what is sex addiction essay

Dispelling Myths About Sex Addiction

What comes to mind when you hear “sex addiction” it’s time to dispel the myths..

Posted October 23, 2023 | Reviewed by Abigail Fagan

• The Fundamentals of Sex
• Find a sex therapist near me
• Compulsive sexual behavior disorder is recognized by the ICD-11 yet often misunderstood.
• Compulsive sexual behavior is not defined by the amount of sexual activity but by the hallmarks of addiction.
• Recovery from compulsive sexual behavior doesn't mean abstaining from sex for the entirety of one's life.

For a subset of individuals, sexual activity can become compulsive, uncontrollable, and continue despite negative consequences. These individuals have what is referred to as compulsive sexual behavior disorder , sex addiction , or hypersexual disorder . The World Health Organization recognizes compulsive sexual behavior disorder in the 11 th revision of the International Classification of Diseases . This diagnosis is not recognized in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; APA, 2013), although the condition can fall under other specified disruptive, impulse-control, and conduct disorder with the specifier of hypersexual disorder (Kafka, 2014).

There are many 12-step and peer support programs dedicated to supporting those with compulsive sexual behavior, formalized assessment instruments to identify the condition, and a specific credential for mental health professionals, the Certified Sex Addiction Therapist (CSAT).

Although the understanding of compulsive sexual behavior is increasing, there are many myths surrounding the concept that should be addressed to facilitate useful discourse.

Myth 1: Compulsive sexual behavior means engaging in too much sex.

It is imperative to differentiate between high involvement in a behavior and a behavioral addiction. Indeed, “amount of time spent engaging” is insufficient for identifying a behavioral addiction. Instead, behavioral addictions are recognized by four hallmarks: compulsivity, loss of control, continued engagement despite negative consequences, and cravings/mental preoccupation in the absence of the behavior (APA, 2013; Giordano, 2021; WHO, 2018). Thus, if someone’s sexual activity is compulsive (not planned or intention, resulting from an impulsive urge; occurring in inappropriate situations), if the individual has lost control over their sexual acts (unsuccessful attempts to reduce or stop sexual acts; broken their own limits for sexual behavior) or if the sexual acts continue despite negative consequences (e.g., financial, physical, relational), and the individual experiences cravings/mental preoccupation when not engaging in sexual activity (fantasizing about next sexual act; reflecting upon previous sexual acts), this indicates that they may have compulsive sexual behavior.

Myth 2: Compulsive sexual behavior is extremely rare.

A recent study by Bothe and colleagues assessed compulsive sexual behavior disorder rates in 42 different countries. The authors found that among over 82,000 participants, 4.84% were at high risk for compulsive sexual behavior disorder (Bothe et al., 2023). For comparison, global depression rates are estimated to be at 4.4% and anxiety at 3.6% (WHO, 2017). Therefore, the number of people affected by compulsive sexual behavior is on par with other mental health concerns.

Myth 3: You can’t have compulsive sexual behavior because sex is naturally rewarding.

Sexual activity is naturally rewarding causing a cascade of neurotransmitters implicated in the experience of reward (e.g., dopamine , endogenous opioids; Doidge, 2017). For a subset of individuals, however, this naturally rewarding act can become compulsive and out of control. There are a number of risk factors that increase an individual’s vulnerability to compulsive sexual behavior such as a genetic predisposition to addiction (including abnormalities of the brain’s reward circuitry; Blum et al., 2012), early trauma and toxic stress (Katehakis, 2009), and early exposure to the supernormal stimulus of pornography (a supernormal stimulus is an artificial exaggeration of a natural instinct that can be more rewarding than the natural stimulus; Barrett, 2010; Doidge, 2007; Hilton, 2013). It is important to note that as with all addictive behaviors, people with compulsive sexual behavior become addicted to changing the way they feel. Sexual acts become their primary means of emotion regulation . Indeed, scholars have found that those with compulsive sexual behavior have poorer emotion regulation skills than those without (Cashwell et al., 2017). Thus, a subset of individuals have risk factors that increase their vulnerability to developing compulsive sexual behavior, and sex becomes the primary means by which they regulate emotions.

Myth 4: Compulsive sexual behavior is synonymous with sex offending.

Compulsive sexual behavior and sex offending are distinct constructs from the legal field and psychology field (Schneider, 1999). However, some individuals with compulsive sexual behavior may offend (their sexual acting out behavior crosses the legal line) and some individuals who have committed a sexual offense may meet the criteria for compulsive sexual behavior disorder. There is reason to believe, however, that the majority of those with compulsive sexual behavior do not offend and the majority of offenders do not meet the criteria for compulsive sexual behavior disorder. For example, among studies of individuals convicted of a sexual offense, the following percentages have met the criteria for compulsive sexual behavior or hypersexuality : 33% (Krueger et al., 2009), 5.8% (Efrati et al., 2019), 12% (Kingston & Bradford, 2013), and 43.9% (Marshall et al., 2008). Additionally, in the study of 87 men who were in treatment for hypersexual disorder, the two most commonly reported compulsive sexual acts were compulsive masturbation (86%) and pornography addiction (81%; Reid et al., 2010). Indeed, scholars have noted differences in patterns, motivations, and the nature of sexual behaviors between those who have compulsive sexual behavior (and do not offend) and those who offend (but do not have compulsive sexual behavior; Delmonico & Griffin, 1997; Smith, 2018). Thus there are distinctions between compulsive sexual behavior and sex offending, although there may be some individuals who meet the criteria for both.

Myth 5: Recovery from compulsive sexual behavior means never engaging in sexual activity again.

Like other addictive behaviors (e.g., food, work, technology), abstinence from compulsive sexual behavior does not mean completely removing sex from a person’s life. Instead, mental health professionals and peer support groups typically rely on some version of the Three Circles Technique (ISO of SAA, Inc., 2000).

The counselor/sponsor and individual with compulsive sexual behavior work to identify the specific compulsive, uncontrollable, sexual acts that lead to negative consequences, and write these down in the innermost of three concentric circles. These are the behaviors from which the individual will abstain. In the middle circle, the individual identifies behaviors that serve as “warning signs” that they are moving toward inner circle behaviors. Finally, the outermost circle contains all behaviors that are healthy, adaptive, and aligned with the individual’s goals and values. Thus, an individual may abstain from pornography use (inner circle behavior), monitor the extent to which they watch sexual content on TV (middle circle behavior), and develop a healthy, consensual dating relationship (outer circle behavior).

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Association.

