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Therapy Can Help Fight Sex Addiction But How Can We Fight The Taboo Around It ?

“When I was a teen, I used to force myself to drink three litres of water every day and then not go to the toilet because the urge to urinate made me orgasm faster. But I never thought that there was anything wrong with me. All my friends masturbated all the time as well. I thought I was just like them,” says Riya, a 26-year-old fashion designer living in Delhi. She pauses to thumb through a stack of tarty red crotchless panties, resting her back against a dusty mannequin that displays a bra made of crystal beads and golden thread. We are at Tina Bazaar, an underground market in Delhi’s Lajpat Nagar that sells a vast variety of lingerie. With nothing priced above Rs 400, Riya happily fills her shopping bag with two animal print corsets, six lace bras and three thongs. “I grew up in Ranchi but attended college in Delhi. It’s tough to make ends meet in the city. I earn only Rs 22,000 as a design trainee. But I enjoy splurging a little now and then,” she admits with a sly grin and then quickly adds the flimsy crystal bra to her pile of purchases. As she’s paying the bill, she informs me in a low voice that she’s hoping the bra will help her seduce her boss later on in the evening. A 49-year-old man, her boss was the 84th man she had slept with and the first to help her realise that she had become a sex addict.

“I was engaged to the man of my dreams. No, I’m not joking,” she adds hastily before I can roll my eyes, then continues, “He was everything that I had ever searched for in a partner. And God knows, after 82 failed attempts, I had searched enough. So you would imagine that I would have been thrilled to have finally found the right guy. And I was–for a whole year. Then I met the head designer of my firm and all I could think about was making love to him. I forgot I was already with the man of my dreams, that I was engaged, that the wedding was to happen in a month’s time… I could only think of my boss and how to get him to touch me. It used to be torture to just sit across the table from him–his smell, his gaze, his voice, everything aroused me. I’d change my underwear three or four times a day because I got so excited every time he came near me.”

We have left Tina Bazaar by now and are walking towards a nearby pharmacy to pick up a strip of birth control pills. “It’s the only contraceptive that I can live with. Condoms are useless. I like to feel the skin and not rubber inside me. It is just a thousand times better. If, as several people inform me, I am already living in sin, I might as well go the whole way,” shrugs Riya and rushes forward to place her order at the counter.

It was only after she cheated on her fiancĂ© with her boss that Riya realised she needed help. “Earlier I could excuse sleeping around because I would tell myself that I was only trying to find the right man. But what about after you’ve found the love of your life? I couldn’t understand why I would ruin my happiness for sex. I couldn’t understand why I was feverish and excited in the company of a man twice my age,” she says. That was when she confessed the story of all her previous sexual encounters to her boss. “He was horrified and told me that it wasn’t normal to have had so many partners in just six years. The next day, he fixed up a counselling appointment for me at AIIMS hospital in Delhi. I went along because I knew that he was right. I wasn’t sexualised, I was hypersexualised,” recalls Riya.

Now, a year after she began therapy, Riya says she is finally starting to realise why she craves sex more than anything else. “At first I thought it was a hormone problem,” she says, “But during counselling sessions, I realised that my hypersexuality stemmed from depression. It was difficult to open up completely to my psychiatrist and bring back horrible memories.” But she did open up eventually. She told her psychiatrist of the first time she went out on a date in Delhi and how the boy made out with her in his car and then didn’t call back the next day. She talked about the first time she had drunken sex and woke up all alone, half-naked on a pavement outside a city nightclub. She remembered how she gave herself up to each of these men, hoping against hope that one of them would fall in love with her, just like in the Mills & Boon novels she had grown up reading. “None of them did, though. And by the time someone did, it was too late. I had become so used to sex that I could no longer understand love. I would only get excited at the prospect of the first kiss, the first touch… being wanted, being desired. It made me feel sexy and happy. I didn’t know what to do after the first few sexual encounters, I was so used to men leaving me after having had sex,” she recalls sadly.

First coined in 1886 by Richard Freiherr von Krafft- Ebing in his book Psychopathia Sexualis, the term ‘hypersexuality’ quickly replaced ‘nymphomania’ and ‘satyriasis’ (once used to describe increased sexual desire in women and men respectively) in general medicine. “Practitioners want to discourage the use of non-clinical labels to describe sex addicts, arguing that it stigmatises and marginalises those who need medical intervention,” says Dr Narayana Reddy in an interview to Open. A consutant of sexual medicine at Apollo Hospital, Chennai and a fellow of the American College of Sexologists, Dr Reddy has been treating patients with compulsive sexual behaviour for over two decades. According to him, hypersexuality is yet to be classified as a standalone clinical disorder and does not find mention in the American Psychiatry Association’s Diagnostic and Statistical Manual of Mental Disorders, the most widely read journal among mental health practitioners and doctors.

