How To Make Feelings of Insecurity Go Away · by Susan Krauss Whitbourne Ph.D.

Feelings of insecurity can come from many sources, both real and imaginary. You may feel unsure about whether other people really like you or whether you’ll get to keep your job. Or you may just be generally insecure. Whether the basis of your insecurity is real or not, the feeling can be crippling unless you know how to handle it. A new study by Peking University’s Wenjie Yuan and Lei Wang (2016) provides a simple step you can take to keep insecurity from getting in the way of your happiness and your mental health.

As proposed by Yuan and Wang, there are specific forms of insecurity, but also a general life insecurity, which they regard as detrimental to your mental health. They define general life insecurity as “a diffuse psychological concern about the safety issues across all life domains including, but not limited to insecurities of job, food, economic affairs, public incidents, health and medicine, and traffic” (p. 312).

The authors draw from Hobfall’s (1989) classic stress theory, Conservation of Resources (COR), which proposes that insecurity drains resources from our mental bandwidth, sapping any resources that are already threatened by loss or the prospect of loss. It’s difficult to concentrate on what you need to do to improve a bad situation if the situation itself is causing your coping resources to drain away.

The potentially easy way to put an end to those insecurities, as proposed by Yuan and Wang, is to crank up your optimism levels. When you’re optimistic, you tend to attribute events that could have negative consequences in a way that reduces their threat value, primarily by seeing those events as being caused by outside factors that will undoubtedly change for the better. Being an optimist, in other words, means that you see the glass as half full, that you ultimately view it as completely fillable, and that you are not responsible for its emptying.

It stands to reason that optimism would be beneficial to your mental health, and the Peking University researchers maintain that optimistic people are not only happier and less anxious, but better prepared to handle stress as well. Their optimism becomes a resource they can draw on in times of difficulty. The beneficial effect isn’t unlimited—under enough actual insecurity, when one is in danger for prolonged periods, it can become entirely eroded.

To test the relationship among insecurity, optimism, and mental health, Yuan and Wang recruited a sample of 209 adults (52 percent male, with an average age of 29) to complete questionnaires over two time points, about a month apart. The researchers used a four-item measure of general insecurity, gauging whether participants felt that all aspects of their life were “safe,” whether they felt generally insecure in “current social conditions,” “when walking down the street sometimes,” or it they wanted to “escape” due to feeling threatened.

The tendency to attribute success and failure to external events was assessed by asking participants to indicate, for example, how much chance causes problems in their relationships with friends. A Chinese version of a measure of “psychological capital” assessed whether participants tend to “look on the bright side.” Finally, general mental health was measured by asking participants to complete a standard questionnaire that included an assessment of one’s ability to concentrate.

The prediction was that the tendency to use external attribution would play a role in affecting optimism’s role in reducing the effects of insecurity on mental health. In other words, people who tend to make external attributions could face situations that threaten their feelings of security by drawing on optimism as a coping resource. Looking at this result, you may conclude that it’s fine to be optimistic as long as you’re a “glass half full” kind of person. However, the authors argue that optimism is modifiable: It’s a state (something that one can change) and not a trait (part and parcel of your personality).

In viewing optimism as modifiable, we can now discuss the challenge of viewing situations that threaten your safety and security in a favorable enough light so that you can cope with them. The ability to do so seems to lie in the attributional piece of the puzzle. Although the study regarded the tendency to externalize as a part of one’s psychological makeup, because it is a cognitive attribute (a function of the way we think), it would also seem to be modifiable under the right circumstances.

Let’s consider what happens when you’re facing a job interview or a first meeting with someone you met online. The measure of insecurity used in this particular study involved a general sense of being threatened, not a specific situation. However, if you’re someone who goes about your day feeling uncertain and afraid, such a situation could tap into those general feelings of anxiety about how you’ll respond. You may know it’s best for you to maintain an optimistic attitude because you’ll seem more self-confident and therefore more attractive to a potential employer or date. However, in the back of your mind, all you can think about is the last time you blew an interview or first date, and how badly it reflects on your personal qualifications; your insecurity levels are now sky-high.

Instead of making an internal attribution for your failure on the previous occasion, the study suggests you find someone or something else to blame: You didn’t get enough sleep; the weather was bad; the other person lacked the wisdom to see your many stellar qualities. You were not at fault. Now you can change your outlook and approach this new situation with a much brighter view of what’s going to happen. Presumably, your lowered stress levels will make that success all the more likely to occur.

It’s not necessarily wise, of course, to chronically ignore negative outcomes or personal culpability when bad things happen to you; you can always learn from failure. In the moment of trying to prepare for a successful encounter, though, that negativity will only make things worse.

Taking a vacation from self-blame can be the key to giving yourself the latitude to succeed, even at difficult tasks. By building your optimism, you can tackle feelings of insecurity through “proactive behaviors” (p. 316) that nip them in the bud. You may not be able to fend off all forms of insecurity all the time, but you’ll at least be able to prevent the threats that are within your control.


Hobfoll, S. E. (1989). Conservation of resources: A new attempt at conceptualizing stress. American Psychologist, 44(3), 513–524.

Yuan, W., & Wang, L. (2016). Optimism and attributional style impact on the relationship between general insecurity and mental health. Personality and Individual Differences, 101312-317. doi:10.1016/j.paid.2016.06.005

Sex Addiction as Affect Dysregulation: An Interview with Alexandra Katehakis, MFT

Recently, my colleague Alexandra Katehakis, founder of the Center for Healthy Sex in Los Angeles, published a research-based book entitled Sex Addiction as Affect Dysregulation: A Neurobiologically Informed Holistic Treatment. Her thorough understanding of the neurobiological underpinnings of sexual addiction along with ways to address these underlying issues in the treatment process is impressive. Recently, I was able to speak with her about both her book and her theories on treating sexual addiction. A partial transcript of our conversation is presented below.

