Sex & Relationships

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.

“When I’ve told people, they think it’s funny, not true, or that I’m a pervert,” Dean said. “The biggest thing that hurts as a person is that (sex addiction) is so misunderstood.”

To underscore the reality of his situation, Dean points out to the addictive patterns that played out in his life—twelve to fourteen hours of looking at pornography at a time, he said, and extended phone sex binges. One of his phone sex binges lasted 36 hours, in which Dean neither ate nor slept, and which cost him $2000. In all, Dean estimates that he spent more than $150,000 on phone sex over the course of his addiction.

The addictive pattern, Dean said, was a way to escape feelings of low self worth and loneliness. These deep feelings had roots in both his parents and his grandfather being alcoholics; his brother has a gambling problem. Dean said that he was emotionally, physically, and sexually abused as a child. His steep investment in his therapy—he has been through many intensive programs and has been in a weekly program for more than two years, most of which is not covered by his health insurance—is in part an effort to ensure that his own child is not affected by his addiction.

Elle can attest to the pain that sexual addiction can cause a family. The Canadian mother, who asked that her real name not be used, never heard of sex addiction until her husband confessed to her that he was seeking recovery from it.

“I was floored. (Sex addiction) …  what the hell was that?” Elle said. “I worried that it meant he was a pervert. The very next morning (after he told me about it), we had a conference call with his counselor who helps set up treatment programs for sex addiction. Thankfully he laid out the facts, assured me it was treatable, explained to me that my husband was doing very well and desperately wanted to put his past behind him.”

That past involved betrayal that Elle said nearly destroyed her. What she initially thought was one affair turned out to be a pattern of secrecy that was difficult for her to accept.

“I had a very hard time with it. Felt very, very lonely. Felt duped. Ripped off,” Elle said. “My perfect world wasn’t so perfect after all.”

Elle and her husband didn’t discuss the details of the sex addiction with their young kids, but Elle said that the process of recovery has made it possible for her husband to reconnect with his whole family by spending more time together; his addiction had led him to detach from the family. Recovery, she said, “involves a lot of soul-searching, a lot of reparations, total disclosure, total transparency.”

There remains, however, a strong segment of the population that believes that sex addiction is merely a manufactured phenomenon. John Wilder is one of them. A retired Baptist minister from Newcastle, Indiana who serves as a marriage and relationship coach, Wilder contends that sex addiction is so much “pop psychology.” A true addiction is distinguished by a chemical dependence, resulting in painful physical withdrawal, he argues. While many people have obsessive-compulsive patterns of sexuality, often out of a need to be soothed, Wilder said, it is misleading to call it an addiction.

“There’s simply no physical (withdrawal) component with so-called sex addiction,” Wilder said.

In the most recent version of the American Psychiatric Association’sDiagnostic and Statistical Manual of Mental Disorders (DSM-IV), published in 2000, “sex addiction” is not listed as a diagnosis.

Nonetheless, Canning said that in the last ten years, public awareness about sex addiction has developed—though it has a long way to go. In no small part, this is because American culture itself is sex-addicted, she said.

“As a sex-addicted culture, we carry a lot of sexual shame,” Canning said. “We haven’t really been able to accept it, we like to act out, and we objectify people sexually. This all reinforces the belief that sex is the most powerful thing.”

It is a point where she and Wilder actually seem to agree.

“This society teaches people, especially girls, that sex is a nasty, dirty thing,” Wilder said. “Sex is a great gift from God, but you never see that taught in churches or Sunday school. … Most of us get stuck in an adolescent mode: ‘Hurry up, get it over with before someone catches us.’ … There’s very poor communication about sex.

Canning added that, “oftentimes as a culture, we confuse intimacy for intensity.

“We think the goal is to have the most intense kind of experience—that’s where the high is, the power, the excitement. We need to shift our paradigm of what healthy sexual experience is. When we make someone an object, we depersonalize him or her. When we depersonalize them, there can’t be intimacy.”

Both Dean and Elle were able to relate to the idea of objectification.

“I learned (in therapy), even though its still difficult, not to objectify women,” Dean said. “Objectification in our culture is just rampant.”

Elle said that she was particularly surprised about one woman her husband had an affair with because she was someone he typically would find unappealing. But as she learned about addictive behavior, she realized that this woman was ‘safe’ because her husband knew he’d never have an emotional connection with her.

“Sex addicts usually—not always but usually—seek out partners they can objectify. That are really nothing more than sexual partners,” Elle said. “My husband feels a lot of shame that he treated people that way—that he didn't even really see them as human beings, but as objects.”

Elle added: “Believe me, there's nothing sexy or passionate or exciting about (sex addiction). It's generally two sick people feeding off each other.” 

The public reaction to Tiger Woods’ personal struggles has ignited this sex-addicted culture. The top athlete is reported to have sought treatment for sex addiction at a recovery center in Arizona.

Canning said that while the publicity of his treatment provides an opportunity for discussion, which can ultimately normalize struggles with sex addiction, she’d like to see the conversation about it be more educated—and less joking.

“I think if we are more educated about it, there’s less shame for an individual to reach out for resources and help when they need it,” she said.

In his support communities, where he connects with about forty people each week who are seeking treatment for sex addiction, Dean said that there is almost unanimous hope that Woods will speak out about his experience.

“There’s a glimmer of hope (in the therapy groups) and a sense of understanding,” Dean said.  “I hope he gets the help he needs.”

Dean said one of the most important things that could happen for sex addiction would be the emergence of a spokesperson like Tiger Woods, as well as active support from the National Institute of Health and coverage from health insurance companies. He added, though, that he knows that recovery takes many years of reducing shame and guilt—and he suspects that Woods will probably not go beyond making a public statement indicating, “everything’s taken care of.”

Elle too hopes that the conversation about Woods leads to more public understanding. While emphasizing that there’s no clear confirmation that Woods is indeed receiving treatment for sex addiction, she admits that the signs seem to indicate that it’s so.

“I would hope that (the Woods story) might bring sex addiction to the public arena and perhaps educate more people, particularly those who know their sexual behavior is causing them pain, but don’t have a name or understanding of it,” Elle said. “And I would hope that maybe, just maybe, we might become more compassionate about it.”

Elle added, “My husband isn’t the least surprised that his background is similar to Tiger Woods. The domineering father who demanded perfection, the high pressure career… the false sense of invincibility. … I ache for (Woods’) wife, who has to be witness to her pain being played out on the world stage.”