sex addiction

Sexual addiction is a controversial term used to describe a phenomenon in which individuals report being unable to manage their sexual urges. While the condition is not universally accepted by sex researchers and there is some debate, proponents of the idea have offered definitions of sexual addiction modeled after common definitions of substance addictions, but replacing the substance with sexual behavior. Skeptics believe that sex addiction is a myth, a by-product of cultural and other influences.

Proponents of the concept have described sex addicts as people who repeatedly and compulsively try to connect with others through highly impersonal intimate behaviors: masturbation, empty affairs, frequent visits to prostitutes, voyeurism, and the like. They have argued that there is an adrenaline rush that can be achieved through these obsessive, highly ritualized patterns of sexual behavior.^[1] Proponents have compared sexual addiction with alcohol and drug addiction and have argued that sexual addiction is a worldwide problem. Sexual Addiction and Compulsivity: The Journal of Treatment and Prevention, a journal in which proponents explore the topic, has devoted an entire issue to AIDS and sex addiction as a worldwide problem.^[2]

1 Definition
2 Symptoms and proposed diagnostic criteria
- 2.1 Other criteria
- 2.2 Controversy
3 Epidemiology
4 Manifestation
5 Sexual addiction cycle
6 Etiology
7 Treatment
8 Portrayal in popular culture
9 Notes
10 Further reading
11 See also
12 External links

Definition

Sexologists have not reached any consensus regarding sexual addiction. Some experts believe that sexual addiction is literally an addiction, directly analogous to alcohol and drug addictions.^[3]^[4]^[5] Other experts believe that sexual addiction is actually a form of obsessive compulsive disorder and refer to it as sexual compulsivity.^[6]^[7] Still other experts believe that sex addiction is itself a myth, a by-product of cultural and other influences.^[8]

In their book, Substance Abuse, Lowinson and colleagues use the addiction model and define sexual addiction as a condition in which some form of sexual behaviour is employed in a pattern that is characterized at least by two key features: recurrent failure to control the behaviour and continuation of the behaviour despite harmful consequences. ^[9]

Patrick Carnes, another proponent of the addiction model of sexual addiction, argued that most professionals in the field agree with the World Health Organization's definition of addiction.^[10]^[4]

Richard Irons and Jennifer P. Schneider have argued, "Addictive sexual disorders which do not fit into standard DSM-IV categories can best be diagnosed using an adaptation of the DSM-IV criteria for substance dependence."^[11]

Symptoms and proposed diagnostic criteria

Because there are no diagnostic criteria established in the DSM-IV, there is controversy regarding the existence of sexual addiction and regarding treatment. An abstract on the problem of the DSM IV's exclusion of sexual compulsive behavior is outlined in: "Differential Diagnosis of Addictive Sexual Disorders Using the DSM-IV", Sexual Addiction & Compulsivity 1996, Volume 3, pp 7-21, 1996. by Richard Irons, M. D. and Jennifer P. Schneider, M.D., Ph.D.

Patrick Carnes, a proponent of the idea of sexual addiction, proposed using:^[12]

Recurrent failure (pattern) to resist impulses to engage in extreme acts of lewd sex.
Frequent engaging in those behaviors to a greater extent or over a longer period of time than intended.
Persistent desire or unsuccessful efforts to stop, reduce, or control those behaviors.
Inordinate amount of time spent in obtaining sex, being sexual, or recovering from sexual experience.
Preoccupation with the behavior or preparatory activities.
Frequent engaging in violent sexual behavior when expected to fulfill occupational, academic, domestic, or social obligations.
Continuation of the behavior despite knowledge of having a persistent or recurrent social, financial, psychological, or physical problem that is caused or exacerbated by the behavior.
Need to increase the intensity, frequency, number, or risk of behaviors to achieve the desired effect, or diminished effect with continued behaviors at the same level of intensity, frequency, number, or risk.
Giving up or limiting social, occupational, or recreational activities because of the behavior.
Distress, anxiety, restlessness, or violence if unable to engage in the behavior.

