Sexual Addiction

Basic Information

Sexual addiction is a behavioral disorder that is becoming more prevalent in modern society. Sexual addicts are people who compulsively engage in sex, even when the sexual relationships turn out to be destructive both to the self and others. Most behavioral psychologists consider sexual addiction to be just as dangerous as drug or gambling addictions.

Approximately 15 million people are sexual addicts in the United States. It is estimated that about 8 percent of all men in the United States are sexually addicted to some degree, compared to 3 percent of all women. Sexual addiction is not a recent development in society. Even the oldest civilizations have produced what is today considered pornography and manuals for sex cults. However, sexual addiction has received heightened media attention during the past few decades, bringing it to the forefront of the collective psyche. It has also been the subject of several research studies, which has increased our understanding of how it can be both identified and treated.

In the late 1970s, a psychologist named Patrick Carnes promoted the idea that sexual addiction is a behavioral disorder that requires specialized treatment. He created a diagnostic criteria so that psychologists could identify patterns that indicate sexual addiction. He also wrote two books (Out of the Shadows: Understanding Sexual Addiction and Don't Call It Love: Recovery from Sexual Addiction) which have played an integral part in increasing the public's awareness of this potentially devastating addiction. In these books, Carnes compares sexual addiction to other more established types of addiction. In particular, he notes how the sexually addicted person becomes dependent on the neuro-chemical changes that happen in the body during sex, just as a drug addict "needs" the chemical. He also points out that people can enjoy an abundant amount of pleasurable sex in their relationships and still not be sex addicts. In fact, he claims that sex is "a self-affirming source of physical pleasure" for most people in society. The difference between sexual addiction and "healthy sexual behavior" is when the person compulsively uses sex to avoid internal discomfort, even when continuation of the act leads to adverse consequences.

Consequences of sexual addiction are wide in range. It is a compulsion that causes a great deal of inner pain and distress. Sexual addiction can ruin families and friendships, can cause poor work performance and loss of career, and can even lead to disease and death. It plays a significant part in the transmission of STDs. At the same time, it is particularly horrible when sexual addiction results in the partner of a sexually addicted person getting AIDS. In most cases, sexual addicts are so involved in their own compulsions that they do not have any consideration of others. Many sexual addicts say that while they are aware of the unwanted consequences of their actions, they feel unable to control their sex drives.

Types of Sexual Addiction

Sexual addiction cannot be identified by specific sexual acts. Rather, it is distinguished by the compulsive manner in which a person engages in the act of sex. Although a person may feel compulsively about only one behavior, most sexually addicted people are drawn to a range of sexual activities (from pornography to prostitution). At the same time, it is possible for a person who has a healthy sex life to engage in any one of these activities and not be considered a sexually addicted person. This is because it is not the act, but the compulsion to repeatedly commit the act that indicates sexually addictive behavior. The following are some of the more common activities associated with sexual addiction:

inappropriate sexual touch or fondling
constant viewing of pornography on the internet
arranging sexual enounters through the internet
sexual anorexia
involuntary voyeurism
sexual abuse of children
sexual coercion or rape
multiple sexual affairs outside of an involved relationship
involuntary masturbation
compulsive engagement of prostitutes
anonymous sex with several partners
perpetually engaging in unsafe sex with random partners
constantly going to stripshows or pornography shops
constant exhibitionism

Signs of Sexual Addiction

Sex is a beautiful and pleasurable act when partners respect both themselves and each other, and when it involves choice. Choice means that partners can make the decision to have sex or not to have sex, and then can realize this decision.

Sexual addiction, on the other hand, is a condition in which the participants are compulsively driven to have sex in order to compensate for emotional frustrations or other psychological problems. For example, a person may feel unwanted, and in turn use sex to make up for this feeling that "they are uncapable of being loved" or "just aren't good enough". In most cases, sexual addiction is not distinguishable as a group of sexual acts as much as it is identified by the emotions and psychological processes that are brought out by the act of sex.

