Sexual addiction (also known as Compulsive Sexual Behaviour) is controversial and rarely ever taken seriously, if ever acknowledged and spoken about. Most people don’t understand sexual addiction and simply deny it being a potential problem. This is especially true for a minority of gay men, who are mostly reluctant to acknowledge a problem with sex addiction.

Understandably, any criticism of their sexual behaviour is perceived as yet another attempt to pathologise their sexuality as a whole and to judge it by heterosexual norms and standards. I can almost hear you protesting in annoyance, “What is the problem with having a high sex drive and wanting to shag often?”

Nothing per se. According to the Kinsey Report (Sexual Behaviour in the Human Male), 54% of men think about sex every day or several times a day and 43% think about sex a few times a week or a few times a month. Translating these thoughts into behaviour, according to the Global Sexual Wellbeing Survey (Durex), the following trends have been observed globally:

• The frequency of sex peaks between the ages of 20 and 34;
• Only 38% are satisfied with their current sex life, in quantity and quality;
• Almost 2/3 feel they don’t have sex as often as they would like;
• 43% of men masturbate at least once a week;
• 67% have sex at least once a week and only 10% have sex at least 5 times a week.

What these results suggest is that most men think about sex often and appear to desire more, in terms of quality and quantity, from their current sex lives. If you can identify with this global phenomenon then it means that you have something in common with most guys.

So, what is sexual addiction then?

According to Addictionologists, a sexual addiction is a progressive intimacy disorder, whereby an individual persistently engages in escalating patterns of sexual behaviour despite increasing negative and/or dangerous consequences to the self and others. As such, sex and the thought of sex tends to dominate the sex addict’s thinking, often causing some personal distress, interfering with ability to work or engage in healthy and meaningful relationships, and increasing the risk of emotional and physical injury.

The emphasis here is not on the number of sexual partners one has or the personal choice to go out and have as much sex as one possibly can. Rather, the focus is on the continued engagement in high risk and self-destructive sexual activities (in an obsessive-compulsive manner) despite the potential for negative and/or dangerous consequences for the individual and others. As such, these individuals are unable to stop or curtail out-of-control and extreme sexual behaviours despite a possible desire to do so. According to the literature, sexual addiction may take on various forms:

• Intrusive thoughts of sex and consistent talking about sex;
• Compulsive masturbation;
• Consistent use of pornography;
• Compulsive phone or computer sex;
• Making obscene phone calls;
• Prostitution or compulsive sex with prostitutes;
• Anonymous sex with multiple partners;
• Obsessive dating through personal ads;
• Multiple affairs outside a committed relationship;
• Habitual exhibitionism (e.g., flashing others);
• Habitual voyeurism (e.g., watching others);
• Inappropriate sexual touching;
• Repeated sexual harassment;
• In extreme cases, sexual abuse, molestation and/or rape.

Sexual addiction is progressive in the sense that it occurs more frequently and becomes more extreme over time, as evident in the following account:

“It all started so innocently when I was a kid. I would expose myself to the gardener by standing naked in front of my bedroom window. Each time I would pretend not to be aware that he could see me. It wasn’t long before this whole routine became boring, and a craving for something more exciting developed. I would then go and play at friends’ houses with the sole aim of daring them to strip naked.

Once naked I would touch their penis and offer my penis to be fondled. I can remember my heart racing and feeling very excited each time. But soon this was not enough. The touching then progressed to jerking each other off. I was about twelve at the time. Jerking off was all I could think about. I then came across some of my dad’s porn videos and every day I would come home after school and just lie in front of the TV watching porn and jerking off.

Then I started inviting friends over to watch porn and jerk off together. I would often feel guilty afterwards, but I was hooked. Then when I was about sixteen I started experimenting with alcohol, and would give guys blow jobs and hand jobs for money to buy alcohol illegally at a shebeen. One time, I hitched a ride with a truck driver and gave him a blow job in return for the ride. Then a few years later I discovered the internet.

I would spend hours searching through porn sites and would hook up with guys for sex. These guys were mostly older than me and married, but I didn’t care. I am currently in a relationship with a great guy. Unfortunately, he can’t keep up with me so I now hook up with groups of guys for sex on the side. Maybe it is wrong but this is all I can think about these days.”

- Nick, 29 years old.

