Editor’s note:

This is a 2-part series tackling sexual addictions among Muslims from a Psychological point of view.

You can find part one here.

Both cases of part one illustrate Sexual Addiction. The first example may illustrate an environmental-social model of addiction and the second a possible biological etiology.

Sexual Addiction is a real addiction as any other such as alcohol, cigarettes, heroin, cocaine and so forth.

PsychCentral outlines the following behaviors are indicative of a possible sexual addiction: Compulsive masturbation with or without pornography; ongoing abuse of soft- and hard-core porn; multiple affairs and brief “serial” relationships; attending strip clubs, adult bookstores and similar sex-focused environments, prostitution, or use of prostitutes and “sensual” massage; compulsive use of cybersex;  ongoing anonymous sexual hookups with people met online or in person; repeated patterns of unsafe sex; seeking sexual experiences without regard to the immediate or long-term consequences; and exhibitionism or voyeurism.”

What identifies a sex addict?

While this is not a complete list, it is one that therapists often utilize when assessing someone for sexual addiction. In addition, therapists look for “loss of control over sexual thoughts and behaviors, escalation in frequency and intensity of sexual activities, negative consequences resulting from sexual behaviors, losing significant amounts of time as well as interest in other activities as a result of pursuing or engaging in sexual activities, irritability, and defensiveness or anger when trying to stop a particular sexual behavior as signs” (1).

In open-ended interviews, many sex addicts report a type of “euphoria and detachment, disassociation, trance-like feelings while engaged in the act”.

The euphoria and trance-like state related to the sexual acts are indicative of a possible biological etiology and similar to drug addiction “research suggests that these feelings, often described as being in “the bubble” or “a trance,” are the result of the neurochemical process induced by a fantasy-based release of adrenaline, dopamine, endorphins and serotonin, not dissimilar to a “fight or flight” response” (2).

This coupled with denial, manipulation, lying, and other defensive tactics can provide therapists, researchers and others with a model similar to alcohol/drug addiction, which is recognized by the DSM-V (The Diagnostic and Statistical Manual of Mental Disorders).

According to Nymag “The term “sexual addiction” first showed up in the DSM-III in 1980, but was removed in the 1994 edition owing to lack of research.” and “In an overview of the DSM-V changes, the American Psychiatric Association offers a caveat to the section on sexual disorders: “Research suggests that sexual response is not always a linear, uniform process and that the distinction between certain phases (e.g., desire and arousal) may be artificial” (3). Many therapists who work with those who have sexual addictions are outraged by the DSM-V decision to omit this as a clinical disorder. It does exist in the DSM-V, but only in vague terms.

Speculations about omitting Sexual Addiction from the DSM-V range from a lack of ability to obtain a large pool of research studies that are reliable and valid. The factors that define and contribute to Sexual Addiction are very personal and somewhat obscure, making it hard to conduct research in a reliable manner.

It is also interesting to point out that the DSM-V does have a category for sexual dysfunctions for woman “hypoactive sexual-desire disorder” or low sex drive. How convenient, how gender specific, and how sexist, given that 85% of people with sexual addictions are men (4).

In light of the absence of a clear clinical diagnostic code and subset of criteria, the DSM-V, PsychCentral uses the National Council on Sexual Addiction and Compulsivity definition of sexual addiction stating:

“engaging in persistent and escalating patterns of sexual behavior acted out despite increasing negative consequences to self and others.”

In other words, a sex addict will continue to engage in certain sexual behaviors despite facing potential health risks, financial problems, shattered relationships or even arrest.” This definition is in alignment with other addictions. While the person who addicted may desire to stop or even attempt to stop, they cannot. In this light, it may be viewed as a compulsion and therefore may also be classified in the future as part of the OCD complex.

Causes & treatment

Causes of sexual addiction are similar to those of other addictions. Some researchers have found strong correlations between sexual addiction and having distant, cold parents while growing up. A study found that “82 percent of sex addicts reported being sexually abused as children. Sex addicts often describe their parents as rigid, distant and uncaring.” Others have reported high numbers of patients with sexual addictions have fears of abandonment, separation anxiety, low self-esteem, unmet emotional needs as well as a fear of intimacy (5).

Treatment for sexual addition has included the tradition 12 step program approaches as seen in AA (Alcoholics Anonymous). Therapeutic approaches include cognitive behavioral therapy, support groups, medications. Medications which have shown to be useful are mood stabilizers, SSRI’s, and “naltrexone, a medication that is often used to decrease the effects of narcotic medications, may be useful for decreasing the sexual compulsions” (6).

Addictions are difficult to treat, ask anyone who has been an addict and they will tell you they have relapsed many times. I had several clients with addictions and it was not uncommon to hear of relapsing 20-80 times within a 10-year-period.

The most successful clients who suffered with addictions reported what kept them “clean” away from the substance or thing they were addicted to, were the ones who maintained their spirituality/connection with God and attended their weekly support group sessions. It was not one or the other variable, but both combined.