One way to understand Anthony Weiner's compulsive sexting

Anthony Weiner has a sexting problem that most people just don't understand.

Since 2011, the struggle has played out publicly for the former Democratic congressman and his wife Huma Abedin, a close confidant and aide to Hillary Clinton.

Revelations that Weiner traded sexual messages and photos with women online led to his resignation from Congress in 2011, significantly undermined his New York City mayoral campaign in 2013 and, as of Monday, played a role in breaking up his marriage.

While Abedin had remained with Weiner in the years since the first scandal, she announced their separation Monday after a New York Post story detailed Weiner's long relationship, conducted electronically, with an unidentified woman. The pair exchanged sexually provocative messages and revealing photos. One of the images included what appeared to be Weiner and Abedin's son sleeping next to his underwear-clad father.

While the public may rush to judgment, experts say that Weiner's behavior could be indicative of underlying emotional health problems or a serious addiction on par with chronic substance abuse and gambling. In 2013, Weiner denied that he had an addiction but has not commented on that subject since the Post story was published.

Tweet may have been deleted

Some experts disagree that sex addiction is a psychiatric disorder. When they do agree on that fact, there’s still confusion over what exactly to call it; terms in the field include compulsive sexual behavior and hypersexual disorder.

Robert Weiss, senior vice president of clinical development for Elements Behavioral Health, arranges and oversees treatment for patients who live with addictive sexual disorders, including sexting. Addiction, he says, is defined by loss of control, exhibiting the same behavior despite negative consequences and an ongoing preoccupation with acting out that behavior.

Weiss, who has not treated Weiner, says he should be held accountable for his actions, but also feels sympathy for a man who appears to be suffering from a problem beyond his control. If Weiner's compulsive sexual behavior is an addiction, Weiss says the fact that his child appeared in one of the photos demonstrates how far he was willing to go to appear attractive to the woman he sexted, who also had children.

"It's like the alcoholic who picks up his kids drunk," he says. "Nothing matters except maintaining the relationship with the alcohol."

Weiss, author of Sex Addiction 101: A Basic Guide to Healing from Sex, Porn, and Love Addiction, arranges and oversees treatment for patients who live with addictive sexual disorders, including sexting. The high, he says, is not necessarily engaging in sex, but reveling in the "anticipatory fantasy excitement" of imagining the next nude picture or the next raunchy message.

Blaming the technology that makes such fantasies possible, however, is a mistake. Smartphones, social media and apps, says Weiss, do not cause addiction but facilitate it efficiently. These affordable, accessible and sometimes anonymous tools make finding a sexting partner instantaneous, but the roots of the behavior go much deeper.

While sex addiction isn't included in the most recent version of the Diagnostic and Statistical Manual of Mental Disorders — a reference manual for clinicians — Weiss says that omission reflects cultural politics in the U.S. more than people's lived realities. In contrast, the next edition of the International Classification of Diseases (ICD), which is developed by the World Health Organization and used internationally, will reportedly include compulsive sexual behavior amongst impulse control disorders for the first time.

Dr. Charles Samenow, a psychiatrist and associate professor at The George Washington University School of Medicine & Health Sciences, says researchers don't fully understand why one person might develop a compulsive sexting habit while someone else can sext without losing control.

Samenow believes a pattern of emotional and psychological factors common to addictive behavior, such as unhealthy relationships, difficulty forming attachments and underlying mood and anxiety disorders, can help explain risk.

Those who develop an addiction, he says, often seek a high, feel guilt and shame, and then despair as the cycle repeats itself, even in the wake of dire consequences.

"People who are predisposed to this get into trouble a little quicker and a lot deeper," Samenow says of behavior like compulsive sexting.

Samenow also believes that the sexual nature of Weiner's behavior makes it easier for the public to dismiss and shame someone who may be a "sick" or "broken" individual. He looks instead to the model used to treat people with chronic substance abuse disorders: require accountability and responsibility, but provide support. "The problem is people look at this and they can’t believe it," says Samenow. "Because it’s sex, there’s an automatic judgment that he’s a pervert or dumb. What doesn’t come to mind is that he’s distressed."