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Sex Addiction, or Too Much of a Good Thing?

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This last post of 2010 will start with a declaration. One of my famous “Thus Sayeth Dr. Dick” sorta things, if you please.

Ready?

I categorically reject the concept of sexual addiction that has been floating around in the popular culture for the last 20 years or so.

And yes, I know this will rankle a bunch of you, but you’ll just have to get over it. You see, there is no such thing as a sexual addiction. Period!

Nowadays people bandy about the term addiction as if it can be applied to any and all obsessive behaviors. I have an addiction to chocolate; I’m addicted to shopping; I’m addicted to video games; I’m addicted to porn—or, I’m a sex addict. NONSENSE!

That being said, I hasten to add that I do believe there are sexual obsessions and compulsive sexual behaviors, plenty of ’em in fact. However, obsessions and compulsions are not addictions, and addictions, while they may involve irresistible impulses, are not the same thing as compulsions. Get it? Got it? Good!

I want to be absolutely clear about this. An addiction is a very specific condition. It denotes a dual dependency, physical as well as a psychological.

  • A physical dependency occurs when a substance is habitually used to a point where the body becomes reliant on its effects. The substance must be used constantly, because if it is withheld, it will trigger symptoms of withdrawal.
  • Psychological dependency occurs when the substance habitually used creates an emotional reliance on its effects. There is no functioning without it. Its absence produces intense cravings, which if not fed will trigger symptoms of withdrawal.

Check it out. With the help of my handy-dandy dictionary, a good place to start in discussions of this sort, I discovered these three very distinct definitions:

Addiction: The need for and use of a habit-forming substance (as heroin, nicotine, or alcohol) characterized by well-defined physiological symptoms upon withdrawal. Broadly: persistent use of a substance known by the user to be harmful. A state of physiological and psychological dependence on a drug.

Compulsive: Driven by an irresistible inner force to do something; i.e., a compulsive liar.

Obsession: A persistent disturbing preoccupation with an often unreasonable idea or feeling.

See? Different words. Different meanings. Not a particularly complex notion to grasp, right?

And listen, just because a bunch of yahoo afternoon talks show hosts and even a load of my esteemed professional colleagues banter these words about like they were interchangeable doesn’t make it so. In fact, we do ourselves a huge disservice by muddling these very specific concepts into a jumble. My fellow therapists should be the first to recognize this because finding help for an addiction or an intervention for an obsessive/compulsive disorder will be as specific as the problem itself.

One thing is for certain: identifying one of the things, as the other will complicate the problem solving. It’s like going to the doctor with a headache, and when the doc asks where does it hurt, you point to your stomach. It just won’t do.

Hi Dr. Dick,
I recently found out my boyfriend has been cheating on me. He wants me to forgive him, but he keeps on doing the same thing over and over again. He’s like addicted to sex or something. I love him very much, but I feel dirty just by being around him and knowing what he’s doing. It also makes me feel stupid putting up with all of this and at the same time I still love him, please give me some advice. Thank You.
— Darlene

Before we turn our attention to your boyfriend’s behavior, let me make a quick observation about you. You’re a big fat ball of contradictions, huh? How can you say that you love the person that makes you feel dirty and stupid? You’re deceiving yourself about at least one of those feelings. And if I had to guess, I’d say what you’ve got with your man ain’t love—it’s an obsession.

Your boyfriend probably has you figured out by now, and he knows that you will tolerate his misbehavior, which gives him tacit permission to do whatever he feels like doing. From where I sit, you’re the real sap. If you’re really serious about reining in your wayward BF, you’d better come up with a clear, unambiguous message about what you will and will not tolerate. Until you do precisely that, he’ll just think that he can roam wherever he wants and whenever he wants.

If the two of you are supposed to be living in a sexually exclusive relationship, and he’s taking his business elsewhere, then he’s got a problem, too. However, I caution you against thinking that his sexual behaviors are an addiction. Because they’re not.  And thinking they are will not help you find the solution to the problems you folks are having.