Barrett, D. (2010). Supernormal stimuli: How primal urges overran their evolutionary purpose . W. W. Norton & Company.

Blum, K., Werner, T., Carnes, S., Carnes, P., Bowirrat, A. Giordano, J. … Gold, M. (2012). Sex, drugs, and rock ‘n’ roll: Hypothesizing common mesolimbic activation as a function of reward gene polymorphisms. Journal of Psychoactive Drugs, 44, 38-55.

Bothe, B., Koos, M., Nagy, L., Kraus, S. W., Demetrovics, Z., Potenza, M. N. … Vaillancourt-Morel, M. P. (2023). Compulsive sexual behavior disorder in 42 countries: Insights from the International Sex Survey and introduction of standardized assessment tools. Journal of Behavioral Addictions, 12, 393-401.

Cashwell, C. S., Giordano, A. L., King, K., Lankford, C., & Henson, R. K. (2017). Emotion regulation and sex addiction among college students. International Journal of Mental Health and Addiction, 15 , 16 - 27.

Delmonico, D. L., & Griffin, E. (1997). Classifying problematic sexual behavior: A working model. Sexual Addiction & Compulsivity, 4, 91-104.

Doidge, N. (2007). The brain that changes itself: Stories of personal triumph from the frontiers of brain science . Penguin Group.

Efrati, Y., Shukron, O., & Epstein, R. (2019). Compulsive sexual behavior and sexual offending: Differences in genitive schemas, sensation seeking, and impulsivity. Journal of Behavioral Addictions, 8 , 432-441.

Giordano, A. L. (2021). A clinical guide to treating behavioral addictions: Conceptualizations, assessments, and clinical strategies. Springer.

Hilton, D. L. (2013). Pornography addiction- A supranormal stimulus considered in the context of neuroplasticity. Socioaffective neuroscience & Psychology, 3, 20767

International Service Organization of SAA, Inc. (2000). Three circles: Defining sexual sobriety in S.A.A. https://saa-recovery.org/literature/three-circles-defining-sexual-sobri…

Kafka, M. P. (2014). What happened to Hypersexual Disorder? Archives of Sexual Behavior, 43 , 1259-1261

Katehakis, A. (2009). Affective neuroscience and the treatment of sexual addiction. Sexual Addiction & Compulsivity, 16, 1-31.

Kingston, D. A., & Bradford, J. M. (2013). Hypersexuality and recidivism among sex offenders. Sexual Addiction & Compulsivity, 20 , 91-105.

Krueger, R. B., Kaplan, M. S., & First, M. B. (2009). Sexual and other Axis I diagnoses of 60 males arrested for crimes against children involving the internet. CNS Spectrums, 14 , 623-631.

Marshall, L. E., Marshall, W. L., Moulden, H. M., & Serran, G. A. (2008). The prevalence of sexual addiction in incarcerated sexual offenders and matched community nonoffenders. Sexual Addiction & Compulsivity, 15, 271-283

Schneider, J. P. (1999). New paradigms for treating sex offenders. Sexual Addiction & Compulsivity, 6, 267-269.

Smith, A. (2018). Sexual addiction and sex offenders. In T. Birchard & J. Benfield (Eds.). The Routledge international handbook of sexual addiction . (pp. 362-372). Routledge/Taylor & Francis Group.

World Health Organization. (2017). Depression and other common mental disorders: Global health estimates . Author.

World Health Organization. (2018). International statistical classification of diseases and related health problems (11th Revision). https://icd.who.int/browse11/l-m/en

Amanda Giordano, Ph.D., LPC, is an associate professor at the University of Georgia and the author of A Clinical Guide to Treating Behavioral Addictions.

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Understanding and Managing Compulsive Sexual Behaviors

Timothy w. fong.

Dr. Fong is Assistant Clinical Professor of Psychiatry Director, UCLA Impulse Control Disorders Clinic, Semel Institute for Neuroscience and Human Behavior at UCLA, David Geffen School of Medicine, Los Angeles, California

Compulsive sexual behavior, otherwise known as sexual addiction, is an emerging psychiatric disorder that has significant medical and psychiatric consequences. Until recently, very little empirical data existed to explain the biological, psychological, and social risk factors that contribute to this condition. In addition, clinical issues, such as the natural course and best practices on treating sexual addictions, have not been formalized. Despite this absence, the number of patients and communities requesting assistance with this problem remains significant. This article will review the clinical features of compulsive sexual behavior and will summarize the current evidence for psychological and pharmacological treatment.

Introduction

Sexuality in the United States has never been more socially acceptable. Sex has become part of mainstream culture as reflected through the explicit coverage of sexual behaviors in the media, movies, newspapers, and magazines. In many ways, sexual expression has become a form of accepted entertainment similar to gambling, attending sporting events, or watching movies. Internet pornography has become a billion-dollar industry, stretching the limits of the imagination. Digital media offers portability, access, and visually explicit depictions of sexual acts in high-definition that leave nothing to the imagination. Sales and rental of adult movies through DVDs and pay-per-view services allow access to sex anywhere and at any time. The adult entertainment industry generates close to $4 billion per year and its acceptability in society is reflected in the mainstreaming of its products into traditional retail stores and the portrayal of its actors and actresses as role models and celebrities. Strip clubs have evolved from backroom cabarets into large multimillion dollar nightclubs and are present in virtually every state in the US. Inside them, the degree of physical contact has also increased, as compared to a generation ago, to the point where the boundaries of what constitutes sexual intercourse are blurred. Escort services, massage parlors, and street prostitution continue to be available in every major city in the US. Strengthening their presence and availability is the internet, which has created an information portal for these services through online dating services, classified ads, and discussion boards for those in pursuit of sexual gratification.

Together, these cultural changes have increased the acceptability and availability of sexual rewards. For some, though, this increase in availability has uncovered an inability to control sexual impulses resulting in continued engagement in these behaviors despite the creation of negative consequences—otherwise known as sexual addiction. This term has been used synonymously with others, such as compulsive sexual behaviors, hypersexuality, and excessive sexual desire disorder. 1 It can take many forms, and although it may seem obvious to diagnose, standardized criteria have yet to be developed. Furthermore, debate is ongoing about where this behavioral pattern fits into the American Psychiatric Association's Diagnostic and Statistical Manual (DSM-IV), and how it should be classified and conceptualized. 2 Is it an addictive disorder, an impulse-control disorder, or a variant of obsessive compulsive disorders? Does it merit enough empirical evidence to stand alone as a separate disorder? Finally, what are the boundaries and limits that distinguish disease patterns, at-risk behaviors, and socially appropriate expression?

