Originally posted on December 19, 2012.

This is a touchy and gross subject. I am a 17-year-old girl growing up in an adoptive family in Australia. I was sexually abused by my birth family, and I think it really fucked up my sexuality. The only thing that gets me off is the idea of people absolutely destroying their lives for an orgasm. I started with mild S&M stories and then moved on to grosser stuff like murder (stories and online images), pedo (stories only), and lately I've been thinking about my (adoptive) parents. The thing is, it doesn't have to be a particular category. As long as it's the most vile thing I can think of, it will get me off. There isn't a pattern as far as gender, age, or relationship to the people I am fantasizing about; it just has to be horrible, the kind of thing that would destroy you in real life. These fantasies alone are scary enough, but because they are literally the only things that get me off, I can't even really tell if I'm attracted to boys or girls or none of the above. I'm scared to talk to a counselor about this because I don't want to freak my parents out. I mean, I've got my quirks, but overall I seem like a pretty healthy kid, and I try not to worry them. I don't expect you to solve this problem via your column, but do you have any ideas for how I could get help with this without messing up my family?

Not Over Painful Experiences

Sane people can have extreme and/or violent sexual fantasies, NOPE, and extreme and/or violent sexual fantasies do not make sane people crazy. (Let's call them EVSFs for short, shall we?)

But you need to talk to a shrink—not because you're hopelessly damaged or the only person out there with EVSFs, but because you're troubled by your fantasies. And that's understandable. It's difficult to have EVSFs—or to find a healthy way to incorporate EVSFs into your sex life, or to figure out how to dial EVSFs way the fuck back if there's no healthy way to incorporate them into your sex life—when your erotic imagination is constantly dragging you to new and more disturbing places. And while most people's fantasies are relatively fixed, i.e., certain types of people or scenarios turn them on, your erotic imagination seems to be on the hunt for new "wrong" thoughts, images, stimuli, and scenarios. You need to seize control of your sexuality, and you'll need help doing that, or your sense of estrangement from your sexuality will only continue to grow.

That said, NOPE, you could be seeing causation where there is only coincidence. There are a lot of people out there who didn't suffer the kind of abuse you did—or any kind of abuse at all—but who nevertheless have EVSFs. Some people with troubling fantasies or interests have found relief with low-dose antidepressants; some folks with post-traumatic stress disorder (PTSD) have been helped by novel programs that incorporate MDMA, aka ecstasy, into their treatment plans. You could be suffering from PTSD, considering your history.

A good therapist—one with whom you are completely honest—may be able to help you reshape and redirect your fantasies in the direction of still-intense, less-wrong, not- constantly-escalating stimuli that gives you the "wrongness" charge you need without nuking your mental health or your life. (Stay away from all pedo porn sites, NOPE, even "stories only" porn. Please.) And a good sex therapist can help you draw a clear distinction between your adult sexuality—whatever form it takes—and your history of sexual abuse. (I shared your letter with a sex researcher I trust, and she urged me to urge you to insist on seeing a reputable therapist who does sex therapy specifically, as they're less likely to be sex-negative and therefore less likely to react with prudish or panicked judgments when you disclose your EVSFs.)

Considering the abuse you suffered at the hands of your family of origin, NOPE, I trust that your adoptive parents are aware that you may need professional help throughout your life and that your asking for help is a good sign about (1) you as a person and (2) them as parents. At your very first appointment, ask your shrink to confirm that your sessions are confidential. If for some reason your shrink tells you he or she can't offer you complete confidentiality (which they can and, in most places, are required to do by law, unless you're a danger to yourself or others), thank the nice shrink for his or her time and ask your parents to make you an appointment to see a different shrink.

Please get help—not because you are or may be kinky, NOPE, but because you're struggling with doubt, you're confused about your sexual orientation, and you're rightly worried about the way your erotic imagination keeps upping the "wrongness" ante. And remember: Not all counselors or shrinks are created equal. If you don't like or click with the first one you see, tell your parents you want to see someone else.