Sex Addiction Q & A

“Like an alcoholic unable to stop drinking, sexual addicts are unable to stop their self-destructive sexual behavior. Family breakups, financial disaster, loss of jobs, and risk to life are the painful themes of their stories.

Sex addicts come from all walks of life - they may be ministers, physicians, homemakers, factory workers, salespersons, secretaries, clerks, accountants, therapists, dentists, politicians, or executives, to name just a few examples. Most were abused as children -- sexually, physically, and/or emotionally. The majority grew up in families in which addiction already flourished, including alcoholism, compulsive eating, and compulsive gambling. Most grapple with other addictions as well, but they find sex addiction the most difficult to stop.

Much hope nevertheless exists for these addicts and their families. Sex addicts have shown an ability to transform a life of self-destruction into a life of self-care, a life in chaos and despair into one of confidence and peace."

Sexual Dependency: What it is.

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 addiction has been called sexual dependency and sexual compulsivity. By any name, it is a compulsive behavior that completely dominates the addict's life. Sexual addicts make sex a priority more important than family, friends, and work. Sex becomes the organizing principle of addicts' lives. They are willing to sacrifice what they cherish most in order to preserve and continue their unhealthy behavior.

No single behavior pattern defines sexual addiction. These behaviors, when they have taken control of addicts' lives and become unmanageable, include: compulsive masturbation, compulsive heterosexual and homosexual relationships, pornography, prostitution, exhibitionism, voyeurism, indecent phone calls, child molesting, incest, rape, and violence. Even the healthiest forms of human sexual expression can turn into self-defeating behaviors.

Recognition of sexual addiction by the professional health care community

Sexual addiction was first brought to the forefront in Dr. Patrick Carnes' 1983 book, Out of the Shadows: Understanding Sexual Addiction (CompCare Publishers). Since then, thousands of people have come forward seeking help, and more and more professionals are being trained to identify and treat sexual addiction.

The National Council on Sexual Addiction (NCSA) was created in 1987 to serve as an independent clearing house for information on sexual addiction and treatment options. One of NCSA's missions is to decrease the stigma surrounding sexual addiction problems and treatment. They may be contacted at:

NATIONAL COUNCIL ON SEXUAL ADDICTION/COMPULSIVITY
1090 Northchase Parkway, Suite 100 South
Marietta, Georgia 30067 1-770-989-9754

Sexual dependency and other addictions

Sexual addiction can be understood by comparing it to other types of addictions. Individuals addicted to alcohol or other drugs, for example, develop a relationship with their "chemical(s) of choice" -- a relationship that takes precedence over any and all other aspects of their lives. Addicts find they need drugs merely to feel normal

In sexual addiction, a parallel situation exists. Sex -- like food or drugs in other addictions -- provides the "high" and addicts become dependent on this sexual high to feel normal. They substitute unhealthy relationships for healthy ones. They opt for temporary pleasure rather than the deeper qualities of "normal" intimate relationships.

Sexual addiction follows the same progressive nature of other addictions. Sexual addicts struggle to control their behaviors, and experience despair over their constant failure to do so. Their loss of self-esteem grows, fueling the need to escape even further into their addictive behaviors. A sense of powerlessness pervades the lives of addicts.

How many people are affected by sexual addiction?

Estimates range from three to six percent of the population.

Multiple addictions

National surveys revealed that most sexual addicts come from severely dysfunctional families. Usually at least one other member of these families has another addiction (87%).

Dual addictions include sexual addiction and:

Chemical dependency 42%
Eating disorder 38%
Compulsive working 28%
Compulsive spending 26%
Compulsive gambling 5%
Sexual addiction and abuse

Research has shown that a very high correlation exists between childhood abuse and sexual addiction in adulthood.

Sexual addicts who have reported experiencing:

Emotional abuse 97%
Sexual abuse 83%
Physical abuse 71%
Sexual addicts: male and female

It remains unclear whether one gender has a higher incidence of sexual addiction than the other. Research by Dr. Carnes shows that approximately 20% of all patients seeking help for sexual dependency are women. (This same male-female ratio is found among those recovering from alcohol addiction.)

As once was the case with alcohol addiction, many people cannot accept the reality that women can become sexual addicts. One of the greatest problems facing female sexual addicts is convincing others that they have a legitimate problem.

