The Steve Wilkos Show: Multiple Tragedies for the Sake of Ratings

I saw a tragedy on TV a few nights ago. It wasn't in Darfur, Tibet or New Orleans. It took place in a Chicago television studio for The Steve Wilkos Show.

I don't watch much TV. No time - with two young kids, a husband, an ailing mother, my therapy practice and this blog. I happened to be mending a hem and flipped on the TV to pass the time. What I watched really upset me.

Apparently about a week before this show was taped, a four-year old girl told her mother that the boyfriend of her aunt (the mother's sister) had pulled down his pants and put his penis in the little girl's mouth. This man was the father of several children with this aunt though they had apparently not gotten legally married. Then, the little girl told this same story to her aunt when questioned during a drive they went on in the car. The aunt, without questioning her common-law husband about this allegation, took her children and left their home for an unknown destination.

On the TV show, Wilkos (a former Marine, police officer, professional wrestler and director of security for The Jerry Springer Show) badgered each of his guests about their decisions and actions building to a crescendo involving the suspect results of a lie detector test administered by someone affiliated with the show. The "results" did not indicate conclusively that the accused had lied about the contact he'd had with the girl, but there was some question about whether he was telling the truth.

I had some major issues with the show.

During the lie detector interview, questions had apparently been asked about whether the accused had ever had sex with males. It turned out that he had. And, based on the few things he said about it, he was probably more attracted to males than females. But in his Latino culture this taboo was so large he had desperately tried to fit in as a heterosexual by fathering a few children to seal the deal.

The revelation that the accused had these sexual experiences with men somehow made it all the more plausible to Wilkos that he was lying in his denial about the four-year old girl. Wilkos may fancy himself some sort of expert on questioning suspects from his 11-year service in law enforcement, but he is not an expert in the area of sexual offenses. It's a very rare occurrence for a bisexual or gay adult male to be interested in sexual contact with young female children. But, that didn't really matter to Wilkos. In his mind, once you're off the heterosexual path anything's possible.

At one point, Wilkos wondered out loud, "How could a four-year old make this up?!" And rather than have his staff do a little research, he ran full tilt at his target, a man in his twenties at least a foot shorter and probably a hundred pounds lighter - jamming his finger inches from the face of the diminutive accused and yelling into his face with one inch between the tips of their noses.

"How could a kid make this stuff up?" That is exactly what a Los Angeles community wondered when it tried the teachers of the McMartin Preschool in Manhattan Beach, CA in 1983. Yet, when it all came out in the wash, there was no corroboration of the statements made by 46 preschool children that included murders, underground tunnels, ritual abuse, dogs, trap doors, drinking blood, Santa Claus, clown suits and burials right on the preschool property.

It turned out that these children were led by unlicensed social workers (one Kee MacFarlane, in particular) in their interviews. It lasted six years - the longest US criminal trial in history. At a cost to the state of $15 million, it was also the most expensive. No convictions were obtained. Here are two good links about this topic:

• Learning From the McMartin Hoax
• "McMartin" Ritual Abuse Cases in Manhattan Beach, CA

This story filled national newspapers for six years. OK, Wilkos was in the Marines and perhaps wasn't in this country, but wasn't anyone on his staff reading the newspaper then? (Silly me, for wondering that. Most TV talk shows have scruples-free producers half my age. They were still running around in diapers then.)

But for one instance, which I'll explore in a moment, the accused man insisted throughout the show that he never did this or anything like it. Of course, many times when an accused perpetrator denies the action of sexual contact, she or he is lying. It isn't something that is always easily admitted.

The one instance was this: After a particularly prolonged session of badgering, the accused said to Wilkos, "Whatever you say, man. Whatever you say." Wilkos leapt upon this and berated him for joking about such a serious matter.

What dawned on me at this point was that this accused man was going through this show and enduring it in the same way that some men sit in the chair of a dunking booth at a carnival. He just stayed on stage and endured one verbal "dunking" after another. Why? There had to be money involved somehow. And, while I don't have the answer to this right now, my intuition still leads me in that direction.

So, how much money will allow a man to be branded (probably for life) as a child molester? How much will compensate him for the likely loss of contact with his own children?