Compulsive sexual behavior has not yet received extensive attention from researchers and clinicians. To date, there have been very few formalized studies of compulsive sexual behaviors. As an example, a keyword search on PubMed, as of October, 2006, for “sexual addiction” yielded 518 articles, while “compulsive sexual behavior” yielded 264 (in comparison, “substance abuse” yields 164,104). Funding agencies, such as the National Institutes of Health (NIH), and pharmaceutical companies have not supported research into the etiology and mechanisms of compulsive sexual behavior and, as a result, evidenced-based treatments are limited. Despite the paucity of research, a significant number of patients with sexual addictions do present for treatment. This is evidenced by the number of treatment centers dedicated to the treatment of sexual addictions in both residential and intensive outpatient settings. Mental health professionals in any setting are likely to encounter patients with this hidden addiction and require better tools to diagnose and manage them. This article will review the terminology, the epidemiology, and the existing treatments that are currently available for compulsive sexual behaviors.

Defining Compulsive Sexual Behaviors

The DSM-IV currently does not list compulsive sexual behavior as a separate disorder with formal criteria. There are 12 listed sexual disorders and they are divided into disorders of sexual dysfunction, paraphilias, and gender identity disorder. 3 Among these disorders, there is no mention of repetitive, continued sexual behaviors that cause clinical distress and impairment. In fact, the only place where compulsive sexual behaviors might be included is within the context of sexual disorder, not otherwise specified (NOS) or as part of a manic episode. In other words, hypersexuality , sexual addiction , or compulsive sexual behaviors are terms that are not found within the DSM-IV.

Some of the reasons for why there is a lack of formalized criteria include the lack of research as well as an agreed-upon terminology. This is due, in part, to the heterogeneous presentation of compulsive sexual behaviors. 4 For instance, some patients present with clinical features that resemble an addictive disorder—i.e., continued engagement in the behavior despite physical or psychological consequences, a loss of control, and a preoccupation with the behavior. Others will demonstrate elements of an impulse control disorder, namely reporting irresistible urges and impulses, both physically and mentally, to act out sexually without regard to the consequences. Finally, there are patients who demonstrate sexual obsessions and compulsions to act out sexually in a way that resembles obsessive compulsive disorders. They do so to quell anxiety and to minimize fears of harm. For these patients, the thoughts and urges to act out sexually are ego-dystonic, whereas other types of patients describe ego-syntonic feelings about their sexual behaviors.

One important feature to note is that hypersexuality is not necessarily symbolic or diagnostic of compulsive sexual behaviors. Libido and sexual drive can be seen as similar to other biological drives, such as sleep and appetite. States of hypersexuality induced by substances of abuse, mania, medications (e.g., dopamine agonists), or even other medical conditions (e.g., frontal-lobe tumors) can induce episodes of impulsive and excessive sexual behaviors. 5 However, once those primary conditions are treated, the sexual behaviors return to normalcy in terms of frequency and intensity.

Clinical Features

Compulsive sexual behaviors can present in a variety of forms and degrees of severity, much like that of substance use disorders, mood disorders, or impulse-control disorders. Often, it may not be the primary reason for seeking treatment and the symptoms are not revealed unless inquired about. Despite the lack of formalized criteria, there are common clinical features that are typically seen in compulsive sexual behaviors.

One of the fundamental hallmarks of compulsive sexual behavior is continued engagement in sexual activities despite the negative consequences created by these activities. This is the same phenomenon seen in substance use and impulse control disorders. Psychologically, sexual behaviors serve to escape emotional or physical pain or are a way of dealing with life stressors. 6 The irony is that the sexual behaviors becomes the primary way of coping and handling problems that, in turn, creates a cycle of more problems and increasing desperation, shame, and preoccupation.

Compulsive sexual behavior can be divided into paraphilic and non-paraphilic subtypes. Paraphilic behaviors refer to behaviors that are considered to be outside of the conventional range of sexual behaviors. These include the eight paraphilias recognized in the DSM-IV: Exhibitionism, voyeurism, pedophilia, sexual masochism, sexual sadism, transvestic fetishism, fetishism, and frotterurism. 3 There are many other forms of paraphilias that are not listed in DSM-IV (e.g., gerontophilia, necrophilia, zoophilia) that exist but have not been yet recognized as clinical disorders. A key clinical feature in diagnosing a paraphilic sexual behavior is that it must be distressing and cause significant impairment in one's life, with the exception of pedophilia and fetishism. In other words, with the noted exceptions, engagement in these behaviors leads to sexual gratification but does not cause distress or impairment and do not represent clinical disorders. 7 Thus, frequency, amount of time spent, and amount of money spent are not necessarily reliable indicators of the presence of a compulsive sexual disorder. Paraphilias begin in late adolescence and peak in the mid-20s. 8 Commonly, paraphilias do not occur in isolation; as the expected course is characterized by multiple paraphilic and non-paraphilic behaviors. 6

Non-paraphilic behaviors represent engagement in commonly available sexual practices, such as attending strip clubs, compulsive masturbation, paying for sex through prostitution, excessive use of pornography, and repeated engagement in extramarital affairs. The onset, clinical course, and male predominance are fairly similar to paraphilic disorders. 9 Various epidemiological studies estimate that close to six percent of the general population meet criteria but there are no national or large datasets to confirm this. 8 Because of the variety of activities possible, non-paraphilic compulsive sexual behavior can present in a number of ways. This has the potential to confuse and cloud clinicians. In addition, a clinician that screens only for some but not all of the potentially problematic sexual behaviors is likely to miss important clinical information. Thus, asking about both paraphilic and non-paraphilic behaviors is critical in screening. In addition, it is important to assess the consequences as well as the nature of the behavior. A person who spends $1000 per week on strip clubs may at first glance appear to meet criteria, but if there are no notable adverse consequences in his or her life, then the disorder may not be present.

Identifying a compulsive sexual disorder is a challenge because of its sensitive and personal nature. Unless patients present specifically for treatment of this disorder, they are not likely to discuss it. 10 Much like other impulse control disorders, the physical and psychological signs of compulsive sexual behaviors are often subtle or hidden. Even signs of excessive sexual behaviors (such as physical injury to the genital area) or the presence of sexually transmitted diseases does not necessarily indicate compulsive sexual activity. Their presence does signal the need to screen for those behaviors but one cannot assume a compulsive sexual disorder exists based on physical examination alone.

