Sex Addiction

Defining Sex Addiction

Sex addiction, also known as a hypersexual disorder, is characterized by persistent and escalating sexual thoughts and acts that have a negative impact on the individual’s life. Sex addicts struggle to control or postpone sexual feelings and actions. Most sex addicts do not know how to achieve genuine intimacy, forming no attachment to their sexual partners.

Eventually, the pursuit of sex becomes more important than family, career, and even personal health and safety. As sexual preoccupation increases in terms of energy and time, the sex addict follows a routine or ritual leading to acting out on desires which is then followed by feelings of denial then shame, despair and confusion.

A common misconception is that someone who has a strong libido or has a number of sexual partners must have a sex addiction. In reality, most sex addicts crave the pursuit of sex and may gain little pleasure from a sexual act itself. Whereas most people stop engaging in a behavior that harms their health, relationships, finances or careers, sex addicts are unable to stop seeking out sexual experiences in spite of these consequences.

Similarities with Other Addictions

Addictive sexuality is like most other compulsive behaviors: a potentially destructive twist on a normal life-enhancing activity. Like drugs, sexual activities produce chemical changes in the brain. When a sexual behavior is engaged in compulsively over time, the brain adapts to the flood of neurotransmitters and craves more intense or more frequent stimuli to feel the initial rush.

Like other addictions, sex addiction is characterized by the repeated, compulsive seeking or use of a substance or activity despite adverse social, psychological and/or physical consequences. Addiction is often accompanied by physical dependence, withdrawal and tolerance.

Physical dependence is defined as a physiologic state of adaptation to a substance or chemical change in the brain, the absence of which produces symptoms of withdrawal.
Withdrawal syndrome consists of a predictable group of symptoms resulting from abrupt removal of, or a rapid decrease in the regular dosage of, a psychoactive substance or activity; the syndrome is often characterized by overactivity of the physiologic functions that were suppressed by the drug and/or depression of the functions that were stimulated by the object of addiction.
Tolerance is a state in which a drug or activity produces a diminishing biologic or behavioral response; in other words, higher doses or in the case of sex addicts, riskier or more intense behavior is needed to produce the same initial effect.

Symptoms of Sex Addiction

A wide range of behaviors can be symptoms of sex addiction, including:

Compulsive masturbation
Multiple affairs
Anonymous sex
Multiple one-night stands
Obsessive dating
Excessive use of pornography
Risky or unsafe sex
Cybersex
Exhibitionism
Voyeurism
Molestation/rape
Prostitution or use of prostitutes

Are You or Someone You Know Struggling with Sex Addiction?

The following questions are designed to be used as guidelines to identifying possible signs of sex addiction. They are not intended to provide a sure-fire method of diagnosis, nor can negative answers to these questions provide absolute assurance that sex addiction is not present.

Many sex addicts have varying patterns which can result in very different ways of approaching and answering these questions. Despite this fact, we have found that short, to-the-point questions provide as effective a tool for self-diagnosis as have lengthy explanations of what sex addiction is. We appreciate that the diagnosis of sex addiction is both very serious and very private, and believe these questions can aid in the process of getting help for sex addiction.

Have you tried unsuccessfully to control your sexual behaviors?
Do you lie about or hide your sexual activities?
Have you had sex at inappropriate times, in inappropriate places, and/or with inappropriate people?
Do you make promises to yourself concerning your sexual behavior that you find you cannot follow?
Have you had or do you have sex with someone you don’t (didn’t) want to have sex with?
Do you believe that sex will make your life bearable?
Have you ever felt that you had to have sex?
Do you keep a list, written or otherwise, of the number of partners you’ve had?
Do you feel desperation or uneasiness when you are away from your lover or sexual partner?
Have you lost count of the number of sexual partners you’ve had?
Do you feel desperate about your need for a lover, sexual fix, or future mate?
Have you had sex regardless of the consequences (e.g., the threat of being caught or facing financial problems, or the risk of contracting a sexually transmitted disease)?
Do you feel that your only (or major) value in a relationship is your ability to perform sexually?
Do you feel that you’re not “really alive” unless you are with your sexual partner?
Do you feel entitled to sex?
Do you find yourself in a relationship that you cannot leave?
Have you ever threatened your financial stability or standing in the community by pursuing a sexual partner?
Have you ever had a serious relationship threatened or destroyed because of outside sexual activity?
Do you feel that life would have no meaning without sex?
Do you find yourself flirting with or sexualizing someone even if you do not mean to?
Does your sexual behavior affect your reputation?
Do you have sex to try to deal with or escape from life’s problems?
Do you feel uncomfortable about your masturbation because of the frequency with which you masturbate, the fantasies you engage in, the props you use, and/or the places in which you do it?
Do you engage in the practice of voyeurism or exhibitionism in ways that bring discomfort and pain?
Do you find yourself needing greater variety and energy in your sexual activities just to achieve an “acceptable” level of physical and emotional relief?
Do you need to have sex in order to feel like a “real man” or a “real woman”?
Do you feel that your sexual behavior isn’t rewarding or satisfying?
Are you unable to concentrate on other areas of your life because of thoughts or feelings you are having about sex?
Do you find yourself obsessing about a specific sexual act even though these thoughts bring pain, craving or discomfort?
Have you ever wished you could stop or control your sexual activities for a given period of time?
Do you find the pain in your life increasing no matter what you do?
Do you feel that you lack dignity and wholeness?
Do you feel that your sexual life affects your spiritual life in a negative way?
Do you feel that your life is unmanageable because of your compulsive sexual thoughts or behaviors?
Have you ever thought that there might be more you could do with your life if you were not so driven by sexual pursuits?

