoxicated at 3:00 am, after a night out with colleagues, with unexplained credit cards slips in their pockets for hundreds or thousands of dollars. They may find an STI clinic report.   

The person acting out will likely try to vigorously “manage” all this fallout with their partners.  

They may rationalize, minimize, intellectualize, normalize – or simply lie, to explain away all this overwhelming cumulative evidence. They may “gaslight” their partner, making them think they are crazy.

And it may work…for a time.

Meanwhile partners may feel: shocked; rejected; confused; angry, even rageful; anxious; and depressed. They may even blame themselves and feel inadequate as a partner and  ashamed.

They may: become irritable, angry or overly anxious with their children; stop doing things they enjoyed, stop seeing people; forego self-care and grooming; or try to become overly sexual and breach their own boundaries to save the relationship.

They may become sleepless, without appetite and lose weight – or over eat and gain weight; and they may use medication and alcohol to numb their emotional pain. They may keep getting flus and colds that refuse to go away; or chronic backaches and neck aches that make sleep or activities painful.

The shame may be crushing.

Some partners may have experienced earlier traumas in their own childhood or adulthood, in which emotional and sexual or other physical abuse, neglect and rejection were prevalent.  The acting out person’s behavior may therefore trigger strong trauma reactions, and lead to bonded relationship traumas, resulting in self-harm or even attempted suicide.

How can a partner respond when they get a feeling something is not quite right?

If they can persuade the person acting out to undertake a clinical assessment, the person will be able to understand that their behavior has become a serious self-destructive compulsion, and that they need treatment.

Even if the person won’t attend therapy, the partner can take an assessment of the extent of their trauma, and the role of the person acting out. The partner can then receive treatment, and explore the options for the family. Do they stay or go?

Promises Healthcare Pte Ltd. provides therapy for both those with compulsive sexual behavior and their partners, so that together they can find a way out of their suffering and plan a better future for their families.  

PARTNERS OF SEX ADDICTS II

PARTNERS OF SEX ADDICTS II

“My partner’s sexual behaviour has left me devastated – should I stay or should I go?”

Many clients come to therapy wondering whether they should leave or stay, after they have discovered their partner’s infidelity, or other compulsive sexual behavior. This may include a combination of: serial affairs at work; Internet pornography; sexual massages; use of sex workers; and use of anonymous dating Apps. Excessive alcohol, drugs and workaholism may also be involved.  

Even though the behavior is intolerable or very risky, and causing great suffering – there may often seem compelling reasons to stay.

Young children may be involved. If the acting out partner has been a “good enough” parent, the children will suffer greatly if they leave. Further, the burden of parenting the children alone may seem too much.

The client may worry about the family finances – that they may not be able to support themselves and their children if the partner withholds money or does not agree to split the money appropriately.

The client may have to return to their country of origin and may not be able to bring the children with them, if their partner contests this.

Leaving may cause the client great shame, particularly with their family, friends and work colleagues.

The client may fear loneliness; or may ardently fantasize that things will get back to the way they were – eventually. After all, the couple may have a long, shared history, and may have weathered many other difficulties together.

Starting with a new relationship in future may be as daunting as living alone forever.

Some clients may be so angry and resentful, that leaving may seem like the partner getting away it. Leaving may appear like giving the partner a license to continue their intolerable behavior – unchecked and unavenged. It may result in the partners frittering the family money away.

Friends and family may be unhelpful – full of directive and conflicting advice.  Clients may be ashamed, or too anxious of the reaction they will receive to even share about their suffering.

However, some clients are unaware that there may be a solution.

If the partner is assessed for a compulsive sexual behavior disorder and subsequently undertakes recovery; and the client works in therapy on taking care of themselves; learning and growing from the experience; and improving their relationship – there may still be hope in keeping the family together.

Ultimately, both need to work on themselves and the relationship, if it is to be saved.

But the first step may just be reaching out to seek help.

Promises Healthcare Pte. Ltd. provides support for both the partner and the person suffering from compulsive sexual behavior and can help the couple to work on the solution.  