Consequences of compulsive sexual behaviors can vary with some being similar to that seen in other addictive disorders while others are unique. Medically, patients are at a higher risk for sexually transmitted diseases (STDs) and for physical injuries due to repetitive sexual practices. Human immunodeficiency virus (HIV), Hepatitis B and C, syphilis, and gonorrhea are particularly concerning consequences. 13 , 14 Virtually unknown is the percentage of those individuals with STDs who meet criteria for compulsive sexual disorders.

Another significant consequence is the loss of time and productivity. It is not uncommon for patients to spend large amounts of time viewing pornography or cruising (also called mongering) for sexual gratification. Financial losses can mount quickly, and patients can accumulate several thousands of dollars of debt in a short amount of time. In addition, there is a long list of legal consequences, including arrest for solicitation and engaging in paraphilic acts that are illegal. One look at recent news headlines will likely reveal several stories focusing on illegal sexual activities or behaviors that jeopardize someone's livelihood or wellbeing.

The psychological consequences are numerous. Effects on the family and interpersonal relationships can be profound. Compulsive sexual behaviors can establish unhealthy and unrealistic expectations of what a satisfying sexual relationship should be. At the same time, the deception, secrecy, and violations of trust that occur with compulsive sexual behaviors may shatter intimacy and personal connections. The result is a warped view of intimacy that often leads to separation and divorce and, in turn, puts any future healthy relationship in doubt.

Finally, the shame and guilt that those with compulsive sexual behaviors experience is different from those with other addictive disorders. There are no substances of abuse to explain seemingly irrational behaviors. The stigma of not being able to control sexual impulses carries with it a connotation of depravity and moral selfishness. Stigmatization in the media and criminalization of “sexual offenders” creates an atmosphere that does not promote treatment and prevention. As a result, access to care and seeking care, even when one recognizes that sexual behaviors are out of control, is a decision faced with barriers and limitations.

Epidemiology

There have been no national studies documenting the past-year or lifetime prevalence of compulsive sexual behaviors in the general population. Regional and local surveys suggest that approximately five percent of the general population may meet criteria for a compulsive sexual disorder (using criteria that are similar to substance use disorders). 7 Further replication of these data is needed but if true, these rates represent a significant percentage of the general population and would be higher than the rates for schizophrenia, bipolar disorder, and pathological gambling. One of the reasons why reliable epidemiological data are lacking is the inconsistency in defining criteria for compulsive sexual behaviors, lack of funding, and the lack of researchers committed to documenting the extent of this problem. Most of what is known about the epidemiological nature of this disorder comes from clinical treatment programs that focus on sexual addictions. Men appear to outnumber women with compulsive sexual behaviors. 7 Comorbidities include substance use disorders and co-occurring impulse control disorders, and there is an association with histories of sexual abuse. 15 , 16 Other significant epidemiological data is simply not known, such as the rate of compulsive sexual behaviors among prosecuted sex offenders or the rate among those who work within the adult entertainment industry.

As with impulse control and substance use disorders, no single biological cause has yet been identified to explain the origins and maintenance of compulsive sexual behaviors. Neuroscience research, which would be an excellent approach to understand basic brain differences between those with and without compulsive sexual behaviors, has rarely been applied to this population. In particular, neuroimaging studies in patients with compulsive sexual behaviors would be interesting to compare with those involved in substance abuse and other behavioral addictions. To date though, most of the neuroimaging work has been done with nonclinical populations and has examined the biology of sexual arousal in healthy subjects.

Hypersexual behaviors have been reported in patients with frontal lobe lesion, tumors, and in those with neurological conditions that involve temporal lobes and midbrain areas such as seizure disorders, Huntington's disease, and dementia. 17 – 19 Frontal lobe damage may trigger the expression of disinhibited behaviors, which could partially explain the increased sexual activity along with decreased control. 20 Still, more investigation is needed to understand the specifics aberrances because there are certainly those individuals with frontal lobe injuries that do not experience the emergence of compulsive sexual behaviors.

Neurotransmitter studies in compulsive sexual behaviors have focused on the monoamines, namely serotonin, dopamine, and norepinephrine. 21 Again, research in clinical populations is scant. Normal sexual functioning involves all of these monoamines as evidenced by selective serotonin reuptake inhibitor (SSRI)-induced sexual dysfunction and the increased sexuality observed among those on stimulants. Cases of hypersexual behavior have also been shown to be induced by medications for Parkinson's disease, implicating dopamine systems in compulsive sexual behaviors. 22 , 23 What remains unclear is understanding how these perturbations in neurochemical functions differentiate compulsive sexual behaviors from those with hypersexuality alone without a negative life impact.

In addition to neurotransmitters, the sex hormones are obviously a critical component to sexual functioning. Testosterone levels have been correlated to sexual functioning but curiously, levels do not necessarily correlate to libido and sexual desires. 24 The implication of these hormones in compulsive sexual behaviors is critical to understand. It may be that regions of reward and pleasure are modulated by these hormones through facilitating or enhancing the response to sex and the desire for sex.

Clinical Assessment Measures

There are existing screening instruments, which are only as valid as the responder's honesty and integrity. Although this is true of all psychiatric screening instruments, revealing sexual practices is probably the most humbling because of its private nature. Questions about time spent on sexual activities and impact of functioning are important clinically, but also rely on self-report. Patrick Carnes, one of the pioneers in the field of compulsive sexual behavior research, developed the Sexual Addiction Screening Test, which is a 25-item, self-report symptom checklist that can be used to identify those at risk to develop compulsive sexual behaviors. 11 The Sexual Addiction Screening Test has also been modified for women and for internet sexual behaviors. Kafka has suggested a behavioral screening test (i.e., Total Sexual Outlet) in which a total of seven sexual orgasms per week, regardless of how they are achieved, could represent at-risk behavior and requires further clinical exploration. 12

Treatment: Psychosocial

Various types of psychosocial treatments are available for individuals suffering from compulsive sexual behaviors. The most widely available and accessible are Sexual Addicts Anonymous, Sex and Love Addicts Anonymous, and Sexaholics Anonymous. 25 All three are modeled after 12-step theory and practice, and are available throughout the US. There is almost no data evaluating their efficacy or effectiveness. Nevertheless, participation in these groups is usually recommended because they provide a place for fellowship, support, structure, and accountability, and they are free of charge.

Inpatient and intensive outpatient treatment programs for compulsive sexual behaviors usually focus on helping to identify core triggers and beliefs about sexual addiction and to develop healthier choices and coping skills to minimize urges and deal with the preoccupation of sexual addiction.

