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The Treatment of Sex Addiction – An Analytic Approach

It is well known among people in the 12-step sex programs that of all the addictions, sex is the most difficult to master. Far from the notion that sex addiction is the “fun” one, the suffering of dealing with this affliction is enormous. The compulsion is so compelling that it is common for members of the sex recovering groups to be unable to maintain any continuous time of sexual sobriety, giving way to despair and hopelessness. Before treatment, sexual enactment is the addict’s only source of safety, pleasure, soothing and acceptance. It vitalizes and connects. It relieves loneliness, emptiness and depression. Sex addition has been called the athlete’s foot of the mind: it is an itch always waiting to be scratched. The scratching, however, causes wounds and never alleviates the itch.

Furthermore, the percentage of people who go to therapy or a 12-step program is quite small. The majority of sexual compulsives live in isolation filled with feelings of shame. Almost 100% of the people who come to me for an initial consultation, whether it be for compulsive use of prostitutes, phone sex, a fetish, cross dressing, or masochistic encounters with dominatrixes, relay that beneath the shame they feel in telling me their story, they also experience a sense of freedom that comes from finally being able to share with another human being the hidden, shameful, sexually compulsive acts that imprison them.

This is a condition that gradually bleeds away everything the person holds dear. The life of a sex addict gradually becomes very small. The freedom of self is impaired. Energies are consumed. The rapacious need for a particular kind of sexual experience drives the addict to spend untold hours in the world of his addiction. Inexorably, the compulsion begins to exact higher and higher costs. Whether it be on the internet indulging in sexual fantasies with fantasy people, being on the phone to the sex hot-lines, or frantically searching the net and the S&M clubs for someone who will act out a particular, ritualized fetish fantasy, or cruising the bars searching for the “one” who will have sex in a public toilet, or going to dungeons to be whipped, flogged and humiliated, sex addiction is a devastating illness that takes an enormous toll. Friends slip away. Hobbies and activities once enjoyed are dropped. Financial security crumbles as sums as high as $40,000 or $50,000 a year are spent on sex. Then there is perpetual fear of exposure. Relationships with partners are ruined, as the appeal of intimate sex with a partner pales in comparison to the intense “high” of indulging in the dark and devious world of sexual compulsion.

What is a sex addict? Sex addiction, of course, has nothing to do with sex. Any sexual act or apparent “perversion” has no meaning outside of its psychological, unconscious context. A simple definition of sex addiction is not dissimilar to definitions of other addictions. But a simple definition of this complex and intractable condition doesn’t suffice. What sets sex addiction apart from other addictions and makes it so persistent is that the subject of sex touches on our innermost unconscious wishes and fears, our sense of self, our very identity.

Current treatment might include participation in a 12-step program, going to an outpatient clinic, working with the Patrick Carnes material, aversion therapy, or the use of medications to stave off hypersexuality. Most therapy is cognitive-behavioral, designed to help the patient to control or repress the instinct for a period of time, usually out of a desire to comply with the group norms of their 12-step meeting or a need to please the therapist. While I recognize the efficacy the 12-step programs to provide structure and support, in my opinion, the reason that relapse is so prevalent is that these treatment modalities do not effect long-term structural personality change that eliminates the compulsion at its roots. Current treatment does not aim to transform psychic energies so that the reality sector of the mind dominates the personality so that the impulse to act out can be understood and controlled.

While the definition of sex addiction is the same as that of other addictions (recurrent failure to control the behavior and continuation of the behavior despite increasingly harmful consequences), sexual compulsion is set apart from other addictions in that sex involves our innermost unconscious wishes, fears and conflicts. Sex addiction is a symbolic enactment of deeply entrenched unconscious dysfunctional relational patterns with self and others. It involves a person’s derailed developmental process that occurred as a result of inadequate parenting. Hence, permanent growth and change are most likely to occur in the arena of contemporary psychoanalysis, which seeks understanding and repair of these unconscious dysfunctional relational patterns along with the development of a more unified and structured sense of self. This new personality restructuring can better self-regulate feeling states without the use of a destructive defense like sexualization and can find meaning, enjoyment, intimacy, meaningful goal setting and achievement from attainable and appropriate sources in life.

