Sex Addiction Treatment: Is Sex an Addiction?
Sex-Love Addiction Overview
For many people, the first step in understanding sex addiction or love/relationship addiction is to forget everything you’ve seen about this disorder on TV or in the movies. In television shows and films, sex addiction is often either portrayed as a moral failure or played for laughs.
The truth about sex/love addiction is far from funny.
For people who have developed a sex/love addiction, experiences that are normally sources of great pleasure morph into compulsions that lead to harmful, self-destructive, and otherwise risky behaviors. Sex/love addiction isn’t about having fun — instead, it is an obsessive behavior disorder that often leaves the sufferer emotionally unfulfilled, ashamed, and in danger of myriad negative consequences.
The good news is that as awareness and understanding about sex/love addiction increases, there is a greater likelihood that individuals who struggle with this disorder will have access to the professional treatment that can help them regain control over their lives.
One might ask how sex can be an addiction when it is doing what comes naturally and does not involve abuse of a psychoactive substance like drugs or alcohol. The scientific argument for addiction is based, in part, on recent advances in neurochemistry that suggest we carry within us our own source of addictive chemicals.
When pleasure centers in the human brain are stimulated, chemicals called endorphins are released into the blood stream. Endorphins are believed to be associated with the mood changes that follow sexual release. Any chemical that causes mood changes can be addictive, with repeated exposure altering brain chemistry to the point that more of the chemical is “required” in order to feel “normal.”
For example, experiments with hamsters have shown that the level of endorphins in their blood increases dramatically after several ejaculations. Experimental rats habituated to endorphins will go through much pain in order to obtain more. In rats, the addiction to endorphins is even stronger than the addiction to morphine or heroin.
Indicators of Sexual Addiction
The sex addict uses sex as a quick fix, or as a form of medication for anxiety, pain, loneliness, stress, or sleep. Sex addicts often refer to sex as their “pain reliever” or “tension reliever.” In a popular novel, the heroine describes sex as “the thinking women’s Valium.”
Other indicators that sexual behavior may be out of control include: an obsession with sex that dominates one’s life, including sexual fantasies that interfere with work performance; so much time devoted to planning sexual activity that it interferes with other activities; strong feelings of shame about one’s sexual behavior; a feeling of powerlessness or inability to stop despite predictable adverse consequences; inability to make a commitment to a loving relationship; extreme dependence upon a relationship as a basis for feelings of self-worth; or little emotional satisfaction gained from the sex act.
Compulsive or addictive sexual behavior may take various forms, including what many regard as “normal” heterosexual behavior. The type of sexual activity and even the frequency or number of partners are not of great significance in diagnosing this problem. Some individuals have a naturally stronger sex drive than others, and the range of human sexual activity is so broad that it is difficult to define “normal” sexual behavior. What is significant is a pattern of self-destructive or high risk sexual behavior that is unfulfilling and that a person is unable to stop.
The first major study of sexual addiction was published by Patrick Carnes in 1991. It was based on questionnaires filled out by 752 males and 180 females diagnosed as sex addicts, most of them admitted for treatment in the in-patient Sexual Dependency Unit of a hospital in Minnesota. The others had at least three years of participation in one of the 12-step programs for recovery from sexual addition. Of the sex addicts in this survey, 63% were heterosexual, 18% homosexual, 11% bisexual, and 8% were unsure of their sexual preference.
The sexual addicts who responded to Carnes’ questionnaire were typically unable to form close friendships. Their feelings of shame and unworthiness made them unable to accept real intimacy. They were certain they would be rejected if others only knew what they were “really” like, so they found myriad obsessive ways to turn away a potential friend or loving partner. Despite a large number of superficial sexual contacts, they suffered from loneliness, and many developed a sense of leading two lives–one sexual, the other centered around their occupation or other “normal” activity.
In Carnes’ survey, 97% responded that their sexual activity led to loss of self-esteem. Other reported emotional costs were strong feelings of guilt or shame, 96%; strong feelings of isolation and loneliness, 94%; feelings of extreme hopelessness or despair, 91%; acting against personal values and beliefs, 90%; feeling like two people, 88%; emotional exhaustion, 83%; strong fears about own future, 82%; and emotional instability, 78%.
Carnes found that 42% of sex addicts in his sample also had a problem with either alcohol or drug dependency and 38% had eating disorders.
The roots of out-of-control sexual behavior may be quite varied. It may be caused by an underlying personality disorder, an “addiction” to sex, or a physical disorder. The traditional disorders of exaggerated sexuality, nymphomania in the female and satyriasis in the male, are believed to be caused by a disorder of the pituitary gland or irritation of the brain cortex by a tumor, arteriosclerosis or epilepsy. These physical disorders are rare.
Consequences of Sexual Addiction
Out-of-control sexuality may have serious adverse consequences. In the Carnes survey of individuals in treatment, 38% of the men and 45% of the women contracted venereal diseases; 64% reported that they continued their sexual behavior despite the risk of disease or infection. Of the women, 70% routinely risked unwanted pregnancy by not using birth control, and 42% reported having unwanted pregnancies.
