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The Devil Inside

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 PERSONAL ESSAYS


My father sleeps with prostitutes. This is his late-life confession to us, his children and his wife, and he makes it on the shore in Florida: Florida, the state with the prettiest name and the skankiest underside; Florida, a place where the beach is as white as a baby’s bed sheet, and there are hookers galore, feathered, bangled, pointed and pierced, blooming like hothouse flowers above the black sewer grates of the southern city near where my father lives.
     From the beach where we sit, I can smell that city, Miami. I can see the high-rises, sharp as syringes, poking through the hot smog. But it all seems so far away. Here, on the sand, my father is a little man. He is an older man, his red hair fading to gray. “I’m sorry,” he says. His wife, my stepmother, looks pale, with trembly lips. My father turns over his wrist, so we can all see the display of veins, trefoiled and stringy. Very deliberately, he raises one forefinger and palpates a vein, over and over, and then makes a little whisking motion, as though to slice it.
     “Dad?” I say.
     Meanwhile the waves flounce in and out, each one frilled as a petticoat.
     “Dad?” I say again.
     “It’s a disease,” he says. “I have a disease.”
     “Sex,” I say, “is a disease?”
     “Not sex,” he says, “but sex addiction, which is what I’m telling you I have. It’s been diagnosed.”
     That’s that then. Say the word “diagnosis” and all the other doors — the ones that open onto sin, or spirituality, or responsibility — click closed. Diagnosis is slim as a test tube, its circumference confining but safe. My father has a disease.
     He then tells us, there on that beach in Florida, that his behavior, which of course he’s kept hidden from us, has been going on for the past ten years. He tells us what the disease of sex addiction consists of — its symptoms, so to speak, which include compulsive sexual behavior concealed from family and friends, repeated failed attempts to stop the behavior and persistent sexual fantasies that interfere with functioning. He tells us that he loves us all very much, that he loves his wife, that he is sorry. He reports that he’s in treatment: a twelve-step group called Sex and Love Addicts Anonymous; four-times-weekly behavioral therapy and psycho-therapy; a cartload of medications, pills for depression and anxiety; and then, at last, a particularly ominous sounding medication, what he calls — what is called — an antiandrogen, a testosterone-suppressing compound that evaporates the libido.
     I listen to all of this. I feel so many things. I feel sad for my stepmother. I worry that they will now divorce. I can’t believe my father, my little rabbinical father, has so much roar and romp in him. Part of me is proud. Part of me is horrified. Part of me is pissed and very suspicious.
     This “illness” thing. This disease. Does he think we’ll let him off the hook if he can concoct a pathogen? We leave the beach and go home. Tomorrow I will fly back to Boston. Tonight, in my father’s house, I go through his cabinets, skeptical. My father apparently loves disease. I find his sleeping pills (is sleep a disease, or lack of it?), I find his antidepressants, his dexedrine (is laziness, indolence, a disease?) and then what I guess are his antiandrogens, smooth pills, pink pills, of course, I put one on my tongue and it tastes confectionary, tastes pastille, a little bit like peppermint, and later on that night, alone in my bed in my father’s house, I touch myself and feel dead.

