Sex addiction
is an illness of escape, a repression mechanism and a mental illness which we often
find in society, yet it is still widely
misunderstood. Like all addictions its goal is to medicate, ignore reality or serve
as an alternative to allowing oneself feel hurt, betrayal, worry, stress or
loneliness. It is not an inborn illness but rather a consequence of a childhood
trauma or dysfunctional family.
The journey
for the acknowledgement of Sex Addiction (SA) has only started. Already we are
seeing patients coming to treatment centre’s with SA as their primary
addiction, we are finding trained and qualified SA therapists and highly
successful Sex Addiction Anonymous & Love and Sex Addicts Anonymous support
groups, yet the truth is that SA is still being debated amongst some
professionals whether it is a real addiction or not. According to the latest
DSM (Diagnostic and Statistical Manual of Mental Disorders) it has not been
included as an addiction, yet the symptoms, destruction, neurological damage,
and root causes are all clear indication that this is an addiction like any
other substance or process addiction.
While the
debate continues, it is wise for counsellors and therapist to learn more about
this mental illness as we see numerous patients in our practices who are being
diagnosed as bipolar, obsessive compulsive disorder or narcissistic, which are
all symptoms mimicking SA but yet never being correctly treated or diagnosed as
SA.
So how
would one describe Sex Addiction (SA)? SA is first of all an intimacy and
attachment disorder. As addiction is an indicator that the addict is trying to
repress some form of hurt, betrayal, stress etc. by acting out, SA is focused
on the sexualization of feelings or the distortion of uncomfortable emotions.
Reality distortion starts within the family.
Addicts typically come from families in which addiction is already
present. Often, parents, grandparents, siblings, or extended family members or extended
family members struggle with alcoholism, compulsive gambling, nicotine
addiction, eating problems, illegal drug use, compulsive sex or often a
combination of addictions.
According
to Dr. Patrick Carnes (Internationally acclaimed speaker and authority on
addiction treatment) –as children, sex addicts grow up in environments where
there is the classic “elephant in the living room” syndrome: everyone pretends
there is no problem in the family although there’s a huge issue interfering
with everyone’s lives. In such a situation, children learn very early with everyone
pretending there is no problem and everyone pretends to avoid the painful and
the obvious: to look at addiction and family dysfunction and not see it.
Sex addicts
also tend to come from rigid, authoritarian families. These are families in
which all issues and problems are black and white. Little is negotiable and
there is only one way to do things. Success
in the family means doing what the parents want to such an extent that children
give up being who they are. Normal child development does not happen. By
the time children enter adolescence, they have few options. One is to become
rebellious or develop a secret life about which the family knows nothing. Both
positions distort reality. Both result in a distrust of authority and a poor
sense of self.
In the
family’s rigidity, sex is also perceived negatively (children are taught that
sex is dirty, sinful, bad or nasty) sex becomes exaggerated or hidden. Worse
yet, the forbidden can become the object of obsession.
An
important observations by most therapists are that most sex addicts come from
families in which members are “disengaged” from one another – there is little
sharing or intimacy. Children develop few skills about sharing, being
vulnerable, or risking anything about themselves. As a result, they learn to
trust no one but themselves in such families. Children who are abused or
neglected conclude that they are not valuable. They live with a high level of
anxiety because no one teaches them common life skills or provides for their
emotional needs. Yet this is not the only cause for addiction to develop. Abuse
victims (emotional, sexual, and physical) tend to distort reality and also
distort the reality of emotions.
Addicts
suffer from an inability to express their emotions, suffer from connecting with
other people in an intimate way and have learned through time that the only way
that they can connect with someone else is through a sexual manner. Somewhere
through their childhood development a psychological link is made between
meeting their needs and the kind of sexual arousal which eventually becomes
their way of acting out. SA is not about having a high libido, or wanting a lot
of sex but it is about masking an emotional need through their sexual choice of
preference.
Feelings
are being sexualized that has nothing to do with romance, sex or relationships.
For instance an addict acts out as a loved one dies. The death of the loved one
is not erotic in any way, but because the addict does not know how to express
his grief in a healthy way, he acts out sexually by picking up a prostitute.
According to Dr. Carnes sex addiction is a process
addiction and diagnoses can be done by evaluating the following phenomena:
1.
Recurrent failure
(pattern) to resist impulses to engage in acts of sex.
2.
Frequently
engaging in those behaviours to a greater extent or over a longer period of
time than intended.
3.
Persistent desire
or unsuccessful efforts to stop, reduce, or control those behaviours.
4.
Inordinate amount
of time spent in obtaining sex, being sexual, or recovering from sexual
experience.
5.
Preoccupation with
the behaviour or preparatory activities.
6.
Frequently
engaging in sexual behaviour when expected to fulfil occupational, academic,
domestic, or social obligations.
7.
Continuation of
the behaviour despite knowledge of having a persistent or recurrent social,
academic, financial, psychological, or physical problem that is caused or
exacerbated by the behaviour.
8.
Need to increase
the intensity, frequency, number, or risk of behaviours to achieve the desired
effect, or diminished effect with continued behaviours at the same level of
intensity, frequency, number, or risk.
9.
Giving up or
limiting social, occupational, or recreational activities because of the behaviour.
10.
Resorting to
distress, anxiety, restlessness, or violence if unable to engage in the behaviour
at times relating to SRD (Sexual Rage Disorder).
Specialists in obsessive-compulsive disorder and
addictions use the same terms to refer to different symptoms. In addictions,
obsession is progressive and pervasive, and develops along with denial; the
person usually does not see themselves as preoccupied, and simultaneously makes
excuses, justifies and blames. Compulsion is present only while the addict is
physically dependent on the activity for physiological stasis. Constant
repetition of the activity creates a chemically dependent state. If the addict
acts out when not in this state, it is seen as being spurred by the obsession
only. Some addicts do have OCD as well as addiction, and the symptoms will interact.
According to proponents of sexual addiction as a
disorder, addicts often display narcissistic traits; these are said to often
clear as sobriety is achieved, although others exhibit the full personality
disorder even after successful addiction treatment.
Sex Addicts are often described sufferers as
repeatedly and compulsively attempting to escape emotional or physical
discomfort by using ritualized, sexualized behaviours such as masturbation, pornography, including obsessive thoughts. Some individuals
try to connect with others through highly impersonal intimate behaviours:
empty affairs, frequent visits to prostitutes, voyeurism, exhibitionism, frotteurism, cybersex, and the like.
Patrick Carnes argues that when children are
growing up, they develop “core beliefs” through the way that their family
functions and treats them. A child brought up in a family that takes proper
care of them has good chances of growing up well, having faith in other people,
and having self worth. On the other hand, a child who grows up in a family that
neglects them will develop unhealthy and negative core beliefs. They grow up to
believe that people in the world do not care about them. Later in life, the
person has trouble keeping stable relationships and feels isolated. Generally,
addicts do not perceive themselves as worthwhile human beings . They cope with
these feelings of isolation and weakness by engaging in excessive sex.
According to Patrick Carnes the cycle begins with the "Core
Beliefs" that sex addict’s hold:
1. "I am
basically a bad, unworthy person."
2. "No one would
love me as I am."
3. "My needs are
never going to be met if I have to depend on others."
4. "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. 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.
However dark this situation looks like, freedom,
hope and sanity does exist for these sufferers. The question then arises, are
we as counsellors and therapists trained enough to handle this ticking time
bomb?