What and Who Is Missing in Sexual Addiction Treatment?

In the wake of the much-publicized tragedy for Tiger Woods and his family, the subject of sexual addiction is banter for talk show hosts, news commentators, comics and bloggers: “Is there such a thing as sexual addiction?” “What is the ‘treatment’ the renowned golfer is receiving?”

Mr. Woods’s misfortune may do for sexual addiction what Magic Johnson did for HIV, if only from the perspective of being a beloved public figure, whose personal tragedy is taking sexual addiction out of the closet. The news coverage, undoubtedly painful and intrusive to his family, portrayed the women with whom he was involved as glamorous. Interviews were coveted, head shots of the women appeared on the internet and in newsstands. One ambitious entrepreneur sold golf balls with the faces of these women — an act that begs interpretation regarding our culture’s acceptance of objectification. Mr. Woods, of course, is neither the typical representative of the rank-and-file sexual addict, nor are the women he is with. However, the media circus surrounding Mr. Woods may be an opportunity to look in the mirror at ourselves, our culture, pornography, sex addiction treatment and our ability to value or degrade each other.

What responsibility does the helping professions have to improve our ability to aid those who suffer?

What Is Sexual Addiction?
Dr. Mark Gold of PsychCentral.com describes it as “[a] progressive intimacy disorder, characterized by sexual thoughts and acts…Over time, the addict has to intensify the addictive behavior to achieve the same results.”

Womenshealth.com states, “Sexual addiction is not sexual desire, nor defined by the type of sexual act performed, or even by the frequency of sexual activity…a compulsive use of sex to address non-sexual emotional needs…frequently indicated by the willingness of an addict to suffer enormous consequences for engaging in sex.”

The literature suggests that sex addicts are typically cross-addicted, most commonly as workaholics, and secondarily as substance abusers. Given the size of the pornography industry — which rivals big oil, arms and illegal drugs — the increasing number of people needing treatment and the definitions above, one might surmise that we are collectively suffering from a pandemic of intimacy disorders and objectification.

Who Goes to Treatment, Who Doesn’t?

Those who enter treatment for sexual addition are primarily white professional men. Dr. Patrick Carnes, considered a leading expert in the field, stated in a 1999 Fortune Magazine article, “Most of my patients are CEOs, doctors, attorneys or priests — they are people with a great deal of power. We have corporate America’s leadership marching through here, and they are paying cash because they don’t want anybody to know…”

A sex addict/workaholic in a corporate environment, where power and control often reign over authenticity and information, creates the perfect conditions for the progression of an intimacy disorder. Sexual addiction has not just affected corporate America; it’s rampant in prison populations where creative men and women (inmates) make a living writing and selling porn to others. In inner cities, the sex-addicted workaholic might be focused on gang-building, drug-selling…even murder. These are people who lack $45,000 for treatment, and would probably not attend an all-white treatment center or 12-step meeting even if they were able to do so. Just as the age of first drug use dropped from the late teens to middle school, the age of first exposure to and use of pornographic materials has dropped, precipitated by a generation that uses the Internet as its parents used television.

Cyberspace Pornography: Porne Graphos
Cyberspace pornography addiction is reported as one of the most common manifestations of sexual addiction, as well as a gateway activity that fosters ramp-up to increased acting out. Adult channels are found in hotels, cable networks and cell phones. In l999, the Omni hotel chain announced that it would no longer offer adult movies in hotels or sell adult magazine in its gift shops, incurring a $1.8-million loss in revenues. Omni made the decision “in response to what it perceives as a growing need for corporate America to support pro-family issues.” For hotels that didn’t follow Omni’s footsteps, Frontline’s “American Porn” 2002 report claims that in-room adult movies generated more revenue than mini-bars.

The word pornography has its origins in the Greek word porne, meaning “whore or female captive” and graphos, which means “to write or tell about”. Erotica, on the other hand, comes from the name of the Greek god Eros. Gloria Steinem pointed this out in her essay, “Erotica vs. Pornography”, observing that what society needed was love, and what we got was pornography. Her observations were made before the explosion of the Internet and simultaneous explosion of easily accessible cyberspace pornography.

