05/26/2013– How is Sex Addiction Treated?

According to the American Psychiatric Association’s Diagnostic and Statistical Manual IV (DSM IV), there is no official designation of sexual addictions. Does this mean they doesn’t exist? Is it something made up by doctors just to get more patients?

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The DSM IV lists a disorder known as “paraphilia.” Paraphilia is a “biomedical term used to describe sexual arousal to objects, situations, or individuals that are not part of normative stimulation, and that may cause distress or serious problems for the paraphiliac or persons associated with him or her.” The definition goes on to explain that there are more than 500 listed paraphilias. It also states that in practical terms, sexual addiction is a demonstration of uncontrollable behaviors that lie outside the norm; exhibitionism, fetishism, pornography, pedophilia, transvestism, sexual masochism and/or sadism, voyeurism, or excessive sexual demands. Until 1973, homosexuality was also included. Their definition is not universal, and certainly not applicable in every instance.

An addiction generally follows three minimum criteria: persistence despite negative consequences; increasing tolerance; and a specific withdrawal syndrome. Sexual addictions are impulsive, and generally do not include rape which is a crime of control and violence. For the sexual addictions that fit this criteria, how can they be treated?

Treatment is generally cognitive, meaning talk therapy, during which many components are examined and addressed as a source of pain that is causing the addiction. Treatment should include education about healthy sexuality, individual, group, and family counseling, and in some cases drugs such as Prozac or Anafranil may be used to curb internal cravings. The basis for the abnormal behaviors can usually be traced to childhood and like other addictions can serve to distract one from the pain of a memory. As a result of the social stigma attached to sexual “deviants,” sexually-based addictions are often held close to the person for fear of humiliation and not reported or treated. As with all addictions true recovery only commences when the addict wants to recover.

There are many experimental therapies being explored as a means to help those wishing to recover. Until society accepts that sexual addictions are consequential, and not necessarily a choice, opportunities for healing will be retarded and both the addict and society will suffer. Society needs to start the healing by changing its perception of what a sex addict really is. Only then can they truly recover.

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