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by Sharon Lamb
W. W. Norton, 2006
Review by Kevin M. Purday on Mar 4th 2008

Sex, Therapy, and Kids

There is quite a bit of literature on adolescent sexuality aimed at workers in the field of therapy but much of it is to be found in specialist journals. The beauty of this book is that a great deal of that literature has been absorbed by the author and has informed her practice with the result that here we have the best of both worlds -- a ready reference book and the fruits of many years working in the field.

Dr. Lamb is both a privately practicing, licensed psychologist and an academic -- she is professor of psychology at St. Michael's College in Colchester, Vermont.

The book covers more or less every aspect of sexuality vis-à-vis children and adolescents. The introduction sets the tone by asking what the term 'normative' means in this context. There follows an extraordinarily sensible discussion of the problems surrounding the term 'normative'. She points out that there is probably more data on the behavior of abused and otherwise disordered children than there is about 'healthy' children. Her observations here are very useful -- not just to therapists but parents too.

The first chapter, General Principles and Guidelines, is aimed very directly at psychotherapists but its message is relevant to a wider audience, again especially parents. Her warnings about overstimulation are a timely reminder in our heavily sexualized world. Her thoughts about sex as a permissible pleasure and sex not inherently equaling danger are wise and useful food for thought for parents as well as therapists.

The second chapter starts the series of themes with each chapter dealing with one aspect of sexual behavior. The author starts with sexual issues that arise in play among children who have not been abused. The issues here link up with the question about what is normal and reading this chapter one is struck by the huge variations in parenting and the massive range of experiences that children undergo. It is no wonder that children sometimes have problems with sexual behavior!

The third chapter goes on to look at working therapeutically with children who have been abused. Here one learns that these children's play is not necessarily more sexualized but instead reveals aspects of the trauma of the abuse. This is obviously a very sad topic but the author handles it in a way that is extremely informative

The fourth chapter deals with 'acting-out' by which she means highly sexualized and even sexually abusive behavior. The author makes it clear that this type of behavior is usually the result of either abuse or the lack of clear boundaries in parenting. As always the author gives very sound advice as to how to handle a wide variety of situations which she exemplifies with cases she has had to deal with.

Chapters five and six deal respectively with teenage boys and teenage girls in therapy. The author wisely separates the two because this enables her to deal with issues such as the way society explicitly and more subliminally sends out message about male and female sexuality. Issues concerning the links between alcohol, drugs and sex are very well brought out in these chapters.

Chapter seven moves on to the topic of working with the parents of teens -- usually teens who are also being seen on an individual basis by the therapist. This reviewer found particularly interesting the insights into the range of parenting from extraordinarily conservative and rigid, usually fundamentalist Christian, parents at one end of the spectrum to ultra-liberal parents at the other end and how both of the extremes can bring its own particular problems.

Chapter eight looks at the issues surrounding coming out whether as lesbian, gay or bisexual. There are many aspects of coming out to be considered in a society which is still largely homophobic. What this reviewer particularly admired was the author's own soul-searching as part of her thoughtful consideration of various problems she has encountered when dealing with coming out, particularly by boys.

Chapter nine looks at the very specific issues surrounding sexual behavior and developmentally disabled teens. Developmental disability itself comes in a spectrum from severe to moderate and the author deals sensitively with a whole range of issues affecting teens along that spectrum

The final chapter is aimed very particularly at therapists. It encourages them to reflect on their own sexual feelings as they affect and are affected by the therapeutic sessions they lead. It also raises questions about how therapists find it difficult to avoid bringing in their own moral standards to therapy. There are no dogmatic answers but some very sensible questions.

The book finishes with references and resources listed chapter by chapter so that readers can follow up on any particular issue. Finally, there is a superb index.

This is an excellent book. It is true that it is aimed primarily at therapists but as a teacher this reviewer is very pleased to have read it. For therapists it is a must. For teachers and parents it could only be a very useful and enlightening source of information that they would find it difficult to obtain elsewhere.      


© 2008 Kevin M. Purday

Kevin M. Purday, Principal of the Shanghai Rego International School

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