Individual psychotherapy for compulsive sexual behaviors is varied but the two most common approaches are cognitive behavioral therapy (CBT) and psychodynamic psychotherapy. CBT in compulsive sexual behaviors borrows greatly from treatment with substance use disorders, focuses on identifying triggers to sexual behaviors and reshaping cognitive distortions about sexual behaviors (e.g., “I'm not really cheating on my spouse if I go to a massage parlor”), and emphasizes relapse prevention. Psychodynamic psychotherapy in compulsive sexual behaviors explores the core conflicts that drive dysfunctional sexual expression. Themes of shame, avoidance, anger, and impaired self-esteem and efficacy are common. 26 Note that these types of therapy are not sex therapy, but individual therapy that focuses on reducing or controlling compulsive sexual behaviors. 26

Other forms of therapy may helpful, as well. For example, family therapy and couples therapy may restore trust, minimize shame/guilt, and establish a healthy sexual relationship between partners. 27

As for the assessment of treatment outcome, one of the unique difficulties in compulsive sexual behavior is determining when a patient has relapsed. Since there are no biological tests to indicate relapse, collateral history and functioning within the patient's significant relationship tends to be the most reliable markers. Despite the availability of psychosocial treatments, there are little data documenting treatment outcomes, success rates, predictors of treatment outcome.

Treatment: Pharmacotherapy

There are no US Food and Drug Administration (FDA)-approved medications for compulsive sexual behaviors. While preliminary case reports and open-label trials that have been conducted, no known randomized, double-blind placebo-controlled trials have been published. 24 Various classes of medications have been tried, including antidepressants, mood stabilizers, antipsychotics, and antiandrogens. The rationales for these drugs are based on clinical phenomenology and symptoms seen in other disorders, such as substance use or obsessive compulsive disorders.

SSRIs have been tried for both paraphilic and non-paraphilic compulsive sexual behaviors through both case series and open-label studies. 24 , 28 No one SSRI has demonstrated superior efficacy to another. Theoretically, SSRIs may decrease the urges/craving and preoccupation associated with sexual addiction. Attempting to use SSRIs to create sexual dysfunction through their side effect profile and thus to reduce compulsive sexual behaviors does not appear to be effective. Clinical experience suggests that patients who respond best to SSRIs have co-occurring psychiatric disorders, such as depression, anxiety, or obsessive compulsive disorders. Those who do not have sexual dysfunction from SSRIs have the best treatment response.

In addition to SSRIs, naltrexone, an opiate antagonist, has been evaluated in the treatment of compulsive sexual behaviors. Grant describes a case report of co-occurring kleptomania and compulsive sexual behaviors treated successfully with naltrexone after treatment failure with SSRIs and psychotherapy. 29 The rationale for using this medication is based on previous work in substance abuse populations and pathological gamblers, where the intent is to reduce the cravings and urges by blocking the euphoria associated with the behavior. In an open-label trial of naltrexone with adolescent sexual offenders, 15 out of 21 patients noted reductions in sexual impulses and arousal. 30 There have also been studies examining the efficacy of intramuscular naltrexone in this clinical population.

Mood stabilizers, such as valproic acid and lithium, appear promising in the treatment of patients with bipolar disorder and compulsive sexual behaviors. 31 , 32 Whether this class of medications has an independent effect on reducing compulsive sexual behaviors in patients without comorbid bipolar disorder remains to be seen. Other medications, such as topiramate and nefazadone, have also been tried, but further replication is needed to determine their effectiveness. 33 , 34

In the treatment of paraphilic compulsive sexual behaviors, some pharmacotherapy strategies have focused on altering or attenuating sexual hormone function. 35 Anti-androgens, such as medroxyprogesterone acetate (300–500mg per week, intramuscularly) or cyproterone acetate (300–600mg per week, intramuscularly), lower serum testosterone levels and diminish sexual drive and desire. 24 , 35 On a more drastic level, surgical intervention (castration) has been shown to reduce recidivism in sexual offenders by theoretically lowering testosterone levels to reduce urges and cravings. There are no known double-blind, randomized studies of anti-androgenic agents in the treatment of non-paraphilic compulsive sexual behaviors. However, case reports and open label studies suggest these may be effective treatments. 13 Of importance to note, this treatment approach is temporary. Once the medications are stopped, testosterone levels will return to normal levels. This treatment approach has not been utilized in the non-paraphilic sexual behaviors.

Conclusions and Future Directions

We have much to learn about compulsive sexual behaviors, particularly their neurobiological roots, psychological risk factors, and the impact of societal values on their emergence. For now, compulsive sexual behaviors are the extreme end of a wide range of sexual experience. These behaviors can present in a variety of manners and undoubtedly have many different subtypes, severities, and clinical courses. Clinicians can enhance the identification and treatment of these disorders by implementing formal screening practices, becoming familiar with the warning signs, and knowing which types of patients are vulnerable. In time, research will begin to uncover the different subtypes of compulsive sexual behaviors as well as determine which treatment and prevention practices work the best. Currently, since there are no guidelines from which clinicians can work, we are left to review the work of those who specialize in the treatment of compulsive sexual behaviors.

Essay on Sexual Addiction

Today, specialists have no doubt that sex can be the object of addiction just like food, shopping or gambling, alcoholism or drug addiction. In cases when a person becomes sexually addicted intimate relationships become the keystone, while all life priorities quietly fade into the background and eventually disappear altogether. The only occupation a person devotes one’s own energy and thoughts to is the striving for pleasure, incessant desire to experience sensual delight. As a result, sexual addiction leads to the loss of ability to control thoughts, feelings and actions.

The physiological basis of addiction consists in the fact that sex and love provoke the production of the same chemicals in the brain as heroin and cocaine do, and therefore people suffering from sexual addiction obtain from sex the same experience that drug addicts get from drugs, and alcoholics from alcohol: extremely pleasant sensations, incomparable to anything else in their lives. Sexual relationships become for them the only way to lift the spirit. From the standpoint of psychological roots, the addicts use sex in order to suppress such feelings as sadness, anger, anxiety or fear, as well as get rid of the burden of everyday life. Current observations show that this need is so great that sexually addictive people, like alcoholics, are almost unable to resist their addiction, and therefore the emergence of the disease should not be socially justified by hypersexuality or treated as libertinism, another sexual disorder. Further in this paper, we will attempt to draw this line, considering the epidemiology, causes and course of sexual addiction, as well as will discuss possible therapeutic solutions.

