In developing patterns of compulsive behaviour, sex addicts genuinely want to stop their actions but can't – despite the often serious consequences. Sexual Addiction is disorder of the brain and is characterised by delusion about sexual wants and love. In terms of sexual arousal, brains begin to adapt to increasing stimuli, derived from pornography and other sexually stimulating materials, and leading to a variety of sexual acting out behaviours, including compulsive masturbation. Some sexual addicts never act out sex with actual people, but for many pornography and masturbation stimuli aren’t good enough and they look to more engaging stimuli to achieve the desired high, in part to reset their brain’s neurons.
To further escalate arousal, an addict may start looking at escort sites. They may delude themselves into thinking and believing: “I’ll just have a look”. However, delusion has now firmly taken hold: the addict is pursuant of further arousal and the compulsion to act is far too strong to resist. “I've already come this far, why not just go to a motel room and meet up?”
Despite the incredible guilt, shame, and disbelief, the addict will begin pursuing even more and entertaining, even greater delusions. Some addicts increase arousal and push the triggers of their brain’s reward centres by hiring two escorts or prostitutes. Others might even steadfastly believe that they are falling for their escort: they might support this delusion with the grandiose notion of buying them expensive gifts or even setting them up in an apartment. An addict might feel so strongly in love with their escort that they may even want nothing more than to marry them – leaving their partners, children, and family behind.
Problematically, as the intensity of these activities and desires increase, so too do the delusions: the addict may start to distance themselves from their partner and isolate themselves from their families. It is not uncommon for many sex addiction therapists to hear sex addicts declare their undying love for their escorts. In spite of fully knowing and being consciously aware of just how financially exploited they are being, the sex addict simply cannot cease their compulsive behaviour – behaviours which are now becoming increasingly dangerous, harmful, and emotionally distressing.
When caught within the throes of sex addiction, addicts are also ensnared in the throes of delusion. Non normative sexual behaviours start becoming normalised: “They’re all mine”, the addict thinks. Unfortunately by now, it’s common for addicts to be so hijacked by their escort rituals that they no longer desire sex with their partner. Yet they still believe they’re in control: it’s only until they’re thrust deeply into shame that reality begins breaking through.
While men suffering from an addiction to sex will fearlessly pursue it, they are actually chasing something else, according to Dr Kenneth Adams, an international expert in this field of sex addiction.
"It's not about sex at all. Rather it's a way sex addicts medicate their feelings, wounds and insecurities," he says.
Adams, who was in Sydney in 2016 to run a course on a fresh approach to treating this condition, says these addicts have developed patterns of compulsive behaviour which they genuinely want to stop but can't, even though the consequences can be dire.
Unlike a promiscuous and opportunistic narcissist who feels entitled and doesn't have much regret afterwards, a sex addict is in his shame. While the narcissist experiences no conflict with his behaviour, the addict does.
The new approach Adams was teaching at South Pacific Private, an addiction and mental health facility in Sydney, is geared to preserving the addict's primary relationship with his partner while limiting the damage that discovery and complete disclosure can cause to the family structure.
The course was developed by the International Institute for Trauma and Addiction Professionals (IITAP).
Adams has 30 years' experience in this area, co-edited the text book Clinical Management of Sex Addiction and is on the editorial board of Sexual Addiction & Compulsivity: The Journal of Treatment and Prevention.
In the United States an estimated 3 to 5 per cent of men have a sexual addiction and there is concern that unprecedented access to sex online is drawing more vulnerable people into addiction.
"The more opportunity, more access to funds and the more the culture supports gratification at the cost of integrity, the more likely the numbers will go up," he says.
But there are various views about what constitutes sexual addiction as was evident earlier in 2016 when former New York congressman, Anthony Weiner, was in trouble yet again for exposing himself to women over the Internet.
It was his third scandal in five years. Some said this politically brilliant, well connected man with a high profile wife and a child was clearly suffering sexual addiction. Others discounted this saying it was an oversimplification that reduced the psychological complexity that drives self-destructive behaviour.
