Treatment for compulsive sexual behavior typically involves psychotherapy, self-help groups, and medication.

Certain psychiatrists hold that sexual compulsion is maintained by mood-dependent motives, and that pharmacological treatment of the underlying mood disorder can diminish the urges and cravings associated with addiction. Interventions that enhance mood/feelings regulation and behavioral inhibition also have positive effects on the ability to control impulses.

The Erotic Haze

That there are chemical changes in the brain when the sex addict enters “the erotic haze” cannot be disputed. Sexual arousal is a stimulated neuro-chemical state, induced by the release of adrenaline, serotonin, dopamine, and endorphins that occurs when the sex addict engages in intense sexual fantasy, ritual, and behaviors.

Sex addicts are high on their own neurochemistry long before actually having sex. In fact, most sex addicts try to stay in the “erotic haze” as long as they can, putting off any actual sexual release. The “erotic haze” is a somewhat euphoric state, not dissimilar to the inner state of an opiate user.

Medications for Sex Addiction

Although not a necessity, certain medications can often help alleviate some clients’ compulsivity, anxiety, and depression. Some medications act on brain chemicals linked to obsessive thoughts and behaviors and reduce the chemical “rewards” these behaviors provide. Which medication is best for you depends on your overall situation and other mental health conditions or addictions you may have.

You may have to try several medications, or a combination of medications, to find what works best for you with the fewest side effects. Medications used to treat compulsive sexual behavior are often used primarily for other conditions, including:

• Antidepressants. The antidepressants most commonly used to treat compulsive sexual behavior are selective serotonin reuptake inhibitors (SSRIs), such as Prozac, Paxil, Zoloft, and others. SSRIs often have a side effect of a reduction in libido and sexual functioning, which is sometimes useful in decreasing sexual activity.
• Mood stabilizers. These medications are usually used to treat mania, but research suggests that they also reduce uncontrollable sexual urges.
• Naltrexone. This medication is generally used to treat alcoholism and blocks the part of your brain that feels pleasure with certain addictive behaviors.
• Anti-androgens. These medications reduce the biological effects of sex hormones in men. Because they reduce sexual urges, anti-androgens are often used in men whose sexual behavior is dangerous to others, such as pedophilia.
• Luteinizing hormone-releasing hormone (LHRH). This medication may reduce obsessive sexual thoughts by reducing the production of testosterone.
• Anti-anxiety medications. Examples include Klonopin, Ativan, Librium, Valium, and Xanax. These medications are used to reduce serious anxiety and aggression in emergency situations, but are generally avoided, as they may worsen compulsive behavior in the long run.

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.

References
Goodman, A. (1998) Sexual Addiction: An Integrated Approach; International Universities Press, Inc.

Weiss, R. (1992) When Too Much Sex is a Problem…Understanding and Treating Sex Addiction. www.clinicalsocialworksociety.org/

"It was a hell of an expensive party, let me tell you," Taylor told 60 Minutes in a 2004 interview. "That party never ended."

The former New York Giants linebacker had a highly publicized struggle with drug addiction and had multiple legal run-ins before he was arrested and charged Thursday in the alleged rape of a 16-year-old girl. "I saw coke as the only bright spot in my future," Taylor told 60 Minutes, in 2004.

"I had gotten really bad. I mean my place was almost like a crack house, not where you sold it, but I had a lot of stuff in my house," Taylor said in the interview, adding that at the time he didn’t want to know anyone who wasn’t an addict, dealer, or hooker.

In 2001, Taylor was convicted of possessing drug paraphernalia in New Jersey. The conviction stemmed from the September 1998 discovery in a hotel room of a butane torch and other materials commonly used to smoke crack cocaine.

In 1996 and 1997, he was arrested in South Carolina and Florida on drug charges. In those cases, he either admitted his guilt or agreed to enter a pretrial intervention program.
In 2000, he drew five years of federal probation for filing false tax returns and for tax evasion.

