Sex Addiction: Overview

It is well known among people in the 12-step programs that of all the addictions, sex is the most difficult to master. Far from the notion that sex addiction is the “fun” one, the suffering of people dealing with this affliction is enormous. It is common for members of the sex recovering groups to be unable to maintain any continuous time of sexual sobriety, giving way to despair and hopelessness.

Before treatment, sexual enactment is the addict’s only source of safety, pleasure, soothing and acceptance. It vitalizes and connects. It relieves loneliness, emptiness and depression. Sex addiction has been called the athlete’s foot of the mind: It is an itch always waiting to be scratched. The scratching, however, causes wounds and never alleviates the itch.

The percentage of people who go to therapy or a 12-step program is quite small. The majority of sexual compulsives live in isolation, filled with feelings of shame. Almost 100 percent of the people who come to me for an initial consultation — whether it be for compulsive use of prostitutes, phone sex, a fetish, cross dressing, or masochistic encounters with dominatrixes — relay that beneath the shame they feel in telling me their story, they also experience a sense of freedom that comes from finally being able to share with another human being the hidden, shameful, sexually compulsive acts that imprison them.

The life of a sex addict gradually becomes very small. The freedom of self is impaired. Energies are consumed. The rapacious need for a particular kind of sexual experience drives the addict to spend untold hours in the world of his addiction. Inexorably, the compulsion begins to exact higher and higher costs. Friends slip away. Hobbies and activities once enjoyed are dropped. Financial security crumbles as thousands of dollars a year are spent on sex.

Then there is perpetual fear of exposure. Relationships with partners are ruined. The appeal of intimate sex with a partner pales in comparison to the intense “high” of indulging in the dark and devious world of sexual compulsion.

Sex addiction, of course, has nothing to do with sex. Any sexual act or apparent “perversion” has no meaning outside of its psychological, unconscious context. What sets sex addiction apart from other addictions and makes it so persistent is that the subject of sex touches on our innermost unconscious wishes and fears, our sense of self, our very identity.

While the definition of sex addiction is the same as that of other addictions — recurrent failure to control the behavior and continuation of the behavior despite increasingly harmful consequences — sexual compulsion is set apart from other addictions in that sex involves our innermost unconscious wishes, fears and conflicts. Sex addiction is a symbolic enactment of deeply entrenched unconscious dysfunctional relationships with self and others. It involves a derailed developmental process that occurred as a result of inadequate parenting.

Current treatment might include:

•     participating in a 12-step program;
•     going to an outpatient clinic;
•     engaging in aversion therapy; or
•     using medications to stave off hypersexuality.

Cognitive-behavioral therapy is used to help the patient control or repress the instinct for a period of time.

Addicts usually have a dysfunctional mother-child relationship. An unempathic, narcissistic, depressed or alcoholic mother has low tolerance for the child’s stress and frustrations. Nor is she able to supply the empathy, attention, nurturing and support that foster healthy development. The result in later life is separation anxiety, fear of abandonment and a sense of imminent self-fragmentation.