Читать книгу Real Hope, True Freedom - Milton S Magness - Страница 15
ОглавлениеIS THERE AN “ADDICTION GENE”?
We know genetics likely play a role in the development of alcoholism.15 Although there is speculation that genetics may also play a role in the development of sex addiction, there is as yet no clear scientific evidence to support this. Although genetics may make some people more susceptible to developing addiction, susceptibility does not translate to inevitability.
Furthermore, genetics alone cannot explain addiction. Environmental and social factors also play a role. Even when addiction is kept secret, as is typically the case with sex addiction, people with active addiction tend to be preoccupied, emotionally unavailable to their families, and frequently absent physically in order to pursue their addiction. Addicts are often so self-absorbed they are not able to give their children the care and attention they need. Children may never see evidence of a parent’s addiction but the consequent neglect, lack of emotional and often physical availability, and perhaps the imposition of demanding standards and harsh discipline may set the stage for addiction to develop as those children grow.
My therapist said I should see a psychiatrist. Why would he suggest that?
Being evaluated by a psychiatrist prior to or at the beginning of recovery is generally recommended. This is part of the “due diligence” process to either confirm or rule out other problems that may impact problematic sexual behavior. The presence of certain conditions may help explain a wide variety of behaviors including compulsive sexual behavior. Psychological risk factors include attention deficit hyperactivity disorder, mood disorders like depression and bipolar disorder, obsessive-compulsive disorder, anxiety disorders, and personality disorders.
Attention Deficit Hyperactivity Disorder (ADHD)
My wife is convinced I have ADHD. Could this cause my sex addiction?
ADHD does not cause sex addiction, but ADHD and sex addiction often co-occur. Persons with ADHD have a stimulus-seeking brain. They seek out things that are stimulating or novel. They may have difficulty reading a book if the subject matter is not particularly stimulating or if a plot develops slowly. When a person has ADHD, they may tend to procrastinate and be good at starting projects but not good at finishing them.
Persons with ADHD have multiple, even racing thoughts that can shift their interest from one subject to another in rapid succession. As their thoughts move from subject to subject they may find themselves stuck in the limbo of inaction. One physician described his ADHD by saying, “bright shiny objects distract me.”
So how does ADHD play into sex addiction? Sex is the ultimate stimulation. Fantasizing about sex may occupy hours of a person’s time. Because pornography is so visually stimulating and there is so much of it available online, someone with ADHD can easily view pornography for hours at a time.
Video games provide much the same stimulation. Some sex addicts with ADHD spend hours playing video games before venturing into sexually oriented Internet activities. Before they are aware of it, they may be totally engrossed in a wide variety of sexually oriented Internet activities.
Will taking my medication for ADHD eliminate the need for me to attend twelve-step meetings?
No. Treating all co-occurring disorders is necessary for a person to have the greatest chance of success in recovery.
What part does depression play in sex addiction, and how does sex addiction affect depression?
Substance addiction and depression frequently co-occur. One third of people with major depressive disorder engage in substance abuse.16 In the absence of studies related specifically to sex addiction, we assume the rate of co-occurring depression and sex addiction may well be as high. Our considerable experience working with sex addicts shows this to be true. Additionally, we know that the development and pursuit of sexual acting-out behaviors may predispose a person to developing significant depression. The cycle feeds on itself because sex addicts may seek relief from their depression by acting out sexually, and in the aftermath of compulsive sexual acting out, people often experience depression.
The presence of depression may make it difficult for some and impossible for others to remain sexually sober. (Sexual sobriety is achieved when one is able to live free from all of the problematic sexual behaviors that have brought harm to the addict and/or other people.) It is imperative for sex addicts who recognize symptoms of depression to be evaluated by a psychiatrist. Although any physician can diagnose and treat depression, the advanced diagnostic skills of a psychiatrist are most helpful in treating it. Treating depression will not curb sex addiction but it will make it possible for a person to engage in a successful recovery process.
