 Okay, Svanpanim, Shovavim, Shoshanim, Babieses and all other creatures of land and sea. Today we are going to discuss sex addiction, either such a thing, or is it all male chauvinistic hype? And my name is Sam Vaknin, I'm the author of Malignat Sir Flav, Narcissism Revisited and I'm a professor of psychology in C.A.P. C.A.P. The Center for International Advanced Professional Studies and the C.A.P. Consortium of Universities. So, but before we go into the issue of sex addiction and whether there is such a thing, my video is about mate poaching, backstabbing, bed mouthing, fake friends elicited a tsunami of questions. By far, the most common question is, should I punish them for what they have done? Of course you should. The entire justice system is founded on retribution and just deserts. And in case of betrayal so profound, there is no statute of limitations and no proportionality. You see, I am an Old Testament kind of Jew, two eyes for an eye and a nose into the bargain. Mind you, it may take weeks or months or years, but justice will be meted out and whoever the perpetrator may be, he should be looking behind his shoulder day and night. But I will deal with deserving penalties for friendship betrayal on my return from my trip to Budapest. I remind you that if you want to book a counselling session with me, just write to sanvacnin at gmail.com. I will be in Budapest. We can meet face to face to your great detriment. So let's dive right in, pardon the pun. There is a lot of misunderstanding, there are many misunderstandings, a lot of misrepresentations regarding sex addiction. I'm going to make a few points which are essentially counter-intuitive as I usually do, and then we will go into the clinical picture of sex addiction. Before we start, the field of sexology or sex studies is thoroughly contaminated by political correctness. Actually, this applies to many other disorders. For example, masochistic and sadistic personality disorders, self-defeating personality disorder as it used to be known, they were dropped after the DSM-3 because of pressure by feminists who insisted that masochistic personality disorder is a gender bias construct. It reflects on women much more than men. That's one example of political correctness contaminating, and I'm using the word judicially, clinical discourse. Same applies to sex addiction. Everyone knows that there is such a thing. Everyone knows it's a clinical entity, I will go into it shortly, but no one dares to include it in the most recent edition of the Diagnostic and Statistical Manual Edition 5, text revision published a few months ago. Why? Because of special interest groups and political pressure. This is not science, this is pseudoscience, this is politics. Of course, there is such a thing as sexual addiction. But there are many misapprehensions and misco-prehensions regarding this, and I'm going to try to shed some light on some of the aspects of sex addiction which are much neglected. First of all, do not confuse and conflate sex addiction with promiscuity. Promiscuity is a choice to be indiscriminate in mate selection, sexual partner selection. In other words, promiscuity is simply having sex with anyone and everyone, regardless of attributes, character, physical properties and so on and so forth. Promiscuity is indiscriminate. Sex addiction is an entirely different thing. Many sex addicts are actually not promiscuous. They do apply certain standards, they are not indiscriminate, they are discriminated. But once certain attributes or certain standards have been met, they are unable to control the impulse to have sex. So sex addiction is a compulsion. Promiscuity is a lifestyle choice, a behavioural pattern, sexual style. It's not compulsive. Sex addiction is compulsive. But ironically, in sex addiction, usually there are some standards, while in promiscuity, there are none. The next thing you should know, sex addiction doesn't necessarily involve other people. For example, most sex addicts masturbate 10 or 20 times a day. They can't control their masturbation. This is their outlet for their addiction to sex. Many sex addicts are actually celibate because they are terrified of their inability to say no. They don't want to place themselves in situations where they will end up having sex and hurting loved ones, spouses, intimate partners, boyfriends or girlfriends. So you can find sex addicts who are celibate, but they masturbate compulsively, usually consuming porn. And this porn consumption in sex addicts is gender neutral. While among other people, healthy people, normal people, other people with personality disorders and so on, among all other people, men mostly consume pornography. About 70 plus percent of pornography is consumed by men. Among sex addicts, both men and women consume pornography equally. Now, the porn addict, the sex addict, actually is not obsessed with sex. It's not about having sex. It's not like constantly thinking about sex. It's more impulsive. It's more sudden. It's more an uncontrollable craving or urge to have sex with someone who fits the bill, with someone who meets certain criteria and standards. So there is like a threshold condition. The sex addict comes across someone who satisfies a certain profile, a certain