Compulsive sexuality is a complex, multi-causal disorder that incorporates various aspects of the individual’s personality, bio-chemistry, sociocultural environment, family-of-origin issues, thinking/feeling processes, gender consolidation, self-esteem, and quality of relations with others, both sexual and non-sexual. I see sex addiction as a prism; depending on the angle you hold it up to, it can look completely different.
Its complexity is shown by the fact that psychologists still don’t know if it’s a symptom of an obsessive-compulsive disorder, an impulse control disorder, or an addictive disorder. The fact that it was recognized as a distinct disorder only in the mid-80’s means that not much substantive research has been done to understand this complexing and multi-dimensional syndrome.
We do know that sexual addiction represents an expression through sexual behavior of the same processes that underlie all addictions: an enduring, inordinately strong tendency to engage in some form of pleasure-producing behavior in order to regulate unwanted emotional states or self states that are painful and potentially overwhelming. Being perpetually ensnarled in the jaws of the addiction cycle with its loss-of-control, shame and distress, negatively impacts on the person’s work/relationships/finances/self-esteem. Yet the perceived benefits seem to outweigh the high cost of the behavior, as sex addicts experience the lure of the sexual rush to be irresistible.
An integrated therapeutic approach must address both the destructive addiction to sex as well as the underlying addictive process. The challenge to the sex addiction therapist NY who orchestrates an integrated approach is that he/she needs to have the concrete skills of an addiction counselor as well as the psychological sophistication of the psychodynamic psychotherapist.
This approach brings together psychopharmacology, relapse prevention (see: www.sextreatment.com/relapse prevention. com) and 12-step participation to abate the symptom of compulsive sex. Cognitive-behavioral therapy, group therapy, and psychodynamic therapy can then work in tandem to address the addiction process that underlies the acting out.
Couples counseling is definitely indicated for people in life-long partnerships.
If sexual acting out is the top of the iceberg, then the personality deficits, recurring self-defeating patterns, trauma from early-life relationships with caretakers, unconscious conflicts and skewed perceptions about self, others and environment represent the bottom of the ice-berg. I contend that permanent freedom from enslaving, out-of-control, humiliating sexuality cannot be achieved unless the issues on the bottom of the iceberg are resolved, primarily through cognitive and psychodynamic psychotherapy.
If you take a look at my book “Total Sex Addiction Recovery – A Guide to Therapy: (available on Amazon as an e-book), I over the following modalities that can be used in treating sex addiction:
Therapy for sex addiction, then, is most likely to be effective when it emerges from an integrated approach that brings together various treatment modalities, is individually tailored and evolves as the patient progresses.