Why sexual addicts don't "just stop" their destructive behavior

Sexual addicts feel tremendous guilt and shame about their out-of-control behavior, and they live in constant fear of discovery. Yet addicts will often act out sexually in an attempt to block out the very pain of their addiction. This is part of what drives the addictive cycle. We say that they are addicts because they are out of control and unable to stop their behaviors despite their self-destructive nature and potentially devastating consequences. Years of treating chemically dependent individuals have shown that successful intervention with an addict's extensive denial and repression system often requires professional help.

AIDS and the sexual addict

As a function of their denial system, sexual addicts often ignore the severe emotional, interpersonal, and physical consequences of their behavior. Addicts are so entrenched in maintaining their behaviors that environmental cues which would signal caution and danger to most non-addicted people are lost to them. Such has been the case with the HIV virus and other dangerous, sexually transmitted diseases (STDs).

Sexual addicts are focused on getting a sexual 'lix." They may occasionally consider the possible consequences of their activities, but in the throes of the addictive cycle, rational thinking is seldom, if ever, present. Often dismissing the potential danger of their behavior, addicts will embrace an anxiety-laden situation to enhance their sexual high. Avoiding reality and disregarding personal safety and health are typical symptoms of sexual addiction, and they put sexual addicts at grave risk for contracting one of the many disabling STDS, including HIV.

Fear of being infected with the HIV virus and developing AIDS is not enough to stop an addict intent on being anonymously sexual, picking up prostitutes, or having multiple affairs with unsafe sex partners. Even the potential of infecting a loved one with an STD is often not enough to stop addicts from acting out. In fact, sexual addicts may find ways to act out even more intensely after such sexual practices in order to help drown out the shame and guilt of an overloaded and repressed emotional life.

Despite the frequency and range of their acting-out experiences, sexual addicts are often poorly informed about sexuality in general- An important part of their recovery process is learning about healthy sexual practices: behaviors which are connecting and affirming rather than shaming and guilt inducing. In addition, sexual addicts often need to be taught about safe sexual practices, basic self-care, and health concerns.

Diagnosing sexual addiction

Often sexual addicts don't know what is wrong with them. They may suffer from clinical depression or have suicidal tendencies. They may even think they are losing their minds.

There are, however, recognizable behavior patterns which indicate the presence of sexual addiction. Diagnosis should be done by a mental health professional trained in carrying out such diagnoses.

To help professionals determine whether a sexual addiction is present, Dr. Carnes has developed the Sexual Addiction Screening Test (SAST), an assessment tool specially designed for this purpose.

Behavior patterns which may indicate sexual addiction

While an actual diagnosis for sexual addiction should be carried out by a mental health professional, the following behavior patterns can indicate the presence of sexual addiction. Individuals who see any of these patterns in their own life, or in the life of someone they care about, should seek professional help.

1. Acting out., a pattern of out-of-control sexual behavior Examples may include:

Compulsive masturbation
Indulging in pornography
Having chronic affairs
Exhibitionism
Dangerous sexual practices
Prostitution
Anonymous sex
Compulsive sexual episodes
Voyeurism
2. Experiencing severe consequences due to sexual behavior, and an inability to stop despite these adverse consequences

Some of the losses reported by sexual addicts include:

Loss of partner or spouse 40%
Severe marital or relationship problems 70%
Loss of career opportunities 27%
Unwanted pregnancies 40%
Abortions 36%
Suicidal obsession 72%
Suicide attempts 17%
Exposure to AIDS and venereal disease 68%
Legal risks from nuisance offenses to rape 58%
3. Persistent pursuit of self-destructive behavior

Even understanding that the consequences of their actions will be painful or have dire consequences does not stop addicts from acting out. They often seem to have a willfulness about their actions, and an attitude that says, "I'll deal with the consequences when they come."

4. Ongoing desire or effort to limit sexual behavior

Addicts often try to control their behavior by creating external barriers to it. For example, some move to new neighborhood or city, hoping that a new environment removed from old affairs will help. Some think marriage will keep them from acting out. An exposer may buy a car in which it's diff icult to act out while driving.

Others seeking control over their behavior try to immerse themselves in religion, only to find out that while religious compulsion may soothe their shame, it does not end their acting out.

Many go through periods of sexual anorexia during which they allow themselves -no sexual expression at all. Such efforts, however, only fuel the addiction.

