Addiction Treatment

Exploring the Concept of Sex Addiction

Tiger Woods continues to be reproached for his moral infidelities on the global stage, although he is still holding fast to his 12-step rehabilitation efforts after having completed a 45-day treatment program. Now that Woods has made the most private aspects of his life public, admitted to his wrongdoings, apologized to those he harmed, and promised to better himself, he appears to have accepted the first steps of overcoming addiction.

Woods is part of the 6 to 8 percent of the population (about 18 to 24 million Americans) believed to be sex addicts, according to the National Council on Sexual Addiction Compulsivity. This figure does not account for individuals who do not seek treatment. Sex addicts describe themselves as being incapable of stopping their actions, preoccupied with sex, and compulsive to various sexual acts such as masturbation, voyeurism, pornography, Internet sex, multiple partners, anonymous sex, solicitation of prostitute or escort services, sexual seduction, and varying degrees of these activities.

Many critics oppose the concept of sexual addiction. A large group of the medical professional field rejects the theory, and the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) only categorizes sex addiction as a “Sexual Disorders Not Otherwise Specified.” The DSM-IV defines sex addiction as “distress about a pattern of repeated sexual relationships involving a succession of lovers who are experienced by the individual only as things to be used” and involves “compulsive searching for multiple partners, compulsive fixation on an unattainable partner, compulsive masturbation, compulsive love relationships, and compulsive sexuality in a relationship.”

A basic human need and necessary for survival, a person’s sexual instinct is natural and innate; many psychologists and psychiatrists find the idea of sex as an addiction controversial since it potentially dismisses the fundamental impulse of human sexuality as a disease similar to alcoholism or chemical dependence. Variations of the term being introduced to the psychology field include “sex compulsivity,” “sex and love addiction,” “sexual addiction,” “sexual dependence,” or “hypersexuality.” Opponents consider the acceptance of sex addiction as a medical condition as providing an excuse for improper behavior for which society is normally held accountable. By diagnosing it, individuals can shift responsibility off themselves and plead that the diagnosis as the cause of their misconduct. Was Woods manipulating his fame, fortune, power, and accessibility to many of life’s luxuries—or is he legitimately suffering from an addictive disorder? Most medical professionals consider hypersexuality an underlying symptom for a more serious behavioral condition, such as manic depression or obsessive-compulsive disorder. Sex can be a way for these individuals to cope with fear of intimacy or solitude, reduce stress, and escape from problems.

The idea of sex addiction as an independent condition came about during the mid-1970s but became popularized in 1983 by Dr. Patrick Carnes in his book, Out of the Shadows: Understanding Sexual Addiction, in which Carnes first recognized the destructive behavior called sex addiction. Sexual addiction is classified as an obsessive-compulsive disorder, or excessive sexual behavior disorder, characterized by despair and severe distress involving the individual’s sexual acts and compulsions. “Consequences may be relational, emotional, physical, financial, legal, occupational, social, and spiritual in nature” writes Brenda Schaeffer, D.Min., M.A.L.P., C.A.S., in her book Is It Love or Is It Addiction? “In the process, a physical dependency on the bio-chemical or mood-altering experiences of arousal, satiation, and fantasy occurs. There is usually marked tolerance and continued involvement in spite of negative consequences. And, like other addictions, sexual addiction becomes an unconscious habit, a compulsive ritual that is no longer a choice, and a psychological and biological attachment to the stimulus that provides the pleasure. Withdrawal symptoms occur when the sexual stimulus is removed, and preoccupation begins to interfere with life.”

Although little research has been conducted on abnormal sexual activity, some recent studies have helped chip away at the complex, unofficial diagnosis. Sex has been found to release dopamine within the brain and create a temporary sense of euphoria like intoxication. Unhealthy sexual behavior is being considered as affecting an individual similar to a chemical dependency. When stimulated, sex addicts display a loss of activity in the top frontal lobe of the brain where reasoning, emotions, judgment, and voluntary cognitive function are controlled. Signs of sex addiction include: inability to stop sexual acts or thoughts; preoccupation; using sex as a coping mechanism, escape, or fix; mood changes; increasing tolerance and need to seek more stimulation; a developing routine; negative consequences; risks involving family, occupational, and social relationships; destructive behavior; maintaining a secret life; suppressing sexual trauma; feelings of shame or guilt; and sexualizing in inappropriate settings. A sex addict normally does not recognize the negative consequences of their sexual behavior and pursuits, which can include: depression; anxiety; loss of self-respect; loss of self-esteem; stress; loss of concentration and productivity; suicidal thoughts; comorbid substance abuse addictions; illness; risk of HIV, AIDS, and unwanted pregnancies; objectifying others or feeling objectified; violence to self and others such as molestation, assault, rape, or scandal; betrayal; engaging in illegal activities; and inappropriate physical or sexual behavior that is out of context or out of character.

According to the Sexual Recovery Institute, “sex” is the most commonly searched topic on the Internet. Around 25 million Americans visit pornographic websites between 1 to 10 hours per week. Approximately 40% of those with sex compulsivity with Internet pornography are now women. Schaeffer also states that around 83% of sex addicts have a comorbid substance abuse addiction or behavioral disorder; 70% have thoughts of suicide; 60% have experienced financial troubles or failure; and 58% have engaged in illegal acts to foster their sexual compulsions. Another concern for classifying sex addiction as an official disorder is that the diagnosis might assist sexual predators and rapists in a court of law. Not all sex addicts are sex offenders, and vice versa. Approximately 55% of sex offenders are considered to be sex addicts. The problem is more serious when involving child sex offenders, whose compulsions are believed to never be prevented unless kept behind bars. Around 70% of child sex offenders have a sex addiction. The Society for the Advancement of Sexual Health (www.sash.net) assists those struggling with a sex addiction by providing multiple resources, information, and guidance on how to manage their compulsive behavior.