Anita Rao
There is one quote about sex that I think about often. It's from sex educator, Emily Nagoski.
Emily Nagoski
It's not how much you crave it, how often you do it, where you do it, who you do it with, what positions — it's whether or not you like the sex that you have.
Anita Rao
That, she says, is how you measure sexual wellbeing. Emily said that to me more than three years ago in our first episode of Embodied, and it made me realize how often I turn outward for information about my own body. Instead of focusing on how much sex I want to have and what in particular feels good to me, I get caught up in thoughts about what's normal — and what it means if that's not what my own sex life looks like. What I know about looking outward for these answers is that while it gives me a lot of information, it doesn't give me any more clarity.
This is Embodied. I'm Anita Rao.
There is nothing simple about human sexuality. Our preferences, behaviors and desires are shaped by a confluence of things: genetics, socialization, personal history, religious and political context and so on. For folks who are struggling with their relationship to sex, figuring out where to turn can mean confronting complex layers of assumptions and judgments about their behavior. This is especially true with hypersexuality.
Krista Nabar
Hypersexuality is the term that a lot of folks in the medical community use. Other terms that you'll probably have heard would be sex addiction or compulsive sexual behavior. And ultimately, it means people who engage in too much sex or sexual behavior despite having negative consequences.
Anita Rao
That's Krista Nabar. She's a psychologist and sex therapist who's been steeped in this work for a decade, and she will be one of the first to tell you that there is a lot of disagreement in her field about hypersexuality. In addition to disputes over what term to use, there's debate on how to diagnose it and even whether or not it actually exists. For some practitioners and patients, the addiction model is helpful for describing the experience. But Krista says that lens also has some shortcomings.
Krista Nabar
There is some research that shows that there are changes that happen in the brain that contribute to sex addiction. But I think part of the problem with the sex addiction community is the over-focus on what's happening neurologically and not really focusing on what's happening contextually, or the big picture of why folks might be using these behaviors. I think that sex addiction tends to over-focus on sex, ironically, and not focus on the bigger picture.
Anita Rao
In Krista's practice, the Carolina Sexual Wellness Center, focusing on the bigger picture means taking a sex-positive approach to treatment and letting her clients lead the way.
Krista Nabar
Some people use checklists and make the determination that certain behaviors are healthy and certain behaviors are not healthy. That is not, in my opinion, a sex-positive approach, because I think it tends to pathologize behaviors that could be very normal and healthy for some people. You know, some people are having a lot of sex, and they feel perfectly fine about it, and it fits well into the context of their relationship, and there's, just, really no issue to be had. And someone else could be having that same amount of sex, but have a lot of shame associated with that and have the belief that there's something wrong with them — there's something wrong with their sex drive. And so, it can be difficult to really tease out when is it a problem and when isn't it.
Treatment is really individualized for folks. And part of my job is to really help people understand what is making them think about this as a problem, how are they identifying this as a problem? What information are they using? And try to understand those underlying assumptions that they're using in order to make that determination. And sometimes there's some challenging involved. So I think that, you know, really helping clients tease through for themselves what's actually problematic and what is just a function of what society or — or church or social groups are telling you about your sexual behavior.
Anita Rao
So you say there's this understanding in the field of trying to better understand — or there's an attempt in the field to better understand what is going on in folks' brains to better understand hypersexuality, but the popular culture and media narratives are missing a lot of that nuance. And there is often a conflation between hypersexuality and illegal boundary crossing behavior like sex offending. So why did these get confused as synonymous?
Krista Nabar
It's important to think about these two groups as distinct groups. If we think about folks who are dealing with sex addiction, they are usually crossing their own sexual boundaries; whereas folks who have engaged in sex offending behavior are crossing other people's sexual boundaries in addition to crossing their own sexual boundaries. But I do think that, as a society, we just have a really ambivalent relationship with sex, and there's a lot of negative connotations and negative associations that people have. And so they just put them both in the cultural "bad sex" box, and they don't feel the need to go and explore it any further. It just makes things easier — we can cognitively organize what's happening — if we just demonize both groups and put them in that box.
Anita Rao
Because of this association that exists — and it's conflation that exists — is there a fear that you see in folks who are experiencing hypersexuality that they're going to be seen in a certain way or associated with a certain behavior if they speak up about this?
