Sex addiction: This compulsive behaviour causes them more pain than pleasure

In the 40 minutes that I spend with Randhir*, he does not look at me once. As we sit down, he readjusts his chair so that the swimsuit-clad woman in the pool behind us does not distract him. “Don’t mind me. When you’re recovering, you need abstinence,” he tells me.

Randhir is a recovering sex addict who heads a sexoholics support group in Delhi — The Sex Addicts Anonymous (SAA). A medical practitioner, his addiction led to depression and he was soon hooked to sleeping pills. He battled the addiction for over a decade before seeking help. “I would buy dozens of porn magazines every week and spend obsessively on the women I slept with,” confides Randhir.

Ironically, he had no relationship with his wife. Today, he helps young men battle the disorder. 

So what exactly constitutes sex addition. Is it compulsive masturbation? Or a nagging porn habit you’ve nursed since the class 7? Or does seven-eight orgasms per day make you an addict?

“Addiction cannot be linked to numbers. If an individual’s sexual desire is uncontrolled, his needs unquenched, and behaviour compulsive, that’s sex addiction,” says sexologist Prakash Kothari, who set up Asia’s first department of sexology at KEM Hospital in Mumbai.

It was only after the breakdown of his third marriage that 42-year-old Sudhir* realised that what he was staring into was a problem. “I would repeatedly cheat on my wives, get caught and then reconcile. And, cheat again. I spent lakhs on escort services. Now all I have is remorse,” he reveals in a telephonic conversation. He has been sober for over two years now and continues to take professional help.        

“There are two prominent theories about sex addiction. One is that addiction is a biochemical reaction. The other theory attributes addiction to psychodynamic causes. Usually children of dysfunctional families with a negative attitude to sex develop a sense of low self-esteem, that can only be redeemed by sex or masturbation,” explains prominent Chennai sexologist Dr Narayana Reddy. “Most cases have a strong psychological background. But, in some, where the individual has a ancestral history of mental illness, genetic resurgence plays a part,” explains Kothari.

Sociologist Vivek Kumar, who teaches at JNU, believes that the disorder is largely a consequence of social actions. “Usually, such behaviour patterns are linked with the person’s history. There’s always a trigger when you investigate his sociological background,” says Kumar.

For all the prurient interest the disorder drums up, sex addiction — or ‘satyriasus’, the medical term for male sex addicts, and ‘nymphomania’ for female sex addicts — does not find mention in the American Psychiatry Association’s Diagnostic and Statistical Manual of Mental Disorders, the go-to journal for mental health practitioners

The term, ‘sex addiction’ was first coined by Patrick Carnes in 1983 in his book Out of the Shadows: Understanding Sexual Addiction. It has come a long way in popular imagination with celebrities like Bill Clinton and Tiger Woods now a part of dinner time conversations. Films such as Steve McQueen’s Shame, with a powerful performance by Michael Fassbender as a man grappling with his addiction, Clark Gregg’s Choke adapted from Chuck Palahniuk’s novel, among others have all helped to turn the spotlight on sex addiction.

RECOVERY ROUTE
For the longest time, the battle was with myself. I was in denial,” says Randhir. “I spent lakhs on my treatment abroad. I wonder how many addicts can afford that. Many people here don’t even know it is a disorder.”  In India there’s also the stigma attached that hampers identification. “But the numbers are increasing. “A decade ago, I would get barely five to six cases a month. These days, it is anywhere between 15 and 20 cases,” says Kothari.  “When we started SAA, (part of the SAA in the US), there were only two members. Now, with more people talking about it, it has risen to seven,” says Randhir.

SAA caters only to men. This reporter was barred from attending an SAA meet on the plea that since it was felt that all SAA being men, the presence of a female would disrupt proceedings.

“Maybe it is the nature of the condition, but paraphilia is seen in males mostly. I’ve had only five-six women walk up to me to discuss the problem,” says Reddy.

Addiction is often mistaken for criminal behavior. Kothari distinguishes between the two. “Sex addiction is closely related to Obsessive Compulsive Disorder (OCD) and disorders like schizophrenia. Only a skilled psychiatrist can differentiate between the two. People also link sexual crimes to the disorder. Addiction is compulsive and not easily treatable. But an offender acts at the spur of the moment.”

Some psychiatric therapies found to work with sex addicts include the Cognitive Behaviour Therapy which employs goal-setting to recover, Rational Emotive Behaviour Therapy which focuses on emotional well-being, and the Robert Carkuff Model, which includes a combination of the above. “Since it is closely linked to OCD, the same medication works sometimes. But broadly, apart from psychotherapy, therapists also use anti-androgens to bring down hormone levels to pre-puberty levels. But this usually leaves side-effects and needs to be handled carefully,” says Reddy.

But as any sex addict will tell you, the road to recovery is long and slippery.

*Name has been changed on request.