Many patients had pursued their sexual activities to the point of exhaustion (59%) or even physical injury requiring medical treatment (38%). Many (58%) pursued activities for which they felt they could be arrested and 19% actually were arrested. Sleep disorders were reported by 65%; they usually resulted from stress or shame connected with the sexual activity.
Of the survey respondents, 56% experienced severe financial difficulty because of their sexual activity. Loss of job productivity was reported by 80%, and 11% were actually demoted as a result. Many of these problems are, of course, encountered by persons whose sexuality is not out of control, but the percentages are much lower.
Compulsive or addictive sexual behavior is a security concern because it may lead to poor judgment or lack of discretion, indicate a serious emotional or mental problem, open one to exploitation, manipulation, or extortion, or attract the attention of hostile intelligence or security services. Sexual intimacy often leads to personal intimacy. The bedroom is an ideal location for a hostile intelligence or security service to learn of an individual’s resentment of a boss, longing to be rich, compulsive need to feel important, or problems with a spouse.
Addicts of all types typically organize a part of their life and their circle of friends around their addiction. Intelligence and security services generally maintain sources in these circles, and it is easy for them to place an agent in contact with a potential target who attracts attention through these activities. Habitual behaviors that provide such access opportunities for foreign intelligence and security services increase the risk that an individual will become a target and that any vulnerabilities that do exist will be discovered and exploited.
Causes of Sex-Love Addiction
As is also the case with most addictions and behavior disorders, no one factor or influence has been identified as the direct cause of sex addiction or love/relationship addiction.
Many experts believe that problems in the pleasure/reward areas of the brain may lead to sexual addiction. (This is consistent with the belief that these same areas of the brain are involved in the development of drug addictions and food-related compulsions.)
Individuals who experience significant traumas in childhood (such poor parental relationships or childhood sexual abuse) may also be more prone to develop sexual compulsions in adulthood. Adults with traumatic childhood histories are also more likely to have the diminished self-esteem and self-image that is common among individuals who display addictive behaviors toward sex and relationships.
Symptoms of Sex-Love Addiction
Sex addicts use sex the way drug addicts use drugs or alcoholics use alcohol — as a compulsive means of self-medicating for anxiety, pain, loneliness, stress, or other emotions.
As with other forms of addiction, sexual addiction manifests itself as a compulsive behavior that the afflicted individual is incapable of stopping, even after the behavior has resulted in negative consequences. Symptoms of sex addiction include the following:
- An obsession with sex that dominates one’s life
- Sexual behaviors and fantasies that interfere with work performance
- Constantly thinking about or planning sexual activity
- Powerful shame about the sexual behavior
- Inability to stop acting out sexually
- Inability to make a commitment to a loving relationship
- Depending upon relationship status as a basis for feelings of self-worth
- Little or no emotional satisfaction gained from having sex
Sex addictions can also manifest via compulsive masturbation, an obsession with pornography, cybersex, exhibitionism, and voyeurism
Again, it is important to understand that sex/love addiction is not a matter of having a strong sex drive or being “overly romantic.” Individuals who are struggling with sex addiction or love addiction have a compulsive (and ultimately self-destructive) behavior disorder that compels them to continue to engage in dangerous, destructive, and demeaning acts.
Treating sex/love addiction is a complex and highly individualized experience that must take a number of factors into account. Sex/love addicts are often trauma survivors (many of whom endured sexual abuse during childhood), and many are also struggling with co-occurring disorders such as alcoholism, addiction, and depression or other mood disorders.
Depending upon the unique circumstances of the individual patient, sex/love addiction treatment may involve a number of the following:
- Medication (such as anti-depressants and related psychiatric drugs)
- Individual, Group, and Family Therapy
- EMDR (Eye Movement Desensitization and Reprocessing) — for trauma survivors
- Relationship Counseling
- Cognitive-Behavioral Therapy (CBT)
- 12-Step Philosophies (both for co-occurring substance addictions and for the sex addiction itself)
- Family Systems Therapy
- Psychodrama Therapy
Sex Addicts Anonymous, Sex & Love Addicts Anonymous, Sexaholics Anonymous, and Sexual Compulsives Anonymous are all nationwide organizations for individuals recovering from problems with compulsive sexual behavior. They are 12-step recovery programs patterned after Alcoholics Anonymous.
A membership survey of Sex and Love Addicts Anonymous found that 58% of its members were male, 92% Caucasian, 44% in professional jobs, 24% with a postgraduate degree and 31% with a college degree. The sexual orientation of its members was 63% heterosexual, 11% bisexual, and 26% gay or lesbian.
It is normal for recovery groups like this to have a disproportionate number of highly educated members. That is only because well-educated persons are more likely to seek out self-help programs. There is no evidence that well-educated persons are more likely than others to suffer from sexual addiction.