Internet has put a spotlight on sex addiction

Each week in his Bellevue counseling office, Bill Lennon sees 13 groups of eight men, all seeking help for compulsive sexual behavior. Such behavior can range from obsessively viewing pornography to answering Craigslist ads for minors selling themselves at cheap motels.

He said that none of the men are there voluntarily. Instead, they got busted in a police sting, or were caught by their wives or their employers and forced to confront their conduct.

And most, Lennon insists, are nice guys.

"These are doctors, lawyers, pastors, professional athletes, your neighbor. Sex is an equal-opportunity addiction," he said.

As many as 12 million Americans suffer from sex addiction, according to the American Association for Marriage and Family Therapy. Lennon and a growing number of sex-addiction therapists argue it is a highly treatable disease that affects the brain in ways similar to drug or alcohol addiction, etching in neural pathways a powerful drive for pleasure and an increasingly compromised ability to exert control.

These therapists say that the explosion of online pornography and internet sites for escorts and hookups has meant that men who would never have considered picking up a prostitute can now make a date for sex with ease and anonymity on their cellphone or computer.

"When you give people immediate access to highly stimulating, highly pleasurable content or experiences, the likelihood that addiction will appear goes up," said Rob Weiss, a California-based sex-addiction therapist and the author of "Always Turned On: Sex Addiction in the Digital Age."

Weiss divides sexual activity into three categories: casual, at-risk and addictive.

Addicted users, he said, compulsively seek non-intimate sexual encounters or experiences regardless of the consequences, often as an escape from their own problems. They are unable to quit and typically lead a double life, telling lies, keeping secrets and justifying the behavior to themselves.

"The people I work with get lost in the pursuit of sex," he said. "They lose their wives, their kids, their jobs and they keep doing it. They return to the same behavior again and again, expecting a dazzling new experience. But over time, it isn't that dazzling a new experience. It isn't fun to be caught in a prostitution sting."

Stefanie Carnes, president of the International Institute for Trauma and Addiction Professionals (IITAP), which trains and certifies addiction therapists, said the past few years have seen a surge in research on neuroscience and sex addiction. In one study, she said, the brain scans of sex addicts exposed to stimuli such as pornography mirrored the brain scans of cocaine addicts when shown a line of cocaine.

"There's a convergence of evidence that sex addiction looks like other addictions in the brain," she said.

Carnes said a very primitive part of the brain is triggered by basic drives, including mating and food. The area, known as the reward pathway, is activated with the anticipation of pleasure and accompanied by a release of dopamine, which creates an intense high.

"Orgasm is a powerful release of dopamine in the brain," she said, explaining why, biologically, sex can become addictive.

But over time, she said, the brain reduces the number of dopamine receptors, which makes it harder to experience pleasure. That accounts for the familiar pattern of addicts seeking more frequent or novel experiences and engaging in increasingly risky behavior to attain the same high.

At the same time, Carnes said, the brain's frontal lobes, which are responsible for judgment, decision making and impulse control, get sluggish and less effective.

"This is what we mean when we say the brain is hijacked by addiction," she said. "The reptilian part of the brain seeking these pleasurable responses is highly activated and the critical thinking part of the brain is not. And that's how you start having people make really bad decisions."

In King County, men convicted of soliciting or promoting prostitution are sent to a 10-week class on sexual exploitation that seeks to hold them accountable for the harm caused by the sex trade. Topics include how men are socialized toward women and sex, the relationship between power and violence against women and mutuality in relationships.

Peter Qualliotine, who teaches the class and co-founded the Seattle-based Organization for Prostitution Survivors, said that while the class is not treatment, it encourages self-reflection and critical analysis about the men's decision to buy sex. He sees patronizing prostitutes as part of a continuum of what he calls "toxic masculinity," behavior that includes sexual harassment, domestic violence and rape.

Lennon, the Bellevue sex-addiction therapist, says the diagnosis of addiction is an explanation, not an excuse. Many of his clients are educated professionals who have never talked about their compulsive sexual activity with anyone before seeking treatment.

Some tell him that online encounters or prostitutes are less trouble than real relationships, that they can be scheduled into busy and stressful work lives and that it's an activity between consenting adults.

"It's a lot more work to be in a relationship that's mutually, sexually satisfying," he said. "It's so much easier to use the internet."

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