Hypersexual Behavior Disorder

It was a pretty big deal in the sex addiction community that “Hypersexual Behavior Disorder” wasn’t included in the 5th edition of the DSM – V (Diagnostic Statistical Manuel for Psychiatric Disorders).  As the spouse of an addict, I agree that this addiction should be recognized and treated with the same attention as other process addictions – Food, Gambling, Debting, etc.  The DSM is revised every so often, and is making steady but extremely slow progress in the area of addiction.  For instance, Gambling Addiction was classified in the DSM-IV under the section called “Impulse Control Disorders Not Elsewhere Classified”.  This is the same category as things such as pyromania.  It has been ‘upgraded’ to “Gambling Disorder” in the DSM-V which is great news for those affected by and treating this disorder.  But Sex addiction is still left out.

As much as I would like to see it included in the sixth addition – I have to say that I take issue with calling it Hypersexual Behavior Disorder.  I am not a psychiatrist, but in my opinion it’s the “hypersexual” part that is not accurate or inclusive enough to be the official name of the addiction.  Hypersexuality is certainly one extreme of the problem – just like bulimia is one side of eating disorders.  But there is another side to sex addiction – it is the equivalent of anorexia.

I have been highly sexual my entire teen and adult life.  I’ve had countless sexual partners and when I was in monogamous relationships I had sex, on average, at least once a day, sometimes a dozen.  The surprise isn’t that my own sexuality led me to a relationship with a sex addict but that my husband, the ‘sex addict’, barely has any sex at all.  Am I a sex addict?  Unlikely.  Is my husband a sex addict?  Absolutely.  So the one in the relationship who acts in a hypersexual fashion isn’t an addict – but the one who goes months on end without sex, masturbation, sometimes even an erection is one?  Very confusing to the onlooker.

When I was first dating my husband, we had sex at most 2 times a week.   By the time we got married (6 months later) we were down to a few times a month.  And when we went to Hawaii for our honeymoon – with much prodding I convinced him to make love with me just once, on our last night there.

It seemed like a cruel joke that the girl who grew up as the town/high school/fraternity ‘nympho’ ended up in a sexless marriage.  I constantly craved sex with my husband, but no matter what I did I could rarely interest him.   I eventually told him that if we didn’t start fucking that I would need to take a lover – he promised to start paying more attention to me sexually and blamed his lack of interest on age, antidepressants and stress.  It was a few weeks later that I found out about his cheating and everything changed.

In the 7 years that he was cheating on me, he attempted to have an orgasm about 2 dozen times and achieved orgasm 15 times, give or take.  This includes sex partners, erotic massage parlors, masturbation – ALL OF IT!!!  This certainly doesn’t sound like someone who is hypersexual.

Sex Addiction isn’t about the sex, and most certainly isn’t about the orgasm.  My husband is a prime example.  It makes it harder for me to tell people that my husband is a sex addict because I think the image that goes through their minds is of him having sex and masturbating all day, every day.  It’s just not so.  He has such intimacy issues that he can’t go there and his shame makes him a sexual anorexic.  It would be helpful to have the DSM reconsider the addiction for the 6th edition and to include a broader definition of the disorder.  Maybe “sexual behavior disorder” would be more accurate.  But with or without the medical validation of the DSM, anyone with an addicted family member knows it to be a very true, and very lonely problem.

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