Understanding sexual addiction: symptomatology and causes

Sexuality is an integral human need, a source of pleasure and positive emotions. But this is only a part of life, one of the many human needs, and most people do not put it to the forefront among the others. Harmony is violated in the case when for one reason or another, one of the needs, in this case sexual, becomes an obsession, gains distorted shapes and subordinates all person’s thoughts and actions.

However, where is the line distinguishing the normal human need for sex from a mania? On the one hand, as Karila et al. (2014, p. 4018) state in their research, some specialists long used to deny the existence of sexual addiction as a mental disorder and rather attributed it to libertinism. On the other hand, the differences between promiscuity and engagement in the perverted forms of sexual relations and addiction as such are quite obvious. In particular, similarly to other kinds of addiction, sexual addiction is characterized by such main symptoms as the inability to control one’s own sexual impulses, obsessions with sex ideas, inability to say “no’ and promiscuity of choice (Coleman-Kennedy & Pendley, 2002, p. 145-47; Schaeffer, 2009, p. 154-55). As Karila et al. (2014, p. 4019) rightly put it, regardless of the particular type of sexual behavior, it turns into addiction when it gains elements of compulsiveness and complete disregard for the consequences.

In this way, sexual addiction should be understood as a compulsive sexual behavior that is subconsciously used to achieve psychological comfort and pleasure. Sex addiction symptoms are manifested in (Coleman-Kennedy & Pendley, 2002; Giugliano, 2003; Karila et al. 2014; Schaeffer, 2009):

• implicit emotional obtrusiveness and psychological instability,
• low level of moral values,
• regular uncontrolled sexual impulses arising suddenly and not eliminated by the efforts of will and intellect,
• gradual increase in the frequency of sexual impulses,
• signs of “withdrawals” (abstinence syndrome) after a short abstinence
• penchant for casual sex with strangers,
• inability to maintain a long communication and sexual intercourse with the same partner
• persons’ uncontrollability in other spheres of life.

In this way, for a sexual addict sex is the only valuable and desired thing in life, in which one can express independence and natural talents, as well as to assert in society. However, the number of sexual partners increases together with a sense of inner emptiness (Giugliano, 2003, p. 181). Considering a person of the opposite sex only as an object for sexual satisfaction, addicts appear not to be able to build long-term relationships or experience emotional bond in existing communications. Inability to fulfill the increasingly burgeoning sexual fantasies often leads to aggression, irritability, sudden mood changes, and depression (Giugliano, 2003; Riemersma & Sytsma, 2013).

In psychoanalytic understanding, the basis of sexual addiction is all-consuming anxiety (Giugliano, 2003; Coleman-Kennedy & Pendley, 2002; Maté, 2012). According to Giugliano (2003, p. 179), this anxiety often originates in the disorder of sexual structure of personality: for example, in the sexual need for suppression of painful feelings during early sexual trauma, as well as for overcoming the state of infantile rage, depression, or anhedonia (irritation and displeasure). Reasons of sexoholism can be serious psychological problems related to childhood rape, unsuccessful first sexual experience, parents’ sexual misconduct and distorted set of priorities (Maté, 2012, p. 58-61). Thus, basing on 2012 research of childhood trauma by Gabor Maté, the factors responsible for the development of sexual addiction for women may be, for example, mother’s chronic depression and hyperstimulating sexualized relationship with father. In the case of men, these might be degrading and rejecting parental figures, especially mother, demonstrative exception of the boy from parental love relationships.

In general, expects agree that the lack of love, care, and attention from parents, and especially mother, has a great influence on the formation of future patterns of behavior with the opposite sex (Giugliano, 2003; Maté, 2012; Schaeffer, 2009). An “underloved” child who lacked affection, gentle mother kisses and hugs finds it difficult to feel confident in adult life even with a good outlook. Such people with low self-esteem constantly feel the desire to assert themselves at the expense of attention of the opposite sex. Men tend to prove to each new partner, to themselves and others their power and “sexual might”; women conquering another man subconsciously look for acknowledgement. Thus, deviant behavior patterns mainly form as a response to psychological trauma, and have a fairly strong tendency to develop into a full-fledged addiction.

Dealing with sexual addiction:

epidemiology, risk groups, and their most common behavior patterns

Thus, numerous studies claim that today about 6% of people are obsessed with the constant idea of sex (Karila et al. 2014, p. 4013). It should be noted that the most or nearly 70% of sexoholics who search for skilled medical help are men (Riemersma & Sytsma, 2013, p. 307). As Riemersma and Sytsma (2013, p. 309) describe it, a typical portrait of a sexual addict is a heterosexual man in his forties, married (or having a permanent partner), a professional who leads quite a normal life in all other aspects. At the same time, the situation with identifying dependencies among women is uneasy. According to experts, due to the still-preserved system of double standards, they often do not admit having any disorders and do not seek medical help. Nevertheless, the number of women experiencing constant irresistible need for sex is not less than 30% and shows rapid growth in recent years (Riemersma & Sytsma, 2013, p. 312).

According to Giugliano (2003), some people are more prone to addiction than others. For example, such traits may indicate that the person is able to get hooked on sex: suggestibility and imitation, curiosity and the constant search for new sensations, risk appetite and adventurism, fear of loneliness (Young, 2008, p. 23-26). According to Maté (2012); observations, potential sexoholics often have uneasy relationship with the parent of the opposite sex. Dependence is often provoked by a crisis situation like, for example, a betrayal when the deceived partner seeks to dissociate oneself from pain by using one of the patterns of deviant sexual behavior (Schaeffer, 2009, p. 159).

In general, psychiatrists distinguish 12 behaviors that are often associated with sex addiction (basing on Coleman-Kennedy & Pendley, 2002; Giugliano, 2003; Karila et al., 2014; Riemersma & Sytsma, 2013; and Schaeffer, 2009):

• Compulsive masturbation reaching in some cases 20 times a day,
• Numerous sex and extramarital sexual relations, a high demand for sexual intercourse,
• Promiscuity in sexual partners, frequent “one night” relationships,
• Obtrusive use and watching of pornographic materials, pornophilia,
• Sex with strangers without using condoms and other contraception and protection against STDs,
• Phone sex, constant participation in sexual forums on the Internet and social networks,
• Obsessive dating through electronic and conventional dating services,
• Frequent use of prostitutes or gigolos,
• Exhibitionism,
• Voyeurism (watching other people have sex),
• Sexual harassment and sexual abuse,
• Propensity for sexual abuse and incest, and other paraphilias.