Right now there is a lot of debate about what qualifies as “addictive” sex. What are your thoughts on this?

I conceptualize addictive sexual behavior as adaptive. Sex addiction is an adaptive strategy, because humans are incredibly adaptive. Our brains are highly automatic. If somebody has an experience when they are quite young that relieves some pain or some stress and it is functional for them, it becomes adaptive. So that person will repeat that experience over and over again. Automaticity in that way is a component of dissociation, and that is what we see in sex addicts. So I would say that sexually compulsive or addictive behavior is adaptive, not necessarily a choice as some would argue. It’s a result of the automatic brain. And, as such, it is often a repetition of trauma—not in an attempt to rectify what was done, which is an old definition of trauma repetition, but as a neurobiological construct, a pattern of behavior. And these are patterns of behavior that create stress and problems in people’s lives over time. So what was once pleasurable becomes problematic. Sometimes it remains pleasurable, but it also becomes problematic. Sex addicts report that they cannot stop their behaviors, even though they’re problematic.

So sex addiction is, basically, an adaptive response to early-life relational trauma?

Yes. That’s the aspect of sex addiction that I’m most interested in—what happens when people don’t get proper attunement, usually starting in infancy, so their systems aren’t brought to fruition in the way that the brain and the body are designed to develop and operate optimally. If there’s any kind of chronic unrepaired disruption, you’re going to get distortions in the organism. If you have a mother who is highly depressed or highly anxious, or is under some sort of duress where she’s traumatized, she’s not going to be able to attune to her infant in a way that’s going to bring its systems up optimally, and therein lies the intergenerational transfer of trauma. So it’s not just psychological, it’s biopsychosocial. And it’s all environmental. In other words, part of the environment is the mother’s psychology and another part of the environment is her neurobiology. So you have this problematic attunement, and if there is any sort of trauma after that, whether it’s bullying, beating, sexual, neglect, or anything else, then you are going to have problems.

One of which could be sex addiction.

Yes, because sex addiction is an auto-regulatory strategy. Because the child isn’t getting proper and appropriate co-regulation from its caregivers, the organism itself will find ways to auto-regulate. And as an adult that can manifest as an addiction.

That’s what you’re talking about when you discuss addiction as a chronic brain disorder.

Yes, the brain will adapt. It’s highly malleable. It will organize itself according to what it needs in order to function. The organism is always trying to right itself. It’s always going to try to move toward some kind of healing, so it will adapt and do whatever it needs in order to function.

So a sex addict’s brain looks different and functions differently than a non-sex addict’s (or at least a non-addict’s) brain?

Well, I would say that’s likely, but we’d have to do more research to say that for sure. But there is already some evidence to that effect, and it’s clear that clinically and phenomenologically sex addicts present differently than non-addicts. There are many different examples. Some have to do with perception, some have to do with relatedness. With perception, sex addicts perceive all kinds of distortions because they’re only focused on getting into the sexual experience. That is where their attention is all day, every day.

It’s a little like magic. You see a magician who uses sleight of hand, and the reason that works is because our attention is on one thing that the magician wants us to see, instead of what he’s doing to fool us. We don’t have our attention on other things that the magician is doing. That’s how magic works. For sex addicts, they’re only looking for the sexual experience. If you ask a sex addict how many massage parlors there are in LA, and where they are, they’ll tell you that they’re everywhere. But if you ask a 35 year old soccer mom, she’ll tell you she’s never seen one. It’s an issue with perception.

For evidence of this we might look at the Mechelmans/Voon attentional bias study, which showed that sex addicts are similar with their focus to, say, a cocaine addict. For instance, if you put a cocaine addict in a room with a pile of cocaine on the coffee table, that’s all he will see. He won’t notice the color of the couch, or the carpet, or the walls, or anything else that a normal person would typically notice.

Yes, sex addicts are the same.

In your book you write, “Once addictive sexual behaviors have been arrested, the work of repairing and supporting neurophysiological structures through human relatedness must begin.” Can you explain what you mean by that?

That means that therapy has to be a two person relational system, where the therapist is actually engaging in a real relationship with the client. Historically, psychoanalysis has been more of a symbolic relationship with the client, where the client authentically projects onto the therapist that they’re the mother or the father or some problem figure and the therapist makes interpretations about that. With sex addiction, I believe the addict and the therapist need a real relationship. And together they work through whatever their issues are, so both of their subjectivities are being worked through simultaneously. It’s a coregulatory process where both parties are engaged, both parties are changing. There are ruptures, there are repairs. There’s a slipperiness to the process, but that’s what changes brain structure and function. In the same way, 12 step meetings are enormously valuable. It’s the fellowship, the coffee, the relationship that has addicts starting to trust other human beings again. That’s what starts addicts toward feeling they’re not alone. Twelve step recovery is a come as you are program and all are welcome, so people start to recognize that they can trust other people and they can get their needs met.

So you’re saying these hardwired reactive pathways that we build very early in life need to be rebuilt or worked around with new pathways, and that happens through relatedness?

Yes, we’re rebuilding pathways that were blighted, or that were never formed to begin with. Obviously, with people who are severely dissociated you’re talking about long-term therapy that requires resonance, closeness, safety, and trust between client and therapist so that the client’s uncoupled circuits can recouple. This is the work required for neural integration; this is the process of recovering dissociated self-states. And we really do see profound changes in people over time when they’re working in this way.

I had a guy who came to group last night who’s been in recovery for a long time who has some very serious psychological problems. But he’s worked very hard for years to restore his life. Recently, he lost his job, and he started slipping with pornography, and he felt a tremendous amount of fear about coming into group and talking about it because he didn’t want to be shamed, and he has a hard time with confrontation. To his credit, he came back anyway, and the group was really compassionate with him about what he’s struggling with. I saw a distinct shift in his level of defensiveness and fear, so that he was able to be more compassionate with himself. His pornography use was inconsequential to the group because it was clearly an auto-regulatory coping mechanism and, therefore, a regressed move he made to soothe his many anxieties. What mattered most was the relationship between the men in the group.

