Online Counselling or Face to Face Consultations in Sydney, Australia

Ash Rehn QindsmI’m Ash Rehn, counsellor, coach and Medicare Provider. Take a look around to find out more about my in-person and online services.

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Are You Man Enough? Does Masculinity Therapy Work for Porn Addiction, Anger and Violence?

man lying on bedPorn Addiction recovery groups for men sound like a good idea. Telling your story to a supportive audience has been demonstrated as an effective way to gain more influence over your life. But what about challenging men to be more manly? Is this kind of ‘masculinity therapy’ really in the interests of men trapped by gender expectations and ever-tighter definitions of what it means to be a man?

Therapy Groups for Porn Addiction: Promises and Possibilities

Less than two weeks ago I read a newspaper article promoting peer support workshops for men struggling with their use of pornography. Workshops are an interesting addition to the landscape of therapeutic responses out there. Some men have tried, and abandoned 12-step groups like SLAA and SAA because being labelled an ‘addict’ was not so helpful to their recovery or because the dogma of the group did not fit with their personal experience. So if men get to discuss their own relationship with pornography in more open ways, it could only be a good thing, right?

A couple of aspects concerned me. This program was obviously not neutral towards, but decidedly anti-, porn. Of course this begs the question of the definition of porn, but in any case it seemed there was no room for men in the groups to negotiate their use of erotic imagery or literature. If you are told what you must think about porn, does it leave space for you to make up your own mind?

“They feel their natural libido return and feel more alive, more masculine, more in touch with their natural sexuality and they notice how women feel that.”

- taken from the pornography workshop group website

Secondly, I always wonder about the ethics of promises for such programs. ‘We will transform your life’ sounds to me like an impressive claim. Can therapists make that promise to a person? The other thing I noted were remarks about natural sexuality. What is that? How possible is it to experience sexuality outside the influences of culture? And who decides what is ‘natural’ and what isn’t?

How to Be More of a Man: Commitment or Con-job?

What about men who are not particularly interested in feeling more masculine or being drawn further into the gender binary? And what about gay men? According to the group promotion, these pornography use problems all come from our wounded child and yet the program still challenges us to be man enough. How often did you hear the following questions when you were growing up?

  • Are you man enough?
  • Are you a real man?
  • Are you a man or a girl?

If you poke around the Internet you will find many articles and websites addressing men’s loss of masculinity and even the crisis in masculinity. Of the crises that come to mind, ebola and the spread of religious fundamentalism through terrorism would be at the top of my list, but I am not sure what to make of a supposed crisis in masculinity. I’ve had quite a lot of men contact me reporting they don’t feel masculine or manly enough, but is the answer simply to boost masculinity?

After seeing this article, I heard about another violent attack at Sydney’s Bondi Beach where a man was hit with a ‘coward punch’. Apparently this is the preferred term to ‘king-hit’ these days, yet it suggests that using more than one strike or to have a ‘proper fight’ is somehow more honourable. The same weekend, one of the games of the Super League Grand Final at Manchester was interrupted when one of the players held down another on the field, repeatedly punching him in the eye. Then there was a report from Sayreville in New Jersey that a number of high school students had allegedly been sexually assaulted and anally raped, with objects and fingers, by older players on the school football team.

Are you man enough?

Back in Australia, we had the government Finance Minister refer to the leader of the opposition as a ‘girly-man’.

Aren’t you a real man?

To this, another politician made the observation: If we use ‘girly’ as an insult, what are we telling men & boys about being a girl? Isn’t it suggesting they are less confident or weak?

Toxic Masculinity and Competing Masculinities

What do all these stories of violence and abuse by and towards men have in common? Well someone (most likely a man from the mythopoetic mens movement) coined a term for the kind of masculinity that involves aggressively competing against and dominating others: Toxic Masculinity. What strikes me most is that the usual response to men not feeling masculine enough and the claims of crisis in masculinity is just to offer up competing brands of masculinity. And this seems to be the point of the pornography addiction workshops as well: return men to their natural sexuality make them feel more masculine and everything will be okay again.

The light in this dark week was an opinion piece by the English actor, comedian and writer Robert Webb of Peep Show fame.

Nobody ever told me: you don’t have to waste years trying to figure out how to be a “man” because the whole concept is horseshit.

- Robert Webb

Webb describes the orgy of make believe violence that was his childhood, learning to be a real man.