I want to talk about disease. I am not dead. I am in my mid-thirties. I am married and have sex and have a child. I am a writer and also a psychologist, which means I have the type of training that involves many mice and fat rats, elaborate mazes and smears of brie cheese, measurements, tissue samples, stimuli. In the world of the scientist, a world psychologists claim they are a part of, disease has anatomical correlates. It can be viewed beneath a microscope. It appears in tangles and plaques. Disease is the wayward cell, the hole in the lining of the stomach. Diseases are the swollen ventricles on the schizophrenic’s brain, or the lit-up lobes of the obsessive’s, all stoplight-orange and crisis-red, a burning.
     If sexual addiction, as my father and his bevy of experts claim, is indeed a disease, then it must have physiological or biochemical manifestations. This is what I think. I think it that night, in my father’s house. I think it the next day, flying back on the plane. I think it in Boston, where I live. Call me cold. Call me frigid. I should want to soothe my father, or my stepmother, a beautiful, showy woman with perpetually moist red lips and adorable toes, each one a little pearl-dropped doll. I should think about the family, not the science, but I am a little cold. People tell me so. “You know,” people sometimes tell me, once they know me well, “you can be a little cold.” At parties I stand in one corner and do my fair share of glaring. I am decidedly not demonstrative, except with my dogs. Dogs are perfect.
     Human beings are not, and biological explanations have created the great moral loophole through which we all now seem to slip. I can’t; I must; I have to; it’s inherited. It’s in my genes. And yet, if sex addiction is an illness, then who’s to say that its chemical cousin, sex itself, or lust, or even love, are not sub-clinical expressions, or minor diseases, themselves? Maybe sex is to sex addiction what the common cold is to pneumonia. Maybe every arousal, every kiss, every baby is not an expression of health, but of decay, of death.
     The point, the real point: If sex addiction is a disease, I want to find it. I want to hold it in my hand, like a cholesterol-clogged heart. I am driven in part by curiosity, in part by love for my father. I decide to do some research.
     I am surprised by how much pops up on my computer screen. There are sex addiction FAQs and self-administered tests that deliver a diagnosis pronto, a yea or nay, a judgment, an absolution. One test, called the Sexual Addiction Screening Test (SAST), consists of twenty-six questions ranging from “Were you sexually abused as a child or an adolescent?” to “Do you regularly engage in sadomasochistic behavior?” to “Have you ever participated in sexual activity in exchange for money or gifts?” Many of the questions focus on fantasy, which seems to be a core component of sex addiction: repetitive masturbatory dreams. It is impossible, reading through the questions on this test, not to imagine my father in a way more intimate than I would like. The prostitutes I can handle, as there is something slightly exotic and even Bukowskian about the whole thing — red lights, ladies of the night — but the masturbation. Does he really do that? Solo sex is suddenly, here, the ultimate taboo; we know our parents as a part of us, relentlessly relational, and yet they’re not, he’s not. I imagine him, because I cannot help it, passing hours, days, lost in a hot haze, his penis huge in his hand, the compulsive choking while a cocker spaniel sleeps in the well-appointed living room; this is not my father. But apparently it is. And if genes are catchy, which we all know they are, then in some sense, this is me too.
     As for the gene or set of genes responsible for sex addiction, none have been definitively identified. I do, however, find a set of biochemical theories, pioneered in part by the psychiatrist Martin Kafka (an unfortunate last name indeed for a sexologist). Kafka has explored what he calls the monoamine hypothesis of sex addiction. “Monoamines” is an umbrella term for three crucial neurotransmitters in our brains: dopamine, norepinephrine and serotonin. According to Kafka (who is an assistant professor at Harvard Medical School and an attending psychiatrist at McLean Hospital in Belmont, Massachusetts), people with deviant or compulsive sexual behaviors may have a disturbance in the neurotransmitters of one or all of these chemicals. The most probable culprit is serotonin. Although a debate currently rages in the psychiatric community as to whether serotonin levels consistently correlate to any kind of psychiatric disorder, Kafka, for one, suspects serotonin exists in unusually low levels in people with sex addictions. One study published in a respected psychiatry journal found that decreasing serotonin levels in rodents and cats led to an increase in mounting behavior. Conversely, increasing serotonin levels, through good friends like Prozac and Zoloft, is known to inhibit the sex drive.
     This hypothesis is interesting in all sorts of ways, primary among them, its implication for how we view depression. Depression is also associated with low serotonin levels and many sex addicts carry a secondary or primary diagnosis of dysthymia, or low-grade depression. The most obvious assumption is that a sex addict engages in sex to relieve depression. However, sex, or hypersexuality, may in fact be driven by depression, may be a part of the depression, not its misguided cure. If this is the case, then depression is not only diminishment, but a disregulation in either direction; it can exhibit itself as enhancement, appetitive; it can provoke hunger as well as numbness, jagged peaks as well as white flatness, depending on who it’s targeting. Depression as an aphrodisiac, a stimulant, an inducer of orgasms — how odd.
     “And yet,” says Dr. Charles King, a psychologist who specializes in the study and treatment of sexual addictions, “this is all in a speculative stage. Hormones probably play a role as well as monoamines, but no studies have shown any consistent findings.” That ninety-five percent of the sexually addicted population is male, however, does suggest that testosterone may be implicated.
     “So do you think,” I ask Dr. King, “that sex addiction is primarily the result of faulty chemistry — that it’s a disease?”
     “Yes,” he says, and that depresses me.
     I suppose I should come clean here. I have my own impressive history of eating disorders and other psychiatric ills. Myriad addictions flow through my family’s blood lines. I have a one-year-old daughter with half my genes (don’t let her be doomed). I had always thought my father was the one more or less healthy outpost, a strong branch in our family tree. With his confession, I now cannot point out a single first-degree relative who is not somehow sick. I would rather be sinful than sick. A sinner, after all, can be saved, but a patient whose illness exists at the level of genes, at the level of inherited chemistry, such a patient cannot be cured. Such a patient can at best be given an Eli Lilly or a SmithKline Beecham crutch.
     Dr. King tells me about Sex and Love Addicts Anonymous (SLAA), where many people with the diagnosis go for treatment. This is the twelve-step group my father mentioned. Late at night, I call information for the number. Do I imagine it, or does the operator deliver the listing to me in a voice of disapproval? “Come to bed,” Benjamin, my husband, says. “I feel strange,” I say, and lying next to him, I keep picturing the operator, and in my mind she has hair in a prim little bun, and her hands are very old. The house we live in is also very old, and suddenly I am sure the smoke detectors don’t work. A fire crackles. The baby cries. Outside a bird is picking picking picking at the scab of the sky. Sometimes sounds hurt. Sometimes babies cry. “Shhh,” my husband says to me, and we make love, or make disease, and when I stand up afterwards, semen pours from me like pus.