job description. But then at that point, the sex addict becomes compulsive. He acts impulsively. His actions are sudden. His urges and cravings are uncontrollable, and he has sex, or she has sex. Sex addiction serves many psychodynamic or psychological purposes. For example, the sex addict uses sex to self-soothe or to reduce anxiety. Now various studies starting in 1993 found that anxiety is actually not correlated with sex addiction. There were studies of promiscuity among people with borderline personality disorder, and some of them were sex addicts, promiscuous and sex addicts. And so these studies found that the group of people who were sex addicted, or the group of people who were promiscuous, were not anxious. And the group of people who were anxious borderlines usually self-mutilated. So you could conceive of sex addiction as self-mutilation, the equivalent of self-harm in borderline personality disorder. This is why the impulsive, the sudden, the uncontrollable nature of the sex impulse in sex addicts leads them to situations which are egodistonic, they feel shame, they feel guilt, and they do damage their relationships to a large degree. They hurt themselves, it's dysfunctional, they are in distress. Now many sex addicts are actually motivated by the need for attention. It's not about sex so much, it's about attention. There is an automatic negative thought involved and catastrophizing. And the automatic negative thought is, if I don't give sex, if I don't agree to sex, there's nothing else I can offer that will guarantee attention. If I want attention, I have to engage in sex. Sex is a condition for obtaining attention. I get attention mostly from the focus of attention, only when I engage in sex. It's an automatic negative thought. The catastrophizing aspect is, if I were to abstain, if I were to not give sex or to not agree to have sex, to not give consent, then I will be abandoned, I will be dumped, I will be ignored. Now, sex addiction didn't make it owe into political pressures, didn't make it into the diagnostic and statistical manual. Edition 4, text revision 4, 5 and text revision 5. It's taboo, it's not discussed. This is despite the fact that several very important studies have demonstrated clearly that sex addiction is a real clinical entity. It's a real thing, it's a real phenomenon. There was a major study led by Rory Reid, R-E-I-D, Rory Reid, I think his name is. Rory Reid is a research psychologist in the Department of Psychiatry at the University of California, Los Angeles, UCLA. And he led a team of researchers. He investigated at the time the proposed criteria for what was called then hyper-sexual disorder, being too sexed, having an id in Freud's terms, which is too dominant, overrides the ego. So, Reid and his team made the most thorough study of sexual addiction, and they published their findings in the Journal of Sexual Medicine, and they concluded that the given criteria for sexual addiction are valid, and that the disorder could be reliably diagnosed. Now, Europe, as usual, is very different to the United States, and much more advanced than the United States in terms of diagnosis and classification, because European authorities like the WHO, World Health Organization, they are not subject to political pressures. So, in the diagnostic manual ICD, International Classification of Diseases, published by the World Health Organization, and in this, in the 11th edition, there is something called Compulsive Sexual Behavioral Disorder, CSBD. It's also known as Hypersexual Disorder. Remember, Reid and his study? It's a pattern of behavior involving intense preoccupation with sexual fantasies and behaviors that causes distress, that cause distress, are inappropriately used to cope with stress, cannot be voluntarily curtailed, and risk or cause harm to oneself or to others. The disorder, again, Compulsive Sexual Behavioral Disorder, CSBD, also involves impairment in social, sexual, or other important functions. So, we have something very similar to sex addiction in the ICD-11, but not in the DSM. Now, I will read to you the criteria of Compulsive Sexual Behavioral Disorder. A persistent pattern of failure to control intense repetitive sexual impulses or urges resulting in repetitive sexual behavior. Symptoms may include repetitive sexual activities becoming a central focus of the person's life to the point of neglecting health and personal care or other interests, activities, and responsibilities. Numerous unsuccessful efforts to significantly reduce repetitive sexual behavior and continued repetitive sexual behavior despite adverse consequences or deriving little or no satisfaction from it. Now, just to make clear, sexual behavior could include compulsive masturbation, compulsive porn consumption, porn addiction. It doesn't have to be with other people, but usually it is with other people. And it's very important that these activities do not give the sex addict any pleasure in most cases. The sex addict cannot control these behaviors. Even when she knows that this is going to ruin her relationships or marriage, even when she knows that the consequences are going to be horrible and totally disproportional, she can't stop herself or, of course, himself. The criteria in