Taylor was arrested Thursday in connection with the rape of a 16-year-old girl in a suburban New York City hotel room, and another man is accused of bringing her there, police said.

He was arrested at a Holiday Inn in Suffern, said Christopher St. Lawrence, supervisor of the town of Ramapo. The alleged victim, at 16, is one year below the legal age of consent in New York, St. Lawrence said.

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.”

The answers may surprise you. Then, again, maybe they won’t. Let’s begin with a definition of sexual compulsivity.

Sexual Compulsivity

Although there is no universally-accepted definition of sexual compulsivity, with some experts in the treatment field, along with numerous websites, articles, books and journals contending that sexual compulsivity is synonymous with sexual addiction, most sources agree that sexual compulsivity involves behavior that the individual understands that sexual behavior is interfering with his or her life and yet he or she continues despite negative consequences. At the heart of sexual compulsivity, then, is both the recognition of the condition and the inability to control the sexual behavior.

What specific behaviors, actions or thoughts constitute sexual compulsivity? In other words, how do you know if what you do, think or say means you have a problem with sexual compulsivity? Various websites provide self-questionnaires that you can complete that may point to a problem with sexually compulsive behavior, but they are by no means definitive, nor should they be taken as a diagnosis. They can, however, solidify in your mind whether or not you may be able to benefit from some kind of treatment or therapy.

The following sexual addiction screening test (SAST) is adapted from and used with permission of Patrick Carnes, Ph.D., psychologist and author, whose website SexHelp.com was created to help those affected (directly or indirectly) by sexual addiction and sexual compulsivity.

• Were you abused sexually as a child or adolescent?
• Are you often preoccupied with thoughts of a sexual nature?
• Did your parents have problems with sex or sexual behavior in the marriage?
• Does your sexual behavior ever make you feel bad?
• Do you believe that your sexual behavior is somehow not normal?
• Is your sexual behavior causing problems for you and your family? Has it ever?
• Have you ever hurt someone emotionally because of your sexual behavior?
• Has your own sexual behavior ever prompted you to seek treatment or help?
• Are there specific sexual behaviors that you’ve ever tried to quit – and failed?
• Do you hide any, some or all of your sexual behaviors from others?
• Have you ever done something against the law in connection with your sexual behavior?
• Have you made a diligent attempt to stop doing some parts of your sexual activity?
• Do your sexual behaviors make you feel degraded?
• In your opinion, do you feel that you are controlled by your sexual desire?
• After having sex, do you feel depressed?
• Do you ever have the thought that your sexual desire is stronger than you are?
• Are you, or have you been, neglecting important parts of your life – such as your marriage, relationships, job and leisure activities – because of the amount of time you spend on sexual activities?
• Do you constantly think about sex?
• Do you escape your problems through sex or romantic fantasies?
• Are you in crisis over sexual matters?
• Is sex becoming, or is it already, the most important part of your life?
• What about the Internet? Has it created sexual problems for you?
• Do you find that you’ve been spending too much time online for sexual purposes?
• Do you purchase erotic services online (friend finder, dating sites, pornography and fantasy)?
• Do you make connections for romantic or erotic purposes online?
• Have your online sexual activities caused another person to be upset?
• Have you tried to stop your online sexual activities?
• Do you purchase, rent or subscribe to sexually-oriented materials such as videos, magazines and books or online pornography?
• Do you find yourself spending inordinate amounts of time surfing pornography online?
• Have you ever had sex or been sexual with minors?
• Have you spent considerable money and time on strip clubs, movie houses and erotic bookstores?
• Have you used prostitutes and escorts to satisfy your sexual urges?
• Have you ever regularly purchased sexually explicit magazines or romantic novels?
• Do you continue to use sexually explicit books, magazines or online pornography despite the increased risk that family members may find out and be upset by your behavior?
• What about romantic relationships – have you ever stayed in one even after it has become physically or emotionally abusive?
• Have you traded sex for gifts or money?
• Have you ever been paid for sex?
• Do you have multiple romantic or sexual relationships at the same time?
• Do you refrain from sex for a period of time after sexually acting out?
• Have you regularly engaged in sadomasochistic behavior?
• As part of your regular sexual activity, do you ever visit bath houses, adult video/bookstores or sex clubs?
• Do you cruise public restrooms or rest areas or parks looking for sex with strangers?
• Have you engaged in risky sex even though you know it may cause you and other harm?
• Has your sexual behavior ever put you at risk of arrest for lewd or indecent behavior?
• Do you believe your pursuit of casual, anonymous sex has prevented you from having more long-term, intimate relationships?

