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My partner may be a Porn Addict – What should I do?

My partner may be a Porn Addict – What should I do?

Written by: Andrew da Roza, Addictions Therapist, Sex Addiction Specialist

With the introduction of the fast speed Internet, a new addiction was born – Internet porn addiction. 

One client who has fallen down the “Rabbit Hole” of porn addiction reports: 

“I saw porn in Manga mags and comics when I was in my early teens and occasionally saw a porn mag. 

It wasn’t until the fast speed Internet came in and I could stream videos on my mobile phone and iPad, that I started to watch it regularly. After a year or so, I started to watch it every day at home, when I was alone. 

Later on, I started watching it in the bathroom of the office; then at my desk, and finally, in public places and on public transport – I am amazed I wasn’t caught by someone!”

Some clients come to therapy to kick the porn habit because they recognize that they have a problem. They have been “caught” multiple times by their partner – always promising to stop. 

Or they may have inadvertently left sites open on the family computer. Some even get called in by HR at work and asked to explain the hundreds of times they have logged into porn sites, which the IT department has uncovered.   

Others don’t see they have a problem – even when their experiencing porn-related erectile dysfunction, anejaculation, or loss of libido and intimacy with their partners and spouses. 

They may simply consider this distressing, though natural, change in their relationship – a product of familiarity and boredom.  

As it turns out – they may be quite wrong – because there is nothing “natural” about porn. It’s toxic and it can effectively hijack intimate relationships, which could otherwise have been healthy and fulfilling.

Clients with porn use compulsivity often say:

“I wouldn’t have come to therapy unless my partner had given me an ultimatum – “get help or we break up!”.

And it’s also common to hear: 

“At first I thought I would just see a therapist once or twice to appease her, and let her know I want us to stay together”. 

However, after discussing in therapy how long a client has been using porn, how frequently they were using it, where they were using it – and the type of porn they have digressed to watching – they often realize all the risks they are taking with their relationships, marriage, families, and their jobs or their studies.

One client reports:
“the therapists gave me a detailed questionnaire. I was staggered by the report that came out. Seeing my behaviour over the last few years, what motivated me to do it, and how it changed me and my relationships, I became really worried.”

“I hadn’t realized that because of porn, I was losing interest in sex with her, I wasn’t present for my family, and I was getting irritated, restless and discontent at home and at work.

I thought that my problem with my sex drive and erections was our relationship – not the porn.”

These revelations, and many more, may be tough for a person with porn compulsion but at least they may be motived to take recovery actions. 

But what about the partner or spouse? They may be feeling frustrated, angry, fearful and ashamed. They may be devastated. 

They may be confused when friends, relatives and the community at large believe that porn is the “new norm” and that “boys will be boys”. 

What can they do? 

While relationships are all as different and unique as the people in them, there may be some common actions that spouses and partners may wish to consider. 

These include:

  • Attend therapy with the person who has porn use compulsivity – and learn about Internet porn addiction. How it arises; what it looks like; is the behaviour compulsive – or is it a moral issue, a lack of discipline, selfishness – or have they just stopped loving or desiring me?
    In a couples’ session, you can also learn what the recovery actions are, what it takes to succeed in recovery, and how you will know that he is in recovery – and will he ever do it again?

 

  • Read about porn addiction and how porn changes the brain. There are many good websites with excellent information. Fight the “New Drug”, “NoFap”, and “Your Brain on Porn” are but a few sites with good articles and videos. Robert Weiss, Paula Hall and Stephanie Carnes also have helpful YouTube videos.   

 

  • Insist that your partner initiates a regularly weekly couples’ check-in session; in which he shares: what actions he taken in his recovery that week and what he has learned; what actions he hasn’t done and why; what he will do next week; and what help he needs from you – and you always have the right to say “no”, or “yes, but…”. 

 

  • Judge his recovery only by his actions – not by his promises, intentions, desires or apologies. What he says is important – but what he actually does, is definitive.    

