The Meadows Blog

The Meadows will sponsor a breakfast at a multimedia presentation by Debra Kaplan, MA, LAC, LISAC, CMAT, CSAT-S, on Thursday, November 8 from 8:15 to 10:30 at the Tucson Jewish Community Center. Debra's topic is "Emotional Incest: The Elephant in the Therapeutic Room." 1.5 CEU's are being offered for this event.

Much is written regarding the devastating effects of sexual abuse. However, no less destructive but often overlooked is the wounding of emotional incest (EI) or covert sexual abuse (CSA). Many a skilled clinician has missed the glaring signs - deflection, family loyalties and relational sabotage- to name just a few-; passing as the incestuous pink elephant in the room. Our clients are not aware of their internalized messages and iron clad loyalties holding them hostage from an emotional freedom. Join us for this multimedia presentation as Debra Kaplan explores the foundational family dynamics underlying EI and CSA, and the adaptive, trajectory of interpersonal and relational consequences.

To register and for more information, please visit

Debra Kaplan is a licensed therapist in Tucson, Arizona. Ms. Kaplan specializes in the treatment of attachment and intimacy disorders, complex traumatic stress and accompanying dissociative disorders. Debra's area of expertise includes sexual addiction/compulsivity; issues that are often rooted in unresolved childhood trauma. Debra serves as faculty for the International Institute for Trauma and Addiction Professionals (IITAP), founded by Dr. Patrick Carnes and publishes and presents nationally on trauma and sex addiction. Debra has received additional training at The Meadows Wickenburg. Debra continues to study under Pia Mellody, a preeminent authority in addictions, relationships, and codependency at The Meadows.

Published in Blog
Monday, 21 November 2011 19:00

Denial by Michael Cooter

The current news coverage regarding the alleged sexual abuse perpetrated by Sandusky can potentially be activating of old memories for many men and women. Most people react with disgust, rage, and shame due to their own abuse histories that involve being sexual violated. Some others may find themselves acting out or acting in without consciousness of the trigger for their behavior. Regardless of the outcome of the Sandusky case, there is help and more importantly hope for survivors of sexual abuse. It is imperative to process thoughts and emotions regarding the abuse. Vital is for the individual to recognize that they did nothing to cause the abuse. They are not to blame. An Insidious feature of sexual abuse is for the victim to internalize and carry the shame of the shamelessness of the perpetrator. Feelings of shame and guilt are pervasive. Feelings of anger and rage often are expressed directly and indirectly to others. A classic question most, if not all, survivors ask is "what did I do to cause this to happen?" Men, in particular, have a greater propensity to express their emotions with rage, covert / hidden depression, and if the perpetrator was male - homophobia. Hope for the survivor comes with processing the abuse and engaging trauma treatment modalities such as EMDR and Somatic Experiencing to gain some resolution of what happened to them. Surviving sexual abuse, particularly from childhood experience, allows the individual to establish sanity in their lives, intimacy with loved ones. It affords the individual the opportunity to embrace the joy that can be found in life. Message to the survivor: "you did nothing wrong", "you did nothing wrong". Stepping out and accessing help in the form of counseling, peer support, or inpatient treatment is the first step in the journey of healing. You are not alone. Secrecy binds the individual to the trauma. Secrecy allows the abuse to continue. We all have a legal, moral, and ethical obligation to ensure the safety of all children. Report, report, report.

Michael Cooter, MSSW, LCSW

Published in Blog
Sunday, 28 August 2011 20:00

Sex Addiction and Sex Offending

In the world this past week the curtain was pulled back to reveal an International sting identifying 72 individuals (all of whom are men) charged with the sharing and distribution of website images depicting physical and sexual abuse on infants and children. The private networking site called Dreamboard consists of over 600 members.

More illuminating is that Dreamboard is a part of a larger more sophisticated online child abuse network promoting pedophilia, called Dreamland. Dreamland is a private, online bulletin board in which as many as 600 members could file share upwards of ten thousand videos or images of sexually abused infants and children.

A member's level of contribution defined the member's level of access. Those members who "merely" swapped and exchanged images (file sharing) had more limited access as compared to other members "prestige" access that photographed, uploaded and swapped newer more violent images of their personal physical and sexual assaults on young children. Those members ranked in what was termed, "Super VIP." What was revealed this past week speaks to those horrors and atrocities that humans are capable of inflicting on the smallest and most vulnerable among us - children and infants.

But, no sooner were the Dreamboard events splashed across global media venues they became eclipsed by and buried under other fast breaking, news worthy expos the kind that speak to downgrades in a national credit rating, global war crimes and credit concerns.

I suspect that while the Dreamboard fallout is far from over, the collective and visceral disgust that was felt when learning of the multinational sting operation was too horrific to remain "on the front pages."

As a licensed therapist who works with trauma and sexual addiction, I see people, behavior and associated definitions as being along a continuum. People (clients) and their behaviors (either collectively or individually) will ultimately come up against my defined continuum of behavior that may be healthy, traumatic expression, addicted, compulsive, morally void or outright sociopathic.

