"New" therapy program for CSAM viewers

Maintaining Your Change

To plan your continued work and to reduce the risk of a relapse, you will now be able to design a maintenance program. The maintenance program enables you to formulate your continued work on values and goals, and the strategies that will be helpful for you to reach those goals. You should work on your maintenance program on a regular basis; it would be good to set a certain time once a week to make sure you stay on the right track. Think of your maintenance program as a living document that you need to change and update to fit your current life situation.

First, please list your updated ā€œred flagā€ situations and what your plan of action will be. You can consider this as your ā€œrisk cardā€ for when you encounter an unavoidable situation where you start to experience urges. Over the course of this treatment, you have been testing your alternative behaviors, and finding which ones are most effective.

Choose the behaviors and activities you have found most effective during the treatment to write on your risk card. This can serve as a reminder for you in the moment, that if you have a strong urge you can choose instead to use your plan of action. You can print this card to keep with you, and download your other worksheets so that you can keep a record for yourself. Keep updating this periodically as your life and situations change.

= A high risk situation for you

: I am looking at legal pornography but sometimes get the urge to look for something illegal.

Plan of action: I take a break from pornography, stepping away to do something else and letting the illegal urge subside before resuming my legal consumption.

: Iā€™m browsing the Internet when I see people posting links to sketchy sites choc full of CSAM. A desire to click on these links and view the images seeps into my mind.

Plan of action: I report the offending link and, in the meantime, go do something else until the link has been taken care of.

: Iā€™m feeling suicidal and have stopped caring about consequences.

Plan of action: I calm myself down, seeking the aid of family/friends if needed. Getting fresh air, putting on cozy and comforting clothing, etc., until the episode subsides. If things ever got too bad, I could always schedule a therapy session or even voluntarily commit myself for a week or so if necessary. But hopefully it wonā€™t come to the latter.

: I begin to think about the failures of my past. The opportunities Iā€™ve let slip past me. I worry a great deal about my future. My fear and hesitancy is crippling and killing me. I fear that my life doesnā€™t matter, that Iā€™ll never be good enough. That I donā€™t deserve to be loved or forgiven.

Plan of action: I need to talk to others about how I am feeling. Not just my parents or sister, I need to talk to as many people as I can. My extended family, etc.

Next, set your goals and values that you will continue working toward and how you will be doing it.

My thoughts and feelings about my continued work:

Some of this project was very insightful. Some of it was very much not. But it has helped me realize that there are much more important things than looking at CSAM.

May I be honest? I only looked at CSAM for a brief period of a few months. I had already effectively quit before I signed onto this program. Itā€™s been several months since Iā€™ve seen it.

I joined this program to prevent myself from ever seeing it again. But I believe that, unless I stumbled upon it by accident, Iā€™m not seeing it again. I realize that thereā€™s much more important things in my life.

Values and goals:

My values and goals at this point are simply this: I want to do what is right by my family. And I know that suicide is not the answer to this conundrum.

If I were a rich man, I would spend it for my family.

Areas of my life and values that are the most important to me right now:

Area of my life: my sexuality.

Sexuality values: To keep myself out of trouble, to avoid hurting anybody with my actions.

Area of my life: my family.

Family values: To support my family, to put their happiness before my own.

Area of my life: my livelihood.

Livelihood values: To exercise my potential more often, to find a career I am fulfilled and satisfied with.

Goals Iā€™m currently working towards:

ā€¢Supporting my loved ones.

ā€¢Eating less.

ā€¢Careful spending.

Partial goals Iā€™m currently working towards:

ā€¢Learning how to drive.

ā€¢Going to college.

Strategies that could help me reach my goals:

ā€¢Seeking support from my family and community.

ā€¢Being organized and scheduled.

ā€¢Medicine and therapy.

Date for evaluation (YY:MM:dd): 23:05:26

What parts of treatment have been important to you?

My response:

Anything that has me confronting my own insecurities. The risk card, for example.

What have you learned from the treatment?

My response:

Iā€™ve learned that Iā€™m much, much more suicidal than I think I ever realized. Go back and read my responses to each module and youā€™ll find suicide to be a reoccurring topic. Nearly every module answer has at least one or two mentions of or references to suicide.

