Sex addiction involves a high, tolerance, craving, dependence, withdrawal, fascination, compulsion, secrecy, and a personality change. This paper will discuss motivates of people to become sex addicts. The role of psycho dynamically based psychotherapy is also been discuss as useful approach in identifying and addressing the developmental problems that occurred in a person’s childhood as an effect of abuse. Moreover, the four major schools of thought about addiction are the self-medication hypothesis, the stress reduction theory, the cognitive/behavioral thesis, and the disease model has also been discussed.An addiction is a dependence to an activity, person, or thing that is characterized by disproportion, lack of control, loss of power, distortion of values, inflexible centrainess to the person’s life, unhealthiness, pathology, chronicity, progression, and potential fatality. More simply put, an addict is a person who cannot say “no.” A sex and love addict cannot say “no” to his or her desires to have sex or get into a love relationship. An addict is a person whose thoughts and behaviors are causing problems but who cannot stop them (Book, 1997). However, Sex and love addictions are not often seen as severe or, at least, not as obviously dangerous as drug addiction or cigarette smoking. This is far from the truth. The arrival of AIDS has made unsafe sex potentially lethal. Moreover, love and sex addicts have a high rate of suicidal ideation, and often are admitted to psychiatric hospitals for depressions convoyed by suicidal thoughts or actions. Even driving as under the influence of a sexual or love addiction can be hazardous if not fatal.The Diagnostic and Statistical Manual for psychiatric disorders does not list sexual addiction as a specific disorder, but it has been usually recognized as a problem in the psychiatric and addiction literature for several decades.Compulsive sexual activity meets the criterion for addiction when it involves a loss of control over the behavior and persistence of it despite negative consequences. The particular type of sexual activity may diverge and include various behaviors. Some of these behaviors, such as voyeurism and fetishism, are addressed as sexual disorders in the diagnostic manual, and there is some overlie between sexual addiction and other sexual disorders (Knauer, 2002).The pervasiveness of sexual addiction in the general population is thought to be between 3 and 6 percent and is more common in men than in women. Sexual addiction frequently coexists with substance addiction, mainly to cocaine. The prevalence of sexual addiction may be as high as seventy percent in cocaine addicts entering treatment. While unrecognized and untreated, it is a common cause of deterioration of the cocaine addiction.“Contrary to enjoying sex as a self affirming source of physical pleasure, the addict has learned to rely on sex for comfort from pain for nurturing or relief from stress” (Carnes, 1991, pp 34).Sexual abuse or incongruously seductive relationships with adults are common findings in the childhood histories of sex addicts. Sexual abuse damages a child’s sense of self and the capability to self-regulate painful emotional states. It also predisposes the child to view sexual activity as a coping approach. Women with addiction to alcohol or drugs have a higher incidence of sexual addiction than other women, and the pervasiveness of sexual abuse experienced in the past by women addicts who are in treatment centers has been estimated at about eighty percent.Treatment of sexual addiction involves a mixture of approaches. Twelve-step recovery groups are available and provide helpful support. Sex Addicts Anonymous is one such group. Although these groups are usually closed to the public, participation can be gained through referral from a treatment center or a personal interview. Cognitive behavioral psychotherapy is mostly helpful, assisting the individual in identifying core beliefs and basic assumptions that inspire behavioral choices and allowing for conscious changes in behavior. Psycho dynamically based psychotherapy is often useful in identifying and addressing the developmental problems that occurred in a person’s childhood as an effect of abuse.One of the significant characteristics differentiating addicted people from normal people is the aspect of motivation. Someone who depends on sex or love to survive is motivation. In other words, a sex and love addict feels that he or she cannot live without constant involvement in sexual or loving thoughts, feelings, or behaviors. Normal people may want love and sex in their lives to greater or lesser degrees, but they also know that they can live without it for a while (Schneider, 1994).The concepts of human motivation in addictions came about in regard to alcohol and drug addiction. Motivation was considered to mean physiological dependence. That is, alcohol, narcotics, and central nervous system depressant–type drugs form physical dependence. Our bodies not only develop an acceptance for these chemicals, but actually become dependent on them in order to function on the whole. The absence of a regular dose will produce a withdrawal syndrome that is repulsive and, for some chemicals, potentially life-threatening. Thus, an alcoholic will “need” a drink in order to avert symptoms like agitation, complexity concentrating, anxiety, problems eating and sleeping, seizures, and hallucinations such as delirium tremens.Human motivation is a very important and often overlooked aspect of an addiction. After all, this is the thing that gets the person keen in the first place. There is a “good-feeling fix” with which the person falls in love and that he or she then wants more and more (Freeeman-Longo, & Blanchard, 1998). For some addictions, the motivation is rather obvious; for example, the intoxication of a drink, the “rush” of cocaine, or the “mellow” feeling of marijuana. The “fix” an addict gets from nicotine or caffeine is not so authoritative but can be just as habit-forming. We have even been capable to observe such a thing as a “runner’s high” (Goodman, 1992). All these good