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Information about Sex Addiction
Sexual addiction refers to a phenomenon in which individuals report being unable to manage their sexual behavior. It has also been called “sexual dependency”, and “sexual compulsivity”. The existence of the condition is not universally accepted by sexologists and its etiology, nature, and validity have been debated.
Proponents of the concept have offered varying descriptions, each according to their favoured model of the putative phenomenon. Proponents of an addiction model of the phenomenon refer to it as “sexual addiction” and offer definitions based on substance addictions. Proponents of lack-of-control models refer to it as “sexual compulsivity” and offer definitions based on obsessive-compulsive disorder (OCD) etc. Skeptics believe that it is a myth that the phenomenon exists as a disease or disorder at all and is instead a by-product of cultural and other influences.
Definition / Symptoms
While Sex Addiction does not yet appear in the Diagnostic and Statistics Manual (nor did addiction until a few years ago), several experts have provided useful diagnostic criteria and definitions.
Proposals based on addictions models
Irons and Schneider have noted that “Addictive sexual disorders that do not fit into standard DSM-IV categories can best be diagnosed using an adaptation of the DSM-IV criteria for substance dependence.” Similarly, Lowinson and colleagues use the addiction model and define sexual addiction as a condition in which some form of sexual behaviour is employed in a pattern that is characterised at least by two key features: recurrent failure to control the behaviour, and continuation of the behaviour despite harmful consequences. Patrick Carnes, another proponent of the addiction model of sexual addiction, argued that most professionals in the field agree with the World Health Organization’s definition of addiction.
Patrick Carnes, a proponent of the idea of sexual addiction, proposed using:
- Recurrent failure (pattern) to resist impulses to engage in extreme acts of lewd sex
- Frequent engaging in those behaviors to a greater extent or over a longer period of time than intended
- Persistent desire or unsuccessful efforts to stop, reduce, or control those behaviors
- Inordinate amount of time spent in obtaining sex, being sexual, or recovering from sexual experience
- Preoccupation with the behavior or preparatory activities
- Frequent engaging in violent sexual behavior when expected to fulfill occupational, academic, domestic, or social obligations
- Continuation of the behavior despite knowledge of having a persistent or recurrent social, academic, financial, psychological, or physical problem that is caused or exacerbated by the behaviour
- Need to increase the intensity, frequency, number, or risk of behaviors to achieve the desired effect, or diminished effect with continued behaviors at the same level of intensity, frequency, number, or risk
- Giving up or limiting social, occupational, or recreational activities because of the behavior
- Resorting to distress, anxiety, restlessness, or violence if unable to engage in the behavior at times relating to SRD (Sexual Rage Disorder).
A maladaptive pattern of behavior, leading to clinically significant impairment or distress, as manifested by three (or more) of the following, occurring at any time in the same 12-month period:
- tolerance, as defined by either of the following:
- a need for markedly increased amount or intensity of the behavior to achieve the desired effect
- markedly diminished effect with continued involvement in the behavior at the same level or intensity
- withdrawal, as manifested by either of the following:
- characteristic psychophysiological withdrawal syndrome of physiologically described changes and/or psychologically described changes upon discontinuation of the behavior
- the same (or a closely related) behavior is engaged in to relieve or avoid withdrawal symptoms
- the behavior is often engaged in over a longer period, in greater quantity or at a higher intensity than was intended
- there is a persistent desire or unsuccessful efforts to cut down or control the behavior
- a great deal of time spent in activities necessary to prepare for the behavior, to engage in the behavior, or to recover from its effects
- important social, occupational, or recreational activities are given up or reduced because of the behavior
- the behaviour continues despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the behaviour.
According to Patrick Carnes the cycle begins with the “Core Beliefs” that sex addicts hold:
- “I am basically a bad, unworthy person.”
- “No one would love me as I am.”
- “My needs are never going to be met if I have to depend on others.”
- “Sex is my most important need.”
These beliefs drive the addiction on its progressive and destructive course:
- Pain agent — First a pain agent is triggered / emotional discomfort (e.g. shame, anger, unresolved conflict). A sex addict is not able to take care of the pain agent in a healthy way.
- Dissociation — Prior to acting out sexually, the sex addict goes through a period of mental preoccupation or obsession. Sex addict begins to dissociate (moves away from his or her feelings). A separation begins to take place between his or her mind and his or her emotional self.
- Altered state of consciousness / a trance state / bubble of euphoric fantasized experience — Sex addict is emotionally disconnected and is pre-occupied with acting out behaviours. The reality becomes blocked out/distorted.
- Preoccupation or “sexual pressure” — This involves obsessing about being sexual or romantic. Fantasy is an obsession that serves in some way to avoid life. The addict’s thoughts focus on reaching a mood-altering high without actually acting-out sexually. They think about sex to produce a trance-like state of arousal to eliminate the pain of reality. Thinking about sex and planning out how to reach orgasm can continue for minutes or hours before they move to the next stage of the cycle.
- Ritualization or “acting out” — These obsessions are intensified by ritualization or acting out. A sex addict first cruises, then goes to a strip show to heighten arousal until they are beyond the point of saying no. Ritualization helps distance reality from sexual obsession. Rituals induce trance and further separate the addict from reality. Once the addict begins the ritual, the chances of stopping that cycle diminish greatly. They give into the pull of the compelling sex act.
- Sexual compulsivity — The next phase of the cycle is sexual compulsivity or “sex act”. The tensions the addict feels are reduced by acting on their sexual feelings. They feel better for the moment, thanks to the release that occurs. Compulsivity simply means that addicts regularly get to the point where sex becomes inevitable, no matter what the circumstances or the consequences. The compulsive act, which normally ends in orgasm, is perhaps the starkest reminder of the degradation involved in the addiction as the person realizes they are a slave to the addiction.
- Despair — Almost immediately reality sets in, and the addict begins to feel ashamed. This point of the cycle is a painful place where the Addict has been many, many times. The last time the Addict was at this low point, they probably promised to never do it again. Yet once again, they act out and that leads to despair. They may feel they have betrayed spiritual beliefs, possibly a partner, and his or her own sense of integrity. At a superficial level, the addict hopes that this is the last battle.
According to Carnes, for many addicts, this dark emotion brings on depression and feelings of hopelessness. One easy way to cure feelings of despair is to start obsessing all over again. The cycle then perpetuates itself.
Help and Treatment for Sex Addiction
The first step in sex addiction treatment is to get the addict to stop the behavior. A period of abstinence gives the person who is addicted to sex time to focus on getting to the root of the addiction. Sex addiction treatments can include inpatient or outpatient therapy at a rehab center. Individual or group sessions focus on the reasons why the person chose to act out in this way and identify the triggers for the behavior. The addict can learn new coping skills.
Part of the sex addiction treatment must include helping the addict learn how to have healthy sexual relationships. This part of the treatment includes the addict’s partner, if they have one who is willing to continue in a relationship with them. Unlike being treated for alcohol or drug addiction, lifelong abstinence is not the goal for a person who is addicted to sex.
Recovery from sexual addiction can continue with sessions with a therapist. Support groups or 12-step programs such as Sex Addicts Anonymous and Sex and Love Addicts Anonymous may also be helpful. In some situations, prescribed medications (such as Prozac or Anafranil) can help to deal with the obsessive-compulsive part of the addiction. Interacting with people with the same addiction problem may also be of help.