Employee Assistance Programme

There has been a growing awareness of the need for mental health wellness in corporate work settings. For one, employers are recognizing how work stress negatively impacts an individual’s job performance and productivity. According to a survey reported by Forbes, 31% of responding employees experience extremely high levels of stress at work, thereby affecting productivity and innovation. Thus, as reported by the Straits Times on 25 March 2019, companies have started to view wellness programmes not only as an employee benefit or responsibility, but also as performance strategy for the company.

In today’s world, such work stress seems inevitable due to competition, cost-cutting measures, and the intrusion of work into our personal lives through technology. Few cope well with sustaining these increasing demands and pressures in their work place. Thus, companies that are committed to safeguarding their employees’ mental wellbeing are empowering them with tools to manage their stress at work.

Such tools are available at Promises Healthcare through our Employee Assistance Programme (“EAP”). The EAP is premised on the belief that mental health has a direct correlation to the performance and productivity of the employee. Appropriate outlets for employees to address their psychological concerns can help alleviate stress, leading to a positive and more balanced mental disposition. This in turn will contribute more effectively towards the goals of the organization.

Promises has developed and provided EAP services for a number of major corporations over the years. EAP services include Employee Training Packages, Critical Incident Intervention, Critical Incident Consultancy for Senior Management, Media Information Management, Individual and Group Counselling, Confidential Helpline services, and Family Support programmes.

Our customer references include present and past clients, such as the Ministry of Health, SCORE, IMH, MSF, Singapore Prison Services, SAMH, Singapore Red Cross, NTU, NUS, Ngee Ann, Temasek Polytechnic, Singapore Polytechnic, La Selle School of Arts, Singapore Police Force etc.

Promises has also been actively providing EAP services to the Singapore Press Holdings, Exyte Singapore Pte. Ltd., Monetar Authority of Singapore, Connexion Asia, Carrot Consulting, Allianz Prudential, MSIG, ANZ bank, IMDA, AVA Singapore, Defence Science and Technology etc.

CAN SEXUAL BEHAVIOUR ALSO BE COMPULSIVE?

CAN SEXUAL BEHAVIOUR ALSO BE COMPULSIVE?

There is a proposed new law on exploitative sexual relationships – but can sexual behaviour also be compulsive?

The proposed new law in Singapore that will make sexually exploitative relationships a new offence, is controversial because it results in prison and corporal punishment. 

https://www.singaporelawwatch.sg/Results/what-constitutes-an-exploitative-sexual-relationship-proposed-law-on-new-sex-crimes-sparks-debate

Those suffering from compulsive sexual behaviour are urged to seek treatment before they become embroiled in criminal prosecution. 

The World Health Organisation has included compulsive sexual behaviour as a mental disorder in the recently published International Classification of Diseases, Edition 11. 

Do you have a persistent pattern, over 6 months or more, of being powerless over controlling intense, repetitive sexual impulses and urges, which result in repetitive sexual behaviour? Has this behaviour made your life, and the lives of loved ones, unmanageable? 

As with other addictions, the disorder results in neglecting health and personal care, family, work and other responsibilities. 

Typically, those with this compulsive  behaviour have made numerous unsuccessful efforts to significantly reduce it – but it continues, despite severely adverse consequences. 

Clinicians qualified in sex addiction treatment use validated and reliable questionnaires and detailed clinical histories to assess clients, in order to determine whether they have a sexual behaviour disorder. These clinical tools have high sensitivity in detecting the disorder. 

There are also clear therapeutic protocols to assist a client into and through recovery, substantially reducing the risk of reoffending behaviour. 

Contact Andrew da Roza, an addictions Psychotherapist, at Promises Healthcare Pte. Ltd.

Email: Clinic@promises.com.sg Tel: +65 6397 7309

DO I HAVE A SEX ADDICTION?  IS MY PARTNER A SEX ADDICT?

DO I HAVE A SEX ADDICTION? IS MY PARTNER A SEX ADDICT?

