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Sex Addiction 101

Addiction in the 21st century

Carol Conklin

on 15 June 2011

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Transcript of Sex Addiction 101

Sex Addiction 101 Healthy Sexuality Important in both physical and mental health, fosters intimacy, bonding, and shared pleasure, and involves mutual respect between consenting partners Sexual health requires a positive and respectful approach to sexuality and sexual relationships, including pleasurable and safe sexual experiences, free of coercion, discrimination, and violence. Sexualization “Occurs when a person’s value comes only from his or her sexual appeal or behavior, to the exclusion of other characteristics..." "A person is held to a standard that equates physical attractiveness (narrowly defined) with being sexy..." "A person is sexually objectified—that is, made into a thing for others’ sexual use, rather than seen as a person with the capacity for independent action and decision making; and/or sexuality is inappropriately imposed upon a person.” www.apa.org :Report of the Task Force on the Sexualization of Girls Sexual Deviance Atypical sexual behaviors generally defined in moral, social, legal or medical terms. Sexual deviance includes a range of unusual sexual expressions from fetishism and crossdressing at the low end of the continuum, to sexual sadomasochism and pedophilia, incest, and rape at the extreme end of the continuum. Sexual Addiction (SA) A persistent pattern of sexual fantasies, urges, obsessions, or behaviors acted out compulsively despite increasingly negative consequences to self or others. Sexually Addictive Behaviors Compulsive masturbation Excessive use of pornography Dangerous, unsafe sex Multiple affairs Sexual massage, escorts, prostitutes Multiple anonymous partners Phone sex, Sexting, Cybersex Prostitution and Solicitation Objectification, partner sexualization, fantasy Strip clubs and adult bookstores Sexual anorexia Sexual Offending (SO) Unlawful sexual behaviors which involve the victimization of others, directly or indirectly (i.e., child sexual abuse, child pornography, sexual assault, rape, incest, exhibitionism, voyeurism). Offending behaviors often demonstrate addictive elements and patterns in sexual acting out. DSM-IV Sexual Disorders - Paraphilias Bestiality Coprophilia Ephebophilia Exhibitionism Frotteurism Acrotomophilia Klismophilia Necrophilia Pedophilia Somnophilia Sexual Sadism Telephone Scatologia Transvestic Fetishism Urophilia Voyeurism Vampirism Hypoxyphilia Stigmatophilia Similarities to Alcohol & Other Drug (AOD) Addictions Criteria for Substance Dependence are met. Brain chemistry changes are similar. Family background of addiction. Lack of nurturing and other forms of emotional, physical or sexual trauma in childhood. Multiple addictions can co-exist. The treatment focus is the same - involving individual and group counseling, 12-step recovery programs, and medical intervention. Causes of Sexual Addiction Biology Cultural Influences Sexualized Media Internet: The Crack Cocaine of Sexual Addiction Family of Origin The Addictive Brain Causes: Biology Reward Pathway vs. The Coach (Prefrontal Cortex) Gender Differences Causes: Brain Regions & Functions Addiction: A Disease of Motivation? Causes: Neurochemical changes potentiated by sexual arousal Stimulus – used like cocaine, amphetamines, opiates – dopamine

Satiation – used like benzodiazapines to reduce anxiety, fear, pain – serotonin, norepinephrine.

Escape – used like marijuana, LSD, other hallucinogens – serotonin, dopamine Chronic Sexual Activity “Affected individuals may fail to avoid or may even be drawn to abusive or potentially frightening or traumatic situations, and may seem helpless to alter their behavior…” R. Joseph (1996) Neuropsychiatry, Neuropsychology, and Clinical Neuroscience, pg 370. Male Gender Differences Male brain is more compartmentalized and specialized, has greater abstract and spatial reasoning, and is better in science, math, sports. Male limbic systems are more influenced by the hypothalamus, and circulating testosterone and other androgens. Aggression and competition is a source of male pleasure, and they seek and tolerate risk better. Difficulty discussing personal difficulties or expressing emotions other than anger and happiness. 20-30% lower levels of serotonin which is linked to impulsive behaviors, alcoholism, suicide, violence, sexual compulsivity. Male Gender Differences Men engage in behavioral excesses that objectify their sexual partners and require little emotional involvement (fantasy sex, voyeuristic sex, paying for sex, anonymous sex, and exploitative sex). Female Gender Differences Females have 18% larger amygdala, more numerous and densely packed neurons – which “predisposes them to be more emotionally intelligent and socially sensitive, perceptive, and expressive.” "…less aggressive, affects sexuality, feelings of dependency and nurturance and desire to maintain and form attachments in a manner different than males.” Larger corpus callosum, allow processing in both hemispheres - “bigger picture” reasoning. 20-30% higher levels of serotonin linked to fearfulness, shyness, low self-confidence, depression, mood disorders (2-3 times more than men). Female Gender Differences Women tend to be excessive in behaviors that distort power -- either in gaining control over others or being a victim (fantasy sex, seductive role sex, trading sex, and pain exchange). Women sex addicts often use sex for feelings of love, power, control and attention.

