Sexual Addiction (Compulsive Sexual Behavior)

What Is Sexual Addiction (Compulsive Sexual Behavior)? What Causes Sexual Addiction?

Sexual addiction, also called sexual dependency, hypersexuality, nymphomania (females), satyriasis (males) compulsive sexual behavior and sexual compulsivity, refers to the phenomenon in which people cannot manage their sexual behavior. The individual is obsessed with sexual thoughts - thoughts which interfere with their ability to work properly, have relationships, and go about their daily activities. Many say that sexual addiction is a form of obsessive compulsive behavior.

The individual with sexual addiction has an obsession with sex, or an abnormally intense sex drive. Their lives are dominated with sex and the thought of sex; so much so that other activities and interactions become seriously affected.

It is not uncommon for the person with sexual addiction to rationalize and justify their behavior and thought patterns. People with a sex addiction may deny there is a problem.

Experts say there is a strong link between sexual addiction and risk-taking. Even though the risk of danger is clear, the individual with sex addiction may take risks regardless of the potential consequences, even if this means potential health problems (sexually transmitted diseases), physical risks or emotional consequences.

The sex addict may initially be involved in a healthy and enjoyable sexual situation which eventually develops into an obsession. Fantasies and sometimes actual acts may be well outside the radar of most people's idea of what is sexually acceptable behavior.
According to Medilexicon's medical dictionary:

Nymphomania is An insatiable impulse to engage in sexual behavior in a female; the counterpart of satyriasis in a male.

There is effective treatment available for individuals with sexual addiction.

The World Health Organization in the International Classification of Diseases (ICD) includes "excessive sexual drive" as a diagnosis of sexual addiction.

What are the signs and symptoms of sexual addiction?

A symptom is something the patient senses and describes, while a sign is something other people, such as the doctor notice. For example, drowsiness may be a symptom while dilated pupils may be a sign.

Even though there is no current official diagnosis for sex addiction, doctors and researchers have tried to define the disorder using criteria based on literature on chemical dependency. Some sex addiction behaviors may include:

• Compulsive self-stimulation (masturbation)
• Multiple affairs, this includes extra marital affairs
• Multiple one-night stands
• Multiple sexual partners
• Persistent use of pornography
• Practicing unsafe sex
• Cybersex
• Using prostitutes
• Prostitution
• Exhibitionism
• Dating through personal ads, but in an obsessive way
• Watching others in a sexual way (voyeurism)
• Sexual harassment
• Molestation
• Rape
• Detachment - the sexual activity does not satisfy the individual sexually or emotionally. Bonding with the sexual partner is lacking.
• Feelings of guilt and shame
• Feeling of lack of control over the sexual addiction, even though he/she is aware of the financial, health, or social consequences. The individual may have a recurrent failure pattern to resist impulses to engage in extreme acts of lewd sex.
Individuals find themselves often engaging in sexual behaviors for much longer than they had intended, and to a much greater extent.
• There have been several attempts to stop, reduce or control behaviors.
• The person spends a great deal of time obtaining sex, being sexual, or recovering from a sexual experience.
• The person may give up social, work-related or recreational activities because of their sexual addiction.
• Sexual rage disorder - the individual may become distressed, anxious, restless and even violent if unable to engage in their addiction.

What are the causes of sexual addiction?

Nobody is sure why some people become addicted to sex while others don't. As antidepressant medication and some other psychotropic drugs have been found to be effective in the treatment of sex addiction in a significant number of cases, experts believe sex addiction may be linked to a biochemical abnormality or some chemical changes in the brain.
There may be a common pathway within our brain's survival and reward systems which dictate our behavior with food, drugs (abusing them) and sexual interests. The pathway may reach parts of our brain which influence our judgment, rational thought and higher thinking.

Researchers found that lesions of the medial prefrontal cortex (mPFC) - a part of the brain - result in compulsive sexual behavior (link).

Some studies have found that people with sex addiction frequently come from dysfunctional families. A person with sexual addiction is more likely to have been abused than other people. A significant number of recovering sex addicts have reported some type of addiction among family members.

What are the complications of compulsive sexual behavior?

If left untreated, compulsive sexual behavior can leave the individual with intense feelings of guilt. His/her self confidence and feeling of self-worth may be low. Some patients may develop severe anxiety, and even depression.

Other complications may include family relationship problems and even family break-ups, financial problems, becoming infected with sexually transmitted infections, and unplanned pregnancies. If the individual becomes involved in stalking, exhibitionism and/or prostitution (client or prostitute) there may be problems with the law.

How is sexual addiction diagnosed?

People who suffer from sexual addiction/compulsivity may have several similar symptoms to those present in individuals with other addictions. Health care professionals and most members of the public used to, until recently, ignore sexual addiction as a serious and debilitating condition. As destroyed careers, extreme emotional pain, deep shame and serious health risks linked to compulsive sexual behavior are known about more widely, more people and doctors understand this disorder better today.

A common characteristic of sexual addiction, as in many other addictions, is the combination of denial and demonstration of loss of control - the patient denies he/she has a problem, but it is clear they are not in control. Psychiatrists commonly use the DSM (Diagnostic and Statistical Manual of Mental Disorders), created by the American Psychiatric Association, to help with the diagnosis of sexual addiction.

