Sex addiction, to those without much experience with it, may believe that it is a joke. Too much sex? “Oh, I see, you want to cheat on your spouse and then blame it on an “addiction”?” Over the last decade and a half, there has been an overwhelming burden of evidence that addiction to sex, is a very real and a pervasive phenomenon. This is not alarmist, sex-negative, puritanical talk. There are droves of people in the U.S. that are suffering emotionally, physically, and financially, stuck in a habit that is making them feel more and more hopeless and helpless. Their intimate relationships have been destroyed, or are non-existent. Most sex addicts will find that a sexual activity that once gave them pleasure, has become insurmountable. The shame and helplessness that this compulsion has created, usually leads to a very lonely and helpless state. At its core, I believe that sexual addiction, and most addiction in general, is an attachment disorder with a strong biochemical, and behavioral component.
Sexual addiction is a diagnosis for individuals who engage in “excessive” or compulsive sexual behavior, often in spite of the negative consequences. As a result of this sexual behavior, these individuals suffer from distress. There is a lot of controversy over the existence of a true process addiction of the sexual kind. Some people believe that it doesn’t exist, or at least not in the same way as drug, alcohol, and gambling addictions. However, many psychologists, sexologists, psychiatrists, and other specialists agree that it is a very real phenomenon.
For many sex addicts, conduct does not progress further than compulsive masturbation or the extensive use of pornography or phone or computer sex services. For others, addiction can involve illegal endeavors such as flashing, voyeurism, profane telephone call, child molestation or rape.
Even though sexual addiction as a diagnosis is not included in the DSM, research studies have shown that the brains of drug addicts and sex addicts respond in a similar way to drugs and sex respectively.
The National Council on Sexual Addiction and Compulsivity has defined sexual addiction as “engaging in persistent and escalating patterns of sexual behavior acted out despite increasing negative consequences to self and others.” In other words, a sex addict will continue to participate in certain sexual behaviors despite facing potential health risks, financial troubles, shattered relationships or even incarceration.
The Diagnostic and Statistical Manual of Psychiatric Disorders, Volume Four defines sex addiction, under the category “Sexual Disorders Not Otherwise Specified,” as “distress about a pattern of repeated sexual relationships involving a succession of lovers who are experienced by the individual only as things to be used.” According to the manual, it also involves “compulsive searching for multiple partners, compulsive fixation on an unattainable partner, compulsive masturbation, compulsive love relationships and compulsive sexuality in a relationship.”.
Growing sexual provocation within our society has spawned a rise in the number of individuals engaging in a range of uncommon or illicit sexual practices, such as phone sex, the use of escort services and computer pornography. Many more of these individuals and their companions are looking for help.
The same compulsive behavior that characterizes other addictions also is common of sex addicts. However these other addictions, including things like drug, alcohol and gambling dependency, involve elements or actions without any necessary relationship to our survival. For instance, we can live typical and happy lives without ever gambling, taking illicit drugs or consuming alcohol. Even the most genetically susceptible person will function well without ever being exposed to, or provoked by, these addictive activities. I have written several articles on the shame cycle that drives sexual compulsion, to give prospective patients, or their spouses, a way to better relate to the compulsive nature of the disease. The shame cycle is a critical component of, or perhaps might even be considered the “engine” of sex addiction. If you or your loved one can relate to it, they may want to accept this invitation for treatment!
Sexual activity is truly distinct. Like eating, having sex is necessary for human survival. Although many individuals are celibate– some not by choice, while others choose celibacy for cultural or spiritual reasons– healthy humans have a strong desire for sex. Actually, lack of interest or decreased interest in sex can signify a medical issue or psychiatric illness.
One reason many people are hesitant to consider sexual compulsivity as a real phenomenon is the fear that people will use it as a front to excuse bad behavior. It’s fairly common to hear about Hollywood stars seeking treatment for sex addiction after a major sex scandal. For example, after being accused of sexual harassment, rape, and assault by dozens of women, Harvey Weinstein claimed to be suffering from sexual addiction in a video. However, many experts concur that Weinstein suffers from selfishness and misogyny rather than the true complulsion.
Other celebrities who have claimed to be suffering from sexual compulsivity include Tiger Woods, Charlie Sheen, Micheal Douglas, Amber Smith, Amy Winehouse, and Robbie Williams.
