The concept of nymphomania dates back to Victorian times. It was then described as a “female pathology of over-stimulated genitals” and an “illness of sexual energy levels gone awry, as well as the loss of control of the mind over the body.” Some of the behaviors that lead to this classification, such as women taking of their clothes in public or grabbing at the first man who came into sight, are consistent with the manic states of bipolar disorder, among many other pathologies. In fact, in those days, women run the risk of being treated for nymphomania if they bore children out of wedlock or were discovered masturbating. Historians and medical researchers today argue that the concept of nymphomania was largely derived from the tension of Victorian gender oppression, and it might have had little to do with an actual medical condition.

Popular culture has embraced the concept of nymphomania, and the description of the symptoms in the collective consciousness today doesn’t much differ from that of Victorian times: a nymphomaniac is a woman who constantly wants to have sex with any man that crosses her path, more or less. Many films and books in popular culture have helped maintain this tradition; for example, the best-selling novel “Diary of a nymphomaniac,” the autobiography of a rather contented prostitute.

From Sex Addiction to Hypersexual Disorder

Reality is much more complex than both Victorian diagnoses and popular belief. Even today, there is much argument as to what constitutes pathological sexual behavior, namely, where to draw the line between personal preferences and habits and an illness that truly affects the individual’s well-being. There is also an issue of comorbidity; namely, research has shown a clear tendency for hindering sexual compulsive behaviors to coexist with bipolar disorder, anxiety, depression and substance abuse, among a variety of other problems and pathologies. This makes sexual compulsions even harder to pin down.

While the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition DSM IV describes sex addiction as “distress about a pattern of repeated sexual relationships involving a succession of lovers who are experienced by the individual only as things to be used,” the proposed revision for DSM V includes the creation of a new category called hypersexual disorder.

The traits of hypersexual disorder are much broader and encompassing than the descriptions in the current DSM. First of all, the proposed category establishes that the symptoms must have been observed consistently for at least six months. These symptoms include experiencing, “recurrent and intense sexual fantasies, sexual urges, and sexual behavior,” where excessive time is consumed in both fantasies and sexual activity, sometimes in response to stressful life events, and both the physical and emotional risks of such activities for oneself or other are consistently disregarded. It is also established that these sexual behaviors shouldn’t have been caused by substance abuse or a manic episode.

The behaviors and practices used in this category definition include masturbation, pornography, sexual behavior with consenting adults, cybersex, telephone sex, and frequenting strip clubs. Interestingly enough, some of those wouldn’t have made one qualify as a nymphomaniac during Victorian times, but, alas, times have indeed changed.

In the Virtual World

An educational set of guidelines for assessment of sexual addiction presented during the 2011 US Psychiatric Health Congress focuses largely on some of the behavioral patterns mentioned in the proposed DSM V categorization. Actually, the protocole largely addresses a masculine population who conceal their use of Internet pornography, prostitutes, cybersex and the like from their female partners. Again, it points to the instant gratification of orgasm, appearing in a vicious cycle in moments of distress, and consequentially begetting more distress.

The internet has created a whole new arena for people to express their unfulfilled urges and desires, sometimes with dramatically negative consequences for their daily lives, creating a dissociation that further estranges them from their partners.

The Death of the Myth

Current research on hypersexual disorder focus largely on men. It would seem that, for all the talk about nymphomania, contemporary men are doing much more to fit the description than women.

Although conclusive research has not yet been published, regarding the nature, diagnosis and treatment of hypersexual disorder, and in spite of the fact that the “sexual addiction” term has been rejected by the scientific community, there is no doubt that several complex stand-alone and comorbid disorders exist, involving compulsive behaviors associated with both actual and simulated or imaginary sexuality, which can greatly hinder an individual’s psychological and even physical well-being. As of the present moment, the diagnosis of some of these elusive conditions remains at the discretion of the therapist, while their prevalence seems to be perpetually on the rise.

References

Goldberg, A. Sex, Religion, and the Making of Modern Madness. New York: Oxford University Press, 1999.

Grant JE, Potenza MN. The Oxford Handbook of Impulse Control Disorders. Oxford University Press; 2011.

DSM V Proposed revisions section

Kingston, D., & Firestone, P. (2008). Problematic Hypersexuality: A Review of Conceptualization and Diagnosis Sexual Addiction & Compulsivity, 15 (4), 284-310 DOI: 10.1080/10720160802289249

Levine, S. Sexual Excess Syndromes or Sexual Addiction. Presentation from the US PSYCHIATRIC AND MENTAL HEALTH CONGRESS 2011.

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