Re: EX/RP for impulse control
Thanks for the clarification, Joel. It seems your client has a surprisingly unusual religious belief system. With so much "power" granted to the clergy, I can't help but wonder why he didn't seek pastoral counseling to begin with. (Shame associated with his behavior and thoughts perhaps.)
Concerning your second point, I don't believe in "symptom replacement" -- the idea that helping a client defeat a symptom is useless because another will spring up to take its place as part of the client's psychodynamic defense. In this case, however, the symptom appears to be an "obsessive tendency"; the thoughts concerning women are the object of the tendency. You can help the client deal with the object of the tendency, but it does seem likely that another object will replace it.
The idea that masturbation will provide a "release" is very common, but considering this statement - "he is unable to stop a cycle of zipping through channels until finding one suitably provocative, masturbating and then continuing the search - all of which can go on for hours, at the expense of day to day responsibilities (such as academic requirements)" - it seems to me very likely that masturbation could be the new object of the tendency, and that it could cause even more profound problems than the ones he currently faces.
Please keep us informed on how things progress, if it seems appropriate.
|