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How Sexual Compulsion Can Complicate Your Life
Some Men Can't Help It
“No one comes in with
the problem of being sex addicted until they're caught, and the behavior often
continues.”
— Dr. Joseph DiGiacomo, University of Pennsylvania
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By Rose Pike
ABCNEWS.com
Jan. 28 — Ever since the Monica Lewinsky story broke, the National Council on Sexual
Addiction and Compulsivity in Atlanta has been inundated with calls from the media.
This titillating psychological problem hasn't had so much
limelight since Sam Malone, the charming roue played by Ted Danson on the NBC sitcom Cheers,
joined a sexual compulsives support group. And experts in the field are pleased with the
attention.
"I'm thrilled that this is being talked about," says
Stanford psychologist Dr. Alvin Cooper, who estimates that 7 to 10 percent of American men
have sexual compulsive traits. "It's a major epidemic, and it's not just flashers in
raincoats who get into trouble."
According to Cooper and others, the mantle of sexual
compulsiveness cloaks a wide variety of behaviors, from sexual harassment in the workplace
to the extremes of serial rape or pedophilia.
Over the Line
The most common type is compulsive masturbation, often aided by
pornographic magazines, videos or the latest craze—hard-core online sex sites. Next
is men who have affairs—"not necessarily someone who's unhappy in a marriage and
leaves their spouse," says Cooper, but rather men who have serial liaisons with many
women.
Whatever form it takes, sexual compulsiveness is not the same as
simply having a sex drive that's more powerful than usual. The key to understanding the
problem, which is just now being defined by mental health professionals, is its
unconscious aspects.
"One major hallmark is denial," says Cooper, and others
in the field agree. Men with this problem often have a distorted view of sexual reality
(for example, the harasser who argues that since his target was wearing sexy clothes she
really wanted his attentions), or they rationalize their behavior (oral sex doesn't
constitute cheating).
These men also spend a great deal of time thinking about sex or
doing it. Consequently, they spend less time with family and on other important
relationships, and they continue to act out sexually no matter what the consequences.
Paradoxically, sexual compulsives are always trying to stop their
behavior because, on some level, it makes them feel uncomfortable or guilty. "This is
the last time" becomes a kind of ineffective mantra.
Nature-Nurture
Nexis
What causes some men (and a few women) to become sexual compulsives? Genetics and
biochemistry may be factors. There's evidence, for example, that a gene affects the body's
production of dopamine, a neurotransmitter linked to pleasure and emotional well-being.
And sex itself produces an endorphin rush that some people may crave and go to
extraordinary lengths to seek out.
A history of childhood abuse is not uncommon, and many
compulsives had sexual experiences relatively early in life or precociously became aware
of parental sexual behavior. Also common among many sexual compulsives is a family pattern
of addiction to drugs or alcohol.
For rich or powerful men, the problem of sexual compulsiveness
can take on added dimensions, says Dr. Joseph DiGiacomo of the University of Pennsylvania
Medical School, an internist and psychoanalyst who has treated a number of high-status men
with sexual compulsions.
"The reason some people get to the top of a ladder is
because, according to Freud, they often have huge amounts of sex drive or
aggression," says DiGiacomo. Driven people might be more willing to take
risks—indeed, they find it particularly arousing—or they may not consciously
perceive promiscuous behavior as risky at all.
"For men in positions of power, there's some grandiosity
involved," adds Cooper. "Whether it's justified or not, they believe the rules
are different for them." They may also be narcissistic, he says, "but they're
really driven by some core inadequacy."
Secrets and Lies
Addressing that deep inadequacy is important. But most
therapists agree that getting a sexual compulsive onto the treatment couch is a daunting
task, even in the face of a court order.
"No one comes in with the problem of being sex addicted
until they're caught," says DiGiacomo, and other psychiatrists and psychologists
concur. Nonetheless, he adds, "The behavior often continues. They get caught
repeatedly"—by spouses, by employers, by the courts.
When this happens, denial kicks in with a vengeance. Many people
need intensive psychotherapy to hammer away at the denial, maybe couples counseling and an
ongoing 12-step program to maintain therapeutic gains. Some doctors prescribe one of the
newer antidepressants, such as Prozac or Paxil, which tend to reduce sex drive as a side
effect.
Oddly, says DiGiacomo, among the high-powered CEOs he has
treated, very few have been deserted by their spouses. "The person with the problem
is usually very charming," he says. "He treats you like you're the only person
in the world."
Women who stay don't necessarily tolerate relapses, however.
"One of the most effective things in treatment,"
DiGiacomo says, "is when the wife ups the ante." In one case, the wife of a
wealthy exec made her hubby sign an agreement that automatically gave her a larger
proportion of their assets every time he bedded a new woman. This helped put the brakes on
his overactive libido.
Although sexual compulsives are notoriously recalcitrant in
treatment, says DiGiacomo, many do learn to control their impulses.
"I had a dentist who was just voracious," he says.
"He went to a revivalist meeting and became born again and it ended—and that
happened in one evening." For most men, however, the only real cure is a hard-earned
renewal of self-control and a lifetime of vigilance.
| The Sex Addiction Debate | |
| Dr. Alvin Cooper of Stanford University is one of many experts who
pooh-pooh the idea of using the word addiction to describe pathologically unbounded sexual
impulses. "To say it's an addiction like cocaine is an addiction is simplistic and misses the mark," he says. "It's not one unitary thing, just like sex is not a unitary concept. It's a theme, a dynamic in a person's life." Some experts place sexual compulsiveness in the personality disorder category. But Dr. Joseph DiGiacomo of the University of Pennsylvania Medical School, an internist and psychoanalyst, favors the A word. "Addiction simply defines a maladjusted type of behavior," he says. "Everybody has a sex drive, but if you get into trouble with your wife, your family, your country |
because of your sex drive, we call that an addiction." Robert Weiss, a social worker on the board of the National Council on Sexual Addiction and Compulsivity agrees with DiGiacomo. Sexual compulsives, according to Weiss, "describe the very same symptoms" as other addicts on the make: hyperarousal, sweaty palms, racing heart, the risk and thrill of the chase. "And there's an endorphin release after all that tension," he adds, "so a sense of calm follows." Whether it's an addiction or not is a debate for the experts. The only certainty about it now is that many people will now know more about sexual compulsiveness than they ever dreamed they would. |
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