How much sex is too much?
Franziska von Malsen

MUNICH — Audiences mostly find the sex-obsessed protagonists of Steve McQueen’s movie Shame and Lars von Trier’s Nymphomaniac bizarre and alien, or at the very least irritating. But there really are people like that in real life.

Take, for example, this 58-year-old man somewhere in the eastern part of Germany sitting by his phone. He’s only seen the Nymphomaniac trailer. “It’s disturbing,” he says. And, no, he doesn’t think he could sit through the whole movie. “A reformed alcoholic doesn’t go to wine tastings,” is the way he puts it. His obsession started after the reunification of Germany, in the early 1990s, when he began looking at porn videos and frequently visiting prostitutes. Or phoning. Daily, and always the same woman. Eight hundred euros, 900, 1,000: That’s the kind of money he was spending on phone sex. It represented more than his monthly rent. At some point, he had to tell his wife he’d phoned their life savings away.

Men like him are proof that the Steve McQueen and Lars von Trier movies are not just fiction. There are people whose overwhelming need for sex becomes a torment. Psychiatrists call it hypersexuality, and the phenomenon isn’t as rare as people might think. According to American studies, 3% to 6% of the population suffers from hypersexuality at some point in their life, and for every three men one woman is afflicted. How reliable these figures are is hard to say, however, because defining how much sex is too much is subjective.

“It’s also the wrong question,” says psychiatrist Peer Briken, director of the Institute for Sex Research and Forensic Psychiatry in Hamburg. It’s not about quantity but about inner pain, he says. “If the patient isn’t suffering from his or her condition, then the doctor shouldn’t make a diagnosis,” assuming the case involved isn’t a forensic one where crime is involved, he says. Critics fear that clinical diagnosis of the disorder could lead those who have more sex than average being classed as pathological. Which is why hypersexual disturbance has not yet been included in the new version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

In one common definition of hypersexuality, the person suffering from the disorder has to have experienced intense sexual fantasies for over six months, along with such exaggerated sexual desire or behavior that it is damaging his or her life — in the sense that it is detrimental to social life and that the sleepless nights spent watching porn are making them ineffective at work. The reaction to stress, boredom or anxiety is to turn to sex. Crucial to determining if someone is suffering from hypersexuality is whether their condition makes them suffer. If the word alcohol were used to replace sex in this description, we would very quickly recognize the same patterns.

Men vs. women

There are differences between how men and women suffer. Most hypersexual women act out their desire. “They go out at night, get drunk or take drugs, but the one-night stands sometimes get them into situations that overstep the bounds,” Briken explains. For example, they may seek contact with men with sadistic tendencies who won’t respect signals to stop, or consciously risk getting infected with a STD.

A typical male patient, on the other hand, will sit for hours in front of his computer and masturbate. Briken tells of one man who said that when he was with his girlfriend he didn’t feel like having sex with her. He preferred looking for new porn films on the Internet.

Hypersexual behavior does not bring lasting satisfaction. After sexual acts patients often feel shame. But soon the fires of desire are lit anew, leading to further sexual escapades. It’s a vicious circle that is particularly difficult to break. Both men and women suffering from hypersexuality perceive their sexual behavior as sick but can’t seem to control it.

In the next edition of the World Health Organization’s International Classification of Diseases, at least one obsessive sexual disturbance will be included, Briken believes. In the current edition, only heightened sexual desire — satyriasis for men and nymphomania for women — are mentioned, without more precise definitions. “If a disturbance is not included in the manual, what that means is that it isn’t taken seriously scientifically,” says Briken. “Then it can be difficult getting health insurers to pay for treatment.” So for the time being, psychiatrists are choosing other categories for their diagnoses, such as “disturbance of impulse control” or “non-specific sexual disturbance.”

Confusion about terms and criteria is typical. Even the term “sex addiction” is controversial, though many patients themselves use it. Briken says it doesn’t stand up medically since only some of the criteria of physical addiction are met with hypersexuality. The word “nymphomania” is one that doctors stopped using in the 1990s, even if it still appears in medical literature.

Causes are therapies

The reasons why hypersexuality develops have yet to be conclusively explained. Experiences in childhood and adolescence presumably play a role, for example in cases of sexual abuse or an over-sexualized atmosphere in the family home. Briken relates that some patients had a mother or father who frequently changed sexual partners. These patients sometimes report that their parents invited them to watch porn movies with them.

But the opposite — when sexual desire and behavior is taboo — can be just as problematic, Briken says. In this case, sexuality can come to be dissociated from daily life and associated with everything that can’t be discussed openly. Hypersexuality sufferers are often afflicted by depression, anxiety, boredom and inner emptiness. For them, sex seems to be the only way to mitigate negative feelings.

Additionally, neurobiological mechanisms may play a role when the brain’s reward system reacts more strongly than average to sexual stimulation. Some doctors treat the few patients this applies to with medication such as antidepressants. These diminish not only depression and anxiety but also libido, making patients better able to control themselves.

Psychotherapists have so far had the greatest success rate with hypersexual patients. In a first phase, the therapists explore how patients could better control their behavior, for example by equipping their computer with filter software or putting it in a room where they are observed and cannot spend hours masturbating. They also teach patients how to deal with negative feelings with other means than sex — for example, sports, relaxation and mindfulness exercises.

In a second phase, the patients are asked to look at how their hypersexuality could be explained in the context of their life story, their experiences and conflicts. Therapies of this sort can sometimes go on for years, Briken says, but chances of success are good just as they are for patients who suffer from the opposite problem — too little desire or sex — who far outnumber those suffering from hypersexuality.

