Taking a sexual history

Taking a sexual history

As we progress in our understanding of what it means to be fully human and sexual, it becomes clearer that sexuality is far more complex, comprehensive, broader and richer and is more fundamental to our human existence than simply genital sex. The word sexuality comes from the Latin word sexus and suggests that we are incomplete, seeking wholeness and connection. In essence, sexuality is the divine energy within persons moving them to connect with others. It is important for individuals to be aware of “who they have learned to be sexually” if they are to make informed decisions about how to live as healthy human persons in relationship. It is imperative for religious congregations to understand potential members’ sexual histories to assist them in discerning the best way for them to live a healthy sexual life. To understand a person’s sexual story requires time, opportunity and a vocation director and psychologist working together. Taking a sexual history is an important and complex task which is best accomplished in more than one way, with more than one person and at more than one time.

Perspective matters

An important consideration in approaching any task is one’s mindset or perspective. Because I find this particularly true regarding the task of taking a sexual history, I begin by suggesting four essential attitudes for those charged with obtaining information about an inquirer’s sexual and affective life.

First, I would encourage a developmental perspective rather than an evaluative, judging or pass-fail perspective. In order for individuals to effectively discern their vocation, they need to be aware of their sexual history or who they learned to be sexually and affectively and also be able to share their story with those assisting in their discernment. By conveying an understanding that all persons are in process, vocation directors can assist a discerning individual to see that a sexual history is an opportunity for increased selfawareness through self-disclosure rather than a matter of having “right answers” or passing a test.

Second, vocation directors need to keep in mind that taking a sexual history is not just about the past, but it is also about now and includes what is happening with them and the inquiring person. This requires that vocation directors have a solid understanding of healthy integrated sexuality, that being sexual is more about connection with others in various ways than having sex, and that taking a sexual history is an ongoing process which will happen formally and informally now and throughout the formation process.

Third, vocation directors and inquiring persons need to be aware that this is not a “we-they” task. Rather, the inquiring person and the vocation director are sitting side-by-side on the same side of the table, looking at an individual’s sacred sexual story as a way to assist the individual to grow in self-awareness about this essential aspect of self. Ultimately, the information gleaned from a sexual history will help individuals discern whether living a consecrated life of celibacy in community is the best way for them to be authentically human, to love and be loved and to give their gifts in service to others. Finally, taking a sexual history involves at least three persons: the discerning individual, the vocation director and a competent psychologist who will, as part of his or her clinical assessment, actually conduct the thorough, formal psycho- sexual history.

Learning a person’s sexual history is an ongoing process that is about both the past and the present, happening not once but throughout the formation process. That said, I would like to discuss some fundamental questions: why take a sexual history, what is the role of the vocation director and of the consulting psychologist, what does a sexual history entail, how can it help the individual and the community, when should it happen, and how best to prepare for it? Finally I will address some challenges for vocation directors as they approach this task.

Why take a sexual history?

Regardless of one’s chosen lifestyle, everyone’s first vocation is to be human and therefore, to be sexual. And each person has a sexual story, a sacred sexual story, with positive and often not-so-positive experiences. A sexual history can help a person be clearer about “who they learned to be sexually.” It is one way to identify where they are and what areas will need to be addressed either before or during formation and beyond. An upfront approach early in their discerning journey may assist individuals to be more comfortable being in process and unfinished (not an easy notion for a culture that promotes being all together and not selfdisclosing). An open approach also helps a person to be able to talk about “what I am working on.” It is important for individuals at this time to identify their positive learnings and development and to be grateful for and build on them, as well as name any mistakes and abuses and subsequent consequences (e.g., shame, poor self-esteem, lack of trust) that may have occurred. A good sexual history will assist the individual and the community to identify both potential strengths and challenges that will likely play a role in the discerning of vocation and in their formation for both ministry and communal life.

In addition, taking a sexual history and talking about sexuality raises the individual’s awareness that women and men religious do not leave their humanity or sexuality behind, that they are fundamentally called to love and be loved. It also offers an opportunity to address some myths, such as: “celibate means not being sexual,” “being sexual requires being genital” or that “intimacy is optional for vowed religious.” Finally, the multiple conversations that make up taking a sexual history may help uncover a hidden and often unconscious motivation for religious life, e.g., a desire to escape one’s sexuality in some form. Individuals may be seeking to avoid some distressing aspect of their sexual self (such as a same sex orientation or compulsive cybersex use), or they may be trying to rid themselves of sexual shame resulting from past sexual abuse or sexual behavior. Uncovering these unconscious motivations and discovering healthier motivations for choosing religious life will be essential for individuals to make a free choice of a celibate life in community. It will also free them to utilize their sexual energy to form healthy, intimate, mutual relationships with both men and women, within and outside of the community.

