Sex Addiction: The Painful Side of Pleasure

Sex Addiction: The Painful Side of Pleasure  

Valerie Lorig


Statistics reveal that an addicted person may experience 99% negative consequences with only 1% pleasure from an addictive high and the addict will still opt for the 1% high. (Mora DeRosby, personal communication). Understanding the way an addict thinks is baffling to the ordinary rational mind. When a person is engaged in addictive behavior, they are no longer in control of their own decision-making processes; in fact, they have a new boss who has “power of attorney” over their life. Whether the addiction is a tangible substance such as alcohol and drugs or a process addiction such as sex, shopping, eating, or gambling, addiction rules the addict’s life with an extremely high price tag.

Sex and love addictions are becoming more prominent as an area of concern in the counseling field. Sex addiction has recently become a viable dis-ease, gaining notoriety in the public eye via scandals involving celebrities and politicians such as Tiger Woods and Eliot Spitzer. Co-dependent behaviors and traumatic responses that accompany those who are close to the addict also are more prevalent.

Patrick Carnes, Ph.D., an expert in the field and author of numerous books on the topic including Out of the Shadows: Understanding Sexual Addiction, said so much shame existed about the illness in the 1980’s that the original title of his book, The Sexual Addiction, was renamed because readers found it difficult to purchase a publication with the words sexual addiction on the cover. (2001, ix). In 1976, a suburban hospital asked Carnes to start a program for chemically dependent families. All family members above the age of six were asked to participate in a general systems theory approach along with a twelve step intervention over 330 hours. One of the factors that stood out to Carnes was that addictive compulsivity had many forms beside chemical dependency but they all shared a similar process. To make matters more complicated, the reactions of family members to multi-addiction patterns [such as alcohol] were as unhealthy as the coping mechanisms of the addicts themselves. (2001, xviii)


What is Sexual Addiction?

Parallel to a pathological relationship with a chemical addiction, sexual addicts substitute a sick relationship for a healthy relationship. The relationship could be to porn, to strangers, or to extramarital affairs. It involves some form of secrecy, deception, and the inability to stop. The addiction may serve as an antidote to a lack of self-esteem or low self worth. It may stem from a sense of entitlement. The sexual addict craves a spectrum of perks, from a sexual high to flattery to adoration or for what the addict might call love. Levels of sexual addiction manifest from continuous or sporadic affairs, obsession with pornography, or sexual offenders. Addict’s actions are based on craving to feel better through the object of desire. The addict’s relationship with the mood altering experience becomes central to his/her life. Family, friends or other things the addict cares about are jeopardized, and their vows to quit are lost against the power of the addiction. Often the only thing that exceeds the pain is loneliness. (Carnes, 2001). However, “often times the addicted person “has shut off their entire feeling system to avoid certain unpleasant feelings.” (Twerski, 1997, p. 98). This creates the circular Addictive System as prescribed by Carnes:

1. Belief System (ie: Low self esteem or confidence, unpleasant or no feelings);

2. Impaired Thinking; (ie: I need something to make these feelings go away,       have good feelings or to feel at all)

3. Addiction Cycle; which includes Preoccupation, Ritualization,

Sexual Compulsivity and Despair

4. Unmanageability. (2001, p. 26)

Sexual addicts go through stages in which they retreat further from the reality of friends and family. Their secret lives become more real than their public lives and what other people know is a false identity. Only the individual knows the shame of a double life – the real world and the addict’s world. An essential part of sanity is being grounded in reality, so in the sense that addicts distort reality, the sexual addiction becomes a form of insanity. (Carnes, 2002, p. 14-15)  The sexual experience becomes the reason for being – it is the primary relationship for the addict. It is the focus of energy, source of nurturing, and origin of excitement. It is the remedy for pain and anxiety, the reward for success, and the means for maintaining emotional balance. Those who care about the addict instead witness unmanageability, personal losses and abandoned values. (Carnes 26-27).


Risk-Taking and Addictive Behaviors  

             The sexual addict also may take bigger and better risks in order to attain the same high they attained from lesser chances taken in the past. This is similar to the concept of tolerance with chemical addictions. Thus having a clandestine affair might be flaunted in front of the families eyes, disguised as a close family friend or one might publicly scorn the very activities they are secretly involved in. TIME Magazine studied the science of risk-taking in an article about Elliot Spitzer, the New York golden boy governor, who while gleaning public approval for prosecuting prostitution rings was caught paying large sums of money for expensive call girls. According to TIME  “Spitzer had a long history of recklessness, a sense that boundaries of authority didn’t apply to him.” (March, 2008).

