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drsarahullman
Interests: racquetball, training, vivaldi, writing, teaching, traveling, trail running, research, consulting, earl grey tea, dylan, kierkegaard, kant, wittgenstein, sartre, albinoni, alan watts, hume, dawkins, the dalai lama, leibniz, the met, wombats, chocolate- macadamia-nut coffee, neurotheology, the brave new world of social neuroscience, may, most things existential, wilson, and dennett, the incredible stringband, paul winter consort, new york anything, really big dogs, potbelly pigs, hillary and bill, cheese doodles, the sunday nyt book review, and off-off b'way.
Recent Activity
cparks: First and foremost, my best wishes for your continued recovery! Thankfully, it appears that the climate is finally shifting (or perhaps it's my wishful thinking showing) as I am receiving a fair share feedback, more as of late. Several patients of mine have taken matters into their own hands and ventured out, keeping the program but eliminating any reference to god/religious verbiage. Forgiveness is an amazing and powerful thing. It enables the bearer to simply be. To live who you are. Reminds me of one of my favorite quotes from Emile Zola "If you ask me what I came into this life to do, I will tell you: I came to live out loud". many thanks for you very kind words. It brings me joy.
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adam: Truth be known, I am an admittedly shameless ham when it comes to praise! Thank you for the kind comment.
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Ahab: Many thanks for the beautifully written and well-reasoned comment. Point taken, I am happy to stand corrected. In fact, what is considered to be the most comprehensive and well-documented account of the historical roots of AA, is Ernest Kurtz's 1979 book Not-God: A History of Alcoholics Anonymous. His writing reads like a fine novel, and he is one of the few people to have been invited into the inner sanctum in order to write the book which actually began as a PhD dissertation, with unprecedented access to privately held archival data. More to the point, my concern was and remains, what is a hole the size of a volcanic crater as it concerns not just the wording (problematic enough as it is), but of course as you illuminate, the very fact that the wording leads one to a place of disingenuousness at best, and ideological complete split in half at its worst. I am really hoping for a singular committee to form and change this incredibly glaring and rather harmful verbiage. Because as we both make mention, the program is based upon the simple premise of an "all are welcome, we are one" policy. As a devout atheist, I certainly wouldn't be welcome...
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Thomas: Many thanks for your input. I am actually a fan of your work! It is true that shame does all that you mention and more, it can be and often is a singularly crippling agent. My work is very much in keeping with Peter Levine's pendulation and we share the same theoretical underpinnings. Trauma does by definition undermine and dysregulate the otherwise regulated nervous system, and shame is a horridly significant trigger for just such an event. I remain bewildered concerning the veritable lack of literature, discussion and research on shame, with some obvious exception such as yourself, Helen Block Lewis, Donald Nathanson, and in my opinion, too few others. People of the Ojibwa First Nation, in whose strength is intimately embedded in their belief of the spirit world, talk about the prized *p'madziwin* and the dreaded *onichine*. P'madziwin is a state of enlightenment for oneself and their community, the later of which is inseparable from the self, as self and community are one. Onichine, on the other hand, can be defined as 'illness through offense', a result that befalls one when they move away, in attitude, behavior, and spirit, from all that is p'madziwin. Onichine is a state of shame, one of the all-time greatest evils. To the ojibwa, shame for the individual translates to shame for the whole of the community. 20 or so years ago, the small community of Hollow Water banded together and created one of the greatest examples of a single-mindedness in eradicating the shame that nearly killed them off. Today their legacy is known as Restorative Practice/Restorative Justice, and is a world-wide movement gaining acceptance and practice in nearly every country. The ojibwa of Hollow Water recognized that their prior legacy of a shame-based community had to change for their very survival, and in so doing gave the world the Community Holistic Circle Healing modal, and the gift of healing the destructiveness and wounding that is shame. I look forward to following your continued work on this crucial and topical primitive emotion.
