SBH therapist Christopher Patrone discusses sex addiction in Addiction and Drug Abuse Weekly
Untreated sex addiction can lead to relapse to alcohol/drug use
Monday, October 27, 2008
ADAW
Addiction treatment professionals
who don’t evaluate their patients
for sex addiction are missing an important
chance to reduce the likelihood
of relapse, according to three
experts interviewed by ADAW. By
not treating any underlying sex addiction,
they are leaving open the
possibility that these patient will not
be able to stay drug- and alcoholfree.
Like chemical addictions, sex
addiction is a brain disease, according
to these experts, who are all involved
with mainstream addiction
medicine.
Patrick J. Carnes, Ph.D., the
founding father of sex addiction
treatment and executive director of
Pine Grove Behavioral Health and
Addiction Services in Hattiesberg,
Miss., Robert Weiss, LCSW, CSAT,
sexual addiction disorder specialist
for CRC Health Group as well as director
of Sexual Integrity Services at
Life Healing Center in Santa Fe,
N.M., and Chris Patrone, Psy.D.,
CAC, LPC, primary therapist at
Seabrook House in Seabrook, N.J.,
discussed the importance of addressing
sex addiction when patients
are evaluated and treated for
alcohol or drug addiction.
“Addictions don’t just co-exist,
they interact with each other,”
Carnes said. And there’s seldom just
one addiction. This is not because
there’s an “addictive personality,” but
because addiction is a brain disease.
“It’s a matter of what happens
in the brain when you access the
pleasure centers,” said Carnes. And
Weiss, who is the CRC’s sexual addiction
disorders specialist, cited
MRI data that shows that the brain
“lights up” when on cocaine. The
same thing happens with sex addicts,
he said. “The MRI studies
demonstrate that when someone is
seeking to act out sexually, the
brain lights up the same way as
when people are high on cocaine,
or are gambling,” said Weiss.
Even with people who aren’t
sex addicts, arousal and orgasm gen-looking for prostitutes.”
If sex addiction isn’t handled in
treatment, it will haunt the patient
later, even if the patient doesn’t
have a relapse to drugs or alcohol,
said Patrone. “Once the drug and alcohol
problems are contained, the
sexual problems are going to surface.”
Patrone sees this happening
at AA meetings. “I see all of the sexual
acting out there,” he said.
Prevalence rate unknown
Because the problem of sex addiction
is often buried, addiction
treatment experts aren’t sure what
the prevalence is. “The short answer
is it’s much higher than most people
imagine, but we have no recent data
on it,” said Carnes.
At Seabrook House, where
there is a sex addiction assessment
for all patients, about 20 percent of
patients admitted for chemical addictions
acknowledge that they alsohave sex addiction, said Patrone.
That’s at the onset of treatment,
when it’s possible for them to get
into the sexual addiction track at the
facility. Weiss and Carnes both have
programs dedicated entirely to treating
sex addiction.
Sex addiction manifests itself in
different ways, said Patrone, including
chronic affairs, relationship issues,
use of prostitutes, chronic
masturbation, and the internet.
Cyber sex
The availability of pornography
on the internet — “cyber sex” — has
dramatically increased the number
of sex addicts, according to Carnes.
“The visual stimulation that a
porn addict gets is very powerful,”
said Carnes, adding that “ cyber sex
is called the crack cocaine of sex
addiction.”
And it is the “lost time” nature
of the internet that can add up to
lost dollars, as well, with some sites
charging $2 a minute. “The sex addict
will engage in this for hours
and hours,” he said. “Before you
know it, he has spent thousands of
dollars.” That’s why part of sex addiction
treatment, for many patients,
includes dealing with the internet.
Waiting for DSM-V
Even though sex addicts may
have compulsive behavior, they do
not have obsessive-compulsive disorder
(OCD), the experts noted.
“The essential component of OCD is
helplessness,” said Patrone. “Someone
with OCD may walk through the
threshold of a door 10 times to mitigate
their distress. It’s not to look for
pleasure.” With sex addiction — as
with other addictions — people seek
euphoria, not relief from distress.
In addition, sex addiction —
like other addictions — is not an impulse
disorder. “With addictions, the
behavior is usually well planned in
advance,” he said.
The quest for a diagnostic category
comes from a controversial deeratebate over whether to include sex addiction
as a psychiatric diagnosis. It
was in DSM-III, but was removed in
DSM-IV because the women’s movement
thought it was a way of giving
abusers an excuse for their behavior.
It is being considered for DSM-V.
Women vs.men
The incidence of relapse is particularly
high for women with alcoholism
and sex addiction, said Weiss,
referring to his clinical experience.
“For women, only about 50 percent
can get sober and stay sober,” he
said. “It turns out that many of these
women were sexually acting out —
for example, one third of them had
sex with a patient in a previous treatment
center.” Weiss said that women
have more shame about sex addiction
than men do, and therefore they
try harder to hide it. “So by the time
women come in for treatment for alcoholism,
they usually are a lot more
troubled. They’re desperate. And
they can’t stop drinking because they
feel so badly.”
Men with sex addiction and alcoholism
have an easier time staying
sober, but a more difficult time
with sex addiction after treatment,
said Weiss. “They get sober first in
the men’s program, but then later
on their lives weren’t working because
they still had a problem with
sex addiction.” •
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