Schneider identified three indicators of sexual addiction: compulsivity, continuation despite consequences, and obsession.^[13]

Compulsivity: This is the loss of the ability to choose freely whether to stop or continue a behavior.^[14]
Continuation despite consequences: When addicts take their addiction too far, it can cause negative effects in their lives. They may start withdrawing from family life to pursue sexual activity. This withdrawal may cause them to neglect their children or cause their partners to leave them. Addicts risk money, marriage, family and career in order to satisfy their sexual desires.^[15] Despite all of these consequences, they continue indulging in excessive sexual activity.
Obsession: This is when people cannot help themselves from thinking a particular thought. Sex addicts spend whole days consumed by sexual thoughts. They develop elaborate fantasies, find new ways of obtaining sex and mentally revisit past experiences. Because their minds are so preoccupied by these thoughts, other areas of their lives that they could be thinking about are neglected.

Eli Coleman proposed:^[16]

involves recurrent and intense normophilic (nonparaphilic) sexually arousing fantasies, sexual urges, and behaviors that cause clinically significant distress in social, occupational, or other important areas of functioning; and
is not due simply to another medical condition, substance use disorder, or a developmental disorder

Goodman proposed:^[17]
A maladaptive pattern of behavior, leading to clinically significant impairment or distress, as manifested by three (or more) of the following, occurring at any time in the same 12-month period:

tolerance, as defined by either of the following:
1. a need for markedly increased amount or intensity of the behavior to achieve the desired effect
markedly diminished effect with continued involvement in the behavior at the same level or intensity
withdrawal, as manifested by either of the following:
1. characteristic psychophysiological withdrawal syndrome of physiologically described changes and/or psychologically described changes upon discontinuation of the behavior
2. the same {or a closely related) behavior is engaged in to relieve or avoid withdrawal symptoms
the behavior is often engaged in over a longer period, in greater quantity, or at a higher intensity than was intended
there is a persistent desire or unsuccessful efforts to cut down or control the behavior
a great deal of time spent in activities necessary to prepare for the behavior, to engage in the behavior, or to recover from its effects
important social, occupational, or recreational activities are given up or reduced because of the behavior
the behavior continues despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the behavior

Other criteria

The DSM-IV describes one example under the heading of "Sexual Disorders Not Otherwise Specified" as "distress about a pattern of repeated sexual relationships involving a succession of lovers who are experienced by the individual only as things to be used." Other examples include: compulsive fixation on an unattainable partner, compulsive masturbation, compulsive love relationships, and compulsive sexuality in a relationship.

Controversy

There are many people and organizations who do not acknowledge sexual addiction as a valid form of addiction. There is an argument as to whether the term has any true meaning for describing human sexual behavior. Many view sexual addiction as an excuse for acting out in this fashion. Other distinctions are difficult to make in a clinical sense, as in between promiscuity and sexual addiction as the main difference lies within the motivation of the act.

Other interpretations of sexual addiction (other than addiction): a compulsion, an impulse control disorder, a sexual desire disorder, a lack of morals and willpower, a form of obsessive compulsive disorder, a disease.

Those who do recognize sexual addiction often equate it to food, gambling addiction, and shopping addictions, where an outside substance isn't used to create the "high."

Epidemiology

Sexual addiction is hypothesized to be (but is not always) associated with Obsessive-compulsive disorder (OCD), Narcissistic personality disorder,^[18]^[19] and manic-depression.^[20] There are those who suffer from more than one condition simultaneously (known as a dual diagnosis or a co-occurring disorder), but traits of addiction are often confused with those of these disorders, often due to most clinicians not being adequately trained in diagnosis and characteristics of addictions, and many clinicians tending to avoid use of the diagnosis at all.^[5]^[21]^[22]

