Dr. Karen

An Overview of Symptoms and Treatment Considerations

by Karen E. Engebretsen-Larash, Psy.D.

With the public eye on President Clinton’s extra-marital experiences, much more attention is being given to sexual expression and it’s role in American Society. Hours and hours of news commentary regarding this scandal have offered a variety of viewpoints which seem to be reflective of public conviction.

In fact, during casual conversation with friends and colleagues, I have heard statements like, “It is a travesty of justice. How could he do such a thing? He’s the President after all!” to comments on the other end of the spectrum such as “He’s a human being just like you and me. Why can’t everyone stay out of his bedroom and leave the poor man alone?”

The aim of this article is not to offer an opinion about the news media’s impression of Mr. Clinton’s predicament, nor is it intended to imply that he is “Sexually Addicted.” To give a diagnosis of Sexual Addiction on ANYONE requires an appropriate psycho-logical assessment of the individual. It is important to remember that, while there are some behaviors which may be considered normal in most people, these very same behaviors can be highly addictive for others.

So, how does one determine if their sexual experiences are “normal” or “addictive?” According to the leaders of the addictions field, Sexual Addiction can be defined as a destructive relationship with sexual activities and sexual relationships which deviates from mainstream experience WITHIN the expected boundaries of the particular sexual culture (heterosexual, gay, bisexual, lesbian or transgender). This relationship becomes central in the addict’s life and relies on sex for nurturing, comfort from pain, and relief from stress. The basic characteristics of addiction include: a) a powerlessness to stop at will; b) harmful consequences if the behavior is maintained; c) inability to manage other areas of one’s life; and d) withdrawal symptoms upon trying to quit.

According to Patrick Carnes, Ph.D. (nationally known author and Clinical Director for Sexual Disorder Services at the Meadows Institute, Wickenburg, AZ), research he found some interesting correlations between Sexual Addiction and trauma:

* 81% of sex addicts experienced sexual abuse (either in childhood or adulthood)
* 76% experienced physical abuse
* 97% experienced emotional abuse

He also found Sex Addicts to experience a variety of co-addictions:
* 42% are chemically dependent
* 38% have eating disorders
* 27% have work addictions
* 26% are compulsive spenders

Several questionnaires have been developed to determine the need for Sexual Addiction treatment. For example, Robert Weiss, LCSW, Clinical Director of the Sexual Recovery Institute, Los Angeles, CA has a brief 15 question survey which can be used to determine whether further evaluation is needed. Dr. Patrick Carnes and Robert Weiss, LCSW also created a gender-specific Sexual Screening Test for men (G-SAST) and one for women (W-SAST).

Treatment for sexual addiction involves the same concepts which are used to treat other forms of addiction (e.g., chemical dependency, eating disorders, etc.). The process is intended to help individuals break through their denial system by taking an honest look at the consequences and damage these unhealthy choices have caused. Therapy also includes involvement of family and significant others so that codependency and other issues can be addressed.

The National Council on Sexual Addiction and Compulsivity suggests that treatment generally works best when services are provided by a therapist who specializes in addictions since traditional psychotherapies have not proven to be as effective. Most major cities have outpatient programs which can be tailored to suit your clinical need and budget. There are also National Treatment centers (such as those listed in this article) which offer specialty programs for Sexual Addiction. Local 12-Step programs (based on the original AA model) can also provide additional support for those everyday challenges which could lead to relapse.

To obtain additional information about this article, treatment programs or 12-Step resources in your area, you may contact Dr. Karen.

Copyright © 1998,1999 Karen E Engebretsen-Larash, Psy.D, PA. All rights reserved