IS THERE REALLY SUCH A THING AS “SEX ADDICTION”?    DO I HAVE A SEX ADDICTION?    IS MY PARTNER A SEX ADDICT? 


These questions become urgent when your or your loved ones’ repeated sexual behaviour cause you acute distress. 


It may be that you feel empty, frustrated, anxious, depressed or ashamed by your behaviour.  Or you may be a loved one who suddenly discovers their partner is sexually acting out, and you feel betrayed, angry, raging, resentful, humiliated, confused or depressed; and have nagging doubts about your own adequacy as a partner. You may be worried for your children and your family life. Your health – or your finances – may be in serious jeopardy.   


Not all sexual behaviour that causes you or a loved one suffering is a sex addiction – even if the suffering is profound and long lasting, or the behaviour is considered by others “deviant” or even “risky”. 
However, if it amounts to an sex addiction, there is a solution in recovery, and a loved one can play an important role. 


It is therefore important to know – is it an addiction?   
Once sexual behaviour is persistent, it sometimes becomes impossible for a person to know whether their behaviour has become compulsive, obsessive, impulsive or even dangerous or intrusive. 
People can become confused.

“There is a way through – and that is to take a clinical assessment and discuss the results with a professional therapist, trained in interpreting them. “


Is the behaviour continuing because they consciously choose not to change? Is it just “normal”, “natural”, “justifiable”, or “cultural”? Is it the loved ones or others who are mainly at fault, because they can’t or won’t give the sexual intimacy needed? Is it just “temporary” or “a one off”.

Is it just a product of some unusual circumstances – such as being in a new country, starting a new job, having a baby, going on business trips, or feeling bored, stressed, anxious, lonely, isolated, neglected, or depressed?     

If the behaviour has been persistent for a period of time, a person may think that it is safer than it really is, or that the risks of being found out, and the consequences, are minimal, manageable and within their control.

Sometimes a person my think that their chosen sexual partners are freely consenting, or that they enjoyed the experience – but  the truth is otherwise. 


Sometimes a person may lie, cover up, tell half truths and keep silent about their behaviour, because they want to protect their loved ones. They may not be willing to admit to themselves or others that they mainly wish to avoid the painful consequences of their behaviour.

After a while, they may even become confused or uncertain about what the real truth is. Being persistently deceitful and living a double life, can become a crushing burden.


There is a way through – and that is to take a clinical assessment and discuss the results with a professional therapist, trained in interpreting them.

There are a number of assessments available online. However, some are not thorough or confidential enough, or they cause unnecessary alarm. Many do not provide a clear interpretation; and some do not provide a path towards a workable therapeutic solution.


The International Institute for Trauma and Addiction Professionals (IITAP) provide Certified Sex Addiction Therapists (CSATs) with an anonymised, online questionnaire, called the “Sexual Dependency Inventory – 4.0”. 
It takes a client 2 hours or so to complete, and a confidential, detailed client report is automatically generated for the therapist to view online – and subsequently share it with the client. 


The report compares the client’s responses with the responses of many thousands of other respondents, both with and without sex addiction, to gauge whether the sexual behaviour and preoccupation are likely to indicate a sex addiction.  


The report provides the client and therapist with a thorough review of the client’s: sexual behaviour and preoccupations; the consequences; the possible origins of the behaviour; and the potential future course and direction of the behaviour. 


The report also helps the client articulate their motivation to change their behaviour.  


This report is coupled with a subsequent clinical interview session, that assesses: sexual, medical and psychiatric history; family of origin history; education and employment history; intimate and social relationships; and other information. Together, this information permits clients and the therapist to determine the next steps. 


If the client’s behaviour is likely to amount to an addiction, the recovery path has been clearly mapped by the IITAP programme; and CSATs are trained and skilled in helping client’s navigate through their recovery using workbooks, videos, books, articles, and other therapeutic interventions.


The recovery path engenders great hope for those who start on it. Life gets better quickly, and keeps getting better with each recovery step that is conscientiously taken. 


What causes the greatest suffering is not knowing. Am I a sex addict? Is my partner a sex addict? 