“Hypersexuality is a clinical diagnosis. It can be diagnosed and treated, often as a symptom of other psychodynamic and biochemical diseases such as depression, compulsive personality disorder or loneliness. Usually children of dysfunctional families or teens who have gone through severe depression end up with low self- confidence or feelings of guilt. They try to feel better about themselves through sex, alcohol or drugs,” says Dr Reddy, adding that the scientific community is still largely divided over how to define sexual addiction. “I hesitate to give an actual number for how many partners constitutes addiction because determining who is having sex on a compulsive basis and who just has an increased sex drive is still largely subjective. Some spouses complain that their partners are wanting to have sex more than once a week and that they are thus addicts. Others have spouses who want to have sex 15 times a week and are fine with it.” Instead, Dr Reddy says a more astute way to judge who is an addict and who is not, is by their behaviour after they have had sex. “Sex addicts harbour negative feelings after sex. A healthy person would normally feel joy or positive feelings. Another noticeable symptom for compulsive sex is intimacy disorder–an intense fear of bonding with anyone else,” explains Dr Reddy. Treatment for hypersexuality currently involves counselling and in extreme cases, oral medication for depression and stress. If found to be a symptom for any other cognitive disorder then the treatment and drugs are adapted accordingly. “Treatment, therapy and open dialogue on not just sex but also parenting, trauma, depression and stress will help erase misconceptions about sex addicts. They are not ‘immoral’. Their addiction is often out of their hands.”

A study on the causes of sex addiction by author and speaker Dr Patrick J Carnes shows just how important a role childhood and family plays. The study, The Making of a Sex Addict, noted that sex addicts tend to come from families who already suffer from addiction, with only 13 per cent of the 650 patients studied coming from families with no addiction; 77 per cent of the sex addicts also came from rigid and conservative families and 87 per cent found their families to be detached and emotionally absent. Another major area of impact was the role of child abuse. Addicts reported physical abuse (72 per cent), sexual abuse (81 per cent), and emotional abuse (97 per cent). The study also concluded that unresolved trauma, high stress, shame and self-hatred contributed to people becoming sex addicts.

To delve further into what causes sex addiction, a research project funded by the Wellcome Trust and conducted by researchers from the Department of Psychiatry at University of Cambridge looked at brain activity in 19 male sex addicts and compared them to the same number of healthy volunteers. The findings of the study were published in the journal Plos One. According to Dr Valerie Voon, a Wellcome Trust Intermediate Clinical Fellow at the University of Cambridge, brain activity in compulsive sex addicts is clearly different from those who are not. ‘The brain activity of sex addicts mirrors those of drug addicts with more activity being observed in the ventral striatum, dorsal anterior cingulate and amygdale regions of the brain,’ says Dr Voon.

Dr Reddy also concedes that there are certain similarities between sex and substance addiction, “Sex addiction follows the same stages as substance addiction: experimentation, regular use, risky use and finally dependence.” Dr Ramandeep, a psychiatrist at AIIMS Delhi, adds to this: “I don’t know if we’ve become more lonely today but the factors that lead to loneliness and depression have increased in Indian cities. Asian societies traditionally had very strong familial bonds which gave people their sense of confidence, belonging and self worth. Today, the joint household is vanishing and children are being raised in broken and dysfunctional homes or by hired nannies. We are also communicating more through gadgets, thus losing out on the depth of human connections and relationships. These changes often manifest in the form of substance addiction like alcohol or drugs or behavioural addiction like social media or sex.”

Riya, who is still taking drugs to battle her depression, agrees that at least in her case, the lack of familial support and guidance played the greatest role in turning her into a sex addict. As she toys with her strip of birth control pills and waits for her boss to come pick her up, she offers me one last explanation for her behaviour: “I come from a fairly well-off but extremely ignorant family. My father made money on real estate and my mother was a housewife who never went to school. They sent me to Delhi to be educated in academics but where was the education for my personality? Nobody ever told me what men are looking for in a big city like Delhi. Nobody ever informed me that what phone you use, where you live and how you dress also determines who will fall in love with you. All I had to go by were books and Bollywood, which basically told me that if you are sexy and good-hearted, love will come your way. I still remember the second time I had sex. I wore a really tiny skirt and paid the dinner bill, thinking sex and sweetness would win him over. The guy took me in his SUV in a parking lot that night. In the morning he told me that he couldn’t date me not only because I was the daughter of a nobody, but also because I wasn’t a virgin and I dressed like a whore. This is the life my parents threw me into, with no anchor, no grounding and no fall-back option. You think I wanted to become a sex addict? Delhi just made it so terribly easy to be one.”

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