Sex Addiction: An excuse or illness?
More and more famous men are knocking on the doors of rehabilitation centres for sex addiction, but it is a disease which can be treated? Lize Maritz finds out
Much has recently been reported in the media about sex addiction, especially following the news of Tiger Woods' numerous extramarital affairs.
He is actually not the only celebrity who has gone looking for help for what he claims is an addiction. On Maxim.com there is a whole list of known addicts. Wilt Chamberlain, a basketball player, reveals in his biography that he had had intercourse with about 20 000 women! Michael Douglas is, according to various sources, a self-confessed (rehabilitated) sex addict. When he married his current wife, Catherine Zeta Jones, she apparently included a clause in their marriage contract whereby he has to pay her a fine of five million dollars if he cheats on her.
David Duchovny, who ironically enough plays the role of a sex-addicted writer in Californication, revealed in 2008 that he had received treatment for sex addiction. Charlie Sheen is another celebrity who, over the years, has become notorious for his "love" of women. According to his own admission, he has had relationships with over 5,000 women, including prostitutes. Though he has never openly admitted he is addicted to sex, he clearly has a problem.
Two of America's most famous and best-loved stars - Halle Berry and Sandra Bullock - have been cheated on by their respective husbands. Both men blamed sex addiction, and went for treatment.
Of all people, Hugh Hefner, the Playboy king, has been quoted as saying that it is just an excuse to blame sex addiction.
A bona fide addiction?
Ordinary people are divided over whether sex addiction really is a disease or not, but the professional world also can't agree.
The American Psychiatric Association publishes the Diagnostic and Statistical Manual of Mental Disorders, which is regularly updated. The manual is widely known and is often referred to as the psychologist's Bible, used for diagnosing disorders. The latest version of the manual does not recognise sex addiction as a diagnosis. The team responsible for the compilation of the guide says "hypersexuality" could be considered for inclusion, but that sex addiction has not yet been classified.
The current version does include a diagnosis of a "sexual disorder not otherwise specified". Some examples include "a pattern of repeated sexual relationships with lovers treated as objects" and "compulsive fixation on an unavailable lover, compulsive masturbation, compulsive sexuality in a relationship, and so on."
The World Health Organization (WHO) compiled the International Classification of Disorders (ICD), which is used worldwide and is not restricted to mental disorders. The latest version includes "excessive sexual desire" as a diagnosis, with a subset of satyrism (for men) and nymphomania (for women).
Claire Newton, a psychologist from Glenwood, said in order for sex addiction to be classified as an addiction, it needs to meet the criteria of addiction. This implies persistent activity associated with sex, despite continuing or recurring work, social or interpersonal problems caused or exacerbated by the activity.
Sexologist Professor Elna McIntosh agrees. She says she understands hypersexuality and addiction, but that she's not so sure that there is such a thing as sex addiction.
She said a high degree of sexual activity presents with many other conditions as well, and before a diagnosis of sex addiction can be given, all those other conditions must first be eliminated. A high degree of sexual activity could first be attributed to mania or bipolar disorder. Other conditions could include an obsessive compulsive disorder, posttraumatic stress disorder, sexual trauma (which can lead to hypersexuality in some people), substance abuse and frontal lobe syndrome. Some depressed people are predisposed to more frequent sex - not because of their increased libido, but to escape their isolation and have contact with others, albeit only physical.
Sex Addiction as a concept falls far short of being able to exclude all of the above. Addiction implies an intense sense of acute pleasure, followed by a desire to repeat it, and often tolerance and withdrawal. Prof Elna questions whether sex meets these criteria for addiction.
How does it manifest?
Claire emphasised that this is a real disorder, but that it doesn't always manifest as people think. "It involves not only the regular act of intercourse, but also by regularly thinking about it. The term "sex addiction" is used to describe the behaviour of someone who has an unusually intense sex drive, or an obsession with sex. Sex, or thoughts thereof, dominate the person's mind, making it very difficult to work or have healthy personal relationships, "she says.
Dr. Douglas Weiss, a renowned therapist and author, said for some sex addiction is a way to share their feelings or deal with life stressors. "It's often their only coping mechanism."
Claire expands further: "Sex addicts engage in distorted thinking - rationalising and justifying their behavior and blaming others for their actions. Sex addiction also involves taking risks.
Sex addicts participate in various sexual activities despite the potential for negative and/or dangerous repercussions. In some cases, the sex addiction progresses to involve illegal practices such as exhibitionism, obscene phone calls and even molestation. This does not necessarily mean, however, that all sex addicts become sex offenders."
These are the symptoms
Dr. Douglas said masturbation is by far the most common sex addiction he treats. "It's usually the first sexual experience many people have on a regular basis. It is here the sexual compulsion for sex addicts begins, and this behaviour - despite other learned behaviour - usually stays active.
He said pornography, along with masturbation, comes first for most sex addicts. "They struggle to wean themselves off it because the pornography creates an unreal world that the sex addict visits throughout his adolescence and other developmental phases. They become emotionally and sexually dependent on them long before they have sex with a person."
Claire said behaviours associated with sexual addiction include:
• Compulsive masturbation.
• Multiple relationships (extra-marital relationships).
• Multiple or anonymous sexual partners and/or one-night stands.
• Consistent use of pornography.
• Unsafe sex.
• Phone or computer sex.
• Prostitution, or use of prostitutes.
• Obsessive dating through personal ads.
• Voyeurism (watching others) and/or stalking.
• Sexual harassment.
Influence and effect on their lives
In general, a person with a sex addiction gains little satisfaction from the sexual act, and forms no emotional bond with their sexual partners, says Claire. "In addition, addiction leads to feelings of guilt and shame. The addict feels a lack of control over their behaviour, despite the negative consequences (financial, health, social and emotional).
Sex addiction also puts the person at risk of emotional and physical injury. Regarding work, family and social life, she says sex addiction causes the following problems:
• It destroys relationships, including through ongoing arguments.
• Interference with work - many hours spent on the internet instead of being productive, and tiredness due to lack of sleep.
• Interference with their social life - they would rather stay at home and spend time on the internet, than go out with friends.
Dr. Douglas said many wives or partners of sex addicts experienced the same feelings. "The feeling of loneliness is common, plus the feeling that his or her needs are not being met and that they fall short."
He emphasises that the problem is not only with men, and the manifestation is the same in women as in men.
Claire and Dr. Douglas agree that sex addiction can be treated. Claire says most sex addicts live in denial of their addiction. Treatment can only start if the person accepts and acknowledges he has a problem. "In many cases it takes a significant event, such as the loss of a job, arrest, or a health crisis for the addict to admit he has a problem.
"Treatment focuses on education about healthy sexuality, individual counselling and/or family therapy."
Support groups and a 12-step recovery programme (e.g. Sex Addicts Anonymous) are also available. Dr. Douglas warned that the recovery process takes time, but with guided help an addict can recover in his emotional, relational, sexual, financial and even spiritual life. "I've seen marriages better than before, and they lead a much happier life than they ever thought possible."
Although there is no agreement about sex addiction and its classification, it is a definite reality for some people and they, and their families, must struggle every day. This causes endless torment and pain.
There is no doubt that some people will use it as a cover for infidelity. Each situation must therefore be judged on its own, and there is help available for those affected by it.