He may also have learned that he can come back to group any time he has a problem.

That’s exactly right. When I asked him what he needed from the group, he said, “I need for everyone to tell me that I should keep coming back.” Which is not what he learned in early life, when he was shamed and ostracized. This is exactly the type of relational work that he desperately needs.

How does your PASAT treatment model, as discussed in your book, differ from the cognitive-behavioral approach that most sex addiction therapists rely on in the early stages of treatment? Or does PASAT simply formalize the process of moving, over time, from cognitive-behavioral work to trauma and relational work?

It’s different than the traditional model of using CBT first, and then moving into deeper dynamic therapy, which is a bifurcated model. With PASAT, the actual relational work is happening during the cognitive-behavioral treatment protocol. Sex addiction therapists in general tend to ascribe to Patrick Carnes’ CBT model, which lays out a road map on how to help people get sober. But therapists have to simultaneously be working on the relational aspects. So it’s not just about giving somebody an assignment and processing the assignment with them, it’s about co-regulation—tracking all the nonverbal cues of the client while the therapist is also paying attention to his or her own somatic countertransference, and tracking the client’s affect, gesture, and autonomic cues. So the therapist is in an “experience near” relationship with the addict, meaning both parties have a felt sense of each other, are processing their experience of each other while also processing cognitive material.

So it’s an integration of the relational work with the behavioral work?

Correct. It’s a holistic model. It brings everything in at the same time. Historically we’ve had addiction therapists and then we’ve had psychodynamic therapists, and never the twain shall meet. I’m proposing that we play all those notes at the same time, requiring the therapist to bring all of himself or herself into the mix. When we do this, we’re affecting and changing both parties’ neuropsychobiology. We’re working the left brain and the higher cortical functions, but we’re also working from the body up. It’s a much more integrated model that’s geared toward regulation and integration. We might also call it the affect regulating “cure” for addictive trauma.

Alex Katehakis’ book, Sex Addiction as Affect Dysregulation, is available on at this link.

Why We Need Forgiveness Education

“I was too busy trying to survive. I did not have room to bring forgivenessinto my world.”

These two sentences together, spoken by someone who lived with an abusive partner for decades, is one of the strongest rationales I have ever read for forgiveness education, starting with 4-year-olds or 5-year-olds.

Source: Star Media website

Do you see that the person, as an adult, did not have the energy and focus to add something new to her arsenal of survival?

What if forgiveness was a natural part of her survival arsenal starting at an early age?

We do this all the time in education as we help students learn how to speak and write coherent sentences.

We do this all the time in education as we help students learn how to add so that a budget can be maintained.

We do this all the time in education as we help students learn how to be just or fair. Teacher corrections and punishments are swift to come once students enter the school door and then misbehave in the school setting.

I think it is unfortunate that educational institutions and societies fail to make forgiveness a natural part of life through early education. Isn’t a central point about education to help people make their way in society? And isn’t a central point of making one’s way in society having the capacity to confront grave injustices and not be defeated by them? And isn’t a central point of confronting grave injustices the knowledge of how to forgive? And isn’t a central point of knowing how to forgive the thinking about forgiveness and the practice of it in safety, before the storms of insensitivity and abuse hit? And isn’t a central point of knowing forgiveness and practicing forgiveness to aid in the survival of people who could be crushed by others’ cruelty?

Source: International Forgiveness Institute, Inc.

Why do we spend time helping children learn to speak and write, learn essential mathematics skills, and be just, but completely neglect teaching them how to overcome grave injustices?

Education in its essence will be fundamentally incomplete until educators fold into it the basic strategies for overcoming grave injustice and cruelty so that students, once they are adults, never have to say, “I was too busy trying to survive. I did not have room to bring forgiveness into my world.”

And the educational challenge of this incompleteness is this: We now know scientifically-supported pathways to forgive (Enright & Fitzgibbons, 2015; Wade, Hoyt, Kidwell, & Worthington, 2014). We have scientifically-tested forgiveness curricula for children and adolescents (Enright, Knutson, Holter, Baskin, & Knutson, 2007; Enright, Rhody, Litts, & Klatt, 2014). Without forgiveness education, a person who wants to forgive may not be able to do so. Without forgiveness education, another person may too easily equate forgiving and reconciling, thus staying in an abusive relationship. With forgiveness education, a person can forgive, not necessarily reconcile, and heal emotionally.

It is time to make “room to bring forgiveness into my world.”


Enright, R. D., & Fitzgibbons, R. P. (2015). Forgiveness therapy: An empirical guide for resolving anger and restoring hope. Washington, DC: APA Books.

Enright, R.D., Knutson, J.A., Holter, A.C., Baskin, T. & Knutson, C. (2007). Waging peace through forgiveness education in Belfast, Northern Ireland II: Educational programs for mental health improvement of children. Journal of Research in Education, 17, 63-78.

Enright, R.D., Rhody, M., Litts, B., & Klatt (2014). Piloting forgiveness education in a divided community: Comparing electronic pen-pal and journaling activities across two groups of youth. Journal of Moral Education, 43, 1-17.

Wade, N.G., Hoyt, W.T., Kidwell, J.E.M., & Worthington, Jr., E.L. (2014). Efficacy of psychotherapeutic interventions to promote forgiveness: A meta-analysis. Journal of Consulting and Clinical Psychology, 82, 154-170.

Can You Ever Affair-Proof a Relationship? · by Linda and Charlie Bloom
Source: bokan/Shutterstock

Can love and good sex “affair-proof” a relationship?

This myth is deeply embedded in our culture and is even held by a fairly large number of marriage counselors. But a lot of people who hold this belief have been deeply disappointed to discover that it’s not necessarily true. While it may seem reasonable to assume that if both partners love each other and have a mutually satisfying sexual relationship, there would simply be no reason for either to stray. Well, that is true: There is no “good reason.” Affairs, however, are generally not motivated by reason or rational thinking, but tend to be matters of the heart, which is the source of passion and desire, and not the mind, which deals with abstraction and logic.