Was it part of "the deal" that he had to stay on stage the entire time in order to receive his fee for participating? He knew why he was coming onto the show. He knew that his sister-in-law would be making these allegations. He knew that her very brawny husband would be right there ready to throttle him.

Did he hope that criminal investigators would see this show for its folly? (Up to the point of taping the show, charges apparently had not been filed.) I don't know. How much could be enough for the loss of his reputation, self-respect, and possibly his children?

I felt for this man. I don't know if he did it or not. Only two people really know what happened - him and the little girl. But even children who are interrogated in particular leading styles by adults who think they already know the answer can get to the point of believing that something that never happened really did.

Wilkos kept circling back to the lie detector test whenever the drama on his stage dropped even slightly. He never minded that lie detectors are not admissible to prove culpability in criminal proceedings (Cal.Evid. Code 351.1). The lie detector test proved everything to Wilkos.

As the show was coming to its close, Wilkos went up to the mother of the little girl and said with pseudo-endearing pathos, "Take care of that baby growing inside you." Yep, she was visibly pregnant. I thought to myself, "How could you? You've just put this woman through the ringer on this stage. No, that wasn't stressful to her or to the baby. How does an hour of non-stop adrenaline affect a fetus?" It was the height of smarminess - and it was tragic for everyone on that set, except Wilkos, his ratings were probably through the roof.

Related Topics:

• Protecting Your Child From Sex Abuse
• Parents - Fear Predators, Not Safety

Technorati Tags: Steve Wilkos, reality TV, sexual abuse, child abuse, homophobia

Sex After Arguing

I've often been asked about why and how people have "make up sex" - sex after arguing. While reading Esther Perel's Mating in Captivity, I found one of the better explanations I've heard.

She was discussing a couple she had been seeing in her therapy office. James was a man who was overly accommodating to Stella. While James' mother had led him to feel burdened with responsibility and guilt, in contrast, Stella was a graceful, vibrant and independent woman.

Summarizing here with a very large stroke of the brush, Stella had become the keeper of their sex life. She wanted it. James didn't. She wanted to talk about it. He didn't. Stella had reached the point of hating being the one who made it happen, but she did not dare stop doing so for fear that he would do nothing to keep their sexual relationship alive.

As it turned out, James' only experiences anxiety-free sex was when he masturbated where he attended to himself without what he perceived as the pressure of another's demands. His fantasy women were not vulnerable and they could not be hurt by his sexual selfishness. When he had sex with Stella, he couldn't allow this side of himself out because deep down he feared that he would hurt her emotionally. During sex, he reenacted (without needing to) a nonsexual aspect of his relationship with his mother: choosing between attending to himself and having closeness.

This couple was stumped. They had written off their relationship as "bad chemistry." But Perel worked on James' issue of overly attending to Stella - in particular, straightening out the difference between healthy separateness and indifference. If you want all the details of this part, get the book.

This couple did get their sex life jump-started. As it turned out, each time they had sex, it was after they argued. James reported that he was bothered by this.

Here's what Perel said:

"Anger and excitement have a complicated relationship. Physiologically, anger and arousal have a lot in common. Psychologically, too. In your case, I think
the anger emboldens you. It relieves you of compliance, and leaves you feeling
more entitled. Anger highlights separateness and is a counterpoint to
dependence; this is why it can so powerfully stoke desire. It gives you the
distance you need. As a habit it can be problematic, but there's no denying that
it's a powerful stimulant."

I have seen a similar pattern among some clients in my therapy practice: internal conflict related to caring for self over others, a preference for masturbation over partnered sex, unexpressed (or seldom expressed) frustration and anger, and a sexual connection that comes to life after the "negative" emotions are expressed - right after they are expressed, say during an argument.

I have seen caricatured portrayals of "make up sex" in TV and movie dramas. And I do think that most people imagine such a scenario where hateful expression transforms into impassioned loving expression.

