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Thursday, February 11,2010

Slaves to Sex: Patients, therapists share the dark side of an emerging addiction

By Katherine Creel

Don't miss Dr. Jenni Skyler's debut of her Sophisticated Sex column, "Is Tiger Woods really a sex addict?"

Since his first sexual encounter at age 16, Andrew, who is now in his 40s, has had more than 3,000 anonymous partners.

When March rolls around, however, he will have an anniversary to celebrate. It will mark his ninth year in sex addiction therapy.

He describes his experience as a “progression of compulsive sexual behaviors,” from pornography and masturbation to cruising and using chat rooms to find random partners.

Even when his behavior made him feel “like shit,” he says, he couldn’t control his compulsion. He couldn’t stop.

Roger, as he asked to be called, first discovered pornography at a young age. It was at the time, however, when magazines and videotapes — not the Internet — were the main sources. Back then, he says, it was “a hassle” to get a hold of erotic material, since it involved a trip to adult bookstores or video stores and all of the possible embarrassments that could occur.

The availability of the Internet, though, took away that hassle and brought affordable, anonymous smut right into his home. For Roger, that accessibility changed an occasional pastime into a compulsive obsession, one that began to interfere with his job and take time from away from his relationship with his family.

While his significant other was out of town, Tim (also a pseudonym) spent a week on a “sexual bender,” spending night after night visiting adult video chat rooms and using the Internet to try to find women to sleep with, often engaging in this behavior well into the following morning.

“I would try to work,” he says, “and find myself checking out online personals for someone to casually hook up with.

“I couldn’t stop.”

Each of these men belong to an anonymous support group for sexual addiction modeled on the 12-step program of Alcoholics Anonymous, such as Colorado Sex Addicts Anonymous and Sexaholics Anonymous. And while each man describes his addiction as “isolating,” they are far from alone in numbers. According to some estimates, as much as 8 percent of the population suffers from some form of compulsive sexual behavior, and the true figure could be much higher due to underreporting.

Sex addiction, as it’s commonly called, can take many forms, from compulsive masturbation, excessive use of pornography, high-risk anonymous sex, prostitution, voyeurism, exhibitionism and multiple affairs. Yet defining it can be difficult, especially when the media and popular focus is more on the “sex” than on the “addiction.”

“Sex addiction is continued and escalating sexual behavior,” says therapist Pam Kohll of Boulder. She says that “escalating” means taking greater and greater risks, such as unprotected casual sex, jeopardizing relationships or even risking an entire career because of sex or pornography.

While most people would complain about not enough sex long before they’d complain about too much, addicts don’t enjoy their addiction any more than an alcoholic does. For them, the passion, intimacy and satisfaction of sex have been stripped away, replaced by feelings of shame, loneliness and helplessness.

“Sex addiction is really not about sex,” Tim says.

“It’s a symptom of a larger problem.” For most addicts, their behavior is a coping mechanism to manage painful emotions.

Public perception of sex addiction is mixed, with some people joking that it’s the “best addiction” and others dismissing it as just an excuse for infidelity. People often wonder how a man with a beautiful wife could possibly choose to be unfaithful, forgetting that addiction isn’t really about choice.

Part of the reason is that “process addictions” — addictions such as compulsive gambling and overeating, which are based in behavior rather than substances — aren’t very well understood by the public.

Chemical addictions such as alcoholism rely on an outside chemical to produce a high or relieve a craving. Process addictions, on the other hand, are all about the brain’s response to specific behaviors.

“The feel-good chemicals, the dopamine, are released as you’re doing the behavior,” local therapist Mark Miller explains, and that behavior can be looking at porn, masturbating or visiting a prostitute. The rush that comes with those chemicals becomes the goal, and the sex act merely a means to that end. With compulsive use of sex, Miller says, the very structure and operation of the brain changes, cementing the compulsive nature of the behavior.

Michael Barta, founder and executive director of the Boulder Sexual Addiction Recovery Center, has been treating sexual addictions for more than 18 years. He explains that the brain of a sex addict is “hijacked” by the need for that rush.