feelings are the result of chemical changes in the brain–some ingested and some produced by our own bodies. Some of us just enjoy these good feelings and do not get hooked, while others (about 10 percent) get addicted to them.What is it on which love and sex addicts get hooked? Some people might think this is a silly and obvious question, but it is not. Surely the pleasure of a sexual orgasm is part of what the addict seeks, but orgasm is a comparatively brief experience. Most people cannot protract a multiply orgasmic state, so there has to be more that the addict seeks. In fact, there is. Most sex and love addicts spend a good deal of time in fantasy, throughout which they are in a state of mild provocation. In this state of preoccupation, their excitement can grow and their pleasure can increase. Most get quite good at developing and sustaining this motivation.For sex and love addicts there is an explicit amount of physical tolerance implicated in an escalating addiction. The chemicals are not ingested from a source outside the self but are instead produced completely from within. Our bodies have, essentially, two nervous systems, the considerate and the parasympathetic. The sympathetic nervous system wakes us up, turns us on, alerts us, arouses us, and arouses us. It is our adrenalin system. It makes us feel alive and ready to engage. On the other hand, our parasympathetic nervous system calms us down, puts us to sleep, assists us to relax, turns us off, and lets us extricate from the world. It is our soothing system, and makes us feel peaceful and content.In a sex and love addiction, the addict is overusing the sympathetic system. The quest for sexual motives produces adrenalin and excitement (Kalichman, et al 1994). It is like driving your car with the accelerator pedal to the floor. As you get used to this pace, it becomes a common, normal, daily feeling. In other words, tolerance develops. You need more speed to create more enthusiasm. The love and sex addict is in the same bind. He or she must find ever more ways to be turned on. An exhibitionist can find that exposing him- or herself is not enough, and may come to do it more often or in riskier situations. A love addict can learn to tolerate more and more danger and physical abuse because he or she feels the force of the relationship more when there are more common conflicts and reconciliations. The fights are worse, but making-up is better.As the sympathetic nervous system is being overtaxed, the parasympathetic system is also working overtime. After the addict has over enthused him- or herself, it takes more and more to calm down. Sleep, then, can become a problem. At one point one orgasm can have been enough to bring on a sense of relief and relaxation, but over time, the addict can need more and more orgasms or may start using other ways of inducing sleep like ingesting drugs or alcohol. Two addictions, that is, chemicals and sex, can then interrelate with each other and produce increasing tolerance in both areas.Addicts who are physically dependent on chemicals need chemicals (1) to feel “normal” and function, and (2) to put off the symptoms of withdrawal (Schneider, 2000). More recently, it has been realized that people who are chemically dependent on drugs such as stimulants (amphetamines and cocaine) and hallucinogens (LSD and marijuana) experience these same dependencies (namely, needing the drugs to feel “normal” or function and to evade withdrawal), even though the drugs on which they are hooked are usually not considered physically addictive. We no longer see a difference between a heroin addict and a marijuana addict in terms of their prospective for being dependent on their drug of choice. In fact, the Surgeon General recently compared cigarette addiction to heroin addiction, although there are also obvious differences.Consequently, it should not be too hard for us to see that sex and love addiction entails a motivation that is both physical and psychological (Schwartz & Brasted, 1985). The physiological motivation is similar to the physical dependency of cocaine addicts; in other words, the addict “needs” the drug, activity, or person so as to feel “normal” and function, and the fix postpones withdrawal symptoms like depression or complexity sleeping. Sex and love addicts have rearranged their bodies’ normal patterns of motivation and relaxation to the point where only a sexual or romantic encounter will avert the feeling of discomfort that signals the beginning of withdrawal and loss of functioning.Examples of motivation for sex and love addicts proliferate. In terms of physical dependence, many sex addicts have programmed their bodies to the point where they cannot fall asleep without an orgasm. Similarly, numerous love addicts cannot sleep without a romantic fantasy of some kind. Sex addicts can experience agitation and anxiety that can increase to the point of a panic attack if they sense that they will be incapable to get their sexual fix. A sex addict said he did not feel normal unless he was involved in some intrigue or affair, although he desperately wanted to have a “normal,” committed relationship. Love addicts can feel dizzy, incapable to concentrate, and nauseous or crampy if they get that their love dependency is threatened (Freeeman-Longo, & Blanchard 1998).Psychological motivation involves being “unable to live” without thoughts of sex or the love object; without patterns of friendships, leisure activities, and sex toys; without the exhilaration and so-called freedom of the addictive lifestyle; without the glamour and stimulation; and without the lying and confidentiality. In most recovery programs, a great emphasis is placed on changing “people, places, and things” linked with the addiction.The purpose of this sort of guideline is to help break the psychological dependency. Most addicts are extremely resistant to suggestions like these and find many ways to justify holding onto old patterns and connections, arguing, for example, “They really are friends,” “I never had sex in a bookstore,” or “I like to collect things like these magazines for research for my