To take a free clinical assessment: contact our therapist Andrew da Roza by calling +65 63977309

Intrinsic motivation as a source of vitality?

Intrinsic motivation as a source of vitality?

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“Vitality management is provided for organizations that have a vision”. A quote from Pauline van Dorssen coach of “Vital people in a vital organization”. This is a new successful training (NIP). Positive psychology and the use of vitality are central. The interest of both Occupational and Organizational Psychologists and Occupational Health Psychologists is high: all groups are full. In addition, the same question arises from organizations. They need advice and coaching in the field of vitality.

To know more, here is the original article in dutch language: Artikel_De Psycholoog_lisa van der Heijden

Written by Lisa van der Heijden, Clinical Psychologist.

If you are interested to know and learn more therapy for children/adolescents, contact me at Promises Healthcare on +65 6397 7309 or email lisa@promises.com.sg.

Care Community Fun Fair : 5 August 2017

Care Community Fun Fair : 5 August 2017

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HMI Institute of Health Sciences in support of the FestivalForGood (organised by raiSE) invites you to join us for hands-on experiences on caregiving through training simulations and fun activities. Some takeaway knowledge include:

  • Knowing how to create a safe home environment for your aged parents/grandparents
  • Safe feeding skills for Caregivers
  • Understanding Caregivers’ stress & preventing/relieving these stresses
  • Understanding how your aged parents/grandparents feel
  • Recognising illnesses & emergencies
  • Simple skills on CPR

-and many more!

Our Career Coaches will also be around to assist you with information on our training programmes and career services.

Event Details

  • Date & Day: 05 August 2017 (Saturday)
  • 3 Sessions: 9:00am · 11:00am · 1:00pm
  • Venue:
    HMI Institute of Health Sciences @
    Devan Nair Institute for Employment and Employability, 
    80 Jurong East Street 21, #06-03, Singapore 609607

To know more information about this event, you can click here: link:http://hmi-ihs.com/index.php/care-community-fun-fair-05-aug-2017

The Relationship Between Media Multitasking and Executive Function in Early Adolescents

The Relationship Between Media Multitasking and Executive Function in Early Adolescents

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The increasing prevalence of media multitasking among adolescents is concerning because it may be negatively related to goal-directed behavior. This study investigated the relationship between media multitasking and executive function in 523 early adolescents (aged 11-15; 48% girls).

The three central components of executive functions (i.e., working memory, shifting, and inhibition) were measured using self-reports and standardized performance-based tasks (Digit Span, Eriksen Flankers task, Dots–Triangles task). Findings show that adolescents who media multitask more frequently reported having more problems in the three domains of executive function in their everyday lives.

Media multitasking was not related to the performance on the Digit Span and Dots–Triangles task. Adolescents who media multitasked more frequently tended to be better in ignoring irrelevant distractions in the Eriksen Flankers task. Overall, results suggest that media multitasking is negatively related to executive function in everyday life.

To read the full article: http://jea.sagepub.com/content/early/2014/02/17/0272431614523133.abstract

Written by Lisa van der Heijden, Clinical Psychologist, Susanne E. Baumgartner and Wouter D. Weeda.

If you are interested to know and learn more therapy for children/adolescents, contact me at Promises Healthcare on +65 6397 7309 or email lisa@promises.com.sg.

NeuroStar TMS Therapy®

NeuroStar TMS Therapy®

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How Does NeuroStar TMS Therapy® Work?

Transcranial magnetic stimulation (TMS) uses a targeted pulsed magnetic field, similar to what is used in an MRI (magnetic resonance imaging) machine. While the patient is awake and alert, NeuroStar TMS Therapy stimulates areas of the brain that are underactive in depression.2

NeuroStar TMS Therapy is an in-office treatment that takes 37 minutes, is performed while the patient sits in a chair, and is administered five days a week, for up to four to six weeks.