 

  • Create physical, emotional, spiritual and sexual boundaries with him – and have consequences that you apply – without fail – whenever those boundaries are breached. 

   

  • Stay connected with others about how you are doing and don’t isolate – but be cautious who you tell about his porn compulsion; only choose a few trustworthy friends or relations. Do not talk to everyone, including your children, when you are angry, in a rage, frustrated – or to retaliate – you are very likely to regret it later.

    If you think an age-appropriate disclosure is beneficial for the children, work on a script together; and allow the person with the porn compulsion to deliver it. It is their responsibility to hold themselves accountable for their actions.

 

  • Take really good care of yourself. Treat yourself kindly and compassionately.  Eat three healthy meals a day; sleep seven to eight hours; exercise regularly; take up yoga, Tai Chi and meditation. There are a wealth of Apps and YouTube videos out there – Calm, HeadSpace and Insight Timer are popular meditation Apps. Spend time with friends and family; take up new interests and hobbies – seek to relax and allow joy into your life. 

 

  • Porn blocking software administration. If you are open to it, you may be asked to be the security administrator for the porn blocking software that will prevent porn from being seen on his devices and the family computer. Consider carefully whether this would cause you more distress – or whether you wish to support him by ensuring that the security blocking software is in place.  

 

  • Consider seeing your own therapist – sometimes porn and deceit can be felt as profoundly as a relationship betrayal. It takes time and help to get through the trauma.

    Some partners feel shame, and some question whether they are the cause of the porn compulsion. Some partners are confused and devastated by all the lies and deceit. They don’t know what is real anymore. Talking to a supportive therapist can help you through this.

 


Photo by Grzegorz Walczak on Unsplash

Addictions in the Digital Age: Technology – The Accelerator of both the Problem and the Solution

Addictions in the Digital Age: Technology – The Accelerator of both the Problem and the Solution

Written by: Andrew da Roza, Addictions Therapist, Sex Addiction Specialist

Ever since people first crushed and fermented grapes, the dark hand of alcoholism has been present. When the first games of chance and competition were born – so too was the addiction to gambling.  

We can well imagine that abusing cannabis came, even as it was used for medicinal and religious purposes in the 3rd millennium BC. 

And breathing in the toxic smoke from burning tobacco was a daily human habit, well before Christopher Columbus landed in the Americas in 1492 and brought it back to Europe. 

But now, in our digital age, technology has accelerated our addictions.

And the stress and isolation brought to us by COVID-19 have pushed many to addictions they never thought they had.  

Alcohol and cigarettes can be delivered to our doors from digital orders placed on mobile phones. The Dark Web and chemistry have conspired to create hazardous new psychoactive substances that pose as cannabis, available with a few keystrokes on a laptop. An Internet poker or roulette game can be found 24 hours a day, every day of the year. The Internet has sped us down the path of over-shopping, over-eating, and over-playing competitive games.

Ever adaptable and flexible, the Internet has even created new addictions – such as Internet pornography and anonymous sex “dating”. 

If we are unlucky enough to fall down these digital “rabbit holes”, what are the results? Alice’s Wonderland? Or: failing health and finances; anxiety; depression; isolation, fractious and failing relationships, lost schooling and jobs; self-harm; and suicidal thoughts. “Jails, institutions and death” – as Alcoholics Anonymous warn us. A life without meaning, purpose or dignity.

But just as addictions have been accelerated by technology and new ones invented, technology has also enabled us to make recovery more convenient, available, cheaper, effective, and timely. 

The longest journey for people suffering from addictions has been from the “bottle” to the therapy room. Any number of “barriers” stood in the way. Not enough time, not enough money, not enough knowledge of which therapist to see or what recovery involves. 

But the biggest barrier of all to entering recovery was shame.

Now, therapy can be done on the Internet: information about therapists can be Googled; prices compared; social service agencies offering low-cost therapy or even free therapy can be found, and rich information and video testimonies on the recovery journey can be reviewed.  

