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Medical Specialists Recognizing Sex Addiction as a Disorder
Posted under Sexual Addiction on Tuesday, February 16th, 2010
At a weekly meeting of Sex and Love Addicts Anonymous (SLAA) in Boston, most of the 50 men and women are professionals, and some are students and retirees. Bella English of Boston.com writes that this could be a meeting to save the rainforests—but these people are trying to save themselves.
Tiger Woods’s admission of infidelity has cast a spotlight on treatment for sexual addiction. Though some believe the term is an excuse for men behaving badly, there is a growing acceptance that sexual addiction is a medical condition similar to compulsive gambling and overeating.
The most recent edition of the International Classification of Diseases, written by the World Health Organization, lists “excessive sexual drive” as a diagnosis. Last week, the American Psychiatric Association proposed that “hypersexual disorder” be included in the next edition of the Diagnostic and Statistical Manual of Mental Disorders. The proposal will be debated over the next two years.
Many agree that compulsive sexual behavior is a condition that can require treatment ranging from medication to residential treatment programs. The rise of Internet pornography (much of it free and anonymous) has fueled the problem. Patrick Carnes, a pioneer in the field, believes that 3 to 6 percent of the population suffers from the condition, which he defines as compulsive behavior that interferes with normal living.
“With the advent of the Internet and access to pornography, the number of men coming for help now who have serious problems with porn has increased greatly,” says Dr. Martin P. Kafka, who has treated more than 1,000 people with sexual disorders. “I think this whole thing is very scary for women.”
Kafka, a professor of psychiatry at Harvard Medical School, has discovered that mood disorders such as bipolar disease and depression are often linked with hypersexual behavior. He treats such patients with antidepressants or mood stabilizers and Ritalin if they have attention deficit disorder.
“In society now, we commonly refer to sex as an addiction, and when we do that, we’re destigmatizing it as a completely moral problem,” Kafka says. “We’re saying there’s something else going on here.”
Suki Hanfling, director of the Institute for Sexuality and Intimacy in Belmont, says sex addiction is different from bad behavior. “A person who’s narcissistic may feel, ‘I’m entitled to this, I’m not getting caught, it’s great,’” she says. “But with a sexual addiction, those people often end up hating themselves and feeling a lot of shame and guilt. Usually people feel awful about it, except when they’re doing it.”
Kafka treats paraphilias (sex offenders, some of them sex addicts). But most of his caseload deals with “totally harmless guys” who are simply obsessed with sex.
“These men have what you call normal sexual arousal, except it is excessive and disinhibited,” he says. “They’re mostly self-destructive.”
Jeff, who ran the recent SLAA meeting, says that description fits him. An engineer, he describes a former life out of control, with constant trips to strip bars, “dirty movie houses,” peep shows, prostitutes, and porn sites. Even after he contracted venereal diseases, he didn’t stop. His low point came, he says, when, in a dream-like state he sexually assaulted his sleeping wife.
“She called the police and had me thrown out, with a restraining order,” Jeff says. He entered a residential treatment program for sex addicts, the couple went into therapy, and he has been attending SLAA meetings for more than 20 years. He and his wife, who have two grown children, reunited, and Jeff says he has been “abstinent’’ from compulsive sex for 12 years.
Those in SLAA use the 12-step model of Alcoholics Anonymous. To be abstinent or sober means that you haven’t violated any of the rules you list on your “bottom line.” In Jeff’s case, that means he doesn’t do anything that would physically or emotionally hurt himself or others, such as having an affair.
Though the majority of sex addicts are men, women also struggle with the issue. Jennie, 50, has been married and divorced twice. By her 40s, she had slept with at least 25 men.
The eldest of five children, she grew up responsible for her siblings. “The one way I knew to get attention was to be sexual,” says Jennie. “From my early teens, I would go out with bad boys and have sex with them.”
As a child, she says, she was sexually abused by someone close to her. In adulthood, every relationship became obsessive. “I would completely lose interest in my friends and everything else; my life revolved completely around the men. I would have sex constantly every time we got together as a way of providing a connection.”
Finally, after having a relationship with a married colleague, Jennie checked into an eight-week residential treatment program. When she returned, she broke it off with her colleague, took a leave from her job, and has been in recovery for three years.
“It means for the first time in my life I like myself,” Jennie says. “It means I have friendships with women who in the past were always my competitors. It means I can have a hug with someone and I know it’s not going to turn sexual.”
She has been going to SLAA meetings for five years and says she will do so for the rest of her life. “If I don’t stay with it, there’s a really good chance I’ll relapse.”
If it’s difficult to be a sex addict, what’s it like to be married to one? One couple was married for more than 20 years when she discovered his affair through an e-mail. He confessed that he had been lost in Internet pornography and was hooking up with other women through chat and dating sites. The couple took out a second mortgage on their home and paid $31,000 for him to enter the Pine Grove residential treatment center in Mississippi, run by Patrick Carnes (the same center that former ESPN analyst Steve Phillips said he attended).
In the residential program, the man met others who had spent fortunes on phone sex and prostitutes. “We were blind to what we were doing,” he says. “We were leading a double life, compartmentalizing it all.”
He attends two SLAA meetings a week, and if he finds himself slipping (“glancing at a bra ad or noticing a woman on the beach for a little longer than is comfortable for me”) he calls his sponsor for guidance.
He says Pine Grove saved his life, with structured days that included psychotherapy, lectures, yoga, art therapy, 12-step meetings, spirituality and grief groups, shame reduction, and exercise.
Thomas Tullos, who was the clinical director at Pine Grove for five years, says sex addicts must establish a healthy relationship with sex—not abstain from it completely. “These are men and women who have, over time, used sexual behavior to medicate their feelings,” says Tullos, who now treats addicts in his private practice in Hattiesburg, Miss.
Neither the husband nor the wife know if their marriage will survive. “It’s a very, very, hard thing for spouses, because sex is such a personal part of your identity,” she says. “It’s impossible not to take personally.”
Still, she has empathy for her husband. “There is no compassion for this on the part of society,” she says. “People don’t realize that if you look at it as a disease, that person is in pain.”