If you have time and it is still online, read the article in the New Statesman. Unlike the blurb for the porn addiction workshop, I can’t promise it will transform your life, but it might point you in the direction of an alternative.

Notions of gender pointlessly separate men from women, but also mothers from daughters and fathers from sons. The whole thing is – at best – just a stupefying waste of everyone’s time.

- Robert Webb

Undefining Masculinity, Recovering Humanity

Resorting to calls to be more of a man seems pointless, especially when these competing definitions of masculinity are what trap men into violent ways of being in the first place. Perhaps the competition between masculinities is toxic too. It would be inspiring to see less about being a man and more about being a human. That doesn’t minimise the principle of taking responsibility for your actions, it just suggests that perhaps it isn’t so important to obsessively define yourself in relation to women or the gender performances associated with women.

As for groups for men concerned about pornography use, I think they are a great idea but how about a workshop program which does not simply problematize porn use or require men to live up to new standards of masculinity. The Australian men’s mental health initiative softenthefckup argues…

We don’t need to redefine masculinity, we need to undefine it.

That makes a lot of sense to me. If you want to have a private conversation about being a man, your masculinity, your porn use or being more human, send me an email. I won’t tell you to stop what you are doing or expect you to be manly. You are welcome to be yourself and let me know what you want out of our time together.

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Treatment for Pornography: From Disease Model to a Response by Men

Young couple in the couch having conflict problemTreatment for Pornography Addiction often focusses on the act of watching pornography and assistance to try to reduce the ‘behaviour’. But if such an approach doesn’t work, what are the alternatives and why don’t we hear more about them?

I’ve been working with concerns about addiction to pornography for a number of years now. When men started to contact me seeking help (and it was mostly, although not always, men who wanted help with porn use) many of them came to me equipped with a glossary of terms from 12-Step programmes like SAA (Sex Addicts Anonymous), SLAA (Sex and Love Addicts Anonymous), SCA (Sexual Compulsives Anonymous) and SA (Sexaholics Anonymous). They spoke of concepts like ‘sobriety’, ‘healthy sexuality‘ and ‘bottom-line behaviours’.

Alternative Treatment to 12 Step Programmes

Some of these men had invested quite a lot of time reading about these models of addiction, understanding the group concepts and attending groups. At the same time, they were consulting me because the groups and 12-step programmes had not completely worked for them: they were still using pornography or were dissatisfied with the amount or type of pornography that they were viewing. Ironically, most of the men who had turned to the 12-step model seemed to want to continue to use the terms and concepts the programme had taught them, despite deciding it hadn’t worked.

It is not always possible to continue to view our actions through the same lenses to which we are accustomed, particularly when those lenses fail to provide us with clarity or vision. One of the difficulties of trying to develop what I call ‘self-agency’ when working within a 12-step model is that the model itself tells the person he is powerless. So it is kind of at odds with the idea of gaining more influence over one’s own life and actions.

The ‘brain chemistry’ model supports a sense of powerlessness as well. If we don’t understand the chemistry of the brain – and perhaps even if we do – we are at its mercy. But dialogue can create meaning. Do we really need to pretend pornography use is all about complex science only specialist medical doctors understand?

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Brain Chemistry or Sobriety? Both are Disease Models of Porn Addiction

Both of these approaches assume that pornography use is a disease. And many people are surprised to find out that there is no diagnosis of pornography addiction according to the major disease classifications,  I realised quite early on that simply accepting that addiction to pornography was a disease would spin off a number of assumptions about a person’s use of pornography that might go unquestioned. So instead of looking at what was the same for these men who were consulting me, I started exploring what might be different for them. And I found many differences. In fact, every man who contacted me had a unique story. While there were some common threads, failing to approach their stories as unique narratives of porn use clearly meant I was missing crucial details about what was significant in each man’s history and the way porn had found its way into his life.

I believe it is disrespectful and fundamentally flawed to use a ‘colour-by-numbers’ approach to concerns about porn use. We need to look beyond the act of a man looking at pornography and instead consider the ways in which that act might be a response. And to what it might be a response. Focusing on porn use as a problem rather than as a response is like simply focussing on cars as the cause of traffic accidents without ever considering transport needs. People watch porn for many different reasons. What I offer is a chance to explore those reasons and investigate how pornography has taken such a place in a man’s life.

