What Does Attachment Have to Do with Out-of-Control Sexual Behaviour?

By Faisandier, Karen M.; Taylor, Joanne E. et al. | New Zealand Journal of Psychology, March 2012 | Go to article overview

What Does Attachment Have to Do with Out-of-Control Sexual Behaviour?


Faisandier, Karen M., Taylor, Joanne E., Salisbury, Robyn M., New Zealand Journal of Psychology


Although out-of-control sexual behaviour (OCSB) is not a new phenomenon, Carnes (1983, 1989, 1991) introduced it as sexual addiction nearly 30 years ago. Since then, controversy and disagreement has characterised the field, and almost 30 terms with over 100 definitions have been proposed (O'Donoghue, 2001), including sexual impulsivity (Barth & Kinder, 1987), sexual compulsion (Coleman, 1992), and hyper-sexuality (Reid, Carpenter, & Lloyd, 2009). The various merits and drawbacks of these and other monolithic terms and definitions have been enthusiastically debated (Gold & Heffner, 1998; Goodman, 2001). In recognition of the current lack of empirical consensus over these terms and their meaning, the all-encompassing term out-of-control sexual behaviour (Bancroft & Vukadinovic, 2004) has gained favour as acknowledging diversity in the experiences of sexual behaviour problems, rather than focusing on certain features such as addiction (Reid & Carpenter, 2009). This is important because research indicates that OCSB is comprised of diverse motivations, experiences, and behaviours (Levine, 2010; Reid & Carpenter, 2009). For example, Levine (2010) reported that 75% of a small sample of 30 men presenting with OCSB over five years did not meet criteria for sexual addiction. Instead, 25% were classified as having a paraphilia while a further 50% required an alternative conceptualisation to addiction as they displayed a wide spectrum of sexual behaviour (e.g., masturbating to pornography, visiting strip clubs), which caused distress for their partner, but did not include addictive features. Reid and Carpenter (2009, p.294) also found no evidence of addictive tendencies in 152 treatment-seeking men, concluding that models offering a "homogenous conceptualisation" of those with sexual behaviour problems can potentially overlook vital nuances in their experiences.

These experiences can include partner sex, masturbation, or use of pornography; multiple relationships or affairs, anonymous online sexual relationships, and phone sex; exhibitionism, voyeurism, or other fetishes; and dangerous or illegal sexual practices, although this list is not exhaustive or mutually exclusive (Hall, 2006). Features of compulsivity or addiction might be absent (e.g., increased time spent engaging in or recovering from the behaviour) when there are infrequent infidelities. Yet the behaviour still risks physical health problems such as sexually transmittable infections, interpersonal problems such as relationship breakups, and distress for the partner and/or children (Black, Kehrberg, Flumerfelt, & Schlosser, 1997). Alternatively, impulsivity might be absent in the case where an individual premeditates or plans the act over a period of time (Levine, 2010). This particular example shows that even the term OCSB is limited in cases where there is good impulse control, yet distress and/or impairment to functioning still occurs.

One important limitation when attempting to define OCSB involves how the individual, generational, and cultural context shapes the perception of these experiences as problematic or not (Coleman, 2007). Typically, individuals whose sexual behaviour deviates from the norms of their society are labelled or pathologised (Levine & Troiden, 1988). Furthermore, the type of sexual activity can moderate the effect of sexual frequency. For example, Langstrom & Hanson (2006) found that high frequency of sex with a stable partner was associated with improved psychological and psychosocial functioning, while high frequencies of solitary or impersonal sex were related to problematic psychological and psychosocial functioning. Therefore individual, cultural, and relational factors must be considered when determining OCSB.

Despite these unresolved issues with defining problematic sexual behaviour, there are two generally accepted factors for determining if sexual behaviour is a problem (Goodman, 2001). …

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