26/12/2015 11:17 AM IST | Updated 15/07/2016 8:25 AM IST

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

Open Magazine

By Staff Writer

"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 fiancé 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."


Delhi, it seems, makes it easy for a lot of other people to be sex addicts as well. Every Thursday evening, the India chapter for Sex Addicts Anonymous (SAA) comes together for a meeting at The Church of Our Lady of Health in Masihgarh, Okhla. Here, around 10-15 regular members gather to encourage and support one another to abstain from sexually addictive behaviour. As one 27-year-old female member, Priti, tells me, "There is no definition of what is sexual abstinence here. They leave it up to you to decide what you feel is healthy sexual behaviour. That is one of the reasons I feel comfortable coming here, because I am not forced to be what anyone else wants me to be. It's not like I want to give up sex entirely." Behind her, a statue of Mother Mary peeks out from inside a gigantic conch shell. Priti adds that SAA is the fourth treatment option that she has tried and that it has been the best so far.

"Do you have any idea how many sex addicts exist in the city? And how few of them receive help because they are never taken seriously? Even in Iran, SAA has 20,000 members. But here in India we don't even have 20! I first joined a group called Sexoholics Limited in Gurgaon. But the members never met, it was more of an online forum. The worst part was that it turned out to be a dating site of sorts, with members meeting up to have sex. So here are 500 sex addicts, all having sex with one another. I think it has closed down since. I then tried counselling, but my psychiatrist was extremely judgemental and I wasn't comfortable opening up to her. My third attempt was with a Catholic Church group in Chennai. I travelled all the way to attend a meeting. But the treatment there included confessing that I am evil, and I wasn't going to do that. I am not evil. I didn't become an addict on purpose."

I ask Priti how SAA has helped her, and she says the most important step that the group takes is to never condemn any of its members. "It's not like we all don't know what we are doing is not healthy for us. The fact that we are trying to overcome our urges should be repentance enough," she explains, then shows me a drawing of her 'Three Circles'. Unique to the SAA, this is a method used to give members a sense of control and purpose. Each member draws three concentric circles, consisting of an inner, middle and outer circle. They then sit together with their sponsor or another member in recovery to write down various behaviours in each of the three circles. The inner circle includes behaviour that the member wants to completely abstain form. The middle circle has behaviour that may lead to acting out what is in the inner circle. In the outer circle, members put down healthy behaviour that will enhance their life and speed up their treatment. Priti's outer circle included 'spend time with mom', 'look for a better job', 'get married' and 'learn to play the violin'. Her middle circle only had one line: 'stop drinking'. Her inner circle listed 'stop cheating'.

Another member steps out from inside the 97-year-old red brick church and joins our discussion. A 26-year-old male addict, Sunny says that alcohol and drugs are the two worst enemies of borderline sex addicts. "I think I was 22 the first time I got drunk. I had just lost my mother to breast cancer and my father had already moved in with his mistress--who made it a point to tell me every day that I wasn't 'male' enough because I liked to use bath salts and wore colourful scarves. She said my body was 'too thin' and that no girl would ever want me. So I turned to whisky to drown my sorrows. But the moment I was drunk, all I would crave was sex. I'd go out late at night to clubs and bars and just dangle my BMW car keys in one hand, hoping to attract some gold-diggers. Eventually either a really drunk girl or a whore would come to me. Then I'd take them to a hostel at Mahipalpur [near Delhi Airport], or, if they were really turned on, we would just do it in my car. Sex helped me reclaim my masculinity. I know it works the same way for some women as well--they feel free, liberated and in control when having sex. Sex is emancipation," says Sunny.

He then tells me of the night when sex stopped bringing him relief. "Once a cop caught me with a girl on one corner of Hauz Khas market. I was so terrified that I left her on the street with him, with half her top torn off, and ran away. I don't know what happened to her. Even today when I read about a rape crime in the city, I can't help but feel terribly guilty," explains Sunny. He adds that he started looking for treatment options the very next day after that encounter with the policeman. "It was one thing to have sex to make myself feel better, but another thing to put someone else's life in danger. Sex by itself is not dangerous. But repeated sex can mess up your head and life."

I ask Sunny to explain what he means by that last line, and he says that by morally condemning sex, cities are actually driving more people to become sex addicts. "All erotic pursuits have to be hidden on one hand, and on the other hand there are thousands of opportunities available to hide them. But why must it be so? We still can't openly just pursue sex for pleasure. Somehow, love, marriage and companionship always creeps in because that is what society will accept. I know plenty of people who end up feeling quite guilty for having one-night stands. This is what drives them into depression and loneliness--not the act of sex itself, but the guilt that follows."