But a more sophisticated look at this is warranted. I do think that the physiologic similarities are relevant. When arguments occur, there is a deeply felt self-centered set of emotions experienced by both. Contrast that type of focus and energy with a somewhat tentative sexual style that some couples fall into. For these couples, their best sex may be "make up sex" because during an argument they've just been engaged in the type of self-centered jockeying that can make for sexual thrills. The arguments become a solution to a problem of tepid sex. For some couples, they never progress past this dynamic. But, others begin to understand that their sexual style needs an injection of energy and that it need not be from an argument.

Related Topics:

• WebMD Video: How Gender Differences Affect Relationships
• Make Over Your Sex Life!
• 31 Ways to Say "Yes" to Sex

Technorati Tags: make up sex, Mating in Captivity, sex matters

The Starfish Position

Yesterday as I sat under a hair dryer waiting for the highlighting bleach to do its magic, I scanned an issue of Glamour magazine since it was within reach once I was under the dryer. I haven't looked at one in more than a decade. I usually bring my own reading material to distract me from the heat, but happened to forget to do so yesterday.

I was really struck by the intensity of the images, different from those in the People magazine that sits in my therapy office waiting room. Sure, there are make up and hair care product ads, but the ones in Glamour just jumped off the page. I sat there thinking about how incredibly difficult it is for teenage and twenty-something females to feel good about their face and body with these amazing images of perfection. Air brushing finished off what actual physical beauty failed to offer in reality.

I was also struck by the sadism of articles on figure flaws and similar topics. If the pictures didn't do the job of planting insecurity, the articles would finish the job. I do understand that magazines are essentially about reader numbers and that playing to people's fears increases readership - yet I found this pretty assaulting.

I know that I'm not writing anything new here - so far.

Later on, I remembered a comment that a client had made that week about some different types of casual sexual encounters. We talked about "Kleenex dates." These were sexual hook ups in which the males essentially saw their female partners as the equivalent of Kleenex - a place to figuratively blow their nose and deposit their semen, nothing more.

Photo Credit: Kyle Flood

Then he brought up another facet of casual sex - a female who is what's called a "starfish." This was a term that was coined to describe that during sex some females merely lay there like a starfish - legs apart and arms outspread with no movement or participation. They provide access to their genitals but there's not much else going on for them nor being done for their partner.

I wondered if there was any connection between the starfish and Glamour magazine. I thought of a few possible connections. Some women think that if they look good, that's all that they need do in order to be a worthy sexual partner. Laying there looking good is the sum total of their participation.

I also thought about how sexualized the Glamour magazine ads are. Obviously, I'm all for sexuality, yet I wondered how many young women find themselves pulled into partnered sex by magazines and other cultural messages before they're really ready, like swimmers in a rip tide. I suspected that some of these women were expert at the starfish position too. For them it isn't so much that they think that it's all they need to do, but instead because they don't have a clue about what they could do.

I'd be interested in hearing from people (probably it would be males predominantly) who have been in sexual situations with women in the starfish position. Was it more about the women thinking, "This is all I need to do" or that they were thinking, "This is all I know how to do?"

Related Topics:

• Virginity Lost, Experience Gained
• The Shy Girl's Guide to Satisfaction (In Bed)

Technorati Tags: sex matters, healthy sexuality, starfish, body image, self image

If Insurance Paid for Marital and Relationship Therapy...

You may not know that most health insurers do not pay for marital (and relationship) therapy. A relationship that is in trouble does not constitute a medical condition - even though it can have a lot of impact on people. So, if it's not a medical condition, no coverage.

Unless a couple is using a Flex Spending Account (also often called a "cafeteria plan"), into which they have put pre-taxed dollars, they most often cannot pay for their couples therapy with anything except their own after-tax money. Most insurance companies require a mental health diagnosis to cover therapy. This forces mental health professionals into labels that can be arbitrary and not the best description of what is going on.

All the way around, this is unfortunate - especially financially. A study in the Journal of Marital and Family Therapy (7, 2007) found that insurance companies who covered the screening and treatment of marital distress would probably save much more money than they spent. This would mean more money for therapists, lower premiums for clients, and improved relationships for many trouble couples.

