New Treatment Models for Teen Porn Addiction

The enormous global proliferation of online pornography has made a vast array of sexually explicit material available to a large teen audience on laptops, tablets and smart phones. And if smart accessories catch on, you will soon be able to wear your pornography.

Online pornography accounts for such an overwhelming proportion of internet traffic that a new search engine has been created specifically for adult content. It was designed by two former Google employees and searches only for pre-screened adult content that is free of illicit or malevolent intent. It is also designed to protect the user from cookies and other forms of identity tracking. The site was launched on September 15th and according to the founders has “taken off like a rocket.”

Internet porn has long been seen as more readily accessible than riskier and more costly habits like prostitutes, massage parlors or anonymous hook-ups. This in turn makes it more easily available to youth, with the typical first exposure being in the pre-teen years.

Effects of porn on teens and young adults

A study published this summer in the by the UK’s Institute for Public Policy Research surveyed 500 18-year-olds about the impact of porn on their lives. Most of the respondents reported that accessing pornography was common throughout their school years, began in their early teens and had a damaging effect on their sexual and relationship lives.

Dr. Anthony Jack, a researcher and neuroscience professor at Case Western Reserve University stated that recent studies show “…widespread rates of sexual dysfunction… such that approximately 50% of late adolescents of both sexes report sexual dysfunction of clinical severity”.  (See “Your Brain on Porn” by Gary Wilson)

Another study published this month by researchers in the US found that among a sample of over 900 emerging adults in college more frequent porn viewing was correlated with a greater number of sexual hook-ups and one night stands.

Other recent studies of the brain activity of chronic porn users have begun to show detrimental effects such as:

• Less gray matter and reduced reward center activity while viewing sexually explicit imagery, i.e. desensitization.

• A weakening of nerve connections between the reward centers and the higher brain centers thus increasing impulsiveness and impairing decision making.

• Porn induced erectile dysfunction

As one of the researchers put it, “…regular consumption of pornography more or less wears out your reward system.” And clinicians here and abroad are seeing many more young adults and teens who can achieve erection and ejaculation with porn but not with a real person.

Treating the young porn addict: three models

The current crop of very young addicts have some special characteristics. The pre-teen brain is not fully mature and their emerging sexuality programs them to react powerfully to sexual stimuli. Getting hooked on porn at an early age can be damaging in at least three different ways. These in turn require interventions very different from the years of addiction treatment and relapse prevention that are appropriate for most adult addicts.

I. The drug-driven model

Jeff’s addiction appears to have come about through the habit-forming nature of porn itself in the absence of any other obvious psychopathology.

At first I thought Jeff was just like any other sex addict client, only younger. He had been watching porn on his computer since he was 13, and at age 18 he realized he had begun to fixate on child porn. Fortunately this scared him enough that he came clean to his parents who put him in a 6 week residential program for sex addiction.

After the residential program Jeff saw me for therapy for about a year. He also attended weekly Sex Addicts Anonymous meetings. He was an attractive, sophisticated kid with a sunny disposition, but at 20 he was still a virgin who had never dated a girl. While he was seeing me he began dating a very appropriate same-age young woman and eventually began a robust sexual relationship with her. Although that relationship ended he never returned to porn use that I know of. I am as certain as I can be that he had no residual attraction to children.

What is striking is that although Jeff went along with the usual program of sex addiction recovery, what seems to have worked for him was just getting away from porn! With abstinence, it seems his young brain rebalanced and in a period of months he was able to resume normal sexual development. He became more outgoing and began college with the ambition to become a filmmaker. Jeff needed a structure that would allow him to stay away from porn along with some outside support to get his life back on a normal track.

II. The trauma model

Brad discovered internet porn at 12 and became instantly hooked. He reports that his use escalated very rapidly as did his sexual tastes. He was binging on porn very heavily every day. While still in his teens he says that he quit, primarily out of exhaustion. His sexual interest diminished to zero and as of his mid 20’s he reported that his libido seemed to be permanently gone. He attributes this result to a kind of virtual sexual trauma.

There is some research that would support the idea that very early exposure to sexually explicit material can have effects on the developing psyche similar to actual sexual assault. The young mind is not ready to deal with the shock, adrenaline and stress of the hyper-arousal caused by porn. It thus constitutes a violation which can leave lasting sexual scars. Brad correctly sought out treatment with a specialist in sexual trauma rather than sex addiction.