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Janice: Thank you for the kind words. Actually, in answer to your important question "what types of therapy are best?" to heal a brain with these disorders, yoga and meditation have been scientifically and medically demonstrated to help heal these parts of the brain biochemically(!). The problem however, certainly as it concerns meditation, is that in order for the brain to reap the parietal and frontal lobe benefit, the impairment must first be healed at a basic level. Meaning, while full brain health is not required to begin, a modicum of brain health is necessary. So the next question becomes, then what therapeutic maneuver will help quiet the impairment at a very basic 'beginner' level. At the risk of stating the obvious, the answer is the type of targeted psychotherapy I have been discussing, with someone trained in this method, someone who understands where the impairment is and how it got there in the first place. It might sound funny at this juncture, but I really do not treat sex addiction per se, and those that do, likely have no idea what they are saying. Sex addiction is a clinically defined set of signs and symptoms that appear second to the actual problem-the real problem - specific areas of brain impairment that produce the behaviors that we then call sex addiction. Treating sex addiction is really like saying one treats bad behaviors. Treating sex addiction is to treat not just trauma, which seems to be all the rage these days, but to focus on the impaired areas of the brain and heal them. Heal the brain and you have changed the individual, whether the impairment is 'sex addiction', or a Cluster "B" personality disorder such as NPD, BPD, or APD. I hope this helps answer your very important question that may on the face of it seem simple, but is actually quite complex. More important Janice, thank you for asking the question!
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Bud: First of all, I applaud your effort in seeking out SA and following the Program. I have always been of the opinion that sponsorship and fellowship are incredibly important components to a life lived in recovery. I wish you the best in your continued sobriety and on-going recovery. Second, as it concerns forgiveness, this is a concept, an ideal if you will, that is achieved only after much contemplative thought yes, but of equal importance, after a passage of time. Forgiveness can only be reached when one has been confronted by the same/similar circumstance/demons, and instead of acting as before, has acted differently. Forgiveness is a gift to the self ultimately, but specifically, a gift that one gives to the recipient of one's initial harm. That gift is presented by way of a vow to do things differently, and then actually doing that thing differently. If it remains at the level of a vow, then one has merely made a verbal promise that has yet to be fulfilled. Forgiveness can only be fulfilled when confronted with the same or similar circumstance, and then traveling the road not previously taken. Forgiveness is something I spend a great deal of time discussing in the beginning of a patients journey, but until that person has gained (or re-gained) a significant amount of sobriety (well past the initial 90-day mark), forgiveness can only remain a conceptual thing to be achieved. One has to be understanding, earnest, prepared, and willing. These are requisite. Many people such as yourself refer to a 'forgiveness meditation'. I think of this as a conceptual exercise. However, I am also of the opinion that words without true meaning, true understanding, are somewhat empty. As such, I do not recommend that someone begin with the verbiage of "I forgive...". I actually think there is danger is doing this since it can be misleading. One cannot forgive one's self or another, until such time that they have gone through this hierarchical process. I would recommend tossing the "I forgive" part altogether, and spend time writing about the harm(s) done, without making any attempt to say "I'm sorry" or "I forgive". Write about it and then sit with it for a while. Only then can one be ready to begin the healing journey of forgiveness. I hope this has helped. It is always difficult to make linear that which is highly conceptual. Thank you Bud, for taking the time to read the blog and send me your thoughts. This is such a difficult yet vitally important topic, to people in general, but certainly to those who have chosen the right path of recovery.
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Thank you mt! If someone were to ask me which is my favorite post, hands down this would be it. Not only did i enjoy writing it (as i do with all my posts), this one felt different. I wrote this post with an urgency unlike the others. Day in and day out (in both my professional and personal life), I hear people talk about 'forgiveness', either discussing it or actually saying it to another. And each and every time, I realize that the vast majority of folks do not understand this incredibly important, difficult, and generally painful but incredibly liberating concept. I think if they did, it would not be tossed about so lightly for one, and for another, and of the utmost importance, they would sometimes, not be in the position of having to forgive in the first place. That said, please understand that I am in no way suggesting that with the understanding of just what the concept of forgiveness entails that we would then all be perfect people with guiltless, shameless perfect lives (never met such a person yet). But what I am saying, is that I do believe we would take ourselves and our actions (both before and after the fall!) an awful lot more seriously and with more presence and intention. I think the human condition is such that it is absolutely inclined to feel little hesitancy and repercussion to break something that can be so easily fixed. If all I ever have to do is say those magical little words 'I'm sorry' and have everything nice and tidy again and be absolved of all guilt and shame and be loved and respected like before my faux pas or crime, then guess what, I might not be so inhibited to commit the bad act to begin with. If diamonds were everywhere and easily accessible by anyone and everyone, then they wouldn't be worth much, right? The addict, when they are in their addiction, and with special thanks to the anesthetized prefrontal cortex, have little if any qualm of continuing to act out in increasingly disrespectful, dangerous, and callous ways, caring little if at all, how their behavior might be effecting those they love most (let alone themselves, their community and society at large). Forgiveness is a topic that it is continually discussed, and omnipresent throughout the life of the patients treatment under my care. It is of such fundamental importance (not to mention a gigantic shame-buster), that in my opinion, is the very thing that takes one from 'sobriety' to 'recovery'. My thanks again for giving me the platform to rant on my absolutely favorite subject.
