.
of acknowledged mental disorders and
their diagnostic criteria. The most
recent version of that manual, DSM-IV-
TR, was published in 2000 and does not
recognize sexual addiction as a
diagnosis

Addiction Model
Patrick Carnes, noted psychologist and
author of Out of the Shadows, is a
proponent of the addiction model of
sexual addiction.   
He proposed using the following symptoms as a definition of “Sexual Addiction:”

1.        Recurrent failure (pattern) to resist impulses to engage in extreme acts of
lewd sex.
2.        Frequent engaging in those behaviors to a greater extent or over a longer
period of time than intended.
3.        Persistent desire or unsuccessful efforts to stop, reduce, or control those
behaviors.
4.        Inordinate amount of time spent in obtaining sex, being sexual, or
recovering from sexual experience.
5.        Preoccupation with the behavior or preparatory activities.
6.        Frequent engaging in violent sexual behavior when expected to fulfill
occupational, academic, domestic, or social obligations.
7.        Continuation of the behavior despite knowledge of having a persistent or
recurrent social, academic, financial, psychological, or physical problem
that is caused or exacerbated by the behavior.
www.ambiente.us  MARCH | MARZO 2009

Sexual Addiction
By Carlos T Mock, MD

Sexual addiction refers to a controversial phenomenon in which individuals report being
unable to control their sexual behavior. It has also been called "hypersexuality," "sexual
dependency," and "sexual compulsivity." It affects all human beings and is not
dependent on your sexual orientation or gender identity.  Studies currently show that 40
percent of people considered sexual compulsives are women.
The existence of the condition is not universally accepted by sexologists, and there is a
lot of debate about its causes, nature, and existence. Proponents of the concept have
offered many descriptions, each according to their beliefs related to the cause.
Terminology
"Nymphomania" and "satyriasis" are not listed as disorders in the DSM-IV, though they
remain a part of ICD-10, each listed as a subtype of "Hypersexuality."  The threshold for
what constitutes hypersexuality is subject to debate, and critics question whether a
standardized diagnostic threshold even exists. The consensus among those who
consider this a disorder is that the threshold is met when the behavior causes distress
or impaired social functioning.  The American Psychiatric Association publishes and
periodically updates the Diagnostic and Statistical Manual of Mental Disorders (DSM), a
widely recognized compendium
.
.
8.        Need to increase the intensity, frequency, number, or risk of behaviors to
achieve the desired effect, or diminished effect with continued behaviors
at the same level of intensity, frequency, number, or risk.
9.        Giving up or limiting social, occupational, or recreational activities
because of the behavior.
10.      Distress, anxiety, restlessness, or violence if unable to engage in the
behavior.

Obsessive/compulsive model
Jennifer Schneider, a physician certified in Internal Medicine, identified three indicators
of the obsessive/compulsive model:

1.        Compulsivity: This is the loss of the ability to choose freely whether to stop
or continue a behavior.
2.        Continuation despite consequences: When addicts take their addiction
too far, it can cause negative effects in their lives. They may start
withdrawing from family life to pursue sexual activity. This withdrawal may
cause them to neglect their children or cause their partners to leave them.
Addicts risk money, marriage, family and career in order to satisfy their
sexual desires. Despite all of these consequences, they continue indulging
in excessive sexual activity.
3.        Obsession: This is when people cannot help themselves from thinking a
particular thought. Sex addicts spend whole days consumed by sexual
thoughts. They develop elaborate fantasies, find new ways of obtaining sex
and mentally revisit past experiences. Because their minds are so
preoccupied by these thoughts, other areas of their lives that they could
be thinking about are neglected.