The Stages of Sex Addiction

Sex addiction often follows a predictable course:

Preoccupation – continual fantasies about sexual prospects or situations, which can trigger an episode of sexual “acting out”
Ritualization – a preferred sexual activity or situation is often stereotyped and repetitive
Compulsion – continual engagement in sexual activity despite negative consequences and desire to stop
Despair – guilt or shame over their inability to control behavior
Other behavioral problems, particularly chemical dependency and eating disorders

Causes of Sex Addiction

Many sex addicts report some form of abuse or neglect as children and frequently see themselves as diminished or damaged in the process. Their parents are often sex and/or love addicts themselves, which suggests that both genetic and environmental factors may play a role. Stress also plays a part in fueling compulsive sexual behavior by feeding the addict’s need for withdrawal and fantasy.

Other factors that may contribute to the development of sex addiction include:

Inconsistent parental nurturing and support
Lack of parental role modeling of healthy, adaptive behaviors
Early exposure to sexual material or experiences

Treatment for Sex Addiction

Overcoming sex addiction starts with recognizing that you are out of control sexually. Getting to that point requires taking a hard look at yourself and the problems caused by your sexual behavior. In some cases, sex addicts remain in denial until a significant life event, such as a spouse or partner leaving, job loss, or a health crisis, prompts them to seek treatment for sex addiction.

As experts have learned more about sex addiction in the past decade, a number of treatment options have been developed. While some individuals are able to commit to sexual sobriety by participating in counseling or an outpatient program, many find that their motivation and ability to change are strongest at a residential sex addiction treatment center. Removed from their familiar environment, routines and triggers for acting out, individuals are immersed in a therapeutic setting where they receive 24-hour support and a full range of therapies to treat sex addiction.

Some of the goals of a sex addiction treatment center may include:

A commitment to abstinence
Developing healthy sexuality
Rebuilding relationships
Stress management

Treatment for sex addiction may follow the 12-Step model initially developed for alcoholics and drug addicts. This model views addicts as chronically addicted to a behavior in spite of their attempts to change. The model focuses on three elements of the addiction cycle:

Use of sex
Self-judgment
Avoidance behaviors

The three elements of the addictive cycle are impacted by a process created by using:

A therapeutic environment
A thorough assessment
Individual, group and family counseling
Education about healthy sexuality and mental health
Self/peer assessment
Self-help support groups such as Sex Addicts Anonymous, Sexaholics Anonymous, Sexual Compulsives Anonymous and Sex and Love Addicts Anonymous

In some cases, medications used to treat depression and other forms of addiction may be used to help manage compulsions.

The creation of an environment that supports the therapeutic process is essential to this approach. Clients must be provided with an opportunity to explore their self-judgments without fear of the judgment of others. They must feel they are listened to with empathy and respect. In earlier models of this approach, the counselor was the only one who possessed so-called counselor characteristics. Although this element is still critical, it now applies to the whole multidisciplinary team, a staff of professionals who provided needed feedback and support.

The counselor conducts an initial assessment, identifies the presenting problem, and, if indicated, schedules the client for sex addiction treatment. A thorough psychosocial assessment is conducted, and identified blocks to treatment or problems are noted. The counselor then works with the client to create a treatment plan to help the client deal with those identified problems or blocks that will prevent healing from sex addiction.

Treatment Issues