Sex Addiction is a Relational Disorder

I’m struck by the fact that people with addiction issues, when confronted with the destructive effects of their behaviors, often find it harder to stop. This is especially true, in my clinical experience, when it comes to compulsive sexual behavior, aka sex addiction. Why is that?

Therapy clients who struggle with drinking or substance abuse tend on the whole to accept – eventually, and with my ongoing support – that they do have a problem with drinking or using, and that these behaviors are an obstacle to happier living. Once “the cat is out of the bag”, they usually attempt to reduce or quit using, over time, or else quit therapy altogether.

Those struggling with compulsive sexual behaviors, however, may remain ambivalent for years, while remaining in therapy –  aware of their dependence on these behaviors and the destructive effects of same, while wrestling with whether or not they want to stop. It’s a matter of two steps forward, two steps back, over and over again, with no change in sight.

Additionally, it is often reported to me that there appear to be more people in Alcoholics Anonymous with long-term sobriety compared to those in Sex Addicts Anonymous or Sex and Love Addicts Anonymous or other 12-step programs for healthier sexuality. Those with long-term sexual sobriety – or “abstinence” – tend to be fewer in number. Again – how come?

I know there is a lot of controversy in the mental health field about whether sexual compulsivity is truly an “addiction.” It is not my intent here to address that complex question. Suffice it to say that the suffering of those who can’t stop, in the face of heartbreaking damage and loss, is staggering to behold. If one of the key criteria for an addiction is an inability to stop in spite of negative consequences, then compulsive sexual behavior more than qualifies as an addiction.

So, if one assumes we are in fact dealing with two actual addictions, we are still left with the aforementioned disparity between drug/alcohol vs. sexual sobriety. Is it because one can live without drugs or alcohol, but cannot “remove” sexuality from one’s being? We are, organically speaking, sexual creatures, and the goal of treating sexual addiction is not to remove one’s sexuality but to create healthier, more intimate and less self-destructive behaviors.

I suspect that, because we are dealing with sex after all, the issue goes even deeper. Sexual desires and fantasies often emanate from the very core and are difficult to interpret. Heterosexual men with compulsive sexual issues, for instance, may desire sex with other men while staying married to a woman; some pursue sex with transvestite prostitutes, in ways that put themselves at legal and medical risk. I know of high-functioning women who are compelled to conduct serial affairs, virtual or real, with men whose only apparent goal is to sexually “use” them in sadistic or degrading ways. These are people who have little to gain, it would seem, and everything to lose.

Another complication is that sexuality is a relational activity. It always implies another person, either real or fantasized. One can use heroin or drink alone, as many do. But it always “takes two to tango”, even if one of those people is a fantasy or “virtual” person. Even when one uses online pornography, for instance, another person is “present”, at least onscreen.

Close readings of sexual fantasies and compulsive behaviors can be revealing of one’s buried self-concepts and unexpressed needs; an S&M fantasy may represent a way of coping with an overbearing or shame-inducing caregiver, by sexualizing the pain and staying in control of the fantasy/scenario (even if one is the “M”). Those struggling with scenarios of dominance over others may be trying to compensate for intolerably low self-worth, an attempt to control chaotic emotions leftover from a traumatic upbringing.

My experience with straight men who compulsively watch porn often reveals a desire for a woman who can offer everything but demand nothing, and disappear when the encounter is over, before she decides he’s “too much” for her, or “gross,” or perverted, etc.  It’s a sort of mini-relationship, easily controlled by someone who usually has a desire for and deep fear of intimacy, who gets his needs met quickly and then signs off.

It’s almost as if these fantasies provide a window into the psyche, revealing unmet needs.   Like the need to feel in control, to express repressed desires, to sexualize (i.e. numb or self-medicate) hurtful or shameful feelings or other emotions that are unconscious or too difficult to articulate.