Some experts have noted that "Addictive sexual disorders that do not fit into standard DSM-IV categories can best be diagnosed using an adaptation of the DSM-IV criteria for substance dependence." (Irons and Schneider). Others define sexual addiction as "a condition in which some form of sexual behaviour is employed in a pattern that is characterized at least by two key features: recurrent failure to control the behavior and continuation of the behavior despite harmful consequences" (Lowinson and team).

Patrick Carnes, Executive Director of the Gentle Path program at Pine Grove Behavioral Center in Hattiesburg, Mississippi, and a leading expert on sexual addiction in the USA, believes that most experts agree with the WHO's (World Health Organization's) definition of addiction.

Patrick Carnes proposed the following as diagnostic criteria for sexual addiction: (Source: Wikipedia)

• Recurrent failure (pattern) to resist impulses to engage in extreme acts of lewd sex.
• Frequently engaging in those behaviors to a greater extent or over a longer period of time than intended.
• Persistent desire or unsuccessful efforts to stop, reduce, or control those behaviors.
• Inordinate amount of time spent in obtaining sex, being sexual, or recovering from sexual experience.
• Preoccupation with the behavior or preparatory activities.
• Frequently engaging in violent sexual behavior when expected to fulfill occupational, academic, domestic, or social obligations.
• Continuation of the behavior despite knowledge of having a persistent or recurrent social, academic, financial, psychological, or physical problem that is caused or exacerbated by the behavior.
• Need to increase the intensity, frequency, number, or risk of behaviors to achieve the desired effect, or diminished effect with continued behaviors at the same level of intensity, frequency, number, or risk.
• Giving up or limiting social, occupational, or recreational activities because of the behavior.
• Resorting to distress, anxiety, restlessness, or violence if unable to engage in the behavior at times relating to SRD (Sexual Rage Disorder).

Dr. Aviel Goodman, director of the Minnesota Institute of Psychiatry in St. Paul, USA, proposed a maladaptive pattern of behavior, leading to clinically significant impairment or distress, as manifested by at least three of the following, occurring at any time in the same 12-month period: (Source: Wikipedia)

• tolerance, as defined by either of the following:
  
  
  • a need for markedly increased amount or intensity of the behavior to achieve the desired effect
  • markedly diminished effect with continued involvement in the behavior at the same level or intensity
• withdrawal, as manifested by either of the following:
  
  
  • characteristic psychophysiological withdrawal syndrome of physiologically described changes and/or psychologically described changes upon discontinuation of the behavior
  • the same (or a closely related) behavior is engaged in to relieve or avoid withdrawal symptoms
• the behavior is often engaged in over a longer period, in greater quantity, or at a higher intensity than was intended
• there is a persistent desire or unsuccessful efforts to cut down or control the behavior
• a great deal of time spent in activities necessary to prepare for the behavior, to engage in the behavior, or to recover from its effects
• important social, occupational, or recreational activities are given up or reduced because of the behavior
• the behavior continues despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the behavior

What is the treatment for sex addiction?

There is much more help available today compared to a few years ago. Organizations include such self-help groups as Sex Addicts Anonymous, Sexaholics Anonymous, Sexual Compulsives Anonymous and Sex and Love Addicts Anonymous.

Sex Addicts Anonymous (SAA) - this has a 12-step program for sex addicts. The group was founded in 1977 by some males who sought a greater sense of anonymity in other 12-Step sex addiction programs. SAA says it is a safe place for heterosexuals, homosexuals and bisexuals who wish to treat their addictive sexual behaviors.

A growing number of SAA groups initially give an enquirer a questionnaire which is used to determine whether a prospective member is likely to be a sex addict.

An SAA member creates his/her own definition of sexual sobriety - a personalized list of compulsive sexual behaviors from which he/she will abstain. SAA encourages members to respect each other's definition of sobriety.

As well as regular meetings, SAA also has boundary meetings attended by doctors, professional caregivers, psychotherapists and clergy who need to attend meetings separate from clients, patients, and parishioners.

Sexaholics anonymous - on its website it says it is a fellowship of people who share their experience, strength and hope so that their common problem may be solved, as well as helping others to recover. The organization has no dues or fees, and survives through contributions.

Sexaholics anonymous "is not allied with any sect, denomination, politics, organization, or institution; does not wish to engage in any controversy; neither endorses nor opposes any causes. Our primary purpose is to stay sexually sober and help others to achieve sexual sobriety." Their recovery program is based on the principles of Alcoholics Anonymous and received permission from that organization to use its 12-Steps and 12-Traditions in 1979.

Sexual Compulsives Anonymous (SCA) - "SCA is a 12-Step fellowship, inclusive of all sexual orientations, open to anyone with a desire to recover from sexual compulsion. We are not group therapy, but a spiritual program that provides a safe environment for working on problems of sexual addiction and sexual sobriety. There are no requirements for admission to our meetings: anyone having difficulties with sexual compulsion is welcome." It also says there are no fees or dues and that its survival is thanks to voluntary donations. It is not allied with any sect, denomination, politics, organization, or institution.

Sources: America Psychiatric Association, Wikipedia, the Mayo Clinic, National Institutes of Health, National Health Service (NHS).