To gain a more specific idea of whether or not your answers may indicate the presence of sexual addiction or sexual compulsivity, go to the actual SAST online questionnaire and complete it.

What to Do About Sexual Compulsivity

Whether or not you completed the online SAST, if you’ve answered the screening questions honestly and have any concerns over how many of them you replied “Yes” to, please consider looking into some form of professional help. You can start with your family physician, clergyman, family or trusted friend. If you and others feel that you may have a problem with sexual compulsivity, perhaps this is something that you should pay attention to.

Help is available in numerous ways. Use any or all of them as appropriate. But do investigate the subject thoroughly and take action. Or, if you are checking into this for a partner or loved one that you believe has a problem with sexual compulsivity, do all you can to become knowledgeable about the condition and encourage that individual to proceed to get help.

• Individual Therapy – Look for a certified sex addiction therapist (CSAT) or psychiatrist or psychologist trained in dealing with sexual compulsivity and addiction. CSAT are all members of The Society for the Advancement of Sexual Health (SASH), an organization dedicated to those seeking resources and information about sexual addiction and sexual compulsivity. For best results, look for a therapist who is both CSAT certified and a SASH member.

• Group Therapy – The therapist you see may offer group therapy as part of the treatment plan.

• Family or Couples Therapy – To be effective, the recovering sexual compulsive or sex addict needs to have the support and understanding of partner and family. For this to happen, these individuals should participate in treatment geared toward couples or family. Couples therapy may be a weekend, once weekly or an intensive 10-day seminar, and should be combined with participation in a 12-step program. Family treatment is usually a weekly participation, although frequency varies depending on type of treatment program.

• 12-Step Groups – Regardless of whether or not you (or the person with the sexual compulsivity) seek treatment from a trained therapist, you will most likely join a 12-step group. Here are some 12-step groups to check out:

o Sexaholics Anonymous
o Sex Addicts Anonymous
o Sex and Love Addicts Anonymous
o Sexual Compulsives Anonymous
o Sexual Recovery Anonymous

• For co-dependents and family members, here are some 12-step groups that can provide assistance:

o Co-Dependents of Sex Addicts (COSA)
o S-Anon International Family Groups
o CO-Sex and Love Addicts Anonymous (COSLAA)
o Recovering Couples Anonymous (RCA)

How Long Does it Take?

Depending on the frequency of the sexual behavior, the length of time, type of behavior or behaviors, the individual and any affected partners or family – as well as other factors – the amount of time therapy takes for sexual compulsivity or sexual addiction varies. It could be three years or as many as five years, according to experts in treating the conditions. The actual amount of time that you need to commit to therapy shouldn’t be a deterrent – or even a major consideration. The point is that if you have experienced significant problems as a result of your sexual thoughts and behavior, if all you think about is sex, and if you are unable to stop or control your sexual behavior despite negative consequences, you do need some form of counseling and therapy in order to develop a more healthy sexual outlook and learn how to achieve true intimacy.

The choice is purely up to you. Although you may be influenced by requests by your partner, significant other, family members or concerned friends, you need to acknowledge you have a problem and be genuinely committed to overcoming it. In contrast to other compulsions and addictions such as alcohol, drugs or gambling, sex is a normal and vital part of human existence. As such, abstinence is not the goal. Learning to have healthy sexual relationships and true intimacy is what you should strive for.

Coming to grips with sexual compulsivity is possible. It will happen – if you truly want to achieve it.