Sex Addiction by Johan Obbes

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?

Exerts from this article was taken from “Facing the Shadow”, Patrick Carnes, pH.D. Gentle Path Press, ISBN 0-977 4400-0-1