Sex Addiction Disorders
Sex addiction is the uncontrollable urge to behave sexually even though negative consequences may occur as a result of that behavior. Various organizations have been created to support sex addicts as well as their families in the treatment community. The Internet is a concern for therapists because it allows sex addicts to access pornography in an anonymous way. A study examining the behaviors of sex addicts is reported here as is research conducted, which focuses on the sexual behaviors of college students. Concerns addressing the lives of clergy members and comparisons between behavioral dependencies, like gambling addictions, and substance dependencies are made here as well.
Keywords Keywords; Abstinence; Abuse; Addiction; Compulsion; Dependence; Disease; Disorder; Predisposition
Psychologist Patrick Carnes has spent years devoted to the research of sexual addiction and sexually compulsive behaviors. In 1983, he published a book entitled The Sexual Addiction. While many people were suffering from the disorder of sexual dependency at the time, the book did not sell. Once he changed the title to Out of the Shadows, however, society embraced the possibility that people could become addicted — compulsively seeking out a behavior rather than a substance. In 1987, Carnes and two colleagues founded the organization known as the National Council on Sexual Addiction and Compulsivity (NCSAC). In 2004, NCSAC changed its name to the Society for the Advancement of Sexual Health (SASH), to focus more broadly on sexual health issues. SASH has an international membership and publishes a website focusing on the issues of out-of-control sexual behaviors.
SexHelp.com (2008), a second resource and advocacy organization created by Dr. Carnes, cites the following definition for sexual addiction:
Sexual addiction is defined as any sexually-related, compulsive behavior which interferes with normal living and causes severe stress on family, friends, loved ones, and one's work environment … Sexual addicts make sex a priority more important than family, friends, and work … They are willing to sacrifice what they cherish most in order to preserve and continue their unhealthy behavior … ("What is sexual addiction?" 2008).
The SASH website also includes a listing of the following predictable consequences for sexually dependent people.
- Social: Addicts become lost in sexual preoccupation, which results in emotional distance from loved ones. Loss of friendship and family relationships may result.
- Emotional: Anxiety or extreme stress is common in sex addicts who live with constant fear of discovery. Shame and guilt increase, as the addict's lifestyle is often inconsistent with personal values, beliefs, and spirituality. Boredom, pronounced fatigue, and despair are inevitable as addiction progresses. The ultimate consequence may be suicide.
- Physical: Some of the diseases that may occur due to sexual addiction are genital injury, cervical cancer, HIV/AIDS, herpes, genital warts, and other sexually transmitted diseases. Sex addicts may place themselves in situations of potential harm, resulting in serious physical wounding or even death.
- Legal: Many types of sexual addiction result in violation of the law, such as sexual harassment, obscene phone calls, exhibitionism, voyeurism, prostitution, rape, incest, child molestation, and other illegal activities. Loss of professional status and professional licensure may result from sexual addiction.
- Financial/Occupational: Indebtedness may arise directly from the cost of prostitutes, cyber-sex, phone sex, and multiple affairs. Indirectly indebtedness can occur from legal fees, the cost of divorce or separation, decreased productivity, or job loss.
- Spiritual: Loneliness, resentment, self pity, self blame (www.SASH.net , 2008).
The sex addict, in theory, is no different from the cocaine addict or the alcoholic. He or she wakes up in the morning thinking about sex — finding sex, watching sex, or taking part in sexual acts — and these thoughts consume the addict until they are acted upon. While the cocaine addict or the alcoholic betrays the people in his or her life by lying, spending money the addict may not have, and possibly committing crimes in order to obtain that next fix, the sex addict betrays the people in his or her life in a way that most people can never understand. People have heard of the addictive nature of cocaine and alcohol, but sex as a compulsion? Even with people like Dr. Carnes promoting the reality of the disorder, a wife who has been betrayed may never welcome the psychology of compulsive tendencies. As such, society as a whole has been slow to accept the concept.
