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human behavior has often been prone to different extremities and in time has been defined by lack of activities or, on the contrary, by an extreme interest for certain activities. While the former takes is not necessarily visible with the open eye, because it would assume the presence of something that is missing (for instance, social behavior), in the cases where extreme behavior is present, there are obvious signs and visible manifestations. One such case is sexual addiction. This is an important issue to take into account because it represents a manifestation of the brain that is similar to drug addiction without the actual presence of a palpable stimulus.
An analysis of this phenomenon is important because it represents a behavior that affects directly the life of an individual that has been identified with suffering from such behavior and at the same time, it is not an issue that can be discussed at large, as there are few, if any, cases which have been diagnosed from a medical perspective to be suffering from sexual addiction. In order to better understand and have a better image of what sexual addiction is, what is the background and its implications, the present paper focuses on several key aspects. It describes the history of sexual addiction and differentiate it from hypersexuality and other competing constructs, it identifies the primary philosophy and basic concepts in recovery, such as sobriety, accountability, reports and describes recent trends in the treatment of sexual addiction such as individual, couples, and group treatment, as well as identifies and describes co-morbid diagnoses and co-addictive behaviors in sexual addiction. This approach is complex particularly because of the complex nature of the subject and the cutting edge matter at hand.
Sexual addiction or sex addiction "defined as any sexually related, compulsive behavior acted out regardless of the negative consequences to the individual's life including causing severe stress on their family, friends, and/or their work environment. Sex addiction has also been referred to as sexual compulsion or dependency" (Lacy, 2013). Another definition of this is provided by the Society for the Advancement of Sexual Health (SASH) which "describes sexual addiction as "a persistent and escalating pattern or patterns of sexual behaviors acted out despite increasingly negative consequences to self or others." (CRC Health Group, 2009). Finally, perhaps one of the most important definitions in the area is that of The National Council on Sexual Addiction and Compulsivity that defines sexual addiction as "engaging in persistent and escalating patterns of sexual behavior acted out despite increasing negative consequences to self and others." In other words, a sex addict will continue to engage in certain sexual behaviors despite facing potential health risks, financial problems, shattered relationships or even arrest." (Herkov, 2013)
Although there is little consensus over an actual definition of this compulsory behavior, it must be pointed out that, regardless of the details of any definition, sexual addiction is by all means an abnormal behavior. From the definition mentioned above, several key elements can be underlined. Firstly, sexual behavior is a compulsive behavior in the sense that it represents a behavior that cannot be controlled at the first sight. Secondly, this compulsory nature determines a lack of consideration for the effects this behavior has on the outer environment such as family or friends. From these two points-of-view, it can be said that sexual addiction resembles any other type of addiction such as drug addiction or compulsory eating disorders.
There are few studies being conducted at the level of this disorder particularly because of the nature of the symptoms. "Some of the reasons for why there is a lack of formalized criteria include the lack of research as well as an agreed-upon terminology. This is due, in part, to the heterogeneous presentation of compulsive sexual behaviors. For instance, some patients present with clinical features that resemble an addictive disorder -- i.e., continued engagement in the behavior despite physical or psychological consequences, a loss of control, and a preoccupation with the behavior. Others will demonstrate elements of an impulse control disorder, namely reporting irresistible urges and impulses, both physically and mentally, to act out sexually without regard to the consequences. Finally, there are patients who demonstrate sexual obsessions and compulsions to act out sexually in a way that resembles obsessive compulsive disorders. They do so to quell anxiety and to minimize fears of harm. For these patients, the thoughts and urges to act out sexually are ego-dystonic, whereas other types of patients describe ego-syntonic feelings about their sexual behaviors." (Fong, 2006) Therefore, it cannot be said that there is a clear clinical overview of the behavior precisely because people in such conditions tend to act differently, yet with certain common elements which include a compulsory nature of their acts that are, one way or another, related to sexually oriented behaviors.
A clear discussion must take place between sexual addiction and hyper sexuality. In this sense, there are voices that argue that sexual addiction is not in fact a disease but rather hyper sexuality and increased libido. More precisely, as mentioned previously, in theory, sexual addiction should be somewhat similar to drug addiction in the belief that both these conditions are urges to consume or limit the individual's outer world. However, "Drug addicts who observe images of drugs show an almost instantaneous change in brain activity when photographs of the substance they are addicted to are placed in front of them. But scientists found that the brain responses from 'sex addicts' were related only to their level of sexual desire, not to the severity of their 'condition'" (Innes, 2013). By comparison, it could be argued that such behavior is not necessarily a means through which frustrations and urges surface, but rather an increased sexual behavior. At the same time though, the issue of control comes into the discussion. Common sense would argue that if an increased sexual libido is in place, it can be controlled. Once this increased libido cannot be subject to control, the argument of compulsory behavior comes into place. At the same time, "While not yet fully acknowledged as a legitimate mental health disorder in the clinical literature (reportedly due to a lack of research study), sexual addiction and hypersexuality nevertheless is becoming identified in the public consciousness as a legitimate neuropsychobiological disorder." (Weiss, 2013)
In terms of defining and agreeing on whether sexual addiction is indeed a behavioral extreme that can be medically treated is still under debate. Despite the controversy, there is a majority of opinions that state that, similar to drug addiction, sexual addiction is a medical condition for which treatment means have been set in place. At the same time, research has concluded that sexual addiction, similar to any other type of compulsory behavior has certain roots in the background of the family from which the individual defined by such a behavior comes from. In this sense, "Research also has found that sex addicts often come from dysfunctional families and are more likely than non-sex addicts to have been abused. One study found that 82% of sex addicts reported being sexually abused as children. Sex addicts often describe their parents as rigid, distant and uncaring. These families, including the addicts themselves, are more likely to be substance abusers. One study found that 80% of recovering sex addicts report some type of addiction in their families of origin." (Herkov, 2013) Therefore, the means through which treatment can be sought include a high degree of comforting and inclusion of the individual in a healthier environment. This approach is similar again to that taken for any other type of addiction.
In terms of trends for treatment and recovery from this type of behavior, once this has been labeled as an addiction, the focus is similar to any other type of addictions. More precisely, "Treatment of sexual addiction is similar to treatment for other addictions, and can include counseling, 12-Step recovery programs and medication. Through the appropriate treatment, recovery from sexual addiction is possible." (CRC Health Group, 2009). In this sense, the means through which sexual addiction can be dealt with are similar to drug addiction particularly because the overall and general symptoms are similar in its effects. These include a high degree of secrecy concerning one's life and interests, sense of remorse or guilt after engaging in such activities, a limited consideration for stability or lack of, an increased time spent in detailing and setting the scene for such encounters, alienation from the personal environment (CRC Health Group, 2009). These overall symptoms can also be seen in drug addiction and drug consumption. Therefore, the means to treatment are similar in nature and approach.
In terms of medication, there is no clear treatment for sexual addiction, but rather its associated levels of side effects. More precisely, "The medical model examines the cause of sex addiction by physiological factors. However, there is no specific drug therapy for sex addiction. Therefore, psychiatric drugs usually are prescribed that can treat the psychological conditions associated with the…[continue]
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