Specialists in obsessive-compulsive disorder (OCD) and addictions use the same terms to refer to different symptoms. In addictions, obsession is progressive and pervasive, and develops along with denial; the person usually does not see themselves as preoccupied, and simultaneously makes excuses, justifies and blames. Compulsion is present only while the addict is physically dependent on the activity for physiological stasis. Constant repetition of the activity creates a chemically dependent state. If the addict acts out when not in this state, it is seen as being spurred by the obsession only. Some addicts do have OCD as well as addiction, and the symptoms will interact.^[21]

Addicts often display narcissistic traits, which often clear as sobriety is achieved. Others do exhibit the full personality disorder even after successful addiction treatment.^[18] Some bipolar people are misdiagnosed as sex addicts. Some sex addicts are misdiagnosed as bipolar. Some addicts do also suffer from bipolar disorder.^{[citation needed]}^{[original research?]}

This article needs additional citations for verification.
Please help improve this article by adding reliable references. Unsourced material may be challenged and removed. (September 2007)

Manifestation

According to the book Synopsis of Psychiatry, sex addicts are unable to control their sexual impulses, which can involve the entire spectrum of sexual fantasy or behavior. Eventually, the need for sexual activity increases, and the person's behavior is motivated solely by the persistent desire to experience the sex act and the history usually reveals a long-standing pattern of such behavior, which the person repeatedly has tried to stop, but without success. Although a patient may have feeling of guilt and remorse after the act, these feelings do not suffice to prevent its recurrence and the patient may report that the need to act out is most severe during stressful periods or when angry, depressed, anxious, or otherwise dysphoric. Eventually, the sexual activity interferes with the person's social, vocational, or marital life, which begins to deteriorate.^[23]

According to proponents of the concept, sexual addicts may enjoy frequent sexual intercourse and other sexual activities including sexual fantasies, but the key to this addiction is more the enjoyment of the journey rather than the destination. That is, sexual addicts do not require an orgasmic event in order to feel accomplished in the pursuit of their addiction. This is why sex addicts are sometimes referred to as "chemical addicts", because of the high dose of brain chemicals that are released during sexual activity, arousal and sexual fantasizing. This heavy dose of brain chemicals is what the sex addict is really after (although many do not even realize it). Some reports indicate that these chemicals are hundreds of times more addictive than heroin or cocaine. While sexually, and even romantically, stimulating activities are what they seek, internally the shot of brain chemicals released when they engage in these activities is what they crave. One such brain chemical released by their activities is the "feel good" neurotransmitter dopamine. Dopamine levels rise dramatically when they are engaged in romantically and sexually enjoyable activities. It is this heightened level that provides them with a feeling of euphoria. An orgasm boosts this level even higher. Certain illegal drugs also facilitate the same release, for example methamphetamines or cocaine. These drugs are believed to raise the level of dopamine in the brain to as much as thirty times that which is present during an orgasm. This makes these drugs' effects on the brain extremely enjoyable and highly desirable to people seeking mood elevation.^{[citation needed]}

Individuals who experience mood issues and discover the soothing effects brought on by these brain chemicals quickly learn which behaviors can effectively repeat the experience. Thereafter, a cascading effect begins. Already prone toward tendencies for compulsive or obsessive behavior, the sexual addict starts repeating 'rewarding' activities with a repetition that quickly creates a conditioned response.^{[citation needed]} Over time, however, the constant release of these mood-elevating brain chemicals into the body causes them to lose their effectiveness and so addicts find themselves needing to increase, vary or intensify their activities more in order to achieve a similar effect.^[24] (Interestingly, the brain chemical releases triggered by the sexual addict are similar to those experienced by gamblers and food addicts.)^{[citation needed]}

According to proponents of the sexual addiction concept, the addicts' obsessive/compulsive tendencies are demonstrated by the frequency with which they use masturbation for stimulation. Quite often they will perform this activity to the point of injury or to where it interferes significantly with ordinary life. Masturbatory activities, because they are an effective and efficient path to success, combined with the sex addict's fear of truly intimate relationships, makes them a desirable alternative to sexual interactions with others. When a sexual addict does feel comfortable enough to involve other people, quite often they seek out strangers for anonymous sex or look for 'new love' through infidelity. Prostitutes are also employed because of their anonymity and non-judgmental willingness to engage in the sometimes unconventional sexual requests of sex addicts. The varying nature of a sexual addict's activities are in sharp contrast to individuals who commonly prefer more narrowly focused sexual activities such as those engaging in fetishism. But this is not to say that sex addicts cannot be found pursuing fetishes.

