Sex addiction - PowerPoint Presentation

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Sex addiction

BEHAVIORAL SYMPTOMS, CAUSES, PSYCHOLOGICAL TRAUMA, TREATMENTSlide2

BRIEF HISTORY OF SEXUAL ATTITUDES AND BEHAVIORS

DEFINITION OF SEX ADDICTION AND THE CRITERIA

CONTROVERSY ABOUT THE DISORDER DIFFERENTIAL DIAGNOSIS – DSM 5DIFFERENCES BETWEEN SEX ADDICTION AND SEX OFFENDING

AGENDASlide3

AGENDA

ETIOLOGY:

FAMILY DYNAMICSTRAUMA EXPERIENCED – PHYSICAL & EMOTIONALATTACHMENT THEORYNEUROSCIENCESEXUAL LEARNING Slide4

BRIEF HISTORY OF SEXUAL ATTITUDES AND BEHAVIORS

PREHISTORIC SEX: PAINTINGS ON CAVE WALLS (32,000

YEARS OLD) INDICATE INTENSE INTEREST IN SEX, HUNTING, RITUAL, AND ANIMAL BEHAVIORS; THE PAINTINGS CONNECT SEX AND SPIRITUALITYCIVILIZATION HAS BEEN SHAPED BY SEXUAL CULTURERELIGION HAS HAD A POWERFUL INFLUENCE ON SEXUALITY: HINDUISM, JUDAISM, BUDDHISM, CHRISTIANITY AND ISLAM Slide5

BRIEF HISTORY OF SEXUAL ATTITUDES AND BEHAVIORS

Species

– we are like allothers in our species Sexuality

Individuality

–

we are like no others

Culture

/Religion

we share similar things with some othersSlide6
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How is sex addiction defined

Briefly stated:

“A pathological relationship to a mood altering experience (sex) that the individual continues to engage in despite adverse consequences.”Stephanie Carnes, Ph.D.Slide8

Sex addiction and sex offending

SEX OFFENDERS ARE USUALLY MORE IMPULSIVE

THEY ARE OFTEN VIOLENT AND USE MORE FORCETHEY ARE EVEN MORE MANIPULATIVE AND IN DENIALTHEY ARE NOT OPEN TO TREATMENTTHERE MAY BE A HISTORY OF OTHER OFFENSESTHERE MAY BE A HISTORY OF PHYSICAL ABUSETHEY DO NOT HAVE REMORSE AND DO NOT FEEL SHAME (MAY HAVE ANTISOCIAL PERSONALITY DISORDER)Slide9
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Sex addicts - 1-

ARE FREQUENTLY MULTI-ADDICTED

CARRY INTENSE SHAMEHAVE A HIGH POTENTIAL FOR SUICIDEUSUALLY HAVE SUFFERED FROM EMOTIONAL OR SEXUAL ABUSE AND PHYSICAL/EMOTIONAL NEGLECTARE PREOCCUPIED WITH SEXUAL THOUGHTS/DESIRESHABITUAL LYINGSlide11

Sex addicts - 2

Distrust of authority

Intimacy deficitPost-traumatic stress disorderExtreme eroticizationCompartmentalizationCompulsive cycles(Patrick J. Carnes, Ph.D)Slide12

Losses suffered by sex addictsSlide13

DIAGNOSES TO BE CONSIDERED

–

DSM 5OTHER SPECIFIED SEXUAL DYSFUNCTIONUNSPECIFIED PARAPHILIC DISORDERMOOD DISORDER*Slide14

DYSTHYMIASlide15

DIAGNOSES TO BE CONSIDERED

–

DSM 5RULE IN OR OUTBIPOLAR AFFECTIVE DISORDEROBSESSIVE COMPULSIVE DISORDERSUBSTANCE INDUCED DISORDERANTISOCIAL/NARCISSISTIC PERSONALITY DISORDER (OR CHARACTERISTICS)PTSDPARAPHILIACOGNITIVE DISORDERSlide16

SEX ADDICTION DOES NOT INCLUDE PARAPHILIAS

EXHIBITIONISM

FETISHISMFROTTEURISMPEDOPHILIASEXUAL MASOCHISM/SADISMVOYEURISMTRANSVESTIC FETISHISMSlide17

PARAPHILIAS

Voyeurism

: watching an unsuspecting/nonconsenting individual who is either nude, disrobing, or engaging in sexual activityExhibitionism: exposing one’s own genitals to an unsuspecting personFrotteurisim: touching or rubbing against a nonconsenting personSexual masochism: being humiliated, beaten, bound, or otherwise sufferingSexual sadism: the physical or emotional suffering of another person

