Rabbi Feuerman's Intervention Model for Lust Addiction
Rabbi Simcha Feuerman, LCSW-R, sent us the following overview on how he views the problem of lust addiction, and his solution through therapy:
My clinical orientation is psychodynamic, relational, family systems, CBT to correct distorted thinking and beliefs, EMDR to reprocess traumatic neural networks, and 12 steps for addiction. However, as a practical matter, this is how I approach troubling sexual behavior:
First and foremost, I try to assess the nature and degree of compulsion and addiction, as well as find out about other stressors and level of functioning, such as depression, past sexual traumas, conflictual family relationships etc that may make these escapes more tempting and also complicate the feelings of guilt and worthlessness that often ensue.
For some, the problem may be more of being ashamed and tormented by guilt, for succumbing to desires that are natural - though of course the behavior may be immoral. The approach in those situations is to work to find healthy outlets, develop a balanced and realistic self-image and philosophical perspective that can be accepting of failures, learn techniques for stress reduction, identify social and vocational goals that add meaning and satisfaction to life, and to learn to do the best you can to avoid being megarer the yezer and avoid triggers, while at the same time learn to move on and let go if there is an unfortunate occasional lapse. Individuals in this category may have introjected a very punishing and harsh G-d in the image of a critical parent, and the work may involve correcting distorted thinking and beliefs as well as addressing past traumas.
Others however may be deeply involved in compulsive and addictive behaviors. In those instances, a general rule is that for every out of control and unmanageable external behavior, there is a corresponding out of control and unmanageable inner life problem. For example, when a man is surfing the web all night long, looking at porn etc, after some exploration I might discover he has a learning disability and sits all day in kollel not really learning but just faking. He is acting unmanageable and out of control in his expectations of himself, i.e. forcing himself to fit a mold of a scholar, and then relieves his tension via his lust addiction. Or a man may secretly feel guilty and conflicted about his choice of spouse, never really having been attracted to her. He obsesses secretly and is tormented with guilt and shame. He has allowed himself to get stuck in an unmanageable life, and then he continues to regulate this unmanageable tension in his sexual behavior. Or a workaholic whose business is out of control and soon to be overwhelmed with debt. The psychotherapy portion of this treatment is to help the person become aware of how and why his life is unmanageable, and then to learn the necessary emotional skills to restore balance. If need be, past traumas may need to be reprocessed to reduce emotional reactivity. In addition, the fellowship, encouragement and guidance of Twelve steps and/or other GYE resources are necessary as well to introduce and reinforce healthy thinking, beliefs and lifestyle.
Rabbi Simcha Feuerman, LCSW-R, can be contacted at 718 793 1376 or by e-mail at firstname.lastname@example.org. (If you contact him, please let him know you got his info from GYE).