III. The hybrid model

Ken is a happily married man in his late 20’s. He entered treatment for an addiction to porn and masturbation dating from childhood. He had no other sexually addictive behaviors but he had significant early trauma. His father died of a cocaine overdose when Ken was a toddler. Ken became the “man of the house” at age 3 and soon after had a serious illness requiring months of hospitalization. He had an unhealthy relationship with his narcissistic, demanding mother. Also as a child he witnessed his teenage sisters being molested by an older cousin.

After about 8 months of abstinence from porn and with the support of group therapy Ken has shifted gears. His relationship with his wife whom he adores is going well and he is comfortable with a new-found intimacy with her. In fact Ken no longer presents as an addict; he does however have issues that he knows he needs to work on. In particular he knows he has never fully understood or worked through his early childhood experiences and he is working his way out of his enmeshed relationship with his mother. He is appropriately seeking help for these problems and appears to be at zero risk of relapse into porn addiction.

So the good news is that the youthful porn addict’s brain can recover and resume a more normal developmental trajectory. And given that their only addictive behavior is internet porn and that their total time of usage relatively short, they do not have to overcome addiction as a pervasive and deeply entrenched coping style. They can get cured and stay cured. The bad news is that there is as yet so little awareness of the risks to children and teens on the part of the medical profession, the academic community, schools and the public at large. As with so many public health issues, prevention and education are sorely needed.

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

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

It’s OK to Have Bad Sex: The Sex Addict’s Difficult Adjustment

Sex addicts tend to be perfectionists.  And this is especially true in their attitude toward sex.  They are known for their all-or-nothing thinking, the tendency to view the world in terms of extremes.  In their sex life with a partner, sex addicts in recovery tend to carry with them an extreme and basically intolerant set of expectations. Just as an aside, there have been a slew of blogs and research survey findings that suggest that we are all having our sexual expectations distorted by the increasing pornification of our culture.  Some in the “feminist porn” movement and elsewhere have attempted to fight the idealized images and expectations shown in mainstream porn and in the “ambient porn” of movies, games, magazines and TV.  See also my journal article the findings of the APA task force on the sexualization of girls in our society.

The over importance of sex and orgasm

Sex addicts have as a core belief that sex is their most important need.  Thus sex addicts place an undue emphasis on sexual arousal and gratification.    Even before the advent of internet porn, sex addicts have always tended to be in a hurry to get to the sex act and to achieve the perfect orgasm.  If this didn’t happen all was lost. Having permission to have “bad sex”, i.e. sex that doesn’t match some perfect ideal, is a way to counteract the desperate need that sex addicts feel.  It can help relieve the pressure and can allow for times when the partners feel less energetic, more sensual etc.  It takes the focus off of “getting my needs met” and places it more on just having a sexual, physical experience with someone you are close to.

Fantasy standards of desirability

Because sex addicts are used to engaging in sex that is excessively loaded with fantasy content, (sex with strangers, cybersex, escorts, strip clubs, and of course pornography) they usually have perfectionistic (fantasy ridden) ideas about how women’s and men’s bodies should look.  This then results in the feeling that any sex with someone who doesn’t measure up to a fantasy standard of beauty or prowess is no good.  Hence the saying that to an addict “sex with a real woman is just bad porn.”

Unrealistic expectations about sexual behavior

Sex in the context of a relationship may seem boring to a sex addict.  In a real situation the addict has to deal with all kinds of awkward, messy and most importantly unpredictable elements.  These will almost certainly burst the addict’s fantasy bubble. In addition, sex addicts are used to fantasy scenarios that may involve all kinds of erotic behavior that their partner may not wish to engage in. We are asking the recovering sex or porn addict to adjust to what they may see as “plain vanilla” sex.

Paradoxically, sex in real life may also be more unpredictable and less boring.  Sex addicts are used to controlling the sexual experience from beginning to end.  In sex addiction, the addict has a preferred scenario or arousal template. This can evolve and escalate into more extreme behaviors, but the addict knows what he or she is going to get.  Real, relational sex is not so predictable.  This means things may end up unusually exciting and passionate or they may end up less so.

