Sexual Addiction

While most of us experience sex as a pleasurable experience with few negative consequences, Sex Addicts are more likely to define their sexual exploits as driven, secretive and shameful, rather than fun, playful or intimate. Sex (and Love) addicts repetitively engage the pursuit of sex, romantic intensity and the sex act itself, much like the alcoholic takes a drink, to tolerate emotional and life stress, dissociate from past trauma or in a misguided attempt to feel in-control. Addiction to sex is similar to gambling addition in that these behaviors stimulate complex biological and neuro-chemical changes in the brain, which create the desired distractions of intense excitement and emotional arousal. Sex addiction can also be accompanied by other addictions, both chemical and behavioral.

Diagnostic Criteria for Sexual Addiction
1.    Inability to control sexual impulses
2.    Failure when attempting to stop or change sexual behavior
3.    Excessive time lost to the pursuit of sex
4.    Increasing amount of time spent in sexual activity and/or increasing intensity of sexual content or acts
5.    Sexual or Romantic activities repeatedly produce identifiable consequences
6.    Decreasing involvement in social life, recreation, career and family due to sexual activity
7.    Inability to keep commitments made to self and/or others regarding sexual behavior
8.    Continuation of problem sexual behaviors despite previous consequences

While Sexual Addiction is not defined by specific sexual acts – like hiring prostitutes or having affairs per se, or by one’s sexual orientation or even by fetishistic interest like sadomasochism; Sex Addiction is defined by how the person manages their sexual life and intimacy as a whole. One can even be a sex addict and never actually have sex with another person – for example the man or women who uses compulsive masturbation and porn to consistently substitute for healthy relationships and intimacy. Sexual Addiction can be diagnosed in people who demonstrate patterns of sexual and romantic behaviors that are often accompanied by an increasing risk of harmful consequences to self or others.  Those consequences, which often precipitate clients seeking treatment, appear in the full bio-psycho-social spectrum and might include:

1.    Threat or actual loss of marriage/primary relationship, friendships, social networks due to sexual preoccupation and behavior. (Social)
2.    Depression and anxiety related to the shame, secrecy and lowered self esteem related to sexual acting out. (Emotional)
3.    Injury due to frequency and/or type of behaviors. Sexually transmitted diseases in self and/or passed along to partners are common. (Physical)
4.    Arrests for sexual crimes, loss of professional stature or licensure for sexual misconduct or sexual harassment. (Legal)
5.    Costs of pornographic materials, use of prostitutes, phone/computer sex lines.  Loss of productivity, creativity and employment. (Financial/Work)

Dr. Patrick Carnes, in his groundbreaking book on sexual addiction, Out of the Shadows defined sexually addictive behavior as sexual activity most often involving Shame, Secrecy or Abuse. Let’s examine this further:

Shame can be defined as a feeling of inner worthlessness or despair about ever being worthy or lovable. For the sex addict who spends endless amounts of time, money and energy going to strip clubs, getting sexual massages, maintaining multiple affairs or compulsively masturbating to Internet porn, the shame he or she feels about these acts reinforces an inner core of negative feelings that ends up sabotaging relationships, careers and self-esteem.

For several years John, a 35-year-old married man with two young children has compulsively and secretively spent several hours online after his wife has gone to bed viewing Internet porn and masturbating. Recently, John made his first live contact with a few women met in chat rooms and has been making plans to meet one of them for sex during the work week.  John justifies this by saying things to himself like “it doesn’t hurt anybody and besides I deserve it, look how hard I work” and “No one will ever know so what difference does it make?” However, each time he lies to his wife and avoids being intimate with her, puts his kids to bed without spending time with them so he can return to his porn use or comes into work exhausted from late night masturbation sessions, he feels a little bit worse about himself and becomes more detached and emotionally distant from everyone around him.

The Internet has fueled a tremendous leap in sexual addiction and related problems because of the instant access it offers to graphic sexual content and connections.  Consider what it would be like for a cocaine or meth addict to be able to get high at anytime without having to leave home or spend money. That is what the Internet offers to most sex addicts!

Secrecy is a hallmark of sexual addiction. Living a compartmentalized life of hidden sexual behavior, the sex addict finds him or herself wrapped in a web of lies and manipulations, consistently distancing from intimacy and using justification, rationalization and outright denial for emotional survival. Female Sex Addicts, though often more consciously focused on flirtation and the power of romantic entanglements than the sex act itself, can also have long-term problems with Sex and Love Addiction. And for women the problem is often more deeply hidden and shameful than it often is for men.

Terry, a 42-year old sober divorced woman with two children is supposedly in a long-term monogamous dating relationship, yet she continues to “find herself” flirting with strangers met at work and in AA meetings. Despite promises made to herself to never again have sex with strangers, she continues to engage in anonymous weekly romantic and sexual encounters that put her at risk of contracting STD’s, experiencing career and relationship loss or physical harm. Each time she hits on a guy it is,” the last time”, and upon leaving each encounter she says to herself, “never again”. Terry lies consistently to her boyfriend about how and where she spends her time and has a never-ending stream of excuses about her invariable lateness, fatigue and emotional distance. When questioned about her poor attitude and inconsistency she often comes across as angry and defensive, pushing away loving friends, co-workers and her long-time partner. Lately, when traveling for work she has been hooking up with guys met in hotel bars and on airplanes. Each time she acts out in this way, she gets a little closer to surrendering her chemical sobriety and returning to the alcohol use that once nearly ruined her life.

