Do you understand [sex addiction]?

There has been a lot of discussion about [sex addiction], and even some movies such as < < female addicts > >, < > mentioned related topics. Today, let’s take a look at this controversial topic.

At present, there is no uniform and recognized standard in psychiatry to define the behavior pattern of sex addiction. With the authoritative diagnostic tool “The Diagnostic and Statistical Manual of Mental Disorders”, Hereinafter referred to as DSM), Although in DSM-I (version 1) and DSM-II (version 2), Sex addiction was once described as a disease phenomenon as excessive and non-sexual perversion, but the diagnostic term [sex addiction] has been deleted from DSM-IV (4th edition) and the latest DSM-V (5th edition). The main reason may be that there is insufficient evidence-based research evidence to prove that sex addiction is indeed an addiction disorder.

Is sex addiction different from what we call addiction in what?

Having said so much [nonsense] before, what kind of state is [sex addiction]? To understand sexual addiction behavior, we need to first understand how to define addiction behavior (that is, addiction as we call it everyday). The core characteristics of addiction behavior are as follows:

(1) It is mostly related to certain chemical components (such as alcohol and heroin), such as nicotine addiction of old smokers;

(2) Excessive addiction to certain behaviors, even more and more addiction;

(3) Have the will to get rid of but always fail. If you don’t continue this kind of behavior, you will suffer from depression, anxiety, irritability and other emotions.

④ This behavior pattern has adverse effects on work, life and study.

Sexual addiction behavior is basically consistent with addiction behavior except that it is not consistent with chemical substances.

Typical characteristics of sex addiction?

Although there is not enough evidence to define sex addiction as a medical obstacle, However, this kind of behavior does bring troubles to some people, so it is still necessary for us to understand some main viewpoints on sex addiction behavior at present. At present, there is great controversy on the definition of sex addiction, and there are mainly three main viewpoints.

(1) Addiction disorder belongs to addiction. Because it has several main characteristics of increased tolerance, withdrawal reaction, and anxiety caused by stopping or reducing sexual behavior, it conforms to the characteristics of dependence, tolerance and withdrawal, so it conforms to the characteristics of addictive behavior (such as the example of nicotine addiction cited above).

(2) It may be more appropriate to define compulsive sexual behavior. If you want to control sexual behavior, However, it cannot be controlled. Although sexual behavior may have adverse consequences, it will continue. This view holds that the main purpose of compulsive sexual behavior is to reduce anxiety rather than to obtain pleasure. For example, it may be similar to patients who wash their hands compulsorily, and washing their hands is to relieve their inner anxiety.

(3) [Sex addiction] may be a kind of impulse control disorder. This kind of behavior may not be related to hypersexuality or addiction behavior, It is driven by repeated strong wishes, and patients need to take timely actions to relieve the strong wishes. Therefore, this kind of sexual behavior pattern is essentially a lack of control over sexual impulse behavior, similar to the characteristics of pathological arson or pathological theft.

Diagnosis and Treatment of Sex Addiction

1. How to make a diagnosis?

Due to the different criteria for defining sex addiction behavior, there is currently no unified and recognized diagnostic criteria for sex addiction disorder. Different experts and scholars have tried hard to give some diagnostic criteria, such as psychologist Patrick Carnes, psychiatrist Ariel Goodman and Carnes team. Take Patrick Carnes’s diagnostic criteria as an example to see the diagnostic definition of sex addiction behavior.

In the past 12 months, at least 3 of the following criteria have been met:

(1) Repeated attempts to control impulsive behavior and repeated failures;

(2) There is a strong desire to continue high-intensity and long-term sexual behavior;

(3) There is a continuous desire to reduce, stop or control sexual behavior;

④ It takes a lot of time to have sex or recover from sexual experience;

(5) Sexual behavior or preparation for sexual behavior occupies a large amount of time or occupies the overall dominant position in life;

⑥ When expecting to achieve professional, academic, scientific research or life goals, they often engage in sexual behavior;

⑦ Although we know that it will bring adverse effects on physiology, psychology and economy, we still continue to carry out the behavior.

⑧ It is necessary to continuously increase the intensity, frequency, quantity or the risk degree of behavior in order to achieve the expected effect.

Pet-name Ruby to carry out these behaviors in the future and give up social, work or other activities;

⑩ If these behaviors are reduced, stopped or controlled, depression, anxiety, fidgeting or irritable emotional reactions will occur.

2. How to treat it?

As mentioned earlier, there is not enough evidence-based basis to define sexual addiction behavior as a medical obstacle, but there are indeed some friends who have problems in this area. No matter how to define this behavior pattern, our goal is to solve problems and troubles, so we must know what treatment strategies may be useful at present.

(1) For the treatment of this behavioral problem, individual or group psychotherapy is preferred: including motivation interview, family therapy, cognitive behavioral therapy and other treatment methods to choose from. From the perspective of ensuring personal privacy, it may be particularly important to comprehensively measure the legal qualifications of treatment institutions and therapists.

(2) Drug therapy may be helpful to reduce sexual impulse, improve impulse control and facilitate emotional management. New antidepressants and antiandrogens are mainly used relatively frequently. In addition, Naloxone may also be effective for sexual addiction and help reduce addiction, but naloxone may reduce orgasm pleasure experience and affect normal sexual behavior. Do not purchase drugs for treatment without medical evaluation by a specialist.

References

[1] Lin Lu. Shen Yu Fu Psychiatry (6th Edition) [M]. Beijing: People’s Health Publishing House, 2018.