Expectations of hyper-arousal and porn induced ED

In addictive sexual acting out, the addict seeks a very extreme form of arousal and often seeks to prolong it.  This level of extreme or hyper-arousal is unlikely to exist in any everyday situation.  Furthermore there is beginning to be evidence that porn addiction in particular can lead men to experience erectile dysfunction when they attempt to have sex with a real person.  This porn induced ED, as it is called, is reversible when the addict abstains from porn use for a period of time.

The use of ED drugs like Viagra is becoming increasingly prevalent, even among younger men and men who don’t need it.  Addicts in particular may have exaggerated ideas about what they need to be able to do to “perform” sexually and may be very anxious in trying to have healthy sex with a partner.  It is normal for men to have a physical response to what is going on around them and sexual “performance” can vary for any number of reasons.  It is unfair, inaccurate and inhumane to see these fluctuations as a sign of something wrong or bad.  In recovery there is often a period of insecurity about sex but this is not a signal to panic and reach for ED drugs.

Sex can be a good thing no matter how it turns out

Sex addicts are so zeroed in on sex as central to life that they don’t realize that it is only one aspect, not the be-all and end-all.  Sex addicts find it hard to fathom the idea that, for many people, sex is great but has its proper place among many other great things in life.  In relationships sex is no doubt very important but it is a source of bonding as well as excitement and gratification.  The behavior of the partners and the level of arousal will exist in a broader spectrum or array of experience.

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

Not Sure if You’re a Sex Addict?

It is normal to feel uncertain about this question.  Addictions are partly self-defined; especially “process” addictions like gambling, food and sex addiction.  Doctors and therapists don’t go out of their way to look for sex addicts.  If someone comes to me for sex addiction help it is because they suspect that they are having a problem with some sexual behavior that is out of control or is causing serious problems.  A sex addiction therapist may help them decide if that is true and can evaluate other possible causes or co-occurring condition.  The official criteria and categories of sex addiction may help in the beginning.

But even after a person has sought help or support groups for sex addiction, they may continue to wonder if they really are a bona fide sex addict.  This is so common as to be a predictable occurrence at some point in recovery.

Someone who has serial affairs or who has a habit of watching a lot of internet pornography may find him or herself sitting in an SAA (Sex Addicts Anonymous) meeting next to a person who did jail time for viewing child porn or who compulsively visits prostitutes or who exposes himself on buses.  The behaviors of addicts are so varied that it invites comparison.  “Am I really the same as him? Surely my problem is qualitatively different and less serious!”

Doubt is not the same as denial or minimization (although these can be involved as well.)  Other things can cause a person to wonder whether they should define themselves as a sex addict.

Sex addiction may not be the “primary” addiction

Many recovering alcoholics and drug addicts have a tendency to use sex as a substitute drug.  Even if they recognize they are doing this they may discount it as secondary to or a product of their chemical dependency.  See also my post on alcoholics and sex addiction

This tendency to discount sexual issues is especially common when there is an “addiction interaction”.  This is the situation where addicts have more than one addiction (and a great many do) and where the two interact in various possible ways.  A sex addict may use drugs as a part of a ritual prior to sexual acting out or as a way to numb the shame afterward.

Addictions may be fused with other addictions

When two or more addictions are only engaged in at the same time (drinking always goes with seeing prostitutes, drugs are always involved with gambling and sexual acting out) they are said to be “fused”.  This makes it very hard to identify one addiction as the primary one and so the addict may go from one program to another or feel confused as to why they cannot see any change.  When different addictions lead back to one another then the addict must quit all of them at the same time if at all possible.

Sexual acting out may not be continuous

When we think of a compulsive behavior we think of the person as seeking it constantly.  Sometimes this is the case and sometimes not.  There are many sex addicts who have a pattern of intermittent acting out with “down time” between their episodes of sexual acting out.  The period between acting out may be caused by remorse, or it may just be that the cravings for that behavior do not return as powerfully right away.

This episodic pattern can be of any length.  And during the periods between acting out, the addict may think they are in good recovery.  Therapists look for a situation in which the addict can go a week, a month or even several months without acting out and then relapse, almost like clockwork.  This is like the smoker who claims he can quit because he’s done it hundreds of times.   They seem to have some control and can quit for a particular period of time—just not for good.

Also it is not unusual for sex addicts in the first year or two of recovery to get totally turned off to sex.  This is a swing to the opposite extreme of sexual anorexia but does not represent real sexual sobriety.