In the 1990’s Israeli researchers identified what they thought of as a risk gene or a bit of behavioral coding, that changes the reapsorption of the neurotransmitter dopamine, making it easier for some people to respond to stress or anxiety. The higher one’s threshold for those feelings, the higher one’s tolerance for the risk. Another study from the University of Delaware, suggested that another neurotransmitter, serotonin, helps inhibit impulsive behavior and could be in short supply of people who take chances. Marv Zuckerman, psychologist and professor emeritus at the university of Delaware, says: “risk-taking can mean seeking sensory experience through food, travel or the more primitive thrills of sex – as may be the case with Spitzer.”  “Humans habituate to thrills, which means needing more and more to get the same buzz. You want to re-create the high so you up the ante,” says neuro-pharmacologist Candace Pert.” (Cloud, 2008, pgs. 26-27)


Co-Dependent Behaviors  – Partners and Families of Addicts

Many loved ones of addicts unwittingly exhibit co-dependent behaviors in an attempt to fix the addict. Saving the addict becomes a focal point of the co-addict’s life and this painful behavior is an addiction unto itself. Melody Beattie, author of Codependent No More, identifies co-dependents as the caretakers. They rescue, persecute, and then end up victimized, as is exemplified on the Karpman Drama Triangle. (1987, p.83) Enabling or rescuing is a destructive form of helping and rarely, if ever, yields productive results. Co-dependents are hooked on getting their sense of self-worth by taking care of other people’s needs, without taking care of themselves. It is a vicarious trap. However self-reliant co-dependents usually do not ask for what they want or even know that have their own needs. The unconscious enabler seeks love in exchange for their martyrdom and they mistakenly feel that taking care of others is synonymous for taking care of themselves. In a relationship where addiction is involved, depletion of the co-dependent is sure to follow because it is frightening to relinquish one’s sense of identity as the caring, selfless, all-good savior. Co-dependents enable addicts by trying to do the other’s work for them. Thus the addict doesn’t have the incentive to take responsibility for their actions. Terence Real, author of I Don’t Want to Talk About It says this about addictions of all kinds:

The turning to any substance, person, or action to regulate one’s self-esteem can be called an addictive process. In this framework, the terms addiction, narcissistic disorder, and the defenses in covert depression are all symptoms. When a covertly depressed man’s connection to the object of his addiction is undisturbed, he feels good about himself. But when that connection to that object is disrupted – when the cocaine runs out, the credit cards reach their limit, the affair ends – his sense of self-worth plummets, and his hidden depression begins to unfold. Such withdrawal drives him back to the drug, the achievements at work, or the next sexual conquest.  (1997, pg. 59)


Betrayal Trauma

Betrayal shatters trust, an essential ingredient for a healthy relationship.

“The principle building blocks that make a relationship last come from trust, not love. Love without trust cannot work. To try to make a relationship work that is untrustworthy is like trying to build a house on quicksand…trust is the glue that holds a relationship together over the long term, not love.” (Campos, 1994, p. 37)

Addicts are not capable of being trustworthy when the addiction is active. Partners of sexual addicts experience extreme reactions from the lack of trust and safety they feel including disbelief, grief, rage, depression, trauma, shame, and PTSD (post-traumatic stress disorder). Left untreated, devastated spouses and significant others often feel crazy. When the addiction is hidden, they feel something is off but don’t know why. When it is exposed partners may try to talk sense into their loved one or devise strategies to bring their spouse back to “normal.” They might try harder to be loveable or sexy or in some cases less sexy if they are the distorted object of desire. They scream, feeling if they delivered their message louder, their partner might hear them. They cry because addiction destroys relationships and families, and there is seemingly nothing they can do but witness the demise. They have trouble eating or sleeping, or they eat or sleep too much. They feel paranoid, overly jealous, or compelled to keep tabs on phone calls and credit card bills. Partners might distance themselves because they no longer feel safe with the person they once trusted. Spouses helplessly try to control the addict’s behavior but until they address their own issues, partners coping with sexual addicts will be an ineffective do-gooder and clueless player in the destructive cycle. Trauma therapies such as EMDR, Brainspotting, Sensorimotor Psychotherapy or Somatic Experiencing help release traumatic deregulation. Individual therapy helps put addictive behaviors in perspective so loved ones and family members can reclaim their lives. Group therapy joins those who have experienced similar pain by sharing their stories and realizing they are not alone in their devastation.


What’s Love Got to Do With It?

In National Geographic’s article on Love the Chemical Reaction, Helen Fischer, an anthropologist at Rutgers University found when a subject’s brain was scanned under an MRI and they looked at their loved one, the parts of the brain linked to pleasure and reward – the ventral tegmental are and caudate nucleus – lit up. Love lights up the caudate nucleus because it is the home to a dense spread of receptors called dopamine. In the right proportions, dopamine creates intense energy, exhilaration, focused attention and motivation to win rewards. (Slater, 2006, p. 35). So we can see how our internal love potion has the ability to crave more dopamine goodies. However in our media driven culture oozing with sexuality, individuals often confuse sex for love in the endless pursuit for more and better pleasure. Dr. Carnes explores some of these issues in Don’t Call It Love. Unfortunately the dissatisfaction that ordinary desire seeks to remedy this kind of craving generally causes further unhappiness. Lama Yeshe, tantric master and author of Introduction to Tantra: The Transformation of Desire, examines the disappointment that ordinary desire perpetuates.