Best of all, Zoom therapy can be conducted with a therapist “once removed” from the personal space of the client by computer screens – and in the comfort of the client’s own living room or bedroom. Clients could even maintain much of their anonymity. In this safe space, shame may deign to take a back seat.

With digital recovery free from barriers, even if the sufferer is still reluctant to seek help, they may be more inclined to reflect on why they remain reluctant to get and receive help. If they do start to reflect honestly – they have started their first step on their recovery journey. 

But more can be done with digital recovery. 

I would submit that the next significant step in using the Internet to accelerate recovery is to bring the therapist to the clients where they are – on the sites that feed their addictions and perpetuate their suffering.

A therapist could join as a “player” in Animal Crossing, Fornite, a poker or roulette game. They can then engage suffering players in unthreatening and therapeutic conversations. Perhaps PornHub will produce an avatar “ambassador” – a therapist who guides users through a porn compulsiveness assessment? Perhaps the GrabEats avatar therapist will help customers with alcohol and calorie counts, consumption and portion control, alcohol use and dietary information – and motivational conversations to help customers build their resolve.     

Engaging suffering people in their digital space opens a whole new avenue for the helping professional to guide someone towards a path of meaning and purpose.

Therapists may wish to think “Digital” – and harness the power of technology to enrich people’s lives – even if technology can also impoverish them. 


Photo by Taras Shypka on Unsplash

Treat Smokers with Compassion – Why Quit Smoking is so tough

Treat Smokers with Compassion – Why Quit Smoking is so tough

Written by: Andrew da Roza, Addictions Therapist

To non-smokers and those who have an occasional cigarette at a party or outside a bar, it is baffling why smokers just can’t simply quit. What’s the big deal?

If you think this, then the conclusion may be: “well they just don’t want to quit”; or “they are uneducated, and don’t know how much damage they’re doing to themselves and those around them”; “they have no conscience” or “they have no self-control”. 

The problem with these conclusions is that the scientific evidence doesn’t support them. 

70% to 80% of smokers want to quit – and many of them desperately want to quit – and most smokers fail.  

A majority have tried to quit multiple times – and about 40% are still drawn to smoking -even after losing fingers and toes to gangrene, or lungs to cancer and COPD, as a result of smoking. Many suffer heart attacks, mouth, throat and colon cancer, or labour under serious diabetes problems; some even lose their close relationships with their families. 

They wish that if only they could quit, their lives would be so much better – yet they continue to smoke. 

So, there is more to the compulsion to smoking than meets the eye. 

Perhaps kindness and compassion for smokers may be a more rational reaction – than dismissal, frustration, irritation, anger or contempt?    

There are very good reasons why the chemicals in cigarette smoke are so compelling – and it’s to do with our brains and our bodies. It’s not a mystery.  

Although nicotine in the smoke is a comparatively benign substance, and it doesn’t cause the damaging effects of the other harmful substances in the smoke – it is highly addictive. It is the nicotine that causes the addiction – but it is the tar and other substances that cause the damage. 

In addition to nicotine, there is another substance, in smoke, that creates a potentially “pleasant” psychoactive effect.  It is a monoamine oxidase inhibitor – which results in chemicals in the brain staying longer in the space between neurons and firing those neurons.

And the effect the smoker feels? Well, there can be numerous combinations of “positive” effects. 

Those smokers who feel down, moody and unmotivated, may feel a pleasant “lift” or “boost”. Anxious, fearful and nervous smokers, may feel calmer, and more able to think straight. Smokers who are tired, sleepy or lethargic, may be able to focus, concentrate and pull themselves out of their procrastination.  

Smoking helps some people become more energetic, have better reactions times and become more effective or efficient. Smoking enables people who are mentally tired with work or constant rumination, to feel like they are taking a break and “relaxing” from their thoughts. They can just let their minds gently wonder. They may even feel that after their “reverie” with a cigarette, they have managed to solve a problem that they have been grappling with.

