Addicted to Sex
At first the news seemed like a joke, or maybe a perverse public relations move: David Duchovny, star of Showtime's "Californication" - in which the 48-year-old actor plays a sex-crazed guy - has checked himself into a rehab center to get treated for sex addiction.
How, I wondered, is sex addiction different from regular old, er, friskiness?
I called Dr. Leslie Lothstein, director of psychology at the Institute of Living in Hartford, Connecticut, to find out.
Lothstein says sexual addiction has no definition in the current Diagnostic and Statistical Manual of Mental Disorders (DSM IV), the document psychologists use to pin down mental-health diagnoses. But over the past 30 years, he says, the study of behavioral addictions such as gambling and excessive shopping has shed light on sexual addiction.
The concept of addiction, he explains, encompasses the twin phenomena of tolerance and withdrawal. In tolerance, the addicted person requires increasingly greater amounts of whatever he's addicted to, be it alcohol or sex, to achieve physical or psychological satisfaction. In withdrawal, the person experiences unpleasant psychological and/or physiological side effects when he stops using the substance or doing the behavior he's addicted to.
Whereas a healthy person who's feeling aroused can seek relief and be done with it, one with a sex addiction can't stop: as soon as she's achieved orgasm she wants another. Lothstein tells of people masturbating for hours on end, often to exhaustion. If they try to quit - after getting caught by a spouse or boss, for instance - their anxiety builds until they have to get another fix.
The Internet has upped the ante for sex addicts, making pornography available free of charge, round the clock, on an anonymous basis. Still, Lothstein says only that between 1 percent and 3 percent of the adult population will become addicted to Internet porn because of their addictive personality. He says MRI-based research has shown that the same brain receptors that light up for cocaine and amphetamines also light up for sex, which suggests a neurobiological basis for the addiction.
Sexual addiction affects both men and women, Lothstein says, though women tend to enjoy sex-oriented chat, fantasy, and romance. "Men go right for the pictures," he says.
The good news is that sex addiction is highly treatable, usually with serotonergic drugs such as Zoloft and Paxil; more difficult cases may require treatment with antiandrogens, which alter hormone levels and keep arousal at bay. Psychotherapy can help, too, he says. Usually men and women are treated together in groups, where, he says, "they can dissect the rationalizations, denials, and minimizations of the behaviors' impact on others."
Treatment is successful in more than 80 percent of cases, Lothstein says.
Good luck to you, David Duchovny.
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