If a person’s behavior matches at least four of the above symptoms, there is high probability that an individual is a sexual addict (Karila et al., 2014, p. 4015).

Essay on  Sexual Addiction part 2

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239 Addiction Essay Topic Ideas & Examples

🏆 best addiction topic ideas & essay examples, 👍 good essay topics on addiction, 📌 simple & easy addiction essay titles, 💡 most interesting addiction topics to write about, 📑 good research topics about addiction, ✍️ addiction essay topics for college.

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What Sentencing Could Look Like if Trump Is Found Guilty

By Norman L. Eisen

Mr. Eisen is the author of “Trying Trump: A Guide to His First Election Interference Criminal Trial.”

For all the attention to and debate over the unfolding trial of Donald Trump in Manhattan, there has been surprisingly little of it paid to a key element: its possible outcome and, specifically, the prospect that a former and potentially future president could be sentenced to prison time.

The case — brought by Alvin Bragg, the Manhattan district attorney, against Mr. Trump — represents the first time in our nation’s history that a former president is a defendant in a criminal trial. As such, it has generated lots of debate about the case’s legal strength and integrity, as well as its potential impact on Mr. Trump’s efforts to win back the White House.

A review of thousands of cases in New York that charged the same felony suggests something striking: If Mr. Trump is found guilty, incarceration is an actual possibility. It’s not certain, of course, but it is plausible.

Jury selection has begun, and it’s not too soon to talk about what the possibility of a sentence, including a prison sentence, would look like for Mr. Trump, for the election and for the country — including what would happen if he is re-elected.

The case focuses on alleged interference in the 2016 election, which consisted of a hush-money payment Michael Cohen, the former president’s fixer at the time, made in 2016 to a porn star, Stormy Daniels, who said she had an affair with Mr. Trump. Mr. Bragg is arguing that the cover-up cheated voters of the chance to fully assess Mr. Trump’s candidacy.

This may be the first criminal trial of a former president in American history, but if convicted, Mr. Trump’s fate is likely to be determined by the same core factors that guide the sentencing of every criminal defendant in New York State Court.

Comparable cases. The first factor is the base line against which judges measure all sentences: how other defendants have been treated for similar offenses. My research encompassed almost 10,000 cases of felony falsifying business records that have been prosecuted across the state of New York since 2015. Over a similar period, the Manhattan D.A. has charged over 400 of these cases . In roughly the first year of Mr. Bragg’s tenure, his team alone filed 166 felony counts for falsifying business records against 34 people or companies.

Contrary to claims that there will be no sentence of incarceration for falsifying business records, when a felony conviction involves serious misconduct, defendants can be sentenced to some prison time. My analysis of the most recent data indicates that approximately one in 10 cases in which the most serious charge at arraignment is falsifying business records in the first degree and in which the court ultimately imposes a sentence, results in a term of imprisonment.

To be clear, these cases generally differ from Mr. Trump’s case in one important respect: They typically involve additional charges besides just falsifying records. That clearly complicates what we might expect if Mr. Trump is convicted.

Nevertheless, there are many previous cases involving falsifying business records along with other charges where the conduct was less serious than is alleged against Mr. Trump and prison time was imposed. For instance, Richard Luthmann was accused of attempting to deceive voters — in his case, impersonating New York political figures on social media in an attempt to influence campaigns. He pleaded guilty to three counts of falsifying business records in the first degree (as well as to other charges). He received a sentence of incarceration on the felony falsification counts (although the sentence was not solely attributable to the plea).

A defendant in another case was accused of stealing in excess of $50,000 from her employer and, like in this case, falsifying one or more invoices as part of the scheme. She was indicted on a single grand larceny charge and ultimately pleaded guilty to one felony count of business record falsification for a false invoice of just under $10,000. She received 364 days in prison.

To be sure, for a typical first-time offender charged only with run-of-the-mill business record falsification, a prison sentence would be unlikely. On the other hand, Mr. Trump is being prosecuted for 34 counts of conduct that might have changed the course of American history.

Seriousness of the crime. Mr. Bragg alleges that Mr. Trump concealed critical information from voters (paying hush money to suppress an extramarital relationship) that could have harmed his campaign, particularly if it came to light after the revelation of another scandal — the “Access Hollywood” tape . If proved, that could be seen not just as unfortunate personal judgment but also, as Justice Juan Merchan has described it, an attempt “to unlawfully influence the 2016 presidential election.”

History and character. To date, Mr. Trump has been unrepentant about the events alleged in this case. There is every reason to believe that will not change even if he is convicted, and lack of remorse is a negative at sentencing. Justice Merchan’s evaluation of Mr. Trump’s history and character may also be informed by the other judgments against him, including Justice Arthur Engoron’s ruling that Mr. Trump engaged in repeated and persistent business fraud, a jury finding that he sexually abused and defamed E. Jean Carroll and a related defamation verdict by a second jury.

Justice Merchan may also weigh the fact that Mr. Trump has been repeatedly held in contempt , warned , fined and gagged by state and federal judges. That includes for statements he made that exposed witnesses, individuals in the judicial system and their families to danger. More recently, Mr. Trump made personal attacks on Justice Merchan’s daughter, resulting in an extension of the gag order in the case. He now stands accused of violating it again by commenting on witnesses.

What this all suggests is that a term of imprisonment for Mr. Trump, while far from certain for a former president, is not off the table. If he receives a sentence of incarceration, perhaps the likeliest term is six months, although he could face up to four years, particularly if Mr. Trump chooses to testify, as he said he intends to do , and the judge believes he lied on the stand . Probation is also available, as are more flexible approaches like a sentence of spending every weekend in jail for a year.

We will probably know what the judge will do within 30 to 60 days of the end of the trial, which could run into mid-June. If there is a conviction, that would mean a late summer or early fall sentencing.

Justice Merchan would have to wrestle in the middle of an election year with the potential impact of sentencing a former president and current candidate.

If Mr. Trump is sentenced to a period of incarceration, the reaction of the American public will probably be as polarized as our divided electorate itself. Yet as some polls suggest — with the caveat that we should always be cautious of polls early in the race posing hypothetical questions — many key swing state voters said they would not vote for a felon.

If Mr. Trump is convicted and then loses the presidential election, he will probably be granted bail, pending an appeal, which will take about a year. That means if any appeals are unsuccessful, he will most likely have to serve any sentence starting sometime next year. He will be sequestered with his Secret Service protection; if it is less than a year, probably in Rikers Island. His protective detail will probably be his main company, since Mr. Trump will surely be isolated from other inmates for his safety.