Whatever the theory, it is agreed sex addiction is a disorder of the brain and is characterized by impaired impulse control, escalations of sexual acts, sexual thoughts, and sexual cravings, and by the addict's inability to stop their behaviour, despite their awareness of negative consequences.
Whether it's eating, gambling, sex, shopping or drugs, Adams says all addiction begins with a flooding sensation in the brain. While the sex addiction cycle can take various forms, a typical male scenario would begin with preoccupation.
"The reward system in the man's brain begins ticking up. He starts feeling high and as his brain floods, he thinks about looking up a porn site, "says Adams.
He may go to the men's room at work and in the privacy of cubicle, go online on his phone. Later in the day, he'll do it again and again.
He manages to suppress any inkling that he should stop because as his front lobes go offline so he's into the ritual of going online.
He is driven, in part, by what is known as the "triple A engine" of cybersex. Affordability, accessibility and perceived anonymity remove the major inhibitors of sexual excess and after a while, vulnerable people like him can become hooked in.
"With sexual arousal, the brain begins to adapt. What fires together wires together," says Adams, describing this process as neuroplasticity.
But over time, this is no longer sufficient and as he seeks more he starts to reset his brain. To escalate arousal, he begins looking at escort sites. Never, in a million years, did he imagine he'd do this and he tells himself they'll just have a drink.
Delusion has taken hold, he is in pursuit, and is missing danger cues that would be obvious to others. The compulsion to act is so strong he thinks 'what the heck, I've gone this far, we are having a drink, let's just go to the motel'.
"Afterwards when he's driving home, he feels ashamed, guilty and can't believe what's he has done, "says Adams. "He's spent all that money, had unprotected sex and feels terrible. Now he has to face his wife and kids."
But the next time his selfhood is in jeopardy, he'll go back in pursuit. Adams repeatedly emphasises that this is not about hyped desire but about fortifying internal fragility.
Despite how others perceive him, internally he's always one step ahead of feeling inadequate, insecure and anxious.
Eventually the brain reward centres don't work like they used to, so again he turns up the intensity to increase the dopamine rush. The need for more sex is not based on desire for more, but desire to alter his mood more.
He's becoming a little grandiose and this time might hire two escorts. Or he might think he's falling in love with his escort and buy her a car or perhaps set her up in an apartment. He may even want to marry her.
As the intensity of these activities increase, so does the delusion and he starts distancing himself from his partner. Adams has heard many men declare they are in love with escorts. They know they are being exploited financially but can't stop.
"In the throes of addiction these men are also in the throes of delusion. 'She's all mine' they think as they normalise sexual behaviour that is no longer normative."
By now it's not uncommon for these men to be so hijacked by ritual they no longer want sex with their partner. But they think they are in control and reality doesn't break through until they are thrust into deep shame.
Financial difficulty, crossing a line at work or a crisis of discovery at home, can fracture their delusion.
Adams says in most cases, the wife discovers something is going on but doesn't have whole story. In pain and in conflict, the couple come for help. While he's denying and minimizing, her world has fallen apart. She's been deceived and feels devastated, angry and hurt.
But she's only seen the tip of the iceberg and if she's immediately exposed to the bulk below, the damage may be irreparable.
"We teach therapists to reign that in so we can get to a formal disclosure process," says Adams. "But we do allow for safety disclosures."
If she is at risk of a sexually transmitted disease or is facing humiliation because a sister, a best friend or a babysitter is involved, she needs to know. The same applies if there is a risk of public disclosure.
In the past marital therapists saw this as an inter-relationship problem for the couple. "That was a huge mistake," says Adams.
"The addict would say 'if only she was more intimate, if only she'd dress up, if only she'd watch some porn with me - I wouldn't be doing any of this'. This left the partner feeling it was all her fault."
Adam's order of business is to manage the addiction process and prepare for structured disclosure. "First we put the addict into recovery and then we help her manage her own reality. Once she's over the discovery shock, we help her get clear about the questions she has."
"Once the truth is out and he's in recovery, we can begin to see if amends can be made and repair is possible. These require serious steps and some couples are unwilling to take them."
"But we are seeing more couples going on to have their 'second marriage' with one another. It's not easy, but it happens."