Most addiction therapists do not agree whether obsessive sexual acting out is an addiction. There have been many debates and still are as to why it was left out of the new DSM-5. (Diagnostic and Statistical Manual, Version 5).
Those who believe sex is an addiction cite the fact that gambling migrated from a disorder of impulse control to a behavioral addiction in the new DSM-5. Perhaps this is largely due to the widespread availability and easy access to gambling in all its varieties on the Internet.
Mark Griffiths, Ph.D., of Nottingham Trent University, an expert on gambling, gaming and other behavioral addictions, believes that “if sex addiction does eventually make it into future editions of the DSM, it will be one of the sub-categories of Internet Addiction Disorder rather than a stand-alone category.” And there are many who agree with him.
For those who are afflicted, they often ask their therapists, is sex addiction a response to stress or depression, or does it create stress or depression? Some say it is like any other addiction, in that sexual acting out is an escape from reality that feels good, as most drugs do. However the chemical response comes directly from a change in brain chemistry, rather than from an ingested or injected drug or other addictive substance.
Sexual acting out produces changes in brain chemistry that can actually be viewed on an MRI of the brain. This is one of the reasons some doctors and medical professionals want to categorize hyper sexual acting out as a bona fide addiction. What is known is that there is a genetic variation affecting D2 dopamine receptors of the brain, part of the rewards center, increasing the propensity for this addiction. The desired effect of the sex addict is escape and dissociation. The resulting adrenaline rush is intoxicating, as many of these addicts report.
Whatever side you may come down on, sex addiction starts the same way as any other addiction – escape from reality that feels good. Clinicians in practice often see it as a response to childhood trauma or abuse, abandonment or betrayal, as many addictions are, and may have a chemical imbalance component. Also, as with most other substance addictions, there is a family history of addiction, so the addictive tendency may be the familial thread, if not the addictive substance.
Hyper sexual activity can easily be hidden or denied, especially as sex is considered a normal human activity. But it does depend on the operative culture to determine how it is viewed. For example, in some cultures, hyper sexual activity is not viewed as abnormal. Another fact about sex addiction is that it is frequently observed by clinicians in individuals who would otherwise be viewed as highly successful, such as business executives and other highly engaged professionals.
The question to always ask in terms of deciding if a particular behavior is an addictive problem is to ask oneself the fundamental Alcoholics Anonymous determinant question: Has my life become unmanageable due to my behavior? If the behavior brings about frustration and pain to oneself or one’s family, it may be time to address the issue head on. Another warning sign, much like with alcoholism or drug addiction, is that large sums of money are being spent on the addiction in some way (denying your family of resources that may be needed) perhaps on prostitutes or other sexual contact venues such as “gentlemen’s clubs.”
All this is not to say that only men are afflicted with sexual addiction. Women are as well, perhaps less frequently, and may be indicated by such behaviors as anonymous encounters in bars or restaurants, frequent use of internet dating sites, and “girlfriend weekends.”
Typical stages of this addiction for men or women include excessive fantasizing about the behavior; obsessing or preoccupation about the behavior to come; ritualization of the preferred activity; feelings of remorse, despair, or guilt after the behavior; engaging in the activity; losing control of one’s life over the behavior; and promising to stop the behavior (whether to oneself or spouse) without success; and compulsion, which is continual acting out of the behavior despite an understanding of negative consequences.
As with any addiction treatment, it is important to separate the addict from the drug to break the cycle, one reason why hospitalization is almost always indicated. Sex addiction treatment is confined to male- or female-only groups, and true release from the addiction can take years. It can be even more difficult than an actual substance to kick, but the first AA step says, “We admitted we were powerless over our addiction.” Once that step occurs, treatment can begin.
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