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Recovering From Sex Addiction


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By Hunter R. Slaton


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One aspect of sex-addiction recovery that doesn’t get talked about as much is the role of pharmaceuticals—specifically anti-depressants of the selective serotonin reuptake inhibitor, or SSRI, variety. A well-known side effect of SSRIs is that they impair sexual functioning, sometimes curbing desire but most commonly making it difficult to have an orgasm.

About three-quarters of those in treatment for sex addiction are on anti-depressants; some in the program like the libido-reducing side effects. But a lot of professionals think using a drug less for its intended benefit than for its unintended complications is a creepy way to do business. “Medications are overused and prescribed too quickly,” says psychiatrist David Reiss, MD. “Of course I prescribe,” he says, “but not with a shotgun approach, a Rube Goldberg approach.” Katehakis objects on principle to the idea of controlling people’s sexual behavior by prescribing them drugs: “That’s some weird thing that hearkens back to the colony days where they gave prisoners saltpeter.” (Saltpeter, aka potassium nitrate, was long thought to quash male libido.)

Jennifer feels that SSRIs have helped her; she is still able to reach a kind of “pleasure peak," so they don’t entirely kill the joy of healthy sex. “I figured I had more than my share of orgasms in my lifetime anyway,” she says.

Many experts think using anti-depressants for their libido-numbing side effects is a creepy way to treat sex addicts.

But another former sex addict, 45-year-old Sarah, nine years sober in SLAA, says it took a while to see that antidepressants were a bad fit for her. Initially the pills were prescribed in part because of a dramatic suicide attempt (distraught over a man she was dating, she’d walked into the middle of an LA freeway to try to kill herself) and in part due to their inhibiting side effects. But she kept on pursuing reckless sexual encounters and feeling awful about it until the day she joined SLAA.

Sex addicts do sometimes need the extra pharmaceutical help to start the 12 Steps or therapy in the first place. It’s hard-to-impossible to do the psychological work necessary to overcome your addiction if you’re housebound due to crippling depression. “They need to be stable enough to be able to manage the emotional experience they’re going to go into,” says Schultz.

Sometimes issues that are beyond the scope of a 12-Step program—such as childhood sexual abuse, a common experience for many sex addicts—don’t emerge in therapy until after a period of sobriety, which most of the experts who spoke to The Fix agreed was a prerequisite for any deeper trauma work. “Our character defects rise to the surface after getting chemically and sexually sober,” says Scott, who has been meeting with an individual therapist since 1998. “12-Step programs can be therapeutic, but they are not therapy.”

With sex and other so-called process addictions, such as to food, gambling or shopping, it’s tricky to capture what “sober” means. By the same token, it’s more likely that the contours of an individual’s self-defined sobriety will shift over time.

When Jennifer started getting sober, she believed that her problem was with anonymous sex—that if she knew her sex partner’s first and last names, then it was OK. But after she fell into a sexual relationship with a man she’d known for a year only later to discover he was married, she realized that knowing his last name hadn’t helped her out this time. She had to expand the definition of what sexual sobriety meant for her. In that sense, recovery from sex addiction is a continual evolution—for Jennifer, even after decades—one day at a time.

Hunter R. Slaton is the Rehab Review Editor for The Fix. He has written for publications including Men's Journal, Budget Travel, Valet, Blender and Time Out New York.

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