Sexual Addiction… in Progress

The recently released film Girl in Progress is on the surface a coming of age story about Ansiedad, a sixteen-year-old girl who develops a plan—based on the clichés of young adult literature—for growing up quickly. A more interesting character in the film is the girl’s mother, Grace, portrayed by Eva Mendez.

On the one hand, Grace is an immigrant single mom trying desperately to make her way in the world while providing for an ungrateful daughter. On the other hand, she’s an archetype for sexual and romantic addiction among women, looking for love in all the wrong places, at all the wrong times, with all the wrong men, despite the emotional and psychological damage this behavior causes to both her and her daughter.

Though Girl in Progress is not likely to become a cornerstone of modern American cinema (early reviews have been mixed, at best), it at least serves as a reminder that sexual addiction is not an entirely male phenomenon, even though media portrayals of sexual addiction focus almost exclusively on men.

The fact is, between 8 and 12 percent of those currently seeking treatment for sexual addiction are women, and we are likely to see those numbers increase as clinicians gain diagnostic clarity.

Romance: A Novel Approach

Although sexual addiction experts have shared anecdotal evidence from the field, there is not yet a formalized process for identifying, diagnosing and treating women who struggle with sexual addiction. Consequently, there is little to no research on women who sexually act out—a fact most prominently noted by Dr. Marty Kafka when preparing the proposed DSM-5 hypersexuality diagnosis for the American Psychiatric Association.

This deficiency is in part related to many mental health and addiction professionals failing to recognize the subtleties of addictive and impulsive sexual behavior patterns in women. Whereas men’s sexual acting out typically takes easily recognizable, overtly sexual forms such as anonymous sexual hook-ups, compulsive viewing of pornography (with or without masturbation), and use of prostitutes and erotic massage, female sex addicts tend to view their behavior in terms of “relationships.”

Thus, women who are struggling with repeated patterns of problem sexual behavior are more likely to enter therapy or treatment reporting romance-oriented symptoms such as:

  • A history of short, failed relationships where sex is the primary bond
  • A pattern of inappropriate sexual relationships (i.e., with a boss or a married man)
  • Consistently returning to or remaining with partners who are abusive, neglectful, and/or emotionally unavailable
  • Compulsive masturbation to romantic fantasies of past or future partners, romantic books or films, etc.
  • Consistently having sex as a means of feeling loved
  • Encouraging “gift giving” from emotionally disengaged sexual partners (or other means of being paid for sex) but not calling that prostitution
  • Acting out BDSM or other fetish behaviors in secret and/or with anonymous partners while in a primary relationship

Men are from Mars and Women…

Complicating matters is our cultural gender bias toward sexual behavior. Men who have a lot of sex are often thought of as “studs” and “players.” Rarely are men who sexually act out portrayed as individuals suffering from deeply rooted, painful psychological issues (the film Shame serving as a notable and well-executed exception).

Hypersexual women, on the other hand, are culturally shamed as “sluts,” “nymphos,” and “whores.” Consequently, women face greater humiliation and embarrassment related to non-relational or dysfunctional sexual patterns, making them less likely to admit to such a problem and seek help.

A man who “hooks-up” for anonymous sex two to three times a week, who also uses masturbation as a means of self-soothing and emotional escape, may readily come to identify as a sex addict if his sexual behavior begins to have serious consequences. And he is likely to be identified as such in a therapy or treatment setting.

The woman who “finds herself” consistently seeking “love and affection” with strangers via chat rooms, on Facebook, or on dating sites like Match.com and eHarmony may have anonymous sex as frequently as her male counterpart, and also masturbate as frequently, but she will probably not self-identify as having a “sexual problem.” Nor is she likely to be diagnosed as having such an issue because many (perhaps most) clinicians have not learned how to identify sexual addiction in women.

Compounding the issue is the fact that women sex addicts are three times as likely as men to have a history of profound childhood/teen sexual abuse. Consequently, therapists and treatment programs often focus on resolving a woman’s past sexual trauma and abuse while not keeping an eye on the other end of the spectrum—her adult sexual behavior with both self and others. Clinicians tend to be so trauma focused that they forget (or are not trained) to look at adult behavior. Sometimes women opt to leave treatment altogether because they are continuing to sexually act out—and they are continuing to sexually act out because the adult manifestations of their issues aren’t being addressed.

