In the public perception, sex addiction continues to garner a raised eyebrow or blunt response and much of the public remains uninformed of the symptoms and factors related to the addiction, including its connections to several types of mental illness.

Similar to alcohol or drug addictions, people with sex addiction may also have co-occurring or undiagnosed mental illness like personality disorder, post-traumatic stress disorder (PTSD) or be living with bipolar disorder, according to recent articles.

In cases of a preexisting personality disorder, sex with multiple partners can become a way of manifesting a desire to self-harm. With bipolar disorder, dangerous or excessive sexual behaviors may be part of the manic phase.

For people who have PTSD, in many cases, abuse has taken place during their childhood and the sexual behaviors become a way to try to achieve a state of control regarding the trauma.

Sex addiction is also connected to love addiction, especially if the person has an underlying mental illness like dependent personality disorder.

Dependent personality disorder, also called an addiction to love, has recently become more acknowledged in celebrity cases and can be demonstrated by a person seeking a love relationship over and over, feeling incomplete or inadequate without one, and often using sex as a tool to draw in the next new partner in a romantic relationship.

The symptoms of sex addiction, such as being unable to control obsessive thoughts and behaviors involving sex, can also be linked to underlying obsessive-compulsive disorders for some people.

Similar to the mainstream treatment associated with alcohol addiction, researchers and experts continue to break down the stigma associated with sexual addiction with research and new treatment options.

Deciding on a label along with criteria and treatment recommendations for behaviors that start out as normal along the human spectrum of activity and then become addictive, harmful and dangerous requires a delicate balance of science and health. This remains a source of debate even 25 years after the terms surrounding sex addiction first started to emerge.

Robert Weiss, the Founder of the Sexual Recovery Institute, addresses the delicate and controversial nature of sexual addiction and its inclusion in diagnostic manuals in a recent article. Though the term sexual addiction, and related terms like hypersexuality, has spanned a gamut of phrases, Weiss addresses specifically how the Internet has created unlimited opportunities for people to engage in obsessive sexual behaviors in relative privacy.

For people who are already living symptoms or diagnoses of mental illnesses related to mood disorders, social problems or past experiences with trauma, Internet-based sex sites can open the door toward sexually addictive behaviors.

The lack of clear recognition among the professional community for sexual addiction may also prolong people’s use of sex as a way to numb out and avoid negative emotions, and may allow more patients a way to self-manage stressful situations through sex instead of seeking effective long-term management for serious underlying triggers.

While media stories about celebrities with sexual addictions have made the terms more commonplace and have helped opened doors to new treatment resources, Weiss also points out that the APA and other leading institutions have seemed to lessen their efforts toward clear terms and more research. These are measures that would help reduce stigma for the millions of people living with the devastating symptoms of the addiction.

The inherent values of care for others, unconditional love, and genuine, honest relating is the core of the sex addiction recovery process, a process that produces a mature personality. Successful application of Step 12 would seem to define the essence of emotional maturity.

Maturity connotes having an authentic self that has been able to develop:

• Adequate coping skills
• A sense of "agency" of the self that had been lost to the addiction
• The ability to tolerate emotional pain with the knowledge that all internal states are transitory
• The development of healthy interpersonal relationships
• A sense of purpose in living

In summary, the addictive experience is marked by interpersonal difficulties and problems with isolation, self-esteem, impulse control, and lack of self-regulation, among other symptoms. The problematic dimensions of the addictive experience are addressed through the structure of "S" meetings.

The 12-Step program, including the Steps, provides cognitive strategies, compensatory mechanisms, and intra/interpersonal resources to assist the addict in successfully negotiating the vicissitudes of human living and stay sober for good purpose.

References
Treating Alcoholism as a Disorder of the Self Insights from Alcoholics Anonymous and Masterson, Kenneth S. Sachs, Alcoholism Treatment Quarterly, 1544-4538, Volume 21, Issue 2, 2003, Pages 75-85.

Alcoholics anonymous as seen from the perspective of self psychology, Connie M. Robinson, Smith College Studies in Social Work, 1553-0426, Volume 67, Issue 2, 1997, Pages 129-145.

Why AA Works A Psychological Analysis of the Addictive Experience and the Efficacy of Alcoholics Anonymous, Ronald E. Hopson; Bethany Beaird-Spiller, Alcoholism Treatment Quarterly, 1544-4538, Volume 12, Issue 3, 1995.

Dorothy Hayden, LCSW has been specializing in treating sex addiction and chemical dependency for 15 years. She has training in sex addiction therapy, psychoanalysis, hypnosis and cognitive behavioral therapy. The full text of her writings on sex addiction can be found at www.sextreatment.com.

Research has consistently shown the psychological and physical benefits of prayer and meditation. The person in recovery from sex addiction discovers that he is not a victim of his own mind and that he does have power over the state of his inner life.

Meditative techniques have a powerful influence in reducing the anxiety that underlies most addictive behaviors. The individual can generate a sense of calm, focus, and direction. Psychologically, Step 11 is a means for even deeper insight into one’s motives and needs.

