Psychosexual and relationship therapist Sarah Berry offers her expert advice on managing sex addiction.
Original Source: netdoctor.co.uk
Concerned you might be addicted to sex? If you’re struggling to control your sexual urges, it’s important to know that you’re not alone and support is available. Psychosexual and relationship therapist Sarah Berry offers her expert tips on managing sex addiction:
What is sex addiction?
Sex addiction is characterised by a persistent inability to control one’s sexual thoughts or behaviour, despite this having a negative impact on themselves and/or others.
There have always been people who have felt overly preoccupied with sex or find it hard to control their sexual urges. With our increased dependency on the Internet, many people present themselves to therapy in order to try and gain control. This is largely because the Internet provides a never-ending sweet shop-type experience of every kind of porn, sex work or hook-up. But also, because more people are understanding of the concept of sex addiction.
Does sex addiction exist?
There is some dispute as to what sex addiction is and whether it actually exists. At the time of writing, the latest edition of the Diagnostic and Statistical Manual of Mental Disorders, which is used by clinicians and psychiatrists to diagnose psychiatric illnesses, is DSM 5. This states that the only process addiction, as opposed to chemical, that they recognise is gambling.
One of the reasons for this is that many experts feel sex addiction is not a diagnosis in its own right, but a symptom of underlying issues. If you start smoking, regardless of your psychological make up, background and lifestyle, you are likely to be addicted. The same with gambling. However, most of the adult world has sex and much of it views stimulating material like porn, without becoming addicted.
What’s more, it isn’t usually just a case of stopping the person having sex, as they might with addictions to things one could live without like gambling or cigarettes. Rather, healing usually involves working out what a healthy, happy sex life might look like for the person and then working out how to get it.
What are the symptoms of sex addiction?
The idea of a dirty old man in a mac is not consistent with the people who present with sex addiction to my practice. In fact, they come in all shapes, sizes, genders, ages (from teen onwards) and from different backgrounds and cultures.
Sex addiction isn’t about a particular behaviour or thoughts. Or necessarily about the frequency one indulges in something – it isn’t about someone solely having a high libido. Rather it’s their relationship to these. So, someone may watch porn, be kinky, visit sex workers or have affairs and not feel out of control.
You may be surprised to hear that some of the people I see are known as ‘the rock’ to friends and family; they can give advice, support and are great in a crises. But they also often can’t ask for their needs to be met, are prone to black and white thinking, have low self-esteem, find it hard to express their feelings and compartmentalise love and sex.
How do you know if you’re a sex addict?
Diagnosis is more about ascertaining whether someone’s sexual thoughts or behaviours regularly impede negatively on their or other’s social life, work life or wellbeing. For example, someone might regularly proposition or harass work colleagues, masturbatefor hours into night or over the weekend, cancels social appointments or see any free time as a chance to ‘act out,’ run up bills spending money on pay sites or with sex workers.
Or they may spend most of their days being preoccupied with and/or planning acting out, and only spend a few hours each year actually doing it. They may also struggle with the fact that they are living a secret life that they can’t admit to family and friends.
What causes sex addiction?
When someone regularly repeats an exciting activity over an extended period of time, their brain is repeatedly flooded by dopamine and, eventually, a new neural pathway is formed. As the user acclimatises to this new pathway, they will feel less of an excitement or arousal hit and so will up the frequency of their acting out, or look for ways to intensify the excitement.
However the brain can rewire itself. The more the person stops acting out, and particularly if they find other ways to get a dopamine hit, new pathways can be formed. This doesn’t mean the old one will go, and an entrenched addict may need to watch out for triggers so that they don’t relapse.
Sex addiction contributing factors
There are many contributing factors that could lead to someone seeking repeated arousal, excitement, comfort or escape from sex. These include:
- Experience of sexual abuse, assault or rape: If someone has not been able to come to terms with negative feelings, fears or dangers from the past, they could use sex to self soothe and inspire feelings of control.
- Unresolved trauma that isn’t sexual in nature: It doesn’t have to be related to sex for it to be used as an antidote.
- A sexualised upbringing with lack of boundaries: This could inspire difficult or confused feelings around sex.
- Isolation or loneliness: For example someone working on an oil rig may rely on porn for their release. It may be hard to break this habit when home.
- An inability to regulate emotions: They may not have had trauma, but may still reach for an external soother when they feel happy, sad, lonely, scared, bored, grieved or excited.
- A difficulty relating to people, particularly romantic or sexual partners: Instead, it’s easier to navigate the less rejecting, more predictable world of porn, sex workers, or disconnected hook ups, than face the difficult, messy, vulnerable-making world of navigating relationships.
