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Sexual Addiction

Concept of Sexual Addiction

The idea that sex can be an addiction is new to many people.1

It is now recognized that many forms of self-destructive behavior that one is unable to stop despite known and predictable adverse consequences are appropriately classified as addictions. Sexual behavior fits that description when it involves frequent self-destructive or high risk activity that is not emotionally fulfilling, that one is ashamed of, and that one is unable to stop despite it causing repeated problems in the areas of marriage, social relationships, health, employment, finances, or the law.

Recognition that self-destructive sexual behavior can be an addiction has spawned the rapid growth of four nationwide self-help organizations for persons trying to recover from this problem. All are 12-step recovery programs patterned after Alcoholics Anonymous.

One might ask how sex can be an addiction when it is doing what comes naturally and does not involve abuse of a psychoactive substance like drugs or alcohol. The scientific argument for addiction is based, in part, on recent research in the chemistry of the brain. This research shows that we carry within us our own source of addictive chemicals.

When pleasure centers in the human brain are stimulated, chemicals called endorphins are released into the blood stream. Endorphins are believed to be associated with the mood changes that follow sexual release. Any chemical that causes mood changes can be addictive, with repeated exposure altering brain chemistry to the point that more of the chemical is "required" in order to feel "normal." 2

For example, experiments with hamsters have shown that the level of endorphins in their blood increases dramatically after several ejaculations. Experimental rats habituated to endorphins will go through much pain in order to obtain more. In rats, the addiction to endorphins is even stronger than the addiction to morphine or heroin.

Indicators of Sexual Addiction

The sex addict uses sex as a quick fix, or as a form of medication for anxiety, pain, loneliness, stress, or sleep. Sex addicts often refer to sex as their "pain reliever" or "tension reliever." In a popular novel, the heroine describes sex as "the thinking women's Valium." 3

Other indicators that sexual behavior may be out of control include: an obsession with sex that dominates one's life, including sexual fantasies that interfere with work performance; so much time devoted to planning sexual activity that it interferes with other activities; strong feelings of shame about one's sexual behavior; a feeling of powerlessness or inability to stop despite predictable adverse consequences; inability to make a commitment to a loving relationship; extreme dependence upon a relationship as a basis for feelings of self-worth; or little emotional satisfaction gained from the sex act.

bullet  Compulsive or addictive sexual behavior may take various forms, including what many regard as "normal" heterosexual behavior. The type of sexual activity and even the frequency or number of partners are not of great significance in diagnosing this problem. Some individuals have a naturally stronger sex drive than others, and the range of human sexual activity is so broad that it is difficult to define "normal" sexual behavior. What is significant is a pattern of self-destructive or high risk sexual behavior that is unfulfilling and that a person is unable to stop.

The first major study of sexual addiction was published by Patrick Carnes in 1991.4 It was based on questionnaires filled out by 752 males and 180 females diagnosed as sex addicts, most of them admitted for treatment in the in-patient Sexual Dependency Unit of a hospital in Minnesota. The others had at least three years of participation in one of the 12-step programs for recovery from sexual addition. Of the sex addicts in this survey, 63% were heterosexual, 18% homosexual, 11% bisexual, and 8% were unsure of their sexual preference .

The sexual addicts who responded to Carnes' questionnaire were typically unable to form close friendships. Their feelings of shame and unworthiness made them unable to accept real intimacy. They were certain they would be rejected if others only knew what they were "really" like, so they found myriad obsessive ways to turn away a potential friend or loving partner. Despite a large number of superficial sexual contacts, they suffered from loneliness, and many developed a sense of leading two lives--one sexual, the other centered around their occupation or other "normal" activity.

In Carnes' survey, 97% responded that their sexual activity led to loss of self-esteem. Other reported emotional costs were strong feelings of guilt or shame, 96%; strong feelings of isolation and loneliness, 94%; feelings of extreme hopelessness or despair, 91%; acting against personal values and beliefs, 90%; feeling like two people, 88%; emotional exhaustion, 83%; strong fears about own future, 82%; and emotional instability, 78%.

Carnes found that 42% of sex addicts in his sample also had a problem with either alcohol or drug dependency and 38% had eating disorders.

The roots of out-of-control sexual behavior may be quite varied. It may be caused by an underlying personality disorder, an "addiction" to sex, or a physical disorder. The traditional disorders of exaggerated sexuality, nymphomania in the female and satyriasis in the male, are believed to be caused by a disorder of the pituitary gland or irritation of the brain cortex by a tumor, arteriosclerosis or epilepsy. These physical disorders are rare.5

Consequences of Sexual Addiction

Out-of-control sexuality may have serious adverse consequences. In the Carnes survey of individuals in treatment, 38% of the men and 45% of the women contracted venereal diseases; 64% reported that they continued their sexual behavior despite the risk of disease or infection. Of the women, 70% routinely risked unwanted pregnancy by not using birth control, and 42% reported having unwanted pregnancies.

Many patients had pursued their sexual activities to the point of exhaustion (59%) or even physical injury requiring medical treatment (38%). Many (58%) pursued activities for which they felt they could be arrested and 19% actually were arrested. Sleep disorders were reported by 65%; they usually resulted from stress or shame connected with the sexual activity.