“…let us look closely at the way ordinary desire works. Feeling somehow incomplete, insecure, and unfulfilled, we look outside of ourselves for something or someone that will make us feel whole… With this thought as our impulse we try to possess whatever attractive object seems most likely to fulfill our desire… In our attempt to gain possession of this overestimated object of desire, we may be either successful or unsuccessful. The person or thing may indeed give us some momentary pleasure, but it can never begin to live up to our expectations… And sooner or later we feel cheated and bitterly disappointed.” (2001, pg. 23 & 24).

In this cycle the addict will often pursue the next person, lover, or activity to get the next rush over and over again. A lover is a common-place commodity and accepted in society, thus this level of the disorder can breed underground for years without being detected.


Diagnostic and Statistical Manual of Mental Disorders

Currently sex addiction and love addiction are not diagnosed in the latest edition of the DSM-V, even though they are as equally devastating as chemical addictions.  “The two main factors defining sexual addiction are the same as with all other addictions: an inability to stop despite repeated efforts to do so, and, escalation with frequency and increased risk taking.” (Conquest, 2013, p. 13).

Hypersexual disorder is a new disorder that has been proposed for inclusion in the   next edition of the DSM-V, and reflects a recognition of what is commonly       referred to as “sex addiction.” It is clear that whether it is called “sex addiction,”        “compulsive sexuality,” or “hypersexuality,” it shares many features of other          addictions, including spending a lot of time thinking about, planning, and      repetitively engaging in the behavior, even when it becomes harmful; having           difficulty controlling the behavior; and experiencing distress or disruption to other    areas of life result. (Retrieved April 17. 2011)



While sex addiction is not officially recognized as a disorder in the DSM-V, it should be treated and more counselors are specializing in this field. Seminars, education, and treatment facilities are more prevalent as sex addiction is explored with both precision and compassion.

Effective treatments include: individual and group therapy, trauma therapy, couples counseling, and family therapy. The addict may have unaddressed trauma that triggered their addictive behaviors. Trauma also occurs in their partners from betrayal, the distorted sense of reality they experienced, and/or health issues from sexually transmitted diseases. Therapeutic interventions such as EMDR, Brainspotting, Sensorimotor Psychotherapy, and Somatic Experiencing have proved successful for the treatment of trauma. Partners can also benefit from learning how to mitigate codependent behaviors. In some cases, medication might help the addict, particularly if the behavior is stemming from mania related to bipolar disorder or other imbalances. Medication may also help partners during the most stressful episodes in order to replenish the feel-good neuro-transmitters that have been depleted due to high anxiety. As research emerges we can expect to see approaches that treat excessive sexuality more effectively. (Retrieved April 17. 2011)

Other interventions require the addict to honestly disclose all their clandestine activities. Evidence of process addictions are often less tangible than physical additions. Lie detection tests are utilized because it is common for most addicts to lie, skew the truth, or reveal partial truths. Betrayed partners are anxious and feel the need “to know all” to help regulate their nervous systems.

Twelve step programs for Sexual Addicts, called SA and their counterparts COSA, Co-Addicts of Sexual Addicts, have proven effective for some people. These organizations are accessible on the web, however precautionary measures are taken first, such as contacting organizers by phone or mail before one actually finds a group in their area. It is advisable for both addicts and family members who are suffering from the effects of sex addiction to seek professional help in order to reclaim their sense of well-being and safety.



As this disorder becomes accepted with less of the accompanying shame that the words sex and addiction trigger, people may seek treatment more readily. Sex is a dicey word that has the power to both entice and repel. Addiction is also a powerful statement and elicits feelings of fear, judgment, or distain. Defining specific behaviors that are part of sexual addiction such as love addiction, flattery addiction, adoration addiction, pornography addiction, or affair addiction, might soften the sex addiction label, making it less shameful. This could get people into treatment faster. At the same time, the wreckage that compulsive affairs, prostitutes, pornography, and other deceptive sexual behaviors cause, need to be examined with blatant honesty, thus we should not round the corners, nor dismiss the tremendous harm that this addiction is capable of by underplaying the term sexual addiction.

It is my hope that our society will explore sexuality with more integrity, compassion, and knowledge. In this way we can understand our biological, emotional, and psychological urges in order to make informed choices. Sexuality is part of being human and our desire for pleasure is also human. Sexuality has the potential to both enhance and confuse our lives depending on how much awareness we afford this issue.

As the symptoms and causes of this disorder peer out of the shadows, those who have been affected by the devastating consequences of sexual addiction can enter the path of recovery and healing.

Valerie Lorig © 2011, Revised 2013



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