Role of vocation personnel

Sexuality, the all-encompassing energy in every one of us that moves us to seek connection, includes three aspects, each with multiple sub-aspects: primary sexuality (embodiment, sexual orientations, gender identity), genital sexuality (genitality and sexual expression) and affective sexuality (emotions, boundaries, relationships, intimacy, friendships, mutuality). Given this broader understanding of sexuality, it becomes clearer that taking a sexual history informally and indirectly begins from the very first contact the vocation director has with an interested person. It begins with what the vocation director sees (e.g., how the individual dresses and cares for his or her body) as well as how he or she experiences the person (e.g., warm and trusting or cautious and distant). To observe an inquirer well requires adequate knowledge of the various aspects of being sexual and a sense of ease with oneself so that the vocation director can use his or her energy for observation.

There are also more direct ways that vocation directors can explore an individual’s sexual and affective life: structured interviews with the individual, live-in experiences, guided written autobiographies, and letters of recommendation. One way to understand a person’s sexual history is to ask him or her questions about various aspects, to interview him or her. I encourage a structured interview, that is, asking the same basic questions of each person. The structure affords an opportunity to develop a sense of how people respond and to sharpen one’s skills.

Regarding the content, I strongly suggest that vocation directors focus their questions on the affective and relational life of the individual. Before asking any “sexual history” questions, however, the inquiring person needs some time to get to know the vocation director and to begin to trust him or her. How long this will take depends on the individuals involved. Trusting is not automatic, and is even harder to achieve in today’s climate because of the violations of trust that people have experienced personally or are aware of in the lives of others. In order for fruitful self-disclosure to occur, it is important to prepare the individual for self-revelation on various topics (e.g., prayer life, relational life, experiences of service to others), and especially to expect conversations that relate to sexuality during this “getting to know” phase of exploring religious life. Showing that you talk about these same topics with everyone can help put a person at ease. In addition, the vocation director’s personal ease or lack of ease with the topic at hand will either encourage or discourage the individual’s self-disclosure.

Another effective tool is an autobiography written by the interested person to be shared with the persons involved in admitting candidates. In order for this to be effective, I suggest giving the person some guidelines that include specific questions about various aspects of their sexuality that you would like them to write about. I suggest that a major focus be on their affective life and include some well-defined questions about the individual’s relational life (family, friends, co-workers, supports) in order to get some sense of how they see themselves relationally. Although these same topics and questions will be covered in-depth by the consulting psychologist, having an autobiography is one way to ascertain whether a person is consistent or not.

Again, by giving each person the same task and guidelines, vocation personnel will be able to examine how people respond and thus sharpen their assessment skills. Non-compliance or avoidance of certain areas will suggest areas for further exploration. Although much can be gained from a person’s autobiography, it also has limitations. Self-reporting can be biased, intentionally or not, as most persons want to put their best foot forward. This type of inquiry is best supplemented by seeing them in action and also hearing from people who know them. When a person is a serious candidate, the community usually asks for honest, frank appraisals from those who know him or her. Rather than asking for a general letter of recommendation, I would suggest that you ask those who make a recommendation to address specific areas. The letters are more likely then to offer specific and helpful information about the person.

Short live-in experiences are another way to understand who a person has learned to be. These are particularly valuable as a means of “seeing” how a person responds to certain situations and how he or she interacts with others. It is also a means of assessing if the person’s sense of self resembles what you see as they interact with other potential candidates and with the community. In addition a live-in affords the interested person an opportunity to see how the community functions and then be able to talk about their impressions and experiences. Finally, for some, using an article that discusses sexuality or celibacy may be helpful during a live-in as a means to explore ideas, beliefs and attitudes about sexuality and consecrated celibacy.

In order to effectively explore another’s sexual story, vocation personnel need to prepare for this aspect of their role through ongoing opportunities for growth, support and challenge that include:

  • opportunities to develop a solid, practical understanding of healthy integrated sexuality and consecrated celibacy, including an opportunity to talk about and practice using sexual language;
  • fostering an ongoing awareness of one’s own sexual history, including issues resolved or in process;
  • doing what you will ask candidates to do (e.g., write your autobiography);
  • ongoing peer supervision and/or an opportunity for consultation with a professional.