Of the survey respondents, 56% experienced severe financial difficulty because of their sexual activity. Loss of job productivity was reported by 80%, and 11% were actually demoted as a result. Many of these problems are, of course, encountered by persons whose sexuality is not out of control, but the percentages are much lower. 6

Security Concerns

Compulsive or addictive sexual behavior is a security concern because it may lead to poor judgment or lack of discretion, indicate a serious emotional or mental problem, or attract the attention of hostile intelligence or security services and open one to exploitation, manipulation, or coercion. Sexual intimacy often leads to personal intimacy. The bedroom is an ideal location for a hostile intelligence or security service to learn of an individual's resentment of a boss, longing to be rich, compulsive need to feel important, or problems with a spouse.

Addicts of all types typically organize a part of their life and their circle of friends around their addiction. Foreign intelligence and security services generally maintain sources in these circles, and it is easy for them to place an agent in contact with a potential target who attracts attention through these activities. Habitual behaviors that provide such access opportunities for foreign intelligence and security services increase the risk that an individual will become a target and that any vulnerabilities that do exist will be discovered and exploited.

Recovery Programs

Sex Addicts Anonymous, Sex & Love Addicts Anonymous, Sexaholics Anonymous, and Sexual Compulsives Anonymous are all nationwide organizations for individuals recovering from problems with compulsive sexual behavior. They are 12-step recovery programs patterned after Alcoholics Anonymous. The order in which these organizations are listed is not meant to imply any judgment about which is best or biggest. One or more of the recovery programs may be listed in your local telephone directory.

A membership survey of Sex and Love Addicts Anonymous found that 58% of its members were male, 92% Caucasian, 44% in professional jobs, 24% with a postgraduate degree and 31% with a college degree. The sexual orientation of its members was 63% heterosexual, 11% bisexual, and 26% gay or lesbian. 7

It is normal for recovery groups like this to have a disproportionate number of highly educated members. That is only because well-educated persons are more likely to seek out self-help programs. There is no evidence that well-educated persons are more likely than others to suffer from sexual addiction.

Sources for More Information

Research on sexual addiction is relatively new, so less information is available than for other addictions. Check with your doctor, local counseling service, or Employee Assistance Program, but you may need to supplement this with information from other sources. Information on sexual addiction and the recovery groups is available on the Internet. Search on sexual addiction.

Books available from your local library or bookstore include:

  • Out of the Shadows: Understanding Sexual Addiction, by Patrick Carnes. Hazelden Publishing & Educational Services, 2001.
  • In the Shadows of the Net: Breaking Free of Compulsive Online Sexual Behavior, by Patrick J. Carnes, David L. Delmonico, Elizabeth Griffin. Hazelden Publishing & Educational Services, 2004
  • Cybersex Exposed: Simple Fantasy or Obsession?, by Jennifer Schneider MD Ph.D, Robert Weiss. Hazelden Publishing & Educational Services, 2001
  • Steps of Hope: A 12-Step Recovery Guide for Sex Addiction, by Douglas Weiss. Discovery Press, 1996.
  • False Intimacy: Understanding the Struggle of Sexual Addiction, by Harry W. Schaumburg. Navpress, 1997.
  • Don't Call It Love: Recovery from Sexual Addiction, by Patrick Carnes. Bantam Books, 1992.
  • Addictive Thinking: Understanding Self-Deception, by Abraham J. Twerski. Hazelden/Rosen, 1997.

Related Topics:  Standards of Personal Conduct, Reporting Improper, Unreliable or Suspicious Behavior

1. Scientists specializing in sexual behavior generally agree on what constitutes out-of-control sexual behavior, but they disagree over whether it is appropriately diagnosed as an addiction or as a symptom of an underlying obsessive-compulsive disorder. This discussion uses the terms "addiction" and "compulsion" interchangeably in a non-technical sense, not as medical diagnoses. For opposing positions in this debate, see the two special issues on Medical Aspects of Sexual Addiction/Compulsivity of the American Journal of Preventive Psychiatry and Neurology, dated May 1990 and Spring 1991.
2. Patrick Carnes (1991). Don't call it love: Recovery from sexual addiction, (New York: Bantam, pp. 22-23, 30-34). Also see H. B. Milkman & S. Sunderwirth (1986). Craving for ecstasy: The consciousness and chemistry of escape, (Lexington, MA: Lexington Books).
3. L. Sanders (1983). The seduction of Peter S, (New York: Putnam).
4. Patrick Carnes (1991). Don't call it love: Recovery from sexual addiction. New York: Bantam. The research was done at the Golden Valley Health Center, 4101 Golden Valley Rd., Golden Valley, MN 55422, but the Sexual Dependency Unit no longer exists there. Dr. Carnes moved to Delano Hospital, 23700 Camino del Sol, Torrance, CA 90505, phone (612) 782-0510.
5. R. J. Barth & B. N. Kinder (1987, May). The mislabeling of sexual impulsivity, Journal of Sex and Marital Therapy, 1, 15-23. Also L. Salzman (1972). The highly sexed man. Medical Aspects of Human Sexuality, 36-49.
6. Patrick Carnes (1991). Don't call it love: Recovery from sexual addiction. New York: Bantam, Chap. 3.
7. Documentation provided by Sex & Love Addicts Anonymous to R. J. Heuer, Defense Personnel Security Research Center, January 13, 1992.




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