Giving Hope to Sufferers of Sexual Addiction

The pain in the man’s voice is controlled, but it takes on a sharper edge when he begins to talk about his wrecked marriage, his secret behavior, his lack of control. Bob is an engineer who lives in Orange County. His tone lowers when he talks about the helplessness, the loneliness, the fear and guilt.

One word, though, seems to recur in his conversation and appears to rankle more than any other. Shame.

“I couldn’t believe it applied to me: sexual addict. Talk about offensive terms. It was like I was a baby killer. I thought of guys wandering around in parks in trench coats. I told myself I was never going to put that millstone around my neck. Yeah, there’s an enormous amount of shame.”

The words--sexual addiction--are charged with dark implications, misunderstanding and age-old taboos. They seem to suggest--and many people believe--that the person afflicted is a kind of subhuman, a predator, a freak possessed by uncontrollable lust, a villain out of a psychological horror story.

Many people, say psychologists and researchers, can’t believe such a condition exists at all and think the term was invented simply to describe those with more active libidos.

“Some people’s first reaction is to think it sounds funny,” said Carl, an Orange County bank executive who admits he has suffered from sexual addiction for “a number of years.”

“ ‘Sexual addict?’ they say. ‘Hey, how can I be one?’ But it’s no joke. It’s real. The guilt can be overwhelming. And you don’t feel that you can talk to anyone about it, because you’ll be suddenly exposed. You can’t talk about it the same way you can talk about compulsive gambling or drinking.

“I used sex just like alcohol sometimes. If I had a bad day, I’d use it to make myself feel better. I’d use other people the way an alcoholic uses a drink.”

True sexual addiction, for all its seeming implausibility, is real, say sex therapists and psychologists. The term has been in use for perhaps 10 years. But, said Tyrone Westlie, senior chief manager of the sexual dependency unit of the Golden Valley Health Center in Minneapolis, the term did not become widely known until psychologist Patrick Carnes established an outpatient treatment center for the disorder in 1978 at Fairview Hospital in suburban Minneapolis.

In the last decade, support groups for sexually dependent people have sprung up throughout the country. The three best-known of those groups--Sexual Addicts Anonymous (SAA), Sexaholics Anonymous (SA) and Sex and Love Addicts Anonymous (SLAA)--use as their model the Alcoholics Anonymous “12-Step” program.

Sexual addiction also is finding wider recognition in the established psychiatric community, said a UC Irvine psychiatrist.

‘The New Frontier’

“It’s the new frontier in sex therapy,” said Dr. Paul Blair, a clinical professor of psychiatry and director of emergency psychiatry at UC Irvine Medical Center in Orange. “It’s a relatively newly recognized phenomenon, but I would guess it’s been around for quite a while.”

And Blair said he agrees with therapists who estimate that the number of sexual addicts in the American population probably is at least as high as the number of alcoholics--around 10%.

A spokesman for Sexual Addicts Anonymous in Minneapolis estimated that sexual addiction is almost equally divided between men and women. The norm is to have single-sex groups, but occasionally, the spokesman said, you’ll find mixed groups.

While sexual addiction is not listed under that name in the diagnostic manual of the American Psychiatric Assn., a spokesman for the association said a body of professional papers on the subject has been published. The Kinsey Institute for Research in Sex, Gender and Reproduction at the University of Indiana, on the other hand, recognizes sexually compulsive behavior. The institute defines it as “hypersexuality--excessive, uncontrollable or compulsive sexual desire.”

“It’s a strange term, and it really means nothing until you know the ‘why’ behind it,” said Ruth Weg, a professor of gerontology at USC who teaches several classes in human sexuality. “And that ‘why’ will vary with each individual. It’s usually much more deep-seated than a simple need for sexual expression of one kind or another. It isn’t an addiction in the same way people can be addicted to drugs. It’s a symptom of something else underneath. It can relate to one’s self-esteem, to alienation or loneliness, and that’s what you have to treat. We can’t separate our sexuality from the rest of our being. And there is no single formula. We all bring different emotional baggage with us.”

Various Behaviors

Sexual addiction can take several forms, said Carnes. It can manifest itself in a man like Bob, who compulsively cheated on his wife by picking up prostitutes, going to massage parlors and initiating affairs whenever he found the opportunity. Left untreated, the behavior can escalate and appear in the form of an exhibitionist or voyeur. Addictive behavior among women often resolves itself into blind pursuit of affirmation, affection or love, using sex--mistakenly--as a means to that end.

On any level, however, sexual addiction can be recognized by a number of telltale signs: The addict’s relationship with sex becomes the central part of his or her life, taking precedence over family, friends and job. Addicts ritualistically act out routines leading up to the sexual behavior, find themselves unable to control the behavior and feel hopeless, desperate and powerless afterward. Further, sex addicts believe they are inherently unlovable. And, imprisoned within a cocoon of guilt and shame, they feel an overpowering sense of isolation.

These signs are described by Carnes in his book, “Out of the Shadows,” which has been called “a bible on the subject” of sexual addiction by those who help treat the affliction and those who suffer from it. Local therapists say his work has provided a foundation for their own treatment and understanding of sexual addiction.

Lewis Baxter, an assistant professor of psychiatry and associate director of clinical psychopharmacology at UCLA, compared it to cocaine addiction.

“These people are anxious to turn as quickly as possible to some sort of mood-elevating experience,” he said, “and after they experience their particular euphoria, they start coming down from it. Then they blame themselves for getting into that type of difficulty.”