At Saint Luke Institute we have developed a special program called Fostering Psychosexual Integration to assist vocation and formation personnel with exactly this type of education and experience.

Role of consulting psychologist

Once a person is considered a serious candidate, most congregations require some form of psychological assessment, which most often includes both psychological testing and an extensive clinical interview by a competent psychologist. The psychologist in most cases shares his or her findings with the candidate and with the community representative designated to receive such reports. I believe that the consulting psychologist plays an important role in helping the individual and the community to understand his or her sexual history and is the best person to be assigned the task of doing an extensive sexual history. There are two reasons for emphasizing the role of the psychologist: his or her skill or expertise in inquiring and the confidential nature of the setting. Well-trained, experienced psychologists will have experience exploring sexuality and will not be timid about asking difficult and personal questions. In addition, they are more likely to recognize and cope with resistance. Because of the confidential nature of the relationship, a person may speak more openly. And if a person shares something that he or she doesn’t want the community to know, the candidate can then choose not to release the report. Although this would be a red flag for most congregations and will most likely terminate the process of entering, it does protect the individual.

Because the consulting psychologist is an agent acting on behalf of the community, it is important that before she or he sees any particular candidate, the community be clear about what it expects—both with regard to content and process. What the community wants to know needs to be clearly spelled out. It is very helpful if the community shares its understanding of religious life and what it takes to live a healthy life of consecrated celibacy in community. It is important not to assume that the psychologist understands religious life and consecrated celibacy. Even with experienced clinicians, it is essential to have a frank conversation about the content to be explored in a sexual history. Although a fuller description of expected content will be explored in the next section, in light of recent events, the following areas should be explored by the psychologist:

  • any form of abuse, be it sexual, physical, emotional or neglect, including how the individual has coped or is coping with the abuse or neglect and its consequences,
  • sexual orientation and attraction and the degree of integration and acceptance of this aspect of themselves,
  • their use of the Internet and cybersex,
  • any indications of sexual compulsivity,
  • a relationship history, including assessment of the capacity for healthy relating with others.

Finally the process of sharing the information with the individual and the community needs to be clearly understood in advance by all concerned.

What to cover in a sexual history?

A sexual history should explore each of the three aspects of sexuality: primary, genital and affective and should include questions to explore healthy development as well as any deviant sexual development or behavior. A sexual history needs to address these fundamental questions:

  • How do individuals see themselves as sexual persons; how do they care for and accept who they are?
  • How have they and how are they dealing with their sexual energy?
  • How do they relate to others, in particular what are their capacities for intimacy, friendship and seeking support.

Areas that need to be thoroughly addressed by the psychologist are: family attitudes about sexuality, sexual development across the life span—prepubescent, adolescent and adult development—sexual abuse, sexual orientation, relationships, including friendships and the capacity to seek support from others, how the individual manages sexual energy and feelings, and the person’s use of the Internet. A description of some of these aspects was developed by Father Stephen J. Rossetti and Carmen Meyer of St. Luke Institute. The material cited below, which is from the unpublished St. Luke Institute Psychosexual Interview, is used with permission. I will share what I believe are some essential goals in each of the designated areas and some key questions that will assist in obtaining the information desired. As mentioned earlier I recommend that an extensive sexual history be performed by a consulting psychologist. The vocation director does best to focus his or her attention on the individual’s affective and relational life.

Family of origin Goal: To obtain an understanding of the broad family attitudes about sexuality. Attitudes and beliefs influence behavior. It is important to note any signs of discomfort around sexuality which may have been passed on to the individual and which may hinder the individual from seeking help with sexual matters. Typical questions would include:

  • Was sexuality discussed openly in your family? Specifically what was said about sexuality?
  • How comfortable were family members (your parents, extended family, siblings) discussing sex and sexuality?
  • What messages, direct or tacit, were conveyed about sexuality in your family?
  • How did you learn the facts of life?
  • Was there any other person(s) in your family or early life whose attitudes about sexuality affected you?

Prepubescent Goal: To obtain an understanding of the individual’s earliest (pre-pubescent) sexual feelings and experiences. Early excessive sexual stimulation is a risk factor for later sexual problems. Precocious sexual activity is a possible indicator of sexual abuse. An absence of curiosity and awareness of sexual interests can be a risk factor for later sexual problems such as unintegrated sexuality. Typical questions would include:

  • At what age were you first aware of sexual feelings or your own sexuality?
  • When did you first have crushes, interests or curiosity in others?
  • Were you involved in any early childhood sexual play and exploration?
  • Did you ever feel pressured to behave in stereotypically masculine or feminine ways—especially when you had no interest in the activity?

