Another Kind of Addict

Are these people unusually egotistical?
There's a lot of narcissism and arrogance with people like this. In therapy you have to help them confront that. They feel like the world revolves around them. But that's really a shield, a protection for an ego that was damaged as they grew up.

Does the kind of guy you were talking about succeed with women, if everyone isn't actually hitting on them as they think?
These kinds of men do get women because they're smooth talkers and they can be very charming. They make women feel like they're the only one, even when she's not. Secrecy is very important—that's a big part of the thrill for them.   

That risk-taking thrill sounds like some of the politicians who have been caught up in sex scandals.
Yes. People wonder why [those sorts of] men … would risk everything. What it is, is that they get addicted to the adrenaline flow. The riskier it gets, the more adrenaline they get. Like all addictions, the more they get, the more they need. It may seem stupid from the outside, but that's not what someone is thinking when they're caught up in the addiction cycle. It starts with a preoccupation—they're thinking and thinking of whatever their sexual compulsion is. Then they move to the next level of the cycle, which we call ritualization. It's whatever activity they do that they think will help them find what they're addicted to. Once they get to that second stage, they're probably going to go all the way. They'll get in the car and drive toward a strip club or the street where they pick up prostitutes. Afterwards they may be very ashamed. But eventually the cycle will start all over again.

What makes them seek treatment? 
Usually, it's because they get caught. Or the addiction is making it impossible for them to function.

How do you help them stop that cycle of addiction?
We try to help them stop when they are in the thinking-about-it stage, the preoccupation stage. That's when we say, "You have to call your sponsor." The other thing is that there have to be no secrets, not from their sponsor and not from their significant other. It's part of the intimacy work they have to do with their partner.

That sounds like Alcoholics Anonymous.
The treatment is somewhat different from alcoholism or other addiction treatments, yet very much the same. The first step is to acknowledge the problem. Then, if they work the 12 steps to recovery, they will go to 90 [group treatment] meetings in 90 days. It's important that they get a sponsor, too. That's the person you call for the purpose of helping you not act out sexually, and also help[ing] you work through the stresses and anxiety that lead to acting out sexually. Sometimes treatment means checking into a rehab center so [patients] can get out of their normal environment and habits.