The remainder of this paper will give a brief overview of the historical psychoanalytic views about sexual deviance, and will then articulate the current analytic understanding about the dynamics and treatment of sexual compulsions.

Any discussion of historical psychoanalysis must, ipso facto, begin with Sigmund Freud. Freud formulated that sexual deviance occurs due to an incomplete resolution of the Oedipus complex, with its concomitant castration anxiety. Unconscious castration anxiety occurs in the person’s present-day consciousness in the form of fear of confrontation, retaliation, or rebuke, a sense of inadequacy, and perhaps doubts about gender identity. Sex addiction, according to Freud, is a defensive way to cope with a tenuous sense of masculinity combined with unrelenting anxiety about sex, women, intimacy, aggression, and competition. Analysts that followed Freud held varying views. Sexual compulsions derive from an insatiable need for approval, prestige, power, bolstering of self-esteem, love and security which are experienced as being necessary for survival. The addict experiences the absence of sexual acting out as a threat to his very existence.

Characteristic of any addict is a long history of a disturbed mother-child relationship. An unempathic, narcissistic, depressed or alcoholic mother has low tolerance for the child’s stress and frustrations. Nor is she able to supply the empathy, attention, nurturing and support that foster healthy development. The result in later life is separation anxiety, fear of abandonment and a sense of imminent self-fragmentation. This anxiety sends the sex addict running to his eroticized, fantasy cocoon where he experiences safety, security, a diminution of anxiety as well as the quelling of an unconscious wish to establish and maintain the missing, yet essential tie to mother. Typical of this person is the hope that he can find an idealized “other” who can embody, actualize and make concrete the longed for endlessly nurturing parent. This approach is doomed to failure. Inevitably, the other person’s needs start to impinge on the fantasy. The result is frustration, loneliness and disappointment.

On the other hand, a mother can be overly intrusive and attentive. She may be unconsciously seductive, perhaps using the child as a replacement for an emotionally unavailable spouse. The child perceives the mother’s inability to set appropriate boundaries as seductive and as a massive disillusionment. Later in life, the addict is hypersexual and has trouble setting boundaries. Real intimacy is experienced as an engulfing burden. The disillusionment of not experiencing appropriate parental boundaries is acted out later in life by the addict’s unconscious belief that the rules don’t apply to him with regards to sex, although he may be regulated and compliant in other parts of his life.

A major theme for all addictions is that they have experienced profound and chronic need deprivation throughout childhood. Addicts in general sustain emotional injury within the realm of the mother-infant interaction as well as with other relationships. Intense interpersonal anxiety is the result of this early-life emotional need deprivation. In later life, the person experiences anxiety in all intimate relationships. Because the sex addict has anxiety about being unable to get what he needs from real people and because his desperate search for the fulfillment of unmet childhood needs inevitably end in disillusionment, he inevitably returns to his reliance on sexual fantasies and enactments to alleviate anxiety about connection and intimacy and as a way to achieve a sense of self-affirmation.

Sex, for the addict, begins to be his primary value and a confirmation of his sense of self. Feelings of inferiority, inadequacy, and worthlessness magically disappear while sexually preoccupied , through acting out or through spending untold hours on the internet. However, the use of sex to meet self-centered needs for approval or validation precludes using it to meet the intimacy needs of a cherished other. Characteristic of this kind of narcissism is the viewing of other human beings not as whole people who have their own feelings, wants and needs, but rather as deliverers of desperately needed satisfaction that shores up a fragile sense of self. This sets up a cycle wherein his narcissism prevents him from deriving satisfaction from mutual, reciprocal relationships in real-life. Sexualizing, once again, is returned to as a magical elixir wherein his needs are magically met without having to negotiate the very real vicissitudes of intimate relationships.