the ICD-11 are a pattern of failure to control intense sexual impulses or urges and resulting in repetitive sexual behavior. Number two, manifested over an extended period of time, example six months or more. Number three, that this behavior causes marked distress or significant impairment in personal, family, social, educational, occupational, or other important areas of functioning. Distress that is entirely related to moral judgments and disapproval about sexual impulses, urges, and behaviors is not sufficient. So we are not talking here about moral judgment. We're talking about objective distress. We're talking about a situation where repetitive urges, compulsive behaviors destroy your life, destroy your relationships, make you lose people you love, destroy your work or career, undermine your life in a variety of ways. What could be the root of all this? What is the psychological etiology, the reasoning behind sexual addiction? Well, not to put too fine a point of it on it, we don't know. We don't know. We know that people with sex addiction, they all the time attempt to control or to diminish the amount of time spent engaging in sexual fantasies, urges, and behaviors. They're obsessed with trying to somehow minimize their compulsion or cage it or somehow control it. They experience these attempts as shameful. They feel helpless. They feel impotent. They feel hopeless because the more they, more often they try, the more often they fail. It's a sense or pervasive sense of personal failure. These people engage in sexual behaviors and do experience them as compulsive. When you interview them later, they say, I was an autopilot. I didn't, I was not there. I didn't know what I was doing. We know that sexual addiction is somehow linked to certain types of dissociation. For example, derealization, the feeling that you are not in reality or in some kind of movie or depersonalization, the feeling that it's not you who is doing these things, someone else is. And of course, depersonalization and derealization are intimately connected with borderline personality disorder. We may conceive of sex addiction as a desperate attempt to regulate shame, guilt, emotions and labile moods. People who engage, people who are sex addicts and keep doing these things could be again, compulsive, time-consuming masturbation and could be sex with highly specific types and could be compulsive sex that follows specific settings. So whenever you're in a date, you end up having sex. Whenever you're in a room, you end up having sex. Whenever you're in a restaurant, you end up having sex. Whenever you're in a camp, you end up having sex. So when there's a context, a specific context, it triggers sexual behavior. And so these individuals find themselves under the spell and control and they know that this is going to have really bad adverse medical, legal, interpersonal consequences. And they neglect other activities, social, recreational responsibilities. They just, the sex takes over, the sex takes over in a variety of ways. And hypersexual disorder, which is the other name for sex addiction, is usually lifelong. It's a dimension of personality in a way. And so in cognitive behavioral theories of sexual addiction and CSBD, we believe that it's somehow linked to shame. The shame is associated with cognitive schema of self-defectiveness. Like I'm defective, I'm incomplete, I'm not whole. This is what I call the bed object. These interjections that keep telling you you're unworthy, you're unlovable, you don't deserve happiness, and so on and so forth. A feeling of social pain and isolation usually follows because you feel that you're not good enough to be loved, appreciated by people. So the chronic shame gets attached somehow to social stigma and they both usually hail from early traumatic experiences. Sexual behavior in this case becomes self-soothing. These people medicate with sexual behavior. It's anxiolytic, reduces anxiety, and this becomes compulsive because they're constantly in an ego-dystonic state, shame, guilt, anxiety, whatever. Sex seems to be the only solution. The excessive and inappropriate sexual behavior is socially unacceptable and this causes extra shame. It's a self-perpetuating, self-sustaining cycle. You misbehave sexually, you feel guilt and shame, you feel like an outcast, you feel like a freak, and so to self-soothe, you engage again in sex, inappropriate sex or inappropriate setting or with inappropriate people and again you feel shame and guilt and again you need to have sex. So it's self-reinforcing, feedback loop. And there is no good treatment. It could be conceived as obsessive-compulsive disorder or maybe anxiety disorder and some medication and some types of treatment reduce shame and help with social reintegration. But all in all, the outcomes are very poor and so is the prognosis. It's a lifelong debilitating behavior, dysfunctional behavior. I'm sorry I couldn't end on a positive note. Actually I'm not. And I encourage you to post your thoughts and experiences, especially those of you who are sex addicts and feel bad about it. Why not share and see what other people have to say. Have fun kids. I'm a stalavista, I'm on my way to Budapest and then when I'm back, it's the time for fake friends.