This paper reflects the research and thoughts of a student at the time the paper was written for a course at Bryn Mawr College. Like other materials on Serendip, it is not intended to be "authoritative" but rather to help others further develop their own explorations. Web links were active as of the time the paper was posted but are not updated.
2001 Second Web Report
Patrick Carnes, Ph.D., the first person to identify and treat this affliction, hypothesized sex addiction results from a person needing certain neuro-chemical changes (4). Everybody experiences certain neuro-chemical changes that make the physical act of sex feel pleasurable. A normal person produces this stimulus, attains the natural high, and is satisfied. An addict, however, uses this chemical to escape pain or seek relief from stress (4). This theory supports a nature argument because there is nothing a person can do about it. Their body creates an altered response to a completely normal act and fosters an uncontrollable need to experience sex. It is comparable to an alcoholic's reaction to alcohol (4). The sex addict needs this chemical to be released in order to desensitize themselves from their problems. This is not healthy, but it is not controllable either. No outside influence planted the seed in their mind. Therefore, from the neuro-chemical standpoint the addiction is a result of an inborn trait.
A more commonly known approach towards diagnosing the addiction explores childhood experiences. Many affected people were subject to sexual abuse from a parent, baby-sitter, or another older person when they were younger. This inappropriate introduction induces feelings of shame and fear that surround sexual activities for these people (4). A chaotic, hostile, or neglectful household can also be a factor driving a person towards sex addiction. The person will use sex or masturbation for comfort and will equate the two with each other. These arguments suggest a nurture aspect to the problem because it arises as a response to their environment. Outside forces act to develop the people into addicts. Childhood is an extremely impressionable period and in the circumstances the dangerous forces push a child towards harmful behaviors.
Sex addiction becomes an overriding power in a person's life and takes it out of their control. Their behavior deviates from the norm, but in such a way that it is unnoticeable by relatives or loved ones because it is so secretive. Typical actions of a sex addict include: compulsive masturbation, multiple affairs outside of a marriage, consistent use of pornography, practice of unsafe sex, sexual anorexia, multiple anonymous partners, phone or cybersex, sexual massages, escorts, prostitutes, and prostitution (2). There are also manifestations within the act of sex itself including fantasy, paying for sex, trading sex for drugs, voyeurism, and other activities (3). A test for men and women has been developed to create a self-evaluation concerning the relevance of these acts to a person's life. The original one can be found at http://www.sexhelp.com/sast.cfm. The addict is afraid of other people finding out and condemning them. The person recognizes the acts to be detrimental to their success, yet are unable to stop.
Now the internet is developing into a major problem for sex addicts. It encourages all of the regressive ideas of the problem. It encourages isolation, fantasy, objectification, anonymity, and transmission of sexual images because a person does it in the privacy of their own house without any real world consequences (2). It also speeds up the progression of the problem and can lead a person to being discovered earlier (4). This can be a positive because treatment will be offered quicker. However, for the most part, the internet represents a major challenge for sex addicts because they can access a wide variety of sites to fuel a growing need for pornography.
These ideas neither prove nor disprove the nature versus nurture argument. On one hand, the acts still stimulate the person and in the end involve a sexual release resulting in the manufacture of the neuro-chemicals. On the other hand, it is only a continuation of past abnormal behavior stemming from childhood problems. Which side is correct, nature or nurture?
Looking at treatments for sex addiction begins to create a distinction between the nature versus nurture argument. If sex addiction were purely a natural phenomenon then medication suppressing the particular neuro-chemicals released during sex would cure the problem. It has been shown that medicine by itself will not end the addiction (3). Once a person stops taking the medication their behavior will return to where it was before the medicinal treatment. While the drug is present and controlling their hormones there will be improvement, but no long-term solution evolves from this approach (3). Thus the nature argument appears to be incorrect. It is not an intrinsic behavior, but one that has been programmed into someone's system through their personal experiences.
A successful method towards controlling sex addiction includes counseling, support groups, 12-step programs, and a commitment towards change. There is an inpatient and an outpatient option to this course. The inpatient program removes the person from their daily routine and places them in a facility for a set amount of time. The benefits of this method are intensive help and around the clock surveillance (4). The outpatient method includes counseling, individually or with a spouse, and support groups (4). This approach emphasizes consciously changing one's behavior, assuming responsibility, and being aware of the problem. As a result, both of these approaches to recovery support the nurture argument. Through the help of outside sources a person will alter their actions and learn to control their impulses again. It corrects the original problem through a method similar to its introduction, external forces.
Further evidence to support nurture is the treatment method followed by the 12-step addiction counseling programs. These groups use God and religion as an instrument to attack the addiction. An example of one group's 12-step rules can be found through the following link, http://www.sa.org/b000english/b060steps.html. Throughout the entire process God is a central figure and the central tenant requires placing oneself entirely into God's hands. This decision must be made purely by the person and does not relate to brain chemistry. Nurture is the only aspect affecting the person throughout this path to control of the addiction.
Sex addiction, throughout the course of the paper, has been shown to develop not from a natural aspect, but from a nurturing aspect. The internal high someone experiences makes the person repeat certain actions in order to attain the same feeling. However, overall the environment around the person influences the most. Sex addiction manifests itself through many different behaviors and all result in detrimental consequences primarily for the person in addition to those around them. They can learn to control their impulses through the discussed treatments. Therefore it is not a disease of the brain to the same extent as schizophrenia or multiple personality disorder. It is very curable, not needing medication, and easily identified. Sex addiction requires a person to exert will power and control over themselves. The application of these ideas will enable a person to conquer their problem and they will realize the addiction results from a source in the environment and not from brain structure.
2) The National Council on Sex Addiction and Compulsivity , Provides basic information and articles
3) Sexual Recovery Institute Home Page , Home page for a recovery center in Los Angeles and Orange County
4) Sexual Addiction Home Page , Home page with basic information
5) Sexaholics Anonymous Home Page , Home page for support group
6) Sexhelp.com Home Page , Home page for Dr. Carnes
7) Porn-Free.com Home Page , Web site about religious recovery help
8) Sex addiction FAQ , Home page with basic information about different aspects of addiction
9)Page on Dictionary.com, definition of addiction