The person who can sexually “act out” in moderation

There are probably some people who engage in secret, illicit or even risky sexual behaviors but who really are using the behavior as an occasional escape, and one over which they have a lot of control.  It is hard to say how many such people there are but I suspect there are a lot given the current prevalence of porn use, cyber sex, and sexual hook-ups (not to mention infidelity).  These people would probably not show up in a sex addiction clinic.   But the dividing line is such that those behaviors engaged in by someone who really is an addict will eventually lead to more frequent, more destructive or more serious sexual acting out behavior.

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

Being Sexually Triggered vs. Sexually Aroused

Maybe you have heard recovering sex addicts talk about being “triggered” and wondered how it differs from just being aroused or turned on by some stimulus or other. Being triggered is a common term used in sex addiction recovery. It means something different from simply feeling aroused by something or someone.

A triggering experience can be seeing, hearing or doing something that is a precursor to the addict’s sexual acting out behavior. There are sexual images and sexual stimuli to be seen everywhere but certain kinds of perceptions will be more likely to be associated with a particular person’s preferred sexual behavior.

What triggers do

A trigger sets the stage for a sequence of behavior moving toward acting out. An addict whose preferred sexual scenario involves power and exploiting someone weaker, such as that of rescuing a helpless female may be triggered by seeing an attractive woman who is in a difficult situation.

Sex addicts are not always fully aware of why an experience is triggering. It may seem to be unrelated to their sexual acting out behavior and still make them want to go out and do that behavior. An addict who typically finds sexual partners for anonymous sex through the internet may begin to feel an urge to relapse into that behavior when simply looking at Craig’s List ads for someone to play bridge with. The mere fact of online descriptions or photos of people may be enough. In this case the addict is on thin ice, often not realizing it.

The triggering experience need not be sexual and in fact often it is not. For someone who is compulsive with prostitutes or sexual massage parlors, certain parts of town or certain streets may cause the beginning of a chain reaction known as the addict’s “ritual.” An addict who is an exhibitionist or a voyeur will likely become triggered in any situation in which being seen or seeing others undressed is a possibility, such as finding him or herself in a locker room or changing room with little privacy.

In contrast to ordinary arousal, being triggered may involve the beginning of delusional thinking. The addict sees something and either consciously or unconsciously it touches off an association with the addictive behavior on whatever level. At this point, sexual acting out begins to seem more like a viable option even though the addict wants to avoid it like the plague when he has his wits about him.

Identifying “triggery” feelings as useful information

Although addicts may slip into ritual or delusional thinking without realizing it, there are often ways to catch yourself and not move toward a slip or relapse.

  • Feeling triggered can involve a sudden feeling of hyper-arousal, a dopaminergic “burst”, which is different from normal sexual arousal or attraction. It is more sudden and intense and is thus more compelling. To an addict in good recovery it is a warning. Sometimes the triggering involves the blurring of boundaries with other intense feelings like fear or anger which in turn bring on sexually addictive urges.
  • Another way that the addict may identify a trigger is through noticing and examining their own thought processes. Addicts in recovery get progressively better at seeing the ways in which their thinking can go awry. Even though you may not think there was any triggering event, you may still notice that your mind has for some reason begun to distort reality.
  • You may find yourself feeling that there is no harm in doing a particular behavior or you may begin to look for little ways to get a sexual hit.  At this point the addict can get a handle on things by going back and looking at what may have been a triggering experience.
  • Since the sex addict is locked into a pretty set pattern of sexual acting out behavior, it is sometimes the case that the experience of feeling triggered is one of sudden familiarity.  The excitement, the intrigue, whatever it is, feels like where the addict belongs. This is another kind of signal.  In normal arousal there is always some sense of not knowing where it is going.

But remember, they are your triggers and you must manage them. It is never someone else’s fault if you get triggered! Most recovering addicts get very good at identifying what are triggers for them ahead of time and avoiding them. This takes time and experience and is part of what happens in treatment and 12-step work.

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

Adult Children of Sex Addicts: What are the Residual Effects?

Growing up with a sex addict will leave its mark.  These are my thoughts based on my own life experiences and my observations over many decades about the results of having a sex addict for a parent.