Krista Nabar
Oh, absolutely. There's a lot of shame that these folks experience around the behavior, whether the behavior is illegal or boundary crossing or not. You know, just looking at how our society views sex in general, anytime there are transgressions related to sex, we definitely see people judge other people when it comes to that stuff, in a different way than they would if they had issues related to some other issue — some other addiction, something like that. So yeah, I mean, I think it's absolutely true that — that there is fear. And I think folks really — it takes people a long time to get to the point where they're ready to actually seek help. You know, usually people have been struggling for years before they actually show up at my doorstep.
Sue William Silverman
My name is Sue William Silverman. I live in Michigan, and I am the author of the memoir "Love Sick: One Woman's Journey Through Sexual Addiction." My father sexually molested me growing up, and because I assumed he loved me, I really confuse sex with love and love with sex. When I grew up and I went away to college, I had affairs with married men — or just affairs with any man who really was not appropriate — you know, they were just emotionally unavailable. And later, when I married, I continued to have affairs. I mean, I acted out, went from, kind of, man to man, sort of a serial adulterer. The addiction really wasn't so much about sex. I wasn't particularly out looking for sex. I really was out looking for love. I wanted one of these men to love me. It was really, kind of, sad and a really desperate struggle, because I really believed that if one of these men wanted to have sex with me that that meant that they loved me.
Anita Rao
That was author Sue William Silverman. We're going to hear more of her story later. Just as there's no widely agreed upon diagnosis for hypersexuality, there's no one reason it occurs. Sue traced her problems with sex back to childhood trauma, but it can also stem from a mental health condition, self esteem issues or diseases and illnesses that affect sexual control in the brain. Writer Erica Garza's sex addiction began at an early age for a few different reasons.
Erica Garza
Early messages I received about sex, both from my parents who were Catholic Latinos and also from school — I went to Catholic school from kindergarten all the way through up until college — and the messages I got about sex were that it was something that was so dirty you don't talk about. Or it was something that happened between a man and a woman who loved each other — for one reason, that was to make babies. So when I started to have sexual interests and feelings — which was quite young, I still have journals from when I was, like, 7, and I had lists of boys I was lusting after. And then, like, pictures I had drawn, and of course, those interests became more complex over time — I started to have attraction to girls.
And then, when I was about 12, I started masturbating. And during all that time, I just felt like I was doing something dirty and something wrong, because this was not something that anyone was talking about. And so, you know, I think all of that is really normal for a lot of people. My — my wanting to masturbate a lot when I first discovered it, but what turned it into something problematic for me was that around the time that I discovered masturbation, I was diagnosed with scoliosis. And so, I had to wear this big bulky back brace to school, and I started getting teased and bullied. And I found that if I could masturbate, then I didn't have to think about those things — it sort of gave me an escape route that was accessible at any time, any place. And because pleasure had always been tied up with shame, I was giving myself a dose of pleasure and shame all the time. And I started hiding those things, and I felt like I wanted to stop all the time, but I didn't know how to stop. And it became secretive.
And all of this was happening around the same time that the internet was coming out. And so, anytime I feel like I may have pulled away and dealt with my emotions, which were becoming more complex over time, I just would tune into the internet instead and find some material to keep me engaged and keep me coming back. And that persisted for a long time, it became harder to untangle — the more sophisticated the Internet became, and the more sophisticated my problems became.
Anita Rao
Yeah, and I mean, this was that — you really, kind of, encapsulated your, your childhood experience. And as this, you know, you got older, you were a teenager, this continued. And then, in your 20s, you were, kind of, a world traveler. And you started to notice that this association between shame and sex was really shaping the kinds of sexual experiences that you sought out and that you engaged in. And I'd love for you to give us, maybe, an example of that that's particularly resonant or memorable for you.
Erica Garza
So I would often look at the kind of porn that, sort of, made me feel disgusted afterwards. And so I would reach for porn in which I saw women being degraded, being belittled. And once I found something that was really shocking to me, I would try to find something harder after that. And I could spend hours just trying to find the perfect clip and trying to top that clip, and that started to leak out into my relationships with men. I would try to find men who made me feel degraded, made me feel used. And at the same time, I was using them to make me feel that way. So it was this pattern of using and trying to find that hit of shame and pleasure that I had found the very first time I masturbated, because I didn't know how to feel pleasure without the shame. And so I would try to manifest it every single time I was having a sexual experience.
