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What If You Can't Stop Having Sex, Even If You Really, Really Want To?

$150,000 on phone sex? 14 hours looking at porn without eating or drinking? Sex addiction is easy to mock, but the compulsive behaviors associated with it truly hurt sufferers.


There has been no small amount of conjecture about Tiger Woods "sex addiction," and yes, there already is a Lifetime movie or two dedicated to the subject. But what really is the story about sex addiction?

Finding out requires sweeping aside the presumption, dismissiveness, and shame that clouds the subject.

The phenomenon didn’t have a name until 1983 when psychologist Patrick Carnes published the influential book,  Out of the Shadows: Understanding Sexual Addiction. Prior to that, the behavior was described as “hyper-sexual arousal.” In short, the term “sex addiction” is used to describe a pattern of frequent, progressive, and often secret sexual behavior, even when the behavior jeopardizes a person’s time, employment, financial stability, relationships, and reputation. While often conflated with adultery, sex addiction does not necessarily mean cheating—or even intercourse. Rather, it can manifest as a dependency on pornography, masturbation, phone or Internet sex, and other related behavior.

People who struggle with sex addictions are of varying ages, genders, and sexual orientations. The Society for the Advancement of Sexual Health estimates that 3 to 5 percent of the American population wrestles with addictive or compulsive sexual activity.

Re-framing of compulsive sexual behavior has led the therapeutic community to look at it through the lens of addiction for the last twenty years, noting how the behavior activates the same pleasure centers of the brain, releasing the same chemicals as drug use does, and providing the addict with the same kind of euphoric high, and numbed escapism that addictive substances cause.

Maureen Canning treats sex addiction both in her private practice and as a consultant at The Meadows, a recovery center in California. She said the therapeutic response to sexual addiction parallels that of chemical addiction. Its diagnosis uses the same assessment tool, gauging, for example, whether the behavior progresses over time and has negative consequences on the person’s life.

If an addiction is assessed, Canning said, the treatment she provides hinges on listening.

“We listen to what they’ve been doing, how they’ve been doing it,” Canning said. “We listen for the story around their childhood, how they were influenced sexually, both overtly and covertly. Sometimes they were abused, or exposed to something traumatic.”

She added that treatment guides people into stabilizing their lives—they often begin recovery while in chaotic circumstances—and then helping the individual learn to manage their feelings, set boundaries, and find healthy coping mechanism. The process can be painful.

“For many sex addicts, they’ve been acting out for most of their lives and (treatment) is like a death—this was the one thing they could count on to make them feel good,” Canning said.

She also noted that there is an anorexic cycle to sex addiction, where an individual compulsively avoids sexuality. Others, she said, especially women, can become addicted to the process of seduction rather than the sex per se.

Especially with the advent of the Internet, there have been more and more diagnoses of sex addiction.

“We called (the internet) the crack cocaine of sex addiction,” Canning said. “It’s affordable, accessible, and anonymous. People who have addictions are likely to experience them more intensely, and those who might not have had them (without the internet) develop them.”

Dean W., who asked that only his first name and last initial be used in this story, said that he was addicted to pornography and phone sex for more than ten years; he continues to be actively engaged in therapy. While he spent 30 to 40 hours a week acting out, he said, sex addiction is “much, much easier to conceal” than other addictions—which is why very successful people, such as CEOS, can find themselves struggling with it, and why he believes the disease is still not well known.

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