As mentioned before, a key feature of sexual addiction is its supposedly compulsive, unmanageable nature. Whereas a normal person might stare as they drive past an attractive person, a sexual addict will drive around the block to stare again. They may even plan future ways to spot attractive people so they can repeat the experience over and over. Addicts can spend an extraordinary amount of time and money on their habit, entirely lacking the ability to control it. They often experience an almost trance-like state in which acting out can go on for many hours. As with other addictions, some addicts experience episodic binges (between which they may believe there is no problem), while others experience more continuous problems. Some sexual addicts also swing into the opposite end of the spectrum, engaging in sexual anorexia, where they so tightly control themselves that they have absolutely no sexual experiences. This does not control or cure the basic compulsion but, like food addictions, is simply another manifestation of the addiction.

Some sexual addicts act in more intrusive ways, or progress to them, as they experience diminishing "highs" for their original activities. A Level 2 addict might include voyeurism, exhibitionism, and frotteurism. A Level 3 addict involves much more serious and intrusive sexual offenses, and has more harmful consequences.^{[citation needed]}

Sexual addiction cycle

See also: Pornography_addiction#Stages in Pornography addiction

According to Patrick Carnes the cycle begins with the "Core Beliefs" that sex addicts hold:^[25]

"I am basically a bad, unworthy person."
"No one would love me as I am."
"My needs are never going to be met if I have to depend on others."
"Sex is my most important need."

These beliefs drive the addiction on its progressive and destructive course:^[25]

Pain agent — First a pain agent is triggered / emotional discomfort (e.g. shame, anger, unresolved conflict). Sex addict is not able to take care of the pain agent in a healthy way.

Disassociation — Prior to acting out sexually, the sex addict goes through a period of mental preoccupation or obsession. Sex addict begins to disassociate (moves away from his or her feelings). A separation begins to take place between his or her mind and his or her emotional self.

Altered state of consciousness / a trance state / bubble of euphoric fantasized experience — Sex addict is disconnected from his or her emotions and he or she becomes pre-occupied with acting out behaviours. The reality becomes blocked out/distorted.

Preoccupation or "sexual pressure" — involves obsessing about being sexual or romantic. Fantasy becomes an obsession that serves in some way to avoid life. The addict's thoughts become focused on reaching a mood-altering high without actually acting-out sexually. He or she thinks about sex to produce a trance-like state of arousal in order to fully eliminate feelings of the current pain of reality. Thinking about sex and planning out how to reach orgasm can continue for minutes or hours before moving into the next stage of the cycle.

Ritualization or "acting out." — These obsessions are intensified through the use of ritualization or acting out. A sex addict first cruises and then goes to a strip show to heighten his or her arousal until he or she is beyond the point of saying no. Ritualization helps to put distance between reality and sexual obsession. Rituals are a way to induce trance and further separate oneself from reality. Once the addict has begun his or her ritual, the chances of stopping that cycle diminish greatly. He or she is giving into the pull of the compelling sex act.

Sexual compulsivity — The next phase of the cycle is sexual compulsivity or "sex act". The tensions that the addict feels are reduced by acting on their sexual feelings. They feel better for the moment, thanks to the release that occurs. Compulsivity simply means that addicts regularly get to the point where sex becomes inevitable, no matter what the circumstances or the consequences. The compulsive act, which normally ends in orgasm, is perhaps the starkest reminder of the degradation involved in the addiction as the person realizes that he or she has become nothing more than a slave to the addiction.