I have been diagnosed with bipolar disorder. How does this impact my sex addiction?
Bipolar disorder is a mood disorder characterized by periods of elevated moods (mania) and periods of depression. To be diagnosed with Bipolar I a person needs to have at least one manic episode. Bipolar II is diagnosed if there is at least one hypomanic (literally “lesser mania” or “below mania”) and one major depressive episode.
When a person with bipolar disorder has a manic episode, he or she may engage in extravagant shopping or enter into outlandish commercial ventures. He or she may also seek sexual adventures. A sex addict with bipolar disorder may be more inclined to engage in even higher risk sexual behavior during a manic episode than when there is no mania present. Bipolar disorder is a serious mental health disorder and usually requires mood-stabilizing medication prescribed by a psychiatrist.
Raymond’s Story __________________
Raymond is a born risk taker. He thrives on adventure and enjoys the accolades that he gets from telling others about his adventures: flying, diving, racing, hang gliding, rock climbing—whatever will get the adrenaline pumping.
He found that the more risks he took with his sexual acting out, the greater the high he experienced. On several occasions, he arranged for one of his partners to be in the same restaurant while he was having lunch with his wife. He surreptitiously made eye contact with her across the restaurant and even arranged to have her meet him by the restroom where he briefly kissed her.
On another occasion, he invited a neighbor and her husband to have dinner with him and his wife. He had been grooming this woman for months with overly friendly conversations and suggestive comments. During dinner, he removed his shoe and ran his foot up and down her legs. He was thrilled when he saw her blush and then grin.
As far as Raymond was concerned, he felt he could get away with just about anything. Raymond felt entitled to all of the fun that he wanted. He even told himself that if his wife were ever smart enough to catch him, he would not stop his acting-out behavior. He believed that she would never leave him.
I’m sure my husband is a narcissist. Is narcissism related to sex addiction?
The term narcissist comes from a character in Greek mythology—Narcissus—who fell in love with his own reflection in water. Sex addicts are very narcissistic in that they are self-centered and self-absorbed. What matters most to them is what they want and what makes them feel good in the moment.
Actually most individuals have some narcissistic traits, and to a degree these are healthy. It is important to look out for ourselves and our interests, to care about our appearance, to want to be successful in our careers, and to have others think well of us. In recovery, both sex addicts and wounded partners will necessarily exhibit some healthy narcissism where they place their own recovery above other interests.
While narcissism is a common factor in sex addiction, many partners seem to want to diagnose their sex addict partner with Narcissistic Personality Disorder, which is much more extreme and which I believe is seldom the case. I would strongly encourage you to leave all diagnosing to trained professionals.
Narcissistic and Other Personality Disorders
Narcissistic Personality Disorder (NPD) is a mental disorder in which people have an inflated sense of themselves and their own importance, along with a powerful need for admiration. Those with NPD give little consideration to the needs of others. They have a lack of empathy for other people, seeing themselves as special, unique, and unlike “ordinary” people. People with NPD tend to see themselves as victims and are offended by the slightest criticism. They often believe that the world owes them simply because of who they are. But, behind this mask of confidence is a fragile self-esteem. They often use people and love things, instead of loving people and using things. They tend to ignore boundaries and view people as objects to be exploited. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) NPD is diagnosed in between 2 percent and 16 percent of the population in clinical (treatment) settings.17 The DSM-IV-TR suggests that between .5 percent and 1 percent of the general population has NPD, and that more men are diagnosed with NPD than women.18
If your husband is a sex addict and has NPD, it is unlikely that he will be willing to get help for either condition. He will likely see his extracurricular sexual behavior as something he is somehow owed. If he is willing to get help and sincerely shows through action that he is willing to do whatever it takes to restore your relationship, I believe that is evidence that, however narcissistic he may be, he does not have NPD.
What is empathy and how do I do it?
