Sexual addiction

Overview
Sexual addiction is characterized by compulsive, sexually related behaviors that create negative consequences in a person's daily life, such as marital or relationship problems, the loss of a partner or spouse, the loss of career opportunities, or health risks (such as exposure to sexually transmitted diseases, including HIV -- the virus that causes AIDS.) Unlike normal sexual behavior, sexually addictive behaviors continue despite severe adverse consequences. A person who has a sexual addiction spends an excessive amount of time engaged in sexual behavior and lacks the ability to scale back or stop the behavior.
Sexual addiction is an arousal addiction with effects similar to cocaine, amphetamines, compulsive gambling and other risk-taking behaviors. The euphoria experienced by a person addicted to drugs is similar to that experienced by a person who has a sexual addiction. Instead of being produced by consuming an external substance, however, the euphoria may be produced by certain brain chemicals, such as endorphins and dopamine. Sexual addiction is progressive -- the person often has to engage in increasingly risky or novel sexual behaviors to obtain the same euphoric effect initially experienced during sex.

Like other addictions, a sexual addiction often follows a predictable course. The person attempts to control the sexual behaviors, becomes despaired at not being able to do so and, in turn, loses self-esteem due to these failures. This only leads to further escape into the addictive behavior. People who have a sexual addiction must often engage in progressively risky or novel sexual behaviors to obtain the same euphoria they initially found with more conservative sexual behavior. A pervasive sense of powerlessness emerges.

According to some estimates, about 3 to 6 percent of Americans are affected by sexual addiction.

It's unclear whether sexual addiction is more prevalent in men or women. Approximately 80 percent of those seeking help for sexual addiction are men.


Typical behaviors
A person who has a sexual addiction may masturbate compulsively or engage in sexually explicit encounters with others through Internet chat rooms, bulletin boards or e-mail. He or she may have a history of extramarital affairs, multiple sexual partners and concurrent romantic relationships. The person may engage in anonymous sex, excessive flirting or other seductive behaviors. He or she may have a pattern of anonymous sex or one-night stands.
Some people who have a sexual addiction hoard or collect pornography, or spend excessive time viewing pornography or other visual erotica on the Internet or through other sources. The person may also frequent strip clubs or adult movie stores. Many people who have a sexual addiction engage in sexual behavior they feel they need to hide from their partners.

Some people who have a sexual addiction seek the rush of having sex in a public place with the danger of being caught. Others may compromise their own safety or the safety of a sexual partner by having unprotected sex. Other behaviors may include touching others without permission or using pornography or a position of power to sexually exploit another person.

A man who has a sexual addiction may rub his penis against the buttocks or body of a fully clothed woman to achieve an orgasm, a practice known as frotteurism. Other behaviors for both men and women who have a sexual addiction may include:

voyeurism (observing an unsuspecting person who is naked, disrobing or engaging in sexual activity to fuel recurrent sexually arousing fantasies, urges or behaviors)
fetishism (using nonliving objects such as undergarments or mechanical devices to fuel recurrent sexually arousing fantasies, urges or behaviors)
pedophilia (recurrent feelings of arousal toward children age 13 and younger, or urge to arouse children age 13 and younger)
Some people who have a sexual addiction engage in illegal sexual activity, such as having sex with a minor, exposing their genitals to a stranger, soliciting prostitutes, or having sex in exchange for money or goods. The person may regularly engage in sadomasochistic behavior or sexual activity with animals.


Family issues
People who have a sexual addiction often have a family history in which one or both parents have a problem with chemical dependency, an eating disorder or sexual addiction. In fact, 87 percent of those with a sexual addiction report that at least one other family member has an addiction of some kind. Other common trends include the availability of sexually explicit material at home and inappropriate personal boundaries, such as inappropriate sexual comments or a lack of privacy in the bedroom or bathroom. More than half report a rigid, emotionally disengaged family in which sex was considered taboo or disgusting.
Spouses or significant others of people who have a sexual addiction often have poor self-esteem, believing they are not worthwhile and no one could love them for who they are. They tend to be attracted to needy people and fear abandonment. They often consider sex the most important sign of love, and many report having participated in sexual activities they found uncomfortable, such as viewing pornography, swapping partners or having sex in public places. Some spouses or significant others of people who have a sexual addiction were sexually abused during childhood and may be afraid of sex or confused by it. They may fear refusing sex or use sex to control or manipulate the other person. They may also feel responsible for the other person's behavior.


Characteristics
Physically, a person who has a sexual addiction may experience euphoria related to sexual activity. The sexual satisfaction is often short-lived, however. In some cases, sexual activity leads to an unplanned pregnancy or physical illness.
Psychologically, the person may have a preoccupation with sexual thoughts and romantic daydreams or experience severe mood changes related to sexual activity. The person may feel controlled or overwhelmed by sexual desire, romantic fantasies or sexual images. He or she may feel degraded by the sexual behavior or alienated from other people as a result of the sexual behavior. The person may have less emotional investment in a relationship with a spouse or partner. Sexual obsession and fantasy may be used as a primary coping strategy, and sexual activity may be used to deal with painful or difficult feelings.

Socially, the person may engage in exhibitionism, fetishism, compulsive masturbation or anonymous sex. He or she may have difficulty relating to other people because of sexual thoughts about them. He or she may also take increasing risks or try new sexual behavior for the same euphoric effect.


Coping
A person who has a sexual addiction often perceives the compulsive behaviors as acceptable, making it rare to actively seek help for a sexual addiction by stating the behavior as the primary problem. More often, a person who has a sexual addiction is pushed into seeking help based on negative consequences of the sexual addiction, such as marital problems, actual or threatened job loss, or legal problems.
Unlike sobriety from substance abuse, sobriety from sexual addiction is not characterized by complete abstinence. The goal is adaptation of healthy sexual behaviors and avoidance of compulsive sexual behavior. This moderation can be difficult to define, which makes it difficult to achieve. A goal of recovery may include helping the person define which sexual behaviors are healthy and which are not. As with people recovering from substance abuse, people coping with a sexual addiction are always considered to be recovering -- never fully recovered. Due to the high risk of relapse, people recovering from a sexual addiction should avoid any people, places or situations that might trigger a relapse.

Treatment of sexual addiction often includes working through issues around sexual abuse, sexual identity, shame and personal relationships, as well as confronting distorted sexual ideas the addicted person may have. Treatment may involve cognitive behavioral therapy, group psychotherapy or 12-step support groups for sexual addiction. Insight-oriented psychotherapy is long and expensive, but often successful. In many cases, the person must forgive his or her partner and rebuild trust in the intimate relationship. Partner involvement in treatment is crucial. In fact, the most important predictor of post-treatment relapse for sex addiction is failure of the spouse or partner to be involved in the treatment program.