So while it does seem logical to assume that there would be little motivation for partners in a happy relationship to go outside of it to fulfill their most intimate desires, particularly if they’ve made an agreement to be monogamous, it does happen—and more frequently often than most of us realize. A study cited in the Journal of Marital and Family Therapy in 2015 reported that 54 percent of female respondents, and 57 percent of males, stated that they had been unfaithful in their relationship. What may also be surprising: The average length of the affairs was two years.

Still more surprising is that according to relationship and sexuality expert Esther Perel, author of Mating in Captivity, the motivating drive to have an affair is a desire not necessarily for sex, but rather for experiences their relationship is no longer delivering. What they desire, according to Perel, is attention, novelty, adventure, vibrancy, aliveness, and passion. They crave the experience of losing themselves in the intensity, excitement, and stimulation of a new relationship, with the hope of re-invigorating the feelings that occur in the stage of infatuation.

Too often, it seems that couples fail to keep that spark alive after they formalize their commitment, and so they run the risk of weakening the glue that keeps their relationship passionate and healthy. When daily routines and responsibilities dominate their attention, the risk of a violation of their monogamy agreement increases. When either partner feels that they must submerge aspects of themselves to maintain peace or avoid conflict, the risk factor is similarly heightened. The fantasy of being free to be fully authentic, and to experience aspects of oneself with another person that one’s partner disapproves of, is a compelling motivator for anyone who has withheld or concealed aspects of themselves out of fear of judgment, rejection, or punishment.

The expectation that one person can and should meet all of another’s needs, particularly when many of them appear to be at odds with each other—security and adventure, excitement and peace of mind, spirituality and sensuality, tenderness, and strength—can be a setup for disappointment or betrayal. This is not to justify violating anyone’s vows, but rather a warning to be mindful of the dangers of holding a partner responsible for fulfilling a range of needs and desires that may be beyond any one person’s capacity.

The experience of loneliness is also something that can occur even in good relationships. This often comes as a surprise to those who wrongly assume that once they enter into a serious partnership, their lonely days are over. But the experience of loneliness has more to do with our relationship to ourselves than whether we are in relationship, or with whom. It is a function of how comfortable we are in our own skin, whether we relate to ourselves with compassion or criticism, and how much we enjoy our own company. When we mistakenly hold our partner responsible for taking away our loneliness and making us happy, he or she will be likely to feel turned off by our efforts to coerce their attention.

There is a significant difference between desire and neediness: Neediness often feels manipulative and is seen as a turnoff. It can also include a sense of entitlement, or an expectation that one has the right to be taken care of by one’s partner. When we experience a partner’s desire, without their expectation of our reciprocity toward us, it feels pleasurable and attractive.

Sometimes the burden of fulfilling family obligations and responsibilities can feel oppressive, and the desire for relief, even briefly, can be compelling. At these times we are particularly vulnerable to the temptation of affairs. When partners take each other for granted and neglect their relationship, they put it in jeopardy. When unresolved conflicts mount up, resentment, anger, a lack of respect, and even contempt may form conditions that are an accident waiting to happen. Such animosity can become a perfect rationalization to go outside the marriage for intimate contact.

Infidelity can be as brief as a one-night stand, or a secret, years-long affair. Some people try to fulfill their need for attention and validation through sex. Some may rationalize their indiscretions with the justification that there was no intimate physical contact, but like emotional affairs, in which literal sex does not occur, even technical infidelity or virtual affairs can do great damage to one’s primary relationship.

No matter what their cause or nature, every betrayal harms a relationship and requires repair work to restore trust and integrity. Another statistic cited by the Journal of Marital and Family Therapy study was that, of marriages in which an affair was discovered or admitted, 31 percent lasted. The shock of the crisis can expose the source of the unmet needs that the affair was an attempt to fulfill, and in doing so, open the possibility for this breakdown to become a breakthrough, provided both partners do the work that is required to heal the relationship.

Pain can sometimes be a great motivator. It would, of course, be more efficient and less painful to avoid the torturous stages of wounding and healing that accompany unfaithfulness. There are many ways to enhance the quality of your relationship without unnecessary suffering. If you don’t know what they are, ask your partner: It’s likely that he or she will be happy to give you a few ideas. As the saying goes, an ounce of prevention is worth a pound of cure.

Linda and Charlie Bloom are excited to announce the release of their third book, Happily Ever After . . . and 39 Other Myths about Love: Breaking Through to the Relationship of Your Dreams:

“Love experts Linda and Charlie shine a bright light, busting the most common myths about relationships. Using real-life examples, they skillfully, provide effective strategies and tools to create and grow a deeply loving and fulfilling long-term connection.” —Arielle Ford, author of Turn You Mate into Your Soulmate

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Why 11 & 12-Year-Olds Are Struggling With Porn More Than Ever Before


An unprecedented number of boys of just 11 and 12 years old are calling Australia’s only public phone counseling service for young people, asking for help. They’re worried they have already become addicted to pornography, reports Courier Mail.

The free and confidential support line’s counseling manager Tony FitzGerald said boys who were exposed to online pornography early in life also appeared to be more at risk of developing unhealthy and compulsive viewing habits.

“It is happening young–we are not talking about older teenagers here, we are talking about boys anywhere between 11 and 15,” FitzGerald said.

“They are contacting us ­because they know that something is not right about their addiction to pornography. We’ve seen a disproportionate number of contacts from young males around this sort of thing… They also have concerns about the impact this (porn) might be having on their own relationships.”

Generation SEXT

Hugh Martin, who runs the organization Man Enough, which provides counseling for males who are struggling with pornography, said parents and schools needed to be more frank in their discussions with young children about the risks of being exposed to pornographic material online.

