When sex becomes an addiction

(Expressyoureself) — “Californication” star David Duchovny made headlines for voluntarily entering rehab last week. But it wasn’t for drugs or alcohol. It was for another dependency, one that affects millions of Americans but is seldom discussed: sex addiction.

While sex can be healthy for a relationship, some people develop an addiction to porn, affairs, and other behaviors.

Sex addiction, also called compulsive sexual behavior, is like a gambling compulsion or alcoholism: It’s about devoting your free time to a behavior that you cannot stop, even if you damage relationships or prompt other negative consequences. That could mean extensively using pornography, having affairs, sleeping with prostitutes, and masturbating excessively, to the point where such behaviors get out of control.

If you think it’s just about primal desire, think again. For many addicts, sex becomes a way to numb out painful feelings, kill time or stop feeling lonely, says Kelly McDaniel, licensed professional counselor in San Antonio, Texas, and author of “Ready to Heal: Women Facing Love, Sex and Relationship Addiction.”

“Most people I talk to get to the point where they don’t even like sex,” said McDaniel, who has no connection to David Duchovny and did not speculate about his specific situation.

Who are sex addicts?

Sex addiction is estimated to affect 3 to 6 percent of adults in the United States, according to the Mayo Clinic, but the American Psychiatric Association has not classified the condition in its diagnostic handbook. Sexhelp.com, run by psychologist Patrick Carnes, provides an online test to help people determine if they have a problem.

The Internet, providing endless opportunities for porn-watching and cybersex, has fueled a surge in cases of sex addiction, experts say.

“We’re seeing it with epidemic proportions now, particularly with regards to cybersex,” said Mark Schwartz, psychologist and former director of the Masters and Johnson Institute in St. Louis, Missouri. “There isn’t a week that goes by where I don’t get two calls” about sex addiction.

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Therapists have recently seen more women with the condition in connection with Internet porn, which has become a “gender-neutral” addiction, McDaniel said. Before, female sex addicts generally tended to have affairs or become sex workers, she said.

Experts acknowledge that people who have affairs or use pornography are not necessarily sex addicts. Such pastimes form an addiction when they generate negative consequences for a person’s relationships, take over free time and become impossible to quit.

Where does it come from?

About 80 percent of sex addiction cases have sexual abuse or emotional trauma in their backgrounds, said Doug Weiss, therapist and executive director of the Heart to Heart Counseling Center. Schwartz also noted that huge numbers of people coming forward as sex addicts have been abused, assaulted or raped.

“When you have abuse in your background, you’re less likely to trust people, [and] you’re more likely to turn to something like sex addiction as a manifestation,” Schwartz said.

Feelings of neglect as a child — whether from divorced parents or parents who both worked and didn’t spend a lot of time with their kids — may also lead to sex addiction, Schwartz said.

Research into the neuroscience of sex addiction has not been conclusive, the Mayo Clinic said. Naturally occurring chemicals in the brain such as dopamine and serotonin do contribute to sexual functioning, but it’s not clear how they are related to sex addiction. McDaniel said these two chemicals are lower in the brains of children who have suffered abuse, which may explain why some of them use their own bodies — or, in other cases, food — to increase dopamine and serotonin levels.

A lot of teenagers develop their sexuality with pornography, and then find that relational sex isn’t as satisfying, Weiss said. Porn gives them a “very strong chemical hit,” and alters ways of thinking about sex, somewhat like the classic “ring the bell, feed the dog” stimulus-response mechanism. Addicts thus learn to become sexually attached to objects, and have trouble getting the same kind of satisfaction from sex in a relationship, he said.

For many people, especially women, sex addiction occurs in tandem with another problem such as an eating disorder, drug or alcohol addiction, McDaniel said.

How does treatment work?

A good treatment center will review the reasons why the addiction has come about, along with the brain chemistry of it, McDaniel said. A premier rehabilitation facility would have a combination of individual and group therapy, 12-step support, and possibly psychiatric medications such as antidepressant medications if necessary.

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The 12-step programs, which have components that parallel Alcoholics Anonymous, are the most widely used form of treatment, said Sam Alibrando, therapist and consultant in Pasadena, California. They involve having a sponsor and being available for others in the group at any time. Anecdotally, however, they work less well than AA because sex is harder to give up, said Alibrando, author of “Follow the Yellow Brick Road: How to Change for the Better When Life Gives You Its Worst.”

“Treatment is long-term, and it’s not easy,” McDaniel said. “I really recommend that a woman or a man find someone who’s trained and understands that sex addiction is a brain disease and does not further the shame that comes with this disease.”

Unlike drugs or alcohol, the goal of sex addiction therapy is usually not abstinence, but rather learning to have sex in a relationship, experts say. Similarly, someone who recovers from an overeating disorder does not stop eating entirely but learns how to manage diet. Marriage counseling often becomes part of the treatment, Weiss says.