Further, my personal definitions or consideration for my clients' sexual behavior may be seen as acceptable or offensive to some.  Simply because what I define as acceptable or not, may not coalesce with another. I don't think there is a clear cut understanding or explanation for the clients I see or the behaviors of humanity.

Trained and experienced therapists among us who treat organic, sexual disorders and sexual compulsivity grapple with the theoretical and real-life meaning and definition of human behavior. While no two therapists may see eye to eye on what constitutes a clinical description for sex addiction - an issue currently debated before the American Psychiatric Association. The next and fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM), the controversial "go-to manual" for clinical designation and classification of mental disorders, is currently in planning and preparation. The publication date is revised for May 2013 - we are likely to agree on this: all sex offenders are not addicts and some sex addicts may become sexual offenders. Nonetheless, sex addiction is no more considered sociopathic than drug addiction, gambling, eating disorders and alcoholism.

While individuals who struggle with addiction may also exhibit and indulge in sociopathic behavior the definition of addiction as defined by The American Society of Addiction Medicine (ASAM) does not include the word sociopath in its definition no more than sexual compulsivity. More often than not, the words addiction, like sex addiction and sociopath are mutually exclusive.

It is important to delineate that sex offenders may engage in sexually compulsive behavior; however not all sexually compulsive behavior involves sexual abuse to minors and therefore, deemed sex offending. Before an individual is classified as a sexual offender and branded by society as sociopathic, a psychosexual evaluation and other mental status examinations are administered by a trained professional.

I see my role as a human practicing in the capacity of caregiver, to be as open and accepting of behaviors in which my clients engage, until such point that I can no longer be objective or open to empathic understanding. At times, and not as of yet, I may come up against my own biases and for reasons of self-care, draw the line in my own defined continuum of unacceptable. Trauma, sex and humanity will for sure never cease to confound, dismay or even disgust.

The sex addict who struggles is worthy of the same compassion as the alcoholic, eating disordered woman and medical provider who abuses prescription pills. Sexual offending behavior along the lines of Dreamboard are deemed illegal and by most societal norms - repulsing. I suspect that events such as Dreamboard's recent detection, while news worthy, is too incomprehensible for most individuals to absorb let alone read in sordid detail.

As I explain the world to myself, there are times that sociopath and sex addict may not be mutually exclusive. Neither, by comparison may a sociopath and medical care provider. Extrapolating along that trajectory neither may a sociopath and a parent. Unfortunately, the two descriptors can and at times do co-exist with devastating results. History has shown us that time and time again. We humans are capable of horrors and atrocities beyond imagination and I suspect until science intervenes, the collective "we" always will.

Debra L. Kaplan, MA, LAC, LISAC, CMAT, CSAT-S is a licensed therapist in Tucson, Arizona. Ms. Kaplan specializes in the treatment of sexual addiction/compulsivity,

Complex traumatic stress and dissociative and attachment disorders. Debra publishes and presents nationally on trauma and sex addiction. She maintains active memberships in the Society for the Advancement of Sexual Health (SASH), the International Society for Traumatic Stress (ISTSS), International Institute for Trauma and Addiction Professionals
(IITAP), and EMDR International Association (EMDRIA).

Published in Blog
Thursday, 17 February 2011 19:00

Frequently Asked Questions about Sex Addiction

I receive many questions about sex addiction. I thought I would share some common questions...

Does all sex addiction come from abuse? I don't think I was abused as a kid.

There are two ways abuse can manifest; the first is overt abuse. Overt abuse is usually aggressive behavior that is measurable, such as bruises, a raised voice, a verbal attack, or an insult. The second is covert abuse. Covert abuse is passive, often unconscious, and not seen as abusive (such as withholding love, giving a stern or threatening look, failing to protect a child, or minimizing his or her realities). One can be abused covertly and/or overtly and, no matter how the abuse is perpetrated, it always leaves victims feeling shame and pain on some level.

Individuals often normalize abusive behavior or, even worse, blame themselves for the abuse. "If I hadn't been drunk, I wouldn't have been raped." "Putting each other down is just what my family does." When it is pointed out that these are examples of abuse, often the reaction is denial, defensiveness, or confusion.

Because of these common reactions, it is important to grasp the scope of abuse and to become aware of how abuse may have affected or influenced one's life.

Once an individual begins to understand the scope of abuse they can see how it set them up to feel disemboweled as a child because of the continual fear, guilt, and shaming one received. The wreckage of such abuse leaves all sex addicts with a sense of betrayal so severe that they lose the ability to trust. They are convinced that if they are seen or really known, they will be despised.

Too afraid to tell anyone, the addict learned what was perhaps his most powerful coping skill. He learned to live a double life- a life of secrets and lies, where shame festers, multiplies, and spreads like a deadly cancer. But when one can establish a bond of trust, they can have a respectful attachment- a place at which the healing can begin.

What does abuse look like?

Below is an outline of the types of abuse, with examples of specific behaviors in each category.