Despair — Almost immediately reality sets in and the addict begins to feel ashamed. This point of the cycle is a painful place where the Addict has been many, many times. The last time the Addict was at this low point, they probably promised to never do it again. Yet once again, they act out and that leads to despair. He or she may feel he or she has betrayed spiritual beliefs, possibly a partner, and his or her own sense of integrity. At a superficial level, the addict hopes that this will be the last battle.

According to Carnes, for many addicts, this dark emotion brings on depression and feelings of hopelessness. One easy way to cure feelings of despair is to start obsessing all over again. The cycle then perpetuates itself.^[26]

Etiology

Proponents of sexual addiction theorize the following factors to be involved in the etiology of the condition:

Trauma
Neurochemistry
- Neural pathways, e.g. Mesolimbic pathway
- Relationship of depression, anxiety, OCD, and Attention Disorders to Sexual Addiction
Social conditioning and imprinting
Developmental impairments
Interaction of loneliness, anger, boredom, and spiritual rebellion
Psychodynamic Perspective:

The psychodynamic perspective is a very effective system to use when explaining sexual addiction. This perspective places very much importance on early childhood development. The way that a child is treated by his or her parents and his or her peers during his childhood and youth has a great impact on his or her later life. Negative events and maltreatment that occurs during this period can scar the rest of a child’s life. The impression that these elements have on someone’s life are very hard to later eliminate.

Patrick Carnes (2001, p.40) argues that when children are growing up, they develop “core beliefs” through the way that their family functions and treats them. If a child is brought up in a family where his or her parents take proper care of him or her, he or she has good chances of growing up, having faith in other people and having self worth. On the other hand, if a child grows up in a family where he or she is neglected by his or her parents he or she will develop unhealthy and negative core beliefs. He or she will grow up to believe that people in the world do not care about him or her. Later on in life, the person will have trouble keeping stable relationships and will experience feelings of isolation. Generally, addicts do not perceive themselves as worthwhile human beings (Carnes, Delmonico and Griffin, 2001, p. 40). They cope with these feelings of isolation and weakness by engaging in excessive sex (Poudat, 2005, p.121).

The development of a sexual addiction theoretically, for some, starts early in life through adolescent experimentation, the discovery of self-stimulation, or early exposure to pornography and other sexual stimulants. Sex becomes a powerful, exciting obsession very early on and the addiction accelerates. For others it may start later in life—during graduate school, divorce, or when stresses become so great that an escape is needed. It becomes a way to self-medicate and cope with the pressures of life and the guilt and shame that follow the addictive behavior.

Treatment

Self-help groups such as Sex Addicts Anonymous, Sexaholics Anonymous, and Sex and Love Addicts Anonymous are popular with proponents of the sexual addiction concept. These are large groups based on the 12-step system of Alcoholics Anonymous. There are various online support forums as well as real-life help through an out- or in-patient program or private counsellor. Some intensive programs work with both the addict and the addict's partner. Health-based programs focus on value development, life management skills and emotional maturity, as opposed to the more traditional disease-based model geared towards managing addiction. In many instances the treatment approaches are complimentary.

Portrayal in popular culture

Some sexual addiction proponents have commented that the concept faces many obstacles to being viewed seriously by the general public. One of these obstacles is the manner in which it is portrayed in popular media. Daily media sources sensationalize and denigrate people who are reported to be sex addicts. This portrayal typically extends into fictional television shows and movies.