Priti joins in the conversation again and adds that the whole thing is just a vicious circle, that once you "use" a person for sex, that person might end up "so hurt" that he or she in turn will use someone else for sex. "There's too much of selfishness going around. We all just want to do what is best for us. And we make choices based on just that. So girls will always want a sexy, nice and rich man. And boys will run after pretty, subservient, independent and rich women. We want it all, but it's impractical. And in the madness, some of us get lost and confused, some of us get so badly hurt that we will do anything to feel better-- even if that includes making love to an obese, bald 60-year-old man," she concludes, refusing to elaborate. She does, however, tell me a little about why she ended up having sex with 120 different men. "I was brought up in a highly conservative and morally righteous family. As a child, if I so much as spoke to a boy, my mother would rush me to church and show me photos of the devil to frighten me. It was drilled into my head that sex is evil. When I moved to London to pursue my higher studies, I was plagued with guilt and shame every time a boy tried to flirt with me. That's why I can never stay with just one man. The minute sex is over, all I want to do is run away... I can't bear to look at the person's face again for fear of feeling ashamed."

The rest of the members arrive for the meeting just then. Together, they all troop into the church to spend the next hour helping one another overcome their extreme desires.


It isn't only Delhi that is home to sex addicts. According to Dr Prakash Kothari, sexologist and founding head of the Department of Sexual Medicine at the KEM Hospital, Mumbai, one in every 20 people are addicted to sex in the country. "The drop in the age of puberty, from 15 to 11 years, lack of knowledge, and easy availability of sex and sexual content has left its mark on the younger generation," he says. Dr Kothari's OPD is still one of the few in the country that caters exclusively to sexual dysfunctions. "Sexual addiction is still a taboo in India," he adds.

Dr Harish Shetty, a psychiatrist at Hiranandani Hospital in Mumbai, agrees that stereotyping sex has only added to the distress of those suffering from hypersexuality. "We are not in the dark ages that sex must be viewed as sinful or evil. Of course, frequent sex with unknown partners has its own repercussions. STD and other sexually transmitted diseases, for example, can ruin both individual health as well as marriages and families. This is why it is so important for addicts to be able to openly seek counselling. They need support and therapy to ensure their mental and physical well-being as well as that of their partners and spouses. If we are providing an atmosphere of titillation for young children and teens, then it is imperative that there should also be means for them to cope with it. Awareness will only improve the quality of life for the next generation," says Dr Shetty.

But it isn't just the lack of open dialogue and awareness that is urging people to seek comfort and solace in sexual intercourse. Social activist and secretary of the All India Progressive Women's Association, Kavita Krishnan, says that a lot also has to do with the kind of expectations society has of men and women. "There is so much pressure on young people to look and behave in a certain manner. Everybody wants to be sexy, but they also want partners who are submissive and 'pure'," she says. When I ask her if people still expect their partners to be virgins, she laughs and says, "When did they ever not? That's one of the biggest problems of our time. We have seen the world and yet remain tied down by outdated morality. On one hand boys want their girls to wear Victoria's Secret, but on the other they only want to take a girl draped in a sari home to their families. Not because they care, but because they have been taught, and sometimes forced to care. And it's not like the pressure on men is any less. There are girls who just want to get married but expect their men to be macho, docile and rich. You can't have both. You can't have sexy and submissive. You can't have docile and macho. People should be allowed to be what they wish to be. This creation of a sexual atmosphere along with high moral standards can be terribly stressful for youngsters," says Krishnan.

And stressful it is. A day after I met with Riya, she rings me up to offer a piece of friendly advice. Having just had oral sex with her boss in the back row of an empty movie hall, she tells me that even though sex is easily available today, one must always keep in mind that there is no such thing as a free lunch. "I always wish that someone had told me that sex isn't the way to get a man's love. The more sex I had, the more pain I inflicted upon myself because it never was sex alone that I was looking for. Trust me, there is no such thing as 'no strings attached'. When you have sex, even with a stranger, you do get attached. You do expect them to at least drop you home or buy you some breakfast. You don't expect a human who has shared your body to treat you like a piece of dirt the next morning. And when this did happen; when I was treated like dirt, there was no one that I could turn to for help or emotional support. If I had told my family or friends that I had slept with 84 men, they would have judged me on moral grounds. Maybe if they hadn't, I wouldn't have become an addict."

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