There are root causes for his behavior, just like there are root causes for your behavior. To get to the bottom of all of this, each of you will need to invest a good deal of time and energy with a qualified therapist. One can only hope that there’s a big enough bank of goodwill between the two of you to carry the day because overcoming your obsession and his compulsions will demand all of your emotional resources.

Dear Dr. Dick,
I have been in a relationship for five years now and truly love my partner, however I can never seem to get enough sex. I am 30 and he is 29, but I constantly find myself in the chat rooms lookin’ for younger guys to have sex with. It’s more than just a hobby—it’s a habit! I’ve actually lost jobs because he’d be out of town and I’d spend almost every waking hour on the PC with a cocktail looking for sex, not caring about anything else. It’s like I’m addicted to sex. He knows I have played around (I actually have talked him into three-ways a few times), but he has no idea how extreme it’s become. I don’t know what’s wrong with me. I’m not unhappy with him. I just can’t seem to stop wanting sex with younger guys. Any suggestions?
— Brian

It’s interesting that you should tell me about your compulsive sexual behavior in the same breath that you tell me of your love for your partner. As you’ve probably guessed already, there isn’t really much of a connection between the two. Love and sex are two very different things. Sometimes they go together, but not always or even often for that matter.

It appears to me that you’ve really got two problems happening simultaneously: First, your compulsive prowling of the internet for sex (complicated, I might add, by your alcohol consumption). Second, the deception you’re practicing on your partner. Let’s deal with each of these in turn.

Your particular sexual activity, like any compulsive behavior (overeating, excessive shopping, etc.), is more than just a bad habit. It’s a serious psychological dysfunction. Take it from me: breaking this behavior pattern will be nearly impossible without some professional help. If the problem is as serious as you say, then you’d better seek help right away. This sort of thing, if left untreated, will not only destroy your relationship, it will ruin your life. When you seek that professional help, I encourage you to include information about your alcohol consumption. If there is an addiction in all of this, it’s the alcohol, not the sex. And in your case, the addiction may be fueling the compulsion.

Now, regarding your relationship. It’s imperative that you come clean with your partner about your sexual obsessions and compulsions, as well as your probable alcohol addiction. Not only will you feel better about not lying to him anymore, you’re going to need his support in overcoming the difficult obstacles you face. I suggest that you attend to this right away. There’s not a moment to lose.

Good Luck

the indomitable human spirit…follow up

I have something extraordinary to share with you.  Here is an email I received in response to Tuesday’s posting:  the indomitable human spirit

Dear Dr. Dick,

About your post today…thank you, thank you, thank you! I appreciate your words and I love that Roman and his girlfriend are having a good time and are willing to explore options.

I am disabled. I had polio as a 13 month old baby in 1955 and use forearm crutches for very short distances and a manual wheelchair for everything else. Basically, my shoulders serve the same function as hips do for others. Due to polio, multiple surgeries and post polio muscular atrophy, I also have some reduced sensation from the hips down and a lack of control with both legs.

I am also a very sensual and sexual person. I love the physical feeling of being touched and kissed, and absolutely relish having orgasms. I love the emotional rush of planning, organizing and getting ready for a sexy time with my guy, and I love the psychological boost of knowing I am desirable.

I have found the world of BDSM to be extremely helpful to me. I have a leather bustier and thong with flames; we have a restraint system under the mattress, a flogger, blindfolds, Hitachi Wand, assorted dildos and other fun toys. While I think people may come from the womb wired for a mindset that jives with BDSM, for someone disabled in the way that I am there are definite perks. The extra levels of touch and physical stimulation in BDSM play help me build toward an orgasm. The building of mood with language throughout the day, calling my guy Master, his comments about spanking my butt after supper, laying out the clothes, choosing the toys from our toy box, lighting the candles for wax play and burning my favorite incense…all work together to get me in the mood, physically and mentally.

BDSM is so much about the focus, the connection and the attention – either using all the senses, or purposely withholding one sense or another, that many people in the BDSM world already make adaptations for personal differences in play and are acutely aware when someone responds more sensually to a quiet whisper rather than a normal tone of voice, or to the sensations of one type of clamp rather than another. In that world, individual differences are considered normal, so my differences seem to make less difference to them. I know of several couples where one or both are disabled and choose to attend BDSM functions…and frequently it is the woman or man in the wheelchair who is the Dom in the relationship.