These are feelings and needs that cannot be expressed in their actual relationships – usually because they are perceived as “disgusting” or “too much” for their partner.  Of course, their partner very often has her own “stuff” and tends to be closed off, angry, controlling, etc.  It’s an extremely painful dynamic that I see with many of my male clients – straight and gay – who struggle with sexual compulsivity.

Why would a man, or anyone really, seek an “emotionally unavailable” partner? Because we tend to gravitate toward the familiar, even if what is familiar is dissatisfying or even abusive.

Very often the person chooses an emotionally closed off, or overly aggressive (or withdrawn) partner because, in reality, the alternative is too scary. It may sound strange, but what’s even scarier than not finding love – especially in cases of a traumatized upbringing, which includes just about everyone I work with – is actually finding it! Why is that? Because love can be lost or taken away, leaving the person abandoned and traumatized (again) – even more painful than being mistreated or ignored. In the latter case, at least you know someone is there.

Thus the person suffering from core interpersonal trauma – the result of a faulty caregiver, another human being – who ends up sexualizing their needs via the behaviors described above, hovers between a desperate yearning for and deep aversion to intimate connection. The sort of “mini-relationship” described above is often a substitute. It satisfies…for a while. One connects, finds relief via sex and affection (what’s actually virtual feels real at the moment) – then detaches before becoming too invested or emotionally “at risk” for abandonment.

That emotional risk, believe it or not, is usually more frightening than the prospect of the legal or health risks that accompany these behaviors. Abuse and emotional distance is familiar, even if painful, while the possibility of genuine love is new and terrifying.

Thus the compulsive behaviors are a temporary solution to the very real and shameful problem of a confusing inability to connect with others.  I say “shameful” because very often the feeling is something like, “I’m an idiot because I don’t know how to stop.  Why do I do such disgusting things.  What a piece of garbage I truly am.”  (Even if the person is outwardly successful, wealthy, etc.  As they say in recovery, it’s always an inside job.)

One of my clients once said in my office, with a smile on his face, “I have no love in my life.  I’d only ruin it if I did”.  This was a successful, married attorney with a compulsion to see prostitutes.

It took me a few moments to realize the smile was an awkward attempt to conceal shame, not any sort of bemusement. That smile was one of the saddest things I’ve ever seen.

What I want to stress here is the pain that needs soothing is, in part, not the result of an unrequited hunger for love, nor a fear of finding it, but rather an impossible non-reconciliation between the two.

Here are two opposing, powerful forces at work, with radically different agendas – one to connect, the other to protect.  Without help, this internal conflict results in unmanageable emotional turmoil and frustration. The cycle never ends, until the person says “enough,” and seeks help.

I’ll talk next time about how therapy can, when effective, provide a slow but steady path towards healthier intimacy and a chance to escape the suffocating shame and loneliness that so many of my clients describe as a slow-moving poison — leading them to behaviors they so desperately want to stop, but can’t.

Related Articles:
Super-sizing Sex
The Good and Bad Sides of Porn
Three Ways to Avoid Sex Addiction Relapse

© Copyright 2011 by By Darren Haber, PsyD, MFT, therapist in Los Angeles, California. All Rights Reserved. Permission to publish granted to GoodTherapy.org.

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

  • 16 comments
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  • Marie

    Marie

    November 21st, 2011 at 2:06 PM

    My ex-boyfriend suffers from that, how Can I help him??

  • Connor

    Connor

    November 21st, 2011 at 4:35 PM

    There is so much shame associated with this type of addiction that you do not find with those who abuse alcohol and drugs. People do not want to deal with it because most of us think that if they wanted to stop then they would. But for many of them it is just as hard to stop the complicated sexual behaviors as it is to stop drinking or using drugs for those addicts. The disease is the same, it is just the method of acting it out is a different realm.