As I watched the recently publicized exchange of tweets between Mylie Cyrus and her father I saw a myriad of familiar patterns.  I am not saying that Billie Ray Cyrus is in any way a sex addict.  And I am no doubt reading into the situation, but it seemed to me that there were key elements in their relationship that rang a bell.

There are many different ways for a young person to experience the sex addiction of a parent that are covert and unconscious both on the part of the addict and the child.  My own father was a sex addict (and an actor) and I experienced his addiction indirectly in the subtle objectification of me as well as in his “girlfriend-izing” me and implicitly using me to triangulate with my mother.

Sex addicts place undue emphasis on sex.  Thus sex addicts can communicate the over importance of sex to the child in a myriad of ways. Here are some of the dynamics that play out in such families.

  • Sexualizing the child or young person by making comments about their body or their sexual desirability or even their prospects for sexual relationships later in life.  This can include taking a personal “interest” in the young child’s underwear purchases, “compliments” on their appearance which are sexually toned and so on.
  • Giving added importance to sex by making it totally taboo.  The hiding of sexuality, the refusal to acknowledge it as something to be talked about at all can convey that sex is not only dangerous but more powerful than it really is or needs to be in the young person’s mind.
  • Sexual duplicity is engrained in the child when there is a total denial of whatever is going on sexually and a repressive atmosphere around sex.  The message is that one must lead a double life, compartmentalizing sex and keeping it secret.  This means that the child and family are engaged in a collective form of denial in which there is a façade of normality and “healthiness” with a whole secret life going on.
  • Early exposure to sex either directly or by observation can be traumatic to a child who is not yet developmentally ready to make sense of this information.  At least it can be confusing and troubling and takes away a level of safety that the child needs.
  • Infidelity, whether it is explicitly seen or just going on behind the scenes can place the growing child and adolescent in a number of binds.  The child may be caught in the middle, may be made into a confidante or used as a weapon.  All these things violate the child’s generational boundaries.  The parents are supposed to be the grown-ups who take care of the child, not the other way around.

When I learned of the idea of Mylie and her father “working on” their relationship it reminded me that although this sounds reasonable, the generational boundaries can become blurred in this kind of set-up and lead to serious confusion for the adult child.

I believe the best things that adult children of sex addicts can do are:

  • Realize that your experience growing up was dysfunctional in subtle or overt ways and that this will have an impact on you.  Everyone’s childhood has its own problems, nobody’s early life is flawless.
  • Learn about sex addiction if you want to but don’t become obsessed with your parent’s problems.  If you have insecurities about yourself, your worth, your attractiveness or doubts about ever having a healthy relationship these are things you can work on in your own growth and development.
  • Don’t become over-involved with your parent’s treatment or recovery.  This is their journey and you have your own life to live.  If you get drawn in you are just continuing to re-enact the early inappropriate family patterns.
  • Be open to new models of relationship and intimacy.  What you observed in your parents as a child may have been a distorted role model built to hide, rationalize or adapt to dysfunctional relating.

Notice that your parents may have grown and changed through therapy and treatment.    If your parent seems to have pulled away from you this may just be because they are learning how to play a more appropriate, less enmeshed role with their children.  Understanding this allows you to shuffle the deck in your own life and have some faith that things can work out well for you; that healthy, happy relationships are possible.