Sexual abuse history Goal: To determine if the individual has experienced any sexual abuse, and or exploitation in his or her development and possible consequences. Although a factual history is essential, it is equally important to obtain an understanding of the impact (physical, emotional and spiritual) of the abuse on the individual as well as how the abuse was dealt with by the person and the family. Although sexual abuse is a significant factor in a person’s sexual development, it does not necessarily lead to dysfunction and life-long problems with sexuality. Typical questions would include:

  • When you were growing up, did anyone older than you ever touch or look at you in a way that was blatantly or overtly sexual? Or that you experienced as unwanted or intrusive?
  • How did you feel and what did you think about this experience?
  • Did you ever tell anyone about this experience? Who and how did they respond?
  • As a child or adolescent, were you ever involved in any sexual play, exploration, fondling or masturbation with someone younger than you? Please describe.

Puberty and adolescence Goal: To obtain an understanding of the client’s sexual development during adolescence, particularly with regard to puberty and masturbatory history. Managing the transitions that accompany puberty is critical. While a certain amount of sexual curiosity, exploration and confusion is normal, excessive sexual involvement in adolescence may be an indicator of sexual problems or deviancy. Likewise, an underdeveloped person may become stuck in an emotional and sexual adolescence and even become fixated. Typical questions would include:

  • Were you prepared for the bodily changes you experienced during the onset of puberty? Did anyone talk to you about what to expect?
  • How old were you when you entered puberty? What was the experience like for you? How did you feel about the changes in your body?
  • Did you feel like you were developing or maturing at the same rate as your peers? Were you ever teased or singled out as being different?
  • How old were you when you first masturbated? Did anyone talk to you about masturbation?
  • What are the fantasies you had when you first masturbated? What fantasies do you usually have during subsequent masturbations (include age, gender and any scenes that are particularly attractive to you)?
  • Did you ever masturbate with others? Describe the incident(s).

Embodiment Goal: To understand how the individual perceives and cares for his or her body. Body loathing, neglect or preoccupation with appearance may indicate some lack of integration or early abuse or neglect. The capacity for self-care is essential for living a healthy, balanced life. Typical questions would include:

  • Do you like your body? If you could change anything about your physical appearance, what would you change? • How would you describe your overall health?
  • Are you currently dealing with any health issues?
  • Is the weight you are now a good weight for you?
  • What do you do routinely to care for your body?
  • Do you smoke? Describe your use of alcohol.

Sexual orientation Goal: To obtain an understanding of an individual’s awareness and acceptance of his or her sexual orientation. It is important for individuals to know to whom they are attracted, what their orientation is, to accept their orientation, and to have integrated their orientation into their life. Typical questions would include:

  • What is your sexual orientation? How do you know your orientation; i.e., what are the concrete signs you use to tell you what your orientation is?
  • Have you ever wished that you had a different orientation?
  • Have you ever felt curious, been sexually aroused, by members of the same sex? Describe the situation. What are you saying to yourself about this situation? Did you ever tell anyone?
  • What is your family’s attitude toward homosexuality? What is your attitude?
  • What do you understand is the Catholic Church’s perspective on homosexuality? How do you feel about it?

Relationships, dating and adult sexual activity Goal: To obtain an understanding of the individual’s experience of dating in school, adult relating and adult sexual activity. Since relationships are central to living a healthy integrated sexual life, it is important to explore with the individual his or her relationship history. This section should include an exploration of romantic relationships, friendships, and previous marriages, if applicable. It is particularly important to ascertain if they are choosing celibacy by default because they do not think anyone will marry them, or if they are running away from a broken relationship. For persons who have been married and divorced, it is important to explore why the marriage ended and what the individual’s current relationship is with his or her children, should there be any. Typical questions would include:

  • Did you date in high school and college? Describe some of your significant relationships.
  • Have you ever been in love? How old were you and the other person? What was the gender of the other person? Describe the relationship between you and this person. What happened in the relationship? Any genital contact? How did it end?
  • Have you ever considered marriage for yourself? Why or why not?
  • Describe your most recent romantic relationship— when, with whom, any genital contact?
  • With whom are you friends? What do you do together?
  • What are ways you deal with your sexual energy? How are you sexually expressive with others? What part does masturbation play in your life now?
  • If previously married, when, how and why did the relationship end? What did you learn about yourself as a result of this relationship?
  • What is your relationship with your children? Do they know that you are considering religious life? What do they think about your decision?
  • From whom do you seek support?

