One by one, well-known individuals are putting a face on the problem of sexual addiction. Beginning with a United States President, who was never formally diagnosed but clearly showed signs of the disorder, to multiple politicians and religious leaders, to media personalities, the term “sex addict” conjures up a specific face for most people. Far from new, this problem has only recently received clinical attention. Indeed, the disorder has yet to be included in the Diagnostic and Statistical Manual (DSM), though a group of professionals is proposing its inclusion in the DSM-V, along with other behavioral addictions. Specific criteria exist for the diagnosis of pathological gambling, for example, and with the simple substitution of the words “sexual behavior,” all the measures apply. Among the public faces shedding light on the condition, one group is conspicuously absent: women. In general, sexual addiction is considered only a man’s problem. Much as early perceptions of alcoholism thought it affected only men–surely, women did not struggle with compulsive drinking–sex addiction is similarly misperceived.
According to Internet Filter Review, approximately 40 million US adults regularly visit pornographic websites, and conservatively, one in three visitors to an adult site is female. Fewer women are online when compared to men, but females are overrepresented in the number of individuals who are cyber compulsives (Cooper, Delmonico, Berg, 2000). This reality means that for reasons as yet unknown, women are at higher risk of becoming addicted to their online sexual behavior than are men.
Based on these statistics and my clinical experience working with hundreds of female sex addicts, I predict research will eventually demonstrate that half of sexual addicts are women, just as equal numbers of women struggle with alcoholism. For many clinicians, and especially for the public at large, a paradigm shift will be necessary to prompt looking outside the box of male-dominated understanding about sexual addiction.
Despite the lack of an official DSM diagnostic category, addiction professionals generally agree on the definition of sexual addiction. Simply stated, sexual addiction is the lack of control of some sexual behavior or relationship. Perhaps the most helpful definition of sex addiction is a practical one: sexual behavior that creates distress and has a negative effect on one’s life.
Like with alcohol or drugs, sex addiction fits the classic, four component model of what comprises an addiction:
- Compulsivity means the loss of control over a behavior. An addict continues in the behavior or relationship despite repeated attempts to stop.
- Continuation despite negative consequences.
- Preoccupation or obsession. Sex or an intense relationship becomes the organizing principle of life.
- Tolerance shows more of the same behavior or an escalation of progressive behaviors is required to get the same “high.”
Just as with substance-related addictions, neurochemistry is an important part of the addictive process for compulsive behavior. Sexual arousal and activity releases powerful chemicals in the brain, especially dopamine, which is a key player in the brain’s reward system. Adrenaline, endorphins, opiate-like substances, and oxytocin (the neurochemical released at skin-to-skin contact) all play a role in the physical rush that is part of sexual addiction.
For most women, the roots of sexual addiction can often be traced to experiences from childhood. Addicts of all stripes are often raised in dysfunctional families, which are governed by rules such as “don’t talk,” or “don’t feel,” or “blame others.” Usually, there is a lack of emotional presence on the part of one or both parents. This environment fails to teach the emotional and relational skills required for intimacy. In addition to the kind of abandonment just described, the vast majority of sex addicts are survivors of some kind of childhood abuse.
Like their male counterparts, female sex addicts need multidimensional help that includes psychodynamic and other therapies to get at the root of the disease, as well as behavioral techniques and 12-Step recovery programs that address acting-out behaviors. However, unique challenges exist for women who seek to become sexually and relationally sober. The most obvious difficulty is that those who are in recovery from sexual addiction are predominately men. That means a woman will likely be the only female in most 12-Step recovery meetings, which is a problem considering the often relational nature of her addiction. It is extremely difficult for a woman to find a same-gender sponsor for her recovery. Women almost always benefit from initial gender segregated treatment, which allows them to focus without distraction. Equally important, a gender specific environment fosters the creation of healthy, intimate relationships with other women, which are key to a female’s recovery.
– By Marnie C. Ferree
Marnie C. Ferree is a licensed marriage and family therapist in Nashville, Tennessee, where she directs workshops for sex addicts, co-sex addicts, and couples affected by sexual addiction. She is a frequent speaker and author of numerous professional articles.
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