Infidelity: Debate about Disorder Aside, Sexual Addiction Can Hurt your Marriage

What exactly is a sex addict? It seems that trying to find the globally-accepted professional interpretation of this ‘maybe’ disorder is a tall act, since consensus within the medical and therapeutic communities is definitely lacking. Not only is there little agreement, even the topic itself is subject of much debate.

The issue has resurfaced as Christie Brinkley’s divorce trial against soon-to-be ex Peter Cook has become media fodder in the last few weeks as it winds its way through the New York courts.Cook, 49, is accused of spending $3,000 monthly on Internet pornography and having an affair with an 18-year-old former toy store clerk he later hired to work in his architectural firm.

“There is frequently this debate about any addiction because addictions are normal behavior gone out of control, and the debate is really about when you draw the line about ‘out of control,’ said Tina B. Tessina, 64, Long Beach, California-based licensed psychotherapist and author. “Addictions have been designated pathology in order to get insurance funding, and some people maintain there’s no disease, only bad choices.”

Sexual addiction is not listed in the in the Diagnostic and Statistical Manual of Mental Disorders IV (DSM IV) published by the American Psychiatric Association, considered by many to be the bible in the field of psycho-analysis. It appears that what is central to the issue is whether or not sex can be considered an addictive disorder.

“I would term someone’s sexual behavior an addiction if it’s creating big problems in his or her life, such as messing up career, ruining relationships, resulting in huge debt, repeatedly creating medical problems or STDs or resulting in arrest. That last one is especially problematic because in some places behavior that is deemed normal (gay sex, sex with a 16-year-old, sex between consenting adults in Arab countries) is criminalized. But, those are the standard criteria for determining whether behavior is addictive. If it’s a problem, and you can’t stop it, it’s deemed addictive,” said Tessina. While some are quick to agree with her, others are not so certain, adding that the lines of clarity are not that clear.

“It’s bandied about as a diagnosis but one of the problems with idea of sex addiction is that it is not as simple as being addicted to a drug or even addicted to running every day,” said Dr. Scott Haltzman, 47, clinical assistant professor at Brown University Department of Science and Human Behavior, in Providence, R.I. “Sex is a complicated behavioral activity that has a lot of variables and another person often has to be involved.”

And he is not alone in his hesitance to label sex as addictive. Sexologist Leanna Wolfe says she, too, has a hard time attaching the word ‘addiction’ to the sex act.

“Mostly when I think of something as an addiction, it’s someone engaging in behavior that causes danger to self and/or loved ones. Whatever it would be compromises their values,” said the 55-year-old, Ph.D., Los Angeles-based anthropologist, sexologist, and author. According to research, she is gleaning from an ongoing, online survey, most people respond to the question of why they cheat on their spouses with a simple answer: For sex. But that doesn’t make them addicts, she says.

“I pass no judgment on people with active sex drives who have sex with those who are appropriate and want to have sex,” said Wolfe. “If someone realizes that they need a lot of sex, and goes to swing parties, that’s not addiction. Research shows that a lot of men think about sex every minute but they know how to manage it. So I would suppose the people we don’t call ‘sex addicts’ manage it through work, sports, and other activities.”

“I largely feel we here in the west, we have a lot of prudery around sexuality, we think of some things as addiction,” she added. “The umbrella that some people put it under is much too big for me.”

“I just bristle at the word addiction. I can say that there are patterns of behaviors, patterns of pornographic behaviors that mirror addiction. All factors involved in addiction happen in these types of activities — being preoccupied or focused on sex, sexual release or achieving orgasm, it can look very much like addiction,” said Haltzman. “My concern is people use the phrase ‘sex addiction’ as an excuse for their irresponsible or immoral behavior. If the adage for AA applies, namely that ‘I recognize that this is out of my control and this is a disease,’ that abdicates personal responsibility in engaging in the sex act.”

However, even those who are cautious to label anyone as a sex addict, admit that there are many cases of people becoming obsessed with sex, pornography, masturbation, prostitution and other forms of sexual gratification, even though the obsession may not be considered a diagnosable disorder.

“I agree that there can be sex addiction, but I think it is overly used. Perhaps it would apply in situations where they do culturally inappropriate behaviors with others who don’t want to be a part of it, such as pedophilia or rape, where they don’t think of the place or the person, or with those who are exhibitionists and like masturbating in public, or perhaps, Peeping Toms. It comes down to how to manage your sexuality. I basically differ with some sexologists about this definition,” said Wolfe.

Haltzman agreed, adding that it’s the overall broad-sweeping use fo the phrase that he is most annoyed by. “I guess the distinguishing characteristic with sex for the sex addict would be relatively indiscriminate. There would be no reason to continue with one partner versus another, if only for the self-gratifying act of having sex. For the sex addict, falling in love with someone only serves the purpose of actualizing his sexual needs. It is secondary to sex,” he added.