I. Physical Abuse (any forced or violent physical action)

  • Hitting
  • Punching
  • Scratching
  • Spitting
  • Pushing
  • Burning
  • Burning
  • Choking
  • Poking
  • Unsolicited touching or tickling
  • Restraining
  • Pulling hair
  • Slapping

II. Emotional or Verbal Abuse (putting down, threatening, and saying cruel or untrue things about another person)

  • Cursing, swearing, screaming
  • Harassing or interrogating
  • Insulting, name-calling, shaming, ridiculing
  • Threatening to harm; beat up; sabotage; hurt; maim or kill pets, children, or
  • family members
  • Controlling others (e.g., through money or power)
  • Criticizing
  • Forcing others to engage in degrading acts
  • Making accusations
  • Blaming
  • Intimidating
  • Punching, throwing, destroying property
  • Going through others' property or possessions
  • Stealing
  • Threatening to kill oneself as a form of manipulation
  • Sexualizing others
  • Driving recklessly
  • Stalking
  • Not letting others sleep or eat
  • Making facial expressions or physical gestures that indicate judgment, rejection, ridicule (e.g., smirking, covering the ears as if unwilling to listen, walking out of the room while someone is sharing, rolling the eyes, shaking the head, moving the hands in a manner indicating that the other is wrong or inadequate)

III. Sexual Abuse (any nonconsensual sexual act, behavior, gesture)

  • Not respecting "no"
  • Making sexual remarks, jokes, innuendos, suggestions, insults
  • Taking advantage of situations and exploiting others' intoxication or incapacitation
  • Demanding or manipulating unwanted sexual acts (e.g., anal penetration, physical restriction, choking, golden showers, oral sex, sadomasochistic acts, role-playing)
  • Having unprotected sex while knowingly having a sexually transmittable disease
  • Giving sexual criticism
  • Engaging in inappropriate touching (e.g., touching in public, grabbing, pinching the breast or groin)
  • Blackmailing or manipulating the vulnerable (i.e., the much younger and/or sexually inexperienced, the disabled, the mentally or emotionally challenged)
  • Taking advantage of a power differential (e.g., the case of a boss, clergy member, lawyer, judge, law enforcement officer, landlord, teacher, coach)

IV. Neglect (failing to provide the essential necessities for a child, including the following)

  • Nurturance
  • Clothing
  • Medical care
  • Dental care
  • Security
  • Protection
  • Hygiene
  • Education
  • Supervision
  • Shelter
  • Attention to physical, emotional, and intellectual needs

This outline does not include every possible abusive behavior, but it does provide an overview of abuse.

If you would like to read more about this, please visit

Published in Blog
Friday, 17 December 2010 19:00

Decisions in Recovery

In "Fabled Truths and Family Lies," published in the Meadowlark Summer 2010 newsletter, I wrote about a client's experience with childhood sexual and emotional abuse, her skewed self-doubt, and her perceptions surrounding that abuse in her family-of-origin.

Specifically, I addressed the challenges that arose for Leah* as she confronted her family's collusion and denial regarding the abuse perpetrated by her father. The article explored Leah's heroic, albeit painful, journey into recovery as she turned a reflective lens inward on her own need for healing. By so doing, she rejected and separated from her family members' need to preserve their own version of the events.

That article hit an emotional nerve with many readers and, in the ensuing months, I've received several emails expressing relief and appreciation for the topic.

I also received a letter from a reader who described her own struggle with her decision to separate from her family-of-origin in order to begin her journey of healing. In her letter, she posed the question of whether her journey toward healing, which involved both physical and emotional distance from her family, was worth the price. That price, she went on to say, came in the form of missed opportunities to be with her family, emotional and physical distance from them, and the loss of a family bond. This reader closed her letter with this question:

"When we separate from dysfunctional family systems, are we in fact hurting that system? Or are we perhaps contributing to its healing by the void we leave in our place?"

There is no ONE correct answer, as each family system has its own fluid and relational dynamic. The healthier and preferred option for one individual (e.g., staying involved in an attempt to affect change) may not be applicable or recommended in another family system with different dynamics. The interaction that distinguishes one family system as healthier and adaptive might not be operative in a more dysfunctional, rigid, or disengaged/enmeshed family.

There are times when a void left by our absence beckons the very change we sought to achieve by our presence.

As a therapist, I often address such therapeutic quandaries. What one individual chooses to do in one circumstance may not be the best course of action for another, even when different individuals make those decisions within the same family unit. Hence, decisions made by siblings or other family members may be different, as each member's relationship to the family system is different.

Inevitably, all decisions that we make for healthy recovery come with consequences. This might be the only certainty: that a consequence is certain.

I often ask my clients to play out a proposed decision to their end. In so doing, I ask them to remain mindful of likely outcomes and, more importantly, to be aware of outcomes that are potential or perceived. As we work through this process, my clients must weigh the emotional, physical, spiritual, sexual, and financial cost/benefits of their decisions.

Leah's decision to separate from her family led to her desired outcome of healing and recovery. For another individual, staying in contact with her family - while using boundaries and increased self-care - may lead to, but by no means guarantee, the desired changes in the family system.

Easy, straightforward answers are rare. In matters concerning our families-of-origin, our only guarantee is that we will struggle in our path to serenity.

Published in Blog
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