In his major 1978 book on sexual addiction, "Out of the Shadows", Patrick Carnes identified three major characteristics of sex addiction. These three aspects of sexually addictive behavior include when the sex is shameful, secretive, or abusive. When sex is shameful, the addict does not feel good about his or her sexual behaviors. In most cases, a sex addict will feel involuntarily driven to have sex, will have reasoned out in their minds why it is ok to have sex, and then will feel terrible or ashamed immediately following the sex encounter. It is a violently self-abusive cycle, in which each sex encounter leads to increased feelings of remorse. Oftentimes, an ashamed sex addict will want to have sex directly after the first "shameful" encounter in order to substitute the pain of remorse for temporary sexual gratification.

A major source of shame for sex addicts is compulsive masturbation. While there is nothing wrong with masturbation ( in spite our cultural conditioning that it is "evil" or "unhealthy"), it does become a problem when a person has no voluntary control over it. In many instances, sex addicts will stay up every night masturbating and will not get a proper amount of sleep. They may end up feeling bad or guilty about not getting into bed with their lovers. Other sexual practices that can lead to guilt include having multiple lovers, having extramarital affairs, and using prostitutes. Some experts suggest that people who suffer from remorse will seek out dangerous or "shameful" sexual encounters (such as sleeping with a best friend's wife) in order to justify their feelings of inner worthlessness. For example, they may continue to engage the services of prostitutes because they do not feel they are worthy of "real" love. As a result, they greatly reduce their chances of enjoying a healthy sexual relationship with a woman. Such behavior can lead to shame and a horribly damaged self-concept, which can detrimentally impair love relationships, friendships, careers, families, and self-confidence.

Another sign of sexual addiction is when the sex is secretive. Sex addicts often live a double life. They may have a model family and a distinguished career on the one hand, and then may be engaging in illicit sexual activities on the other. For example, a man may persistently leave his family on the pretense of "going out of town for business" so that he can engage in prolonged extramarital affairs. Another classic example of secretive sex is the minister who preaches about the eternal dangers of fornification, and who is then arrested for having sex with a prostitute. In order to maintain this division between the two lives, a sex addict will often end up needing to be deceitful to both family members and close friends. In many cases, they will need to lie to themselves as well. These lies can cause a lot of remorse and emotional detachment in the sexually addicted person.

The third characteristic of sexual addiction, according to Patrick Carnes, is when the sexual behavior is abusive. There are two types of sexually abusive behavior: self-abusive and abusive of others. When sex is self-abusive, it typically means that the person is compulsively engaging in sex that is either psychologically damaging or physically harmful. Sex can be physically self-destructive when a person continues to have unsafe sex with a number of people despite the fear of AIDS.

Certain masochistic practices can also result in physical injury. When sex is abusive of others, it means that one of the sex partners is treating the other partner in a harmful manner. Abusive behavior can include deceit, manipulation, sexual coercion, rape, sadistic acts, molestation, fondling, child abuse, exhibitionism, and harassment.

Another form of abusive sex is when a person is brought into a sexual situation that they have not been properly prepared for. This can include bringing a lover to a sado-masochistic party without thoroughly informing first. Research has shown that most sexually addictive relationships involve a dynamic where one partner "dominates" the other. Such an inequity of power can lead both to the dominant partner using the other partner to compensate for feelings of inadequacy, and to the submissive partner developing low self-esteem.

The Pattern of Sexual Addiction

Most behavioral therapists agree that pre-disposing factors for sexual addiction begin during childhood. Many sexually addictive people were raised in dysfunctional families where the parents often fought and the child felt neglected. Another common family situation in which sexual addicts sometimes develop is a household in which love and affection are rarely expressed. Around late adolescence the child begins to use masturbation to compensate for emotional discomfort. Although masturbation can be a healthy and positive activity, many adolescents turn it into an involuntary habit. They may use it to cure boredom, to dull feelings of emotional pain by temporarily deriving pleasure from sexual gratification, or to induce sleep. As masturbation becomes more about escape and less about honoring the body, the adolescent begins to distort their perceptions about sexuality.