Anita Rao
These sexual behaviors followed Erica through college and into her late 20s. It wasn't until she was nearing 30 that she committed to looking at her sexual problems head on. She describes that decade-long recovery journey in her book "Getting Off: One Woman's Guide Through Sex and Porn Addiction" and through many essays published online. Those essays and the book were a big part of her healing, unburdening herself of secrets she'd kept for so long. But alongside that, there was another important step in her recovery — meeting the man who would become her husband.
Erica Garza
For a long time, I felt like I had a problem with sex. I mean, it was obvious to me that my relationships were ending up at the same place over and over again. And so it was almost like a voice in my head telling me that something needed to change. And when I saw my 30th birthday coming up, I thought, "Okay, I want this decade to be better than the last. I need to do something different." And I had just read the book, "Eat, Pray, Love."
Anita Rao
You wanted your own Bali moment.
Erica Garza
Yes, I did. So I went to Bali, just like her, I started doing lots of yoga. Which was really helpful because it gave me something else to do with my body, and it helped me, you know, tune in and breathe and have healthier habits, basically. And also, the Internet was not so great in Southeast Asia, and so I didn't have as much access to porn as I usually had.
And so while I was in this, kind of, space of wanting to change, wanting to do things differently, I met my husband. And he was kind of on the same sort of journey — he was recovering from drug and alcohol addiction. And so he was in the sort of the same place of wanting to do things different and be healthier. And when I met him, and we started getting along and connecting, I just made a choice to just, like, I'm going to do something different in this relationship that I hadn't done before. I'm just going to be completely honest here and see where it takes me.
And so one of our first really deep, serious conversations was about how I thought I might be a sex and porn addict. And my biggest fear for all of the years that I had been dealing with this addiction was that somebody would find this out and they would reject me. And then, you know, it'd be this moment of everyone thinking I was disgusting, everyone would find out all these dark, dirty things I was doing behind closed doors, and instead he wanted to know more. And I felt like it can — it let us connect on a deeper level. And I was actually being real and authentic for the first time with another person. And it just felt so good to reveal something like that about myself that had been hidden for so long and be accepted anyway. It led to a really deep and intimate connection that I hadn't really known before.
Anita Rao
I'm curious about how you navigated the recovery alongside having an intimate relationship with your partner, because, you know, it's still — sex was going to be a part of your life. It was a part of your life that you, you wanted to still cultivate, but there were also these specific behaviors that you were working to, kind of, change your relationship toward. So how did you hold both of those at the same time?
Erica Garza
It was a difficult thing to figure out — to find balance. So the very beginning of my relationship with him — and it was at the beginning of my recovery as well — I thought that I had to, sort of, put myself in this box, and be really strict about what I was allowed to do and what I wasn't allowed to do. So I thought I would never watch porn again, we would always be in this, you know, monogamous relationship. And for a while that really worked, because it allowed me to, you know, analyze my patterns and break some old habits and, you know, take a long-needed break from pornography — which had ruled so many of my days.
But over time, it started to feel like I was holding myself back. And I really wanted to be a sex-positive, sexually experimental person, and I felt like I never really allowed myself to embrace that side of myself. I always just judged myself and felt ruled by the shame that I had attached to feeling like a sexual person. And I realized that the difference between doing something as part of my addiction — like watching porn, or having sex with another person — was because I felt like I needed to do it, or because I felt like I was running away from something. And so it became very clear to me when I wanted to watch porn or do something sexually experimental, if I was doing it as an escape route to not feel something or if I was doing it because I simply wanted to. And having that, sort of, awareness was a really big part of healing and finding that balance that I so needed.
Anita Rao
Erica's intimate and supportive connection with her partner also led her to seek out more help. She tried 12-step programs through Sex and Love Addicts Anonymous and going to therapy. She's certainly not alone in that approach.
