Sex Like You Can't Even Imagine: “Crystal,” Crack and Gay Men
Abstract
The past five years have witnessed a great increase in the use of the stimulant drugs crystal methamphetamine and smoked cocaine (crack) as part of a pattern of hypersexual behavior inextricably interwoven with substance dependence. With these patients, the problems are not independent, and exist almost exclusively in the company of one another. The paper describes a framework for evaluating patients and assessing their readiness for treatment in office based individual treatment that is informed by psychoanalytic principles. Typical resistances at each stage of treatment are described, with clinical recommendations for management. Common transference and countertransference paradigms are described. The paper includes psychoanalytic exploration of the possible meanings of the experience of drug/sex addiction, abstinence and fantasies that often precede relapse.
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Stimulants such as cocaine and methamphetamine enhance desire and their problematic use can lock into association with sexual addiction.
“Stimulants, such as cocaine and methamphetamine ('extraversion drugs'), enhance desire and their problematic use can lock into association with sexual addiction (Antonio et al., 2017;Guss, 2000;Moskowitz and Roloff, 2007a;Sunderwirth et al., 1996).”
From A motivation model of sex addiction – Relevance to the controversy over the concept (2022) · cites this paper as Guss, 2000
Cites
The self-medication hypothesis of addictive disorders: focus on heroin and cocaine dependence
(1985) · American Journal of Psychiatry · doi:10.1176/ajp.142.11.1259 · Cited by 2,538 · see citing works
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Substance Use Disorders in Hypersexual Adults
Reid, R. C., & Meyer, M. D. (2016) · Current Addiction Reports · doi:10.1007/s40429-016-0124-9 · Cited by 66 · see citing works
Adams, C., Zacharia, S., Masters, L., Coffey, C., & Catalan, P. (2016) · AIDS Care · doi:10.1080/09540121.2016.1146211 · Cited by 50 · see citing works
A motivation model of sex addiction – Relevance to the controversy over the concept
Toates, F. (2022) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2022.104872 · Cited by 25 · see citing works
“Stimulants, such as cocaine and methamphetamine (‘extraversion drugs ’ ), enhance desire and their problematic use can lock into association with sexual addiction (Antonio et al., 2017; Guss, 2000; Moskowitz and Roloff, 2007a; Sunderwirth et al., 1996).”
Background
- Authors
- Guss, J. R.
- Affiliations
- New York University (US)
- Corresponding author
- Guss, Jeffrey R.
- Venue
- Journal of Gay & Lesbian Psychotherapy
- Publisher
- Informa UK Limited
- Published
- 2000-12-29
- Volume
- 3
- Issue
- 3-4
- Pages
- 105-122
- ISSN
- 0891-7140 (ISSN-L)
- OpenAlex
- W1531795080
- Cited by
- 36
- References
- 1
- Citations by year
- 2016: 2 · 2015: 1 · 2014: 1 · 2013: 1 · 2012: 2
- FWCI
- 0.90
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Gay & Lesbian Psychotherapy (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Sexuality, Behavior, and Technology
- Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Keywords
- hypersexuality, sexual addiction, stimulants, crystal methamphetamine, crack cocaine, substance dependence, psychoanalytic treatment, transference, countertransference, relapse, abstinence, sexual fantasies
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