Some people use smoking as a bonding experience. Ironically, all the community stigma that surrounds smokers makes some feel like a “band of brothers and sisters”, as they stand outside in smoking areas or in smoking rooms. It enables instant connection and the sense of “belonging”.

In short, the effects of smoking depend on how you are feeling in the moment. 

Insidiously, mental illness and other addictions result in many becoming vulnerable to smoking – either to cope with: their illness; the difficult side effects of their medication; and the social stigma against mental illness addiction that so oppresses and shames them. 

By way of examples, ADHD, schizophrenia, bipolar disorder, anxiety and major depressive disorders, and personality disorders, can all result in life-long suffering – that smoking may appear to “take the edge off”.  

There is now persuasive research that some people are more genetically susceptible to being addicted to cigarette smoke. They may get more of a “buzz” from it, they may be more tolerant to its side effects, the effects may wear off faster, and they may feel the withdrawal effects (when not smoking) more keenly. They may have more trouble starting to quit – and staying quit. 

There are many other vulnerability factors as well: adverse childhood events (which afflicts 2 out of every 3 Singaporeans); traumas; family and peer modelling; rebelliousness, isolation and loneliness, financial distress, problems in relationships and at work; and many more factors, may all conspire to lead smokers to smoke daily. 

Once they smoke enough cigarettes for long enough – the brain changes, it becomes “hijacked” by the smoke.  

Smokers experience brain changes as: 

  • Tolerance – the need for more smoking, more often, to get the same effect;
  • Withdrawals – 45 minutes to two hours after smoking, they may feel the exact opposite of what they felt when they smoked – and therefore need a cigarette to feel “normal”;
  • Impulsiveness – in the moment (of smoking), they forget about the harms of tobacco and their resolves to quit, and habitually light up;
  • Smoking triggers – smoking cues are everywhere – and they trigger the urges and cravings – and once these build up, they become overwhelming;
  • Stress – their stress response slowly but inexorably ratchets upwards, daily – so that even things that used to be experienced as minor, now elicit strong and intolerable emotions. If health, relationships, jobs and self-image are all on the line because of smoking – the stress can be intense. 

Luckily – there is a solution. Smokers now have access to psychotherapy, nicotine replacement therapy, quit smoking medication, and any number of other tools to help them on their quit journey. In other countries, new nicotine delivery technologies like e-cigarettes and heat-not-burn are being improved and refined – and they are much safer than smoking. 

Smokers deserve our respect and compassion in their struggle with cigarettes. And they don’t have to do it alone. So that the help-seeking and quit smoking load can be lightened. 

You can also hear more from Andrew at the 7th Asia-Pacific Behavioural & Addictions Conference (APBAM2020: Forum 1 – “Tobacco Harm Reduction: Myths & Realities).

 


 

Confinement (Circuit Breaker) Emergence and Mental Health: Be Kind To Yourself

Confinement (Circuit Breaker) Emergence and Mental Health: Be Kind To Yourself

Written by: Andrew da Roza, Psychotherapist, Promises Healthcare

As the COVID-19 confinement continues, you may have a nagging question on your mind – “what have I managed to achieve”?

Tidy, clean desk draws, closets, and glove compartments; a surprising proficiency in a new language; the final 100 pages of War and Peace; an impressive yoga position; a dazzling new magic trick?

Several weeks into the confinement in Singapore and with several weeks to go before we can be physically social with our friends, some of us may be deflated. 

When the confinement/circuit breaker started, we may have vowed to use all the new free time to do things we have never got around to doing. 

Now that time is gradually slipping by – we may think that we still haven’t accomplished our goals.

As a psychotherapist, I listen to many people starting to stress that this opportunity of more time isn’t panning out the way they imagined – and that critical voice in their heads is telling them they are inadequate and unworthy.

Feeling Stuck in Shame 

What I hear is the frustration of “stuckness.”   