It has become obvious that, in my mind, suicide is the only clear way out of this mess Iā€™ve found myself in. Isnā€™t that the worst? It puts some bile in your throat just to read something like that:

ā€œI feel that the only way out is to kill myself.ā€

Thatā€™s horrifying! I imagine that, if a brain scan were performed on me, it would look remarkably similar to other victims of depression: rather dim, with low energy and little activity.

I also realize that I am extremely greedy and gluttonous. Greedy in the sense that I enjoy having a comfortable blanket of money to prevent going hungry or getting bored, gluttonous in the sense that I enjoy heavily indulging in leisure. If I could get away with it, I wouldnā€™t work at all unless I wanted to.

What has changed during treatment?

My response:

TBH Iā€™m not entirely certain anything has changed. Iā€™ve made it clear that Iā€™d already quit CSAM sometime prior to actually joining this project. Do you want to know what really happened? I got bored. Hopelessly bored. It was just the same type of video over and over. It became just as much a compulsion as whenever I sought out legal porn. I wasnā€™t truly enjoying myself. The monotony of it all made me realize how sick it truly was. The first time I reported a CSAM link without first checking it out, it feltā€¦ Well, I dunno. I donā€™t know if I felt good about it, but I certainly did not feel like I was really giving anything up. I gorged myself for a few months and had my fill, was ready to move on.

Iā€™m not sure if the treatment has had any real effect on me, but Iā€™d like to think it has only solidified my desire to never seek that crap out again.

What did you not get out of treatment?

My response:

I feel that this treatment is wonderful for those who actively struggle with viewing material that is blatantly illegal. To take the time to jot down their thoughts on the matter and strive for change.

Throughout this entire program, I didnā€™t look at any CSAM. I canā€™t say it was the program that kept me from it, Iā€™d just lost interest in CSAM and hopefully my lack of interest is here to stay.

What remains for you to work on?

I need to work on my self-love and work-ethic. I need to become smarter with my money, and I need to become a more independent person. Not totally, mind you. We in the Western world value our individuality and independence a bit too much. We humans are social creatures, and we should never be in too big a hurry to leave the nest. Some of us might never be fully comfortable with the idea. And thatā€™s OK, that feeling needs to be normalized. Again, humans are extremely social creatures. Without SOMEBODY around, most of us would go nuts!

Loneliness isnā€™t for most people. In fact, itā€™s a leading factor in depression and suicide. College students living away from home for the first time. Office workers stuck in dead-end jobs with no family to show for it. Elderly whose children never visit them are especially prone to suicide. Loneliness is a disease and an epidemic. An un-talked about killer.

Additional thoughts?

My thoughts:

Thank you for your time. I know that Iā€™ve been a bitā€¦ Difficult to work with, taking long breaks between some modules. But thank you for giving me this opportunity, Dr. McMahan and Dr. Rahm (I hope ā€œDr.ā€ is the correct terminology here. Sincerest apologies is it is not!).

In the beginning of this program you were asked about uploading material to Inhope (INHOPE | Home). Here we would like to take the opportunity again to ask you to upload any remaining images you have to this link (https://www.inhope.org/EN#hotlineReferral) in order to help protect the child by removing the image from across the web.

Remember that a relapse, a temporary back slide where you find yourself in old patterns, might be a part of your process of change. If youā€™ve engaged yourself in this full treatment in a dedicated way, you will never be in your original position again. You have new knowledge about your sexual problematic behavior that you didnā€™t have before, but to maintain any changes you need to continuously work on your strategies.

You will have access to the treatment platform for 4 more weeks. You can save the exercises for your continued work. Remember, your work is not over and you need to continuously work with the material and your own behavior.


Finally, we would be very grateful if you could give us feedback on this weekā€™s module content.

Were there any aspects of this module that you found particularly useful?

:heavy_check_mark:Yes

No

You selected ā€œyesā€ to the above question, please share which aspects you found particularly useful:

My response:

It feels good to finally be done with it. I donā€™t mean that in a bad way, I mean it in a ā€œI hope that by completing this it means I now have a better understanding of myselfā€ kind of way.

Were there any aspects of this module that you did not find useful?

Yes

:heavy_check_mark:No

Were there any lessons or strategies from Module 9: Maintaining Your Change that you found particularly confusing?

Yes

:heavy_check_mark:No


Thank you for your participation and good luck!

We hope this treatment program has been helpful for you, and we wish you all the best going forward! Please feel free to reach out if you have further questions.


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