Sex Addiction Is Not So Funny

By Alexandra Katehakis 08/02/11
From Tiger Woods to Anthony Wiener, most bold-faced names who get caught with their pants down blame their actions on sex addiction, while the public largely scoffs at the label. But a top therapist argues that it's no laughing matter.
You're never too young to wear sex-addict Ts. Photo via flickr

In the course of a couple of weeks last spring, three of the world's most poweful politicians saw their careers, marriages and reputations crumble because of sexual improprieties. Rep. Anthony Weiner was forced to resign from Congress for sexting naked pics of himself to anonymous supporters; Arnold Schwarzenegger’s wife of 25 years, Maria Shriver, filed for divorce after learning that he had fathered an illegitimate child with their housekeeper; and Dominique Strauss-Kahn, the head of the IMF and the likely frontrunner to become president of France in the next election, was charged with raping a maid in a hotel. While the circumstances of each man’s sexual transgressions vary dramatically, and the truth of these matters may never be known, the media quickly labeled all three as “sex addicts.” Their actions provoked a flood of sensational stories (often of questionable accuracy), opinion (ditto) and, inevitably, humor of the late-night talk-show genre about what is in fact a serious mental health condition that destroys lives.

Imagine the media playing fast-and-loose with people who are addicted to alcohol or heroin or even food. One problem is that the label "sex addiction" in all too easily applied to pretty much any sexual behavior that usually results in negative consequences to successful, powerful, famous men—people who stand to lose a great deal when caught their with their pants down.

As a result, the public had developed a somewhat cynical view about the very premise of “sexual addiction,” at least as presented in the media. Many argue that applying the mental health diagnosis of “sex addict” gives badly behaving people a pass—permission to act like a jerk without assuming any responsibility for their actions. When these men seek rehab, they again become punch lines. In popular culture, rehab has become a place where celebrities go to repent in order to restore their public image rather than to engage in the hard work that's needed to confront any addiction. Our overall cultural sympathy for drug and alcohol addiction generally does not extend to men in distress from sexual addiction. Instead, they become the butt of our jokes. This confused public attitude reflects our society’s deep but unacknowledged ambivalence about what role our erotic desires play in our lives.

Yet without psychological help,people who are addicted to sex only rarely recovers on their own. For the sake of offering hope to the increasing number of sex addicts in our midst, it is important that we stop laughing about this serious mental health condition and pay it the respect that it deserves.

The Internet has escalated the availability of information and images of a sexual nature just as it has for every other category of human experience. Cybersex has become the crack cocaine of sexual addiction. The actual statistics about the prevalence of Internet porn are staggering. A Google search for “porn” turns up nearly 1.23 billion pages. Internet porn pulls in $5 billion a year in global profits. According to the Business Insider, in 2010, 12% of all websites on the Internet were porn-related, a total of 24.6 million. Some 70% of men, aged 18 to 24, visit a porn site every month. While women make up as many as one third of visitors to popular porn sites, only about 2% subscribe to pay sites. Some 20% of men admit to looking at Internet porn while at work compared to 13% of women. In June, it was widely reported that social media (Facebook) had deposed pornography (Google) as the most trafficked site. For most sex addicts, it's not the actual sex that eases the feelings of distress—it’s all the preparatory, novelty-seeking behaviors, such as the hours consumed trolling personals on CraigsList, that flood the brain’s reward system with dopamine.

In addition, an explosion of social networking websites make hookin-up for sex—and the hours spent engrossed in looking for it—easier than ever. Every day, therapists nationwide see men and women completely out of control of their sexual behaviors. They’re destroying their lives and the lives of their loved ones. And although they know their behaviors are self-destructive, they simply can’t stop themselves.

Take the 30-year-old guy who masturbates to pornography for hours on end, who is so isolated he can’t begin to have a relationship or if he does, he can’t sustain an erection. Gay men now have Grinder on their cell phones giving them 24/7 access to anonymous sex. Married people arrange anonymous dalliances on Ashley Madison all day long. But the Internet is only part of the problem. There’s the married housewife and mother of five who leaves her husband and children repeatedly for another man because she’s always seeking “the one.” White-collar professionals like doctors and lawyers pick up street prostitutes and risk losing their licenses. Business travelers go to “massage parlors” and strip clubs with great regularity to manage their anxiety while away from home.

