I can not want: Is there a dependence on sex
This week it became known that Kevin Spacey will be treated from sexual addiction - presumably in the same clinic where Harvey Weinstein is now undergoing therapy, who has also been repeatedly accused of harassment. Spacey and Weinstein are not the first celebrities associated with this diagnosis: at various times Michael Douglas, David Duchovny and Russell Brand were talking about him. For the first time in earnest about this problem they started talking back in the eighties: in 1983 the book of psychologist-consultant Patrick Carns was published "Out of the Shadows: Understanding Sexual Addiction". The term "sexual addiction" became popular in many respects precisely because of Karnes: he founded a clinic where he has been working with this for more than thirty years.
Sexual addiction usually refers to sexual fantasies or actions that the patient cannot control: the desire to constantly have sex, frequent use of sex services, watching porn or masturbation, virtual sex, and much more. On their own, they usually do not harm a person - dependence arises when a person can no longer control his impulses and is unable to stop when he wants, even if he feels that it is harmful to his relationship, work and financial condition, and giving up the habit gives severe discomfort.
According to Robert Weiss, founder of the Center for the Treatment of Sexual Problems in Los Angeles, for addicted people, sex becomes an obsession. “As with other addictions, a person does not behave this way because he wants to have a good time - for him it’s a way to cope with emotions,” says Robert Weiss. “They want to get away from stress, anxiety, depression and other negative experiences.” . “As in the case of any addiction, there may be another, often unaware, need for sexual intercourse, for example, in recognition or intimacy,” said psychologist Alexander Serov.
Dependence arises when a person is not able to stop, even if it harms his relationships, work and financial condition.
Deborah Schiller, a therapist and director of the program for the treatment of sexual addiction in the Pine Grove Center, says that the clinic works with a variety of patients. There are so-called traditional cases of addiction that progress with time: for example, a man masturbates, then watches a lot of porn, then has sex on the phone, then often has sex with new partners - according to an expert, often this is due to a trauma in the past. There are more "new" cases of addiction, not necessarily due to violence and unpleasant experience: "Such dependence does not progress. But people familiar with porn from childhood quickly fall into dependence on it, it becomes everything to them. One of our patients said that I watched porn every day since he turned four. Someone comes to us and says that he masturbates for six hours a day (and this happens often) - would you call it an addiction? "
Tim Lee, owner of the New York Pathways Sexual Addiction Treatment Clinic, says they take about a hundred patients a week. Among them there are several people who have committed crimes of a sexual nature, and there are those who in the past have faced trauma or violence and are now trying to recreate this pattern. “For example, I had a patient who photographed how he was given a blowjob and put photos on the Web,” Lee says. “I started asking him if he had any violence in his childhood - he said no. I asked him about how he masturbated for the first time. He thought a bit and answered: "Oh, I remembered. My dad gave me a photo in which my mother gives him a blowjob and told me to masturbate."
Although the treatment of sexual addiction is a common practice, it has not yet been included in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), nor in the International Classification of Diseases, and many believe that it cannot be considered addiction in principle. Traditionally, addiction implies an addiction to the use of any substance, the rejection of which leads to physical withdrawal syndrome. It is the absence of symptoms like pain or nausea after refusing to have frequent sex - one of the main arguments of the opponents of the term “addiction to sex”: they believe that compulsive behavior associated with sex can really cause problems to a person, but they should be considered separately.
True, in addition to situations where a person needs a substance, there is something that we could call "psychological dependence", that is, addiction or addiction - for example, kleptomania. Deborah Schiller notes that the Diagnostic and Statistical Manual of Mental Disorders has already included gambling addiction as the first behavioral addiction: "[In the guide] there is a group of disorders of habits and drives, and this is their more specific subspecies - compulsive sexual behavior."
Sex is a natural need for most people, but an attempt to determine how much sex will be “normal” and “healthy” is doomed to failure.
Nicole Proz, who studies neuroscience, believes that sexual addiction is different from addictions - kleptomania or addiction to gambling. She conducted several experiments - one of them, for example, showed that people addicted to sex, unlike people with other addictions, react differently to images related to their addiction. For example, people with alcohol addiction react more strongly to a photo of a bottle of wine than to an image that is not related to alcohol, while people with a sex addiction are less responsive to erotic photos. Another argument of Prose: if with other addictions people lose self-control, then in the case of sexual addiction everything is different. According to her research, in an experimental setting, people with sexual addiction, on the contrary, were better restrained than those who have no dependence — although they thought that this was not the case. At the same time, Proz is sure: this does not mean that people with addiction to sex do not need help - just to solve these problems is needed differently than programs to combat alcohol and drug addiction do.
"The very concept of" sexual addiction "should be treated carefully: it sounds scary, explains little, but it opens up space for sexhobic ideas and speculations," says psychologist Alexander Serov. The idea that a person may want to have sex too often, really raises questions. Sex is a natural need, but an attempt to determine how much sex will be "normal" and "healthy" is obviously doomed to failure and can become a tool for slatting, because for everyone the "norm" will be its own. According to David Ley, a clinical psychologist, psychotherapists who diagnose "sexual addiction" on the basis that a person "has too much" has sex, are repelled only by their own stereotypes. "The mistake of all these" experts "is that they are trying to apply the signs of drug and alcohol addiction to sex. They argue that if there is too much to do with it, it will act like a drug: it will be wanted even more, it will cause withdrawal syndrome, and "tolerance" to him will fall, after which sex "will subjugate their lives to themselves", "he writes in the book" The Myth of Sex Addiction ".
Alexander Serov recalls that by "sexual addiction" can often mean a pronounced libido and a rich sex life in a monogamous couple. But if the partners do not have disagreements about this, there is a lot of sex in the couple, and the relationship is so trusting that everyone has the opportunity to say that he has enough sex and needs a break - for this couple you just have to rejoice. Another common situation, according to the psychologist, is when “sexual addiction” is understood as the need to often have sex with different partners. “Instead of evaluating such a lifestyle, it’s better to study how things work,” he says. “Do I enjoy one-time connections without a subsequent feeling of shame and guilt? Do I really want sex from these meetings, rather than confirming my own attractiveness, communication or intimacy? Is it enough for me to take care of myself and my health during these meetings, etc. It’s worth thinking about revising your habits if you didn’t answer “yes” to at least one of the questions. " The same, in his opinion, relates to porn addiction: it makes sense to talk about it only when it prevents you from fulfilling other needs - for example, having sex and building romantic relationships.
Violent people most often do not feel that they have lost control of themselves - harassment or violence, on the contrary, attract them because they completely control the situation.
But if love for sex with new partners, when there is no hiding behind it, is not a problem in itself, questions remain in the story of sexual addiction. For example, can we talk about it when a person who, like Harvey Weinstein, is accused of numerous harassment and violence, comes to the clinic? “There is no evidence that harassment and sexual abuse are related to what we mean by sexual addiction,” says Nicole Proz. “For example, people who commit violence often don’t feel that they have lost control — harassment or violence, on the contrary , they are attracted by the fact that they fully control the situation. "
“It's all about domination. It's closer to beating someone, not to being dependent on sex,” Deborah Schiller says about violence. “A person who is prone to violence may also have a hidden dependence on sex that needs to be treated, - but we do not consider illegal actions and sexual addiction to be things of the same order. "
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