Does sex addiction exist

I found this the other day.

“Lord Laidlaw of Rothiemay has admitted to receiving treatment for “sex addiction” at a private clinic, likening it to alcohol dependency. But is it really?

It’s a term that first came to widespread attention when actor Michael Douglas was admitted to rehab in 1990 and it was reported, inaccurately he later claimed, that he was a sex addict.

More recently, comedian Russell Brand admitted to spending a week at a centre for sexual addiction in Philadelphia.”

But are so called sex addicts really suffering from an illness or just making excuses for being excessively promiscuous?

“It’s a very serious addiction, says Paula Hall, who runs a group therapy course for “sex addicts” in Warwickshire, and it’s believed about one in 20 people suffer from it.

Although not a chemical addiction like alcohol or heroin, it’s a “process addiction” like gambling, she says, with a biochemical element linked to the release of dopamine in the brain.

It’s a compulsive need to seek out and follow a certain type of sexual behavior. That behavior varies but it’s basically an anaesthetizing behavior, something you are doing in order to avoid dealing with something else.

It’s a coping mechanism and it’s totally and entirely out of control. You are continuing to pursue it in spite of the consequences, like losing your job, your status, your wife and your health.”

The term Sexual addiction is used to describe the behavior of a person who is obsessed with sex and who repeatedly and compulsively seeks sexual contact through impersonal and non-intimate behavior such as swinging or dogging or who compulsively engages in sexual acts such as masturbation and voyeurism. Opinion is divided on whether Sexual addiction is a valid mental illness in itself or is a symptom of other mental disorders such as Obsessive compulsive disorder, Narcissistic personality disorder, or Manic-depression, as traits of addiction can be confused with these disorders, The DSM IV does not include diagnostic criteria for sexual addiction while the ICD 10 is currently working on criteria for this disorder.

There are three main theories which while not mutually incompatible view sexual addition in very different ways.

1) Sexual addiction as an addiction. Being addicted to sex is like being addicted to gambling or other risk taking behaviors but unlike substance addiction is an addiction to a behavior rather than to a substance. Schneider (1994) identified three indicators of addictive behavior.

• Compulsivity: An addict loses the ability to choose freely whether to stop or continue a particular sexual behavior

• Continuation: Addicts pursue their addiction despite the negative effects on their personal and professional lives

• Obsession: Addicts report spending whole days consumed by sexual thoughts developing elaborate fantasies and planning elaborate new ways of obtaining sexual gratification.

2) Orgasm releases large amounts of brain chemicals most notably Dopamine which is why, in contrast to the process view of addictive behavior, sex addiction is sometimes viewed as a chemical addiction. Some reports indicate that dopamine is a hundred times more addictive than heroin and works in a similar manner to cocaine or amphetamines. Nuerolepeptic medication might be one way of blocking the euphoric effect of dopamine acting on the higher decision making areas of the brain via the mesolimbic pathway and there by breaking the addictive cycle, but the low mood and poor self esteem that very often drives addictive behaviour in the first place can often successfully be treated with SSRI antidepressants.

3) The psychodynamic perspective can also be very effective when explaining sexual addiction. Psychodynamics places significant importance on early childhood development and experiences. The way a child is treated by his or her parents and peers has a great impact on their later life. Maltreatment occurring during childhood can scar the individual and lead to obsessional behavior of a sexual nature later in life.

The majority of people who admit to having a sexual addiction are probably male but the secretive nature of the problem means that it is probably under reported in both men and women and while a history of childhood neglect and abuse may contribute to sexual addiction later in life those guilty of committing sexual crimes such a rape or indecent assault may not be suffering from any form of mental illness at all.

Jennifer P. Schneider, (1994), Sex addiction: Controversy within Mainstream Addiction Medicine, Diagnosis Based on the DSM-III-R, and Physician Case Histories, Sexual Addiction and compulsivity, Volume 1, Issue 1, pages 19 - 44