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Sex Addiction, or Too Much of a Good Thing?

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

A Whole Lot Of Wonderful!

Hey sex fans,

One of the real treasures of the Pacific Northwest is the marvelous Center for Sex Positive Culture right here in the Emerald City. The Center and its parent foundation offer events like workshops and discussion groups that are open to anyone 18+. You don’t need to be a member of the Center to attend. And many events are free! Visit them on their website HERE!

So ya know how they say that good things come in threes? Well this is particularly true this month. And I am proud to bring you a little taste of what’s in store for you and me at The Center. Check out this outstanding lineup of upcoming events.

The Feminine Fountain: Female Ejaculation and the G-Spot

This coming Friday, October 22, 2010
8:00 PM to 10:00 PM
Annex
$35 (members receive $10 voucher for the WERK lounge that night)

Join female ejaculation expert and author, Deborah Sundahl, for this amazing workshop. She is a female ejaculation pioneer. Her book, Female Ejaculation and the G-spot, and her video line titled: The Female Ejaculation Sex Education Series, draw on her 22 years experience, research, and instruction on this important topic of female sexuality. Come benefit from her wisdom.

Learn about female ejaculation’s ancient history, current scientific studies, where the G-spot is located, how to have a G-spot orgasm, and how to get this wonderful feminine fountain flowing! Open to both men and women, Deborah’s Power Point lecture with pictures, movie clips and Q&A will tell you all you need to know about female ejaculation and the G-spot.

For more information on this event, click HERE!

An Intimate Evening with Author Christopher Ryan

Sunday, October 24
6:00 PM to 8:00 PM
Main Space
$10-25 sliding scale (no one will be turned away)

Co-author of Sex at Dawn, Christopher Ryan, will make a special appearance at The Center to talk about sex and nonmonogamy, and sex and hunters and gathers, and sex and penises, and sex and orgasms, and well sex, sex and more sex. Sex at Dawn is the book everyone is talking about; it’s the book that is turning sexual scholarship on its head.

I’ll be there, so look for me and say hi.

Be sure to bring your copy of Sex at Dawn for Christopher to sign. Don’t have a copy yet? Not to worry; The Center will have books for sale.

For more information on this event, click HERE!

Kinky Carnival Returns

October 29, 2010
7pm until midnight
$25 advance/$30 door/$100 Gold VIP

Ya wanna start your Halloween weekend off with a bang? I thought so! Well I have just the thing for you. The sixth annual Kinky Carnival is heading your way.

Imagine an event where you can sample a load of delightfully edgy sex stuff. The Kinky Carnival is designed for those who are new to sex-positivity and BDSM. It offers a way for you to realize your fantasies at an easy pace and in a safe space. The Carnival will feature the “Ask” booth, where attendees are invited to ask questions about the activities they see. Other booths include “Zap”, “Pierce”, “Submit”, “Sensation”, “Flog”, “Rub”, “Mmm”, and “Ground”.

If you’re a budding pervert, or you’d like to be, or know someone who is, this evening is made for you. Costumes are welcomed, but not required.

For more information on this event, click HERE! For tickets, click HERE!

FCKH8

Get on this, sex fans!    Do it now!

Human Rights + Sexual Rights = Sexual Freedom

On this the first annual National Sexual Freedom Day, sponsored by The Woodhull Freedom Foundation, I’d like to propose something quite radical. I suggest that our sexual freedoms, here in the United States, are intricately linked to universal sexual rights. And I contend that the notion of universal sexual rights is at its core a respect for human rights and human dignity.

In a world wracked by poverty, disease and war; where we threaten our very existence with climate altering pollution, nuclear proliferation and extreme population growth; is there room to talk about human rights that include sexual rights and sexual freedom?

I emphatically answer yes! In fact, I assert that sexual inequality and oppression is at the heart of many of the world’s problems. I contend that trying to address human rights without including the essential component of sexual rights and sexual freedom is ultimately doomed to failure.

An absence of sexual rights and sexual freedom leads to domestic and societal violence; human trafficking; suicide; a rise in Sexually Transmitted Infections (STIs); unplanned pregnancies, abortion, and sexual dysfunction.

You know how we are always being encouraged to Think Globally and Act Locally? Well while we busy ourselves securing and celebrating our sexual rights here in this nation, I think we’d do well to focus some of our attention on how our struggle binds us to the rest of the human community.

