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Sexual Addiction

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Sexual Addiction, Compulsive Sexual Behavior, Paraphilia

  • Type
  1. Process Addiction
  2. Paraphilia
    1. Abnormal Sexual arousal to objects or situations
    2. Interferes with capacity for reciprocal affection
  • Pathophysiology
  1. Central Tenets
    1. Pain of abandonment or neglect
    2. Search for attachment
    3. Self doubt
      1. Internal sense of decreased self worth
      2. If people would know me, they wouldn't like me
    4. Needs can not be met by others
  2. Pathway
    1. Neurologic pathways craving for Ecstasy
      1. Arousal
      2. Sedation
      3. Hallucination
    2. Sexual Fantasy
    3. Rituals and preparations
      1. Dressing
      2. Obtaining money
      3. Planning the place
    4. Orgasm
    5. Withdrawal
  • Criteria (DSM IIIR)
  1. Persistent desire or effort to cut down on behavior
  2. Considerable time spent achieving the activity
  3. Social, Occupational, and Recreational Impairment
  • Symptoms
  1. Secrecy
  2. Abuse
    1. Sex that crosses significant boundaries
    2. Sex with children, patients, students, subordinates
  3. Mood swings
    1. Shame and despair of having unwanted sex
  4. Empty relationships
    1. Sex with people you don't know or don't like
  5. Compromised values
    1. Behavior violates values
    2. Continues despite dramatic efforts to stop
  • Signs
  1. Sexually Transmitted Disease
  2. Unwanted Pregnancy
  3. Perirectal Abscess
  4. Asphyxiation injury
  • Types of Activity
  1. Level I: Benign
    1. Hypersexual with single partner
    2. Frequent masturbation or Pornography
    3. Fetishism, Masochism, or Sadism
    4. Transvestic fetishism
    5. Telephone sex or Cybersex
    6. Strip Club attendance
    7. Massage Parlor
    8. Prostitution
    9. Infidelity
  2. Level II: Not tolerated by society
    1. Voyeurism
    2. Exhibitionism
    3. Sexual Harassment
    4. Obscene Telephone calls
    5. Frotteurism (Brushes up against others)
  3. Level III: Not tolerated, and highly criminal
    1. Pedophiles
    2. Rapes
    3. Child molestation
    4. Child pornography
    5. Incest
  • Management
  1. Twelve step program