Recovering people are often befuddled about "knowledge of His will." It would seem to me that it is not God’s will, or anybody’s will, that the sex addict return to using. It’s probable that God’s will includes not living a self-centered, self-serving life. Perhaps God’s will includes living a moral life, consistent with one’s deepest values and beliefs.

From a psychological standpoint, it is a conscious contact with our higher selves – the best part of who we really are.

The development of better coping skills in dealing with the vicissitudes of daily living is the psychological underpinning of Step 10. When thrown off emotional balance by people or new events, the process of taking a quick inventory, admitting to errors in the now and forgiving, or at least tolerating, the imperfections of others is a sign of a stable person who has developed a new way of dealing with reality.

Practice of Step 10 releases one from the need to be right, a truly liberating way of operating in the world.

Experts from the Society for the Advancement of Sexual Health estimate that three to five percent of the population have compulsive sexual behavior, also known as hypersexual disorder. About 90% of those with the disorder are middle-aged men, but it appears to be increasing among females, teenagers, and senior citizens. The number of sex therapists that provide treatment increased from 100 to 1500 in the past ten years.

"It used to be 40- and 50-year-old men seeking treatment," said Tami VerHeist, vice president of the International Institute for Trauma and Addiction Professionals. "Today grandfathers are getting caught with pornography on their computers by their grandkids, and grandkids are sexting at 12."

The usual explanation for the increases in the number of sex addicts is the increased availability of pornography. Newsweek is reporting that every day 40 million people visit the 4.2 million websites that offer free pornography on a 24/7 basis. The theory is the more people watch pornography and send each other provocative images of themselves, the more they want the real thing.

Whether sexual addiction is similar to drug and alcohol dependency and whether it causes changes in the chemistry of the brain is a controversial question. Many people in the therapeutic community, including Robert Weiss, founder of the Sexual Recovery Institute in Los Angeles, believe hypersexual disorder is a brain disease that should be considered a medical condition.

"It’s about chasing that emotional high: losing yourself in image after image, prostitute after prostitute, affair after affair," he said. "They end up losing relationships, getting diseases, and losing their jobs."

Others believe there is no such thing as sex addiction, and that it is not an epidemic.

Psychologist and author Dr. David Ley believes sex addiction is modern mythology.

"The sex addiction concept is a belief system, not a diagnosis," he told Newsweek. "It is not a medically supported concept. The science is abysmal. The thing that drives me crazy is it that over the past year or two, they have started trying to use brain science to explain it. They are now talking about morphological changes that supposedly happen in the brain when somebody watches pornography or has too much sex."

Several celebrities, including Tiger Woods and Charlie Sheen, are reputed to be sex addicts. There are many treatment programs available for the condition.

This is another deeply liberating step. After amends have been made, there are no reasons that one has to hide from the world for past deeds. Those we have harmed and avoided out of shame have an exaggerated power over us.

Step 9 implies a readiness to accept the consequences of past behavior, which is important in developing new modes of being in the world. It is an essential step in the development of a self and other orientation to living.

The quality of interpersonal relationships is a mark of a person’s stability and ability to live comfortably with one’s fellows. Here we again come across the word "willingness," implying a deeper insight into the self as carrying responsibility for repetitive, unsatisfying personal relationships. It is only by letting go of resentment of the real or imagined harms done by others and focusing on what can be changed in oneself that the personality becomes less emotionally vulnerable, less reactive, and more stable.

By Dorothy Hayden, LCSW
www.sextreatment.com

Humility is a word much discussed in 12-Step meetings. The posture of humility allows a person to quell ceaseless self-preoccupation and opens her up to having a sense of awe in the moment-to-moment awareness of life, nature, God, and fellow human beings. Humility also suggests a turning point in personality development from the illusion of self-sufficiency to having an inter-dependent view of relating to others.

Step 7 is the beginning of understanding that character building and remaining close to essential values is more important than chasing the high.

"We never thought of making honesty, tolerance and true love of man and God the daily basis of living. We sought to gain a vision of humility as the avenue to true freedom of the human spirit." (From the book "Twelve Steps and Twelve Traditions" (Alcoholics Anonymous Worldwide))

Having a humble approach, along with the admission of powerlessness, leads to a softening of childish demands for immediate gratification.

From a psychological standpoint, an attitude of "willingness" is essential to the process of growth. Again, it puts the person in a less ego-centric stance. It also conveys a breaking down of rigid defense mechanisms that may have worked to survive a frightening, unstable childhood but have now outlived their usefulness and, in fact, contribute to the sex addict’s here-and-now problems in living.

Dorothy Hayden, LCSW has been specializing in treating sex addiction and chemical dependency for 15 years. She has training in sex addiction therapy, psychoanalysis, hypnosis and cognitive behavioral therapy. The full text of her writings on sex addiction can be found at www.sextreatment.com.