Pedophilia

: sexual activity with a child that is prepubescent (usually 13 years old or younger)

Fetishism: sexual fascination with nonliving objects or highly specific body

parts:

cross-dressing that is sexually arousing and interferes with functioning

Other specified paraphilia: some

paraphilias

do not meet full diagnostic criteria for a

paraphilic

disorder but may have uncontrolled sexual impulses that cause enough distress for the sufferer that they are recognized. Examples of such specific

paraphilias

include necrophilia (corpses),

scatologia

(obscene phone calls), and

zoophilia

(animals).

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PARAPHILIAS

Pedophilia

: sexual activity with a child that is prepubescent (usually 13 years old or younger)Fetishism: sexual fascination with nonliving objects or highly specific body partsTransvestism: cross-dressing that is sexually arousing and interferes with functioningSlide19

PARAPHILIAS

Other specified paraphilia: some

paraphilias do not meet full diagnostic criteria for a paraphilic disorder but may have uncontrolled sexual impulses that cause enough distress for the sufferer that they are recognized. Examples of such specific paraphilias include necrophilia (corpses), scatologia (obscene phone calls), and zoophilia (animals).Slide20

OTHER TERMINOLOGY FOR SEX ADDICTION

COMPULSIVE

IMPULSIVEHYPERSEXUALSlide21

American Society of Addictive medicine

Addiction is a primary, chronic disease of brain reward, motivation, memory and related

circuity. Dysfunction in these circuits leads to characteristic biological, psychological, social and spiritual manifestations. This is reflected in an individual pathologically pursuing reward and/or relief by substance use and other behaviors.Slide22

Addictive behavior

N

umb feelingsEscape from painful parts of lifeMood alteringMost important needSlide23

Loss of control

Efforts to stop

Loss of timePreoccupationInability to fulfill obligationsContinued use despite negative consequencesAddictive behavior includes:EscalationLossesWithdrawalSlide24

ADDICTION- 1

While active in their addiction, sex addicts often nurture fantasies and engage in behaviors that are anathema to their core values and beliefs. Most often, their behaviors start out somewhat in line with their moral center, but as addictive patterns escalate, some progress from “vanilla” interests like soft-core porn and fantasizing about sex with someone met on Facebook to hardcore porn, illegal porn, affairs, voyeurism and/or exhibitionism, buying and/or selling sex, fetish behaviors, coupling illicit drug use with sex, etc.Slide25

ADDICTION -2

Each

time an addict violates his or her core values, he or she typically experiences an ever-growing sense of guilt, shame, and remorse. And because they are addicts, these individuals often respond to these uncomfortable emotions by “self-medicating” with more of the same addictive escapist fantasies and behaviors, thereby creating even deeper feelings of guilt, shame, and remorse. This defines the addictive cycle. Over time, as the individual spirals downward into his or her addiction, these negative feelings add to previously internalized beliefs like: “I am a bad and unworthy person,” or, “I am incapable of receiving love,” eventually becoming incorporated as an integral part of the addict’s personality and thinking. This negative self-talk is often bolstered over time by the consequences that addicts routinely experience as a direct result of their problem behaviors. For many such individuals, ruined relationships, lost jobs, financial problems, declining emotional and physical health, and even arrest can feel earned, deserved, and even unavoidable.Slide26

ADDICTION - 3

Over

time, as the individual spirals downward into his or her addiction, these negative feelings add to previously internalized beliefs like: “I am a bad and unworthy person,” or, “I am incapable of receiving love,” eventually becoming incorporated as an integral part of the addict’s personality and thinking. This negative self-talk is often bolstered over time by the consequences that addicts routinely experience as a direct result of their problem behaviors. and physical health, and even arrest can feel earned, deserved, and even unavoidable.Slide27

ADDICTION - 4

For many such individuals, ruined relationships, lost jobs, financial problems, declining emotional and physical health, and even arrest can feel earned,

deserved, and even unavoidable.Weiss LCSW, R. (2015). Addiction and Narcissistic Shame. Psych Central. Retrieved from https://blogs.psychcentral.com/sex/2013/02/addiction-narcissistic-shame/Slide28

Trauma AND SEX ADDICTION

Sexual addiction is strongly affixed in shame and trauma. There is a prevalence of emotional, physical, and sexual abuse with” highly restricted environments regarding sexuality, dysfunctional attitudes about sex and intimacy, low self- esteem, anxiety, and depression.”