“We can’t be coy or squeamish about this,” Martin said.

“I actually invite some adults to go and look at what’s out there so they know what they are talking about… If they’re embarrassed talking about it, it will make it a lot harder next time for the kid to talk with them.”

Martin said he believed age-appropriate references to pornography need to be front and center of sex education lessons so young people don’t grow up believing it is an ­accurate portrayal of healthy sexual relationships.

Is Porn Hijacking Youth?

The most hardcore porn imaginable is quickly becoming the next generation’s first ever exposure to anything sex-related. How could this not influence the way they view relationships and their own selves?

Research shows that young people are as likely to see online porn accidentally as they are to actively search for it. That means, with the amount of porn that’s online today, it is actually easier for a kid to stumble across it then to search for it on purpose. And for almost 2/3 of the children, this first exposure to porn happened right in their own home.

Another unsurprising finding goes to show the escalating nature of porn viewing. Children described how their feelings towards porn have changed over time. About 27% surveyed reported feeling ‘shocked’ the first time they viewed it, but follow up surveys revealed that just 8% remained shocked after the first time they watched it.

Citing this research, an incredibly in-depth survey by The National Society for the Prevention of Cruelty to Children (click here to read the full report) shows the massive role that porn is playing in the development of young kids these days. What they’re learning is skewed perceptions of sex and harmful attitudes about their natural sexuality.

By being educated and raising awareness on these findings, we can hopefully spare the next generation of the many harms that are sure to come due to this pornification of our society.

What YOU Can Do

Porn is one of the worst possible forms of sex education. SHARE these important findings to help young kids understand the harms of watching porn and take a stand for real love.

Have You Really Worked Step 1? – Robert Weiss LCSW, CSAT-S

In today’s world, recovery from addiction typically starts in rehab, followed by addiction focused outpatient therapy, 12 step meetings, and step work. Most of the time, as recovering addicts grow comfortable with their sobriety, they rely less on professional help and more on 12 step support groups and continual working of the steps. This, of course, begins with step 1.

We admitted we were powerless over our addiction—that our lives had become unmanageable.

On the surface, step 1 seems relatively straightforward. And for many addicts it is. For these lucky individuals, simply walking into a treatment center, a therapist’s office, or a 12 step meeting and asking for help is a full and complete admission of powerlessness and unmanageability. However, other recovering addicts must continually battle with denial about their disease. These addicts must consciously and purposefully work step 1 if they hope to establish and maintain lasting sobriety. Often, they must work this step repeatedly, even as other aspects of their recovery progress.

If you’re an addict who finds step 1 difficult, the following tasks can help.

Task 1: Powerlessness

Being powerless means you have lost control over your addictive behaviors. You engage in your addictive behaviors compulsively, even when you don’t want to. Moreover, you have no ability to stop once you’ve started.

  • List 10 or more examples of your powerlessness over your addiction. Use the following format: “Even though I (list a particular consequence), I continued to (list a particular addictive activity).” For example, you might write, “Even though I had three DUI arrests, I continued to drink and drive.”

Task 2: Unmanageability

Unmanageability speaks to the consequences of your addictive behaviors, both direct (obviously connected) and indirect (less obviously connected). Many addicts have relationship troubles, reprimands at work, and even arrests that are very obviously connected to their addictions. Less obvious consequences may include depression, anxiety, feeling worn out, forgetting to pay bills, eating poorly, loss of interest in previously enjoyable activities, etc.

  • List 10 or more examples of unmanageability (consequences) related to your addiction. Try to include a mix of both obvious and less obvious issues. For example, you might write, “I was fired from my job for repeatedly showing up wasted,” and, “I was continually depressed and ashamed because of behaviors I engaged in while drunk or high.”

Task 3: Powerless and Unmanageability Together

An easy measure of both powerlessness and unmanageability looks at failed attempts to either cut back or quit your addictive behaviors. (People who are not addicted rarely feel a need to curtail or abandon a particular behavior, whereas addicts attempt to do this fairly often.) If you’ve tried and failed to control your addiction on multiple occasions, that is an excellent indictor of powerlessness over your addiction, and how your addictive behaviors have become unmanageable.

  • List any attempts you’ve made to either cut back on or quit your addictive behaviors. Note the approximate length of your success. For example, you might write, “After my girlfriend broke up with me because of my drug use, I swore to myself that I would quit and get my life on track. I stayed clean for about 48 hours.”

Task 4: Sharing Your Step 1 Inventories

Writing down examples of powerlessness and unmanageability is not enough for most recovering addicts. To increase the impact of step 1 it is important to share your inventories with your 12 step fellowship, your therapy group, or, at the very least, your 12 step sponsor. For many recovering addicts, sharing step 1 with their support network is the true beginning of recovery. Many say their life began to improve the instant they got honest with their support network by sharing their step 1 inventories.

If you’re like most recovering addicts, you are filled with shame, self-loathing, and remorse about your addictive behaviors and their consequences. Plus, you’ve gotten very used to keeping secrets from the important people in your life. Because of this, opening up about the nature and extent of your addictive behavior may feel both unnatural and uncomfortable. That said, sharing your history and consequences is always worthwhile.


The tasks suggested above are not the only way to work step 1. In truth, there are as many ways to work step 1 as there are recovering addicts. So rather than telling you that the exercises I’ve suggested are the way to work this step, I will simply restate the advice I’ve heard over and over in 12 step meetings: Take what you like and leave the rest. If my suggestions make sense to you, then use them. If not, that does not mean the 12 steps are flawed; it simply means you need to work them in a different way.

In truth, the way you work the steps is not important. What’s important is that you do work them.

Ongoing step-work is a proven route to lasting sobriety. So please go to meetings, please get a sponsor, please build a support group, and please talk with your fellow recovering addicts about their experience working the steps. Each and every one of these people will have something useful to offer, and before you know it you’ll be helping them, too. You will become as important to these folks and their recovery as they are to you and yours.

