Debra Kaplan Counseling

I spent many years on Wall Street—before my years in recovery and before I became the therapist I am today. I worked in international banking, traded physical commodities for conglomerates and later worked for a large brokerage firm on the trading desk in the High Yield “Junk Bond” department. That was back before October 1987, when global financial markets were delivered their first financial and political wake-up call.

In the world of finance, Monday, October 19, 1987 is known as “Black Monday,” a reference given to the day that stock markets around the world crashed. The U.S. stock market had begun to falter three days earlier precipitated perhaps by global concerns over strategic monetary policy; perhaps by the ensuing uncertainty in the Middle East. On October 16, Iran had waged an unprovoked missile attack on an oil tanker in the Persian Gulf and the United States retaliated on October 19, by shelling an Iranian oil platform.

Already jittery markets began to topple and in time-step panic the decline that originated in Europe picked up steam in the Asian markets and reached its fever-pitch plunge on the morning of October 19, 1987. At the close of business the Dow Jones Industrial Average (DJIA-stock market) fell by 508 points and lost 22.61% of its value. This was the stock market’s most precipitous drop ever since the infamy of October 24, 1929.

In a perfect storm scenario, the die was cast. These United States had yet to know about a Gulf War and the various Desert Campaigns that followed. Solemnly, we never anticipated the tragedy that would be delivered on September 11, 2001.

Immediately following “Black Monday” the fixed income department in the firm that I worked was laid off. I quickly secured a potential trading opportunity that led me to the guys up at Cantor.

In the late fall of 1987 I made my way to the corporate headquarters of Cantor Fitzgerald, a global services firm that specialized in U.S. government securities. In the business, at least back then, they were known as the “dealer’s dealer”— the go-to-guys on the street if you were looking for a market in U.S. Institutional bonds, equities or convertible securities.

“High Up in the Clouds”

“What the “#$*” do you do up here in a fire—because you ain’t gettin out” were the exact words I uttered when I stepped off the elevator on the 103rd floor and stared out over the Hudson Bay into the Atlantic. In 1987 Cantor Fitzgerald’s legendary corporate headquarters occupied the 101st-105th floors of One World Trade Center. That remained their prestigious address until September 11, 2001 when Cantor ultimately lost 658 employees—all that were present for that fateful day

My interview lasted all of 30 minutes. It was enough time to discuss formalities and employment goals. I was offered a position that day; however, I declined the offer on the spot. My decision was not based on fear or a premonition of things to come for Cantor. It was based on my realization that what I really wanted was to trade commodity options on the New York Board of Trade which happened to be located in the Fourth tower of the World Trade Center.

I left the interview and rode the elevator down to ground level but not before I took one last glance back over the water and out beyond the bridges.

Ten years later I am reminded of my experience way up on the 103rd floor. I am reminded of how small and seemingly inconsequential decisions can irrevocably impact our life.

September 11, 2011 as with the yearly anniversaries before it, is a time that I reflect on life. I reflect on how life unfolds and the twists and turns that become our own story. I lost acquaintances and colleagues on September 11, 2001. I am grateful that I did not lose family but I am ever so mindful for those that did.

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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 exposés; 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.”

Sexual Behavior Follows Along A Continuum

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.

When Is Sexual Behavior Offending?

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.

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The fields of psychiatry and psychotherapy are peppered with uninformed beliefs and misjudgments. For instance, individuals can be pejoratively diagnosed as borderline or, perhaps more accurately, viewed as exhibiting symptoms of complex traumatic stress. In cases of the latter, old unresolved traumas are reenacted in the here and now and, to say the least, are difficult to clinically modulate.

Betrayal is not Borderline

Nowhere is the borderline label less fitting but more frequently appended than in the case of a betrayed spouse. The label is applied to individuals who present in therapy as “help-me-no-don’t,” chronically angry, scared, defensive, and reactive. Unfortunately, the label is all too frequently applied by uninformed clinicians dealing with an angry, emotional, scared, “leave me-now-no-don’t” spouse who has learned of a partner’s sexual indiscretions, compulsivity, or addiction. Few spouses comport themselves with grace in the face of betrayal, yet the insinuation or diagnosis of borderline disorder is all too readily affixed. And by brandishing the borderline label, the clinical community serves to reactivate the emotional wounding and reinjure the person already reeling from betrayal and violation.  “Few spouses comport themselves with grace in the face of betrayal.”