©2000 Lauren Slater and Nerve.com, Inc.

     

  

 PERSONAL ESSAYS



It is a Thursday night and I go. To SLAA. The meeting is in a church in one of the wealthier suburbs just outside of Boston. Inside the hall, I see Christ in his nave. I see beautiful stained glass. I smell the azalea bushes just outside, huge dense growths of green-topped tropical pink. They smell divine. The people sit in rows. There are six men and one woman. I focus on the woman. She has kinky blond hair, a saddle of freckles over her nose. She is wearing tailored casual pants, chunky shoes and a shirt that I know is from The Gap, because I have the same one, in a different color. She is streamlined in her figure, with a flat chest that I covet. She has a good figure.
     I should lose weight. I recall a factoid left from my physiopsych class in grad school. Sometimes women with narrow hips and very flat chests have higher testosterone levels than the rest of us. She sits amongst the men, pretty.
     “Hi,” she says to me, smiling.
     “Hi,” I say to her.
     “First time here?” she asks.
     “Yeah,” I say. “I have a family member who — ”
     “You know,” she says, “family members are always welcome here, but there’s also a group for them too. A special set-apart group.”
     “Do you feel like this group’s helped you?” I ask.
     “On and off,” she answers. “You have to walk your talk you know.”
     “Well,” I say — and this is relatively easy for me to say, because my career is all about probing; I am a professional busybody — “what brings you here?”
     She tells me then. Her problem is compulsive masturbation. Her problem is that she fantasizes about other women, especially at work, and the fantasies are so intensive and compelling, she has to leave work early to masturbate, and one masturbation session ends only to start up another one, and it goes on and on, up the hill and over the dale, into the night and through the day, her life a series of compulsive clutches at herself, and then, in secret, seeking sex with other women, behind her boyfriend’s back, and money spent as well, on female prostitutes, it’s a mess, because she loves her boyfriend, she’s bi, it’s really a mess, and although we are strangers she says all of this casually, easily, and I take it in, and then the meeting starts.
     We sit in a circle. We say the Lord’s Prayer, and before I can object, someone holds my hand, and so I am held. Who Art In Heaven. Thy Will Be Done. I say the words. I find them immensely comforting. Somehow I always have thought that whatever causes suffering — genes, sin, bad luck — its only cure is in surrender.
     I listen hard when people speak. I note within myself two impulses that fuel my listening. The first is what I think of as the smut impulse. I assume attending an SLAA meeting will be a little bit like oral porn — instead of reading it, you speak it, or hear it. The voyeuristic part of me is hoping for more, and even better descriptions than the one the young woman just gave me. I am hoping for descriptions of orgasms so perfectly timed and pitched that the pleasure is pure shudder and moan. After ten years of monogamy, part of me could stand to hear these things.
     And it seems significant to me that the people in this SLAA group do not once mention, or describe, their affliction in terms of neurotransmitters. Not once is the word “chemical” used. Neither are there, in the actual meeting itself, any anecdotes involving any sex. (A disappointment! I am a voyeur!) Instead people speak of having humility. The topic is “Turning Points in Recovery.” The woman, whose name is Bess, says, “For me, recovery has been about coming to accept that I am not the biggest piece of shit the world revolves around.” A man who goes by the initials C. M. says, “My recovery rests on the fifth step.”
     For just the merest second I am confused by this comment, and look over at the set of steps 1eading to the stage, as though I might see his cure in a little apothecary bottle on one of the treads. But no, of course not. The fifth step is a “fearless and searching moral inventory.” I know this from the pamphlet in my hand, and from clients I have treated. The fifth step is about confession; it’s the mother of all memoirs, it’s about dancing out of the dark, letting your true self be seen, because, as the twelve-steppers like to say, “You are only as sick as your secrets.”
     Now it’s my turn to talk. All the others have shared their turning point, and I need to share mine. “I’m not a sex addict,” I begin, “but my father is. I don’t know, but maybe his turning point was when he confessed it to us.”
     Everyone nods. I’ve decided I really like this group. Bess has beautiful blond hair. C.M. has wire-rimmed glasses and an Oxford cloth shirt. Through the open window I smell those azaleas, and the rich dirt of a wet summer.
     “You know,” I go on, leaning forward, “what confuses me is that the doctors and researchers I’ve talked to say it’s a biochemical disease, but when I listen to everyone here talk, I get the feeling it’s more about . . . about discipline, and having a relationship with God. Do you think of yourselves as having a real and definite physical disease?”
     I am surprised at the response I get. Not a second’s hesitation. Not a moment to reflect. Bess turns intentional and driven. C.M. pushes his glasses up against his nose. “Definitely,” they say. “A disease,” they say. “We’re not talking metaphor,” they say. “We are sick.”
     “If your addiction is a physical illness,” I venture, “then how do you square that with everything you’ve talked about tonight in terms of taking responsibility for your actions? Owning up? Changing through a relationship with a higher power? If you really, really believe you’re sick, don’t you think you should be getting your treatment at a hospital, not a church?”
     I, personally, think that’s a smart question, certain to stump my new friends. Far from stumped, they are ahead of me. “You are always, always responsible,” C.M. replies. “SLAA,” Bess says, “is about learning to take responsibility for your biochemistry.”
     The rest of the group nods. A very handsome man speaks up. He is wearing a shirt and tie, and he has chiseled, perfect facial features, but his body is far too thin and his voice is broken. It is a rusty voice rising from a larynx that must have been riddled with cancer, a ghostly sound, a voice at the very end.
     “We have,” he says, “two brains.”
     “Two brains,” I echo dumbly.
     “Yes,” he says, “and that is the explanation for it all.”
     “Two brains?” I say again.
     “The animal brain,” he says, “and the human brain. In this SLAA group, that’s how we think of it. The animal part of the brain is what makes us do things, or want things, or act sick. But the human part of our brain, which is at the front of our heads, has the capacity to think and pray and make choices. You see?”
     I do. Of course he’s right. Hadn’t I studied it in school? There is what’s called the lizard brain, or the snake brain, that sits in a moist, meaty hump where the spine curves into the skull, and then there is the neo cortex, or forebrain, hugest of all in humans, that bloomed above the baser instincts, allowing us, as some neurologists would say, to reason; as some ethicists would say, to choose; as some priests would say, to transcend.
     This SLAA group, it occurs to me as I drive home that night, may have hit upon a truly unusual and insightful synthesis for the mind-body dilemma that has caused so much confusion and debate of late. These SLAA members, probably correctly, understand that our brains are both body and spirit, that the frontal lobes, while undeniably physiologically real, give rise to untenables, unfathomables like spirit, like sin, like choice. In this model — the two-brain model — the material brain contains the matter that allows it to transcend itself. We may have physiological diseases, but we also have spiritual choices about those diseases. Yes, anatomy is destiny, but because our anatomies are so infinite, that destiny is not reduced, but rich with possibilities for flesh and God.
     So, I will hold my father responsible. Damn you, Dad. Why didn’t you think? I will forgive him too, for who in God’s name can think when there is such a toxic ruckus in the head? How do we learn to evolve ourselves from snake to lizard to primate to man to woman, to sound sense and balance and finally grace? SLAA says it’s possible. I believe them. I have two brains.

