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Sexual Addiction

In the 1970s, psychologist and researcher Patrick Carnes undertook a ten-year study that formed the foundation of understanding and treating Sex Addiction. Like other forms of addiction, sex addicts are unable to stop their behavior and gain little pleasure from the activity. Rather, it is an addiction that the addict cannot control. Carnes’ research identified several forms of sexual addiction, also known as sexual compulsion: compulsive masturbation, sex with prostitutes, anonymous sex with multiple partners, multiple affairs outside a committed relationship, exhibitionism, voyeurism, inappropriate sexual touching, repeated sexual abuse of children, and rape. Most patients that suffer from sexual addiction have low self-esteem, and a distorted body image. They may also have untreated sexual dysfunction or disorders. Sex addicts don’t enjoy sex more than other people. They are compelled to act out, and may not understand why they have constant thoughts of having sex or of masturbating. Some sex addicts have no idea of the seriousness of their condition or the risks they may be taking, yet they may feel that their life is out of control. Their emotional pain can lead to alcoholism, eating disorder, drug abuse or even suicide.

Addicts often punish themselves by engaging in degrading sexual acts, and they may become addicted to one behavior, but increase the variations and types of activities to find new ways to achieve sexual release. The relief the patient feels is temporary and must be repeated. The addict feels shame about what he/she is doing, usually immediately after engaging in these sex acts, but will sometimes attempt to deny that shame and pretend that everything is all right. Feelings of self-hatred, remorse, emptiness, and pain are hidden from others, and the addict is driven inward, away from the reality of his/her situation. Some addicts use the internet to satisfy their needs. The internet provides isolation, secrecy, fantasy, and endless variety, 24 hours a day, with instant access, while other addicts must participate in sex with others in order to relieve their anxiety. Some sex addicts are sexually codependent. They don’t enjoy sex, but participate in these acts to please their partners. Because of their fear of abandonment, they will not tell their partners the truth.

The cause of sexual addiction may begin in childhood with sexual abuse by an older family member or friend, or an environment that is hostile or neglectful. These children are emotionally starved for love in a home where affection is rarely expressed and, as adults, sex becomes a replacement in times of need. The patient looks for a connection to make them whole, and becomes addicted to the ‘unreal’, looking for a magical one-time experience to substitute for the intimacy and love they seek.

What are the symptoms?

Symptoms of sexual addiction will vary with the type of sexual activity and the severity of the condition, as exhibited by the individual patient. Symptoms can include:

• Compulsive masturbation
• Avoids emotional intimacy and connection
• Molestation/rape of adults, sexual abuse of children
• Phone or computer sex
• Obsessive dating through personal ads
• Trades sex for money, drugs or other items
• Multiple or anonymous sexual partners
• Time spent in behaviors to exclusion of other activities
• Tried to control/stop addiction without success
• May participate in partner swap, nudist club or sexually-oriented group gatherings
• Sexual Harassment
• Unsafe sex and risk taking
• Prostitution or use of prostitutes
• Increased time spent in activity to achieve the same relief or result
• Voyeurism and/or stalking, exhibitionism
• Inappropriate, constant seductive behavior
• Secretive about sexual activities, denies activities
• Inappropriate touching of others, propositioning others
• Persistent use of pornography, obsessive sexual fantasies
• Multiple affairs, affairs outside committed relationship
• Spends long periods on internet behind closed doors, family discovers history of surfing pornography sites or chat rooms
• Causing/receiving pain to achieve pleasure, uses dramatic roles, sex aids or animals, use/abuse of partner for sexual pleasure

How is it diagnosed and treated?

Doctors will perform physical and mental evaluations to rule out other disorders. Some disorders can coincide with or masquerade as sex addiction: Impulse Control Disorders; Obsessive-Compulsive Disorder; Sexual Dysfunction; Bipolar Disorder; Adjustment Disorder; Substance Abuse; Post-Traumatic Stress Disorder; Gender Identity Disorder; Dissociative Disorder; and the presence of delusions, delirium, and other cognitive disorders, among others. Doctors look for the following signs of Sexual Addiction:

• Recurrent failure to resist impulses
• Relief from anxiety after activity
• Preoccupation with behavior
• Disruption of work, social or family life
• Restlessness or irritability when patient cannot participate in behavior
• Increased anxiety or tension prior to activity
• Guilt, remorse or shame after activity
• Escalating participation in behavior
• Continued behavior in spite of risk of damage
• Some symptoms have persisted for at least 30 days

The definition of sexual deviance, standards of sexual frequency, and concepts of appropriate gender roles varies among cultures; the U.S. diagnostic criteria do not necessarily apply in other countries and cultures.

Treatment(s) can include:

• Self-Help Programs (12-Step, etc.)
• Family or Marriage Counseling if appropriate
• Group Therapy
• Psychotherapy
• Medication as appropriate for depression and anxiety
• Treatment of any coinciding physical or mental disorders

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