If Mr. Trump wins the presidential election, he can’t pardon himself because it is a state case. He will be likely to order the Justice Department to challenge his sentence, and department opinions have concluded that a sitting president could not be imprisoned, since that would prevent the president from fulfilling the constitutional duties of the office. The courts have never had to address the question, but they could well agree with the Justice Department.

So if Mr. Trump is convicted and sentenced to a period of incarceration, its ultimate significance is probably this: When the American people go to the polls in November, they will be voting on whether Mr. Trump should be held accountable for his original election interference.

What questions do you have about Trump’s Manhattan criminal trial so far?

Please submit them below. Our trial experts will respond to a selection of readers in a future piece.

Norman L. Eisen investigated the 2016 voter deception allegations as counsel for the first impeachment and trial of Donald Trump and is the author of “Trying Trump: A Guide to His First Election Interference Criminal Trial.”

The Times is committed to publishing a diversity of letters to the editor. We’d like to hear what you think about this or any of our articles. Here are some tips . And here’s our email: [email protected] .

Follow the New York Times Opinion section on Facebook , Instagram , TikTok , WhatsApp , X and Threads .

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Trump lawyers say Stormy Daniels refused subpoena outside a Brooklyn bar, papers left ‘at her feet’

Jury selection in Donald Trump’s hush money trial has encountered new setbacks as two seated jurors were excused. Attorneys now need to pick 13 more jurors to serve on the panel.(AP Video: David R. Martin)

FILE - Stormy Daniels appears at an event, May 23, 2018, in West Hollywood, Calif. The hush money trial of former President Donald Trump begins Monday, April 15, 2024, with jury selection. It’s the first criminal trial of a former U.S. commander-in-chief. The charges in the trial center on $130,000 in payments that Trump’s company made to his then-lawyer, Michael Cohen. He paid that sum on Trump’s behalf to keep Daniels from going public, a month before the election, with her claims of a sexual encounter with Trump a decade earlier. (AP Photo/Ringo H.W. Chiu, File)

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Former President Donald Trump approaches to speak to reporters as he leaves a Manhattan courtroom after the second day of his criminal trial, Tuesday, April 16, 2024 in New York. (AP Photo/Mary Altaffer, Pool)

The latest: Get live updates from Donald Trump’s hush money trial

NEW YORK (AP) — Donald Trump’s legal team says it tried serving Stormy Daniels a subpoena as she arrived for an event at a bar in Brooklyn last month, but the porn actor, who is expected to be a witness at the former president’s criminal trial , refused to take it and walked away.

A process server working for Trump’s lawyers said he approached Daniels with papers demanding information related to a documentary recently released about her life and involvement with Trump, but was forced to “leave them at her feet,” according to a court filing made public Wednesday.

“I stated she was served as I identified her and explained to her what the documents were,” process server Dominic DellaPorte wrote. “She did not acknowledge me and kept walking inside the venue, and she had no expression on her face.”

The encounter, prior to a screening of the “Stormy” film at the 3 Dollar Bill nightclub, has touched off a monthlong battle between Trump’s lawyers and Daniels’ attorney that continued this week as the presumptive Republican nominee’s criminal trial began in Manhattan.

Trump’s lawyers are asking Judge Juan M. Merchan to force Daniels to comply with the subpoena. In their filing, they included a photo they said DellaPorte took of Daniels as she strode away.

Daniels’ lawyer Clark Brewster claims they never received the paperwork. He described the requests as an “unwarranted fishing expedition” with no relevance to Trump’s criminal trial.

“The process — instituted on the eve of trial — appears calculated to cause harassment and/or intimidation of a lay witness,” Brewster wrote in an April 9 letter to Merchan. Brewster didn’t immediately reply to a message from The Associated Press seeking comment.

The hush money case is the first of Trump’s four criminal cases to go to trial. Seven jurors have been seated so far. Jury selection is set to resume Thursday.

Daniels is expected to testify about a $130,000 payment she got in 2016 from one of Trump’s lawyers at the time, Michael Cohen, in order to stop her from speaking publicly about a sexual encounter she said she had with Trump years earlier.

Cohen was later reimbursed by Trump’s company for that payment. Trump is accused of falsifying his company’s records to hide the nature of that payment, and other work he did to bury negative stories during the 2016 campaign.

Trump pleaded not guilty last year to 34 felony counts of falsifying business records. He denies having a sexual encounter with Daniels. His lawyers argue the payments to Cohen were legitimate legal expenses, and were recorded correctly.

In a separate filing made public Wednesday, the Manhattan district attorney’s office said that if Trump chooses to testify at the trial, prosecutors plan to challenge his credibility by questioning him about his recent legal setbacks. The filing was made last month under seal.

Trump was recently ordered to pay a $454 million civil penalty following a trial in which a judge ruled he had lied about his wealth on financial statements. In another trial, a jury said he was liable for $83.3 million for defaming writer E. Jean Carroll after she accused him of sexual assault.

Merchan said he plans to hold a hearing Friday to decide whether that will be allowed.

Under New York law, prosecutors can question witnesses about past legal matters in certain circumstances. Trump’s lawyers are opposed. Trump has said he wants to testify, but he is not required to and can always change his mind.

As for the subpoena dispute, it marks the latest attempt by Trump’s lawyers to knock loose potentially damaging information about Daniels, a key prosecution witness.

They are demanding an array of documents related to the promotion and editing of the documentary, “Stormy,” which explores Daniels’ career in the adult film industry and rise to celebrity since her alleged involvement with Trump became publicly known.

They are also requesting Daniels reveal how much, if anything, she was compensated for the film.

Trump’s lawyers contend the film’s premiere last month on NBC’s Peacock streaming service — a week before the trial was originally scheduled to start — stoked negative publicity about Trump, muddying his ability to get a fair trial.

In the filings made public Wednesday, Trump’s attorneys accuse Daniels of “plainly seeking to promote her brand and make money based on her status as a witness.”

The subpoena also demands communications between Daniels and other likely witnesses in the trial, including Cohen and Karen McDougal, a former Playboy model who alleges she had an affair with Trump. It also requests any communications between Daniels and Carroll.

Earlier this month, Merchan blocked an attempt by Trump to subpoena NBC Universal for information related to the documentary. He wrote that subpoena and the demands therein “are the very definition of a fishing expedition.”