The act of sex no longer is a beautiful activity to share with another human being, but becomes a device to nullify pain and to substitute for the lack of other pleasures. Another common way that people develop sexual addiction is when they are abused as children. Some research studies estimate that nearly 60 percent of all sex addicts were sexually abused as children. The experience of sexual abuse can damage a person's attitude towards sex, and create feelings of fear and guilt that are difficult to overcome.

As a result, to make up for the pain that another person caused them when they were children, they may look for sexual relationships in which they can abuse their partners. In this way, the cycle of sexual abuse/addiction becomes self-perpetuating. It becomes clear, then, that what happens during adolescence can permanently shape a person's adulthood sexuality unless the person actively decides to regain control of their sex life.

Opening Up

Sexual addiction is an incredibly uncomfortable subject in modern society. It can be very hard for a person to realize both that they suffer from the addiction, and that they need help. Most sexual addicts need to cover up their secret sexual behavior to such an intense degree that they completely lose touch with reality. Because they are constantly having to justify to themselves why they are lying to loved ones or compulsively abusing sexual partners, their thinking often becomes distorted and illogical.

As a result, they end up believing their own lies, and live in a perpetual state of denial. In most cases, a crisis takes place that requires the sexually addicted person to come to terms with their illicit behavior. This crisis may involve an extramarital affair being "discovered" by a spouse, or an arrest for some illegal activity such as engaging a prostitute for sexual services. These crises can be extremely embarassing and sometimes can make it even harder for the sexually addicted person to confront their problem. They may wish to escape even more from themselves, and in extreme scenarios, may attempt suicide.

In these situations, it is crucial that the sexually addicted person receive support. Such support may be difficult or even impossible to give, particularly if the person has been hurt by the activities of the sexually addicted person. However, support can make all the difference in the world. It can empower a sexually addicted person to open up and talk about their emotional pain for the first time in their life. Such discussion is an incredibly healthy and healing alternative to negative sexual acts, the way that the sexually addicted person had grown accustomed to dealing with inner pain. It can change a person's life in amazing ways.

Diagnosis

Because sexual addiction is a psychological disorder, it can be difficult to diagnose. A fine line exists between a person who likes sex a lot and a person who is sexually addicted. In most cases, experts conclude that addiction is when a person continues to compulsively engage in sex despite negative consequences. These consequences can involve bodily harm or emotional damage. It can be difficult for people to open up about their sexual addiction. As a result, most therapists have a list of questions that they ask that are designed to locate sexual addiction in the most comfortable and direct way for the patient. Once it is determined that a person suffers from sexual addiction, most therapists will obtain a complete sexual history from the patient. In cases where the patient engaged in large amounts of unsafe sex with random partners, the doctor will suggest that each person on the list is notified and asked about their AIDS status. In many scenarios, it is not possible to get into contact with every partner. One thing that behavioral therapists must consider during a diagnostic procedure is that all people are different. A sexual behavior that is unhealthy for one person may not have the same adverse effect on another person. A comparison can be drawn to how the same amount of alcohol can completely impair one person and not have much impact on another. In the late 1970s, Carnes devised a diagnostic chart that many therapists use today to dianose sexual addicts. The chart includes 11 different patterns of sexual addiction, and a person is typically considered to suffer from sexual addiction if they are compulsively drawn to more than just one of the patterns. The 11 patterns are: (1) fantasy sex; (2) seductive role sex; (3) anonymous sex; (4) paying for sex; (5) trading sex; (6) voyeuristic sex; (7) exhibitionist sex; (8) intrusive sex; (9) pain exchange; (10) using objects during sex; and, (11) sex with children. Other aspects may also play a role in the diagnosis of sexual addiction. Most therapists will look to see if the person shows signs of either chemical addiction or co-dependency. Studies have shown that sexually addicted people are more likely than others to display both of these kinds of behavior. Co-dependency is a situation where two sexually addicted persons form a relationship and use each other to meet their compulsive needs. Another characteristic of sexually addicted persons is when they sexualize even the most non-sexual remark or situation. As aforementioned, the important thing to remember when diagnosing sexual addiction is not the particular act in itself, but the compulsion to repeatedly perform the act regardless of the consequences.

