Attention Deficit Disorder and Sex Addiction: What’s the Connection?

A large number of sex addicts have attention deficit hyperactivity disorder (ADHD)

Dr. Rory Reid of UCLA did research in 2007 and 2011 in which groups of men in treatment for sex addiction were assessed for ADHD and in which 23%-26% were found to meet the criteria for adult ADHD.  Almost all of these (97%) were of the “predominantly inattentive type” rather than being predominantly hyperactive. (The prevalence of ADHD in the general population is 3-5% according to Reid.)

Can impulsivity or low self-concept explain the correlation?

Dr. Reid also gathered evidence about whether ADHD might be “driving” sex addiction due to the impulsivity of people with attention deficit as children.

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Sex Addiction is Real: Just Ask a Sex Addict

The concept of sex addiction came from sex addicts. It was never imposed on them by clinicians– far from it. If you read the first of the personal stories in the Sex Addicts Anonymous “Big Book,” which includes an account of how SAA was founded 36 years ago this is clear. At that time people with compulsive forms of sexual behavior were receiving other forms of psychiatric treatment that were mostly doomed to failure; treatments like aversive conditioning or psychoanalysis. The groundbreaking work of Dr. Patrick Carnes and others created SAA as a way to treat sexual addiction in order to help themselves and ultimately to help others.

Listening to addicts, lots of them

And people have been steadily joining the ranks of self-identified sex addicts. Today SAA has 1,176 groups (regular weekly meetings) in the U.S., that are registered with the International Service Organization (ISO) of SAA. In addition there are 62 in Canada, 51 in the U.K., 31 in Central and South America and 48 in other locations including South Africa. There are 101 different registered telephone meetings and other electronic meetings.

These statistics are as of last October and the ISO informs me that the number of meetings has grown steadily by 10% per year in recent years. That’s a lot of people in SAA alone. And there are currently four additional 12-step self-help programs for sex addicts all modeled on Alcoholics Anonymous:

Sexaholics Anonymous (SA)
Sex and Love Addicts Anonymous (SLAA)
Sexual Compulsives Anonymous (SCA) and
Sexual Recovery Anonymous

Even this does not represent the whole picture. Nowadays many sex addicts can get appropriate treatment with therapists who specialize  in working with sex addiction. And of course there are many people struggling with sex addiction who are not getting any help at all, often because they don’t understand the nature of their problem, or because the psychiatric establishment has yet to educate the mass of clinicians as to the diagnostic issues.

The current wave of sex addiction denial

Today there is a rash of sex addiction denialism or misinformation fueled by some flimsy studies that have been easily discredited and gaining followers among those who feel judged or pushed around by the idea that someone might call them (or anyone) a sex addict. But in fact clinicians don’t go around looking for sex addicts or labeling people just because they exhibit certain behavior. People need to be evaluated on a case by case basis. This is partly because compulsive sexual behaviors can be a symptom of at least half a dozen other psychiatric disorders that don’t have anything to do with addiction.

But the “evidence” that porn and sex addicts are not exactly like drug addicts in this one experimental response in this or that isolated experiment is really largely irrelevant to the experience of thousands of sex addicts over decades. In the attempt to save patients from being mislabeled by clinicians, the deniers have ended up undercutting the recovery efforts of bona fide sex addicts. “Sorry, what you have may not be a “real” addiction; so maybe you don’t really need any help!”

The plural of “anecdote” is “data”

Most people and clinicians generally agree that sex is a good thing. People tend to show up for treatment when they, or someone who knows them, notice that their sexual behavior is way out of control and is causing a lot of problems. Some people have had their lives taken over by pornography, some have lost a job due to sexual behavior, others have been arrested more than once for indecent exposure, and some simply spend hundreds of thousands of dollars they can’t afford on prostitutes.

But whatever brings them into the office or the 12-step meeting, they still need to be helped to figure out if in fact they are a sex addict. This can be done by pointing them in the direction of the literature on the subject, by talking to other people with the same problems, and by well validated tests.

I have listened to numerous patients of mine, read hundreds of emails and blog comments and listening to sex addicts talk at hundreds of SAA meetings over the years. Many addicts are unsure to begin with about whether they really have an addiction. But for many there comes a point when the addict realizes that they simply have no control over this or that behavior. I have heard over and over again: “This is an addiction!” ” I can’t stop even though I desperately want to!” and ” I’m ashamed of what I do because it’s not who I am, yet I do it anyway!”

