Sex addiction growing among women: psychologists

By Sharon Kirkey

The women spend hours online looking at pornography or looking for sex.

Some fantasize about being sexual in public. Others cruise bars looking for anonymous encounters with strangers. Tolerance builds and things get boring, so the women have to engage in ever-riskier or more frequent behaviour to get the same “hit,” or even just to feel normal.

Little is known about the prevalence of sexual addiction in women, but psychologists say the phenomenon is real and only now getting the attention given men.

“We’re seeing women getting into pornography in a way we’ve never seen before,” says psychologist and sex-addiction research pioneer Dr. Patrick Carnes, executive director of the Gentle Path program at Pine Grove Behavioral Center in Hattiesburg, Mississippi — the clinic where Tiger Woods reportedly sought treatment.

“Women are engaging in affairs, they’re engaging in sado-masochistic behaviour,” Carnes said. “This thing is just morphing right in front of us.

“We are seeing the biggest change in human sexuality maybe in the history of our species.”

But other observers are wary of the sudden flurry of attention to sex addiction. When do obsessions about sex cross the line into a pathological brain disorder, they ask — and who should get to establish norms for accepted amounts of sexual “activity” or desire?

According to Carnes, sexual addiction is estimated to afflict as much as 3% to 6% of the population and is defined as intense, sexually arousing fantasies, urges and behaviours that the person cannot control or stop, regardless of the consequences.

Profound shame keeps women from seeking help in the same proportion as men, Penny Lawson says — shame, as well as derogatory and loaded words such as “promiscuous” and “slut” that society attaches to these kinds of behaviours in women.

As a result, “women aren’t inclined to come forward and say, ‘I need help,’” says Lawson, creator of Canada’s first residential treatment program for sexual addiction at Bellwood Health Services in Toronto.

The Internet has created once unimaginable access to sexuality, anonymity and relationships, Lawson says — or at least to the illusion of relationships, she says.

Some women spend hours online in chat rooms connecting with men. Sex completely dominates their lives. Some women have chronic affairs; some engage in exhibitionism and dangerous sexual practices. Others spend all their time in fantasy without ever acting on it, Lawson says.

According to the American Society of Addiction Medicine, all addictions are fundamentally diseases of the brain. In a newly released definition of addiction, the society says addiction results from dysfunctional circuits in specific brain regions controlling reward, motivation and memory.

Addiction is defined by cravings — an increased “hunger” for drugs or rewarding experiences — and an inability to stop the behaviour despite devastating consequences.

‘It could be actual sexual abuse by a family member, neighbour or someone in the community. But it might be finding dad’s porn. . . . It doesn’t have to be overt’ —Penny Lawson

In a 2006 article on sex addiction, Carnes described how women were taking on more “male” type behaviours, including “a new level of aggressiveness in approaching prospective sex partners.”

It may represent a shift in cultural or sexual mores, he said, or the fact “women are exercising greater freedom, which can manifest in compulsive behaviour.”

Other researchers say that women are motivated less by power, and more by pain, anxiety or desperation.

Early trauma appears to play a major role, as does a genetic vulnerability to other addictions. Women who struggle with sexually compulsive behaviour often experienced an inappropriate or premature introduction to the idea of sex, says Lawson, who recently helped organize a public meeting for women only on love, sex and relationship addiction.

“It could be actual sexual abuse by a family member, neighbour or someone in the community,” Lawson said. “But it might be finding dad’s porn. . . . It doesn’t have to be overt.”

Women usually don’t seek help until something has happened, some kind of “unacceptable consequence,” Lawson says.

“Perhaps the woman is online with multiple partners, or she’s gone to meet men she has met online and the husband finds out and says, ‘Get help or we’re done.’ She might have been discovered looking at porn online at the office.”

Lawson says that some of the women she has treated have been “high-functioning professionals” — women who can compartmentalize their lives, so that they function in their careers, marriages and as mothers without thinking about the four other relationships they have on the side.

Eventually, the behaviour becomes impossible to ignore, she says. “They don’t like what they’re doing, they don’t feel good about themselves or about what they’re doing. It goes against their own value system.”

But is sexually compulsive behaviour truly an addiction?

“That’s where I think the thinking breaks down,” says Christopher Lane, author of Shyness: How Normal Behavior Became a Sickness.

‘We are seeing the biggest change in human sexuality maybe in the history of our species’ —Dr. Patrick Carnes

“There’s a lot of presumption among mental-health professionals that compulsivity, per se, indicates addiction,” Lane wrote in an email. “But people are compulsive about all kinds of things, often activities we consider beneficial — sports, hobbies, collecting, favourite bands, you name it — without being considered addicts.”

“When we collapse the two things, we end up mislabelling everything that looks broadly compulsive to us as the sign of an addiction, but it isn’t and it’s dangerous to assume otherwise.”

For one thing, he argues, it grossly inflates and distorts the number of people taken to be “mentally ill.”

And those numbers could soon greatly expand.

Excessive thinking about or engaging in sex is poised to become a new, officially recognized mental disorder.

“Hypersexual disorder” is among the disorders being recommended for inclusion in the next edition of psychiatry’s so-called “bible” of mental illness, the Diagnostic and Statistical Manual of Mental Disorders, or DSM.

According to a DSM work group, hypersexual disorder is “one of the more serious” but neglected psychiatric disorders of our time.

The diagnosis would capture men and women who experience “recurrent and intense” sexual fantasies, urges and behaviour for at least six months who also exhibit four or more of five criteria that include spending “excessive time” thinking about sex and engaging in these “fantasies, urges and behaviour” in response to anxiety, depression, boredom, irritability or other “dysphoric mood states.”

Lane questions whether psychiatrists should be setting themselves up to regulate what they assume to be “normal” amounts of sexual desire.

“Above all,” he writes in Side Effects, his Psychology Today blog, about the phrase “recurrent and intense sexual fantasies,” “should it matter that the majority of men and a sizable number of women in this country, as around the world, will recognize themselves in that description?”

Bellwood’s Lawson, who trained under Carnes, says sexual addiction is like any other addiction. “The face of it looks exactly the same to me. The properties are the same,” she said.

“The first step is understanding one’s own story, how I got here, from there. That’s very often what the addict who has just come out of denial wonders, ‘Why did this happen to me?’ ”

Part of treatment involves understanding the patterns that developed, working on “negative core beliefs,” self-esteem and learning what’s healthy in relationships.

“We need to raise awareness and give women an opportunity to come forward if they do identify” with sex addiction, she said.

“We want to get the word out that help is available.”

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