But while the debate continues, those who are on the opposite side of the sex addiction diagnosis debate, believe that the real issues shouldn’t be over the labeling semantics, but rather about understanding the role that sex plays in someone’s life. Therein lies the determiner.

The way I think about it is that anything in the world that you do to excess in order to distance yourself from underlying emotional discomfort, qualifies as an addiction. “Anything,” said Dr. Keith Ablow, 46, a Newburyport, Mass.-based psychiatrist and Fox News psychiatry correspondent as well as founder of Living the Truth. “So you are overeating because you don’t want to look at certain parts of your life story. That’s an addiction to food and it can cause you to be overweight. If you are somebody who has a fear of poverty so much so that you are a workaholic despite being financially stable, this impacts in a negative way as far as your relationships, or even health are concerned.”

“For sexual addiction, you’re using sex instead of intimacy as a component of a full relationship and using it to feel better about yourself or to try not to be depressed. If it is causing you problems in your life, then you should see yourself as having a sexual addiction.”

“The clearest way to decipher the symptoms of a sex addiction is to analyze the power that sex has over your life,” said Ablow. “It doesn’t have to be constantly having sex to be addicted or be a sex addict. I have treated a business person who would sit in his office all day looking at adult entertainment sites, so much so that he became financially insolvent. I have had people who are so distracted by sexual thoughts, without acting on them, more like fantasies, that they are unable to have mutually satisfying real sexual relationships. It’s tough to have a relationship with someone on drugs.”

To further muddy the water, someone who is a chronic cheater or actively seeks extra-marital affairs isn’t necessarily a sex addict, either. “Chronic cheating may not be about sex at all, although there can be similarities with sex addiction,” said Pam Ragland, 45, author of The 7 Whys of Addiction. The Rancha Santa Margarita, California-based counselor says she can remove the negative conditioning that she claims causes addiction and help individuals walk away from those damaging behaviors.

“Basically, every addiction is used to avoid feeling the bad emotions, and this is where my research about negative conditioning comes into play. By the time we are 5-years-old, we have 61 percent of our adult thoughts already formed, and a third of them are negative. A lot of people never learned basic effective coping skills which develop from ages 8 to 12. This is one of the reasons that they start with some kind of addiction early on. A person addicted to sex, it could be their first addiction, but I would guess if look under the covers you might find other addictions, too. They may have smoked or they drink too much. This is not an isolated thing.”

Ablow agreed. “Addictions are more like one another than they different. It’s been my experience of 16 years that it is absolutely essential to find out what is driving this addiction, what is the psychological fuel for this behavior,” he said.

“Compound that with the vulnerability that we are all born with, and it would seem that addictions are much more commonplace, especially at lesser degrees. There is a component in all of us. We all have the tendency to become addictive to something. Everything has potential to become addicted to gambling. That is kind of a normal, physical the release of dopamine. People are driven to seek novel experiences, otherwise, we would all die of boredom,” said Haltzman.

“But it’s when the pleasure starts to turn to pressure to continually engage in it, and then pain, it’s no longer something controllable. The irony is, they quit enjoying it. Like heroin, pretty soon you need more in the moment. And you are thinking about how you can get more in order for it to be considered an addiction,” said Ragland. And when it comes to treatment, that makes the formula a bit tricky, especially since sex isn’t like a drug or alcohol, both of which can be taken from someone’s life with little impact. Sex is a function that is directly connected with our humanness,” says Ragland.

“There are two things about sex addicts: One, they worry if are addicted to sex if they can have any of it ever again once they are recovering. And then the other part of it is they are not sure what is normal behavior and not normal behavior. They are not sure it’s ok to enjoy sex and that it’s a good thing.”

Ragland said the answer to both is yes, adding that it takes a lot of work in removing the triggers that got them there in the first place. But Tessina adds that while that may be true, the seriousness of the addiction adds a complicated layer to the treatment.

“Like all addictions, treating sex addiction has varying results. It really depends on how powerful the addictive impulses are. If it’s just bad habits, ‘I know how to have sex; I don’t know how to sustain relationships; I’m too shy to meet people, so I masturbate home alone at the computer,’ then education and therapy will work pretty quickly,” she said. If it’s self-medication for Post Traumatic Stress Disorder (PTSD), then the PTSD needs to be treated, which takes some time in therapy. Twelve-step programs like Sex Addicts Anonymous can help, but they tend to deteriorate unless there’s some professional supervision, because there are so many court referrals who are not really motivated to change.”

Ablow also points to success with 12-step programs and group therapy in general, as well as individual counseling. If there is an underlying anxiety disorder, which often times there is a with a sex addiction, it should also be treated.

“This is my deep belief after working with patients, is that you want to address the psychological roots of that need,” he said. “Why is this person using a drug or acting out sexually? What is the issue in his or her life? Then you need to motivate these people to look at their life stories, and reclaim parts of their stories that they have not understood they have.”