5. Sexual obsession and fantasy as a primary coping strategy

Though acting out sexually can temporarily relieve addicts' anxieties, they still find themselves spending inordinate amounts of time in obsession and fantasy. By fantasizing, the addict can maintain an almost constant level of arousal. Together with obsessing, the two behaviors can create a kind of analgesic "fix." Just as our bodies generate endorphins, natural antidepressants, during vigorous exercise, our bodies naturally release peptides when sexually aroused. The molecular construction of these peptides parallels that of opiates like heroin or morphine, but are many times more powerful.

6. Regularly increasing the amount of sexual experience because the current level of activity is no longer sufficiently satisfying

Sexual addiction is often progressive. While addicts may be able to control themselves for a time, inevitably their addictive behaviors will return and quickly escalate to previous levels and beyond. Some addicts begin adding additional acting out behaviors. Usually addicts will have three or more behaviors which play a key role in their addiction -- masturbation, affairs, and anonymous sex, for instance.

In addition, 89% of addicts reported regularly "bingeing" to the point of emotional exhaustion. The emotional pain of withdrawal for sexual addicts can parallel the physical pain experienced by those withdrawing from opiate addiction.

7. Severe mood changes related to sexual activity

Addicts experience intense mood shifts, often due to the despair and shame of having unwanted sex. Sexual addicts are caught in a crushing cycle of shame driven and shame-creating behavior. While shame drives the sexual addicts' actions, it also becomes the unwanted consequence of a few moments of euphoric escape into sex.

8. Inordinate amounts of time spent obtaining sex, being sexual, and recovering from sexual experiences

Two sets of activities organize sexual addicts' days. One involves obsessing about sex, time devoted to initiating sex, and actually being sexual. The second involves time spent dealing with the consequences of their acting out: lying, covering up, shortages of money, problems with their spouse, trouble at work, neglected children, and so on.

9. Neglect of important social, occupational, or recreational activities because of sexual behavior

As more and more of addicts' energy becomes focused on relationships which have sexual potential, other relationships and activities -- family, friends, work, talents and values -- suffer and atrophy from neglect. Long-term relationships are stormy and often unsuccessful. Because of sexual over-extension and intimacy avoidance, short-term relationships become the norm.

Sometimes, however, the desire to preserve an important long-term relationship with spouse or children, for instance, can act as the catalyst for addicts to admit their problem and seek help.

Getting help: the first step

The first step in seeking help is to admit to the problem. Though marital, professional, and societal consequences may follow, admission of the problems must come, no matter the cost. Fear of these consequences unfortunately keeps many sexual addicts from seeking help.

Many sources of help are available to provide information, support, and assistance for sexual addicts trying to regain control of their lives. These include inpatient and outpatient treatment, professional associations, self-help groups, and aftercare support groups.

Treating sexual addiction

Treatment programs for sexual addiction include patient, outpatient, and aftercare support, and self-help groups. Treatment programs also offer family counseling programs, support groups, and educational workshops for addicts and their families to help them understand the facets of belief and family life that are part of the addiction-

Unlike recovering alcoholics who must abstain from drinking for life, sexual addicts are led back into a normal, healthy sex life much in the way those suffering from eating disorders must relearn healthy eating patterns.

Dr. Carnes' program is based on the spiritual principals of the Twelve Step program of Alcoholics Anonymous, and it incorporates the expertise of the most knowledgeable health care professionals in the field of sexual addiction.

Recovery from sexual addiction is a lifelong journey. Dr. Carnes' program is designed to set addicts on the road to recovery, to provide relapse prevention techniques, and to help them stay in recovery with the help of aftercare and Twelve Step recovery support groups.

Are sexual addicts ever cured?

Like other types of addicts, some sexual addicts may never be "cured." Sexual addicts achieve a state of recovery, but maintaining that recovery can be a lifelong, day-by-day process. The Twelve Step treatment approach teaches addicts to take their recovery "one day at a time" - concentrating on the present, not the future.

Sexual codependency -- the co-addict

Partners of sexual addicts, like partners of alcoholics, can also benefit from counseling and support groups. Normally these partners are codependents, and they, too, suffer from the extreme adverse effects of the addiction. Inpatient and outpatient programs, counseling, and support groups are all available to help them regain control of their lives and support the recovery of their partner.