Sex Addiction

As a men’s psychotherapist, I have talked more often to the media about sexual addiction than any other topic.  This is strange really because the assumption is that it is only men who become hooked on inappropriate sexual activity.  In fact 40% of sexual addicts are women. Women’s patterns of sexual addiction might be different to men’s, but they suffer in almost equal measure.  Having said that, this article is about sexual addiction in men, and if you are a man who thinks you have a problem with sex, you have come to the right place.

So what kind of sexual activity can men get hooked on?  Well the main ones are ‘dogging’ areas, where straight men and couples cruise car parks for sex, public toilets and other gay cruising areas, prostitution (both selling and buying), masturbation and internet porn.  In fact internet porn is so easy to get hooked on that it has been dubbed the ‘crack cocaine’ of sexual addiction.  As a sexual addicts pathology develops, of course, he can often find himself moving into areas of sexual interest that are even more antisocial and/or illegal.

Sexual addiction first started to come to the attention of professionals who were involved in the treatment of other addictions, such as alcohol.  It was found that if a person has an addiction to a substance, there is a high likelihood that they will also be addicted to sex.  As many as 42% of people addicted to cocaine also have a co morbid sexual addiction.  Some theorists have argued that the neural pathways associated with sexual addiction are the basis for all addictions.  Whether this can be bourn out by the facts I don’t know, but what is clear is that sexual addiction is closely linked to other forms of addiction.

The natural history of the sex addict can often be quite tragic. The man starts to chase sexual ‘highs’ often involving situations of risk.  Risky sex enhances orgasm and sets the man in a trail of activity of escalating risk.  Eventually, it’s the chase of sexual activity that starts to take up more and more of the guys time.  In turn, sexual highs become harder and harder to achieve, a situation which, paradoxically, makes the ‘hit’ of a ‘good’ orgasm all the more addictive.  As the guy spends more and more time searching for sex and sexual activity, he spends less and less time with his friends and family. Social relationships are put at risk, and the man can become socially isolated.  Like other addictions, sex addicts can lose everything, partners, children, jobs, even liberty.

So what can be done to help the sex addict?  One really good intervention is sex addicts anonymous.  This format is similar to narcotics anonymous and alcoholics anonymous based on regular self help group meetings.  Group meetings are a format that does not suit everybody.  I have had good results with clients using various cognitive behavioural techniques such as active monitoring of sexual behaviour and understanding thought processes.

One theory of sexual addiction is that ‘sexual maps’ are laid down in childhood about age 7, and it is these sexual maps that guys continue to ‘act out’ as adults.  It seems appropriate that there is some therapeutic work undertaken aimed at understanding the origin of the sexual behaviour before cbt work is started.

Like all addictions, the hardest thing for me to work with is clients ambivalence about changing their behaviour.  Men often come to me in the ‘pre-contemplation’ phase of trying to decide whether to stop or not.  The good news is that if a man really wants to change, then the approach I use is really effective.  I can’t, however, make a man want to stop.  Unfortunately, for some men, they really do need to loose everything before change seems the best option.

One final word on the matter of shame.  Many men feel ashamed of their sexual behaviour and this inhibits them from coming forward for treatment.  I really understand and respect this.  My suggestion is that men choose a therapist who is experienced at working with sexual addiction, because such a therapist will be best able to help you explore your behaviour comfortably.  If seeing someone face-to-face is too intimidating at first, consider telephone counselling as many men find this safer.

If you want to find out more about sexual addiction, either for yourself or someone else, I can really recommend Patrick Carnes book on the subject, Out of the Shadows: Understanding Sexual Addiction which is now in its third edition and published by Hazelden.