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Ivosan: Of all the questions asked most (and with the most trepidation), there is no question that this is it. The answer is fairly simple; "you" can't. That is you can't without specialized, well-trained professional assistance . If you could do this by yourself I might be inclined to question whether or not you were an addict. This is a topic of some debate but not directly related to your question. When a patient first comes on board, this is explained in depth. The short answer is that an individualized (and doable) Contract is established outlining precisely how this is to be accomplished; I do not like surprises and assume my patients don't either; everything is painstakingly explained. Remember that sex addiction is an attachment disorder. Therefore, the fix if you will, is to learn how to and then to actually become attached, a neurological process that is dependent on a healthy prefrontal cortex. This occurs beginning with the very first session, wherein the Contract, and what is required in order to accomplish the simple but seemingly daunting Contract is outlined. When I hear people (professionals and lay folk alike) say things like this is not obtainable, it is not necessary, and/or it is not advisable, that is when I quickly realize these skepticisms are thrown out there based solely upon their lack of advanced education in how the brain works and therefore how it heals. It is essential to either have an advanced education in neurology or be treated by someone who does. This treatment is not only highly effective, but completely doable. Many thanks for asking this incredibly important question.
Toggle Commented Nov 10, 2011 on Sex and the Bottom Line at the sex addicted brain
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laviajera: There is no question that sex addicted individuals leave behind victims in their wake. When sex addicts are "in their addict", meaning that they have become triggered and entered a dissociative brain state, their otherwise intact defenses and social restraints seem to fly out the proverbial window along with any adherence to boundaries. This is the other side of the sex addicted coin - the victims that have been objectified during these addicted states. Like most mental disorders and disease processes, rarely is an individual acting symptomatically 24/7 in their illness. But when the symptoms do strike, watch out! I am always sorry to hear the discomfort and suffering of those that have unwittingly been targeted. Interestingly, the sex addicted individual, at some point shortly after their dissociative state has waxed and waned, will invariably become filled with utter remorse and intense shame when they take stock of their addicted behavior. This is a prime example of the Jekyll & Hyde functioning that is so very characteristic - when not in their addictive state, their behavior is generally exemplary and quite far removed from those behaviors that appear when under the influence of their disease. The addicted individual themselves do not understand their own dual functioning and consequently do not know how to characterize their problem much less go for help, and where, to whom? Many thanks for sharing your story. Hopefully a better understanding of the disease can help make sense of what you experienced.
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drsarahullman is now following The Typepad Team
Mar 15, 2010
ScottKnick: Many thanks for your candid and thoughtful response. This is a tough and touchy subject for many who follow a 12-step program not to mention those that advocate in the best interest of the folks under their care. Dare I say that the very fact you are "conflicted between letting go unconditionally and trying to establish and maintain functional boundaries when it comes to the God talk", says to me that you are operating squarely in the essence and true spirit of the 12-step program. When it comes to working through something in earnest, the problem is never that one is in conflict. The problem, the REAL problem comes when one is NOT in conflict. This speaks to the core of our desire for change and growth. I recall an old Law and Order episode wherein some criminal, moments after being nabbed and sentenced to a 5-year prison term, said to Lenny the detective, "I can't do 5 years" wherein Lenny promptly chided, "then do as much of it as you can". One of the suggestions I give at the urging of many who ask my opinion on how to stay "rigorously honest" and integrous while denying an adherence to "god" especially while visiting the rooms, is, to do as much of it as you can. In other words, at the risk of being completely trite and petulant, take what you can and discard the rest. This is a common quip heard at most of the meetings. If staying sober is what is most important (for without it there is nothing else), then one is obliged to do what they can, with as much honesty and integrity as possible, in order to maintain their sobriety - that requires for most, attendance in (and I do not mean just showing up!) a 12-step program. My problem is not with those that make the program their home - this is important to do! My problem is that the program forces the very people who rely on it, who need it for their very survival, to subscribe to something that is often in direct opposition to a fundamental part of who they are and what they believe. It asks of many not just to SAY something they do not subscribe to or believe in, but to in effect worship and be made whole by, and spread the message to others who may also not believe, a core aspect of something that is in direct opposition to their spirituality and sense of self. And then, as if that were not problematic enough, it turns around and says that in order to be in recovery, one must maintain a spiritual self. This is fundamentally wrong and even dangerous. It reminds me of the psychological notion of being "gaslighted". Most importantly ScottKnick, please know that "living with authenticity, compassion, awareness and equanimity" are some of the most beautiful words in the English language, and to live with them and of them, is really, in my not always humble opinion, the most spiritual and right and kind and loving thing any person can do - in or out of the program. Honesty does not just mean being honest, it also means that you STRIVE for honesty, but when it is not possible, when it is not in one's best interest, or the best interest of others to be scrupulously honest and when to do so would harm you and/or them in someway, then it can be said that being AWARE of your dishonesty and recognizing that it may be in service to ones self or others to act in such a fashion, then we are acting in a genuine, deliberate, and authentic manner, as circuitous and counter as that may seem. That said, the program MUST change for its own integrity and the integrity of everyone in it, present and future. I hope it does. I know it can. Thanks so much for sharing your post and allowing me the opportunity to respond in kind.