I pull into the driveway at home. Benjamin is sitting on the porch in the dark, smoking a cigarette. The lit tip twinkles like a jewel in the corner of his mouth. I once smoked like a fiend, two packs a day, but I haven’t touched a cigarette since I was twenty-four.
     “How was it?” he says.
     “Pretty tame,” I say, but if that’s the case, then why do I feel so suddenly untame? Why do I feel my snake brain right this minute hissing and curling like a cobra. Imagine it, sex all day. Dreams all day. A perpetual oil slick between the thighs, a desire for degradation. Blood and come. A condition of despair, of delight. Imagine that craving. I do.
     And before I can stop myself I lean over and pluck the cigarette from my husband’s hand, bring it to my lips, place my mouth where his wetness was, and inhale. A deep drag, a hot inward rush, the peppery taste of tobacco, my lungs assaulted and shocked, seizing up. My chest is having an orgasm, and it is not good. It shudders and heaves and then I hack whatever I can back up.
     “Jesus,” Benjamin says. He whacks me on the back. “That’s unfiltered, you know. Since when have you started smoking?”
     I shake my head. I was not prepared for how hard the bite would be. My eyes begin to burn, my skull to ache. “Can you believe my father?” I say. Something loosens in me, and I start to cry. For him. For us.
     “What is it?” Benjamin asks.
     “The cigarette,” I say. “Now my head is killing me.”
     Like this. This is what he does. He sits me at his feet and works my cranium with his hands. He starts to massage at the base of the skull, where the snake brain sits, and then works his way up, up, I can feel him now, hovering over the thalamus, and then over the parietal lobe, and at last to the frontal lobes, right between the eyes; he presses with his thumbs, sweeps away tangles of pain, and then backs down again, to the snake brain, and up, and over to the wise forebrain, which he soothes and rubs, and as he does this some clearness comes, for me, for him, for my father, for my daughter, for all of us here some clearness can come, and if we are lucky it will last for a little while.
 

  

     


©2000 Lauren Slater and Nerve.com, Inc.