Mistaking Sex for Love: Sex Addiction Symptoms and Relationships

Evaluating people in sexual terms is becoming a more common cultural phenomenon as opposed to just one of the sex addiction symptoms. There are increasingly sexualized imagery appearing across all media.  Cocktail waitresses and centerfolds have always looked sexy, but now our TV news anchor seems to look more and more like a former beauty queen at a singles party. At some point most people can begin to separate love from mere physical lust.  But for sex and love addicts this can be a difficult distinction.  One of the sex addiction symptoms is the avoidance of real intimacy with a partner and the seeking out of an intense “experience” with a fantasy object of some sort. The real relationship in the sex addict’s life, if there is one, is likely to be somewhat alienated, even when there is an apparent feeling of attachment.  This is not universally true of course but often the same addict who says he loves his wife will avidly seek out online encounters with people he barely knows, or build elaborate fantasies around his “relationship” with a sexual masseuse or believe that he will be able to date his favorite stripper.  Many addicts in and out of relationships feel a strong and seemingly delusional pull to connect with people they relate to only sexually and sometimes only in their minds. Sex addiction symptoms and behaviors impact a relationship in that the addict is partly “gone,” and this is what often gives partners and spouses the feeling that something is wrong even when they can’t prove it and the addict denies it. Mistaking sex for love can spread in families Children The culture at large tends to encourage young people to view others (and themselves) increasingly in sexual terms.  Children are exposed to sexually explicit material at younger and younger ages not only in online pornography but also in print media, music videos, movies, TV and gaming.  Hopefully most will grow up to be relatively normal in sexual and relationship terms. What happens to children of sex addicts is that they may be given covert messages about sex that cause confusion.  It does not matter whether the addict is an outwardly puritanical while secretly leading a double life, or whether he is more overtly sexual in his talk and attitudes toward people.  The result is the same for the children.  The message gets through that sex is crucial. In the puritanical message sex is given extreme importance through being seen as too dangerous even to talk openly about. And as Patrick Carnes has pointed out the puritanical façade promotes sexual duplicity as the norm. In the overtly sexual parent there may be much discussion of other people’s looks or sexual attributes or even inappropriate focus on the sexual features or attractiveness of the child or their friends.  This conveys to the growing child or adolescent that they are and will be evaluated and found worthy or not in terms of their sexual appeal. Partners Partners and spouses of sex addicts tend to be lead down the same path in various ways.  If the partner or spouse is a woman she will have experienced the cultural pressure to be sexually “hot” from a very early age.  If a core belief of the addict is that “sex is my most important need” then the woman who is the partner of the addict may internalize the corresponding belief that “sex is the most important sign of love.” Long before discovering the sex addiction, partners of addicts may be conditioned to believe that their value as a woman or spouse is largely in their sexual desirability.   This can be reinforced in many subtle ways by a sex addict. I had a voyeuristic sex and porn addict tell me that he knowingly pointed out attractive men to his wife in order to clear the way for him to fixate on other women.  In this way the addict can normalize his preoccupation with sex both for himself and in his wife’s eyes. Another addict in his 60’s that I worked with fixated on and ogled young girls.  He made frequent comments to his wife about women being old or “long in the tooth,” etc. Sometimes women will begin to be more overt in making sexual comments about other men as a way to restore parity, to get back at the partner, and to defend against her own fear of being sexually evaluated. A word about sexual betrayal Most of the literature on partners of sex addicts emphasizes the fact that of all the sex addiction symptoms the deception, secrecy and breach of trust are seen by partners as the most traumatic aspects of the discovery of betrayal.  But the fact that the betrayal is a seen as a sexual rejection (even if some would say that logically it isn’t) is likely to be experienced as a rejection of the whole relationship. It can and does feel like the end of what is most essential to them and to their bond of love. Find Dr. Hatch on Facebook at Sex Addictions Counseling or Twitter @SAResource

Is “Real” Sex Healthier Than Porn and Cybersex?

Many sex addiction therapists base their thinking on the idea that real or “relational” sex, sex with a real person as opposed to porn, cybersex or masturbation is healthier in some way.  They tend to believe that a preference for non-relational sex is not entirely healthy and that it is often the basis of sexual addiction.

Other clinicians and many people generally feel that it is wrong to place relational sex on a pedestal.

Some think non-relational sex is just as valid a form of sexual expression and feel that the other side is just being moralistic and narrow-minded.  I will look at some of the arguments on either side.

The argument for fantasy sex

  • All sex is about domination fantasies anyway

Experts have argued that all sexual arousal relates in some way to fantasy and that all sexual fantasy has ultimately got something to do with domination and submission.  It doesn’t matter whether you are dominant or submissive, so the argument goes, your arousal relates ultimately to a fantasy involving unequal power.

This argument suggests that there is not so much to choose between the real person and the virtual one if the fantasy content that arouses us sexually is basically the same.

  • All sex can be used for damaging purposes

The pro relational sex folks might argue that relational sex is somehow more humane and less prone to exploitive or criminal behavior.  But the other side would argue that sex with a partner can be just as exploitive and potentially harmful in certain circumstances and that solitary sex such as masturbation to porn or fantasy can be seen as safe and humane.