The study of sexually compulsive behavior is not new. In fact, there are several theories that have been used to define or describe the disorder. For example, Kaplan's (1995) research identifies sexual desire as the center of the addiction in that the inability to regulate desire is the catalyst for the compulsivity. However, Quadland (1985) notes that much like rape, the condition of sexual addiction is one of control rather than desire. Dr. Carnes believes that the act of orgasm (ejaculation) releases mood-altering endorphins that sex addicts continually chase (1991). This theory is based on the concept of self-medication. Similar to chasing a euphoric high, Milkman and Sunderwirth (1983) identify that the gratifying effect of an orgasm on neurotransmitters (messengers within the brain) is habit-forming because the addict learns to depend on the increase or decrease of brain messages to actually regulate his or her mood (as cited in Guigliamo, 2006, pp. 361–362).
Furthermore, research has looked at early environmental experiences as the cause of sexually addictive behaviors. Creeden (2004) points to trauma theory as a potential explanation. Trauma theory posits that adults who experienced childhood trauma look toward sexual compulsiveness to dissociate with feeling helpless or out-of-control because of earlier experiences. More specifically, Schwartz et al. (1995) looked at adults who had been victimized sexually as children and noted a correlation between their victimization and their resulting compulsive behaviors. Conversely, earlier research identified narcissism as the root of compulsive behavior. In fact, Kohut (1977) noted that a cycle exists for the sex addict who tries to increase his or her self-esteem by gaining the approval of others. Once sex addicts act out, they feel empty and full of shame, which causes them to chase approval again (as cited in Guigliamo, 2006, p. 362).
Characteristics of the Sex Addict
Since sexual addiction is so misunderstood, Guigliamo (2006) conducted a study in order to humanize its effects. The researcher studied 14 men who identified themselves as being sexually addicted (p. 361). In the course of the study, Guigliamo interviewed participants to learn directly about their loss of control over their sexual behavior. Guigliamo's study was limited to participants who were 18 years of age or older and who did not identify themselves as having sex with adolescents or children (p. 363). Each of the interviews lasted between 60 and 90 minutes, and participants gave consent to being audiotaped during the interview. Guigliamo notes that the purpose of the study was to "understand the affective and motivational aspects of repetitive uncontrollable sexual behavior" (p. 364). The behaviors respondents discussed were grouped into the eight categories listed below, with a combination of categories often resulting:
1. Narcissistic Needs — To supplement self-esteem, sexual conquests and external validation were employed to meet emotional and psychological needs.
2. Desire for Human Affection or Connection — More than half of the informants reported a history of having problems sustaining long-term intimate relationships and about half of the informants expressed an inability to experience any emotional intimacy.
3. Compensation for Feelings of Low Self-Esteem — Low self-esteem and self-loathing were also mentioned by nine of the informants.
4. Avoidance of Disturbing Feelings — Nine of the informants reported using sexual activities to avoid or escape from negative feelings such as loneliness, boredom, and sadness … and to escape painful feelings.
5. Reenactment of Childhood Deficits or Trauma — Five of the informants believed that they were emotionally abused as children. All but one informant reported parental neglect. Some type of childhood sexual abuse was reported by 9 of the informants. Ten respondents reported incest, six involving sexual activities with siblings.
6. A Means to Cope with Issues of Sexual Identity/Orientation — Four of the six gay men in this study reported that their entrance into sexually addictive behaviors was related to coping and understanding their sexual orientation. … The men described a sense of fear, isolation, and alienation, as well as a lack of guidance and support as they struggled through childhood and adolescence, searching for their identity as sexual people.
7. Need for Power and Control — Investigation is essential to assess if the need for control is a result of early feelings of powerlessness that later resulted in habitual sexual aggression or if the feelings of powerlessness progressed over the course of repeated problematic sexual activities.
8. Libidinal and Sexual Needs — Only two of the informants explained their problematic sexual behaviors in terms of strong libidinal needs (p. 365–367).
Essentially, Guigliamo was able to point toward various theoretical models based on his experiment. What should be clear is that the behaviors resulting from sexual compulsion or sex addiction are not primarily based on issues related to sex itself. The acts of having sex, trying to find sex, or even thinking about sex are means of escape from life, just as having a drink, thinking about drinking, or trying to find the next drink helps the alcoholic escape. What is disturbing is that all but one of the respondents in this study stated that...
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