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Thousands of Tunisians gathered in the capital of Tunis

Hannah Steinkopf-Frank, Bertrand Hauger and Anne-Sophie Goninet

👋 Laphi!*

Welcome to Monday, where post-Merkel Germany looks set shift to a center-left coalition, San Marino and Switzerland catch up with the rest of Europe on two key social issues, and a turtle slows things down at a Japan airport. Meanwhile, we take an international look at different ways to handle beloved, yet controversial, comic books and graphic novels characters.

[*Aymara, Bolivia]

🌎  7 THINGS TO KNOW RIGHT NOW

Social Democrats narrowly win German elections: Germany's center-left party claimed a narrow victory in the federal election, beating the CDU party of outgoing chancellor Angela Merkel by just over 1.5%, according to preliminary results. SPD leader Olaf Scholz has claimed a mandate to form a government with the Greens and Liberals, in what would be Germany's first three-way ruling coalition. Germany's capital city Berlin will also get its first female mayor.

Switzerland says yes to same-sex marriage: Nearly two-thirds of Swiss voters approved the proposal to legalize same-sex marriage in a referendum, making it one of the last countries in Western Europe to do so.

San Marino voters back legal abortion: More than 77% voted in support of legalizing abortion up to 12 weeks of pregnancy in San Marino in a historic referendum for the predominantly Catholic tiny city-state, which was one of the last places in Europe that still criminalized abortion.

COVID update: Australian authorities announced they will gradually reopen lockdowned Sydney, with a system that will give vaccinated citizens more freedom than the unvaccinated. Meanwhile, Thailand will waive its mandatory quarantine requirement in Bangkok and several other regions for vaccinated travellers in November. In Brazil, a fourth member of President Jair Bolsonaro's delegation to the United Nations has tested positive to COVID-19.

Power shortages in China spread: Tight coal supplies and toughening emissions standards have led to power shortages in northeastern China, forcing numerous factories including many supplying Apple and Tesla to halt production.

Strong earthquake hits Crete, at least one killed: An earthquake of magnitude 6 struck the Greek island of Crete, with reports that at least one person was killed and several injured after buildings collapsed.

Turtle causes delays at Tokyo airport: A wandering turtle forced the Tokyo Narita airport to close its runway for twelve minutes, delaying five planes, including an All Nippon Airways plane featuring ... a sea turtle-themed fuselage.

🗞️  FRONT PAGE

"Neck and neck," titles German daily Augsburger Allgemeine about the tight results of the federal election, which according to preliminary results, is set to be won by the center-left party SPD led by Olaf Sholz by just over 1.5%. It was the country's tightest race in years, and will likely lead to long, complicated negotiations to form a coalition government.


💬  LEXICON

Magal

On Sunday, hundreds of thousands of Muslim pilgrims from Senegal, but also from elsewhere in Africa, Europe, and the United States, converged to the great Mosque of Touba, as part of the Grand Magal. The annual pilgrimage, a Wolof word meaning celebration, marks the date French colonial authorities exiled spiritual leader and founder of the Senegalese Mouride Brotherhood Sheikh Amadou Bamba.

📰  STORY OF THE DAY

Cancel Tintin? Spotting racist imagery in comics around the world

From the anti-Semitic children's books of Nazi Germany to the many racist caricatures of Asian, African or Indigenous people in the 20th century, comics have long contained prejudiced, sexist and xenophobic stereotypes. These publications have been rightfully criticized but some are pushing back, saying that this kind of unwarranted "canceling" threatens freedom of expression. Here are examples from three countries around the world about how people are handling the debate and sketching the future of comics.

🔥📚 The Adventures of Tintin and The Adventures of Asterix both emerged in French-speaking Europe during the 20th century and quickly developed global audiences. But the comic books have also been called out for controversial depictions of certain groups, including North American Indigenous peoples. And as Radio-Canada recently reported, one group of French-speaking schools in Ontario found the texts so offensive that they decided to go ahead and burn the books. The report, not surprisingly, stirred up a pretty fiery debate on the issues of free speech and what some refer to as "cancel culture."

🤠 In a more progressive model for rethinking cartoons with long — and complicated — legacies, Lucky Luke in France is taking a different direction. Telling the story of a cowboy in the Wild West, the series is notably lacking in terms of diversity. But in 2020, well-known French cartoonists Julien Berjeaut (known as Jul) and Hervé Darmenton (known as Achdé) took on the challenge of a more inclusive Lucky Luke. With its 81st album, Un Cow-Boy Dans Le Coton (A Cowboy in High Cotton), they changed the perspective to focus on recently freed Black slaves.

🇯🇵 Outside of France and Belgium, Japan arguably has the largest market for graphic novels, or manga, which first developed in the late 19th century. And like their European counterparts, certain manga titles have been accused of using racist tropes. One example is the character Mr. Popo, a genie from the popular Dragon Ball series who has been cited for having offensive features. In the meantime, more and more mangaka (creators of manga) are expanding beyond these traditional representations, including in their depictions of women, who are over-sexualized in many mangas.


➡️ Read more on Worldcrunch.com

📣 VERBATIM

"Still now, I am terrified."

— In mid-August, Afghan news anchor Beheshta Arghand interviewed Mawlawi Abdulhaq Hemad, a high-ranking Taliban representative, for TOLOnews. A historic moment for the female presenter, just days after the Islamic fundamentalist group took over Afghanistan. Now exiled in Albania, Arghand tells the BBC in a moving testimony why she had to flee to Albania and how she, like many in her country, has lost everything.

✍️ Newsletter by Anne-Sophie Goninet, Jane Herbelin, Clémence Guimier & Bertrand Hauger


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