A common misconception is that “sex addiction” refers to engaging in frequent sex. While an individual who has “too much” sex may suffer from a sexual addiction, this is not always the case. There is a difference between sexual compulsivity and having a high sex drive. In general, sexual addictions are defined as the compulsive participation in sexual activity in spite of the negative consequences. Here are a few signs that an individual may be suffering from a disorder that is sexually compulsive in nature:
It is estimated that about three to five percent of the population of the United States is afflicted with sexual compulsion disorders. About 90 percent of people who identify as sex addicts are male. Most identifying sex addicts are between the ages of 40 and 50. However, the number of identifying sex addicts that are young and/or female is growing.
Most addictions are cyclical in the sense that there is no concrete beginning or end, and the addiction to sex is no exception to this rule. Each stage of the disease leads to the next and the addict ends up feeling powerless and stuck in a downward spiral. The cycle of sexual addiction can be broken down into six stages.
Triggers (Shame/Blame/Guilt) – A trigger refers to a catalyst that creates the need for the individual to engage in sexual behavior. Physical and emotional stress are common triggers. Some examples of physical and emotional stress are depression, stress, anxiety, anger, loneliness, and shame. Even positive rather than negative agents can serve as triggers for compulsive sexual behavior.
Fantasy (Preoccupation) – A coping method that many sex addicts rely on is the fantasy. After an agent triggers them to crave sexual behavior, sex addicts turn to sex fantasies. These fantasies can be about sexual encounters of the past or about anticipation for sexual encounters in the future.
Ritualization (The Bubble) – In the ritualization stage, the sexual fantasies start to become rooted more and more in reality. The sex addict may go to their favorite porn site or go to a place where sex workers tend to congregate.
Compulsive Sexual Behavior (Acting Out) – This stage is where the actual sex takes place. Contrary to popular belief, this stage is not the ultimate goal of a sex addict. Rather, most addicts attempt to put off the sexual behavior for as long as possible. The dissociation and escape associated with ritualization is the true goal of most sex addicts. After sex, the sex addict is forced to return to the real world and face their emotions.
Numbing – In the numbing stage, the sex addict attempts to justify their behavior and emotionally distance themselves. For example, they might blame their spouse for their behavior or they may minimize the behavior. For example, they might reassure themselves that no one knows that they masturbated to pornography for six hours straight, so it’s not a big deal.
Despair (Shame) – Many sex addicts reach this stage when their attempts to numb and deny fail. They may feel powerless when it comes to stopping their compulsive behavior. Unfortunately, the emotions felt in this stage can serve as a negative agent for compulsive sexual behavior.
Some of the co-occuring addictions and disorders for sexual addiction are substance abuse and mental illnesses like depression and anxiety. Sufferers may also have eating disorders, such as Bulimia nervosa, Anorexia nervosa, and Binge eating disorder.
Many people are surprised to hear that sex addicts tend to be very high functioning people. In fact, many sex addicts are very accomplished and have positions of prominence. The phenomena of high functioning sex addicts can easily be seen with celebrities in Hollywood. Such individuals often have strong incentives for keeping their compulsivity a secret. In some cases, an individual suffering from sexual addiction may appear to be high functioning but may truly be draining the bank to maintain their addiction. This negative coping mechanism may also be destroying their relationships behind closed doors.
Since sex addiction has not been added to the DSM, it is not an official diagnosis. However, individuals are typically identified as sex addicts if their compulsive sexual behavior is having a negative impact on their life in any way. There is no one test that can accurately identify an individual as a sex addict. A holistic overview is necessary to determine whether an individual is truly suffering from the disorder.
Treatment is most effective when it comes in the form of an integrated approach. This approach should combine a number of therapeutic modalities. The treatment should be tailored to the individual and should evolve as the patient makes progress. Sexual addiction treatment needs to address the compulsive sexual behavior as well as the underlying process.
Behavioral symptom management, which can consist of cognitive-behavior techniques like relapse prevention, is used to address compulsive sexual behavior. Therapeutic groups, psychiatric pharmacotherapy, and psychodynamic psychotherapy address the additive process.
When it comes to sexually compulsive behavior, distinct categories don’t exist. It presents however, in a multitude of forms and can manifest in an individual in several ways. The different forms of sexual addiction are as follows:
By and large the most common form of sexual compulsion, pornography of any and all types, is available immediately, for FREE, all over the internet. It is common for the sex addict to spend inappropriate amounts of time on-line looking at pornography, or doing so in inappropriate places and times (for example school or work). Usually there is a need for an increasing amount of one particular type of pornography, which fits into the sex addicts arousal template.
Behavioral symptom management, which can consist of cognitive-behavior techniques like relapse prevention, is used to address compulsive sexual behavior. Therapeutic groups, psychiatric pharmacotherapy, and psychodynamic psychotherapy address the additive process.