In the television show, Nip/Tuck, one of the main characters in some seasons, Gina Russo is portrayed as being a sex addict. She meets Christian Troy, who also has been diagnosed as having a sexual addiction by psychologist Grace Santiago, at a sexaholics anonomyous meeting, after which he sleeps with her after she was 8 months celibate. She later contracts HIV.
Caveh Zahedi's documentary film I Am A Sex Addict addresses, as the title implies, his personal obsession with prostitutes and the subsequent destruction of short-term relationships that initiate in bar/club scenes. In the film Zahedi re-enacts and reminisces on his struggles with sex addiction and his recovery from it.
Brenda, a character from HBO's Six Feet Under, was a sex addict, and while the portrayal may seem to be accurate to a point, the problem also seemed to disappear almost as fast as it appeared.
A Dirty Shame starring Tracy Ullman as Sylvia Stickles is about a conservative housewife who suffers a concussion and is passed "the gift of sex addiction" by Ray Ray Perkins (Johnny Knoxville). While the movie refers directly to Sylvia as being a sex addict, the movie does not accurately represent sexual addiction and rather mocks the stereotype of the condition.
Choke, a novel by Chuck Palahniuk, shows how the main character, Victor Mancini, snoops around groups similar to Sexaholics Anonymous, not only recovering from his own sex addiction, but also to find possible sex partners.
Love Creeps, a novel by Amanda Filipacchi, describes the romantic relationship between a stalker and a sex addict.
Slaughter Disc, written and directed by David Quitmeyer, is a modern horror film where the main character is a college-aged porn addict. The ghost of a murdered porn star seeks revenge by using a porn addict's gravitation towards explicit sexual content to kill them off and enslave their souls. This film has caused controversy amongst horror film fans as it depicts gore, graphic violence and actual explicit hardcore sex acts.
Blades of Glory, a 2007 film, features Will Ferrell as Chazz Michael Michaels, who repeatedly claims to suffer the burden of sex addiction and attends a meeting of Sex Addicts Anonymous.
The Riches, a 2007 TV series, focuses on a family of con artists. In one episode, the mother, Dahlia Malloy/Cherien Rich (Minnie Driver), is forced to pretend to be a sexual addict while conning a former baseball player (who attends Sexaholics Anonymous) into "investing" the scheme her husband Wayne Malloy/Doug Rich (Eddie Izzard) is using to avoid getting fired.
Black Snake Moan , a 2007 film directed by Craig Brewer, tells the story of how a Southern farmer named Lazarus, played by Samuel L. Jackson, takes in and looks after a young woman name Rae, played by Christina Ricci, in order to cure her of her sexual addiction.
Josh's agent in the episode 'Hard Ball' of the television show 30 Rock confides to Jack that he "needs the money, he has a really bad sex addiction". Jack is sympathetic.
DS Phil Hunter of the UK television show The Bill confesses he is a sex addict and secretly picks up a pamphlet during one of his work visits to a doctor.
In the television show Cheers, the main character and owner of the Cheers bar Sam Malone (played by Ted Danson) is a notorious womanizer. However in an episode of the show Frasier in which Sam makes a cameo, it is revealed he actually suffers from sexual addiction and has been attending meetings to help him. This plan backfires however, as Sam merely meets a new girlfriend at the meetings who is also a sex addict.
In the book My Booky Wook by Russell Brand, the first and later chapters detail his time in a Sex Addiction clinic.
The Ugly Betty character Daniel Meade is portrayed as a sex addict throughout the first season