Sadly, sexual addiction in women is most often only recognized after a woman seeks help for a co-occurring disorder such as drug/alcohol addiction or an eating disorder. In fact, many women who end up in sexual disorders treatment programs arrive there only after they have been asked to leave another treatment setting (for chemical dependency, an eating disorder, depression, etc.) because while there they were acting out sexually. The Ranch, www.recoveryranch.com, a gender-separate sex and love addiction treatment facility in Tennessee, actually specializes in treating women who have failed in treatment elsewhere because of their problematic adult sexual behaviors.

Moving Forward

A primary issue that any counselor or therapist should consider discussing in detail with a woman who repeatedly relapses on other addictive behaviors and/or substances is her adult sexual life. Treating clinicians need to understand that women whose sexual behaviors are causing profound problems are not likely to identify as having a sexual problem. Instead, they are more likely to describe their behavior as “a series of relationship issues” or “a tendency to pick the wrong partner.” Because women see and experience sex differently than men—even when they are having sex in the same ways and with the same frequency as a male sex addict—they usually don’t, or won’t, self-identify as having a problem with sex.

Perhaps the ongoing under-diagnosis of sexual addiction in women stems from treatment providers not asking the right questions upon initial assessment. When a woman begins treatment for severe anxiety and chronic depression, for example, her therapist rarely investigates the woman’s sex life with the same rigor as her family of origin issues, drug and alcohol use, exercise, eating patterns, or other potential areas of concern.

And even the savvy therapist who does suspect some type of love, relationship, or sexual addiction in a client might rely on the same diagnostic questions he or she uses when assessing men, a practice that often elicits inaccurate responses or resistance from women. In such instances, clients are best served by an open, non-judgmental discussion of all past and current sexual behaviors, fantasies, and urges. This means asking personal, sometimes uncomfortable questions, such as:

  • Have you been unfaithful to your husband/partner?
  • Do you watch pornography? If so, how often?
  • Do you masturbate? If so, how often?
  • How do you react to feelings of loneliness?
  • Has your sexual behavior ever caused problems to you or someone you cared about?
  • How do you feel after having sex?
  • Are you able to say no when you don’t want to have sex?
  • Have you had a sexually transmitted disease or an unwanted pregnancy (if so, how many)?
  • How many sexual partners do you have on a weekly, monthly basis?

Slowly, both the lay public and the therapeutic community are becoming more aware and accepting of sexual addiction in general and female sex addiction in particular. Recent years have seen an increase in the number of educational programs and trainings for therapists, gender separate sex and relationship 12-step meetings and therapy groups, and a rare few gender-separate residential and outpatient treatment programs. However, these resources are sparse and hard to find, which simply means that in the sexual addiction arena, as with most of mental health and medical care, women continue to be treated as second class citizens.

Robert Weiss LCSW, CSAT-S is the author of three books on sexual addiction and an expert on the juxtaposition of human sexuality, intimacy, and technology. He is Founding Director of The Sexual Recovery Institute, www.sexualrecovery.com, in Los Angeles and Director of Intimacy and Sexual Disorders Services at The Ranch in Tennessee, www.recoveryranch.com, and Promises Treatment Centers in California, www.promises.com. Mr. Weiss is a clinical psychotherapist and educator. He has provided sexual addiction treatment training internationally for psychology professionals, addiction treatment centers, and the US military. A media expert for Time, Newsweek, and the New York Times, Mr. Weiss has been featured on CNN, The Today Show, Oprah, and ESPN among many others. Rob is the Sex and Intimacy blogger for Psych-Central, an online psychology site, and can also be found on Twitter at @RobWeissMSW.

 

 


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Tori Lafferty (May 17, 2012)

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From Psych Central's website:
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    Last reviewed: 6 Sep 2012

APA Reference
Weiss LCSW, R. (2012). Obstacles in Treating Women with Relationship and Sexual Addiction. Psych Central. Retrieved on July 22, 2014, from http://blogs.psychcentral.com/sex/2012/05/obstacles-in-treating-women-with-relationship-and-sexual-addiction/

 

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Recent Comments
  • Gabe Deem: First, I want to say I agree with a lot of the things you say, but I want to point something out to you...
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