But there is another point to be made here. It’s not my place to judge a person’s porn use. The medical model suggests we give ourselves up to the doctor or psychotherapist who presumably knows best. The risk is that the patient or client becomes more or less a helpless victim. When men contact me, I’m interested in their concerns and why they are finding their porn use a problem. I don’t start with an agenda that I know best. So these therapeutic meetings are dialogical: they happen through conversation. They aren’t about instructing men what to do or passing judgement on their actions. Instead we explore the topic brought to the session and develop meaning around it together, in dialogue. That is the way to new understanding and more influence over the choices made in life.

You can contact me if you would like to make an online appointment or meet with me in-person.

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Healthy Sexuality and Sexual Addiction: Two Ideas Worth Exploring

Unhappy couple in bedroomI was recently contacted by a student who was writing a paper about ‘sexual addiction’ for a college course on sexuality. As a counsellor and therapist in private practice, I’m not usually in a position to offer so much assistance to students (I receive many requests and my time with people is my livelihood) but my curiosity was drawn to the theme of his particular course: Healthy Sexuality.

Sexual Addiction and ‘Healthiness’

To date there has not been so much written about the idea of sexual addiction from a narrative therapy perspective. When I saw the course title, what immediately struck me was the lens of healthiness through which sexuality was being judged. I know this is a very common way to consider sexuality because I hear it all the time. And I began my career working in the field of sexuality as a ‘health educator‘. In a state, culture and era when public dialogue about sex was largely taboo, health (and specifically HIV) provided an entry point to talk more openly. The rules were that our sex talk had to be the interests of public health.

When people consult me about sex addiction, they are often describing their actions in terms of whether they are ‘healthy’ or not. These days the concept of healthy human sexuality has become such a norm it is a cliche. It seems to me that, particularly since the onset of AIDS, ‘healthiness’ is the primary lens through which we tend to view sexuality. It is taken for granted that sex and sexuality must be ‘healthy’ first and foremost. And this makes me curious about the division that is made between ‘healthy’ and ‘unhealthy’ sexuality. How useful is this binary? And who determines what is ‘healthy’ and what is not?

It also has me wondering about what happened to other perspectives or lenses through which we might view sexuality. What does sexuality look like, for instance, through a lens of Pleasure? Or a lens of Community? Or a lens of Power? Or Spirituality? Or – dare I say it – ‘Fun’?! What does your sexuality look like if you view it through those lenses instead? Or how about through the lens of Self-Knowledge, finding out about yourself?

Exploring Sexualities and Alternatives to ‘Addiction’

It does strike me that when we start looking at sexuality through a lens of ‘healthiness’ we might also be standing firmly within the disease model. It’s no wonder these fears about addiction figure so strongly when we are viewing ourselves with the presumption of a deficiency or possible health disorder. We lose the context. In the stories I hear, people tell me about the steps they are taking in exploring desire. They describe themselves acting on urges they have had for 30 years but done nothing about due to shame or fear of ridicule. Others tell me about strategies of using pornography for stress relief, or to relieve boredom or to escape from grief that has overwhelmed them. Some people tell me how good they feel when they have sex but say they can’t share this with others because of taboos around discussing sex. I find myself engaged and interested in the courage, skills and abilities of those who consult with me and we draw on all of these in our work together.

history of sexualityIn his book series The History of Sexuality, the French philosopher Michel Foucault claims that the concept of Sexuality itself was developed to ensure power remained with certain people. Sexualities are proscribed in the same way that particular activities or behaviour might be regarded as disordered or pathological or unhealthy. In narrative therapy there is an idea that people can be experts in their own lives. This certainly challenges the standard model supporting doctors, psychologists and psychotherapists as the experts, but it is a way of thinking I personally find exciting and empowering.

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Inspiration in Treatment: The Rewards of Working as a Therapist in 2013

Celebrating 2014How was 2013 for you? What does 2014 have in store? Do you have any New Years Resolutions?

When out socially, I’m regularly told that my work must be demanding, difficult and depressing. It must take its toll on you, people say.

I don’t want to pretend that being a therapist isn’t challenging and personally tough at times. It is. But it is also a vocation full of inspiration and motivation. I thought I would take the time in this post to appreciate and reflect on the meaning and fulfilment I gain from therapeutic consultations and to share some of the most rewarding aspects of my work from 2013.

Therapy as an ‘In Treatment’ Journey

This year, I have met and continued to work with some wonderful people, journeying with them through confusion, uncertainty and change. An ongoing therapeutic relationship is like travelling with someone. You get to know them over time and through different moods and experiences. You see their ups and downs, are privy to their fears and share their relief.