A client of mine, a 48-year-old attractive single man, is in the process of the breaking up of yet another relationship. After spending years of living a noxious childhood household, he went into his own world of fantasizing and masturbation as a way to soothe and protect himself.

“When I was a kid, I was obsessed with beautiful women in the magazines. When I was able to date, I went through one woman after another. In adulthood, I knew there was sadness and anger I didn’t want to face. To evade them, I had a steady stream of women who worshipped me, soothed me, paid attention to my needs. I went to peep shows and I visited prostitutes. Many a night I would spend hours in my car circling the block looking for just the right street-walker to give me oral sex in my car. One night I had sex with a transvestite. I cried all the way home.”

He met a girl whom he designated as “perfect – my redemption, my salvation.” He became engaged but soon lost interest in the sex, which he described as “boring”. While still engaged, he started picking up hookers for oral sex in the car and began compulsively using phone sex.

His current relationship is breaking up because he picked a woman for her youth and beauty (which reflected well on his narcissistic self). The rest of the story is predictable. They moved in together and the beautiful, young, sexy female started become real and having needs of her own. He admits he never felt warmth or love for her; she was merely a supplier of his narcissistic needs. As the relationship deteriorates, he fights the impulses to return to sex with strangers who don’t make demand on him.

Another client of mine, a 38-year-old married man, has a compulsion to visit prostitutes. Three years into the treatment, he was finally able to talk about his anger towards his mother for depriving him emotionally through neglect and for never touching or caressing him. He can now make a connection between visits to the prostitutes and his hostility against mother for depriving him of sensual pleasure. He got lost in the mire of his parents’ constant feuding.

“When I was very young I would put a blanket on my genitals as a kind of soothing which I wasn’t getting from my parents. The rest of my life was a struggle to find other ways to soothe myself. When I discovered prostitutes, I thought I was in heaven. I can get sex now and be in total control. I can have it immediately, any way I want it, whenever I want it. I don’t have to concern myself with the girl, as long as I pay her. I don’t have to concern myself with vulnerability and rejection. This is my controlled pleasure world. This is the ultimate antithesis of the deprivation of my childhood.”

The use of sexualization as a defense is a common theme that runs through the psychoanalytic literature. A defense is a mechanism the young child devises to psychologically survive a noxious family environment. While this way of protecting himself works well for a period of time, the continuous use of it as an adult is destructive to the person’s ongoing functioning and sense of well being.

By losing himself in sexual fantasies and constantly seeing others as potential sex partners, or by erotic internet enactments, the sex addict is able to significantly reduce and control a wide variety of threatening and uncomfortable emotional states. Most addicts control or bind potentially overwhelming anxiety via the addiction process. Diminution of depression, anxiety and rage are some of the pay-offs that operate to facilitate and maintain life in the erotic cocoon.

I quote another patient which illustrates a case of narcissistic personality together with the use of sexualization as a defense. He is a 52-year old attractive, successful single man.

“I went on a date the other night. She wanted sex. I didn’t. It’s predictable. I don’t think I can even maintain an erection anymore. While a spend untold hours compulsively websurfing to live in my erotic fantasies, when it becomes real, when you find someone who seems to be the embodiment of your sexual pre-occupation, interest soon wanes as her wants and needs come into the picture. Sometimes, I don’t even bother with the pursuit of real women, because I know the inevitable result is disillusionment. I’m simply not prepared to meet somebody else’s needs.

Oddly enough, my life is still dominated by sex. It becomes the lens through which I view everything. I go to a family gathering and get lost in sexual fantasies about my teenage nieces. I live in constant fear of being found out to be a “pervert”. I see a woman on the train dressed in a way that triggers me, and I’m ruined for the day. Regular sex just doesn’t do it for me anymore. It’s got to be bizarre or forbidden or “out of the box”. I arrive at work in an erotic haze. Women around me are all objects of sexual fantasy. I’m distracted; not focused. If something requires my attention, when real life intrudes and yanks me out of my sexual preoccupation, I get angry. Real life is so boring. Ordinary sex with a girlfriend holds no interest for me.”