Vaginal intercourse is difficult for me. I don’t have the muscle tone to provide adequate stimulation for my guy to reach orgasm. The adaptation for that is oral or anal intercourse. I went to my gynecologist for a frank talk about any special concerns about anal intercourse for someone in my physical situation. I also called and talked with the Dom of a BDSM dungeon to ask the same questions. He gave me some great advice and ideas, probably more specific and useful information than the doctor.

I have found the Liberator pillows to be extremely helpful for positioning and, combined with the under the mattress restraint system, there is much less problem with losing control of my legs and accidentally kicking someone. Regular bed pillows and other positioning cushions that I have tried over the years would just scoot out from under me and were usually more frustrating than helpful. With any restraint system attention has to be paid to circulation and the restrained person never left alone, but that is true whether the people involved are disabled or not.

All that being said, a sense of dedication and a sense of humor are absolute necessities! Our attitude is one of discovering how to make things work rather than questioning whether they are possible. And humor simply must be part of the process. At one point I decided satin sheets and a matching sexy gown would be a great surprise to put my guy over the moon. A friend came over and put the satin sheets on the bed for me and when my guy arrived home I was waiting in the silky nightie on those expensive satin sheets. My beloved was quite excited and reached out to gently push me over just a bit so he could join me on the bed. Odd how slick those sheets were. I went sailing across the sheets and off the other side of the bed onto the floor. We laughed until we cried.

Thanks again for helping get the word out that disability does not equate to celibacy.

Hugs,
Donna

Dr Dick’s Sex Positive Doctrine

No podcast today; instead there’s this…

Have you ever wondered about the term, sex positive? If you’re like me you see it all over the place, especially on sex-related sites. I confess I use it way more often than I should. It’s become one of those industry buzzwords that has, over time, become so fuzzy around the edges that it’s now virtually meaningless. In fact, if the truth be known, I believe the term sex positive has been taken over by the sex Taliban who have made it a cover for their strict code of political correctness. Oddly enough, this is the very antithesis of its original meaning.

If you want to shame someone in the sex field—be it a sex worker, blogger or adult product manufacturer—you label that person as sex-negative. You may not know anything about that person other than you were offended by something they did, said or made. But still, you hurl the epithet as if you were exorcising a heretic. This is a very powerful tool for keeping people in my industry in line. But I’ve begun to wonder, who is setting themselves up as the arbiter of what is and what is not sex positive? I have to ask: What is the agenda? I mean, could compulsory ideological purity of some artificial standards of thought or behavior be “positive” anything? I say, no!

Like all good ideas that have gone bad due to overuse—or worse, sloppy use—the sex positive concept once had meaning that was life-affirming and enriching. Sex positive has been in the lexicon at least since the mid-1950s. It frequently appears in journals and research papers to describe a movement that examines and advocates for all the other beneficial aspects of sex beyond reproduction.

I’ve been using the term since 1981 when I opened my practice in Clinical Sexology and Sexual Health Care. The opening words of my mission statement read: “I affirm the fundamental goodness of sexuality in human life, both as a personal need and as an interpersonal bond.” Way back then, I was flush with my quixotic pursuit to stand steadfast against all the cultural pressures to negate or denigrate sexuality and pleasure. I dedicated myself to spreading the gospel that healthy attitudes toward sex not only affect a person’s sex life, but his/her ability to relate well with others.

This came relatively easy for me, because I’d learned something very important about evangelization in my life as a Catholic priest. (Another quixotic pursuit, but we’ll have to save the details of that misadventure for another time.) One of the first things one learns in seminary is how to proselytize, to sow the seeds of a creed, and then nurture them taking root by endless repetition of the articles of faith. Of course there is a downside to this, too. Repetition fosters mindlessness, stifles creative thought, and worse makes things boring.

But the creed statements of the world’s three great monotheistic religions are masterful works of theological art.

Barukh ata Adonai Eloheinu Melekh ha’olam!
Allaahu Akbar!
In the name of the Father, and of the Son and the of the Holy Spirit!

