The truth about sex addiction

• By Clair Weaver
• From: The Sunday Telegraph
• June 06, 2010 12:12AM

THERE used to be no excuse when a man was caught with his pants down. Cheating was simply a betrayal of the most intimate kind.

IS sexual compulsive disorder a real addiction or is it just an excuse for bad behaviour?

These days, however, things have changed. Men who are exposed for having flings or multiple sexual partners are no longer disgraced predators or playboys. Instead, they’re victims of a new condition, “sexual compulsive disorder” – or sex addiction.

Golf legend Tiger Woods is one of the latest big names to seek treatment for the disorder after a string of scandalous affairs made international headlines. And Hollywood actress Sandra Bullock’s estranged husband Jesse James is reportedly seeking therapy at the same US rehab clinic after his extramarital relationships became public.

A genuine problem?

They join the likes of fellow celebrity addicts Michael Douglas, Bill Clinton, Jack Nicholson, Robbie Williams and Russell Brand.

So is sex addiction a real medical condition? Or is it just an excuse for devious behaviour?

According to Dr Gaetano Vaccaro, a US expert who presented a seminar on sexual compulsive disorder in Sydney recently, it is a genuine addiction that can destroy lives.

“There’s a feeling of being unable to resist urges, that it’s an uncontrollable impulse to go and seek out sexual partners,” he says. “They don’t have presence of mind.”

He says there are key differences between serial adultery and sexual compulsive disorder. “Simply having a large amount of sexual partners doesn’t make you a sex addict,” he says.

“What pushes it into the realm of sexual disorder is the level of control the person has over what they are doing, whether it’s an overwhelming compulsion to do it.”

A true addict will continue self-destructive behaviour, such as using prostitutes or watching pornography at work, even after they are caught and facing serious consequences such as divorce, he says. Therapists also consider how consistent a patient’s sexual behaviour is with their society’s moral standards. But there is some cynicism within the medical field.

Underlying issues

As a diagnosis, it may appear convenient for a philanderer looking to shift some blame. And sex addiction isn’t recognised in the psychiatric “bible”, The Diagnostic And Statistical Manual Of Mental Disorders (DSM) – although it may be considered for inclusion in the next edition.

Dr Choong-Siew Yong, psychiatry spokesperson for the Australian Medical Association, says sex addiction may be a behavioural symptom rather than a disorder in itself.

“To say it’s a disorder really cheapens it because there may be reasons for that behaviour,” he says. “The scientific evidence that it’s a disorder on its own is very limited.”

But that’s not to say he doesn’t take it seriously. “Where we do see (that) people have an increase in sexual behaviours is (when it is) part of bipolar disorder,” he says. “Someone who is manic can become much more sexually active, have lots more partners than they usually do and it can be out of character.”

Hyper-sexual behaviour may also be a symptom of an underlying emotional or personality disorder, he says.

But Dr Vaccaro, director of program development at both the Moonview Sanctuary treatment centre in California and internet-based 12 Visions International, believes sex addiction can be classified alongside alcoholism, compulsive gambling, eating disorders and drug addiction.

“It has a lot of neurological and physiological connections to addiction,” he says. “Addicts have no impulse control and muddle through relationships and attachments. There’s a huge trauma component to it too.”

Most experts agree that trauma – including sexual, psychological or physical abuse and emotional neglect – can be a strong risk factor for compulsively promiscuous behaviour later in life.

“A lot of the time, sexual activity can involve repetition compulsions – that’s a repeat scenario of something that’s happened earlier in their lives,” Dr Vaccaro says.

There is believed to be a genetic component too, with some people more susceptible to slipping into addiction than others. “It’s kind of a perfect storm – a combination of everything that comes together to create these behaviour patterns,” Dr Vaccaro says.

Multiple disorders

The sexualisation of 21st-century life, such as easy 24-hour access to an endless supply of online porn and increasingly explicit imagery in mainstream media, may be feeding the problem. But experts stress this is a trigger rather than a cause.

It’s also common for addictive personalities to have more than one disorder. Male sex addicts are more likely to abuse disinhibiting drugs such as cocaine and methamphetamine, while women are predisposed to anxiety, eating disorders and depression.

Men are statistically far more likely to be diagnosed as sex addicts, accounting for 75 to 80 per cent of those who seek help. Many have double lives: a family at home and a variety of sexual partners they visit separately. But it is a problem that also affects women, albeit in different ways.

“Usually women who have sexual compulsivity have serial relationships one after another,” Dr Vaccaro says.

“They can have really abusive relationships. They don’t feel involvement – they feel like they have to do it. It’s the dissociated quality that exists for women.”

Sexual anorexia, a condition coined by US psychologist and author Dr Patrick Carnes, is an obsessive state in which avoiding sex dominates a sufferer’s life. More common in women, it is regarded as a coping mechanism to avoid getting hurt and shares characteristics with food anorexia.

“In both cases, the sufferers starve themselves in the midst of plenty,” Dr Carnes says. “Both types of anorexia feature the essential loss of self, the same distortions of thought, and the agonising struggle for control over the self and others. Both share the same extreme self-hatred and sense of profound alienation.”

Getting help

So what happens if you think you have a sexual compulsive disorder? Admitting it’s a problem and seeking help is the first step, says Dr Vaccaro, who believes subsidised treatment should be available under Medicare.

But not everyone can be whisked off to rehab for intensive therapy like Tiger Woods.

Dr Yong recommends a more conservative approach, as he warns: “There is no proven treatment.”

“In the first instance, a person should see a counsellor or a GP and seek advice about why this is a problem for them,” he says. “The GP may recommend a psychiatrist or psychologist. Sometimes people’s sexual behaviour isn’t about sex – it’s about fears. It’s pretty complex.”

Yet the debate over whether sex addiction truly exists looks set to continue. But for the real victims – like Woods’s estranged wife Elin Nordegren, who allegedly chased her husband with a golf club and smashed his car windows when she discovered his “transgressions” – it may be harder to believe. Or forgive.

Where to seek help: Sexaholics Anonymous Australia (meetings in all capital cities), www.saoz.net; Sex and Love Addicts Anonymous, www.slaa.org.au

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