This patient uses sexualization as a defense. He uses his sexual pre-occupation as a way to ward off chronic feelings of loneliness, inadequacy and emptiness born of a childhood trying to get nurturing from a withdrawn, depressed mother. When stress or anxiety begins to overwhelm the regulation of his emotions, he is beset by intense urges to indulge in his fantasies and enactments. Sexualization thus becomes his standard way of managing feelings that he perceives to be intolerable as well as a way of stabilizing a crumbling sense of self-worth.

It is my belief that sex addiction requires a contemporary psychoanalytic approach. Psychoanalysis changed drastically in the 1970′s with the work of a prominent psychoanalyst who jettisoned the Freudian approach and established a kind of treatment that is particularly useful in treating sex addiction. Contemporary analysts no longer conduct treatment three-times a week on the couch. They do not unearth hidden meanings, or remain silent, or put themselves on a “thrown” as being the “One Who Knows”. The process is a shared one and the relationship between patient and therapist is co-created and mutual.

Some contemporary psychoanalysts use the concept of a vertical split in treating the addict. The split exists from inadequate parenting which results in structural deficits in the personality. Patients often report that they feel fraudulent, living two separate lives with two different sets of values and goals. They feel they’re acting out a version of “The Strange Case of Dr. Jekell and Mr. Hyde.”

One sector of the personality, the one anchored in reality, is the responsible husband and father. This part of the person is conscious, adaptive, anchored in reality, structured, and often successful in business. This is also the sector that experiences guilt and shame about his sexual behaviors and ultimately drives him to seek therapy to ameliorate his misery.

The “Mr. Hyde” side of the vertical split has a completely different set of values and seems to be impervious to his own moral injunctions. “Mr. Hyde” represents the unconscious, split-off part of the personality. It is impulse-ridden, lives in erotic fantasy, and is sexualized, unstructured and unregulated. This side of the vertical split seems to be incapable of thinking impulses through, and thus is oblivious to the consequences of his behavior. This is the part of the self that is hidden, dark, driven and enslaved.

A comprehensive discussion of the actual process of therapy is beyond the scope of this paper. Suffice to say, the therapist uses him/herself as an instrument in integrating the split which results in personality structure building. Treatment bridges the gap of the split. Its aim is the establishment of a relationship with the therapist that regulates emotional states, is used as a “laboratory” to bring to consciousness maladaptive relationship patterns, provides empathy and understanding and reconstructs the childhood origin of the addiction. The goal is an integrated self that is able to merely experience a sexual fantasy without being preoccupied with it and without acting out a damaging sexual scenario.

The patient achieves some ability to self-regulate moods, and to seek out adequate and sustaining available supportive relationships both in and out of treatment. He is then free to put sexuality in its proper place and free up energies to gain satisfaction from real relationships, pursue creative or intellectual goals, obtain pleasure from hobbies and activities, and have a heightened sense of self-esteem, thus enabling him to end his isolation. He is then free to love, to have deeply satisfying, self-affirming sex, work to his potential, and experience being a valued member of the human community.

Your Sexual Pleasure Points And Different Kinds of Sex

Sex oh sex! As soon as you feel sexy, the thread of your thought runs along the line of your orientation, either heterosexual sex, bisexual sex or homosexual sex, which refers to both gay sex and lesbian sex, respectively.

Being straight or heterosexual is what society sees as normal sexual practice, but the truth is that whatever sexual orientation anyone has is inborn. Whether you are Catholic about sex, attracted to the same sex or both sexes is all about how you feel. No one has the right to judge you, so long as you do not break the law with your sexual drive.

Everyone loves sex stories because they are good for sexual fantasies, yet discretion is the norm, lest people find out that you like sex, ha, ha ha. Which is why online free sex stories and free sex videos thrive like wild fire, especially patronized by teenagers who are already engaged in teen sex or about to commence their sexual drive?

Sexual arousal erupts from whence no one knows, just like your thoughts. Though sex is resourcefully the source of life and procreation, it is not solely for the purpose of procreation. Married couples don’t do sex every time to make babies. Often they engage in hardcore sex using the same sex positions in the videos they have watched. Married couples will readily engage in both oral sex and anal sex.