Coleman E. Is Your Patient Suffering from Compulsive Sexual Behavior?. Psychiatr Ann. 1992; 22: 320-325. doi: 10.3928/0048-5713-19920601-09 0Slide29

TRAUMA AND SEX ADDICTION

When a child suffers sexual abuse, sexual arousal becomes activated prematurely and can largely impact the survivor’s sense of autonomy over their body and sexual sense of self (Roller,

Martsolf, Draucker & Ross, 2009).Slide30
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neuroplasciSlide32

Neuroscience issues

Sex addicts experience powerful sexual conditioning and learning

Structural changes in the brain Cognitive deficits in certain areas of functioning, such as memory, decision makingSlide33
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ADDICTION INVOLVES:

Sensitization

– repeated administrations of a stimulus results in amplification of a response – cues create cravingsDesensitization – the more exposure, the less activity in the reward circuit – less sensitive to pleasure; tolerance develops after desensitizationHypofrontality –decreased executive control functioningStepanie Carnes, Ph.DSlide35

Reward deficiency syndrome

Provides a

platform for understanding the commonality of brain function in substance and non-substance addictive behaviors. The goal has been to find a specific genetic variant that could be contributing to this RDS. Early research regarding Reward Deficiency Syndrome discovered a link between carrying a certain allele (the “A1”) and alcoholism.  Upon further investigation, this same allele was also associated with the development of other addictive, compulsive, and impulsive behaviors and disorders. (Journal of Reward Deficiency Syndome and Addiction Science)Slide36

Brain functions

Researchers completed brain scans of individuals with sex addiction and without.

Compared to their counterparts unaffected by sex addiction, the participants dealing with the condition experienced an unusual elevation of activity in three separate parts of the pleasure center. These brain structures are responsible for things such as the ability to recognize a rewarding sensation and the ability to control emotional responses to pleasureSlide37

BRAIN FUNCTIONS

T

he observed brain function changes in the study participants with sex addiction made these participants desire sex more but did not make them like sex more than their unaffected counterparts. The study’s authors believe that this unusual juxtaposition between sexual desire and sexual liking largely helps explain the presence of sex addiction.Addiction Research, Slide38

Multiple addictions

Alcohol is the most frequently co-occurring addiction in

males and femalesDrug abuse is most frequent among gay malesWomen scored higher on compulsive spending, compulsive eating, and compulsive cleaningSlide39

ATTACHMENT ISSUES

Attachment patterns have to do with how the infant is tended to by his/her primary caretaker, usually the mother. This means that when an infant is upset, the “good enough” mother soothes the infant which regulates his/her nervous system. If the baby is soothed while under the duress, that baby will grow into an adult who can soothe himself while under stress. This ability helps to create a securely attached adult.

Alexandra KatehakisSlide40

ATTACHMENT ISSUES

If the mother or caregiver does not provide nurturance and soothing to the infant because of her/his own

dysregulation, the child gtows into an adult who cannot self-soothe when under stress. The ability to self-soothe creates a securely attached adult.Slide41

INSECURE ATTACHMENT STYLES

The

Anxious-Avoidant type of person is both anxious and avoidant of intimate relationships. He can appear to be commitment phobic in his way of relating.The Disorganized type is simultaneously terrified of engulfment and abandonment. If you get too close, too fast, they bolt. If you get close and have arguments or struggles in the relationship, theySlide42

INSECURE ATTACHMENT STYLES

The Preoccupied personality is ambivalent in her attachment style. You get mixed messages from her where she seems to be saying, "come here, go away" at the same time. She, too, has difficulty with long-term commitment.Slide43

INSECURE ATTACHMENT STYLES

The Disorganized type is simultaneously terrified of engulfment and abandonment. If you get too close, too fast, they bolt. If you get close and have arguments or struggles in the relationship, they

fear that you will leave them. It can be exhausting to be in a relationship with this attachment style. These patterns are changeable.Alexandra KatehakisSlide44

TREATMENT

Education

Group Therapy12 Step Support Recommended:Celibacy agreementSexual health plan Recovering task completionMindfulness/CBTTrauma treatmentPartner trauma treatmentCouple treatmentSlide45
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