Clients tell me: –

  • I must be more productive 
  • I should have achieved more since confinement began
  • I should be able to concentrate more and procrastinate less
  • I must have more enthusiasm, motivation and energy

Note the use of the words “should” and “must”. Our inner critic loves to remind us of all the things we should have done or must do.  

It is important to be compassionate to ourselves and banish these words from our vocabulary – at least for the time being.

We may have overestimated what we could achieve in confinement; and underestimated the power of the inner critic, worry and low mood. These are preventing us from feeling satisfied with what is. 

Perhaps we had the fond notion that confinement would be like a holiday – more rest, more family time, novel and interesting things to do, and relief from work and the other routines in life.

Reality may now be striking home. Anxiety about our jobs, income, and savings; fear about us and our loved ones contracting the virus; worry that food, masks, and other resources may be scarce; boredom at a routine in the cramped confines of home; the resurrection or development of old family dynamics, fraught with irritations, frustrations, disappointment, mistrust and anger. For some, isolation and loneliness may be an even more crushing weight.             

Reframing our Expectations

What will help is kindness – and, in particular, kindness to ourselves. 

Perhaps some of us are high achievers, driven by: concrete stretch goals, targets and objectives; KPIs; reports; numbers; test or exam scores. 

But COVID-19 confinement is not the time to measure yourself in this way. It’s like drinking soup with chopsticks – frustrating.

I recommend that we redefine productivity and measure our day by whether:

  • we have achieved an emotional connection with ourselves and others, 
  • ate healthily, 
  • slept well, 
  • got some exercise, 
  • meditated for a few minutes, 
  • did some yoga or Tai Chi, 
  • walked outside, 
  • read something (other than COVID-19 news or social media content); 
  • did something creative, like photography, videos, painting, made some music, baked something new; and 
  • spent “me time” – just sitting quietly, relaxing and enjoying being in the moment. 

 

This confinement is not a competition – so we do not need to compare ourselves against others. 

We must permit ourselves some numbing out to Netflix and videos – and not beat ourselves up if we eat some chocolate, cookies or chips. 

Let’s also be realistic and recognise that our routines will be different – and that we won’t accomplish the same things in confinement. We will have accomplished things – but they just won’t be the usual things.

Manage your expectations, be gentle with yourself and kind to others – and you will find that there is meaning and purpose to your confinement.   

 


Photo by Paolo Bendandi on Unsplash

Straits Times Interview: “Drug Syndicates Get Crafty As Supply Disrupted, Prices Spike”

Straits Times Interview: “Drug Syndicates Get Crafty As Supply Disrupted, Prices Spike”

In an article titled “Drug syndicates get crafty as supply disrupted, prices spike”, Andrew da Roza, addictions therapist at Promises Healthcare, told Straits Times reporter Zaihan Mohamed Yusof that “anecdotally”, the costs of illegally imported prescription medication and illicit drugs have risen, “although supplies appear to be available”. Mr da Roza goes on to say that he has noticed that some drug addicts are managing withdrawal symptoms and cravings by substituting their drugs of choice with alcohol, new psychoactive substances and over-the-counter medication. The article also mentions that people may seek alternative methods to obtain illicit substances as supply chains are disrupted – such as turning to the Dark Web to get their needs fulfilled by mail.

It wrote that we (Promises) have seen a 25% increase in visits to the clinic “because people are having a harder time managing compulsive behaviours such as substance abuse, smoking and gambling during the circuit breaker period.”

If you are having trouble managing an addiction, you should know that Promises Healthcare has kept its doors open all through the pandemic in service of promoting mental health. Further, in keeping with social distancing measures, our clinic is also offering teleconsultations in place of regular visits. Support groups have also moved meetings online, which are going ahead as scheduled – on platforms like Zoom instead of physical gatherings. Do contact us for more details

COVID-19 AND ADDICTION – RECOVERY USING ONLINE THERAPY

COVID-19 AND ADDICTION – RECOVERY USING ONLINE THERAPY

Author : Andrew da Roza

COVID-19 has posed a challenge to everyone, and those more physically vulnerable in our community clearly need our care and attention. 