Each contains the most profound kernel of religious truth the believer needs to know, but all are easy enough for a child to learn. And like I said, the secret is in the repetition. For the true devotee, these creedal statements are uttered dozens of times a day and to great effect.

Early on in my career as a sexologist, I decided to put the principles I learned in the Church into disseminating my new belief system. First, keep the message simple! I settled on: “Sex is Good—and Good Sex is Even Better.” This has been my mantra for decades. It contains everything you need to know about being sex positive, but it’s easy enough for a child to learn. Even now, I close each of my podcasts with this same article of faith. To this day it soothes me to hear myself say these words. And it comforts me in the same way blessing myself did in my priestly days.

Despite my apprehensions, I continue to be an apostle of the sex positive doctrine. I know that even though my industry has corrupted the concept, others have yet to hear the good news. And there’s something almost spiritual about seeing someone grasp the idea for the first time. Let me tell you about one such instance. Some while ago I was asked to offer a workshop for a group of doctors on the topic: Health Care Concerns Of Sexually Diverse Populations. Unfortunately, just a handful of doctors attended the workshop—which was pretty disconcerting, considering all the work I’d put into the presentation. I guess that’s why kinksters and pervs, as well as your run-of-the-mill queer folk, are often frustrated in their search for sensitive and lifestyle-attuned healing and helping professionals.

Since the group of doctors attending was so small, I decided to ask them to pull their chairs in a circle so that our time together could be a bit more informal and intimate. Frankly, I’ve never found it easy talking to doctors about sex; and discussing kinky sex was surely going to be very tricky. So, I decided to start off as gently as I could. My opening remarks included the phrases “sex positive” and “kink positive.”

Sitting as close to my audience as I was, I could see at once that these fundamental concepts weren’t registering with them. I was astonished. Here was a group of physicians, each with a large urban practice. Could they really be this out of touch? I quickly checked in with them to see if my perception was correct. I was right! None of them had heard the term, sex positive. The two who hazarded a guess at its meaning thought it had something to do with being HIV+. I had my work cut out for me.

I decided to share my creed with them. “Sex is Good—and Good Sex is Even Better.” I asked them repeat it with me as if I were teaching a catechism to children. Surprisingly, they did so without resistance. After we repeated the mantra a couple more times, I exposed them to the sex positive doctrine unencumbered by political correctness.

  • Sex Is Good! Sex is a positive force in human development; the pursuit of pleasure, including sexual pleasure, is at the very foundation of a harmonious society.
  • And Good Sex Is Even Better! The individual makes that determination. For example, what I decide is good sex for me, may be boring sex to someone else. And their good sex may be hair-raising to me. In other words, consensual sexual expression is a basic human right regardless of the form that expression takes. And it’s not appropriate for me, or anyone else, to call into question someone else’s consensual affectional choices.
  • Sex Is Good! Everyone has a right to clear, unambiguous sexual health information. It must be presented in a nonjudgmental way, particularly from his or her health care providers. And sexual health encompasses a lot more then just disease prevention, and contraception.
  • And Good Sex Is Even Better! The focus is on the affirmative aspects of sexuality, like sexual pleasure. Sexual wellbeing is more than simply being able to perform. It also means taking responsibility for one’s eroticism as an integral part of one’s personality and involvement with others.
  • Sex Is Good! Each person is unique and that must be respected. Our aim as healing and helping professionals is to provide information and guidance that will help the individual approach his/her unique sexuality in a realistic and responsible manner. This will foster his/her independent growth, personal integrity, as well as provide a more joyful experience of living.
  • And Good Sex Is Even Better! Between the extremes of total sexual repression and relentless sexual pursuit, a person can find that unique place, where he/she is free to live a life of self-respect, enjoyment and love.

Finally I told them they ought to think creatively how they could adapt this concept to their own practice. It was up to each of them to make this creed their own. As it turned out, this primer was just the thing to open my planned discussion of health of kinksters.

In a way this experience was a bit of a spiritual reawakening for me, too. Despite my misgivings about the contamination of the sex positive doctrine by malicious people bent on using it as a weapon against those they disagree with. I can’t tell you how refreshing it was to watch these sex positive novices hear, and then embrace, the message for the first time. It was nothing short of a religious experience.

