Sexual behavior that mirrors patterns of other addictive behaviors has similar symptoms to all addictions, such as:
- recurrent failure to resist the impulse to engage in sexual behaviors, despite wanting to or being unable to stop
- inordinate amounts of time and effort spent in obtaining sex or engaging in sexual behaviors
- engaging in sexual behavior instead of fulfilling work, family or social obligations, as well as continuing these behaviors as these areas suffer.
- increasing tolerance to the behavior requiring increases in the intensity, frequency and risk of the behavior.
When one becomes preoccupied by sexual thoughts and/or engages in risky sexual behaviors which lead to conflict in relationships or avoidance of relationships (and other negative consequences), we could say that an individual has a sexual addiction. This is because it meets the general criteria for “addiction.” Another term used to describe sexual addiction is Compulsive Sexual Behavior.
It is important to keep in mind that not all interest in sex is an addiction. Because sexual addiction is much more common among men, it is not uncommon for sex therapists to encounter couples in which the female is concerned that her male partner is addicted to sex. This may be particularly relevant when considering pornography. Many men (and women) enjoy viewing pornography. Certainly, viewing pornography by itself does not constitute a sexual addiction.
However, if it is excessive, causes problems in the relationship, and produces negative consequences, then discussing the possibility of an addiction becomes necessary.
Here are some common examples of behaviors that may indicate an addiction:
- Being unable or unwilling to have sex with your partner except while viewing pornography,
- Spending large quantities of money on sex (i.e., pornography, prostitutes, and phone sex),
- Not going to work because the majority of the day was spent engaging in sex, or viewing sexual material. Similar to other addictions, the addict may minimize or ignore the harm they are causing to themselves or others. Therefore, treatment is often delayed until some crisis occurs.
There is no single cause of sexual addiction. Multiple research studies indicate that up to 60% to 80% of people with sexual addiction were victims of child abuse. There is also frequent comorbidity with depression, anxiety and obsessive-compulsive disorders. Many researchers believe that sexual addiction follows the same neural pathways as drug and alcohol abuse.
Compulsive Sexual Behavior typically begins in late adolescence or early adulthood and impacts men more so than women. There may actually be brain impairments in individuals who have a sexual addiction which makes it so that they cannot judge the danger and negative impact of their sexual behavior. Alternatively, individuals with sexual addiction may have such impaired impulse control they immediately gratify sexual cravings without regard to the consequences. Regardless of the reasons, sexual addicts may seek out stimulation by viewing pornography, engaging in cybersex, or having sex with others, often paid, sex-trade workers. This puts them at risk for a number of life-threatening illnesses (e.g., AIDS), legal problems, (e.g., purchasing child pornography), and financial ruin.
Treatment is not focused on the complete abstinence of sex (like a heroin addict would want complete and permanent abstinence from the drug) but rather a cessation of the compulsive and damaging behavior and replacement with a healthy sexuality. Group treatment is common and similar to 12 step programs like Alcoholics Anonymous, such as Sex Addicts Anonymous. Treatment of any underlying comorbid psychiatric illnesses is essential. There is anecdotal evidence that some antidepressant medications may reduce sexual urges due to the (usually unwanted) side effect of decreased libido.
Medications
In terms of treatment alternatives, research has suggested there may be a biological component to sexual addiction; providing hope that medication may be a promising alternative for treatment. For instance, androgen reduction therapy using GNRH agonists, Pristiq, Lexapro, and Zoloft , have shown promise. Another proposed biologic model of addiction is that of chiropractic medicine. Some practitioners believe that compulsive disorders, such as sexual addiction, to result from an interruption in the brain reward cascade which produces a reward deficiency syndrome. The approach to treatment involves attempting to correct the “deficiency” through spinal adjustments and nutritional support.
Therapies
Additionally, several psycho-therapies have been designed for the treatment of sex addicts. There are several inpatient treatment programs throughout the country that have designed treatment programs specifically for sexual addiction. The majority of these programs incorporate cognitive-behavioral therapies and 12-step programs such as Sex Addicts Anonymous, or Sexaholics Anonymous. However, some therapists argue against inpatient treatment. They believe it is more beneficial for an addicted person to remain in their own natural environment where they learn to recover while dealing with ordinary, everyday stressors.
Facilities that do not provide sex addiction help directly may refer patients to a sexual addiction treatment center if sexual issues are detected during treatment for chemical dependency for example.
In cases where sexual addiction has led to exceptionally serious problems, such as when an unfaithful person has exposed the partner to HIV infection, or when sexual misconduct has occurred that could result in legal charges, loss of professional license, and financial adversity for the family, sex and love addiction rehab centers like The Sexual Recovery Institute can provide a certified sex addiction therapist who has the training necessary to assist clients in navigating these uniquely difficult situations. Certified Sex Addiction Therapists or CSAT’s have extensive long-term training and supervision in the management of sex addiction cases.
Sex addiction counselors face challenges different from those of other addiction specialists. Unlike the goal in treatment of chemical dependency, which is abstinence from use of all psychoactive substances, the therapeutic goal in sexual addiction is abstinence only from compulsive sexual behavior with a coexisting goal, that of adapting and integrating healthy sexuality.
Clearly, sexual addiction can cause great harm to relationships. Considering that sex is still a taboo, there may be a great deal of shame associated with sexual addictions. Partners of individuals who have a sexual addiction may be very distraught by their partner’s dishonesty and secret life. They may feel a sense of betrayal, and fear the legal, economic, and personal repercussions, they endure as a result of their partner’s addiction. To complicate matters further, the great deal of taboo associated with sex may not allow for discussion of the matter, and limits the amount of social support the individual receives.
It is extremely important to realize that while the past cannot be changed, moving forward with a clean slate is possible. Admitting a problem and seeking out help is the most important step a person can take towards overcoming sexual addiction.
Current estimates indicate that there are approximately 8 million men and 3 million women in the United States who meet the criteria for suffering from sexual addiction.
Sexual addiction is defined by the National Council on Sexual Addiction and Compulsivity as “engaging in persistent and escalating patterns of sexual behavior acted out despite increasing negative consequences to self and others”.
Similarly, the Diagnostic and Statistical Manual of Psychiatric Disorders IV describes the condition as ‘distress about a pattern of repeated sexual relationships involving a succession of lovers who are experienced by the individual only as things to be used”, as well as “compulsive searching for multiple partners, compulsive fixation ona an unattainable partner, compulsive masturbation, compulsive love relationships and compulsive sexuality in a relationship”. The DSM-IV-TR does not specifically define the condition as an “addiction” but rather a “Sexual Not Otherwise Specified”
Compulsive Sexual Behavior typically begins in late adolescence or early adulthood and impacts men more so than women. It may be associated with substance use or other mental health conditions i.e., (depression, anxiety, personality disorders). An additional mental health condition that may be associated with compulsive sexual behavior is bipolar disorder. Individuals with bipolar disorder often go through manic phases during which they may excessively engage in pleasurable activities, such as sex, without regard to their safety or well-being.