What the Heck is a Paraphiliac?
Within the therapeutic community there is considerable confusion as to what constitutes sexual addiction, what constitutes paraphilic behavior, and what constitutes sexual offending. In part this is caused by our collective inability as sexual addiction professionals, sex therapists, and sex offender treatment providers to engage in useful, integrated discourse, perform research, create conferences, and most of all to work together. Complicating matters is the APA’s lamentable inability/unwillingness (so far) to provide diagnostic criteria defining Hypersexual Disorder (sexual addiction), despite the way our twenty year tech-connect boom has dramatically increased the average person’s ability to affordably and anonymously access endless amounts of highly graphic pornography, casual sex, online prostitution, and information about and/or depictions of fetishistic and illegal sexual behaviors. As those of us working in the field are well aware, this proliferation of access has led to and/or escalated problematic sexual behavior – be it addictive, paraphilic, illegal, or some combination thereof – in numerous individuals with pre-existing addictive or other psychological disorders such as social inhibition, profound childhood or adult trauma, depression, anxiety, etc.
Amidst revelations of an affair between CIA Director General David Petraeus and his biographer, Paula Broadwell, not to mention the alleged inappropriate communications between Petraeus’ successor in Afghanistan, General John Allen, and Petraeus family friend Jill Kelley, one can’t help but wonder: What were these men thinking? Of course, we asked the same question with Tiger Woods, Anthony Wiener, Eliot Spitzer, and a whole bunch of other sexually misbehaving public figures.
The Neurochemical Quagmire
As is the case with substance addictions, process (behavioral) addictions induce a neurochemical pleasure response comprised of dopamine (pleasure), adrenaline (anxiety, energy), oxytocin (love, jealousy), serotonin (mood stability), and endorphins (mild euphoria). But unlike the substance abuser, those with sexual and other behavioral addictions don’t need to ingest a substance to evoke a neurochemical high. Essentially, individuals who struggle with underlying emotional or psychological issues such as early-life emotional trauma, social anxiety, low self-esteem, and depressive episodes can unconsciously learn to self-medicate by abusing their sympathetic nervous system through intense fantasy, urges, rituals, and ultimately behaviors as means of dissociating from or otherwise coping with internal and external life stressors, emotional pain, and uncomfortable feelings. This “addictive” response is the underlying biological component that drives the dysfunctional behavior patterns of compulsive gamblers, shopaholics, sex addicts, and others who seek intensity as a means of self-soothing distraction.
Eyes Wide Shut
Sex addicts – men and women who obsess about and compulsively abuse sexual and romantic behaviors to the point of self-harm and/or harm to others – frequently appear to be quite functional in other areas of their lives. Unfortunately, as with most active addicts, these individuals are often out of touch with the unforeseen costs of their addictive behavior patterns until a related crisis emerges for which they seek help. Ignoring signs that most others would not miss – STDs, workplace trouble, related chemical dependency relapses, broken relationships, etc. – sex and love addicts place the compulsive search for sex and romance at the top of their priority list without a second thought. In fact, when confronted in the early stages of treatment with something as elemental as an adult sex and relationship history, many sex and love addicts are shocked to “discover” the extent and depth of their acting-out behaviors. This is their denial. It is almost as if they refuse to see, or are unable to integrate into their conscious thought process, the destructive effects of their sexual and romantic activity not only upon themselves, but on those who love them.