Sex is the fulfillment of an inner yearning for bodily pleasure. So, wherever the pleasure point is for people is where they take it, irrespective of what other people think. The pontificating people have there own pleasure points too.

The Sacredness of Sex:

Sex is a sacred spiritual practice that transcends all inhibitions. Even though most people will do so much to hide their true sexual feelings, because they are afraid of what society will say or do, yet sexual behaviors win all the same and, a man or woman will obey their sexual feelings and do sex the way they like it. Most people engage in sex games, watch free sex movies and use sex toys, as a matter of personal choice, for relieving sexual hunger.

Sexual Differences:

When interracial sex was frowned at by powers that were, it did not stop whites, who were inclined, from doing black sex or Asian sex. Some men engage in Gay sex because they favor doing sex with fellow men. These people abhor sex with the opposite sex, just as some women engage in lesbian sex because they favor doing sex with women and abhor sex with men. Some people are so liberal about sex; they do it with both sexes. Others do sex with themselves by way of masturbation; ha ha ha. Interestingly, this social behavior is evident also in animals.

I have seen this attitude in both dogs and goats. For instance, female dogs and goats, even when he-goats and “he-dogs” are around, make sexual advances on fellow she-goats and “she-dogs.” The point here is that homosexuality is a natural genetic structure. I have also seen videos in which humans do sex with dogs. Dog sex is so popular that you have thousands of people searching for it online on a daily basis.

Religious Altercation:

The controversy surrounding sex and homosexuals became uproarious when a particular Church began ordaining Gay Priests and Bishops to the utmost consternation of the thoughtless lot who cry to heaven about the insufferable sin of homosexuals.

For goodness sake, sex is a private practice that is not done in the open or at work. The services of an excellent Mathematics teacher who happens to engage in either Lesbian sex or Gay sex should not be denied his or her community just because of their sexual orientation. It does not make sense.

The Risk In The Sexual Pleasure Points:

Now don’t get carried away that it is your right to do as you please with your body and the body of your submissive partner. Unprotected, whether oral sex, anal sex or vaginal sex is foolish, to put it mildly. This is because in sex, bodily fluids mix between you and your partner. You truly become one in the act, so whatever diseases present in one find home in the other. The HIV/AIDS pandemic ravaging mankind today mostly gains easy access into its victims through different kinds of sexual orientations.

Before HIV/AIDS, Gonorrhea, Herpes, staph, syphilis etc were the common sexually transmitted diseases that sexual partners contracted and, they weren’t big deals, unlike today when careless unprotected sex is tantamount to committing suicide.

When sexy feelings erupt, enjoy your sexual pleasure points with a sense of responsibility for your sound health.

Sex Addiction FAQ

1. What is sex addiction? Sex addiction is a way some people medicate their feelings and/or cope with their stresses to the degree that their sexual behavior becomes their major coping mechanism for stresses in their life. The individual often can not stop this sexual behavior for any great length of time by themselves. The sex addict spends a lot of time in the pursuit of his or her sexual behavior/fantasy or they may have a binge of sexual behaviors.

2. Why do people become sexually addicted? This is different for every sex addict but generally speaking there are biological, psychological, and spiritual reasons. The following is a short explanation of each reason why someone can become a sex addict. The biological addict is someone who has conditioned their body to receive endorphins and enkephlines (brain chemicals) primarily through reinforcing a fantasy state with the ejaculation that provides these chemicals to their brain. Psychologically, the need to medicate or escape physical, emotional or sexual abuse can demand a substance, the early addict finds the sex medicine usually before alcohol or drugs. Spiritually, a person is filling up the God hole in them with their sexual addiction. The addiction is their spirituality, it comforts them, celebrates them and is always available and present. Then there is the sex addict who can be two or even three of the above reasons. This is why a specialist in sex addiction is the best route for recovery with sex addiction.