In future postings to this site, I will present suggestions for how to effectively work steps 2 through 12. For other general information about healing from addiction, check out my website. For treatment referrals, click here, here, or here.

Robert Weiss LCSW, CSAT-S is Senior Vice President of National Clinical Development for Elements Behavioral Health. In this capacity, he has established and overseen addiction and mental health treatment programs for more than a dozen high-end treatment facilities, including Promises Treatment Centers in Malibu and Los Angeles, The Ranch in rural Tennessee, and The Right Step in Texas. He is also the author of several highly regarded books, including Sex Addiction 101: A Basic Guide to Healing from Sex, Porn, and Love Addiction. For more information please visit his website,

Child Sexual Abuse Prevention Goes to TEDMED

Source: Stephanie Neal

Last year culminated in a once in a lifetime opportunity—the chance to give a TEDMED talk to a curated, attentive and influential audience about child sexual abuse prevention. TEDMED is the independently owned and operated health and medicine edition of the world-famous TED conference. This annual event is dedicated to “ideas worth spreading.”

The theme for 2016 was “What if…?” and speakers were asked to imagine new possibilities for advancement in medicine, public health and biomedical sciences.

I asked the question: what if we stopped treating child sexual abuse as solely a criminal justice problem and instead treated it as the preventable public health problem that it is?

In my talk, I told the story of the fateful day I met with the journalist who would break the story about non-offending pedophiles and my research in finding a public health approach to ending child sexual abuse. Luke Malone brought the idea of child sexual abuse prevention into the living rooms of millions of Americans who listened to his story on This American Life.

I also discussed some important statistics that everyone should know. The peak age for engaging a prepubescent child in harmful or illegal sexual behavior is 14, and about half of all sexual offences against prepubescent children are committed by other children.

Another important statistic is that nearly 98 percent of children convicted of a sexual offense are never reconvicted of a new sexual offence. This shows that adolescent sexual offending is short-lived and it strongly suggests that we can prevent the first offence.

And yet, instead of focusing on prevention, we put most of our efforts on punishment.

Children who are caught engaging in harmful sexual acts might receive treatment instead of prosecution, which acknowledges that children, even those who make serious mistakes, have the potential to be rehabilitated.

For the children who get caught, prosecuted and convicted of sex crimes, they are often treated like adults. They can face incarceration and sex offender registration and public notification, sometimes for life. Registered children can be prohibited from living near schools, parks and playgrounds—the very places where our children thrive.

And what do we make of the people who discover in adolescence that they have an unwanted attraction to prepubescent children? Our interviews with 30 young adults living with an unwanted attraction to children revealed just how hard it is to find help and cope with their attractions. Many reported that they felt isolated, depressed and even contemplated suicide. Many said that what they truly needed (and could not find) was help in dealing with the shame and stigma that can accompany these attractions.

As part of the TEDMED talk, I presented quotes from these interviews to provide the audience with a better understanding of non-offending pedophiles. (Luke Malone also moderated a panel discussion on non-offending pedophiles that was held in 2015). For children dealing with an unwanted attraction to prepubescent children, acting out might not be the only issue. Some will need our help to resist acting on strong urges some of the time.

So what needs to happen now?

We must start thinking about child sexual abuse as a preventable public health problem. This includes providing all children access to effective prevention programs that focus both on avoiding harm and on attaining health and happiness.

Good programs will teach children how to behave responsibly around younger children; they will encourage children to disclose attractions to others when it is safe to do so and they will inspire all of us to respond to those disclosures with understanding and compassion.

I’ve had positive feedback about the talk so far. A reporter from the Huffington Post called it “one of the boldest” TEDMED talks for that year.

I anticipate that TEDMED will release a publicly accessible link to my talk (and others). But for now, I’ll continue to look for opportunities to bring the idea of child sexual abuse prevention to as many diverse audiences as possible.

Why Is Your Partner’s Smartphone Use an Issue?

Source: Rido/Shutterstock

Smartphones have now been with us for 10 years, and play a huge part in our lives. We use them to take selfies, connect on social media and dating apps, read the news, and play interactive games. Many people check their smartphones as the last thing they do at night and then first thing in the morning. Train and bus passengers constantly gaze at their phones; people even stare at them when walking down the street, oblivious to others. There is no doubt that phones have changed the ways we behave and live.

Smartphones provide a way for people to stay closely connected with family and friends, and the array of options arguably create feelings of connectedness with others, but excessive use means that users forgo face-to-face interactions. Diverting one’s attention to a smartphone while in the company of another is a behavior known as phubbing, a portmanteau of phone and snub, and generally considered to be impolite or inappropriate in the context of social interaction.

If phubbing is impolite and inappropriate, what is the effect of such behavior on romantic relationships? Is it tolerated because of the closeness of romantic partners, or is its impact exacerbated because of it? Further, are there gender differences in emotional reactions and responses to phubbing?

McDaniel and Coyne (2016) suggest that smartphones can be intrusive and interfere with face-to-face interactions, with one partner feeling upset if the other becomes too absorbed in their phone when they are spending time together. Any distraction or intrusion when partners are together might cause upset, but are intrusions caused by smartphone use more of a problem? Does phubbing merely cause one partner to feel upset because they feel ignored? Or does it go further and cause them to be upset due to a feeling of jealousy as their partner is possibly connecting with a third party via their phone? Remember that one aspect of jealousy is the perceived threat to a relationship from another party.

Hanna Krasnova and colleagues investigated jealousy in partner phubbing and relationship outcomes (Krasnova, Abramova, Notter & Baumann, 2016). In their study, they employed participants between the ages 26 and 40, an age group they argue are most likely to use smartphones, while at the same time likely to be seeking sustainable romantic relationships.