  • The preference for relational sex is a religious leftover

This argument assumes that if you are not an anything-goes “liberal” then you are a conservative throw-back.  It ignores the fact that there are increasingly arguments coming from the gender justice, humanist and neo-feminist camps that view pornographic fantasies as corrosive on grounds other than traditional ones.  The “liberals” argue that there is nothing wrong with heightening arousal through imagery and fantasies that add an air of mystery or the forbidden and that sexual experimentation is normal and healthy.

The argument for relational sex

  • Deception, secrecy and shame

We don’t blatantly look at pornography in public or engage in cybersex in front of friends and relatives and so there must be something inherently shameful about it.  Although the secrecy may add to the arousal, it can also be construed as promoting a secret life and a splitting off of sexuality from relationships.

Having a secret life is an integral part of sex addiction and so the pro relational sex people might see that what started out as a harmless promoter of fantasy arousal can become a compartmentalized way of life.

  • Cybersex leads to losing track of reality

People who engage in cybersex can present themselves as other than who they really are.  This is based on the problematic belief that no one would want them as they really are.  But this can lead deeper into fantasy life and away from reality.

Sex addicts who engage in behaviors like online relationships, phone sex and even massage parlors and prostitutes can and do become very fantasy ridden about the person they have the make-believe relationship with.  They can become semi-delusional about what is really going on in the “relationship.”

  • Relational sex is more gender equal

A recent article reported that sex in an onging relationship provided more equal satisfaction to both partners in terms of such things as orgasm and equal amounts of giving and receiving of oral sex when compared to having sex with someone you were not dating or just met.

Another line of argument says that sex outside of a real relationship with another person is sexual objectification.  And a host of ill effects of sexual objectification  are talked about; everything from eating disorders to an increase in cosmetic surgery among teens.  See any of the excellent work by professor Robert Jensen like “Pornography is What the End of the World Looks Like.”

There is no question that there are major changes going on in the realm of real and virtual relating as well as changes in the way relationships are established and conducted.  My own feeling is that we are in a period of great turmoil and confusion about where it will all end up.  This in turn breeds overblown fear and polarized attitudes.  But real connecting with another person is a huge part of what makes us human, and I for one believe it’s here to stay.   Find Dr. Hatch on Facebook at Sex Addictions Counseling or Twitter @SAResource

“Honesty is an Aphrodisiac” – But is This True for Sex Addicts?

I heard the saying “honesty is an aphrodisiac” a long time ago and I felt intuitively that it was true.  But does honesty really set the stage for sexual arousal?  If we are talking about a healthy, committed relationship I think the answer is probably yes.

If honesty in a relationship is being yourself with a partner, being open about who you are and what you are feeling at a given moment then honesty undoubtedly brings you closer.  In fact being vulnerable enough to let a partner know what you feel and what you need is one definition of intimacy.

In sexual terms there is no doubt that communicating honestly about what we feel, what we like and don’t like frees us up to experience what is most arousing to us and can increase our enjoyment of sex.  This suggests that if we share our secret sexual wishes with someone we are letting go of any residual shame that we may feel about those thoughts or urges and are allowing ourselves to become more comfortable with ourselves.

For practicing sex addicts honesty doesn’t work

Comfort and vulnerability are not what sex addicts associate with sexual excitement. Practicing sex addicts find powerful sexual excitement in a world of fantasy.  Whether this fantasy is a scenario on a computer screen, a lap dance, online sexual chat, or a hook-up with a prostitute they are “acting out,” and what they are acting out are their fantasies.  The experience is one of hyper-arousal and in fact sexual arousal is thought to be physiologically connected in some ways to fear.  Fear and risk taking can increase our general level of arousal and can amp up our sexual excitement, as can certain drugs.

If the addict has a spouse or partner but is completely lost in fantasy during sex then they are using their partner to act out their addiction, to use their drug.  And if this is the case they are being dishonest and are closing the door to sexual intimacy with that person.

Honesty works better for the addict in recovery

Recovering sex addicts hope to have a sex life that, while it involves some personal erotic fantasies, also involves a real relationship and an ability to become aroused and to be sexually gratified within a partner.

As addicts progress in their recovery, honesty becomes increasingly meaningful in supporting a healthy sex life.

As the addict recovers he or she gains a stronger and more positive sense of who they are.    Sharing our honest feelings and wants with someone is an act of trust.  It means not only that we trust our partner, but that we trust our new found sense of self, we know that we have nothing to be ashamed of.

