Three months ago Sam finally hooked his computer up to the Internet. The first few weeks he had fun "surfing the net" for hours at a time, but recently he has found himself spending most of his on-line time in sex chat rooms or downloading different sexually explicit pictures. His wife thinks he's finally able to get back to his undergraduate studies on his computer and is relieved. She has been worried about him ever since his mother died 5 months ago and he stopped studying. Little does she know.

Bart and Beth celebrated their seventh wedding anniversary in June. Everything was fine. Boring, but fine. Six months later, Bart had an affair with his temporary secretary. He felt guilty about it after he fell asleep one night at her place and frightened his wife by failing to come home to sleep. He ended the affair and took his wife on a cruise. Now his wife is pregnant and they're having financial problems. He's longing to see his former secretary and former lover.

Judith married Frank 25 years ago. Their fourth son just left home. She's masturbated a lot more often lately and recently decided she wanted to act out one of her masturbation fantasies: making love to a stranger in front of an open window for people to see. She did it. She enjoyed it, but didn't feel quite satisfied. She did it again, four months later, but soon found herself thinking about doing it almost every day. She restrained herself for a while, then did it again, two months later.

Joe and Deb are very much in love and have been married 12 years. Ever since their daughter was born, he sneaks pornography into the house and watches videos and masturbates when his wife and daughter are out. Lately, he catches himself hoping that his wife and daughter will be gone when he arrives home so that he can masturbate more.

Do any of the people described above sound familiar to you? Do any of them seem to connect to a hidden part of yourself or someone you know? It wouldn't be all that surprising if one of the scenarios did hit close to home. The above descriptions are all signs of sexual acting out behavior. Many people will have thoughts or fantasies of sexually acting out. But what keeps some people from actually acting on these fantasies while others uncontrollably act out risky sexual behavior?

What is Sexually Acting-Out Behavior?

Sexually acting out behavior encompasses a wide variety of behaviors. The most severe can include sexual addiction, a progressive disease, as Patrick Carnes in Out of the Shadows observes. Carnes (1992) explains that sexual addiction has stages of development in which the addict retreats further and further from reality, family, friends, and work but is more and more compelled to pursue the forbidden fruit of secret sex. In the above scenarios, Joe and Sam are probably in the first stages of a sexual addiction. They realize something is wrong in their lives, but they're not sure what it is. At this stage, it may be unclear to them what their problem is--whether it is their secret sexual lives or their real lives, the ones they live with family and friends. In reality, the problem is both. Something is missing in their family and work lives because of hidden problems that they are not yet prepared to see.

Sam, for instance, began showing signs of sexual addiction and acting out behavior when his mother died. She was always working and never gave him much attention because she worked two jobs and drank too much. His wife has qualities similar to those of his mother. She doesn't like sex and he feels deprived of her attention. But because he has great loyalty to them both, he chooses not to address his feelings about the situation. Instead, he seeks attention elsewhere, from people he imagines to be passionately attentive.

Similarly, Joe was overwhelmed by a gory birth his wife endured while he watched in horror. Since that time, he copes with his guilt and sense of repulsion about the scene by doing what he had been doing all his life--ignoring the situation and saying it wasn't that big a deal. The problem is, having sex with his wife is no longer a big deal either. Pornography has filled for him the emptiness of a life gone dry by forcing himself to shrivel significant events into nothing.

Some sexual addictions, such as those to Internet sex rooms, can be difficult to admit and identify. Although addictions of all kinds are difficult to identify, 'net sexual addictions can easily be disguised as computer work or denied by the addict, who tells him/herself they are healthy fun. Additionally, virtual sexual addictions can often become real life sexual addictions, such as when a computer romper decides to rendezvous with several of her/his computer sex pals.

Besides sexual addiction, a wide range of sexually acting out behaviors exist, including voyeurism (otherwise known as Peeping Tom behavior), exhibitionism (otherwise known as flashing), sadomasochism, transvestitism, and fetishism. Any of these types of behavior may be experienced as episodic/infrequent impulsive actions caused by a turn of events in their lives, or, if help is not sought, more compulsive, and eventually addictive actions.

Judith, for instance, has the beginnings of a sexually acting out behavior called exhibitionism. By all indications the episodic behavior could become more compulsive and frequent. She doesn't feel fully satisfied when she does act out; she constantly fantasizes about acting out; she tries to use will power as a means to restraining herself, but fails. The result is that she is acting out more and more frequently rather than less and less.

Complicated Causes

Sexually acting out is a complicated happening in any person's life, as well as in his/her family. For every person, the turn of events which leads him/her to act out is intricately woven into other issues. One issue is often what we might call co-dependency--denying one's own needs and feelings for the sake of loved ones.

Co-dependency may result from an early crossing of sexual boundaries in the person's childhood, such as being sexually abused by an adult, or even by hearing about or seeing a parent's sexual exploits. Faced with a lack of a consistent parental role model for sexual behavior and values, a child can become confused about sexuality and his/her sexual self. Low self-esteem then comes into the picture as a result of the sexually abusive childhood. Even when no sexual abuse occurred, low-esteem can also be a precipitating factor if the person experienced emotional or physical abuse. An absent, unavailable, or destructive parent can also construct the sticky web. Difficulties with social interactions and relationships often befall the person and escalate the impulsive behavior through a poor understanding human sexuality and an over-reliance on myths of sexual expectations. Add a reliance on substances, such as alcohol or drugs, and the web of impulsive desire turns into an out-of-control compulsion for more sexual acting out.

Warning Signs

There can be many warning signs before the onset of an embedded sexually acting-out pattern. In fact, one of the self-help strategies for those who have identified their problem as a sexually acting out issue is to continue to identify desires, wants, and needs, rather than to deny them. Relapse prevention depends on the person observing, accepting, and addressing sexual feelings, rather than religiously and rigidly attempting to deny or avoid them.

Joe, for instance, often notices now that he masturbates more than a few times a week but is not satiated. Judith notices the times she is more and more compelled to act on her fantasies. When she does, she is learning not to ignore the fantasies, but to ask herself, what the fantasies are telling her she needs and how else she can address that need.

Self-help Strategies

Many people end up trying to deny they have a sexual acting problem because they erroneously believe it is not treatable or they feel too much shame. The first step in recovery is to confront their denial about the situation and admit their problem--to someone, such as a lover, a therapist, a 12-step group, but most importantly to oneself. Partial treatment always includes self-help techniques designed to instill more hope, and to soothe the yearning inside that has been ignored for so long.

Reading and learning about sexual acting out can alleviate much of the shame and guilt that can accompany the urgency of wanting to act out again. Dr. Patrick Carnes' book Out of the Shadows and Dr. Ralph Earle and Dr. Gregory Crow's book Lonely All the Time can help bring people out of their isolation and sense of shame about their acting out.

Similarly, self-help and twelve step groups, such as Sex and Love Addicts Anonymous and Sex Addicts Anonymous can help people help themselves by finding that they are not alone in their loneliness and need. These groups encourage sufferers to keep the focus on themselves and to listen, accept, and soothe the pain of sexually acting out. Additionally, because sexually acting out is such a complicated web of cause and effect, combined treatment of self-help techniques with support groups, as well as a therapist with specific training in these matters, is highly recommended.

1/19/98

Dr. Mary Ann Aposhian is a therapist with extensive experience running groups and seeing people for sexual acting out issues at the San Jose Marital & Sexuality Centre.

Alvin Cooper, Ph.D., is the Clinical Director of the San Jose Marital and Sexuality Centre and runs the training program of the Counseling and Psychological Services at Stanford University. He can be reached at (408) 248-9737.