Different Motivations

It is an affliction, said David Lynn-Hill, a sex therapist who teaches at Saddleback College in Mission Viejo, that presents the analyst with an intricate web of behavior, usually involving different motivations for men and women.

Lynn-Hill, who has served on the Orange County Health Planning Commission’s special task force reporting on “special needs of sexual minorities,” said the male sexual addict’s behavior mostly is one of conquest, while the female’s generally is one of submission.

“And there’s a lot of validation for men in having a series of conquests--the thrill of the hunt, risk-taking. Men are actually sanctioned indirectly by society for this. They’re conquistadores ; they’re supposed to take.

“For women, on the other hand, it’s often being in a relationship, being in love,” said Lynn-Hill. “Most women have been trained from a very early age to be nurturers, and everything is set up for them to fulfill that role. Many (female sexual addicts) have been abused as children, and it may make them feel horrible that they weren’t loved in an acceptable way. Still, that’s the one way they got approval, through their bodies. They have been taught that this is the way to get validation, so they end up picking men with whom they slit their emotional throats. They pick men who are never going to be acceptable.”

Some call such behavior “love addiction,” although, said an Orange therapist who has treated cases of sexual dependency, it is simply another manifestation of sexually addictive behavior.

“You can have (addiction) without sex involved at all,” said Phil Allen, a marriage, family and child counselor who practices in Orange. “That type of person will cling onto people and look for the answer to all their problems in another person . . .

“They’re looking for the knight in shining armor who’ll fix everything, but what they have to learn first is to love themselves, to work on their self-esteem.”

She is a schoolteacher, and she asks that her real name not be used, but her background, Amy says, is painfully real.

She was sexually molested by her alcoholic father as a child. She has been married twice, both times to alcoholic men. Her first husband abused her “verbally, sexually and physically,” and her second inflicted on her “a lot of passive-aggressive behavior.” Her numerous relationships have been based almost entirely on sex as a means to get love, appreciation and attention from men. She has a type of sexual addiction, but her case is different because she feeds off the behavior of other addictive personalities.

Amy is what therapists call a “co-addict” or “co-dependent”--”a loved one or friend who becomes so involved in the life of the addict that he or she truly starts to participate in the same impaired mental processes of the addict,” according to Carnes.

“I wasn’t aware of how I was feeling,” she said, “I just went ahead and did things, sexually and otherwise, that I didn’t want to do, that were out of my value system, that were objectionable to me. I never got any sense of fulfillment. I just came out feeling more empty and bewildered. I was fearful that if they became angry with me they might harm or even kill me. I didn’t know I could say ‘no’ to men.”

Sexual addiction as a compulsive behavior, therapists say, bears a striking resemblance to other compulsions such as gambling or overeating or alcoholism. But while the drinker, gambler or obese person can get help through extensive networks of support organizations and--at least in the last decade or so--a society full of sympathetic ears, the sexual addict continues to live in a shadow world.

“Alcoholics Anonymous has almost become chic,” said Bob, whose marriage ended in divorce last year because of his compulsive extramarital affairs. “Few people are completely comfortable with their sex lives. We’re talking the big issue. Still, most people don’t believe that people could use sex to escape from their feelings.”

Sexual Addicts Anonymous is a Minneapolis-based organization with chapters across the nation, including one recently started in Orange County and another in Torrance. Groups meet, usually weekly, to discuss problems, praise successes and offer mutual support. (Sexaholics Anonymous also has a group that meets regularly in Orange County, as well as others that meet in Los Angeles County, but its members were not willing to talk, according to a spokesperson at the national headquarters in Simi Valley. Sex and Love Addicts Anonymous is based in Boston, with chapters primarily on the East Coast.)

Lynn-Hill said the meetings of Sex Addicts Anonymous are routinely conducted with secrecy, and new members usually are admitted through referrals from their therapists or from other dependent support groups such as Alcoholics Anonymous.

“Nobody is ready to open up a Betty Ford center for sexual compulsiveness yet,” he said.

While the primary method of help for sexual addicts is individual therapy, said Bob, therapy within a group helps dispel the greatest enemies of the addict: secrecy and isolation.

When Bob obtained a copy of Carnes’ book, he found that “it read like a biography. It gave me a great sense of comfort, because this is one of the loneliest of difficulties to suffer.”

He didn’t believe it until he befriended Carl, a banker and the husband of a woman he knew who was attending group meetings to overcome an eating disorder. The meetings were being held at New Pathways, a Fountain Valley clinic that treats compulsive disorders, dependent behavior and addictions. With the help of New Pathways, which agreed to provide a meeting place, the two men began an Orange County chapter of Sexual Addicts Anonymous about nine months ago.

Since then, said Bob, membership in the group has fluctuated from a low of two to a high of around 10, and a similar group for co-dependent sexual addicts, called COSA, also has been formed.

A third means of treatment, said UCLA’s Baxter, may involve medication therapy.

“When you’re talking about alcohol and drug abuse,” he said, “there’s evidence that the person doesn’t necessarily have an addictive personality but is suffering from an underlying mood disorder. Any medication used would depend on what the problem is, say if a person were diagnosed as being manic depressive or as having certain kinds of anxiety disorders.”

The same treatment could apply to sexually dependent people, he said, but emphasized that medication is not used “when there is not some underlying diagnosable psychiatric disorder.”