Being accepted for who we really are not only makes us feel more trusting it makes us feel that it is possible to be loved.  We feel that we are OK in our core we not longer feel that we have to put up a front or an act in order to be acceptable.  This in turn works wonders for intimacy and for sexual fulfillment.

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

Predatory Flirting and Intriguing as Sex Addiction Symptoms

When I first heard the term “predatory flirting” in connection with  sex addiction symptoms I was taken aback. Predatory sounds like something criminal, but flirting seemed so normal and harmless. But the term describes a symptom, a behavior, which is characteristic of certain sex addicts.

Who engages in predatory flirting?

One type of sex addict, dubbed the Seduction Role addict by Patrick Carnes, is particularly likely to engage in a lot of flirting.  The seduction addict gets his “fix” by getting women interested in him sexually or romantically.  The seduction is everything.  One seduction sex addict told me that the real high was the first kiss.  After that he would begin to lose interest and start looking for the next conquest.

The related concept in describing sex addiction symptoms is intriguing.”  Like flirting, intriguing is a way to create a feeling of private, personal intensity.  It is a way of establishing through some subtle means such as coded comments, private jokes or pointed eye contact, that you and the other person share a connection that no one else is a part of.

Other sex addicts whose preferred behavior is serial affairs have flirting and intriguing as sex addiction symptoms.  They may use flirtation as a way to line up their sexual supply.  They follow through with the sexual liaison but can only take things so far.  A real relationship is frightening and overwhelming.  The addict will find a way to end things and move on to the next affair.  Many serial seducers are married and are investing most of their sexuality in their secret life.

Sex addicts who are addicted to romantic seduction and affairs are driven by the need to constantly re-establish their attractiveness to the opposite sex.  They are as insecure as most other kinds of sex addicts and often feel that their sexual attractiveness is all they have to offer.  They fear that if they do not hook people sexually then there will be no reason for people to be around them.

What does predatory flirting look like?

Normal flirting is a casual and tentative way of initiating contact that may become romantic.  It is the first step in a possible courtship and lets someone know that we are potentially interested.  It involves saying things that are more personal, intense, suggestive or flattering than we would say to just anyone and then if there is a response, following up with real attempts to get to know the person better.

Smoke and mirrors

When it is predatory, flirting is intense but not sincere.  It is designed to capture the person’s interest and attraction but it is not backed up by any genuine interest.  Rather it is just a habitual way that the addict approaches anyone in a broad category of target people.  It is almost automatic, a default position which represents the addict’s safest way of relating.

Wholesale sexualizing

If you know the seduction sex addict well and you observe them flirting, you will see that they are rather indiscriminate in who they flirt with.  They want to captivate everyone, from the waitress to their mother-in-law.  Also, they will begin flirting right away with someone who is attractive looking even if they don’t know them and will never see them again.


Another feature of the seduction addict’s predatory flirting is that it is eminently deniable.  It is throwing out a lure while and the same time pretending that there is no such thing going on.  It is suggestive of something but it is hard to pin down, and this vagueness is frequently a part of predatory flirting.

One type of predatory flirting involves being over-attentive or caring toward a woman.  This suggests that the addict has a real interest in her and also that he is a caring and generally good guy.  This may be a consciously seductive scheme or not.  But often the woman will get interested in this “nice” guy and approach him back only to be told that she has misinterpreted the situation.

Intensity without intention

The predatory flirter will throw out seemingly suggestive comments designed to create a feeling of connection with not other intention than to get the woman’s attention on him. I observed a seduction addict I know run into a woman whom he had seen once before somewhere.  She remarked that it was a coincidence to which he responded: “There are no coincidences.”  It is the initial stage of the empty seduction, the attempt to create a feeling of intensity without intention.

Why is this process predatory?

The addict’s lack of intention or ability to follow through in establishing a relationship with his target women are not just sex addiction symptoms in the abstract.  What the behavior means is that he is being exploitive and insincere.  He is using his ability to hook the woman into thinking he is interested in her when in fact he is using her to get an addictive hit, to make himself feel attractive.

This kind of seductiveness and compulsive flirting is a distortion of what flirting is really for.  It is a symptom of a problem that underlies most sex addiction: deep insecurity and the fear of intimacy.   Find Dr. Hatch on Facebook at Sex Addictions Counseling or Twitter @SAResource