It is of note that prior to the Nazi invasion of Poland, the Nazis launched a campaign proliferating pornography, in the hopes of destroying community and promoting shame and isolation, hence making their conquest easier. The pornographic images of those exploited were Jewish women, adding to the mindset that Jews were “less than human.”

On today’s computer, a few clicks can progress from standard centerfold fare to child porn, teen porn, bestiality, pregnant women, incest, elderly women, chat rooms and web cam views in the heterosexual, homosexual and transsexual worlds. On “granny sites”, rape and bondage are particularly popular with women who appear to be between 60 and 85. Any user searching otherwise benign keywords in combination, such as boys, nubile, teen, legal, nasty, barely, zoo and girls enters a world where video trailers to lure viewers are full of daughters, sons, sisters, brothers, mothers, fathers, grandparents and grandchildren. The young girls — barely developed, pig-tailed and sometimes wearing braces — are asked “Are you really 18?” and answer, “Yes, I am really 18.” They then have ejaculate squirted onto their faces. The young boys staring doleful and naked from the computer screen, would seem better placed in a little league uniform, or eating cookies in their grandmother’s kitchen.

In ancient Japan, an unfaithful woman was humiliated by a practice known as Bukkake, tied and publicly held captive, while all the men in town would ejaculate on her face. Today, Bukkake porn is a niche group for straights, gays and lesbians. Men, women and children can be looked up by weight, strength, age, race, body parts, sexual preference and ability or activity. For those of us who know Black history, through another lens this is reminiscent of requests made at the auction block. Three decades ago, Susan Griffin’s heartfelt book, Silence and Pornography, was heralded by Sam Keen (one of our most thoughtful societal observers) as a book that “told me more about cruelty and tenderness, more about sadism and masochism (and) more about myself …”

Ms. Griffin observed:

“…pornography depicts acts of terrible violence to women’s bodies… is violent to a woman’s soul. In the wake of pornographic images, a woman ceases to know herself… Her experience is destroyed. Like men and women living in the institution of slavery, we have become talented at seeming to be what we are not…. the racist mind of the slave owner required that the men and women he enslaved resemble the image which he had of them. Because he imagined that blacks were stupid and slow, he required of his slaves that they appear to be stupid and slow. And because they wished to survive, men and women of quick intelligence learned to mime a slow and stupid manner. That this racist mind had a frantic need to believe its own invention…we can see in the slave owners’ injunction against the slave’s learning to read. One might ask, why would a law against learning to read be necessary for a people supposedly too dull to perform this skill? But, of course, the answer is that the people were not too dull… their masters had to be fooled, had to be deceived even against their own knowledge of black intelligence into a belief of black stupidity.”

To continue Ms. Griffin’s analogy, imagine a Fellini-type time-travel movie where plantation owners who beat, rape, exploit and sometimes kill slaves gather in self-help groups. They commit to recovery, discuss powerlessness, economic effects of their behavior, selfishness and loss of productivity at work. They participate with renewed fervor in church, have spiritual awakenings, take moral inventory, articulate the emotional effects on their family and thank each other for sharing. Associations are formed for spouses, social events are held. Slavery itself is never addressed, nor the reality of the slaves’ lives, who they are and the effect of slavery upon them. They remain nameless and faceless. The plight of the slave doesn’t occur in the mind of the owner…after all, they have housing, are cared for, they made “choices” and they are from a different class. The plantation owners, proud of their sobriety, honesty and community, establish a network of help and service, exclusively to address their own suffering.

What Is Missing?
Are the sincere efforts of those in the treatment field — many of whom are in recovery themselves — de facto promoting racism, classism and sexism? Sobering and notable by its absence in this sea of information and advice for sexual addiction is the voice representing the experience of those in the sex industry. What is their experience as they contribute to the multi-billion-dollar worldwide industry? Why are those who are objectified, raped, used, bartered, sold and exploited left out of the process? How does it feel to them, even if it is only “play acting”, to pretend to have sex with animals, enjoy being ejaculated on or fake orgasms before a camera for hours? How do they explain their jobs to children? Whether “play” or not, the fantasy life of the sex addict takes the performance seriously. The addict, like the slave owner, has a frantic need to believe the sex purchased — whether virtual or actual — is relished by the seller. In treatment, people walk the walk, talk the talk, suit up and show up to develop new roles for themselves — is the reverse not true? Does the field understand the culture of degradation? Do addicts think of the 16 year old — the age of their daughters and granddaughters — who works as an erotic dancer and does wall dancing for extra money? Do treatment professionals even know what wall dancing is?