“You’re addicted to your own chemicals,” he says.

“You can’t stop because you’re addicted to your brain chemicals.”

“It’s really like Dr. Jekyll and Mr. Hyde.” And like any addiction, achieving that high becomes more and more difficult with time. Both Miller and Barta emphasize the escalating nature of sex addiction. Behavior becomes riskier and more reckless.

While almost everyone enjoys having sex, addicts are so intently focused on achieving the “high” that all enjoyment is leeched away. For the majority of people, the typical progression of sexual feelings goes from interest to arousal to stimulation and finally to satisfaction. For sex addicts, the progression is compressed to immediate arousal and climax. The satisfaction phase — the time after an orgasm when partners are relaxed and intimate — is almost nonexistent, as the addict’s brain immediately begins craving its next rush.

“Sex addicts substitute intensity for intimacy,” Kohll says.

Miller, who works with the Denver-based Redimere Group, has been treating various addictions for more than a decade. About eight or 10 years ago, he says, he noticed fewer people coming into his office to talk about their drinking problem and more people talking about their sex addiction. Now, roughly half of his practice is related to sex addiction, and that proportion isn’t likely to go down.

“By all indications,” he says, “it’s growing.” Just because the problem is growing, however, doesn’t mean public understanding of the issue has followed.

“Sex addiction is like alcoholism in 1935,” Barta says.

Most people see sex addiction as a moral issue, he says, similar to the bygone view that alcoholism was something that could be overcome with willpower and self-discipline.

And addicts themselves often feel the same way. “I saw the problem as a moral failing,” Tim says.

“I thought that if I merely deepened my own spiritual practice, or took to exercise, that I could solve the problem on my own.”

Roger says that such a view is common among addicts. “A thousand, five thousand, ten thousand times we’ve vowed ‘never again,’” Roger says.

Each lapse, he says, only increases the addicts’ feelings of guilt and hopelessness.

For many of the men — and about 75 percent of those attending anonymous support groups around Boulder are male — their addiction is layered with other issues, from substance abuse to mental difficulties, such as depression and suicidal thoughts.

It also affects a broader range of people than most would imagine.

Roger says that anywhere from 40 to 50 people attend each session of local weekly meetings of sex addiction support groups, and there are several sessions each week. Included in the numbers are men and women from all backgrounds and upbringings, and even some well-known figures.

“It’s an equal-opportunity addiction,” Roger says.

“And it wants you.”

What most people want to know, however, is who’s got it.

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Sex addiction provides an increasingly popular explanation as to why men buy women and girls for sex. Many professional therapists and their clients support this theory, perhaps in part because the therapists directly profit and the clients are viewed with some empathy as victims of loneliness exploited by a multi billion-dollar industry.

Having helped rape victims including prostituted/trafficked women and girls for 10 years, I am compelled to write to offer another point of view.

Consider for a moment if we were talking about therapy and groups to help white people handle their shame and embarrassment for the way in which they bought and enslaved black people. We would not tolerate that today. So why do we accept the theory when we are talking about the buying and selling of women? There is a notion that women are voluntarily in the sex trade but in reality the average age of entry into prostitution in the US is 12-14 and 87%  say they would leave prostitution if they could. Most experience severe violence and bear the brunt of the harm – not the men who buy them.

In a recent major study of “Why Men Buy Sex” most of the buyers told the researchers that they would be easily deterred if the current laws were implemented. Fines, public exposure, employers being informed, ... the risk of a criminal record would stop most of the men from continuing to pay for sex. Discovering the women were trafficked, pimped or otherwise coerced would not appear to be effective according to the 700 men interviewed. Men know that the women are underage and harmed and they buy them anyway.

The slave owners knew that there was harm done to the people they bought and exploited but it was not enough to stop them.

Criminalizing the slave owners and offering freed slaves equal opportunities stopped the slave trade. We can learn from the slavery abolitionists and help improve the humanity not only of the men that purchase women but also save the lives of the women and girls trapped in the sex trade today.

Louisa C. Russell