21:51 | 25th May 2019

Lifestyle: Sex Life

Tue 16 Feb, 2010
By Darren Waite

Is sexual compulsion a sign of mental distress – or do serial shaggers just have bigger appetites?

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When too much is not enough - Sex Life

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Is sexual compulsion a sign of mental distress – or do serial shaggers just have bigger appetites?

It’s like eating peanuts; have one and you want another straight away. You don’t enjoy them; you don’t even like them that much, but they’re there; so you have one after another, and then a few more, just because you can.” Meet Joseph, a bright, articulate and apparently self-composed man in his late 20s, describing the sexual compulsion he has lived with since his teens.

Multiple men
It’s difficult to imagine sexual compulsion on its own as a significant mental health problem.

After all, many gay men have lots of sex with lots of partners. Year on year the Gay Men’s Sex Survey reports increases in the number of gay men who say they have 30 or more sexual partners in a year. Lucky buggers you may say, but getting plenty doesn’t necessarily make you happy. But it doesn’t necessarily make you miserable either. Ford Hickson, senior researcher at Sigma Research, says: “Volume of partners on its own is a poor way of assessing ‘happiness’, In our study, Sexual Health For All, we didn’t find a correlation between high or low numbers of partners and people’s happiness with their sex life.”

But Joseph, who is HIV positive, may beg to differ: “It was only after more than ten years of this repetitive cycle of sex and more sex that I finally received a proper diagnosis of what was behind it: Borderline Personality Disorder “Relationships were impossible to keep going. Most were short and very volatile. I found myself clinging and uncontrollably jealous whenever a boyfriend wasn’t there in person. I’d also feel constantly abandoned when their attention was on something else, even when they went to work or just to the shops.”

Positive strokes
It was only after a suicide attempt that the pieces were put together. Self-harming and suicidal tendencies were the final piece of the jigsaw. This was the first step for Joseph to able to begin to make changes.

“I’ve purposely avoided relationships because I now understand they are a trigger for my BPD; starting relationships, ending them and the bits in between. When I’m looking for someone else to give me the love I can’t allow me to give myself.” Joseph made a conscious decision to stop himself from relentlessly having sex: “I’ve even stopped myself from cruising all the time and taken a break from being online for hours searching for it.” Although Joseph feels happier for these changes, he struggles with how to fill his time and find other ways get the ‘positive strokes’ he used to get from a new conquest.

Risky sex
At a population level, there are fairly obvious sexual health implications when you are having so much sex with so many people. “There’s a clearly proven correlation between higher numbers of sexual partners and greater likelihood of contracting HIV and other sexually transmitted infections,” says Will Nutland, head of health promotion at Terrence Higgins Trust. “The more people you have sex with, the chances are one of them will have an infection. If you have unprotected sex, there’s an increased risk of exposure to those infections.” Of course, if you already have an STI or HIV and are having sex with many men, the greater chance you will pass on that infection, particularly if you’re driven to having riskier types of sex.
Joseph’s personal experience echoes these statistics. “I often wonder if I hadn’t had BPD I probably wouldn’t be HIV positive now. And I wonder who I might have put at risk since I became infected.”

Cruise unlimited
Sexual compulsion and sexual addiction are different ways of describing this behaviour, although the term ‘sex addict’ is more likely to be found in the pages of a tabloid than on the lips of a psychologist. This compulsion doesn’t necessarily involve actually having sex. Cruising or just being seen to be sexually available can be part of the same ‘problem’. “Getting into this kind of pattern doesn’t mean you have a serious mental health disorder,” says consultant psychologist and co-founder of Terrence Higgins Trust (THT), Dr Rupert Whitaker. “But it can be an indicator of other mental health difficulties. Things like depression, low self-esteem, loneliness or feelings of isolation.” “It was important I had a feeling of sexual power; that people found me attractive and that I could exercise that sexual power over them,” says Gareth, a gay man in his late 30s. He has the looks and build to carry this off, but it doesn’t make Gareth happy. “I find I just can’t switch off the cruise instinct. I have to do it, even when it pisses other people off. Like when I’m taking to friends but cruising over their shoulder at the same time. I’ve lost friends because of it.”John is one of those friends. “It’s hard to keep tolerating someone just using you like the straight man in a comedy double act. You’re only there as someone to act as a foil to their cruising. You feel like you’re worthless and just a prop,” says John.

Sex as self-medication
Gareth realised that, despite his good looks and seemingly confident exterior, he needed to repeatedly bolster his self-esteem either by having sex, or at least winning sexual interest from other people.
This compulsion caused his other relationships to suffer, which in turn drove him on with his compulsion as he was no longer getting a sense of self-worth from friendships or other interests. Gareth admits he’s becoming increasingly isolated and depressed because of the cycle he’s got into. He also feels it’s too hard to change and is worried that as he gets older he will find it harder and harder to get the positive buzz from being able to pull men at the drop of a hat. “I’ve just got used to using sex as a kind of medication for what the real issue is. And now I’m lost to know what to do as an alternative.”