Prostate Cancer Awareness Month

Scheduling difficulties prevent me from bringing you the latest installment of The Erotic Mind podcast series today. But with a little luck, that will resolve itself by next week.

Actually, I’m glad I have this positing opportunity, because September, as you may know is Prostate Cancer Awareness Month.  And I have something important to say about that.

Curiously enough, I was contacted by another website recently and asked to contribute to a series they were doing on this very issue. They were looking for a unique take on prostate cancer awareness. I told them I had just the thing; and proceed to outline what I think is an exceptionally important, yet universally overlooked, aspect of prostate health — prostate self-awareness. Alas, the folks who run the website thought the concept of prostate self-exam was too edgy for them. After they declined my offer I thought to myself; man, there is incredible resistance, on virtually every front, for us men to become proactive in this aspect of our health.

Name: Gordon
Gender: male
Age: 67
Location: Florida
I guess I have more of a comment than a question. I’m 67, a widower and have been recently diagnosed with prostate cancer. I never was very adventuresome when it came to sex. In fact, before my wife died two years ago, I never had sex with any other woman. I never gave prostate cancer a thought, never gave my prostate a thought either. Now I’m mad as hell that I didn’t. You see when I started to go to a prostate cancer support group I discovered I could have monitored myself better with a simple self-examination. Why don’t doctors tell us about this? Women are supposed to examine their breasts why don’t men examine their prostate? It’s so easy actually and yet it’s this big secret. Why don’t people talk about this? It makes me so mad because it could have made a big difference in my own life. Do you know about this self-examination Dr Dick? If you do why don’t you tell other people about this? I think it would help a lot if you could get the word out on this. Now that’s all I have to say. Thank you.

No, thank you Gordon. Thank you for sharing your concern with me…with us.

I’ve been a tireless activist of prostate self-exam for decades. Let me explain. My career as a therapist began in San Francisco in 1981. That was precisely the same year a mysterious new disease began showing up among gay men. Back then it was being called gay cancer, but soon it would have another name — HIV/AIDS.

As it turned out, my private practice focused down almost exclusively to working with sick and dying people. Luckily, I discovered that I was well suited for the job and I liked it very much. So much so that in the mid-90’s I founded a nonprofit organization called, PARADIGM; Enhancing Life Near Death. It was an outreach and resource for terminally ill, chronically ill, elder and dying people. This was brilliant cutting-edge work and I learned so much from the people I was working with. One of the things that struck me most was that regardless of the disease — cancer, HIV, MS, you name it, or even aging process for that matter — there was always a woeful lack of information about regaining a sense of sexual-self post diagnosis, or sexual wellbeing for seniors.

I recall one participant in particular, a man much like you, Gordon. He too had prostate cancer and, like you, he was mad as hell with the indifference of the medical industry toward prostate self-exam. One day during a group session, John was railing against doctors and cancer associations for their lack of interest in promoting prostate self-awareness. He pointed to the success of the cultural campaign to encourage women to self-examine their breasts. There is even a modest campaign to promote testicle self-exams. But apparently the medical industry draws the line at prostate self-exams. I guess no one is going to encourage a man to finger his ass, even to save his life.

Another group member, Clare, a senior woman in her 70’s and a breast cancer survivor, helped put things in perspective. She reminded us that breast self-awareness is a relatively new phenomenon. Her mother, aunt, sister and a niece all died of breast cancer before the self-exam campaign began in earnest. Clare went on to say that it was only through the hard work of individuals and grassroots organizations that actively campaigned for breast self-exams that things began to change. Eventually, this movement changed the medical and cultural mindset. Clare said that it was these individuals and grassroots organizations that helped all of us overcome the denial, shame and embarrassment that was associated with women touching themselves, even to save their lives.

This is an indication of just how ingrained the sex-negativity and body-negativity runs in this culture.

I continue to work with sick and dying people here in Seattle. I had a brief gig at a local cancer center where I developed an NIH (National Institute of Health) funded program for women newly diagnosed with ovarian cancer. At the same time, I was also working with a group of women with breast cancer and group of men with prostate cancer. Again every therapeutic intervention I encountered — government funded or foundation funded — was woefully lacking in any clear and unambiguous information about sexual health, wellbeing and intimacy issues post-diagnosis or surgical intervention.