Sue William Silverman
After quite a few years of, you know, acting out and having affairs, I really reached a place where I was emotionally and spiritually depleted. I kind of hit bottom. But I found a therapist who specialized in sex addiction who could help me, and I also was in group therapy, which is really important for an addict — to be in a group with other people who are struggling in the same way that they are struggling. I had to learn how to love myself, I had to learn how to see myself not as a sex object, I had to learn what healthy love was. And what that means for me is to have safe sex. And that is within a loving relationship with one person, where there really is love and it's not just about sex. There is help out there, and it's so important to take that first step or make that first phone call and ask for help. That's what I did, and it saved my life.
Anita Rao
That was Sue William Silverman again, the author of "Love Sick: One Woman's Journey Through Sexual Addiction." One throughline we heard from everyone we talked to about hypersexuality was that a telltale sign for needing help was feeling like their sexual urges and impulses were destroying important parts of their life, including their relationship with themselves. When hypersexuality is a symptom of a larger mental health diagnosis, making this connection can be a game changer.
Mz. Cici
Excuse me. Hey fool, how you doing? Before you scroll, if you suffer from anxiety, depression and bipolar disorder and the result of that is hypersexuality, go ahead and hit that follow button, so we can go ahead and talk about it.
Anita Rao
That's content creator Mz. Cici. Cici talks openly about hypersexuality on TikTok and Instagram. We'll link her handles in our show notes. She started doing research into sex addiction and hypersexuality about a year and a half ago after having an abortion that made her want to rethink her relationship to sex and the types of sexual encounters that she had.
Mz. Cici
When I was looking into my mental disorder — bipolar disorder — and I seen the word hypersexuality, and the definition of obsession, of sexual thoughts, urges and behaviors, it definitely made sense, because I've realized sex was on my mind more than I would like to admit. The way that I would, just, have one night stands or, just, be with people or, just, have this strong sexual desire for people — it made a lot of sense for me.
Anita Rao
Like Erica, Cici went to therapy to get help. She also started taking medication for her bipolar disorder and made the decision to abstain from sex.
Mz. Cici
I chose that as part of my journey, because I need to understand the reasons why I was having sex, what was triggering my sexual, you know, urges and things. So I feel like it helped a lot. It helped me recognize, okay, I'm having these desires because I'm either having anxiety or I'm going through my mania. I needed to understand like, how can I figure this out and get it, really, under control? So I said, let me go abstinent for a while, so I can figure out what's going on.
Anita Rao
What has it been like to date and be in relationships during this period, if you have?
Mz. Cici
Oh, it's very frustrating, because as I'm getting to know someone, those sexual thoughts crossed behind — you know, it crosses through my mind. So I'm trying to refrain from that, I'm trying to stay out of intimate situations where I can fear of being out of control. And it's also hard, because at the same time in my life, I want to be able to be sexually compatible with someone. So it's always finding the right time when to talk about my — my sex drive.
Anita Rao
How have folks responded when you have brought up hypersexuality?
Mz. Cici
They either shy away from it because it's intimidating, because some people feel like it can be overwhelming, like, okay, I don't think I can handle that. And for some, it adjusts them to either only want to pursue me for that experience.
Anita Rao
So it becomes sexualized in itself, you talking about that?
Mz. Cici
Exactly.
Anita Rao
Erica, I mean, you mentioned, you know, reframing your relationship with porn and bringing it back into your life now, but I'm curious, kind of, listening to Cici talk about triggers and handling triggers — like, at this point in your recovery journey, are there things that are still triggering for you that you have to be sensitive of, or maybe change your relationship with for particular periods of time?
Erica Garza
So, yeah, sometimes there are triggers. I mean, I think that just comes with the territory of being human, right? I mean if I have a difficult emotion that I don't want to deal with at the time, or feel overwhelmed, there is that thought that, you know, maybe if I just watched porn or something — like, it's still, it's a remnant from that time and an emotional crutch I had for so long, so it doesn't disappear completely. But if I feel like I'm more — I'm less reluctant now to question that. So I'm more willing to recognize when that's happening, and to catch myself before I start to make a decision based on, you know, wanting to escape something, and I'm more willing to talk about it than I was in the past. And it just takes a lot of self-awareness and willingness to be open and honest and talk about things that are uncomfortable.
Anita Rao
And what I love about how you write and talk about your experiences — you do talk about in the context of romantic relationships and your partnership with your husband — but you also talk about how sex addiction has affected your friendships. I'd love to hear a bit more about that and what it's been like to navigate friendship with hypersexuality.