3. What’s the difference between sex addiction and a high sex drive? I have heard this question on almost every national talk show or radio show I have been on over the years. A person with a high sex drive is satisfied with sex. It’s not about a fix for something; when their partner says “NO” it doesn’t make them go off the handle thinking their partner is totally rejecting them and have to leave the house or act out in some other way. If you can relate to this the chances are there may be an addiction issue.

4. Can you be addicted to masturbation? Yes, this is by far the most common sex addiction that I have treated in working with sex addiction. This usually is the first sexual behavior many of us will have on a repeated basis. This is usually where the sexual compulsion starts with sex addicts and this behavior, regardless of other acquired behaviors, usually stays active.

5. What role does pornography play in sex addiction? Pornography for many sex addicts combined with regular masturbation is the cornerstone for most sex addicts. Many sex addicts have great difficulty getting sober from this combination of behavior. The pornography with fantasy creates an unreal world that the sex addict visits throughout their adolescence and other developmental stages and creates an object relationship that conditions their emotional and sexual self to depend upon these objects and fantasies to meet their emotional and sexual needs hundreds of times before having sex with a real person.

6. Can someone be a sex addict and not be sexual with their spouse or committed relationship? YES! We call this later stage of sex addiction, sexual anorexia. In this stage of sex addiction, the addict prefers the fantasy world and fantasy sex with themselves or others instead of relational sex with their spouse or partner. The addict/anorexic avoids relational sex and hence this couple has sex infrequently and often at the partners request not the addict/anorexics.

7. What is it like to live with a sex addict from a partner’s or wife’s perspective? The partners/wives of sex addicts report many similar feelings about living with the sex addict. The feeling of aloneness is a common experience with partners of sex addicts, the sense that he can’t open up and tell you about his “real” self. The confusion of even after you do certain behaviors that this still is not enough and the hopelessness that there isn’t enough. Anger for many different unmet needs as a person and as a woman are often common.

8. Can partners get help even if the sex addict doesn’t? Yes, even if the addict stays in denial of their addiction the partner can receive help and support for herself. The feelings of anger, loss, loneliness and many other feelings encountered over the years of living with this addiction will effect a person. These feelings need to be dealt with therapeutically whether they stay married to the addict or not. The addiction was in no way your doing as a partner or wife, the addicts addiction started many years before you even met your addict. This addiction would have grown and damaged anyone they would have related to in any relationship.

9. Is there recovery for sex addiction? Yes, there is recovery for sex addiction. This recovery takes time and hard work especially in the first year but with guided help the sex addict can experience restoration in their emotional, relational, sexual, financial and even spiritual lives. I have seen marriages made better than they ever were and addicts live much happier lives than they ever thought possible. I have been in successful recovery over eleven years and I know it’s available for those who choose to work for and maintain recovery.

10. Is there research on sex addiction available? There is research being done in the field of sexual addiction. The monitored mail list of Heart to Heart Counseling centers provides weekly research information as well as excerpts from 101 Practical Exercises for sexual addiction recovery as well as Twelve Step discussions.

11. Can women be sex addicted? Yes! The number of women desiring treatment is growing significantly. The behaviors are the same as their male counterparts including: masturbation, pornography, internet activity, anonymous encounters and affairs. Over twenty recovering female sex addicts contributed in writing She Has a Secret: Understanding Female Sexual Addiction. This book plus the Secret Solutions Workbook, with over 115 helpful techniques for recovery is just for her. If you would like to set up a telephone counseling appointment to start your journey of recovery, call today. There is hope for female sex addicts to recovery.

12. Is there any way to help our children not become sexually addicted? Yes! Even though many of our adult male clients report that their fathers were sex addicts (porn, affairs, prostitutes etc.) they also report getting little to no proper sexual information to balance their sexual perspective. Good Enough to Wait is the first video of this kind to help your children understand sex and the brain, the long-term affects of pornography, long term sexual satisfaction and a whole lot more. This is the best combination of sex research and spiritual principles to date for youth to watch to give them a proper and currently informed sex talk.