Sexual Addiction

Sexual addiction: Serious affliction, or a 12-step fad?

It certainly makes for good TV (with my favorite psychologist and personal hero: Dr. Drew!)

It gives celebrities something to blame their indiscretions on.  Suddenly - a reason for us to pity them when the awful things they have done are being run through the tabloids.  Their good names through the mud.  Tiger Woods, I am looking at you.

Addiction is moderated by the brain's reaction to the pleasure response.  Some things are meant to feel good... and other substances overload the brain with an unnatural feelings that can't be replicated elsewhere.  Overuse of pleasure inducing substances, such as cocaine and meth, can actually change brain functioning.  This is where addiction and dependence occur.

This leaves some to wonder, can sex - an activity designed to be pleasurable by nature - stand in the same place as a synthetic chemical?  Our sex drive actually sits in the same part of the brain that controls hunger and thirst - the hypothalamus.  Its a peach pit sized structure that sits near the base of the skull and is fueled by testosterone.  Romance and lust can be felt in the same moment and both occur in our "reptilian brains" or the structures that run our most basic drives.  Romance - the butterflies in your stomach during a smooch from a hottie - looks similar in the brain as snorting a line of blow if we were to view the brain in an fMRI!  In both instances dopamine floods the brain and fills you with delusional optimism as well as obsessive thoughts.  It is actually "romance" that has the highest addictive qualities.  This is why celebrities have stalkers and relationships end messy.  An "addiction" to relationships and romance alone is referred to as codependency in the mental health world.  

“Just because something is addictive doesn't mean that you will get addicted to it. But . . . if your stomach ties up in knots while you count the seconds waiting for a phone call from that special someone . . . if you hear a loud buzzing in your ears when you see a certain person's car (or one just like it) . . . if your eyes burn when you hear a random love song or see a couple holding hands . . . if you suffer the twin agonies of craving for and withdrawing from a series of unrequited crushes or toxic relationships . . . if you always feel like you're clutching at someone's ankle and dragged across the floor as they try to leave the room . . . welcome to the club.” 
― Ethlie Ann Vare, Love Addict: Sex, Romance, and Other Dangerous Drugs 

Orgasm creates intense brain activity!  All three of the above systems are going full speed ahead in the same 5-20 seconds!  There aren't too many differences between the male and female brain when it comes to sex either; contrary to what some would have you believe.  Orgasm essentially replicates the drug heroine in how it effects the brain.  The parts of the brain that control fear and pain are actually shut off!  A 54 year old female student at Rutger's University consented to masturbating until orgasm while in an fMRI machine in 2011 - all in the name of science (and completing her dissertation)!  The outcome is striking:

“Just as a heroin addict chases a substance-induced high, sex addicts are bingeing on chemicals — in this case, their own hormones.” 
― Alexandra Katehakis

Ok so we have established that the body's response to orgasm (naturally occurring as it may be) is on par with other substances with identical addictive qualities.  But how does one go from enjoying sex to being a raging sex-aholic?  Sexual addiction is a condition that has been coined many different names throughout history - nymphomania, hypersexuality, erotomania, and Don Juanism, just to name a few.  Patrick Carnes, Ph.D is credited with publishing the modern bible on sex addiction and compulsive sexual behavior in 1983, Out of the Shadows: Understanding Sexual Addiction.   The doctor currently runs a sexual addiction program in Mississippi.   In his writing he names addictive personalities, escapism, psychological disorders, low self-esteem, self-destructive behaviors, low sexual inhibition, and conditioning as precursers to sex addiction.  

Sexual addiction can take on a variety of forms, and because it highly correlates with risk-taking often what characterizes the behavior as an "addiction" is damage to oneself or others. I am speaking about activities such as compulsive masturbation, multiple affairs, voyeurism, unsafe sex, paying for sex, exhibitionism, etc. etc..  Some antidepressants are successful at curbing compulsive behaviors and sex addiction should also be treated with counseling and education about what healthy sexual relationships looks like. For the sex addict sometimes the relationship piece is the most difficult part of the puzzle to get back together.  This is because sexual addiction is characterized by a fear of intimacy.  Fear of attachment can happen for many reasons. Trauma or not feeling cared for by your guardians as a child are examples. Sex addicts are skilled at pushing others away by their overwhelming need for sex, constantly requiring new sexual partners. Their sole focus always being on their own pleasure and nothing else during sexual activities.

Currently, however, there is no "Sexual Addiction" or "Hypersexuality" disorders listed in the DSM-5 as stand alone disorders.  This can be frustrating because when making a diagnostic assessment the clinician must attribute hypersexuality to another disorder.  Hypersexuality is a common symptom of bipolar spectrum disorders and therefore many times people suffering with this problem are wrongfully diagnosed with a serious mood disorder and encouraged to take prescription medications that will not solve their problem.  I would encourage mental health professionals to not jump to the conclusion of bipolar, but instead be willing to explore trauma, codependency, and attachment etiologies of hypersexuality with your clients first.  

While the medical and mental health world will continue to argue whether hypersexuality fits on the addiction spectrum, the compulsive (OCD) spectrum, or is a symptom of mania (bipolar spectrum), ... There are 12 step groups that have stepped up to fill the gap regardless.  SAA, or Sex Addicts Anonymous, would encourage you to find a group and begin talking about your struggle.

"My life as a sex addict was a life of grim zombie numbness. I used sex to dull the pain of waking up in the morning, to medicate my feelings, to get me to sleep at night. I used sex when I was celebrating, when I was commiserating and when I was bored of life. In short, sex was something I abused: an opiate I dispensed ‘under the counter’ to myself." - Anonymous

Is all of this hitting close to home?  There is a screening tool devised by a psychological clinic in my area about sexual addiction. Before you let your results freak you out keep in mind this is telling you how vulnerable you may be to sexual addiction, NOT that you ARE a sex addict. 

Stay happy.  Stay healthy,

- The Sexpert