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John: One of the very problems that have plagued the dissemination of sex addiction research and literature since the get-go, is a steady stream of moralistic misinformation or actual research that was unfortunately couched in a religious or otherwise thinly-veiled and highly-bias setting, further clouding the effort to define "sex addiction" as a legitimiate neurological addictive disorder or disease process. Unfortunately sex addiction is often lumped together with a host of sticky-wicket taboo subjects and topics that become a breeding ground for social moralizing, all of which serves as good media fodder but sadly, provide a hideous diservice to the actual science and real information that is necessary in order to understand, treat, and penultimately eradicate this very treatable and dare I say preventable disorder. So please accept my sincere gratitude for both your comments and the oportunity to ramble on about my passion and mission which is two-fold: to accurately and scientifically present the latest cutting-edge research on sexual addiction, free of bias, unfeddered and unattached to outside sources, agencies or funding, and to disseminate the information to the widest international audience in the hope of a more accurate way in which to garner scientific interest, understand, diagnose, treat, and ultimately curtail if not prevent, sexual addiction as it manifests in hundreds of thousands of people worlwide (and growing exponentially thanks to cyberporn in younger and younger persons). Thank you John, for finding the blog, for your kind encouragement, and for taking your valuable time to write in and let me know that people are tuning in!
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anon SA - Many thanks for taking the time to share your thoughts. You and those like you are EXACTLY why I have this blog! I particularly want to call attention to what you said about "grief", or put another way, mourning your old behaviors and a large part of who you were - this is really an important concept that few people realize. You are learning how to re-live your life and change significant parts of it that were in fact defining features of what your life was all about - no small feat here. Many people see their BEHAVIORS as the same thing as their PERSONALITY - they ARE what they DO. There is some truth to this and it is where the "rewiring" of the brain comes into the picture. Our brain buys into our behaviors and doing good things or what we call prosocial behaviors, does change the brain and our belief in how we perceive ourself (and others). If we DO good, then we must BE good on some level. Much research has demonstrated this very point. This is an example of how WHAT WE THINK directly influences HOW WE FEEL and how we feel in turn can dictate our behaviors. Nowhere in my opinion, is this more clear than in sexual addiction. The bottom line here is that sex addiction is about the brain, and being in recovery from sexual addiction means doing the requisite things that will change those parts of the brain that were damaged. But you cannot change what you do not know is broken, so the first step if you will, is learning that what you have is repairable and finding the tools you need to get the job done. In this case, understanding, willingness, and fellowshiping are the big tools of the trade. Best of luck to you and keep me posted!
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Susan - Great question! Unfortunately, research finds that cyberporn is NOT the same as that proverbial "magazine" under the bed". First and foremost, kudos to you (and your son) for raising a youngster that feels comfortable enough and is honest enough to confide in you on this very delicate issue. Second, most parents semi get around this issue by preventing their kids from having a puter in their private spaces such as a bedroom. This becomes nearly impossible however for the tween and teen set. The answer seems to be a filtering program. A Net Nanny program would filter everything with the words that you input, such as "sex" or "porn". Another great choice which might be right for you given your relationship with your son is what Covenant House offers which is an "accountability" program. It does not prevent sites from being opened, but provides a sort of log of those sites that are visited, hence providing an accountability to you and of course your son. This is generally a great first step. If this proves problematic, you can always up the ante and move to a blocking program such as Net Nanny. And I would share this info with your son who sounds as if he would be willing to do this. If he is not, that might give you lots of information right there! Good luck with this and keep us posted on what works.
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