Empathy is the ability to put yourself in someone else’s place and feel what they are feeling. It is the epitome of “walking in someone else’s shoes.” Empathy is very different from sympathy. Sympathy is feeling sorry for another’s hurt or pain. Without empathy it is impossible to understand how someone else feels or what her or his experience is like.
If you are a sex addict, to have empathy for your partner, imagine how you would feel if your situations were reversed. How would you feel if you found out that she had been secretly engaged in the same behaviors as you? What would be going on in your mind if you found your world crumbling down around you? How would you feel if her behavior threatened to take away everything that you hold dear?
Society has imposed a certain definition of what it means to be a man. Being tough, resilient, unmoved by hardship, and never shedding tears may be some people’s idea of masculinity, but such emotional detachment is poison to an intimate romantic relationship.
Empathy is related to “emotional intelligence,” a term frequently used to describe a person’s ability to tune in to and understand the feelings, motivations, and desires of others. Empathy can be learned. When you see your partner is sad, put aside your own feelings and ask yourself what might she be feeling. Make it a priority to develop a deeper understanding of emotional intelligence. Give your all to studying empathy and how you can increase your awareness of others’ feelings.
How did I become a sex addict?
It is usually impossible to identify specific causes for any individual’s sex addiction. A number of the factors covered earlier may be involved. This question is located in the section on narcissism because, for some, the quest to find out why they became a sex addict is just another expression of their narcissism. This group believes they are so special that surely something extraordinary happened to them that can explain their sex addiction. However, the bottom line can be as simple as having had a difficult, challenging childhood and having coped with stress and emotional pain in unhealthy ways that became patterns and led to unhealthy decisions and actions. Regardless of the family background, through repetition unhealthy actions involving sex become habituated into the obsessive and compulsive patterns that lead to addiction. In general, this is how most people become sex addicts—there need not be anything especially unique about them or their background.
If I think my husband may have a personality disorder or some other form of mental illness, what should I do?
If there are signs of mental illness or mental instability, I strongly recommend getting a full battery of psychological testing by a clinical psychologist. The testing should include a Millon Clinical Multiaxial Inventory (MCMI-III) and Minnesota Multiphasic Personality Inventory-2 (MMPI-2), as well as other assessments and a clinical interview that will help a qualified professional make a formal diagnosis. Whenever possible, if a personality disorder or any other form of mental illness is suspected, it is important that this be either confirmed or ruled out through a comprehensive assessment process before proceeding with sex addiction treatment. The assessment results will help determine the best course of treatment.
I think I may have an abnormally high sex drive. Could my sexual behavior be a hormonal problem?
Persons who have abnormally high levels of sex hormones (androgens), or very high levels of certain neurotransmitters, such as dopamine, serotonin, or norepinephrine, may display an unusually high sex drive, known as hypersexuality. Additionally, some medications (such as dopamine agonists that are used to treat Parkinson’s disease and restless leg syndrome) may cause hypersexual behavior. The presence of any of these factors needs to be considered prior to beginning sex addiction treatment.
True sex addiction has nothing to do with the level of a person’s sex drive. Sex addicts can be obsessed with having sex or trying not to have sex. They may go from one sexual relationship to another, carrying a feeling that they cannot get enough sex. Some have sexual behavior so out of control they are physically exhausted from their sexual exploits and yet still feel that they must find someone else to be sexual with or perhaps masturbate to the point of injury. For them, too much sex is not enough. This is a hallmark of sex addiction; not an abnormally high sex drive.
15 National Institute on Alcohol Abuse and Alcoholism, “Genetics of Alcohol Use Disorders,” accessed September 20, 2016, http://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/alcohol-use-disorders/genetics-alcohol-use-disorders.
16 L. Davis, A. Uezato, J. M. Newell, and E. Frazier, “Major Depression and Comorbid Substance Use Disorders,” Current Opinion in Psychiatry 21, no. 1 (2008): 14–18.
17 American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, 4th ed. Text Revision (Arlington, VA: 2000).
18 Ibid.