Treatment

Sexual addiction is a progressive disorder. If a person does not confront their emotional pain or does not have their condition treated, it inevitably becomes worse and leads to larger problems. Many experts suggest that sexually addicted people experience cycles switching back and forth between release and control. In other words, a person will give into their sexual addiction until something happens that causes remorse. When the addict feels remorse, they will attempt to control themselves until that part of the phase breaks down and they begin engaging in sexually addictive behavior once again. Thus, it can appear that the person has overcome their sexual addiction when really they are playing out the "dormant" part of the cycle.

Because sexual addiction is progressive, it is tremendously important that the sexually addicted person seek treatment as soon as they come to terms with the fact that they have a problem. The purpose of treatment of this condition is not complete abstinence. Rather, therapy seeks to allow the person to continue to engage in sex, but only when it is noncompulsive and self-affirming.

Typically, treatment of sexual addiction involves enrolling into a one to three-month long program. These programs are either outpatient or in-house. During this time, the sexually addicted person is advised to discontinue all sexual practices (even masturbation) to prove to themselves that they can overcome the urge to have sex.

This time of temporary abstinence can be very empowering to the person who thinks that they have no control of either their sex drives or of themselves. Most programs suggest that the person's lover and family take part in the program. Studies show that when a person has support while enrolled in these programs, they are less likely to relapse into their former behavior.

During their time in the program, patients are exposed to different models of healthy sexuality. This exposure is important because most sexually addicted persons were either sexually abused as children, or grew up in families that had twisted views about sex. In many cases, the change from sexual addiction to healthy sex life is all about proper education.

At the same time, sex addicts in treatment programs are given an opportunity to open up their emotional pain and insecurities to others. Behavioral therapists agree that sex is not typically the root of the problem. Rather, sex is used as an expression for inner pain that people do not know how to deal with. Thus, the treatment programs often focus on patients' disclosing and releasing their psychological distress. Through group discussion, a patient can learn that other people suffer from similar feelings of inadequacy and pain. This can be particularly empowering as the patient discovers that they are not "alone" or "wrong". Most of all, group discussion provides support and a chance for reflection for sexually addicted persons.

Nowadays, many treatment centers use the 12 step program of Alcoholics Anonymous to help treat sexually addicted persons. The 12 step program provides a forum for group support, and is generally free for the participant. It also encourages the patient to understand that addiction cannot be cured. This means that a recovering sexual addict must learn to avoid certain people and situations that might trigger a relapse. Various 12 step programs can be found in any phonebook and can be called to find out meeting times and locations.

Conclusion

Sexual addiction can be an extreme psychological problem. It is not just about sex, but the lifestyle of deceit and manipulation that accumulates around the act of sex. As the person gets more wrapped up in the lies and the abuse of others, they slowly become more detached and emotionally dead. Not only can the addiction lead to physical injury such as STDs, but it eventually keeps the addict from having any healthy and positive relationships with others. When a person finally chooses to confront their problem, they are capable of receiving treatment. They often discover that their emotional problems stem from childhood, and that they have long been playing out a pattern of sexual abuse. Treatment of sexual addiction is a long and difficult journey, but it eventually results in the person being able to engage in noncompulsive behavior. The best forms of treatment are programs that involve counseling and group discussion with other sexually addicted persons. In the end, the best way for the sexual addict to overcome this problem is if they both receive support from others, and are willing to confront the emotional pain that they have avoided for so long.