03/20/2014 07:21 pm ET Updated May 20, 2014

Thoughts on Nymphomaniac: Volume 1

After more than two decades of treating and writing about sexual addiction, I've developed a modicum of expertise. As such, whenever a new film about sexual addiction debuts, such as the just released Nymphomaniac: Volume I, I get hit with a barrage of press inquiries posing all sorts of interesting questions. For instance, last week I got a request from Semana, a Columbian lifestyle magazine. Their first question was: "What is the medical definition of nymphomania, and what are its symptoms?" Slightly amused, but also a little sad, I found myself once again explaining that "nymphomania" is an antiquated and demeaning term used to shame "loose women" rather than any sort of useful medical or psychiatric diagnosis. Then I explained that calling a female sex addict a nymphomaniac is about as empathetic and insightful as calling an alcoholic a hopeless bum (which was common practice just a few decades ago).

So, needless to say, I'm not in love with the title of Nymphomaniac: Volume I. However, the film itself, starring Charlotte Gainsbourg, Stellan Skarsgard, and Shia LeBeouf, among others, is quite good, serving as an interesting and artful complement to the equally excellent 2011 film Shame, starring Michael Fassbender. Both movies provide a dark, haunting, and relatively gritty look at active sex addiction, with Nymphomaniac: Volume I focusing on wounded women who act out sexually and Shame focusing on traumatized males who act out sexually. Interestingly, neither of these films offers resolution or redemption to the main character. (Nymphomaniac: Volume II is yet to be released, so it is possible the story may ultimately end in a happier place.)

In a very succinct and useful way, both Shame and Nymphomaniac: Volume I deliver meaningfully accurate portrayals of the emptiness, misery, and shame that typically accompany active sex addiction. For instance, Joe (Charlotte Gainsbourg), the main character in Nymphomaniac: Volume 1, self-identifies as a "bad person" and never once wavers from this portrayal of herself as she reveals her history to the sympathetic ears of Seligman (Stellan Skarsgard). This omnipresent negative self-image is consistent with the worldview of most sex addicts, in particular female sex addicts who must deal not only with their behavior and its consequences, but with the negative and highly shaming labels (nympho, slut, tramp, whore, etc.) that society routinely attaches to women who have a lot of sex, regardless of whether they do so because they enjoy it, because they are getting paid for it, or because it gives them a sense of control over early-life trauma.

Nymphomaniac: Volume I is "sex addiction accurate" in other aspects, too. For instance:

• Joe's sexual exploits start out (rather early in life) as innocent and fun-seeking, but before long she's using them less for enjoyment and more for escape. This is typical. Simply put, addicts of all types engage in their addictions not to feel better, but to feel less.
• Joe views men as objects -- a means to sexual gratification -- rather than seeing them as equals and potential partners in emotional intimacy. When her lies actually ruin one man's life, she feels nothing for either him or his wife and kids. Nor does she change her behavior.
• Joe spends nearly all of her free time pursuing sex. She has no other interests or hobbies.
• Joe's sexual activity escalates in both amount and intensity. She has more and more partners as her addiction progresses, and she engages in ever-more risky behaviors.
• Joe's response to any sort of emotional crisis is sex. When her father is terminally ill in the hospital, she has sex with an attendant. Later, she experiences sexual arousal at his deathbed.
• Joe seeks a sense of control and power through sex. For instance, she "allows" or "forbids" certain activities. At one point she speaks to Seligman about "privileges" granted to one of her regular sex partners. Using sex to feel "in control" is common with sex addicts, especially with female sex addicts.
• Joe appears to have not bonded appropriately with her "cold hearted bitch" of a mother, relying on her father for kindness and nurture. Her childhood flashbacks show that she learned ways to "please" her father, and that doing so was incredibly important. Even though their relationship does not appear to have been sexual or otherwise abusive, it is clear that she learned early on that the way to get love from men is to please them. This type of dysfunctional childhood bonding is common in sex addicts of both genders.
• By the end of the film, Joe's entire life (not just her sex life) has become "monotonous and pointless." She compares her daily movements to those of a caged animal. Everything she does is rote and repetitious, and nothing has any meaning -- especially not the sex. At one point she says to a partner, during sex, "I can't feel anything," and it is clear that she is talking about both physical numbness and emotional numbness.

Probably my favorite part of the film is when Seligman explains the oftentimes compartmentalized nature of the music of Johann Sebastian Bach, noting that Bach relied upon multiple independent melodies woven together to form a simultaneously disjointed yet cohesive whole (a technique known as polyphony). Joe immediately grasps this concept, as any true sex addict would, launching into a description of three separate lovers, each of whom meets, for her, a singular and separate emotional need -- nurturance, animalistic sexual desire, and affirmation of her existence as a human being.

Interestingly, Seligman, who empathetically and without judgment listens to Joe's story, plays a role similar to that of a sex addiction therapist at places like The Ranch and The Sexual Recovery Institute, where shame reduction is among the primary goals of treatment (along with reduction of denial, acceptance of consequences, implementing a plan for long-term behavior change, and developing healthier coping mechanisms). Seligman, like a good therapist, seems to innately recognize that Joe's childhood was highly traumatic, even if she was not overtly abused. He also seems to understand that early on she learned unhealthy (sexualized) patterns of relating and gaining both comfort and control, and that over time her sexual behaviors have become the go-to coping response to any and all incidents of emotional and/or psychological discomfort. He even attempts to convey the idea that "escaping the pain of life" is an important underlying facet of all addictions. It will be interesting to see if this direction is pursued in Volume II.

In sum, Nymphomaniac: Volume I is the latest in a string of widely released sex addiction themed films that started with Shame in 2011 and continued last year with Thanks for Sharing, a terrific film about sex addiction recovery, and Don Jon, a not-so-terrific film about porn addiction. The fact that three of these four films are accurate in their portrayal of sex addiction as it manifests in both males and females is actually somewhat amazing, considering how misunderstood sexual and romantic disorders typically are. Excepting Don Jon, these films are highly recommended for anyone interested in learning more about sexual addiction, as they without doubt bring viewers into the dark and painful world of those who struggle with this debilitating disorder.

Robert Weiss LCSW, CSAT-S is Senior Vice President of Clinical Development with Elements Behavioral Health. A licensed UCLA MSW graduate and personal trainee of Dr. Patrick Carnes, he founded The Sexual Recovery Institute in Los Angeles in 1995. He has developed clinical programs for The Ranch in Nunnelly, Tennessee, Promises Treatment Centers in Malibu, and the aforementioned Sexual Recovery Institute in Los Angeles. He has also provided clinical multi-addiction training and behavioral health program development for the US military and numerous other treatment centers throughout the United States, Europe, and Asia.