Sex addiction is marked not simply by poor decision-making in the face of temptation, but also by a sense of powerlessness before one’s own compulsive behavior.
There are many types of sex addicts, including so-called sexual anorexics who avoid physical intimacy with their partner and seek it out in fantasies or with others. Despite the shortage of statistics, researchers agree that the vast majority of sex addicts — over 90% — are men. Rob Weiss, founder and executive director of the Sexual Recovery Institute in Southern California, estimates that up to 5% of Americans deal with some form of sex addiction, though he says there is no real way to know.
Rehab length varies from two-week outpatient seminars to inpatient clinics that keep patients for up to six weeks. Treatment — to address both the addiction and its underlying causes — involves a mix of one-on-one sessions, group therapy and family counseling, with addicts and their partners encouraged to participate in supplemental 12-step programs.
The first step in treatment of sexual addiction is a full evaluation of a patient’s history and any past trauma. “All the men I’ve worked with — and I’ve worked with thousands of them over the years — have some profound experience of abuse and/or neglect in childhood,” says Weiss. Without addressing the underlying sexual, physical or emotional trauma that usually leads to addiction, there is little hope of ending it.
The second stage of treatment involves confronting patients’ distorted view of reality. Did the addict really believe that paying for a sensual massage was not the same thing as hiring a prostitute? Or that he or she could spend most of the day surfing the Internet for pornography and that no one would find out? These questions are not meant to shame a patient, but to force him or her to understand what really happened. As Weiss puts it, “We may not stop the behavior, but we’re going to ruin it for you.”
The last stage of treatment is relapse prevention. Therapists and patients discuss triggers for addictive behavior — unstructured time alone, for example — and identify ways to avoid them. Brian spent the first nine years of his marriage addicted to pornography. His treatment was supervised by members of his church who belonged to an anti-pornography ministry group called XXXchurch and a neighborhood friend, who all acted as “accountability partners,” monitoring his Internet usage after he decided to get sober. (Sex addiction shares use of the word sobriety with other forms of addiction, though the definition varies on the basis of an individually determined level of acceptable sexual behavior.) With the monitors’ help, which he no longer needs on a regular basis, Brian has not looked at pornography for the past four years.
A patient’s partner can also play an integral role in his or her treatment. Recovery is a three-legged stool for a couple — his recovery, her recovery and healing, and then the marriage recovery. Addicts are encouraged to disclose the full range of their behavior to their partner when confronting their distortions of reality in the second stage of treatment. If an addict happens to contract an STD and never tells his wife, “his behavior could kill her,” Weiss notes.
Clients are encouraged to come back for annual polygraphs to test their sobriety. Simply working through the addiction could take two to five years of therapy, enhanced by 12-step programs for both partners; working through related trauma could take a lifetime. Sex addiction is not about remaining abstinent for the rest of your life. It is about learning to have sex in a way that makes you happy again.