Thursday, December 14, 2006

Sex Addictions

There are many things I haven’t talked about yet, anger, primarily, probably since I’m an anger-phobe, but I’ll get to that when the time is right.

Sex addictions is another.

I’m going to loosely define a sex addiction as a compulsion to seek out sexual relationships with strangers, knowing that the relationship will in all likelihood never be more than a sexual relationship.

Like the other addictions, sex with strangers is self-medicating and compulsive in nature. The high people get from the excitement of new relationships, the hope against hope that the sexual relationship will become much more, and the act of physically connecting to another human being fill voids in the psyche, emptiness.

Docs who are more psychoanalytic than me will pontificate about replacing lost love objects in childhood, meeting unmet dependency needs, and the like.

You know that’s a bit abstract to be practical.

Oh, and it doesn’t explain our example.

Here’s a story I’ve heard a dozen times (probably, which isn’t bad over 25 years, is it?).

A guy comes in with a broken marriage. He knows it’s over. She knows about the sexual abuse he suffered as a child, but hasn’t a clue that he seeks out relationships with men and never refuses sex when propositioned. The marriage is conflictual and unaffectionate.

He considers himself a hopeless case. He’s a nice looking man who thinks he’s unattractive. He showers twice, even three times a day. He’s sweet, soft-spoken, non-violent. In his marriage this type of patient has been exploited in some way or another by his spouse. Perhaps she married him to gain citizenship or because she knew she could get him to pay off her Visa. He’s the one who does EVERYTHING in the family, including the carpool, the laundry, the work outside the home that brings in the money. Inevitably, he hands over his paycheck to her.

His self-esteem is trash, of course. He hates himself and has never recovered from the stain of childhood sexual abuse. He’ll always remember how he “performed sexual acts” on his abuser and was sworn to secrecy. He’ll describe these acts in therapy and he will feel a little better having shared this (he’s not told anyone else). But at the end of the session he goes home, self-esteem no better than it was the day before, looking for love.

These are tough cases and a doc like me can work with a guy like this for a year and it will help. No question, therapy really will help. ANY therapy that does not exploit him will probably help.

But remember, those of you either with this problem or those of you who are going to become therapy docs, there are OTHER RESOURCES out in the world that can be extremely effective, that can provide EVEN MORE SUPPORT THAN INDIVIDUAL THERAPY.

I’m talking, of course, once again, about the 12-Step programs. The one for sex addictions in the Chicagoland area is called Sex and Love Anonymous. There are dozens of local chapters all over the U.S. Sex Addicts Anonymous is great, too.

If you’re on-line, you can use a search engine to find the nearest chapter. If you’re a social worker with a client and you have Internet access in your office (and if you don’t, you should) then go there while you are with your patient and don’t let him leave without a piece of paper and a chapter meeting time and place in hand.

Here, I’m giving you the link, saving you the work. Bookmark it or put it in your Favorites. Welcome to my world. I cannot vouch for the effectiveness of any particular group, and watch out for the For Profit websites using similar names.

The word on groups is that if you don't like one, look for another. Try up to 6 different groups before you give up.

Sex Addicts Anonymous

Sex and Love Anonymous

Hopeless just doesn’t make it into the vocab, okay?

Copyright 2006, TherapyDoc


Anonymous said...

Good, solid information about a subject which is not talked about much. You gave me an education on the definition of a "sex addict". What is the difference between a sex addict and a nymphomaniac?
Funny, that in a society which in many ways seems to be obsessed with sex, we still do not want to talk about the darker side of this subject.

therapydoc said...

You're so right. Sex therapists have varying definitions, and even the one I put in this post isn't the only one I'd use. Generally we think of addictions as having no control over certain behaviors that tend to get us into trouble. Nymphomania used to be used way too liberally. A normal woman with a decent libido might have been considered a nymphomania if she wanted sex more than once a day.

Anonymous said...

Oh gosh, i just bookmarked your site. I like your content a lot. It's the type of thing I like to learn more about -- have always been fascinated with psychology, psychiatry, therapy and such. Very informative! btw - thanks for your comment at my site! Yours is splendid.

Anonymous said...

You are correct, nymphomnia was a term that was used to loosely to describe women that were not all that loose.

April_optimist said...

Interesting. Very different picture from what I've seen elsewhere and I'm guessing very important to a lot of people.

Anonymous said...

Just learned about your blog...
I saw this and wanted to comment. Sex addiction is more than just cheating with other people. It invloves pornography, online and offline, masturbation, cruising the streets for hours and hours looking for a prostitute, prostitution in general, going to adult bookstores, etc, etc. It is a far and wide spreading mental health issue. Experts term sex additction as "an addiction of intimacy"...somthing which I see is a major theme in your blog titles. Besides SAA and SLAA, there is SA, SCA, and SRA. The known leading expert in the country is Patrick Carnes who has a few books on the subject which are absolutely exxcellent, both for the therapist, the addict, and a co-dependent. Robert Weiss, his protege, also has a book or two on this. This addiction is very hard to deal with, both for a therapist and a client. However, in cultures such as Orthodox Judaism, where sex is still considered to be a taboo subject and masturbation is such an evil sin which will get you a lot Hell (as my freshman year rabbi told us) the guilt and shame is so terribly difficult. And that is just for masturbation. Imagine someone like that becoming a sex addict in this culture, growing up, etc, etc. And I think, wait, I KNOW that a lot of jewish (orthodox) people are dealing with these issues; if not actually being an addict to atleast having issues with viewing pornography and masturbation, etc. Anyways, I hope my post was appropriate for your site. I am a budding therapist in the U.S. who stumbled across your blog and who is an orthodox jew (frum), and I would love to comment often on your posts. I also wish you good luck in your work.

therapydoc said...

ANON, Thank you SO much for your input. I'm going to get to that reading. Of course you should comment often. It's hard being a Jew, even harder being observant, harder still doing things from the heart. I judge no one. Good luck in this incredible profession, too.

Anonymous said...

thank you!....i want to let everyone that is struggling know that Rosh Hashanah and Yom Kippur are great times to practice "Steps" 1,2 and 3. Totally realize that we are powerless over our addictions and compulsions and if we could just tell G-d this, and ask him to help us EVERY MOMENT, then we will feel such a sense of freedom and serenity. Yom kippur is not a few days away. For those of you going to shul (synogogue) there are two types of prayers. One type focuses all on G-d's Kingship and His praises and His ability to do anything and everything. At these moments give yourself over to Him and try to internalize His strength. The second type of prayer is when he specifically ask for forgiveness. This is not about self-deprecating thoughts about what we did. It is about asking forgiveness for not turning ourself over to him and therefore what actions and behaviors that led to. It's a subtle difference but makes all difference in terms of how we connect with G-d. I would love to hear feedback by anyone who reads this......Anonymous

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