One of the most misunderstood aspects of sex addiction is that the act of sex (whether or not it culminates in an orgasm) is in reality a by-product of the entire activity, despite the fact that it may seem to the addict to be the goal. It’s not sex itself that temporarily eases the feelings of distress—it’s the preparatory, novelty-seeking behaviors, such as the hours consumed trolling sex ads in the CraigsList personals, that flood the brain’s reward system with dopamine.

Dopamine creates the feeling of intensity and pleasure in the body, and helps our brain remember events that are exciting, important and novel. People act out sexually in order to pump dopamine into their reward systems. Many addicts report feeling shame and disgust after a sexual binge. In the process, they have likely blunted their reward system sensitivities over time.

When focused on getting into the sexual experience, the addict quite literally isn’t thinking. Over time, the brain becomes increasingly tolerant of dopamine levels so behaviors must escalate in order for the addict to achieve the same dopamine high, increasing the risk for self-destruction.

The preparatory stage continues to increase the feeling of being “high” as dopamine and adrenaline are released which often includes, but is not limited to, rituals such as cruising the Internet, going to a bar to “hook-up,” cruising for prostitutes, going to an adult book store, or visiting chat rooms. These rituals can last anywhere from a few minutes in duration to several weeks in length, depending on the type of acting out.

For example the business traveler may find that planning the trip is part of his ritual whereas the cybersex addict will ritualize his activities by making sure his partner is out of the house, closing the blinds, or locking doors. These rituals almost always lead to some sort of sexual acting out and are part of stoking the fire of the “high.” The escalating energy eventually leads to a sexual release, which is the shortest part of the acting out cycle.

When a surge of dopamine is released to the brain, it helps wire the circuitry of the brain towards the activity that makes a person feel good. The brain will remember this feel-good activity and the person will repeat the activity over and over again. However, once that activity is no longer novel, the brain no longer releases the same amount of dopamine when it comes in contact with it. This growing tolerance partly explains why sex addict’s tire of relationships and seek new people or experiences. In order to get the same or increased dopamine high, the brain is going to look for increasingly novel forms of it. This may also be the reason that more and more men are finding themselves looking at child pornography. Their search for a “higher high” takes them into new—and more taboo—realms, while in the end leaving them terrified of being arrested, confused by the erosion of their value systems, and disgusted at themselves.

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Alexandra Katehakis, Ph.D., MFT, CSAT-S, CST-S is a Marriage Family Therapist, Certified Sex Addiction Therapist/Supervisor and Certified Sex Therapist/Supervisor, and Clinical Director of Center for Healthy Sex in Los Angeles. Dr. Katehakis has extensive experience in working with a full spectrum of sexuality; from sexual addiction to sex therapy, as well as and problems of sexual desire and sexual dysfunction for individuals and couples. She has successfully facilitated the recovery of many sexually addicted individuals and assisted couples in revitalizing their sex lives. She earned her Ph.D. from the Institute for Advanced Study of Human Sexuality.

Alexandra has been a guest on several national radio, podcast, and news media programs including NPR, Inside Hollywood, Dr. Drew Live, Conversations with Alanis Morissette, Voice America, Sounds True, and WebMD. She has been a regular guest blogger at Psychology Today, Huffington Post, PsychCentral and has published in the Journal of Sexual Addiction and Compulsivity and the American Journal of Play. Additionally, Alexandra has been featured as a sex addiction and sex therapy expert in publications from New York Magazine, NBC News, Men’s Health, Rolling Stone, the LA Times, The Hollywood Reporter, and the Washington Post.

She is the author of Sexual Reflections: A Workbook for Designing and Celebrating Your Sexual Health Plan (2018), Sex Addiction as Affect Dysregulation: A Neurobiologically Informed Holistic Treatment (2016), Erotic Intelligence: Igniting Hot Healthy Sex after Recovery From Sex Addiction (2010), co-author of Mirror of Intimacy: Daily Reflections on Emotional and Erotic Intelligence (2014), and a contributing author to Making Advances: A Comprehensive Guide for Treating Female Sex and Love Addicts (2012) — all available on Amazon

Find Alex on LinkedIn or Twitter.