Saying n... yes
John went through a different journey. “I felt like crap because I felt compelled to compete with Gareth. “I knew I wasn’t in the same league, but what I didn’t realise was cruising was as much down to technique, practice and confidence as it was to looks alone. “I just saw my mates being able to pull all the time. For years I thought it ‘just happened’ to them and not to me because I was plain Jane.” The more John’s confidence decreased, the less he was able to pull, and this led to a downwards spiral into depression. “I couldn’t afford to knock back anyone prepared to have sex with me. I couldn’t risk saying no to unprotected sex either, in case that meant they wouldn’t want to have sex with me at all. It wasn’t till I was diagnosed with HIV that I got the wake-up call.”

Symptoms and causes
So, too much sex can sometimes be a symptom of undiagnosed mental health problems; sometimes it can be used to mask depression and sometimes it can even cause it. Sexual compulsion can also have a negative effect on those around you. It can be especially problematic if drink and drugs are thrown into the mix. Adam, a mental health support worker with a London borough, who was diagnosed with HIV three years ago and with depression for a lot longer, says it is a familiar pattern. “HIV carries huge stigma as does mental health. A lot of people can’t cope with the powerful feelings that plague them day and night; fears about life expectancy, feeling damaged and anxious. They seek comfort from sex, drugs and alcohol to periodically block out the pain. But as they take bigger risks they often compound feelings of guilt and loneliness until they get to a point where they no longer care.” He thinks one-to-one therapy is the most effective treatment but accepts the NHS does not provide enough.

How much is too much?
The big questions are: how much sex is too much and how many partners are too many? And when does a does a varied sex life end and sex addiction start? We are conscious that any attempt to grapple for answers risk providing headline fodder to tabloid newspapers that are only too happy to cast gay men as amoral and unable to sustain ‘normal’ relationships. The real answer though is probably that there’s no single definition of ‘too much sex’; the ‘line’ will vary from person to person. What’s right for you is different from what’s right for someone else. But to give you an idea, try the test (see box, below right).

All about balance
Many of us will answer yes to a lot of these questions and still not have significant mental health problems. But if you find yourself saying, “Yes, more than I feel comfortable with…’ to most of them, it may mean something is out of kilter in the role sex plays in your life. You may want to take another step and seek some professional help to try to restore the balance.

Christine Mead, head of Wellbeing Services at THT in London agrees counselling can be useful for people with sex problems. “Some clients want to look at ways they can give other parts of life more meaning. Emotional support can be a good way to explore different ways you could try.”

If you are HIV positive and unhappy with your sex life, you are not alone. In a Sigma survey, ‘What Do You Need?’, sex came top of a list of 18 things people living with HIV were unhappy about. By comparison, ‘taking treatments’ came third from bottom. So you might want to keep an eye on the way you use sex. But remember, there’s nothing wrong with a few notches on the bed-post; the only problem is that too many might weaken the bed-frame. PN

Borderline Personality Disorder
Most associate Borderline Personality Disorder (BPD) with the film Fatal Attraction. Joseph’s no bunny-boiler, but he’s the first to admit that it’s had a serious impact on his life and on those around him. Sexual compulsion is often one of a suite of other compulsive behaviours that make up BPD. Risk taking is another which may influence the type of sex you have and where you have it, such as public places where there is a risk of being caught. BPD is typically characterised by patterns of unstable and intense interpersonal relationships; frantic avoidance of real or imagined abandonment and confusion of identity about life choices, goals and career. Uncontrolled spending, binge eating, reckless driving and some aspects of substance misuse are other common compulsions associated with BPD. Mental health charity Mind say it is still a ‘controversial diagnosis’ that can still be missed or misdiagnosed by some less confident professionals.

Answer yes or no to the following:
• Do you pursue sex in inappropriate places and times?

• Has having or looking for sex ever got in the way of important things like your job or seeing family or friends?

• Has your pursuit of sex ever had a bad impact on close personal relationships?

• Do you ever find yourself having sex with people you don’t find attractive simply to avoid going home alone?

• Do you find yourself needing drugs or alcohol to help you deal with getting or having sex?

• Do you find having sex is more about ‘just having another one’ than enjoying the experience?

• Do you find yourself regretting having sex with someone, or at a particular time or place?

• Do you have sex just to make you feel better about yourself?


• Follow the index for its online booklets on Borderline Personality Disorder and Confidence & Self-Esteem

• If you have concerns about sex and mental health, your GUM or HIV clinic is the best place to start looking for local services


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