Simple steps for NeuroStar TMS Therapy:

  • Step One: The patient reclines comfortably in the treatment chair, awake and alert
  • Step Two: A small curved device containing the magnetic coil rests lightly on the patient’s head
  • Step Three: The device delivers focused magnetic stimulation directly to the target areas of the brain
  • Step Four: The patient can immediately resume normal activities

During treatment, the patient hears a clicking sound and feels a tapping sensation on the head. The most common side effect is generally mild-to-moderate pain or discomfort at or near the treatment area during the session. When this occurs it is temporary, and typically occurs only during the first week of treatment.

There are no effects on alertness or understanding; patients being treated with NeuroStar TMS Therapy can drive themselves to and from their treatment sessions. Above information is taken from: https://neurostar.com/neurostar-tms-depression-treatment/

A Play in Psychodrama

A Play in Psychodrama

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As I mentioned in my first article, the phrase,”reverse roles” was very much what I heard at my first psychodrama workshop. As this was uttered by the group leader, two people on the stage switched places and began playing the opposite role. 

 “This is it! “, I thought as I began to think of how I could use it in my work. Get people to reverse roles and voila! Well I was sorely mistaken those many years ago. As I began to explore this fascinating form of group work I discovered several techniques that are used in Psychodrama. Here are two key techniques used and an example of how I used them. 

Role reversal

Here the Protagonist says a few words in the role of a particular ‘character’ or entity in their drama. The Auxiliary then says these lines to the Protagonist who is in the complimentary role. 

Concretization

In this technique, objects and people are used to represent the scenario the Protagonist wishes to explore.

A Drama using Role reversal and Concretization

Ken is aged 19, and has a serious problem with drugs and alcohol which he has managed to stop after going to the alcohol treatment centre. He had just come out of Rehab in the United Kingdom and was brought to my practice by his concerned father. His father has tried very hard to help him over the years and has now brought Ken to us at Promises. Ken is worried about going out for dinner with his Father and a family Friend, whom we shall call Andy, because he might be tempted to drink again.

I encourage him to enact a scene at dinner with his father and Andy, playing out what he expects to happen. He sets out the chairs and chooses two people in the group to be his Father and Andy. As he greets the two older men rather lethargically, his shoulders slouch and he speaks in a flat voice.

Reversing roles, Ken now plays the part of Andy. He perks up now, smiling and full of energy. ‘Andy’ says, “The last time I saw you Ken, you were a small boy. My how you’ve grown!” Playing the role of his tempter, he urges Ken to “have a drink now as a real man” holding a glass towards him.

Back to being himself after another role reversal Ken’s face reddens and he clenches his fists in agitation.  He speaks to me as the Director, saying that he is afraid he might have a relapse. I immediately ask him to take on the role of his father.

As his father, he sits with his arms crossed and says through clenched teeth, “It’s Ok, you don’t have to drink. I don’t want to cause a relapse.” As himself, Ken is at a loss for words. I ask the other audience members to do some modeling and try different responses in the role of Ken as he watches.

Ken cheers up as he sees the other group members rising to the occasion. Everyone is animated as they get a chance to act the part and try to tell Andy off. There is much laughter and hilarity as people do and say whatever they think might work. A sort of role training session is underway.

Ken is noticeably inspired by the group and he chooses one response. He stands tall with a cheeky smile and says to Andy, “I’m not drinking today, and I wonder why you are so determined to force alcohol on me!”  In role reversal as Andy, he changes the subject and backs down, no longer the magnanimous host. The drama ends. Ken is no longer a deflated doomsday worry wart. Instead he is positive about going out for dinner and knows what he can do later that night at dinner. The group has come to his aid and I once again marvel at the magic of Psychodrama.

In future articles, I shall illustrate more psychodrama techniques with dramas I have directed. It continues to be a privilege to be allowed into the lives of group members and I am continually amazed at the transformations that happen.

Written by Sharmini Winslow, Therapist.

At Promises Healthcare, we are committed to helping you through your journey to recovery. Discover a new life and find renewed hope. If you or someone you know needs mental health support, please contact our clinic on: +65 6397 7309 or email: clinic@promises.com.sg for inquiries and consultations.