The researchers asked participants to think of the last time their partner used their smartphone for too long in their presence. Participants reported that this happened:

  • When they were at home together (33.6 percent).
  • In bed before going to sleep (19.6 percent).
  • When they were home having a meal together (10.8 percent).
  • In the car or on public transport (9.8 percent).
  • When going out (4.5 percent).

(The remainder of the answers were watching TV, walking, and shopping.)

When asked to describe their emotions on these occasions, participants reported the following:

  • Loss of attention (28.6 percent).
  • Anger (19.4 percent).
  • Sadness/suffering (11.1 percent).
  • Boredom (3.2 percent).
  • Indifference (38.1 percent).
  • Happiness (4.4 percent).

The only notable gender difference was in happiness, with males reporting more happiness than females. However, compared to males, females reported more anger, sadness, and indifference.

The researchers then asked about participants’ coping strategies to phubbing. Reactions included:

  • Voicing intervention, such as making a request to stop using the phone (27.1 percent).
  • Showing curiosity by either looking at the other’s screen or voicing suspicion (7.3 percent).
  • Mirroring; for example, doing the same as a partner (6.9 percent).
  • Doing something else (13 percent).
  • Loyalty, such as showing tolerance, waiting, and understanding (22.3 percent).
  • Feeling negative—being annoyed or angry (7.3 percent).
  • No reaction (22.3 percent).

In terms of gender differences, males reported coping more in terms of loyal reactions compared to females. Further, males were twice as likely to exhibit mirroring behavior compared to females. Overall, it seems that males report more positive emotional responses and coping with phubbing behavior compared to females.

Finally, the researchers tested the relationship between partner phubbing, feelings of jealousy, and relational cohesion (the feeling of togetherness or emotional bonding). They found that it was not just annoyance or the feeling of being ignored when their partner used their phone that impacted on cohesion. Rather, it was more likely affected by an individual’s feeling of jealousy at their partner using their smartphone.

While jealousy is often discussed within the context of partner rivalry, jealousy is often experienced in other ways, such as a partner spending time with friends, or time at work; overall, jealousy can be associated with relationship deterioration. Previous research on jealousy revealed that not all interruptions to a social interaction are perceived equally; even from an early age we experience more intense feelings of jealousy towards social objects than inanimate ones (Hart et al, 2004).

The research of Krasnova et al. seems to suggest that we tend to see smartphones more as social objects—not just phones or computers—because they enable connection with others. Overall, it seems that it is not the process of phubbing itself (merely being ignored), but the feeling of jealousy (a partner connecting with another person) that phubbing triggers which ultimately leads to relationship dissatisfaction.

Visit my website and follow me on Twitter @martingraff007 and YouTube


Hart, S. L. Carrington, H. A., Tronick, E. Z. and S. R. Carrol (2004).’When infants lose exclusive maternal attention: Is it jealousy?’ Infancy 6 (1), 57-78.

Krasnova, H., Abramova, O., Notter, I.,Baumann, A. (June 2016) ‘Why phubbing is toxic for your relationship: Understanding the role of smartphone jealousy among ‘generation Y’ users’ (Unpublished). In: 24th European Conference on Information Systems (ECIS). Istanbul, Turkey.

McDaniel, B. T. & S. M. Coyne (2016). ‘Technoference: The interference of technology in couple relationships and implications for women’s personal and relational well-being.’ Psychology of PopularMedia Culture, 5(1), 85-98.

How to Avoid Depression Induced by Social Media

Source: CC0 Public Domain

You check Facebook while in line at the grocery store.

You glance at Twitter while waiting at a stop light.

While working on your computer, social media alerts pop up in the corner of the screen.

Social media is a constant presence in the lives of billions of people across the globe. Facebook alone boasts of nearly 1.8 billion users.

As this cultural trend expands, researchers are asking how social media impacts users – and specifically their mental health.

A new systematic review by researchers in the United Kingdom distills the evidence on the connection between social media and depression. Clinical psychologists at Lancaster University reviewed nearly 800 articles and selected 30 with the strongest methodologies. They examined data that included more than 35,000 participants between the ages of 15 and 88 from 14 countries.

Their analysis offers a mixed bag of conclusions and helps to explain the intricacies of technology and communication in our culture today. Of the studies included in the review, 11 of them provided simple correlations between online social networking and depression. Of those 11 studies, 45 percent identified a link between online social networking and depression. Eighteen percent found that online social networks have a positive impact on mental health, and 36 percent found no significant conclusions either way.

How can so many high quality studies draw completely different conclusions?

The review authors unpack the data to help explain when social media is harmful to mental health, and when it is helpful.

Their review found that study participants were more likely to feel depressed when they spent time comparing themselves to others on social media. Research shows that these comparisons lead to rumination – or continuously thinking about negative social interactions.

The data found social media users were more likely to suffer from depression when they:

  • Felt envy triggered by observing others’ social media posts.
  • Accepted former partners as social media friends.
  • Posted frequently on social media, and especially with negative status updates.
  • Obsessed over their virtual identity.

It’s no surprise that people are more likely to develop depression from comparing themselves to others on social media than when they make comparisons in real life. That’s because it’s easier to present a polished – and unrealistic – version of your life in a snapshot or snippet of text. Think of a mother who posts a photograph of an intricate meal she has prepared and displayed on a beautifully set table. But just out of the frame is a stack of dirty dishes and whining children waiting for their mother’s attention.

The review also underscores evidence that social media platforms can actually help people improve their mental healthy by enhancing their social support networks and helping them connect to mental health resources.

What’s important is to use social media in positive ways, explained Janis Whitlock, a research scientist in the Bronfenbrenner Center for Transnational Research and Director of the Cornell Research Program on Self-Injury and Recovery.

“In a world saturated by communications technology, comparing your off-line life to what we think we can see about other people’s perfect on-line lives is problematic, “ she said. “Worrying excessively about your on-line ‘look’ has become increasingly normalized. Helping people recognize this tendency and redirect social media time to enhance wellbeing is a critical skill for parents and educators.”

