The debate between professionals today relates to how we identify process addictions.  Many professionals view sexual acting out as part of a broader symptomatology of mental illness or compulsive behaviors.   As we learn more about the processes involved with sexual acting it better fits within the addictions model.

Anxiety, depression, and compulsive thoughts apply to sexual acting out.  The sequence with which the individual experiences these emotions seems relevant to making the distinction between an addiction and a compulsion.  Process addictions such as gambling addictions, sex addictions, and binge eating disorders share a lot of common features.

One clear distinction relates to the onset of the anxiety.   Some individuals feel compelled to engage in an action to diminish their anxiety and nothing else will suffice until they have completed the act.  For these individual’s relief follows the action. Even though they realize the disruptive quality of the action on their lives. For example, if you feel the need to drive back home to make sure you locked the door, even though you did, you will not feel relief until you check.  Perhaps you feel like your preoccupation dictates your life.

Sexual addiction has similar qualities.  The preoccupation controls one’s thoughts and sometimes actions.  Just thinking and planning to engage in the action often lifts the person out of their anxiety or depression.  The mere thought of the act results in elation. However, once the addict engages in the act shame, guilt, anxiety, and depression soon set in.  The addict does not experience relief. Rather, and intense downward spiral occurs.

Once the individual completes the action, they feel worse.  The shame, guilt, and anxiety lead the addict to feel out of control and vulnerable.  Therapy is most likely sought during this part of the addiction process. The addict experiences great highs followed by very low lows.  Compulsive behaviors don’t always fit as nicely into this scenario.

The therapist misses the bigger picture by treating all process addictions as compulsive behaviors.  The addict’s treatment approach must involve family members, especially wives or significant others. Therapists describe addiction as a family disease because it has such a profound effect on individuals within the family.  When working with individuals who have children it isn’t wise to include young children in the treatment. Rather, the kids can learn new ways of interacting with their depressed or anxious parent. The children should understand they did not cause the problems.

I’m not criticizing clinicians who treat sexual addiction as a compulsion.  I simply think the two exhibit adequate differences that warrant a different look at treatment goals. In conjunction with individual treatment, marital therapy and meetings are recommended.

If you or someone you love is struggling with a sexual addiction, please don’t hesitate to call or email Dr. Goschi at (312)595-1787 or barbara@drgoschi.com.  I look forward to hearing from you in order to begin the healing process.