The goals of recovery vary for different people, says Alibrando. He’s currently treating a couple in which the wife cannot tolerate her husband even looking at other women. On the other end of the spectrum, he has treated couples in which a woman will buy her boyfriend pornography.

“The spectrum is so wide in terms of where people draw the line,” says Alibrando.

Some recovering addicts join support groups requiring that members only have sex with their partners, even prohibiting masturbation.

What’s after recovery?

Weiss considers himself a former sex addict, having recognized his problem in his early 20s. Women weren’t making him happy; he was using pornography and felt “in conflict” about it.

Now, he runs a resource Web site for recovery at sexaddict.com, along with three-day intensive workshops to jump-start recovery for sex addicts.

Weiss said he’s proud of Duchovny for voluntarily seeking help, apparently without prodding from press reports or lawsuits.

“This kind of person who decides to get recovery for themselves without getting exposed” is “likely to get better,” he said. “People who voluntarily get better have a much better chance of staying well.”

Obama sets out to sell his vision

Barack Obama has a hard act to follow at this convention: himself.

Barack Obama faces a career-defining moment

Four years ago, when Democrats gathered for their national convention in Boston to nominate John Kerry, the then-US Senate candidate made a much-lauded, career-defining speech. His message of a unified America, coming from the mouth of a young, mixed-race politician, marked the effective launch of the history-making Obama phenomenon.

It also brings a level of expectation ahead of his speech on Thursday, which the last Democratic candidate, who went on to become president, did not have to face.

When nominee Bill Clinton spoke at the 1992 Convention in New York, it was four years after he had made a convention speech that was widely seen (including by Clinton, himself) as rather long-winded and boring.

He did not repeat his mistake. With his “I still believe in a place called Hope” speech, the Arkansas governor defined himself in a way that resonated with the country at large.

Weight of history

Barack Obama needs to do something similar. With opinion polls placing him in a tight race with Republican John McCain and suggesting that sections of the public still do not have a clear impression of who he is, his goal is to come out of the week having defined himself as someone whom Americans can feel comfortable about as a leader.

He needs to sell his vision, his experience and his unconventional background.

Mr Obama must unite the Democrats behind his campaign

He will be selling that vision of himself on an auspicious date: the 45th anniversary of Martin Luther King Jr’s “I have a dream” speech.

But, while that may add to the weight of history on his shoulders, the location of his speech represents a break with history.

Obama will not accept the nomination in the Convention Hall, but at the 70,000-seater Invesco Field, home of the Denver Broncos Football team. This will provide a unique spectacle, but it also presents a certain danger of perception for a candidate who – since securing the Democratic nomination in June – has faced accusations of being too presumptuous about his chances of winning the November election.

Clinton tensions

And while the 1992 Clinton experience offers him a something of a blueprint for success, the 2008 Clinton presence, on the other hand, presents him with potential pitfalls.

Both Hillary and Bill Clinton will be speaking at the Convention. Their performances – on Tuesday and Wednesday respectively – will be watched closely for signs of party disunity, that could harm not only Barack Obama’s chances, but those of Democrats running for Congress in November.

Despite a joint appearance with Senator Obama in Unity, New Hampshire earlier this summer, Hillary Clinton is still dogged by questions about her level of support for the man who narrowly beat her to the nomination. Many of her supporters are still unhappy about the manner of her defeat. There is also concern that she was not seriously considered for the position of running mate, which Senator Joe Biden has secured.

Observers will be closely watching Bill Clinton’s mood

By allowing Senator Clinton’s delegates to participate in a formal nominating roll call vote – recognising the historical nature of her campaign – the Obama team hopes to defuse some of the remaining tensions and shore up the support of the millions who voted for the former First Lady. Neither outcome is a foregone conclusion.

John McCain’s campaign is doing its mischievous best to stir things up: releasing an advert, showing Hillary Clinton asking some of the same questions about Barack Obama’s experience and judgment during the primary campaign which they are asking now.

But, perhaps, it is Bill Clinton’s speech that will be the most closely dissected; both for its words and for the body language of the man delivering it. By his silence, the former president has given the impression that he is still sulking about Obama’s victory over his wife.

Many Convention-goers will be looking for him to swallow his pride and give the sort of full-throated endorsement of the party’s nominee, that will sway Democrats flirting with John McCain, and help to repair some of the damage done to President Clinton’s own reputation during the primaries.

As he effectively hands over the role of party leader to a younger man, he can still play the role of party healer.

How to measure the success of this? The time-honoured tradition has been to look at the “convention bounce” – the boost in the opinion polls which a candidate gains from his moment engulfed in balloons and ticker tape. Bill Clinton, for example, got one in 1992 and never relinquished his lead over George H W Bush.

Time is not Barack Obama’s side, though. No sooner has the Democratic Convention finished, than the Republicans meet in St Paul, Minnesota.

So the onus is on Senator Obama to make the most of his time in the spotlight, before the spotlight quickly turns to his Republican rival, John McCain.