Notes

^ Ralph Earle; Gregory M. Crow, Kevin Osborn (1989). Lonely All the Time: Recognizing, Understanding, and Overcoming Sex Addiction, for Addicts and Co-dependents. Simon & Schuster, pp.2-3.
^ Carnes, Patrick (2001). "Preface to 2001 Edition", Out of the Shadows, p.xii.
^ Cline, Dr.Victor B., Treatment and Healing of Sexual and Pornographic Addictions, http://www.obscenitycrimes.org/vbctreat.cfm, "I found that once addicted, whether to just the pornography or the later pattern of sexual acting out, they really lost their "free agency." It was like a drug addiction. And in this case their drug was sex. They could not stop the pattern of their behavior, no matter how high-risk for them it was."
^ ^a ^b Bechtel, Stefan; Larry Stains, Laurence Roy Stains (1996). "Sex Addiction", Sex: A Man's Guide. Rodale, p.381. ISBN 9780875962993. "To define sex addiction precisely is difficult, admits Julius P. Lundy, Ph.D., a sex therapist in San Antonio, Texas. But to say that sex addiction doesn't exist is clearly wrong. Most experts concur that it is a legitimate, actual problem, and is at least similar to drug and alcohol addiction."
^ ^a ^b Francoeur, Robert T. (1994). Taking Sides: Clashing Views on Controversial Issues in Human Sexuality. Dushkin Pub. Group, p.25. "some therapists have borrowed the label addiction from alcohol and substance abuse and applied it to the behavior that the patient, the therapist, or society labels "promiscuous.""
^ Francoeur, Robert T. (1994). Taking Sides: Clashing Views on Controversial Issues in Human Sexuality. Dushkin Pub. Group, p.25. ISBN 9781561342495.
^ Mayo Clinic staff (September 29, 2005). "Compulsive sexual behavior". Mental Health Center. Mayo Clinic. Retrieved on 2007-01-31.
^ Levine, M. P., & Troiden, R. R. (1988). The myth of sexual compulsivity. Journal of Sex Research, 25, 347-363.
^ Lowinson, Joyce H.; Pedro Ruiz, Robert B. Millman, John G. Langrod (2004). Substance Abuse. Lippincott Williams & Wilkins, p.508. ISBN 9780781734745.
^ Carnes, Patrick; Kenneth M. Adams (2002). Clinical Management of Sex Addiction. Psychology Press, pp.345-346.
^ Schneider, Jennifer P.; Richard Irons (1996). "Differential Diagnosis of Addictive Sexual Disorders Using the DSM-IV". Sexual Addiction & Compulsivity (Sexual Addiction & Compulsivity) 3 (3): pp 7-21, http://www.jenniferschneider.com/articles/diagnos.html.
^ Patrick Carnes; David Delmonico, Elizabeth Griffin (2001). In the Shadows of the Net, p.31.
^ (1994, p.19-44)
^ (Carnes, Delmonico, & Griffin, 2001, p. 18)
^ Arterburn, 1991, p.123
^ Coleman, E. (2003). Compulsive sexual behavior: What to call it, how to treat it? SIECUS Report, 31(5), 12.
^ (Goodman, 2001, pp. 195-196)
^ ^a ^b Ulman, Richard B.; Harry Paul (2006). The Self Psychology of Addiction and Its Treatment. Psychology Press.
^ (1989) Lonely All the Time: Recognizing, Understanding, and Overcoming Sex Addiction, for Addicts and Co-dependents, p.57.
^ Williams, Terrie M. (2008). Black Pain: It Just Looks Like We're Not Hurting. Simon & Schuster, p.114. "[..]diagnosed as bipolar or manic-depressive, but his depression first started manifesting itself as sexual addiction."
^ ^a ^b Hollander, Eric; Dan J. Stein (1997). Obsessive-compulsive Disorders. Informa Health Care, p.212.
^ (2001) Couples Therapy. Haworth Clinical Practice Press, p.375. "They found that sexual narcissism is more common among men ... These characteristics are also central to the person with a sexual addiction"
^ Sadock, Benjamin J.; Harold I. Kaplan, Virginia A. Sadock (2007). "21.3 Paraphilias and Sexual Disorder Not otherwise specified", Kaplan & Sadock's Synopsis of Psychiatry. Lippincott Williams & Wilkins.
^ :Post Register - Idaho Falls, ID:
^ ^a ^b Patrick Carnes, Out of the Shadows
^ Patrick Carnes (2006) Facing the Shadow

External links

Does Sex Addiction Exist? by Lynne Schultz
Sexual Addictions: contains characteristics of the condition and recovery advice

Retrieved from "http://en.wikipedia.org/wiki/Sexual_addiction"

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