Sex addiction

by Jeff Siegal

Sex Addiction

Compulsive sexual behavior is more than just another hot media topic. As many as 10 million Americans may suffer from the disorder, which can lead to personal or family distress, problems at work, and legal or financial consequences.

Jan. E. (not her real name) was continually late for work, and she kept missing appointments. Her boss spoke to her several times about her performance, but it kept getting worse. Her family wondered why they saw so little of her, even on birthdays and holidays that she had previously never missed.

Jan had a problem, but it wasn't the problem most people would associate with her symptoms. She wasn't mixing gin with her orange juice to get through the morning, and she wasn't ducking into the restroom to snort cocaine. Jan's problem was sex. She couldn't get enough of it -- literally.

"It's not recognized as an official diagnosis, but I don't think there's any doubt that it exists," says Kenneth Skodnek, MD, the director of addiction services at Nassau County Medical Center in East Meadow, Long Island. "It satisfies all of the criteria for addiction."

Experts say that as many as 10 million Americans (a majority of them men) may suffer from the disorder, and that it can lead to personal or family distress, problems at work, and legal or financial consequences.

What's more disturbing is that its trendiness has worked against it, cutting off the flow of research dollars and making it harder to help people who suffer from the disorder. "It's hard to get this matter taken seriously by the scientific community," says Donald Black, MD, a professor of psychiatry at the University of Iowa College of Medicine in Iowa City and one of the leading researchers in the field. "You're unlikely to get money from the National Institutes of Health because no one thinks this is a serious problem."

It is not only serious, but a problem especially unique to the last decade of the 20th century and the social, moral, and cultural climate of the United States.

"Our society has created so many freedoms that didn't exist 20 or 30 years ago," says Dr. Skodnek. "There has been a breakdown in trust in authority and trust in institutions. In the past, people had fewer or more limited choices than they do now. Combine that with the emphasis on personal gratification, with more people doing what they want, and you have a situation where this sort of behavior is more possible."

There may also be relationships between compulsive sexual behavior and other sex-related disorders such as pedophilia. Says Dr. Black: "What links a pedophile who engages in such acts repeatedly and someone who masturbates compulsively is that both behaviors are repetitive, indulgent, and enjoyable for the person doing them. But we're talking about two totally different conditions, really."

And while the obsession may not be as widespread as alcohol or drug addiction, it can be just as painful for the person suffering from the disorder and the person's family. Just ask Jan E.

"All I ever thought about was sex," says Jan, a married, high-level corporate communications executive who would use her car phone to call one of her boyfriends so he could talk suggestively to her. "It was on my mind constantly. I focused on it to the exclusion of everything else."

Jan's actions were typical of someone struggling with compulsive sexual behavior. Their behavior generally involves normal sexual behavior taken to extremes in a number of ways:

- Cruising during the day in search of sexual partners, when they should be at work or school.

- Compulsive sex within a relationship, as well as compulsive masturbation. The former, say the experts, is not a discussion about whether three times a week is a lot of sex, but whether three times a day is enough.

- Using sex as a defense mechanism, in the same way alcoholics drink to protect themselves from unwanted feelings. It may be related to their family, problems in their marriage, or similar situations.

- Other psychological disorders, such as substance abuse or anxiety or mood disorder. "Using drugs or alcohol may disinhibit some of these people enough to carry out the behavior or to numb their sense of shame," says Dr. Black.

Treatment is more complicated, too. If it takes the same format as other addictions, abstinence is usually the only approach. A number of 12-step programs (including Sexaholics Anonymous, Sex Addicts Anonymous, and Sex and Love Addicts Anonymous) do exist. Drugs, especially some of the newest medications for depression and other psychiatric disorders, are also an option. But more study needs to be done, say researchers, to learn just how much abstinence is enough, since a healthy sex life is generally considered to be part of a well-adjusted life.

And if that's not complicated enough, consider that it's one thing to admit that drinking or drugs cause problems. But sex? "People are reluctant to come forward because they think it's silly that they have a problem with sex," says Dr. Skodnek. "Plus, there are moral and personal issues, which makes for a lot of resistance to acknowledging the problem."