(Carnes et al, 1991, Kasl, 1989). Cultural Influences
Social Norms Sexualized Media Hyper-masculinity Early sexualization Causes: Sexualized Media Television
The amount of sexual content on television continues to increase.
References to safer sex or sexual risks or responsibilities remain rare on TV.
When intercourse on TV is depicted or strongly implied, the characters involved … are more likely to have just met. Advertising Music & Movies Causes: Hyper-masculinity Causes: Early Sexualization Pornography Carol Conklin, LCSW-R
President/Founder, iOppose, Inc.
City Gate LRC - Private Practice
Buffalo, NY www.ioppose.org
www.citygatelrc.com Sexual Violence in Advertising Boys are taught form an early age to aspire to be a very stereotypical adult-male.

Hyper-masculine places emphasis on, strength, violence, aggression, etc. and places very little value on emotional involvement when it comes to women and relationships. The early sexualization of children and adolescents leads to a distorted pattern of sexual development. The early sexualization leads to three of the most common mental health problems diagnosed in girls and women - eating disorders, low self-esteem, and depression. Children learn about sex at earlier and earlier ages due to the amount of sexualized material marketed to children and the amount of explicit material that is readily available to them via the internet. US porn revenue -13.33 billion- exceeds the combined revenues of ABC, CBS and NBC which is 6.2 billion

70% of all internet pornographic traffic occurs during the workday

15% of viewers develop sexual behavior that disrupts their lives Distorted Perceptions of Sex In an Arizona State study:

“Subject exposure to common non-violent pornography strongly impacted self-assessment of sexual experience.

Subjects reported less satisfaction with their intimate partners affection, physical appearance, sexual curiosity, and sexual performance.

Subjects assigned increased importance to sex without emotional involvement.” Internet Pornography:
A Slippery Slope Internet porn is "the crack cocaine of sexual addiction" because of anonymity, affordability, accessibility Internet Pornography “The proliferation of pornography is coloring relationships, both long and short term, reshaping expectations about sex and body image, and most worrisome of all, threatening to alter how young people learn about sex.”

Men who frequently view porn may have difficulty forming and sustaining relationships and feeling sexually satisfied Internet Child Pornography Over 100,000 websites offer child pornography.

Child pornography is a three billion dollar industry exploiting more than 1.5 million children worldwide.

1996-2007 - FBI opened 20,134 cases, and converted investigations to 9,460 Arrests, Locates, or Summons (a 2500% increase) Family of Origin Risk Factors* Addicts in the family - 87% (alcohol, drugs, work, food, sex, gambling)

Rigid Family - 87% (“no room for differences”)

Disengaged Family - 88% (“ships passing in the night”)

Rigid & Disengaged Family – 68%

Abuse/Early Trauma:
Emotional Abuse – 97%
Sexual Abuse – 81%
Physical Abuse – 72% * Based on survey and interviews with over 1000 graduates of an in-patient sexual addiction treatment program, as reported in Carnes (1991) Don’t Call It Love Family of Origin Risk Factors* Trauma and Attachment Deficits
Lack of intimacy in close/familial relationships
Low self-esteem, shame based personality
Fears of Abandonment/rejection
Blurred/rigid boundaries/confused role expectations
Social and communication skill deficits
Secretiveness and superficiality; distrust
Entitlement; lack of empathy
Cognitive distortions
Isolation and profound loneliness * Based on survey and interviews with over 1000 graduates of an in-patient sexual addiction treatment program, as reported in Carnes (1991) Don’t Call It Love Consequences Negative Consequences on individuals, partners, children, families, communities, and society


Abusive behavior

Perpetuation of abuse
Cost to society/government

Distorted perceptions of sex Sexual preoccupation – preference for compulsive behavior affects relationships.

Most sex addicts lie to their partners, keep sexual secrets, and find ways to justify their sexual behaviors.

Loss of partner, friendship and family relationships. Social Isolation, anxiety, stress from fear of discovery.

Shame and guilt increase due to violating one's own values and beliefs.

Boredom, fatigue, despair as addiction progresses.

Ultimate consequence – suicide (75% have had suicidal thoughts) Emotional Physical Disease

HPV, chlamydia, gonorrhea and syphilis (on the rise), cervical cancer, HIV/AIDS, genital herpes, genital warts, and other STDs


Self/partner inflicted physical injury, violence Legal Violation of the law:

Sexual harassment, obscene phone calls, exhibitionism, voyeurism, prostitution, solicitation, rape, incest, child molestation and child pornography

Loss of professional status:

Medical or other health care license, teaching certification, license to practice law, ministerial credentials

Prison, probation, criminal record Financial & Occupational Debt from cost of using prostitutes and escorts, cybersex, phone sex, internet pornography, affairs.