To remedy this, I decided to produce a series of videos for people experiencing life threatening and/or disfiguring illnesses. Videos that would help them address reintegrating sex and intimacy into their lives post diagnosis. One of the first videos was going to be Public Service Announcement showing men how to do a prostate self-exam and what to look for. Unfortunately, I couldn’t find the necessary funding for this groundbreaking work. My grantwriting efforts turned up zilch. I did, however, get a whole lot of, “What a fine idea, Richard. Good luck with that…” brush-off letters though. No foundation would be caught dead funding sexually overt pattern films, even ones with the laudable intent of assisting people with the life-saving information they needed most.

I’m sorry to have been so long-winded in my reply, Gordon. I just wanted you to know that many have preceded you with outrage at the conspiracy of silence regarding prostate self-exam. Let’s face it; our society is so ass-phobic that we’d rather see men die than offer them simple instructions on how to finger their butt, find their prostate and keep tabs on their prostate health.

If we want this to change we all need to speak out…as well as stick a finger in our ass.

Keep up the fight, Gordon! And please, stay in touch.

Good luck

It ain’t necessarily so!

Podcasts will resume on Monday, September 6th.

Name: Tomasz
Gender:
Age: 64
Location: Budapest
Are there any vitamins or minerals that will increase the amount of ejaculate? Thanks…your site is very nice and provides a great service!

Why, aren’t you a sweetheart, Tomasz! Thank you for your kind words.

There are loads and loads of companies out there who claim to have products that will increase the volume of a man’s ejaculate. But when I search the web for products that promote male sexual enhancement, or potency, or whatever; I do so as a skeptic. That’s how everyone should go about such a search. If you keep your eyes open and look beyond the pseudo-medical babble you’ll discover two very important things, just like I did.

First, every site I visited advertises their product as a miracle medical breakthrough. Often there is a testimonial or two from some doctor (MD) or doctor (Ph.D.) who substantiates the claims being made. We never really discover who these professionals are, but we are encouraged to take their words as gospel. Why? Well because we all know that professional people would never knowingly try and hoodwink us. Exactly! And if you buy that we have some swampland in Louisiana for ya.

Each site also claimed that the product they hawk has undergone rigorous clinical studies proving its efficacy. But they never actually cite any of the studies in question or where these supposed studies were published. Here’s a tip, if there is a sited study and that study was sponsored by the company that produced the product, or is published by them, then you know you’re in trouble.

Second, inevitably the manufacturers of these products make the most outlandish claims. Take this one for instance. I’ll not disclose the product’s name, but this is actual promotional copy from one site. It says, Product X will…

  • Intensify ejaculatory contractions due to the strengthening of the vas deferens muscle (the muscle responsible for the expulsion of semen)
  • Increase volume of released ejaculate
  • Produce faster recovery for second orgasms
  • Improve semen quality
  • Produce more satisfying orgasms due to increased contractions and ejaculate
  • Improve prostate health
  • Improve Erectile Dysfunction caused by diabetes
  • Increase sexual well-being and vitality
  • Cure cancer
  • End world hunger

Ok, I made the last two up.

One has only to look closely at the claims to realize they’re hogwash. Besides, they don’t really tell us anything other than the product in question might somehow improve something that may have something to do with male virility. The same could be said about a glass of water.

Listen up…

The truth is, Tomasz, you can probably do just as well with a modest daily intake of a zinc and lecithin supplements. For some, these nutrients have a noticeable effect on the volume of ejaculate produced. And they’re a whole lot cheaper and easier to get then the trumped-up stuff you see online.

Keeping yourself hydrated will also increase the volume of your spunk. It just stands to reason, the more hydrated you are the easier and more efficiently all your glands responsible for secreting a watery substance, like your prostate and seminal vesicles, will have getting water from the bloodstream. If you’re dehydrated, your glands will not have as much water available, and subsequently you’ll spooge considerably less.

Good Luck!

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