Skeptics
Sex drive varies widely in humans; what one person would regard as a normal sex drive
might be deemed to be excessive by some and low by others. Skeptics believe that a
“normal” amount of sexual activity can’t be quantified; therefore they refuse to define
what would be considered hypersexual.  For instance a person who is unemployed
because of a mild disability has a lot of free time.  
.
He has a lot more time and access to sexual behavior than a workaholic.  The
argument follows the logic that what some people consider a normal amount of time
spent working at your job, varies from one individual to another. Skeptics argue that
society does not condemn workaholics, and for that reason should not condemn
hypersexual individuals.  
Those who work in the sexual addiction field say that for some, its root is in childhood
trauma. For others, there are underlying factors such as anxiety, depression, a need for
attention and validation and extreme loneliness. Other issues that impact the problem
are high rates of substance abuse and alcoholism, which add another layer.  But
according to skeptics and many others in the field, it isn’t about the actual sex. That’s
why you see a compulsive gambler continue sitting at the table even after he or she won
all the money they could possibly need. It’s the prospect of winning, of getting laid, of
finding a steamier image than the last.
Manifestation
According to the book Synopsis of Psychiatry, sex addicts are unable to control their
sexual impulses, which can involve the entire spectrum of sexual fantasy or behavior.
Eventually, the need for sexual activity increases, and the person's behavior is motivated
solely by the persistent desire to experience the sex act and the history usually reveals a
long-standing pattern of such behavior, which the person repeatedly has tried to stop,
but without success. Although a patient may have feelings of guilt and remorse after the
act, these feelings are not sufficient to prevent its recurrence and the patient may report
that the need to act out is most severe during stressful periods or when angry,
depressed, anxious, or otherwise dysphoric.  Eventually, the sexual activity interferes
with the person's social, vocational, or marital life, which begins to deteriorate.
Etiology
Addiction theories: Neurophysiologist Earle has argued that neurochemical changes,
similar to an adrenaline rush in the brain, temporarily reduce the discomfort an
individual experiences with urges and cravings for sexualized behaviors that can be
achieved through obsessive, highly ritualized patterns of sexual behavior.
Obsessive/compulsive theory: Psychologist Patrick Carnes argues that when children
are growing up, they develop “core beliefs” through the way that their
.
family functions and treats them. If a child is brought up in a family where his or her
parents take proper care of him or her, he or she has good chances of growing up,
having faith in other people and having self worth. On the other hand, if a child grows up
in a family where he or she is neglected by his or her parents he or she will develop
unhealthy and negative core beliefs. He or she will grow up to believe that people in the
world do not care about him or her. Later on in life, the person will have trouble keeping
stable relationships and will experience feelings of isolation. Generally, addicts do not
perceive themselves as worthwhile human beings. They cope with these feelings of
isolation and weakness by engaging in excessive sex
Treatment
Some sexual addiction proponents have commented that the concept faces many
obstacles to being viewed seriously by the general public. One of these obstacles is the
manner in which it is portrayed in popular media. Daily media sources sensationalize
and denigrate people who are reported to be sex addicts. This portrayal typically
extends into fictional television shows and movies.
Self-help groups such as Sex Addicts Anonymous, Sexaholics Anonymous, and Sex
and Love Addicts Anonymous are popular with proponents of the sexual addiction
concept. These are large groups based on the 12-step system of Alcoholics
Anonymous. There are various online support forums as well as real-life help through
an out- or in-patient program or private counselor.
Conclusions
The Society for the Advancement of Sexual Health estimates that 3-5 percent of
Americans suffer from sexual addiction. They call their estimate “conservative” because
the numbers are only based on those who seek treatment. Many don’t because of the
stigma attached to it.  Proponents of addiction as the cause of the phenomenon refer to
it as "sexual addiction" and often compare it to substance addictions.  Proponents of
lack-of-control as the cause of the phenomenon refer to it as "sexual compulsivity" and
consider it part of the obsessive-compulsive disorders (OCD).   Skeptics believe that it
is a myth that the phenomenon exists as a disease or disorder at all and is instead a by-
product of cultural and other influences.  
Sex drive varies widely in humans; what one person would regard as a normal sex
.
drive might be deemed to be excessive by some and low by others.  Sexologists have
not reached any consensus regarding whether sexual addiction exists or, if it does, how
to describe the phenomenon.  Despite the skepticism that surrounds it, “sexual
addiction” is a topic that can’t be ignored.  While most people will not even talk about the
subject, the fact is that many of these people know someone who fits the bill, whether it’
s a friend who spends every night of the week hooking up with strangers at the expense
of sleep and relationships, or a coworker who gets fired for constantly surfing for porn
during office hours.




















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