I offer three examples of what I’m talking about. I invite you to consider how a myopic sexual rights and sexual freedom agenda, divorced from the overarching issues of human, economic and social rights, can be ineffectual and even counterproductive.

***

In 2008 the research community was all aflutter about ‘conclusive’ evidence linking HIV transmission and uncircumcised males. While I’m certainly not ready to take this data on face value, let’s just say, for the sake of discussion, that the link is conclusive. A massive campaign of circumcision was proposed as the best means of HIV prevention. The medical community would descend on epicenters of the disease, scalpels in hand; ready to eliminate the offending foreskins from every male in sight, young and old.

But wait, there’s a problem. Most HIV/AIDS epicenters are in underdeveloped countries. In these places, access to enough clean water to drink or attend to even the most basic personal hygiene, like daily cleaning under one’s foreskin, remains an enormous chronic problem. Without first addressing the problem of unfettered access to clean water and adequate sanitation, which according to The United Nations is a basic human right, further disease prevention efforts are doomed.

I mean, what are the chances that surgical intervention would succeed—one that would involve significant and sophisticated aftercare—if there is not even enough clean water for drinking and bathing?

These well-meaning medical personnel suggest imposing a strategy that not only works against nature—our foreskins do have a purpose after all: a healthy prepuce is a natural deterrent to infection. But this intervention would also violate long-held cultural and societal norms—circumcision is abhorrent to many of these same cultures. Wouldn’t this proposed prevention effort to stem the tide actually make matters worse?

***

Indentured sex work is another indicator of how human rights, sexual rights and sexual freedom are intertwined. Until the economic and educational opportunities for women throughout the world improve—which is a basic human right according to The United Nations—women will remain chattel. Families in economically depressed areas of the world will continue to be pressured to sell their daughters (and sons) simply to subsist.

Closing brothels and stigmatizing prostitutes overlooks the more pressing human rights concerns at play here. Sex is a commodity because there is a voracious market. Men from developed nations descend on the populations of less developed nations to satisfy sexual proclivities with partners they are prohibited from enjoying in their own country. Young women (and boys) in developing countries are viewed as exploitable and disposable, because they don’t have the same civil protections afforded their peers in the developed world. And runaway population growth in countries that deprive their women and girls access to education and contraception inevitably creates a never-ending supply of hapless replacements.

Addressing the endemic gender inequality in many societies is key. Equal access to education and economic resources must come before, or at least hand in hand with any serious sexual liberation effort.

***

Finally, people in the developed world enjoy a certain level of affluence and economic stability which allows them to indulge in sex recreationally. Thanks to effective birth control methods we can ignore the procreative aspects of sex and replace it with a means of expressing a myriad of other human needs. Not least among these are status, self-esteem and self-expression.

If we’re trying to prove something to ourselves, or others, by the way we conduct our sexual lives, simple prohibitions against certain sex practices won’t work. If I’m convinced that unprotected sex with multiple partners and sharing bodily fluids is edgy, cool fun, without serious consequence, as it’s portrayed in porn; I will be more likely to express myself the same way. This is especially true for young people who are already feeling invincible.

Case in point: there has been a startling uptick in seroconversions among young people, particularly gay men, which indicates that disease prevention efforts, even in the world’s most affluent societies, are simply not up to the task. It’s not that there is a scarcity of resources, quite the contrary. It is more likely that these efforts are not connected to a fundamental understanding of the role sexuality plays in the general population. I believe that sexual expression and sexual pleasure are the overarching issues here. These too are fundamental human rights.

No amount of safer sex proselytizing is going to prevail unless and until we look at why and how we express ourselves sexually. As we unravel this complex jumble of motivations and behaviors, effective prevention strategies will manifest themselves clearly. We must develop a sex-positive message; one that celebrates sexuality, builds self-esteem and counteracts the prevailing media messages of sex with no consequences.

***

National Sexual Freedom Day brings into focus the micro-strategies needed to combat a macro problem. But it also shows that we cannot work for and celebrate sexual freedom in a vacuum. It’s imperative that we see how global health and wellbeing is completely dependent on basic human rights, including sexual rights that include gender and reproductive rights, the elimination of sexual exploitation and the freedom of sexual expression.

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

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