I recently was invited to give a presentation on common (mis)perceptions of relationship and sexual compulsivity at the 2018 Ensure Justice Conference, hosted by Vanguard University. Here are some of the keynote’s highlights on common perceptions with regards to compulsivity (especially in relationships), current research, and research-based communication about this important subject.
The Diagnostic and Statistical Manual, 5th edition (DSM V) lists hypersexuality as a condition that requires further research. The DSM V conceptualizes sexual compulsivity as an impulse control disorder, not as an addiction. No diagnostic criteria formulated for adolescents and emerging adults are specified. Recent brain scans of individuals with sexual compulsivity show similar brain patterns to those found in people with addictions to cocaine. The World Health Organization defines an Addiction: a progressive brain disease that, if left unattended, may lead to premature death.
-45 % of self-identified female sex addicts had traded sex for money/gifts:
-8.4% for money (in comparison to 2.2% of non-sexually addicted females);
-26.3% for gifts (in comparison to 5.7% of non-sexually addicted females); and
-7.8% of female sex addicts identified themselves as sex workers (in comparison to 4.4% of non-sexually addicted females) (Corley & Delmonico, 2011).
-Sex work in sexually addicted women coincided with use of drugs plus More partners; A higher frequency of sex; Use of drugs before and during sex more often; and A higher incident rate of STDs than women who were not addicted (Logan, 2000).
Complex interactions between the brain’s reward center facilitate that a formerly exhibited problematic behavior can be replaced by one or more of four types of addictions:
(1) Substance (that is, legal or illegal drugs); (2) Process (that is, shopping, gambling, online behavior); (3) Emotion (that is, intensity, drama, depression, anxiety, self-hatred); and/or (4) Unhealthy attachment/”trauma bonding” to another person (that is, for example, patterns such as “rescuing” another person, pathological giving, impression management). What to abstain from is a “moving target” (Carnes, 2012): one needs to watch if the addictive behavior switches to another of the aforementioned four types of addiction.
Furthermore, 97-99% of sex addicts reported at least one of various types of abuse (e.g., sexual, verbal, physical). Such unwanted events can produce complex layers of so called trauma. Often times, chronic trauma manifests itself in the re-enactment of trauma in relationships.The withholding of or absence of addiction behaviors, especially if underlying trauma is not decreased, may activate the brain’s reward center in the same way that the addictive behaviors once did.
Therefore, addiction and complex trauma require two tracks of treatment:
Track 1: Decrease of the impact of trauma;
Track 2: Completion of recovery tasks (Carnes, 2006) to create healthy thoughts and healthy attachment.
The exposure to chronic trauma may stunt a woman’s emotional development and predispose her to anxiety and depression due to a hyperactive nervous system. The effects of chronic trauma may continuously impact the women when she reaches the age of majority (Heim et al., 2002; Nemeroff, 1998). Furthermore, so called “trauma bonding” (that is, an attachment pattern to unhealthy behaviors and/or people due to the impact of trauma on the brain (not driven by free will)) may occur.
The engagement in 12 Step Programs has been found to be very helpful for successful recovery from addictions. In addition, attending to addiction interaction and multiple addiction patterns, one needs to tackle as many of the addictive behaviors at the same time, systematically.
Sex and relationship addictions: ”intimacy disorders” due to genetic vulnerability, complex trauma, and lack of skills to connect with another person in a healthy way. Health care providers and medical professionals get to be proactive psycho-educators, on a joint mission with his/her colleagues from other disciplines to establish holistic, long-term, sustainable mental, physical, spiritual, and relationship health in their clients. This can happen through role-modeling of successful behaviors, constructive thoughts, how to create rewarding circumstances, and physical vitality.
Carnes, P. J. (2006). Children of wrath: Women and sex addiction. Counselor, 7, (3), 34–40.
Corley, M. D., & Delmonico, D. (2011). Closing the gap: Results from the Women’s Sexuality Survey on Female Sex and Love Addicts. Presentation at Society for the Advancement of Sexual Health Conference, La Jolla, CA.
Georgianna, S. (2015). Addressing Risk Factors Associated With Women’s Sexually Compulsive Behaviors Through Psycho-Education and Self-leadership Development. Sexual Addiction & Compulsivity, 22:314–343. DOI: 10.1080/10720162.2015.1072489
Heim, D., Newport, J., Wagner, D., Wilcox, M. M., Miller, A. H., & Nemeroff, C. B. (2002). The role of early adverse experience and adulthood stress in the prediction of neuroendocrine stress reactivity in women: a multiple regression analysis. Depression and Anxiety, 15, 117–125. DOI:10.1002/da.10015
Logan, T. L. (2000). Sexual and drug use behavior among female crack users: A multi-site sample. Drug and Alcohol Dependence, 58, 237–245.
Nemeroff, C. B. (1998). The neurobiology of depression. Science America, 278, 42–49.