Sexual addiction usually becomes a vicious cycle: The secret sexual behaviour may produce feelings of guilt and shame, and the feelings of guilt and shame may compel further secret sexual behaviour as a form of coping. Similarly, the experience of withdrawal symptoms (e.g., headaches, nausea, chills, sweats, fatigue, anxiety, tension, depression, insomnia, intrusive dreams, irritability etc) in advanced stages and consequent attempts at avoiding or reducing them can in and of itself perpetuate the addiction cycle.

Before long, an individual feels trapped (whether in denial or not) in an ongoing secret double life, fraught with potential risks and dangers (e.g., injury and infection).

So what causes sexual addiction?

According to theorists and treatment specialists, sexual addiction may be caused (and maintained) by a number of psychosocial and biological factors. It has been suggested that the presence of deep-seated erroneous beliefs and shame about one’s self based on internalized homophobia (including a pervasive and enduring sense of unworthiness, being unlovable, and a notion that being gay is simply a matter of sex and nothing more), low self-esteem, and poor body image can all contribute to developing a vulnerability to sexual addiction.

In addition, possessing the exaggerated idea of the importance of sex, as an immediate form of connection and happiness (albeit it be temporary), as well as, the underlying belief that others are unable to meet your physical and emotional needs can also contribute to the development of a sexual addiction. This may be related to the finding that many sexual addicts were brought up in hostile, chaotic or neglectful homes, or the family may have been very normal but the child grows up emotionally starved for love because affection was rarely expressed.

Research into sexual addiction also seems to suggest a previous history of sexual abuse among 60% of sexual addicts. In most cases, sex gradually becomes a maladaptive means of coping with (and escaping from) internal and external discomfort, pain and stress. In terms of biological determinants, sexual addiction is viewed as a process addiction.

As such, the individual experiences a euphoric high from chemicals (e.g., adrenaline, phenylethylamine and dopamine) released in the brain at the time of the sexual activity, rather than from an external source (as is the case in substance addiction). As the individual becomes accustomed to the temporary euphoric high, they will continue searching for more (and often more exciting) sexual experiences to maintain that high.

How can I be sure if I have a sexual addiction or not?

Use this brief screening quiz to help you determine if you might need to see a mental health professional for a diagnosis and treatment of a possible sexual addiction:

• Are you preoccupied with sex?
• Do you find yourself looking for sexually arousing articles or scenes in newspapers, magazines or other media?
• Do you find yourself spending a great deal of time accessing sexually explicit images (online and via your cell phone)?
• Do you feel your sexual behaviour is abnormal?
• Have your needs driven you to have sex in places or situations or with people you would not normally choose?
• Have you noticed a need for increasing variety and frequency of sexual activities in order to reach similar levels of excitement and relief?
• Does your sexual partner ever complain about your sexual behaviour?
• Do you frequently want to get away from a sex partner after having sex?
• Do you frequently feel remorse, shame or guilt after a sexual encounter?
• Do you hide aspects of your sexual behaviour from your partner or those important to you?
• Have you ever engaged in practices of voyeurism, exhibitionism, prostitution, sex with minors, indecent phone calls etc?
• Has your sexual behaviour ever interfered with your family life and/or job?
• Has your sexual behaviour ever gotten you into trouble?
• Do your sexual activities include the risk, threat or reality of disease, coercion or violence?
• Have you been unable to stop your sexual behaviour even though you know it is inappropriate?
• Has your sexual behaviour ever left you feeling hopeless, alone, sad or suicidal?

What help is available for sex addicts?

Most sexual addicts live in denial of their addiction, and treating an addiction is dependent on the person accepting and admitting that they have a problem and need help. In most cases, it takes a significant event (e.g., loss of a job, ending of a relationship, an arrest, or a health crisis) to force the addict to admit to his problem.

Treatment is focused on controlling the addictive behaviour and helping the person to develop a healthy sexuality. Support groups and 12 step recovery programmes are generally recommended. In some cases, medications used to treat obsessive-compulsive disorder may be used to curb the compulsive nature of sex addiction. For more information contact a counsellor at the Prism Lifestyle Centre on 012 430 3272.

For more information and advice on sexuality, safer sex and sexual health, log onto www.men2men.co.za. For more information on the services offered by OUT LGBT Well-being call 012-344-5108 or log onto www.out.org.za (Helpline: 012 344 6500).