8. Sex addiction is linked with other addictions

By Tom O'Connell

There is a link between sex addiction and a host of other addictions, reports psychotherapist Patrick Carnes, known for his pioneering work in the sexual disorders treatment field. "The addiction process has an interactive nature," he says.

Reporting to the 12th Cape Cod Symposium on Addictive Disorders, Carnes stressed the need to take a closer look at patients to ascertain their primary addictions. "Often they realize that the addiction they thought was primary was not."

In the drug culture, chemical manipulation to achieve "ideal" altered states has been prevalent for decades. Now, with the proliferation of drugs and behavioral addictions, a patient's true addiction of choice may not be as evident as in the days when alcoholics were obviously alcoholics.

Today when you scratch the surface of an alcoholic you may come up with addiction to marijuana, heroin, cocaine, and other stimulant or depressant drugs, as well as  behavior addictions such as compulsive sex and compulsive gambling.

For quite some time now, it has not been unusual for alcoholics to use cocaine to stretch out their alcoholic highs. Yet they may have been considered just coke addicts.

About 1.6 million men use prostitutes compulsively, says Carnes. Two-thirds have a problem with spending; a financial disorder. Their use of money becomes eroticized.

Since we're in the age of multiple addiction, Patrick Carnes is alerting psychotherapists to the need to screen patients with this in mind.

Initially, he discusses "cross tolerance"  in which there is a simultaneous increase in addictive behavior in two or more addictions. Then he talks of a transfer of a high level of addictive activity "with little or no developmental sequence."

An example is a man with a serious sex addiction who tries cocaine once and it immediately escalates into a full blown addiction instead of following the steps from experiment to habit to addiction.

"Withdrawal mediation" is the next concept emphasized by Carnes. "One addiction serves to moderate, relieve or avoid withdrawal from another." For example, the alcoholic uses the nicotine habit to make the withdrawal from alcohol more bearable.

"Replacement" is when "one addiction replaces another with a majority of the behavioral and emotional features." A wealthy man loses a fortune through high risk ventures. Then, to rebuild his fortune, he engages in compulsive debting. He becomes a stockbroker, marries a wealthy woman, and the stress of risk-taking leads to his marijuana use. Then he takes his wife's inherited money and loses it. In drug treatment, he pledges to stop marijuana, but proceeds to gamble addictively, and to deal with stress he sees a prostitute. Soon his sexual addiction becomes a daily habit. What's he addicted to?

Another concept is "alternating addiction cycles." A promiscuous anorexic girl marries, then becomes compulsively nonsexual and out of control with food. She loses the marriage, loses weight, goes out of control sexually, etc., in a similar cycle. Only after four marriages does she enter treatment and deal with her addiction problems.

In "masking," an addict uses one addiction to cover up for another perhaps more substantial addiction. In "ritualization," the addictive behavior of one addiction serves as a ritual pattern for engaging in another. Alcohol, drugs and sex are often used in these ways.

"Intensification" is another key word for Carnes. And he describes "fusion dependence" in which "neither addiction separately is sufficient." Examples he gives are cocaine addiction with sex addiction, or smoking in a closet.       

"Numbing" is another word in Carnes' addiction vocabulary. This means "an addiction is used to medicate the shame or pain caused by the other addiction or by addictive bingeing." 

"Disinhibiting " is an important concept too. This is when one addiction is used to lower the inhibitions for other addictive acting out. Many alcoholics, male or female, have sexual challenges in recovery because they have become accustomed to using alcohol for lowering their sexual inhibitions. Without it, they experience impotence or frigidity.

Addiction is complex, not simple. Therefore, in treating for sexual addiction, Carnes wants addictions to be viewed as "packages" and is pushing for more depth and scope in treatment, a closer look at underlying issues, and more effective strategies for dealing with multiple addictions.

- Back -