 Currently debated — and I might add not-so-nicely at times — is whether sex addiction is an addiction at all. Is it merely a hall pass for out-of-control behavior, or is it an addiction warranting legitimate attention? The psychiatric and psychological camps contend that it’s objectionable to label a behavior as an addictive disorder without rigorous scientific support. Assessment, diagnosis, and practice based solely on anecdotal experience may not be legitimate, yet the field of psychotherapy often treats issues and behaviors with modalities and techniques that have yet to be invited to the scientific table of clinical legitimacy.

Judge Not the Name…

So it makes sense that borderline personality disorder and sex addiction find their way into the same scrape. An individual who exhibits reactivity and another who exhibits out-of-control sexual behavior tend to face negative public reception, while the pain and wounding that drive the behaviors are overlooked. By brandishing a label, the professionals with whom the pain can be shared reinforce disapproval of the behavior and invalidate the pain.

The American Psychological Association determines what is included in the Diagnostic and Statistical Manual of Mental Disorders, the fifth edition of which is to be released any year now. The term “borderline personality disorder” is currently under reconsideration; it is quickly becoming a term of old to describe a cluster of symptoms driven by trauma-induced stress.

A more appropriate term is “complex traumatic stress,” which speaks to abuse inflicted by an attachment figure, the loss of the authentic self due to repeated trauma and abuse, or problems in regulating emotion. Whether that description finds its way into the upcoming DSM remains to be seen. So far the jury is out, and confusion still rules.

Clearly, this is not an exact science.

 We must realize that an individual who struggles with a behavior by any name is an individual who suffers. As clinicians, we are at the forefront of healing and facilitating growth. Whether addictive behavior centers around sex, drugs, or rock-and-roll, it involves pain and suffering. To label the pain or question its legitimacy is to shut down an opportunity for growth and healing — for both the clinician and the client.

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This article was originally published on The Meadows’ Addiction Treatment Blog.

It was a sad day in Tucson, Arizona, as a lone gunman made a foiled assassination attempt on the state’s Congresswoman Gabriel Giffords while she was conducting a meet and greet at a local supermarket. On that Saturday, January 8th Tucsonans and the greater nation became aware of the tragedy as the day unfolded. As the events became known we learned that 19 people were shot and six people were left dead.

The lingering question for most people is, “Why—why did this happen?” That answer or a variation of the truth may remain unsolved. However, the answer, with or without the facts is that an unstable mind coupled with aggression can be, and in this case was, a dangerous coefficient.

The fallout from this devastation will linger, certainly for the lives of those affected. On a broader scale, however, the damage remains with the potential for secondary trauma as we look on from the sidelines and are left to ponder our own lives and human fragility.

In the days since this tragic event I have noticed a strong need for people to share their thoughts and feelings on the topic. Regardless of their political or personal persuasion, one thing is clear to me. As communities lay witness to these events both within our own backyards and around the nation’s landscape, I see signs of psychological distress due to the increasing frequency of senseless violence against others and our loved ones.

In the helping profession we know this to be vicarious trauma. Vicarious trauma (or secondary trauma) is a trauma response that results from the cumulative effect of contact with and exposure to survivors of violence or disaster. This can occur over a period of time with delay after days, months or years of direct or indirect contact. Those of us who work with and treat psychological trauma know that we are vulnerable to this condition and therefore, take steps toward increasing self care on a regular basis.

So it comes as no surprise to me that as our society is increasingly exposed to acts of violence certain individuals who already struggle with their own internal distress, inch that much closer to an inability to cope. Still, for others who are on the cusp of emotional fragility, their ability to stay functional might become greatly compromised as a result of an event or a series of events such as this and move toward an emotional unraveling.

One’s ability to handle a traumatic experience(s) is not formulaic. Further, no two individuals will respond nor manage the distress in quite the same way. For some, violent acts such as this, will elicit a healthy call-to-action in the service of political or social change. For others these events might induce an emotional decompensation rendering them emotionally unable to function as before.

In the aftermath of a crisis or crises, an already fragile emotional structure is likely to become more vulnerable to the duress and re-experience an old, but, unresolved traumatic response. As the unresolved and underlying trauma is triggered, the response in the here and now can be physiological, psychological or emotional in nature. A few of those moderate signs and symptoms include: sadness, anxiety, social withdrawal, increased signs of depression, loss of appetite, sleep disturbance, and anxiety to name a few.