The bottom line is that the risks and benefits of social media use depend on how you interact online. Using Facebook to keep in touch with former colleagues or schoolmates spread across the globe can add value to your life. But constantly comparing yourself to others or going to extreme lengths to improve your social media image is likely to take a toll on your mental health.


Baker, David A., and Guillermo Perez Algorta. “The Relationship Between Online Social Networking and Depression: A Systematic Review of Quantitative Studies.” Cyberpsychology, Behavior, and Social Networking 19.11 (2016): 638-48

Opposite Genetic Profiles of Autism vs. Schizophrenia

Although difficulties with social communication are symptomatic of both autism spectrum disorder (ASD) and schizophrenia, symptoms of ASD typically occur during early childhood, whereas most symptoms characteristic of schizophrenia do not appear before early adulthood. A new study has investigated whether the overlap in common genetic influences between these clinical conditions and impairments in social communication depends on the developmental stage of the assessed trait.

The study reports developmental profiles in common genetic overlap for both ASD and schizophrenia with respect to longitudinal measures of social communication difficulties within the general population. Analyses were based on the largest publicly available genome-wide data for ASD and schizophrenia, in addition to a large Danish ASD sample from the iPSYCH project and a well-studied UK birth cohort, the Avon Longitudinal Study of Parents and Children (ALSPAC).

Overlap in genetic influences between ASD and social communication difficulties during development decreased with age in the ASD samples, as might be expected of this early onset disorder. Genetic overlap between schizophrenia and social communication difficulties, by contrast, persisted across age as observed within two independent sub-samples, and showed an increase in magnitude for traits assessed during later adolescence—the typical age of onset. Both clinical ASD and schizophrenia were found to share some genetic influences with impairments in social communication but revealed distinct developmental profiles in their genetic links consistent with the onset of clinical symptoms, as illustrated below.

Developmental changes in genetic effects of polygenic scores for (a) clinical ASD and (b) clinical schizophrenia on SCDC scores. Polygenic scores (PGS) were constructed in ALSPAC based on the largest publicly available samples for ASD (PGC-ASD) and schizophrenia (PGC-SCZ2) as a training set, and then Z-standardised. A P-value threshold of PT o0.05 for selecting risk alleles in clinical samples is displayed. Using a mixed Poisson regression framework, longitudinal measures of untransformed SCDC score counts were regressed on ASD-PGS and schizophrenia-PGS simultaneously allowing for changes in genetic effects over time. Repeatedly assessed SCDC score counts in ALSPAC were available at 8, 11, 14 and 17 years of age with individual ages ranging between 7 to 18 years. Genetic effects for ASD-PGS (a) and their 95% confidence intervals (shaded) as well as schizophrenia-PGS (b) and their 95% confidence intervals (shaded) were estimated across development, and show the increase in SCDC log counts per standard deviation in PGS score. A dotted line indicates the P-value of the genetic effect. ALSPAC, Avon Longitudinal study of Parents and Children; ASD, autism spectrum disorder; PGC-ASD, ASD collection of the PGC; PGC, Psychiatric Genomics Consortium; PGC-SCZ2, Samples of the second PGC mega-analysis of SCZ; SCDC, Social Communication Disorder Checklist; SCZ, schizophrenia.
Source: Molecular Psychiatry (2017) 00, 1–8

This study provided evidence for shared common genetic overlap between social communication difficulties and both ASD and schizophrenia, but does not imply a shared genetic susceptibility between these clinical conditions. Instead, we identified distinct patterns in genetic trait-disorder relationships, largely consistent with the onset of clinical symptoms. Genetic links were driven by independent polygenetic influences and showed opposite trends in magnitude with progressing age of the population-based trait, as supported by longitudinal analyses.

This is exactly what the diametric model predicts. According to this way of looking at it, ASD and schizophrenia are opposites: ASD is characterized by deficits in mentalism (aka people/social/communication skills) while schizophrenia exhibits hyper-mentalism epitomized in symptoms resulting from excessive mentalizing such as delusions of being watched, hearing voices, or being the subject of persecution. And just as both over-sensitivity and under-sensitivity to light or sound would result in visual or hearing deficits, so the diametric model proposes that both the hypo-mentalism of ASD and the hyper-mentalism of schizophrenia result in mentalizing difficulties. Nevertheless, the difficulties will be different, and their causes opposite, just as the authors’ figure above and mine below illustrate.

Source: C. Badcock

Only the diametric model can explain why this is so, and can do so very readily. This is because it follows as a matter of necessity that, if ASD is characterized by symptomatic failure to develop normal mentalizing, such deficits will inevitably appear at the time mentalism is first developed: early childhood onwards. But because you have to acquire normal mentalistic abilities before you can take them to pathological extremes and because mentalism takes many years to master, the hyper-mentalism of psychoses such as schizophrenia normally only becomes apparent much later, typically during late adolescence or early adulthood. To this extent, schizophrenia and other such psychoses are comparable to other hypertrophic syndromes: giants have to reach normal size before they can become gigantic. Indeed, the model also explains why psychiatrists often report that some schizophrenics—strikingly unlike autistics—can show remarkable mind-reading abilities on occasions: hyper-mentalism isn’t always misleading!

To this extent then, the new study vindicates, not only the diametric model of mental illness, but its core concept: a mentalistic continuum ranging from the hypo-mentalism of ASD to the hyper-mentalism of schizophrenia. And the fact that an opposite pattern of gene expression was found for each also of course corroborates the basic claim of the imprinted brain theory that genetic conflict is the fundamental factor. Indeed, a previous study of 1.7 million Danish health records which found birth size to be a reliable indicator of risk of mental illness as predicted by the theory underlines the parallel with hypertrophy in general, and more than hints that imprinted genes with their known links to growth are the specific agents in both ASD and schizophrenia.

(With thanks to Bernard Crespi for bringing this to my attention.)