Legal fees from divorce or separation, less productivity or job loss.

Legal costs of defending illegal behaviors. Loss of connection to God, or a Higher Power – guilt and shame related to violating basis beliefs and values.

Emptiness, loneliness, resentment, self-pity, self blame, despair. Spiritual Stigma and shame

Societal perceptions of sex

Cost Barriers to Sexual Addiction Treatment Cognitive Behavioral Therapy
3 Circles - Harm Reduction
Stages of Change (Motivational Interviewing)
Psychopharmacological Current Best Practices Three Circles Inner Circle Middle Circle Outer Circle April Awareness April is both Sexual Assault Awareness and Child Abuse Prevention Month. Childhood Sexual Abuse 1 in 4 girls and 1 in 6 boys are sexually abused before the age of 18.
90% of victims know their abusers.
1 in 5 children are solicited sexually while on the internet.
Far fewer than 1/3 of child sexual abuse incidents are identified or reported
Nearly 70% of all reported sexual assaults (including assaults on adults) occur to children ages 17 and under.
An estimated 39 million survivors of childhood sexual abuse exist in America today Know the Warning Signs of Child Sexual Abuse Victim

An increase in nightmares and/or other sleeping difficulties
Withdrawn behavior
Angry outbursts
Not wanting to be left alone with a particular individual(s)
Sexual knowledge, language, and/or behaviors that are inappropriate for the child’s age Child Sexual Abuse Perpetrator

Looks to children for emotional or physical comfort
Crosses personal boundaries, i.e. insisting on hugging, kissing, or tickling
Seems unusually interested in children's or teens bodies or sexual development
Misreads typical gestures of friendliness or affection as sexual
Often has a "special" child friend; gives money or expensive gifts to this child Facts on Sexual Assault In 2007, there were 248,300 victims of rape, attempted rape, or sexual assault (victims older than12 years).*

Sexual assault is one of the most under reported crimes, with 60% still being left unreported.

Males are the least likely to report a sexual assault, though they make up about 10% of all victims *U.S. Department of Justice's National Crime Victimization Survey Sexual Assault on College Campuses At least 1 in 4 college women will be the victim of a sexual assault during her academic career.

At least 80% of all sexual assaults are committed by an acquaintance of the victim.*

In a survey of students at 171 institutions of higher education, alcohol was involved in 74% of all sexual assaults. Sexual Assault on College Campuses One in 4 college-aged women report experiences that meet the legal definitions of rape or attempted rape; but 48% did not consider the attack rape.

Most survivors of sexual assaults are full-time students. Approximately one-third of them are first year students between 17-19 years old. Sexual Assault on College Campuses One in 12 college men admitted to committing acts that met the legal definition of rape.

More than one in 5 men report "becoming so sexually aroused that they could not stop themselves from having sex," even though the woman did not consent.

35% of men report some likelihood that they would rape if they could be assured they wouldn't be caught or punished.

81% of on-campus and 84% of off-campus sexual assaults are not reported to the police. Be an Active Bystander - Speak out, Stand up! You can help prevent sexual assault by being an active bystander...

Speak out if a fellow student is being manipulated or manipulating a situation, especially when alcohol is involved.

Stand up to your male peers about the risks of sexualizing females, even if its only amongst yourselves.

Speak out and Stand up if you suspect a friend has been drugged, contact law enforcement immediately.

Be explicit with doctors so they can give you the correct tests (you will need a urine test and possibly others). Tips for Reducing the Risk of Sexual Violence Know your boundaries and express them assertively and clearly.
Trust your instincts. If you feel uncomfortable, remove yourself from the situation.
Know your limits when using alcohol and other drugs.
Prior to going out at night,determine your plan for your return home. Let someone know where you're going when you leave.
Go out in groups and do not leave a group member alone at a party or bar.
Never leave your drink unattended or drink from an open container or punch bowl.
Try not to walk alone at night. If you must walk alone, walk in well- lit areas Resources UB Campus Police Phone Number

National Sexual Assault Hotline

Child Abuse Hotline
Childhelp.org [75-90% of sex addicts] [10-25% of sex addicts] Stiffler Sexualized Media Internet: The Crack Cocaine of Sexual Addiction Biology What We've Learned Family of Origin Cultural Influences - According to Time Magazine January 19, 2004 article “The Porn Factor” - Bureau of Justice Statistics iOppose, Inc. was founded to:
To promote prevention of sexual exploitation; most importantly, child sexual abuse
Raise awareness about the harmful effects of the early sexualization of children and adolescents
Reduce the stigma and promote early intervention strategies with those at risk for developing deviant sexual behavior Become a member of iOppose by signing up today! The decline of healthy sexuality in our society is a public health issue, and when it is recognized as such we will be better equipped to intervene early and prevent sexual deviant behavior.
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