teaching.” (Freeeman-Longo, & Blanchard 1998).The love and sex addict’s psychological motivation is quite strong; additionally to the physical withdrawal symptoms he or she may have, there will be profound and powerful psychological withdrawal symptoms as well. The psychological withdrawal symptoms comprise boredom, depression, anxiety, suicidal ideas, guilt, and shame. The addict does everything in his or her power to avoid these feeling states as he or she has no way of coping with them other than acting out sexually or romantically.Addicts have little tolerance for monotony due to the high level of excitement and secrecy with which they are implicated on a daily basis. They are terrified of the emptiness and dysphoria that will set in if they are not implicated with their addiction, and they fear the feelings of worthlessness and guilt that will come over them. They have had periods of self-restraint before, and are familiar with all these psychological complications (Carnes, 1999).However, letting go is hard. One love-addicted woman who came who held onto a relationship with a man with whom she had been involved because “We are such good friends.” Rather than facing the pain of having to renounce someone that she cared about, she chose to make herself vulnerable by keeping the friendship alive. She restructured her behavior, and felt justified because the man was a traveling salesman and was hardly ever available. However, once when he was available, she had a slip that shook her self-esteem and confidence. She was capable to avoid a full-blown relapse by telling her sponsor about what had happened, but still she wanted to hold on to this idealized “friendship,” and was not willing to admit how she was being mistreated, and how she was participating in her own victimization.Another addict, whose addiction had had reflective effects on his life due to his compulsive pedophilia, was extremely resistant to any suggestions that he was overly dependent. He maintained a strong attachment to his parents, and frequently visited them on weekends. He held on to a mortifying clerical job that did not agree to him to grow because he was afraid to go on job interviews. One weekend, on his way to visit his parents and play a tennis game with a friend, it began to rain. In spite of six months of sobriety, he ended up wandering around in a shopping mall and having anonymous sex with someone in the men’s room. Then he went to a pornographic bookstore. Afterwards, he felt awful at losing his half year of sobriety. He resented the understanding that he had set himself up by his pattern of refusing to work out his dependency issues. He also resisted using the phone to ask for assistance when he felt like acting out. Thus, he was avoiding developing healthy dependencies as holding on to his unhealthy dependencies. This pattern of keeping up old coping styles makes addicts susceptible to slips and relapse. Breaking the psychological dependency is, then, a necessary part of the recovery process.Most Americans view sex addiction as a disease. This has not always been the case and, actually, many experts in the field of sex addiction see this change as a major improvement in terms of approach toward and treatment of sex addiction. There are people who object to the idea of sex addiction as a disease. They claim that the label is at best misleading, and at worst in fact destructive, and an impediment to helping people gets better. This is not the place for a full-fledged review of the argument, but it seems worthwhile to at least review some of the issues as it can help addicts and those who work with and care about them to have some conceptualization concerning what an addiction is.The four major schools of thought about addiction are the self-medication hypothesis, the stress reduction theory, the cognitive/behavioral thesis, and the disease model. Simply put, the self-medication hypothesis states that addicts have a fundamental psychological, emotional, or mental disorder that they are treating themselves with a medication that they have discovered on their own. Their basic problems, then, are seen as the cause as well as the driving force behind the active addiction. To treat an addiction, a professional would have to facilitate the person identify and fix the underlying problems. Once the roots of the addiction have been worked on, the addictive behavior will no longer be needed by the addict and will be redundant (Goodman, 1992).The stress reduction theory of addiction assumes that the addict uses addiction as a way of coping with the stress in his or her life. Since all of us experience stress, we have all found coping means that are more or less successful. A person’s use of addiction is a poor and rather dysfunctional method of coping, and needs to be replaced with more adequate and suitable means of coping with stress. When this new learning has been accomplished, the addict will have no more require for the addiction.The cognitive/behavioral approach views addictions as over learned responses. Actually, behavioral therapists have been usually unconcerned with the origin of the behavior, and instead have focused on changing dysfunctional behavior (Freeeman-Longo, & Blanchard, 1998). The social learning school believes that behaviors are learned. Cognitive therapists believe that our thought processes direct our emotional as well as behavioral states. The combination of cognitive and behavioral treatment of addictions observes the thinking and subsequent emotional responses that create obsessive, over learned behavioral reactions. They then set up new modes of thinking that are linked with new behaviors so that addictive behaviors will not be resistant.The disease model looks at addiction as an illness. There is a biological/ medical basis to this view in that biochemistry and genetics are seen as fundamental causes of addictions. The organism is considered sick and out of homeostasis. There is an etiology, a set of symptoms, an expected course, a treatment, and a response to that treatment which can be particular for any disease, including the disease of addiction.