There are also people whose mental vulnerability deserves equal care.

Mental illnesses such as depression, anxiety, and addictions are exacerbated by a pandemic crisis in multiple ways. 

Collective family and community fears are (in themselves) contagious; and the constant bombardment of medical and financial bad news, can leave those with mental illnesses lost in a cascade of negative rumination and catastrophising. 

The mentally ill and people with addictions commonly have compromised immune systems, and suffer stress or substance, tobacco and alcohol abuse related diseases – leaving them wide open to severe pneumonia with acute respiratory distress symptoms – and other complications from COVID-19. 

Isolation, separation and loneliness – caused by working at home and social distancing – are perhaps the worst contributors to: low mood; agitation; irrational fears; moments of panic; self-disgust; resentment; anger; and even rage.

People whose ability to pause, use reason and find practical solutions can be severely compromised. They may find themselves bereft of the motivation, and ability to engage in even the simplest tasks of self-care. 

Added to this, listlessness, boredom and frustration can lead to despair. Then self-harm and suicidal thoughts may arise, take hold, and even overwhelm them.

Those in recovery or active addiction may also turn to their compulsive and impulsive behaviours of choice, to sooth and find momentary respite from the moods and thoughts that have hijacked their mind. Triggers, urges and cravings may become relentless and unbearable. 

The solution may begin with finding a way out of isolation. 

Starting the journey out of this darkness can start with talking to people who can demonstrate unconditional positive regard, show kindness and compassion, and help reframe the situation. Such people can assist those suffering to put a name to and validate their emotions. 

In short – therapy can help!

In times of COVID-19, working with a therapist via teleconsultation can be effective using ZOOM, Skype, WhatsApp video and FaceTime. 

Although the calming and soothing sensation of the physical presence of a therapist is absent, for those in isolation – distraught with shame and despair – Internet enabled therapy can prove a lifeline.   

Isolation can be further broken, using similar Internet methods, by attendance in recovery groups such as Alcoholics Anonymous, Narcotics Anonymous and Sex and Love Addicts Anonymous – all of whom now hold Zoom meetings in Singapore. 

These Zoom opportunities in Singapore are supplemented by Zoom, Skype and telephone conference meetings in Hong Kong and Australia (in Singapore’s time zone) and in the U.K. and the US (during our mornings and evenings).             

Having broken the isolation, the second step therapists can provide is guidance and motivation towards self-care. This would include tapering or abstinence from the addictive substances or behaviour. A well thought through relapse intervention and prevention plan, specifically tailored to a person’s triggers, will also assist.

Triggers may be particular places, situations, people, objects or moods. 

The acronym “HALT” is often used by those in recovery; which stands for the triggers of being: Hungry; Angry; Lonely; or Tired.

When these triggers arise, people are encouraged to 

  • HALT their behaviour; 
  • breathe deeply, with long outward breaths;
  • think through consequences;
  • think about alternatives;
  • consult with others; and
  • use healthy tools to self-soothe.      

Daily mindfulness, meditation, exercise, sleep hygiene, healthy eating and following a medication regime are important aspects of self-care – and for some suffering mental illness – these actions – and time – may be all they need to find their footing again.

Luckily, the Internet gives a vast array of possible self-care options, including things to distract us, soothe us and improve us. 

Everything is available from: calming sounds and music; guided meditations; games; home exercise, yoga and tai chi; self-exploration and improvement videos; video chats with loved ones; to healthy food delivery options. They can all be had with a few keystrokes. 

Today we live at a time when suffering from mental illness and addictions is commonplace. But we also live at a time when the solutions are literally at our fingertips – if we only reach out for them. 

For information on teleconsultation for addiction therapy and addiction recovery meetings, contact:  Andrew da Roza at Promises Healthcare by email to andrew@promises.com.sg or by calling the Promises Healthcare clinic at: (+65) 6397 7309