With the publication of “Out of the Shadows” in 1983, Dr. Patrick Carnes introduced the concept of sexual addiction to a mass audience. He compellingly described the emotional conflict, anguish, and despair experienced by sexual addicts. Using the “addiction model” he explained the development of the disease and how to begin to recover.
At that time he did not foresee the creation of the internet, where easy access to sexual content and contacts can speed up and intensify the addiction process for men and women vulnerable to the disease.
Today, sexual addiction is probably “out of the shadows,” but it remains shrouded in negative attitudes and stereotypes that contribute to the shame and lowered self-esteem of addicted individuals. This is largely due to our discomfort as a society with sexual behavior in general, and to continued misunderstanding about the nature of addiction itself.
In our practice, we offer psychotherapy to men and women with sexual addiction issues. Treatment often begins with individual therapy, but can involve couples work if appropriate. Individual therapy for the partners of sexual addicts is also available.
Psychotherapy offers an opportunity to:
- Understand the disease of addiction, including the biophysical, social and psychological factors that encourage addictions; and why some people are more vulnerable to sexual addiction than others.
- See through destructive myths, like it just takes willpower to stop, or people with addiction problems are “weak” or “bad.” People from all walks of life and all socioeconomic groups suffer from sexual addiction.
- Remove the stigma, and reduce the shame and isolation that accompanies and maintains addictive behavior, while recognizing the serious negative consequences to self and others that can occur with addiction.
- Create an individualized recovery plan that meets your physical, emotional, and spiritual needs.
- Improve relationships, save marriages, and preserve the family.
All addictive patterns – whether involving substance use or various types of behaviors – have some things in common. Important signs of sexual addiction are:
1. A pattern of out-of-control behavior, which may occur on a regular basis, or be more episodic. The behavior may go further than intended, or happen despite wishes to stop. Because personal values may be violated, feelings of shame or remorse after “acting out” are often part of the cycle, followed by efforts to stop which inevitably fail. Maintaining secrets, living a “double life,” and the hiding of behaviors are common.
The actual behaviors enacted can vary from compulsive relationships, to affairs, to anonymous sex, to involvement with pornography, to paying for sex. Excessive internet use may be part of the picture. Almost any sexually related activity can have an addictive quality depending on the overall context.
2. The addiction interferes with the fulfillment of major role obligations at work, school, or home, ultimately leading to physical, psychological, social, legal, or economic problems. For example, marriages may be threatened, and jobs lost. Depression can occur along with the addiction. Behavior continues despite the adverse consequences.
3. Over time behaviors tend to escalate, as it takes more or different behaviors to get the desired “high.” The prior behavior doesn’t suffice. Life revolves more and more around the activity; and thinking about it and planning for it can take on the quality of obsession.
4. There is an increasing inability to abstain as addiction progresses. Withdrawal involving physical and emotional symptoms can occur after stopping.
5. The behavior has an important coping function, sometimes referred to as “self-medicating” or “numbing out.” It can be consciously or unconsciously used to avoid painful feelings, feel better or relax. Unfortunately the coping function backfires as underlying problems are not addressed, and the addiction itself creates a whole set of problems that increases stress dramatically. Since addictive activities are used to deal with stress, addiction is maintained and can escalate in a vicious cycle.
6. Individuals with multiple addictions are common. A person can be in recovery for alcoholism while his sex addiction escalates. Usually one addiction is primary.
Addiction is difficult to self-assess. Part of the illness is a strong tendency to minimize or deny the problem. This is because people fear being labeled and misunderstood. And acknowledging the problem implies stopping, which is threatening. Also the disease is progressive, so it is easy to rationalize the behavior at the earlier stages by thinking that only advanced stage symptoms constitute a real problem. Unfortunately, it can take a serious crisis (“hitting bottom”) to break through denial. Don’t wait for a crisis!
If you seem to be struggling with one or more of the above signs, in the area of sexual behavior, psychotherapy can help you to:
- Assess current behavior in a supportive setting without judgement.
- Increase self-esteem and feel hopeful about the possibility for change and recovery, if needed.
Recovery will allow you to:
- Break through isolation and secrecy.
- Face problems by overcoming denial and objectively clarifying the negative consequences of behavior, thereby increasing the motivation and possibility for positive change.
- Develop effective strategies to cope with and overcome impulses to act out; and substitute healthy ways to feel good, manage stress, and increase self-care. (There is no reason people “should” know how to deal with stress. This is a learned skill!)
- Build support systems, and learn about the importance of 12-step programs and other resources.
- Work through underlying emotional triggers and stressors as recovery progresses.
- Increase intimacy and improve relationships