  • Darren Haber

    Darren Haber

    November 21st, 2011 at 4:39 PM

    Hi Marie, thanks for writing. I think the more you yourself get the facts about addiction, and how it affects friends/partners of those with addiction, the better. There’s a program called COSA and their website is cosa-recovery.org. If you can’t get to an actual meeting they have telemeetings (i.e., via phone). Talk to other partners or ex-partners of those with compulsive sexual issues and see if you can relate to anything they have to say. You could also attend AlAnon meetings and make the mental substitution of “sex addiction” whenever you hear “alcohol” mentioned. Thanks again for posting. Best of luck to you, Darren. p.s. I also recommend two books: CONTRARY TO LOVE by P. Carnes and MENDING A SHATTERED HEART by S. Carnes (P.’s wife!)

  • Darren Haber

    Darren Haber

    November 21st, 2011 at 10:47 PM

    And to Connor — well said!

  • Marie

    Marie

    November 22nd, 2011 at 1:31 AM

    Thank you, I’ll try that. At first I was disgusted when i found out he was cheating on me with so many women. He broke my heart & our “dream” with all those lies so I left him. He was so devastated he begged me to stay & not abandon him, even threaten suicide… But I was so hurt, I just left & thought he was only playing the victim with all the drama. Since then he locked himself in a vicious circle, accumulating the sexual partners, doesn’t believe in love no more, doesn’t show love, he said that He has no heart & doesn’t love anyone. From an external point of view he is a very succesful young man, has everything to be happy, and He does everything to show to the that he’s more than happy. But I know he’s not He suffers a lot, sometimes he tells me that He still loves me, we even tried to go back together, but He can’t do it, the devils come back again & He goes back to his self-destruction routine…
    I care for him & still want him, but i guess I’ll only suffer again & again ( it has been 2 years). But at least I wanna help him, nobody knows what he’s going through except me, they all thing He is perfectly happy, but He is the more lonely & miserable young man I know

  • katy

    katy

    November 22nd, 2011 at 8:38 AM

    a lot of people suffer from sex addiction if you ask me.its just that the problem is not as well known and as well understood as other addictions because sex is seen as something very natural for humans and anybody wanting more and more of it is just seen as normal or at the most a little more of a sex-enthusiast if you can call them that.

    so how can this problem be overcome?

  • Sheila

    Sheila

    November 22nd, 2011 at 5:06 PM

    I often wondered who these women were who stayed with men like this, men who chose to watch porn over having a real relationship with a woman. And then that very thing happened to me. I was mortified to think that I was not enough to satisfy him, although he insisted that that was not what it was about. But what was I supposed to think? I mean, I thoght that he did not want to have sex because he was tired or whatever, but come to find out he was online all night on some crazy websites that I am even too grossed out to think about. And who can I talk to and tell? What will everyone then think about me? Oh, he has the problem but I must be doing something wrong to cause him to act out in that way.

  • Darren Haber

    Darren Haber

    November 22nd, 2011 at 5:14 PM

    Dear Katy, thanks for writing — and, you’re jumping ahead to my next article! In short, the problem can be overcome by a diligent, ongoing program involving some combination of a support group (be it religious or 12-step or some kind of support group with other people who have the same problem, and good counseling. I really like what you said in your post and agree. It’s important to find a counselor or therapist with experience in compulsive sexual behaviors, because it’s possible to treat but requires specific clinical skills.

    As for Marie, it sounds devastating and very traumatic for your ex-boyfriend AND for you too. It’s horrible to see someone we love suffer so deeply. I think it would be good to find some outlets so you can share some of your frustration, sadness, etc., and get help protecting yourself from the insanity of his addiction. By practicing good self-care you set a good example for him, too; people with untreated addiction can really hurt others, usually unintentionally, so it would be good for you to find support for yourself so you can detach from him so you don’t keep suffering ‘again and again’. Sometimes those who leave an addict feel guilt or anger or all of the above. Unfortunately there is really nothing you can do unless he decides to get help for himself. I really hope he does. Thanks again for writing. Take care, Darren.