Two very different things, but related. Paying for sex, through escort services, classified advertisements, massage parlors, strip club “side rooms.” There is a never ending stream of potential sexual partners, willing to sell there body for sex. This can also include “phone sex,” webcams. Sex for trade is when an addict receives remuneration in some form (usually money, shelter, other drugs, other services), for sex. This is done compulsively.
Compulsively seeking out new partners for non-paid sex is easier that it has ever been. Entire on-line communities and web/phone apps exist to put two (or more) willing participants together. Sites like AdultFriendFinder, apps (Tinder), local classifieds, and many other resources exist for the purpose of anonymous sex. Not all participants on these sites are sex addicts. However, it might be very difficult to find a community with such a preponderance of people suffering from sexual addiction.
Sex addicts who engage in exhibitionism typically enjoy exposing their genitals to unwitting people, most often in public. The public nature of this compulsion makes it one of the most risky types, with very damaging legal consequences if caught and/or prosecuted. “Peeping tom” is a term used for those that derive sexual gratification by by masturbating while secretly watching victims (who do not know that they are being watched). This is usually done while the victims are engaged in some intimate moment, or some degree of undress.
Interestingly enough, the phenomenon of sexual anorexia is prevalent in those men and women who have attempted to stay abstinent. It is simply the other extreme in the continuum of compulsive sex. It is the flip side of the same compulsive coin: compulsively NOT engaging in sex. Avoiding opportunities for intimacy, for fear of sex, or fantasy can certainly become a pattern in the sex addict, which leads to more emotional pain. In essence itThe goal of treatment, inevitably is to reintegrate a happy, healthy, shame-free sexuality that strengthens more fulfilling relationships.
Sadomasochism or S&M, is where the addict is either a sadist, derives sexual arousal from causing pain or humiliating their partner, or a masochist, in which they become aroused by having pain inflicted upon them. Fetishes, the concentration on a particular body part, or object, behavior (real or imagined) is the object of sexual obsession.
Sex addicts do not necessarily become sex offenders. Furthermore, not all sex offenders are sex addicts. Approximately 55 percent of sentenced sex offenders can be deemed sex addicts.
About 71 percent of child molesters are sex addicts. For many, their issues are so acute that imprisonment is the one way to ensure society’s safety against them.
Society has recognized that sex offenders act not for sex-related satisfaction, but instead out of a disturbed desire for power, dominance, authority or revenge, or a perverted expression of rage. More recently, however, an awareness of brain transformations and brain reward associated with sexual behavior has actually led us to understand that there are also strong sexual drives that motivate sex offenses
A common question that many people have is whether sex addiction recovery is possible. The answer is yes but the road is often long and arduous. First of all, it is important to keep in mind that recovery from an addiction to sex is not necessarily abstinence from compulsive sexual behavior. It is considered far more involved to recover from sex addiction than to stop engaging in compulsive sexual behavior. This process takes years rather than just months or even weeks. Throughout these years, the sex addict will make a number of positive changes to their life and abstinence from compulsive sexual behavior is just one of these changes.
Sex addiction must be viewed from the context of issues with intimacy. Often, issues with intimacy stem from a relational trauma that occurred during the individual’s childhood. Sex addiction therapy and treatment involves resolving these trauma issues.
An arousal template is what dictates what an individual will find arousing. Every individual has their own arousal template. For example, an individual may feel aroused by exchanging money for sex. Understanding an individual’s arousal template can be helpful when it comes to treating their sexual addiction. For example, an individual can create a diagram of their arousal template and identify all of the decision points. At these decision points, an individual can make changes to reduce their compulsive sexual behavior.
Sexual compulsion is best identified as a progressive intimacy disorder characterized by compulsive sexual thoughts and acts
Like all addictions, its negative impact on the addict and on family members increases as the disorder develops. Gradually, the addict most often has to redouble the addictive behavior to achieve the same results.
For the majority of sex addicts, conduct does not progress beyond compulsive masturbation or the extensive use of pornography or phone or computer sex services. For others, addiction can involve illegal activities such as exhibitionism, voyeurism, obscene telephone call, child molestation or rape.
A great many sex addicts are themselves victims of childhood trauma, most often coming in the form of sexual, mental, physical abuse or neglect.
Healing these past traumas through therapy, understanding the disease concept of addiction and how it manifests on a personal level (triggers), and finally developing new patterns for healthy sexuality; these are essential tools for the sex addict to become a well integrated and fulfilled sexuality.
Understanding the shame cycle which perpetuates acting out compulsively is central to accepting, and healing from sex addiction.
If you feel that you are ready to take the next step towards a happy and healthy sexuality, free from addiction please call or make an appointment today.