Other addicts will occasionally waver in their grasp on the addictive nature of the problem. This is not at all unusual. “So am I really an addict?” “So-and-so is so much worse than I am!” But of their own accord or because of many unsuccessful attempts to quit, they come back around to the need to approach the behavior as though it were on a par with alcoholism or drug abuse. Many will tell you that it is more addictive even than these.

Find Dr. Hatch on Facebook at Sex Addictions Counseling or Twitter @SAResource

Losing a Partner Complicates Sex Addiction Recovery

A sizable number of couples stay together through the upheaval of sex addiction. According to my educated estimate about half of all sex addicts in sex addiction recovery are working with a partner to try to repair the relationship.

By the same token many sex addicts end up losing their partner following the disclosure of sex addiction and the ensuing crisis. I have found that there are complications for recovery in both situations.

If the sex addict’s partner chooses to stay in the relationship, then the sex addict has certain advantages. The presence of a partner (and possibly children) very often provides a strong motivation for the addict to follow through with treatment and recovery. No matter what the addictive behavior, internet porn, prostitutes, hook-ups, etc. the married sex addict has a lot to lose by failing to get “sober”.  Also the presence of a partner adds a level of accountability. If the addict is truly engaged in recovery, then he or she will be committed to transparency and honesty with a partner and in general. Agreeing to tell all can help to give the addict a reason to be more conscientious about avoiding situations that might lead to relapse.

But what happens when the addict comes clean to a partner, becomes sincerely engaged in recovery and then the partner or spouse leaves? I would like to share my observations as to the impact of divorce on sex addiction recovery; both the negative impact and to whatever extent, the positive impact as well .

Negative impact of break-ups

  • Apart from the loss of motivation and accountability that was connected to the relationship, separation and divorce add serious emotional stresses to the situation. The end of any relationship, even a bad one, is experienced as a loss. This means that even for a person who was not struggling with addiction and recovery, there would be grief and deep feelings of abandonment.
  • As I have discussed elsewhere,  sex addicts tend to be highly co-dependent themselves even though they have lead a secret life outside their relationship. They are insecure and tend to base their self worth on the perceptions of others. The rejection of a break-up only reinforces their feeling of unworthiness which in turn can derail any new found sense of strength in recovery.
  • The turmoil surrounding a separation or divorce can become a serious distraction from the addict’s recovery routine. The mechanics of leaving familiar surroundings, finding a place to live, arranging to see their children if there are any, and dealing with the legal process of impending divorce proceedings can sap the addict’s energy and resources.
  • Addicts in a break-up will be experiencing a great deal of emotional pain and distress. Their typical way of dealing with negative emotions in the past was through escape into their addictive behavior. Thus the added emotional distress of shame and rejection increases the motivation to reach for their “drug”.
  • Most sex addicts have a problem dealing with boredom and loneliness without wanting to act out sexually. Isolation is not helpful to sex addiction recovery and the fact of suddenly being on their own can be a big risk factor, especially if break up has left them feeling less motivated to engage with supportive people.
  • The addict can become obsessed with the partner who has rejected them, thus leading them into destructive fantasies and delusional thinking. They may fantasize that they can win the partner back, or they may ruminate and become angry and resentful. They may also become obsessed with finding a new partner immediately in order to bolster their damaged sense of self and restore parity with the person they have lost. All of this obsessing and emotion pulls the addict away from reality and from the need to address their own recovery and growth.

Is there any upside to break-ups?

Obviously there may be advantages for the spouses and partners who feel that moving on is in their own best interests. But what about the addict? I believe that after the immediate crisis of the break-up and its impact on sex addiction recovery have subsided, the addict will be in a better position to assess the intimacy problems that almost certainly characterized the relationship. I contend that practicing addicts are drawn to partners and styles of relating that do not demand. In that sense, I think the practicing addict promoted a sort of dysfunctional situation both because it was somehow familiar and because it provided a situation that at once allowed and was an excuse for sexual acting out.

In sex addiction recovery, the divorced or separated addict has a chance to recover from the addiction and to learn a new kind of relating built on intimacy and trust.

Find Dr. Hatch on Facebook at Sex Addictions Counseling or Twitter @SAResource