Facing sexual addiction - an article by psychologist Stanley Ducharme, Ph.D.

Facing Sexual Addiction

by Stanley Ducharme, Ph.D.

Sexual addiction is a compulsive and progressive condition for many men and women. It cuts across people of all ages, economic conditions, racial ethnicity and religious backgrounds. Sexual addiction is characterized by a relentless search for sexual gratification without regard to consequences or personal safety. The addiction progresses gradually in stages during which time the addict becomes increasingly detached from friends, family and the real world. Ultimately, the addictive cycle ends with serious legal, financial or personal distress.

It is easy to confuse the presence of a sexual compulsion or addiction with a high sexual drive or libido. Having a sexual addiction, however, is very different than having a strong sexual libido. The individual with a sexual addiction finds little satisfaction in sexual activities or in having an intimate relationship. The emotional components of the sexual relationship are non-existent. For most sexual addicts, there is little concern for issues such as personal feelings, attachment to others and emotional closeness. The sexual act itself becomes all consuming.

In spite of its prevalence and severity, sexual addiction is rarely talked about and often misunderstood. Effective treatment programs are limited and most people would prefer not discussing such personal and embarrassing matters. These reactions further intensify the feelings of despair experienced by an individual with a sexual addiction. Self-loathing and diminished feelings of self-worth are universal. Sexual addictions also destroy relationships. Divorce is commonplace and communication with one's partner becomes increasingly difficult. The addict has a secret that he is unable to share. Emotional distance in a relationship becomes a way of life.

The Progression of Sexual Addiction

Today, the most prevalent form of sexual addiction is related to the computer. Fantasy chat rooms, web cams and explicit materials have proliferated in recent years. Typically, masturbation and various forms of auto-erotic stimulation accompany this compulsive search for sexual gratification. For many sexual addicts, this behavior occupies multiple hours each day and can significantly interfere with the completion of other daily activities such as work, family responsibilities and relationships. In more severe cases, the search for gratification can literally consume the majority of one's waking hours.

Like all addictions, the pursuit of sexual gratification can progress rapidly over a period of months or years until the behavior is unstoppable. Often, there is an escalation of risk factors as well as an increasing exploitation of the victim. Although these addictions tend to be seen primarily in the male population, they can at times occur with individuals of either gender. Exact statistics as to the prevalence of sexual addiction are generally unavailable because of the shame and guilt associated with the behavior. Legal consequences also prevent the collection of reliable statistics. Secrecy and shame are the hallmark of a sexual addiction.

Most people would never consider engaging in the behaviors often associated with sexual addiction. Typically, the seriousness of the behaviors has gradually intensified over a period of time until a major legal, marital or financial crisis has developed in the life of the individual. At this point, the addiction has reached overwhelming proportions and the consequences can no longer be ignored or denied.

Most frequently, these addictive sexual behaviors are categorized on three levels according to the degree of risk and the legal consequences involved. Level one behaviors may include: masturbation, prostitution and anonymous sex. Level two behaviors often include: voyeurism, exhibitionism and sexually explicit phone calls. Level three behaviors are considered the most severe and may include: child molestation, incest and rape.

Emotional Considerations

Not surprisingly, severe emotional turmoil also tends to accompany a sexual addiction. For many people, the sexual behaviors associated with an addiction can lead to intense feelings of shame, guilt and despair. Severe periods of depression often follow a period of sexual acting out behavior. Ending the cycle of addiction often seems impossible. In such a helpless situation, suicidal ideation and substance abuse become a way of life. Life often feels out of control.

No one is quite sure why people develop addictions to sex. Generally, the reasons behind such addictions are different for each individual. Psychologists however tend to think that most addictions have some genetic influence as well as psychological factors, such as traumatic childhood experiences. Various addictions tend to follow family lines leading many behavioral scientists to believe that such behaviors are learned during childhood.

Other medical and psychological professionals believe that addictions grow out of a need to escape or "medicate" emotional problems and emotional pain. In this respect, a sexual compulsion is similar to alcoholism or drug abuse. The behavior is used to adjust a mood, cope with emotional turmoil or to escape reality. Denial is commonplace.

Often, obsessive thinking and a preoccupation with sexual matters can accompany the compulsive behaviors. There is an inner turmoil in which the individual incessantly seeks gratification while feeling a sense of self-loathing and detachment from others. In many ways, the individual with a sexual addiction develops a habit to only be aroused during certain situations such as when exposed to pornographic material or when paying for sex.

For the partner, living with a person who has developed a sexual addiction, can be emotionally painful, isolating and extremely frustrating. Partners often feel humiliated and embarrassed by the actions of the sexual addict and have little emotional support available to them. Friends may have few constructive suggestions to offer and qualified professionals may be difficult to find. Because of shame, talking about such problems may be beyond a partner's emotional capabilities. For many people, living with a sexual addict is similar to the experience of being emotionally abused. Silence seems like the only alternative.

Treatment Issues

If you are concerned that your partner may have a sexual addiction, there are a number of steps that might be recommended. Clearly, the first step is to speak with your partner and discuss your observations and concerns. Like all addictions, a defensive reaction is common. In some cases, the individual may not realize that a problem exists or that certain behaviors have become habitual. Encouraging psychological treatment and providing strong emotional support are critical if changes are expected. Expressing emotional support is often difficult at this time because of personal distress and feelings of anger.

There is no one form of treatment that has been proven most effective. Often, a combined treatment approach is used in working with the person who has a sexual addiction. For example, some of the psychiatric medications can be helpful in reducing sexual drive or in decreasing sexually intrusive thoughts. These medications may also allow an individual to consider consequences before acting on a sexual urge or impulse. In addition to medications, treatment almost always involves therapy or counseling on a regular basis. In the United States there are also self-help programs for people with sexual addictions. These are modeled after the AA 12 step programs and are found in most major cities in the U.S.

In certain parts of the country, sexual compulsivity workshops and retreats may be available. These workshops are aimed at recognizing the origins of the addiction and developing a realistic recovery program. These workshops are also built on a 12-step model and follow the standard principles of recovery. To date, there has been no research on their effectiveness.

Like any addiction, maintaining control and avoiding future problems is a difficult, life-long process. Maintaining sobriety over sexual addictions requires strong motivation and a constant vigilance during times of potential danger. With good emotional support, however, it is possible to make the necessary changes. For most people, ending psychological counseling too quickly and developing a false sense of confidence are the biggest mistakes that can lead to future problems.

RECOMMENDED READINGS ON SEXUAL ADDICTION

1_. Out of the Shadows: Understanding Sexual Addiction. Patrick Carnes, Hazelden Publications, Center City, Minn., 1983.

2_. Contrary to Love: Helping the Sexual Addict. Patrick Carnes, Bantam Books, New York, 1992.

3_. In the Shadows of the Net: Breaking Free of Compulsive Online Sexual Behavior. Patrick Carnes, Hazelden Publications, Center City, Minn., 2001.

4_. Looking for Love in All the Wrong Places: Overcoming Romantic and Sexual Addictions. Jed Diamond, G.T. Putnam Publishing Company, New York, 1988.

5. The Warrior's Journey Home: Healing Men, Healing the Planet. Jed Diamond, New Harbinger Publications, Oakland, CA., 1994.

For more information or for a consultation, Dr. Ducharme can be contacted at (617) 638-7358. His office is located at 720 Harrison Street, Suite 606, Boston, MA 02118.