Wednesday, March 10, 2010

Is the 12- step programme any good for sex addiction

Tiger Woods's public apology for his infidelity has fuelled the long-standing debate about sexual disorders and how to treat them. We talk to therapists here about sex addiction and whether the 12-step programme can help

How much is too much, and when does any habit become ''excessive'', be this eating, drinking, shopping or sex? The answer, say therapists, lies in whether this behaviour damages your life in any way. It was Clinton who first offered us a glimpse of how sex can ruin a person's life. More recently, Tiger Woods's string of sexual escapades has confirmed this idea that 'out of control' sexual behaviour which seems addictive can have farreaching consequences.

Sex addiction is being recognised as a problem the world over but in the Indian context, very little research has been done on this problem and its treatment. Experts say that this is because sex is still a taboo subject in our culture.''Ours is a predominantly patriarchal society in which a sexual problem or addiction is considered an affront to masculinity so a man suffering from sex addiction is simply hailed as 'virile','' says Dr Rachna Singh, consultant psychologist, Artemis Health Institute.

Undoubtedly sex addiction has to be defined carefully as a person might have a high libido, nothing more, and his sexual needs might not match his partners, which leads to him being branded unfairly as an addict. ''There are no clear cut lines to define what too much sex is. If a man with a high libido finds a match in his partner then there is no problem. But when the desire to have sex takes over a person's life and renders it dysfunctional, then the psychological and physical condition should be analysed,'' says Dr Wadia.

While the idea that anyone can be addicted to sex is still scoffed at, using this as a 'medical' excuse for promiscuous behavior makes the matter more controversial. Especially since this is not even recognised as a disorder by the Diagnostic and Statistical Manual of Mental Disorders (DSM), considered the psychiatrist's Bible and ''hypersexual disorder'' is under consideration for the next edition.

Woods recently offered a public apology for his infidelity, saying he was returning to his religious faith and admitting that he had ''work to do.'' This declaration appeared to be in the line of the steps advocated by a de-addiction programme called the 12-step approach. This universally-accepted plan was first formulated by Alcoholics Anonymous and has since then been adopted by Narcotics Anonymous, Sex Addicts Anonymous and groups for gambling, food and shopping addictions. Alcoholics Anonymous is the largest of all the twelve-step programs, followed by Narcotics Anonymous.

Woods's apology last week to his family and his wife's family, his business partners and sponsors, and parents who ''used to point to me as a role model for their kids,'' seemed to be in line with steps 8 and 9 of the programme, which advocate listing everyone harmed and the making of amends. The 12-step is intended to provide psychological, social and spiritual support for addicts. Crucial to this is the admission that their addiction isn't in their control and that there is a greater power that can give strength.

Past mistakes are rectified with the help of a sponsor who is an experienced member. The final step is to learn to live a new life with a new code of behaviour and help others who suffer from the same addictions or compulsions. ''We use many of the principles of the 12 - step in our counselling ,'' declares Elizabeth Selhore, director of Sahara, an NGO that runs a rehabilitation programme for drug and alcohol addiction.

Selhore admits that while sex addiction is not ''acknowledged'' in India, it is a problem nonetheless.

''Anything can become an addiction, including love and sex.'' Cognitive behavioural therapy (CBT) and counselling are typically used to deal with addictive behaviour.

According to Dr Samir Malhotra, HOD psychiatry at Fortis Noida, people with addictions avoid seeking professional help. ''Groups like AA are not very active. But many elements of the 12-step programme are a part of recovery programmes, even though people may not follow the exact 12 steps. Systems of recovery vary and the patient's personality and circumstances as well as environment needs to be evaluated especially where sex addiction is concerned,'' says Malhotra.

The pros and cons of the 12-step are debatable. One of the biggest advantages is the sense of community and belonging that it offers those struggling with addiction.

It destigmatises addiction and helps a person accept responsibility for their dependence on drugs, alcohol or sex. Following the plan costs nothing and a person can count on it.

One of the arguments against the programme is that it focuses on the emotional and spiritual, and neglects the physical. ''But that's why it's important to create your own plan based on some of the principles only,'' counters Selhore.

Sahara's plan includes vigorous physical activity and the NGO has its own football team which competes in country level tournaments.

Calling yourself an addict is essential in the 12-step plan.

This admission is hard for some, as is the social involvement that is part of the plan.

Many people struggling with addiction find this hard to deal with as it makes them uncomfortable or nervous.

The public confessional approach is another area of the programme that may make people cringe. Some feel that the need for belief in a Higher Power which is integral for those following the plan also comes in the way of its universal applicability and efficacy.

Selhore doesn't agree though. '' The programme talks of God or a Higher Power but doesn't give any name to this power, so it's applicable to everyone and it doesn't matter whether you are a Christian or Hindu.”

The 12-step requires you to call yourself an addict and accept responsibility for your behaviour and actions

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