Some of these are short journeys, for example, adjusting to separation or the breakdown of a long term relationship. Others have been over longer periods or are ongoing: helping guys who are coming out later in life; assisting adults responding to memories of childhood physical or sexual abuse; supporting those in grief around the death of their partner or a loss of direction in life.

In both my short term and long term work, I admire the preparedness of those who consult me in treatment. I notice and call attention to their courage or their skills, their abilities. I’m curious about the sense they are making of their circumstances. I hear their stories and draw out the meaning they make of what is happening to and for them.

Sex, Sexuality and Relationships: Inspiration through Counselling

One of the areas in which I specialise is depression experienced by gay men. In these conversations, we often find ourselves pulling apart the way in which their identities as gay men have been constructed and taking a closer look at what might have contributed to depressed feelings. I’m very conscious that most of us seem to develop our identity against the backdrop of heteronormativity (and homonormativity). Many men feel constrained by the way sexuality has been defined in the last 50 or so years, by the prevailing assumptions about sexuality being fixed. For some of my clients, the only word that comes close to their experience of themselves is ‘bisexual‘, but they say this does not really work for them for a number of reasons.

There are also questions of masculinity to be explored and I always find these conversations stimulating because, as quite a few guys have pointed out to me, the representation of masculinity in popular media is quite limited. This year, I intend to develop my site www.GayCounsellor.com.au with short blogs and articles that will be of interested to all men.

Something else that has been on the radar this year has been the return to dating or relationships by both men and women who are in what they might describe as ‘middle age’. It might be that a long term partner has passed away, or that the person is beginning a new life post-separation. I might be speaking with a man who has lived most of his adult life with a woman, raised children together with her, but decided now to take a new direction, one that feels more comfortable and in keeping with his sense of sexual orientation. Or it could be someone who has spent the last 20 years having casual sex, who has decided they want to experience something different.

These new directions can be quite scary and also take some time. People often feel they have ‘messed up’ or ‘failed’ when trying to establish a new relationship. Sometimes they tell me that it is about learning to date again. They say they feel like a clumsy teenager trying to get a boyfriend or girlfriend. Often they end up finding themselves in treatment, recovering a sense of connection with something quite important about themselves they had lost.

Developing Professionally as a Therapist: Some Reflections

Through this year, I’ve also changed and grown from my experiences. I was fortunate to attend an international social work conference in Kochi, India and present a workshop to an international HIV conference in Paris, France. I lived across 2 continents and worked with individuals and couples across the world. Due to my masters studies commitments, many of these conversation have been online over webcam. Colleagues are usually surprised when they hear I have conversations with individuals in cities as far spread as Moscow, Bangkok, Dublin, Stockholm, Baghdad, Perth, Capetown and Tokyo. But online clients continue to tell me that they feel more at ease working this way online. I’m convinced online counselling and therapy has a big future and can exist alongside ‘face to face’ therapy as another option for accessing help and support.

I’m now working in-person in Sydney Australia again, as a Medicare provider while I continue with my online clients. The Australian healthcare system is one of the best in the world, up there with the NHS in Britain and the public health system in Sweden. Each has its limitations but I feel quite privileged to work in cooperation with GPs to improve mental health outcomes for individuals. I am grateful to the AASW for representing my interests as a mental health practitioner.

My hope for the year ahead is to continue as a counsellor-therapist both online and in-person in this rewarding work with people and their stories. Specifically, I’ll keep pursing my professional interest in concerns about pornography ‘addiction’, ‘sex addiction‘ and mental health services for gay men. I plan to continue some supervision of social workers and complete my dissertation on community work with men who have sex with men. I’ll also be returning to my creative writing. I believe we make sense of our lives through telling stories, to ourselves and to others. This is also the therapeutic nature of narratives.

I look forward to more conversations with those currently consulting me and with new people who contact me. They are doctors, nurses, paramedics, software developers, IT engineers, mechanical engineers, teachers, academics, students, lawyers, journalists, artists, musicians, actors, sportspeople, business owners, business consultants, tradespeople and sales professionals. I find inspiration in their different experiences, stories and meanings, their different lives.

I’m grateful for the opportunity I have to journey with people through the toughest times in their lives. Regardless of whether you are in difficult circumstances right now, or you are travelling fine, I wish you well for 2014 and hope that you find peace and contentment in the year ahead.

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