#1 Preoccupation
The first stage of the addictive experience is preoccupation.  Pedophiles become hostages of their own obsession.  Do you agree?  Their obsessions about child pornography or other sexual acts which involve children become intrusive on their daily activities.  Jim, age 34, stated, “I couldn’t get these images out of my head.  They invaded my life.  I would start work, but then, all of a sudden, I would get flashes of my nephew in my mind, doing things I wish I hadn’t thought of.  Personally, I’ve never enacted them out with him, but I will go to websites and try to instant message kids, just so I can flirt with the ideas.”

I stated to Jim, “Because of your obsession, every introduction and meeting passes through your sexually obsessive filter.  Normally, these obsessions begin to interfere with daily life, and other areas are affected.  Does that ever happen with you?”  Jim stated, “Yeah, I couldn’t concentrate on work, all I could think about were these images and how to make them come about.  I can’t sleep, so I spend most of my time on the internet.  Sometimes, when I’m chatting with people I know are adults, I’ll fantasize that they’re really young teens.”

Clients like Jim are addicted to sexual behavior, and, in the case of pedophiles, become addicted and preoccupied with the thought of sexual acts with children.  I stated to Jim, “I’d like you to think of this preoccupation as a warning sign that’s telling you to watch your steps.  When you begin to feel the obsession taking over, be mindful of it and of your behaviors.”  Think of your Jim.  Is he experiencing this sexual preoccupation?  How would you address his preoccupation?

For #2, 3 and 4 Stages of a Pedophilic Addictive Experience go to Internet Course

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#1 Sensory Experiences
The first concept is sensory experiences.

Stacy, age 32, suffered from a fear of toilets and doorknobs.  To begin her imagined exposure therapy, I asked Stacy, “How would the external setting of this scene affect you if this were a real situation?  Think about all your senses.  For example, what are you seeing?  What can you smell?  What do you hear?  What do you feel or touch?  What do you taste?”

I asked Stacy to record her senses in her journal.  She stated, “I can see the toilet.  It’s white porcelain, stained slightly off white over the years.  The bathroom smells like my flowery soap, jasmine, which my grandmother gave me a long time ago.  The toilet is running.  I’ve just used the toilet and it needs to be flushed.  The handle is slightly cold to the touch.”

Think of your Stacy. Can you think of any other sense that he or she should be mindful of during his or her exposure?  How would you frame these questions differently?

For 2, 3 and 4  Concepts Regarding Behavioral Strategy go to OCD Course.

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#1 Anger Arising from Limitations
The first manifestation of anger is anger arising from limitations.  Clients who experience chronic pain find themselves constantly frustrated by the reduced scope of their abilities.  Because of their loss of independence, clients become angry at themselves for their lack of ability but also those who do not accept or recognize their limitations.  When another person asks a client to perform beyond their capabilities, the client becomes enraged at him or herself for not being able to accomplish it and also the other person for not recognizing and validating the client’s condition.

Carol, age 31, had an enflamed disc in her spine that caused her constant pain.  One day, a new manager at her office asked her to carry a box down to the warehouse.  Unable to carry the box, but also equally unable to explain her weakness to her manager, Carol instead asked one of her friends to do the task for her, but still complained about the ignorance of her new employer.  Carol stated, “He didn’t even ask me if I could carry that box, he just ordered me to!  He’s such an inconsiderate ass!  I bet if he expressed one ounce of concern for his employees, his head might implode.”

Carol’s unwarranted anger was quick in passing, but I still asked her to explain her condition to the manager the next day.  I stated, “I know that you know people cannot read minds.  If you do not explain to the people around you about your back pain, you will only find yourself becoming more and more angry at your situation.”  I asked Carol to make a list of people that should know about her condition to reduce the frequency of her angry outbursts.

Think of your Carol? Is he or she angry about his or her limitations?

For #2 and #3 Manifestations of Anger go to Pain Management Course

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While each drawing is individually configured and unique in meaning, common pictorial symbols and metaphors of human figures and animals, place and weather, and toys and games usually convey fairly general meanings-albeit at times with wide variance from one culture to another (Oster and Gould, 1987). For example, alligators and other big mouth animals may be used to reflect nurturant needs or oral aggression; dogs and other cuddly animals, companionship and transitional objects; or birds, flight and freedom. Caves may hide and protect or, conversely, trap. Mountains may be attainments, obstacles, or something else entirely. Rain may reflect crying or be cleansing. Snow seems cold, the sun warm. How then, with these and the myriads of other possible meanings, does the clinical social worker figure out what a particular child has in mind? In part, the answer lies in asking the child directly (Timberlake, 1978a; Webb, 1991). In addition, the representational ways in which individual children condense multiple metaphors, details, and memories into one picture and their action style in doing so provide indirect clues to the more individualized meaning in their drawings. To make educated decisions about which of these polar opposite or nuanced generic meanings most accurately represents a nonverbal child’s intended meaning, clinicians draw on their understanding of this child gained during psychosocial assessment and other interviews, comment on the observable, and await the child’s own nonverbal or verbal confirmation that the observation is accurate or not.

To continue reading go to Play Therapy Course

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