Where do the savings come from? It turns out that people use medical healthcare services less after receiving therapy for their relationship problems. One study found that the average couple who went to therapy reduced their use of healthcare more than 20% in the six months following their therapy - regardless of how successful the therapy was! According to this study by the Centers for Medicare and Medicaid Services, healthcare costs average over $7,000 per person per year in the U.S. So, anything that lowers that expenditure by 20% can add up to a lot of saved money for insurance companies.

So, the question was asked, "Is it worthwhile for insurance companies to pay for relationship therapy?" According to Ben Caldwell, the author of the study in the Jouranl of Marital and Family Therapy, the answer is affirmative. It turns out that if health insurance companies paid for therapy for distressed couples, they would save up to $1.48 in later healthcare costs for every $1 they spent.

So, why are things the way they are? Insurance companies need to be convinced that couples therapy can be effective - even as a short term option - and that it will add to their profits. Research that supports this position is starting to emerge. And relationship therapy methods and approaches are continually being refined and honed to offer greater gain for the couple.

The study also found out that tax payers would save money too if marital distress screening and treatment were paid for through governmental sources. A study conducted in Utah found that the taxpayer cost of a single divorce is conservatively estimated at $30,000. This was calculated in direct costs such as food stamps and indirect costs such as more police to combat an increase in crime. If government agencies paid for the cost of marital therapy at about $2,000, every divorce that was avoided would return about $30,000. Even if only 16% of the couples identified as being in distress went on to get therapy, the government would still break even.

This is a no-brainer.

Related Topics:

• The 'Good Enough' Marriage
• Sex Therapy & Other Counseling

Technorati Tags: marital therapy, relationship therapy, health insurance, sexual health

Antidotes to Antidepressant Sexual Side Effects

While at the ISSWSH conference in San Diego, Anita Clayton, MD of Charlottesville, VA, presented research that will prove very interesting to me and to many of the clients in my therapy practice. She reviewed ways to reverse the negative sexual side effects of SSRI type antidepressants.

First, the ways that work for only a few people.

A small number of people who take an SSRI will simply acclimate to the medication and find that they develop a type of tolerance that allows them to function sexually while still getting the benefit of combating their depression. This can take four to six months to occur (if at all) and it works for only about 5% of patients.

Some people will try changing to another SSRI, but this, according to Dr. Clayton, only works with about 10% of patients. In addition, many people worry that if they change from the medication that is working for their depression they will wind up sacrificing the gain against their depression for the possibility (and it's a slight one) of restoring their sexual function. If a patient is willing to risk that situation and make a change, there are also non-SSRI medications that may offer relief from the depression with less likelihood of sexual difficulties: Bupropion (Wellbutrin), Mirtazapine (Remeron), and Nefazodone (Serzone).

Some research on Bupropion has included placebo-controlled trials. This means that these studies involved some patients taking a pill that looked identical to the real medication but did not contain that medication. To get an antidote effect to an SSRI, doses of 300 to 400 mgs. of Bupropion are typically used. Typically, a dose can begin with 150 mgs for one week. Then, 300 mgs. for three weeks and ultimately 400 mgs if needed to get the desired effect. In some cases, the dose of the SSRI can also be lowered when Bupropion is added on.

Buspirone (Buspar) may be selected to treat what is called anxious depression. This type of depression has a restless quality. It can also be added to an SSRI (30 to 60 mgs) to alleviate negative sexual side effects.

SSRIs tend to decrease testosterone levels in both men and women, so some supplementation of testosterone can help -- particularly with issues of sexual desire and sometimes with arousal during sexual activity. Also adequate levels of testosterone are needed for PDE5 inhibitors (Viagra, Cialis, and Levitra) to work.

Cyproheptadine has been studied as an antidote, but it seems to have an effect that is often too sedating for patients. And, on the other end of the spectrum is the use of psychostimulants such as methylphenidate (Ritalin). About 10 mgs per day is often used, but not with patients who are bipolar or possibly psychotic.

Pharmaceutical companies realize the downside of the current batch of antidepressants. No doubt, they are working to develop other medications that don't solve one problem while creating another. Until then, these are some coping strategies that are worth trying for people interested in treating their depression and maintaining their sexual interest and abilities.

Related Topics:

• WebMD Video: Understanding Antidepressants
• WebMD Video: Side Effects of Medications

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