- An inability to act out of their sexual preferences: Maybe these are illegal, fall outside their moral compass, are hard to come by or inspire feelings of shame.
How can you treat sex addiction?
Treatment depends on the client’s needs. I ask clients, if I could wave a magic wand, what would your life – including your sex and love life – look like? Would it incorporate any of the fantasies and behaviours, in a more controlled way? Do they want to come out as a different sexuality? Find ways to embrace their kinky side? We also look at the rest of their lives. How fulfilled are they? How happy? How in control are they of other aspects of their lives? Do they have existential issues – where are they going? Do they wonder, what’s the point?
There may be other issues that could support or give rise to addictions including other addictions, depression, anxiety, grief or heartbreak. Identifying and working through these could be part of a treatment plan. Shame is a common bedfellow of the sex addict. Often clients have never told another person about their secret life. Many fear that I will be shocked, disgusted or laugh at them. While I am human, I hear sexual confessions on a daily basis and I am always very honoured when someone takes a risk to put their trust in me. The very act of sharing one’s shame with a non-judgemental, caring person can be transformative.
Managing sex addiction
Often clients need help understanding their triggers and then with finding ways to manage and/or avoid them. So, if someone sees a person they find sexy in the street, they may distract themselves from arousing thoughts by doing mindful exercises like counting back from 5,000 in units of 13, or taking note of all the red things they can see. If drugs are a catalyst, then they can avoid these. Also limiting use of phones and computers can often help.
If they felt the urge to go onto a porn or hook-up site, instead they could go for a walk, have a bath, or take up a hobby: maybe something that is spiritual, altruistic, creative, energetic, educative or social. The more someone changes their behaviour, the more new neural pathways can be formed. If they suffer from low self-esteem and that has affected the choices they make – maybe staying in a job they hate or not asking out someone they like – then we look at how they can be fulfilled.
I also help people to express feelings and explore defence mechanisms, including old ones that may have developed in their formative years. They learn to acknowledge and express how they feel, then find healthy ways to work with these feelings. So, they learn when they feel happy, sad, angry, scared, and convey this to someone. Then learn how to negotiate requests if they need something.
Stopping the acting out usually means they then have to think how to get their needs met in healthy ways. Including sex and relationships. If they are already in relationship do they want to stay in it? Does their partner know about their acting out – sometimes a client contacts me at the behest of a their partner. We look at the steps clients can take towards being in a happy relationship. This may include being honest, learning to navigate a conflict and work as a team with someone, being comfortable with vulnerability and accepting the humanity of someone else as well as themselves.
When does sex addiction become a problem?
Sex addiction is itself a problem by its very nature. In terms of being dangerous, there may be risks connected to their behaviour. There could be increased risk of spreading STIs – possibly including their partner. Some people are addicted to illegal behaviours. This can include any sex offence, for example:
- The making or viewing of porn that shows rape, revenge, extreme sexual violence, animal or child abuse*
- Unconsensual voyeuring such as peeping Tomming
- Acts of indecent exposure including flashing and sexual activity in a public
- Frottage, sexual assault and rape
- Child abuse
*The legal age of consent for online sexual activity is 18.
Sex addiction and stigma
Understandably, there is an immense amount of shame and stigma around sex offending. It is worth noting that not everyone who has a sexual fantasy about illegal behaviour acts on it, and not everyone who watches illegal porn looks to act out in real life. There is a huge suicide risk amongst this population and many feel that there is no one who would be understanding enough to help them.
It is not my job to absolve someone of their actions. I help them explore what they have done and why. Many people who abuse have been abused in some way and there is often unresolved trauma to work through. While I understand the need for punishment as deterrent, I believe that rehabilitation for a lot of this population, could help stop further abuse in this generation and beyond.
Support and resources
If you need advice or support about sex addiction, try one of the following resources:
- Find recourses and therapists UK-wide: Association of the treatment of Sexual Compulsivity and Addiction.
- Support groups based on the 12 steps approaches: Sex Addicts Anonymous (SAA) and Sex And Love Addicts Anonymous (SLAA).
- Stopso: A charity helping to stop sex offending, with resources and a UK-wide therapist directory, visit StopSo.
- Lucy Faithful: Victims and sex offenders can call the Stop It Now helpline on 0808 1000 900 or visit Lucy Faithful, a charity devoted to stopping child abuse.
- Paula Hall: Sex Addiction therapist’s Paula Hall has written the seminal books Understanding & Treating Sex Addiction and Sex Addiction: The Partner’s Perspective.