Abusive sex can run the gamut from manipulating someone or abusing a position of power to obtain sex, to sexual offenses such as exhibitionism, voyeurism, sex with minors and rape. Potential sexual partners are being abused when they are invited into situations they do not fully understand, when there is a clear inequity of power in a personal relationship or whenever they can’t fully and openly consent to sex

Al is a supervisor in a large corporation. Because he is known to “always being on the make”, women working at the same company have learned to be careful how and where they engage with him. Al doesn’t see anything wrong with simple pats on the butt, commenting on a co-workers legs or breasts or hitting on secretaries after work, though he has always been careful not to sexually engage women who worked directly for him. Married for 11 years, Al engages in multiple sexual affairs both at work and with the prostitutes he picks up when his wife goes out of town.

Sexual Addiction recovery is a challenging complex task that is best undertaken with the support of professionals specifically trained to provide Sex Addition treatment. The current standard of training is a CSAT (Certified Sexual Addiction Therapist), offered by IITAP (The International Institute for Trauma and Addiction Professionals – see below). Sex addiction counselors require special training as they face challenges that differ significantly from those of other addiction specialists. For example: unlike the chemical dependency treatment goal of abstinence from the use of all psychoactive substances, sexual sobriety is defined as abstinence from identified problem sexual behavior with a coexisting goal of adopting and integrating healthy sexuality. In this way sexual recovery is more like healing from an eating disorder than recovery from substances or gambling.

Facilities and individuals not trained to provide Sex Addiction treatment should work to help clients gain insight into the gravity of their sexual behavior patterns and then refer them to specialized sexual addiction treatment professionals or settings. Sex addicts are unlikely to be open about their acting out in treatment programs that treat multiple diagnosis or other addictions in a single group or setting and are best treated in programs that separate them from the general treatment population. To understand this further, just imagine someone speaking up about their most intimate sexual problems in an average AA meeting, then consider how comfortable that experience would likely be for the individual and the group.

Helpful Sex Addiction Referrals
– all offer national 12-step information, along with useful articles, self-tests and referral information

* The Sexual Recovery Institute –
* The Life Healing Center of Santa Fe –
* The International Institute for Trauma and Addiction Professionals –
* The Society for the Advancement of Sexual Health –
* Professional Organizations

Useful Books on Sex and Love Addiction
Heterosexual Men – Out of the Shadows: Understanding Sex Addiction – Patrick Carnes Ph D
Homosexual Men – Cruise Control: Understanding Sex Addiction in Gay Men – Robert Weiss LCSW
Women – Ready to Heal – Women Facing Sex and Love Addiction – Kelly McDaniel MFT
Cybersex and Internet – Untangling the Web: Sex, Porn and Fantasy Addiction in the Age of the Internet – Robert Weiss MSW and Jennifer Schneider MD

About the Author

Basic Questions and Answers about Sex and Love Addiction
Q: How do I know if I am a Sex or Relationship Addict?
A: If your sexual or romantic behaviors have resulted in negative consequences in your legal status, relationships, career, sobriety, health (emotional or physical), yet you continue to engage in those sexual behaviors anyway, then you have a problem. You are a sex addict if your sexual behaviors take up excessive amounts of time, energy and resources or cause you to act in ways that go against your underlying values and beliefs. Sex addicts are often unable to keep commitments made to themselves or others to stop or change their problem sexual behaviors and most have difficulty maintaining healthy, honest intimacy. Typical sex addict behaviors include: Compulsive use of the internet for porn or sexual hook-ups, repetitive use of prostitutes, sexual massage or escorts, multiple affairs and infidelity anonymous sex and compulsive masturbation. Some sex addicts may even cross the line into sexual offending.

Q: Does Sex and Love Addiction result from a lack of healthy intimacy?
A: Sex and Love Addiction is not simply a problem of being too bored, lonely or not getting enough sex. Sex addicts use cruising, flirting, fantasy, intrigue and the sex act itself in an attempt to manage seemingly intolerable life-stressors, underlying emotional conflicts and past trauma. Sex addicts seek a sexual high to substitute for the support and intimacy they really need, but do not allow themselves. Even when surrounded by friends, family or supportive spouses, Sex and Love Addicts turn to the isolating intensity of sex and the search for sex and romance rather than reaching out to those close to them. Some sex addicts engage in an endless cycle of empty and unsatisfying intensity-based relationships, while others live in the isolation of compulsive masturbation and porn addictions.

Q: If I turn out to be a Sex Addict, can’t I just take prescription medications to reduce my excessive sex drive?
A: Certain anti-depressant and hormonal drugs can reduce sexual drive and compulsive patterns, but medication alone cannot resolve a Sex Addiction problem. Healing from addictive sexuality and intimacy disorders requires specialized outpatient and/or residential treatment, along with long-term 12-step or support group attendance, realistic education about addiction and relapse prevention along with ongoing psychotherapy. Sexual addiction is more than a physical problem that can be resolved by taking a pill.

Q: How Do I Know if I Need Treatment for Sex and Love Addiction?
A. Attending Sex Addiction Treatment is likely necessary if you are yourself unable to stop or change your problem sexual behaviors despite a focused effort to do so on your own. People who attend residential treatment have either concluded for themselves, or been convinced by their circumstances, that they need specialized, professional help.

For the purpose of the online CE Course, the article objectives are:

  • Provide interested counselors, therapists and lay people with useful information about the problem of sexual addiction.
  • Provide a brief overview of the problem of sexual addiction.
  • Provide useful reading and references for further information and help.
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