Problematic sexual behavior Goal: To determine if the individual has engaged in sexually deviant, compulsive or problematic behavior. The presence of previous deviant sexual behavior or an attraction to minors is cause for concern, must be thoroughly explored and seriously considered. Typical questions would include:

  • Did you ever engage in any sexual behavior that others might consider unusual?
  • Have you ever paid anyone to have sex?
  • Have you ever used pornographic materials? What age and gender of people are shown? When was the last time?
  • Have you ever had sexual fantasies about people under the age of 18? Some adults prefer to have sexual relationships with younger people, under the age of 18; have you ever felt this way? What do you think of people who do?
  • Have you ever had a sexual encounter with someone that you were in a supervisory role with, such as teacher-student, counselorcounselee or employer-employee?

Current management of sexual behavior and feelings Goal: To understand how the individual experiences, manages and integrates his or her sexual feelings, especially in light of his or her aspirations to enter into a celibate, chaste lifestyle. It is important to identify extremes in this area that could indicate potential problems, such as an absence of sexual awareness, denial of sexual feelings, an excessive or unrealistic spiritualization of sexuality, scrupulosity or excessive moralizing. Typical questions might include:

  • How do you experience sexual desires?
  • How do you understand and respond to sexual feelings and desires?
  • What are the challenges regarding being sexual that you currently face? How are you dealing with these challenges?
  • Are you able to love and be loved in your life now?
  • How do you understand a commitment to celibacy? What do you think the difficulties and struggles will be for you in trying to live a celibate chaste life? What would you do if you had a slip after committing yourself to celibacy?
  • What would you do if you found yourself falling in love?

Internet and cybersex Goal: To understand how the individual makes use of the Internet (e.g., email, Web sites, commercial sites) and to determine how the Internet may be impacting an individual’s communication, relationships and sexuality. Typical questions might include:

  • How much time do you spend online? Do you keep how much time you really spend online a secret?
  • What are your favorite Web sites? What do you find most enjoyable online?
  • Because of your online activities, do you neglect other crucial areas of your life?
  • Has anyone ever mentioned to you that they think you spend too much time online?
  • Do you find that you have more intimate experiences online than in your real life?
  • Do you have your own Web site?
  • When not online, do you find yourself thinking about or reliving past experiences online or planning your next experience?
  • Have you or do you search out pornography online? How often? What type?

Additional considerations

In no time in our recent history has promoting healthy, integrated sexuality for women and men religious been more important and necessary. Being able to work effectively with potential candidates to religious life will require a solid understanding of healthy sexuality, of how to promote ongoing healthy development, an awareness of one’s own psychosexual journey, and a capacity to sensitively and directly inquire about aspects of another’s sexual history. To work effectively with the increasing number of people from other cultures and backgrounds, vocation personnel must be capable of suspending judgment. They must be aware of cultural and age differences and what is appropriate for the individual. Finally vocation personnel must be able to co-labor with both interested persons, other persons responsible for formation, and with professionals. They need to process important information with those who need to know in their community, be able to seek and utilize the expertise of professionals and above all assist interested individuals to utilize their sexual history for awareness, acceptance and appropriate action.

 

Multicultural awareness and sexuality

An authentic multicultural perspective is inclusive, requiring us to look both at how we are different and how we are the same. Although individual cultures have distinct understandings and perspectives regarding sexuality, there are also some fundamental understandings that cut across cultures. It is important for anyone in vocation or formation ministry to know what is fundamental to a solid psycho-spiritual understanding of being human and sexual and be able to share this understanding with persons seeking entrance into religious life. My experience in Central and South America, Mexico, Ireland, Canada and Australia supports both some common foundational understandings that, when addressed, cut across cultures, as well as some diverse perspectives that need to be noticed, understood and sometimes challenged.

—Lynn M. Levo, CSJ

 

Lynn M. Levo, CSJ, is a Sister of St. Joseph of Carondelet and a licensed psychologist who has experience assessing candidates for religious life and deaconate. She lectures and consults with seven intercommunity novitiates in the United States on healthy integrated sexuality and celibacy. She designed and continues to direct the Fostering Psychosexual Integration Program for vocation and formation personnel at Saint Luke Institute, Silver Spring, Md., where she is Director of Education and Editor of Lukenotes.

 



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