Just how an individual copes is based on several factors; their internal strengths, available family/social support, and/or learned coping skills. Those individuals who have worked through their grief and loss due to trauma will have an easier time moving forward past an event. That event becomes a momentary pause versus a roadblock beyond which one is unable to move. When an individual continues to struggle with unresolved trauma they could have a strong identification with current crisis such as the shooting event in Tucson. Others’ grief and loss becomes the catalyst for a re-experiencing of one’s old trauma wounding.

For those that are struggling with this event or others that are traumatic I encourage self care in the following ways:

• Seek support from your identified support system whether that be family or friends.
• Attend 12-step groups to ensure ongoing sobriety for those in recovery.
• Make mindful connections to the positive influences in your world.
• Remember your personal connection with others and the love and support that your presence in their life brings.
• Be of service to individuals who are in need. Giving of one self helps ensure an empathic connection in a time of need, both to your self and to others.

Last, it is always important to remember that reaching out for professional help when or if it is needed is an act of courage and strength. It takes a strong person to reach out for help and present oneself the gift of compassion, love and support.

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This article was originally published on The Meadows’ Addiction Treatment Blog.

Admittedly, I have never met nor ever conversed with Jerry Siegel, co-creator of “Superman”, the fictional comic book superhero. But, had I been granted the opportunity, I would have first thanked him for the borrowed “Superman” metaphor that I so often employ in therapy with my clients. Then, I would have asked him if Krypton, Superman’s native fictional planet held any resemblance to Mr. Siegel’s own native home land of Cleveland, Ohio.

In fictional retelling, Superman was jettisoned to earth in a rocket ship only moments before Krypton exploded into smithereens. As it was written Krypton’s demise was due to its unstable radioactive core, perhaps a deliberate tribute to Cleveland’s Cuyahoga River infamous for its too frequent fires on the water owing to pollution slicks.

I mean no disparaging sentiment for the Clevelanders out there who are reading this, but I can’t but help wonder. Just what did Mr. Siegel have in mind when he referenced the more than obvious point that the one and only element that can strip Superman of his superhuman powers and perhaps, even, render him dead, is the element that comes from Superman’s home planet? The reference is too obvious for this therapist to ignore and better yet, too beautiful a talking point to overlook.

What I would really have wanted to know is how Mr. Siegel felt about his family-of-origin; was the family contentious or dysfunctional in its interaction or warm, connected and validating? Was Krypton—let’s say, like being at home in Mr. Siegel’s own family-of-origin?

And what about Kryptonite—the fictional element that hails from Krypton having perilous effects on Superman’s power? I’ll never know because Jerry Siegel died in 1996 and his co-creator, Joe Shuster, died earlier in 1992.

Were it not for the annual holiday and time honored tradition of family gatherings; legendary accounts depicting contentious and oftentimes destructive, holiday family-feuds, I wouldn’t need to employ my cautionary but appropriate reference to Superman.

Every year as Thanksgiving begins to loom large on the horizon not a week goes by that I don’t pull Superman out of hiding and speak to his comic bound strength and invulnerability. Yet, I ask, “What is the one thing that renders Superman powerless and void of strength?”

I’m often met with a bewildered look and for those clients old enough to remember, they mumble, “Kryptonite?” I quickly exclaim “Kryptonite, exactly!”

And, where, I ask does Kryptonite come from?”

“Krypton?” they ask more enthusiastically.

“Right, again!”

I confess to my clients that I cannot say what Jerry Siegel had in mind when he wrote about Krypton. But it is too ironic that Superman could only be stopped by one thing… an element from his family-of-origin.

It would seem that even the most therapy savvy among us who have risen out of dysfunction and family disorientation are rendered powerless while returning home for the holidays as if time has stood still and waited for our return to fill the family roles-of-old.

As much as we would like to think we’ve arrived at therapeutic transcendence, returning to our family of origin during the holidays often challenges our ability to maintain self care and hold personal boundaries. It takes mindful awareness to remain immune from family havoc and success in so doing is not always achievable.

By way of my comic metaphor, I warn my clients that even the strongest among us is susceptible. It is progress not perfection. “Superman” by virtue of his superhero, superhuman invulnerability (even a luscious glance from Lois Lane didn’t bring Superman aka Clark Kent to his knees) was susceptible to the dangerous and destabilizing effects of Kryptonite.

So, as the holidays approach and we find ourselves staring down a trip to Krypton or Cleveland, we have choices; go and visit the family, stay home or go and bring along your favorite superhero for protection!

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