  • Darren Haber

    Darren Haber

    November 22nd, 2011 at 7:21 PM

    Hi Sheila, you describe being the partner of a person with sex addiction quite well. It really isn’t about you but it ends up hurting you just as much. This is the tragedy of addiction, especially one that involves something so intimate as sex. You might want to check out cosa.org and/or the two books I recommended above: CONTRARY TO LOVE by P. Carnes and MENDING A SHATTERED HEART by S. Carnes (P.’s wife). Thank you for posting.

  • Darren Haber

    Darren Haber

    November 22nd, 2011 at 7:22 PM

    p.s. What I mean in part by “not about you” is that he would have been behaving the exact same way whoever he was with. Small consolation, I’m sure.

  • GL

    GL

    November 23rd, 2011 at 8:08 AM

    I think we all have Tiger Woods to thank for all this. Before his episode, not many people knew about sex addiction and some were even blind to the fact that there could be something like sex addiction!

    As much as a positive effect the episode had in terms of awareness,it still shows our fixation to celebrities’ lives..

  • Angel

    Angel

    November 26th, 2011 at 2:29 PM

    I know that there are some things that can’t be helped, but I’m sorry, I don’t think this about a “sex addiction” at all. Why don’t you think this is just about having a little willpower or self control?

  • Meredith

    Meredith

    November 27th, 2011 at 10:45 AM

    This is such a sad life that these addicts must live, and yes I am one of those who does feel strongly that this is an addiction. If it was not an addiction, who would ever choose to live out something like this. They know that it could ruin and destroy relationships, yet they, just like drinkers or any other addict, continue to do it. Why? because it is behavior that is beyond their control. I know that they did not have to start acting out like this, but the point is that now they have so they have to be able to establish a support system to be able to get through it and move beyond that negative place in their life. And with sex addiction, that has to be pretty hard because of the shame involved and the fact that so many of them probably only start out doing this because they do not feel like they have anyone who loves them to begin with.

  • Darren Haber

    Darren Haber

    November 27th, 2011 at 11:13 AM

    Hi Angel, I can understand your question. It’s hard for me to understand sometimes, and I work with addicted people all day along. In a nutshell, the “mainstream” definition of an addiction is (to paraphrase the DSM-IV, the diagnostic “bible” of the mental health profession): 1. Rising tolerance of one’s drug (or behavior); 2. Negative symptoms if one stops (anxiety, irritability, etc); 3. Difficulty controlling the substance (or behavior); 4. Negative consequences (which do not curb the addiction). There are others, including an inability to stop or control the addiction. All of the people (men and women) that I treat or have treated in my practice meet this criteria — easily — when it comes to compulsive sexuality. Again, it’s a strange and even baffling concept, that one has lost control of a behavior (such as sex, gambling, eating, etc) — but then again, to quote the AA “Big Book”, addiction is “cunning, baffling, and powerful”. Hope this helps. Thanks for writing.

  • Darren Haber

    Darren Haber

    November 28th, 2011 at 7:53 PM

    Hi Meredith: wow, beautifully said. I quite literally could not have said it better myself. I would just say that, even if they did not choose this particular acting-out behavior, they might have turned to some other “outlet” for all those unresolved intense feelings (such as smoking, drinking, gambling, etc). Also, a lot of people with this addiction have had a history of incest in their past, either physical (sexual abuse) and/or emotional (where a parent makes them a “surrogate spouse” and has inappropriate boundaries). Thus their trauma is a big part of what drives this compulsivity. Anyway, thank you for writing!

  • gail

    gail

    September 13th, 2012 at 1:39 AM

    I found out though my partners “disclosure” after he went to anger management course.That was almost three years ago. He is also a recovering alcoholic 26yrs now. I felt shattered and after being together almost 25yrs now, i am still in shock. He finally decided to get help after a slip recently. I am dealing with my mum dying of cancer and my dad has dementia as well. We are just living together no real contact i feel cheated for all the years of lies and deception.Tried Alanon no help there so im alone. Sometimes i hate him and sometimes i pity him. Love has long gone yet i did love him once.He wont tell me how far things got but i am sure he had at least one affair.

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