Erica Garza
It's been difficult, and it's still something that I'm trying to figure out as a recovered sex addict, because for so long, I didn't know how to have intimacy without sex. I didn't know how to have a connection without sex. It was much easier to flirt with someone than have a friendly conversation, much easier to kiss someone, to have sex with someone than to just be present with another person and share something deeply about myself and to be authentic with that person. It just always felt so awkward, and I deal a lot with social anxiety and social awkwardness. And so sex was always the answer to that. But now I'm just trying to embrace that awkwardness and to let myself feel uncomfortable. And now that I've written a book about it, and I've been quite public about my past, it's actually quite easy to jump into deep conversations with people. Sometimes it can get a little bit strange or, you know, somebody will change the subject quickly — but more often than not, it allows for us to have this connection that we wouldn't have otherwise had. And they're more willing to share something personal about themselves, and I can feel safe sharing myself. And it just feels like a much more intimate, closer, real connection.
Anita Rao
Cici are also super open through your TikTok videos about your experience and very, very vulnerable. I'm curious if you've had friends in your life who have responded to this, and how you would answer that same question about how hypersexuality has informed your friendships.
Mz. Cici
Yes, me being open about it, that shocked a lot of my friends and it had them reach out to me to say, "Hey, what's going on?" They didn't know that I was going through certain things. So for some of them, they were understanding and we became closer. And for some of them, we just stopped talking because they felt like having this image out there, you know, "the same birds of a feather flock together," and especially from the people I grew up from with church, they kind of judged me in a certain way. So I lost some, and I gained some.
Anita Rao
At this point in your journeys, both of you have shared so much of yourselves publicly — been very open about your experiences and your behaviors. I'd love to, kind of, end with maybe, like, one thing you've learned about hypersexuality from being so open and, maybe, connecting with other people who have had a similar experience — something that's added to your own understanding of hypersexuality. Cici, let's start with you.
Mz. Cici
I learned that I shouldn't be ashamed. It's something that I can live with, but live better with. And I don't feel like it's my fault, and I don't feel scared and judged anymore. I just try to embrace it and work with it. So that's what I've, kind of, learned: just embrace it and conquer it.
Anita Rao
How about you, Erica?
Erica Garza
Because so much of my addiction was driven by shame, I guess I just want to see pleasure as something that I'm worthy of, and that sexuality is a healthy, beautiful thing. And I shouldn't be ashamed of it, and I shouldn't be ashamed of my past. And the best way to overcome shame is to talk about it. And so I just want to continue talking about it as much as possible, and to help other people feel comfortable talking about it as well.
Anita Rao
You already know I'm 100% behind talking candidly about uncomfortable stuff, and y'all probably listen to this podcast because you see the value in that too. When we talk about sex and "normal" behavior, I think it's super important to tread lightly, and everyone we talked to today agrees. As the medical and psychological communities continue to research and investigate hypersexuality, Krista hopes that they consider this:
Krista Nabar
We definitely need more research. And of course, there are going to be ethical boundaries around how do we research this stuff, but come up with the research so we can actually understand what's going on and develop real criteria. But I think the — the caveat to that is we want to make sure that the underlying assumptions that we're making about what's healthy sexuality, that those are actually based in fact and not based in moral assumptions. I think that that's probably the most important piece.
Anita Rao
Embodied is a production of North Carolina Public Radio-WUNC, a listener-supported station. If you want to lend your support to this podcast and WUNC's other shows on demand, consider a contribution at wunc.org now.
This episode was produced by Kaia Findlay and edited by Amanda Magnus. Audrey Smith also produces for our show, Madison Speyer is our intern and Jenni Lawson is our sound engineer. Quilla wrote our theme music.
The number one thing you can do to support Embodied in 2023 is tell people in your life about this show. I know that my own friends' podcast recommendations are the ones I take most seriously and the shows I find myself enjoying most. If there's an episode of Embodied you've enjoyed recently, or if you have an idea for something you'd like us to talk about, you know where to find us: @embodiedWUNC on Twitter and Instagram, or our email inbox embodied@wunc.org.
Until next time, I'm Anita Rao, taking on the taboo with you.