Carnal knowledge

As a revered psychotherapist and lecturer, Rob Weiss, MSW, has shared his extensive knowledge on the subject of sexual addiction with television viewers of Dateline NBC, 20/20, and most recently, The Oprah Winfrey Show. In the following Advocate.com exclusive interview, the gay 44-year old talks about his latest book on the subject, Cruise Control: Understanding Sex Addiction in Gay Men (Alyson Books, $15.95). Weiss explains how sex addiction compares to other compulsions and offers up some strategies that can help keep the self-destructive behavior at bay.

Is sex addiction about sex? No, not really. It's about distraction and control.

What kind of behavior have you witnessed in your patients?I'm working with this guy right now who ascribes how alone he feels to being from out of state. He started cruising the gyms and the steam rooms and came to me because he specifically wanted to stop doing that. He realized he feels alone a lot of the time, but he doesn't acknowledge it because he will compulsively masturbate, watch pornography, or go out a couple nights a week cruising. So he never really sits with his feeling of loneliness. He doesn't allow it--he doesn't even know the loneliness is there because he's anticipating the sexual excitement and contact.

Is sex addiction simply a variation on other addictions--akin to food, alcohol, or drugs--that flare up during stressful times?Sex addiction belongs in the behavioral category; it's most like gambling addiction because it's not about arousal. Sex addicts can go long periods of time looking at images and cruising boulevards and never get an erection, but they're totally aroused because of adrenaline and endorphins. It's not about an orgasm, either, because then it's over. This is akin to gambling where you're playing and playing, but you're not necessarily playing to win. Sex addiction also resembles an eating disorder because the goal is not to stop eating but to find a healthy way to live.

How entwined is sex addiction with drug use?At this moment in gay culture, there is such an infusion of crystal meth and other drugs with sexual behavior that they become mutually supportive. One feeds the other. There are guys who are crystal addicts, and they do crystal in combination with acting out sexually. They may spend three days at a sex club or two days at a guy's house doing PNP [party and play, a slang term describing combining drug use with intercourse] and having a lot of sex, but they really don't have any history of sex addiction, and without they crystal they wouldn't be that rabidly motivated to be that sexually compulsive. There are other guys who have long histories of sexual addiction and just add crystal to the mix.

In what ways does the Internet make it easier to indulge in dangerous sexual behavior?We're seeing people who become sex addicts and don't have a long history with the problem prior to going online. The Internet is the crack cocaine of sex addiction. Internet sex is not like porn where you have to leave your house and go to the bookstore. The Internet is accessible and also never-ending; there's always another image or person online--not to mention it's cheap as pasta. You don't need a membership for Craigslist. And the anonymity of the Internet means if you're shy you can still find people, but it also means you don't grow because you don't have to push yourself.

Do drugs, specifically crystal, have anything to do with why such a disproportionate amount of gay men--compared to straight--struggle with sex addiction? Or is it a reflection of internalized homophobia and self-hatred? Methamphetamines were very popular in the '60s, and it had nothing to do with sex. It was related to fashion, to clubs, to being extremely thin. The main reason sex and crystal are now fused [for gay men] is because of Viagra and drugs that allow us to have erections for long periods of time while doing methamphetamines. Crystal will drive whatever obsession you're into; a lot of people just use crystal for work, to lose weight. But gay men often use it for extended binges.

[The disproportionate numbers] come from being a repressed minority. The acting out comes from oppression; you see it in black men and other minorities. The main way [gay men] act out is sexually. HIV also contributes to this. Men in their late 30s or early 40s who lived through AIDS don't want to rebuild their social circles. They say, "Fuck it, all my friends died. I'm going to join the party." The young men are frustrated and angry with condoms and all the messages of safe sex, when all they want to do is have a good time. HIV enters into the mix with us in a way that it doesn't with straight people. It's also men being with men. We have innate characteristics. Men are visual: We objectify, we compete. Women tend to be more relationship-oriented and seek out emotional characteristics rather than physical ones.

We have a variety of things working against us.

What's the best way to cope with sexual addiction?Keeping as much structure as you can. If you go to the gym Tuesdays and Thursdays, stick with that. Also, not isolating yourself is important. Even if you go out to the movies or shopping by yourself, you're not really by yourself. Being at home alone with hours to spare and nothing to do is bad news.

Cruise Control focuses on gay male sex addiction, but are women susceptible too?There are female sex addicts out there. Again, women tend to be more relationship-oriented. What women tend to do in their search for love is addictively have a lot of sex. The addicts have delusions and denial about what brings love. This obviously applies to lesbians too.

Who faces more stigma and shame for admitting a problem with sexual compulsion: gay or straight men?I think straight men do because the cultural expectations of monogamy for straight men are greater. For gay men to say, "I've had hundreds of partners," it's like, "Whatever."

You've been making the rounds on TV talk shows talking about sex addiction. Have you experienced uncomfortable moments with straight audiences?A staff member from one of the shows was sort of tapping his foot and, I believe, making obscene gestures behind the camera because others were laughing. After I was done he told me, "Porn built the Internet." I said, "Listen, porn isn't the problem. Like alcohol, with most people it isn't an issue, but for a portion of the population, alcohol is a problem, and they have to deal with it differently than the other 92% of the population who can drink [reasonably]." It's the same with sex addiction. That kind of setting doesn't afford a full explanation, though, and those objecting to the material quite often have a sexual issue themselves.

How did you get into this field of study, and why did you want to write Cruise Control?I went to UCLA for my graduate work and I was fortunate enough to work with Dr. Patrick Carnes (who wrote the seminal book on sex addiction, Out of the Shadows, as well as the foreword to Cruise Control) at one of the first inpatient sex-addiction centers. At that time it was groundbreaking to do inpatient treatment for people with behavioral problems. I spent four years with the guy who coined the phrase "sex addiction"--Carnes is a pioneer in the field. After that time I realized there was no place in L.A. I could refer someone to and say, "Go there when you get out." That didn't seem right to me, so I took the steps necessary to create that by starting an outpatient program for sex addicts.

The book came about because the primary material on the field, Out of the Shadows, is great, and Carnes is a mentor, but he doesn't know what it's like to be gay. He's heard "bathhouse," "sex club," or "glory hole" a million times, but he doesn't really understand those things. You can't really include those things in a book intended for heterosexual men. They would reject it out of hand. I wanted a book about which gay men would say, "That's me."