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Has Anything Changed in What We Know About Satyriasis from Its Original Identification of the Disorder

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Has Anything Changed in What We Know About Satyriasis from Its Original Identification of the Disorder AMERICAN ACADEMY OF CLINICAL SEXOLOGISTS HAS ANYTHING CHANGED IN WHAT WE KNOW ABOUT SATYRIASIS FROM ITS ORIGINAL IDENTIFICATION OF THE DISORDER? A DISSERTATION SUBMITTED TO THE FACULTY OF THE AMERICAN ACADEMY OF CLINICAL SEXOLOGISTS IN CANDIDACY FOR THE DEGREE OF DOCTOR OF PHILOSOPHY IN CLINICAL SEXOLOGY BY JOE KORT ORLANDO, FLORIDA DECEMBER, 2009 For my partner, Mike Cramer Who helps me to dream and make my dreams come true! ACKNOWLEDGEMENTS To my friend and colleague, Tammy Nelson, who encouraged me to become a sexologist and guided me in the right direction. To my business coach, Lynn Grodzki, for helping me become clear on this topic and my work with clients. To Dr. William Granzig who helped me choose this topic and open my mind to alternatives to helping people with hypersexuality and out-of-control sexual behavior. To Dr. Rhonda Fine who helped me refine my outline and include sources and resources for this paper. My gratitude to the American Academy of Clinical Sexology program and its faculty who taught me about healthy sexuality. iii ABSTRACT This study explores the question, “Has anything changed in what we know about satyriasis from its original identification of the disorder?” This question arose around whether anything new has been discovered or used in the treatment of satyriasis. From the original writings it is found that those with hypersexual behaviors risk legal consequences as well as losing their reputation and social graces. Krafft-Ebing was the first to write about this saying that, “This pathological sexuality is a dreadful scourge for its victim, for he is in constant danger of violating the laws of the state and of morality, of losing his honor, his freedom and even his life” (Krafft-Ebing 1965). This is still what seen today in the literature for those suffering from hypersexuality. Since the first reports in the psychological and sexological literature there continues to be an absence of scientific evidence explaining how or why people become afflicted with hypersexuality. Many anecdotal theories exist about the etiology and treatment of hypersexuality with each agreeing that the sexual acting out involves managing anxiety and becomes out-of- control to the person suffering with the problem. However, after it is identified and treated there is controversy around what healthy sexuality is for the client. It is often based on the therapists bias and judgments and not the clients. The findings of this study may be used for therapists in both the fields of sexual addiction and sexology to explore possibilities in developing one or more healthy recovery models after the sexual behavior is not longer out-of-control. iv CONTENTS ABSTRACT ................................................................................................................................... iv PROBLEM STATEMENT ............................................................................................................. 1 PURPOSE OF STUDY................................................................................................................... 2 HYPOTHESIS ................................................................................................................................ 3 CHAPTER 1: REVIEW OF LITERATURE ................................................................................. 4 History......................................................................................................................................... 4 Terminology ................................................................................................................................ 5 Incidence and Prevalence of Satyriasis ....................................................................................... 9 Etiology ....................................................................................................................................... 9 Psychodynamic ..................................................................................................................... 12 Trauma Model ....................................................................................................................... 13 Hypervigalence and Hyperarousal ........................................................................................ 17 Dissociation........................................................................................................................... 18 Sexual Abuse ........................................................................................................................ 18 Covert Cultural Sexual Abuse of Gay Men .......................................................................... 20 Cultural Influences .................................................................................................................... 26 Differential Diagnosis ............................................................................................................... 30 Paraphilia .............................................................................................................................. 31 Stage Five of Coming Out Gay ............................................................................................. 34 Axis I Disorders .................................................................................................................... 35 Personality Disorder (Axis II) ............................................................................................... 35 Attachment Disorders .......................................................................................................... 36 Treatment Models ..................................................................................................................... 38 Sexual Addiction and Compulsivity ..................................................................................... 38 Carnes’ Anatomy of Sexual Addiction ................................................................................. 39 Sexual Addiction Inventory .................................................................................................. 40 Criticisms of Sexual Addiction Model ................................................................................. 43 Compulsive sexual behavior (CSB) ...................................................................................... 49 Criticism of the Sexually Compulsive Model ....................................................................... 52 Sexual Impulse Control Disorder.......................................................................................... 53 Paraphilia-Related Disorders ................................................................................................ 54 Dual-Control Model .............................................................................................................. 55 Treatment for Hypersexuality over the years............................................................................ 56 CHAPTER 2: CONCLUSIONS, IMPLICATIONS, RECOMMENDATIONS ......................... 63 Conclusions ............................................................................................................................... 63 Implications............................................................................................................................... 64 Recommendations ..................................................................................................................... 69 SELECTED BIBLIOGRAPHY .................................................................................................... 74 v PROBLEM STATEMENT There is an absence of a healthy recovery model within the field of sexual addiction and compulsivity. The absence of evidence based treatment leaves the field dependent on antidotal thoughts and clinical impressions. 1 PURPOSE OF STUDY This paper is based on a retrospective consideration of hypersexual behavior over the years starting with its original name Satyriasis. The focus of this paper is confined to nonviolent and non-offending hypersexual behaviors and hence does not include information about sexual offenders and legal matters related to such. The purpose of this study was to explore the etiology, treatment and recovery process of those with hypersexuality since it was first labeled satyriasis. This study will add to the literature in developing a treatment plan which can be generalized and use with individuals suffering with hypersexuality. 2 HYPOTHESIS Is the treatment for satyriasis more effective today than historically? 3 CHAPTER 1 REVIEW OF LITERATURE History The origin of the word satyriasis comes from the Greek mythological word satyr which were spirits consisting of half-man, half beast (Encyclopedia Britannica 1937) In the Oxford Classical Dictionary (2 nd Edition) a satyr is defined as, “’spirits of wild life in woods and hills’, bestial in their desires and behavior, and having details of animal nature, either of a horse or of a goat.” Satyrs historically were young and were half human half goat and later had elements of human and some details of a horse (Hammand and Scullard 1970). The Oxford English Dictionary in 1989 2 nd Edition defines satyr as part of a myth in which he is “one of a class of woodland gods or demons, in form partly human and partly bestial……” The word satyr itself is Greek for membrum virile or penis as the mythical creatures were prone to lust (Wahl 1967). Reportedly satyriasis has been present in every society since the sexology
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