In the plethora of the most commonly available self-help books, only Dr. Sbraga and Dr. O’Donohue in The Sex Addiction Workbook include sections directly addressing the sex industry and objectification. Yet, consistent in testimonials of partners of sex addicts is that they feel degraded because they cannot favorably compare with the pornographic images. Is the culture of treatment such that counselors ever illuminate to partners the reality of life in the sex industry?

Do faces on the screen, prostitutes from the street and the dancers in the club remain unnamed, forgotten, relegated to stay in their place, never dignified within the treatment process as real, feeling people, profoundly affected by their expendability? Is the rationale for those addicted similar to the group that could afford cocaine (and insurance for treatment) in the l970s? Many proclaimed that buying illegal drugs was a victimless crime; meanwhile caskets carrying murdered children from the streets of Bogotá, their organs hollowed and filled with cocaine, were one of the many ways drugs were delivered. Are these issues discussed or is it considered bad form? As part of training, do counselors learn about the actual (not virtual) life of the porn star, erotic dancer and prostitute? Or are sex industry workers dismissed as being “hooked on eroticized rage”? In the age of restorative justice and victims’ rights, do treatment centers offer education or group sessions between addicts and sex workers in recovery?

Susan’s mother turned her out when she was 12 because one of her tricks would not pay unless he could have sex with Susan. It was Detroit, early winter. Thrown outside after the act, Susan washed herself off with the garden hose; she found herself months later enmeshed in the sex industry.

Naked pictures of Juanito were taken at age 11 and circulated in juvenile hall after his first rape by the officers. For the next seven years, each time he returned, the officers who regularly raped the boys knew he had already been “broken in”, and it continued. Juanito found himself turning tricks to support his drug habit and participating in pornographic movies. Years later, he was found dead behind a dumpster, a victim of violence.

Maria, a victim of childhood sexual abuse, was strikingly beautiful. Prostituting before she was 20, she woke up one morning after passing out in a motel room; her trick had stuffed a syringe inside her vagina.

Do our treatment programs and support groups hear these stories? Do we ignore the suffering of those who are used, either in person or the subjects of fantasy and masturbation on the Internet?

In our prison system, people migrate from name to number; in sex clubs, pornography and prostitution, from name to object. Woe unto the nameless faceless people who have worked in the sex trade and end up incarcerated. Many do not realize that the women’s prison population in the United States is growing at a faster rate than that of men. This is where some percentage of sex workers ends up. Interestingly, two states with well-known centers to treat sexual addiction are mandatory minimum-sentencing states: Arizona and Mississippi. Do sex addicts in treatment understand that what gets them off often means long incarcerations for street workers after several arrests? Do high-end treatment agencies do service and outreach to the exploited who have no means to pay for treatment?

Ironically, the plight of those in the sex industry is largely hidden from the sex addict, who continues to rationalize behaviors. The professionals who do work with those in the sex industry are frequently admonished not to encourage people to explore experiences in detail, for fear of re-traumatization. But does that not help the sex addict to maintain the rationalization that the sex addict is the victim alone? In our recent history, the consciousness of the world was changed by the likes Fannie Lou Hamer, Victor Frankl and Elie Weisel — through their honest explication of the horrors they experienced. Bessel van der Kolk, dedicated his book Traumatic Stress to Nelson Mandela and “all those who, after having been hurt, work on transforming the trauma of others”. After studying trauma world-wide, van der Kolk states “that the spirit of squarely facing the facts as a prelude to healing should guide both our clinical and research work with victims of trauma and violence.” The treatment of sexual addiction is rife with trauma and violence, and all parties deserve the facts (not the images) squarely faced.

The words to John Newton’s hymn, Amazing Grace, are known to all. His transformation led him to leave the life of a slave trader and speak out about was arguably the greatest human rights issue of his time: the abolition of slavery. Might we not only sing his words, but also follow his example. Would that those with the resources to get help, and those who counsel them, actualize the grace that will lead to the service and healing of the most exploited.

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