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Sex Addiction

Sex addiction is any compulsive, sexually motivated behavior that is acted out regardless of any negative consequences that the behavior might have on one's life. The condition began to be addressed as an actual mental health concern in the 1980s, and though there are claims that it is not a valid illness, an addiction to sex can interfere with daily life, and treatment can readily be sought from a mental health professional.

Understanding Sex Addiction

Also known as sexual compulsion or sexual dependency, the condition of being addicted to sex is considered by some to be a form of obsessive-compulsive behavior, as it can dominate a person's life. Sex addiction is often solely attributed to men, but the condition can affect anyone: It is estimated that between 18 million and 24 million Americans—6-8% of the population—experience some kind of sexual addiction, and of this number, up to 12% are women.

 

Sex addiction is generally characterized by a pattern of increasing, repeated sexual behavior, which is often uncontrollable despite that person's intentions and efforts to stop the behavior. Acting to fulfill one's intense and frequent sexual thoughts and fantasies will often take priority over family, friends, and work. As with any addiction, problematic thoughts and behaviors may be rationalized and the addiction denied, even when the condition develops to such an extent that it causes the loss of intimate relationships, family, friends, or one's career.

 

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Although there is no one factor that is known to cause the addiction, people who have a parent who acted out sexually or who have a history of familial sexual abuse or addiction may be more likely to become addicted to sex. Sexual acting out may also begin as a form of stress management or a way to cope with emotional pain, but because tolerance grows with sex addiction, as it does with any other addiction, the behavior will generally increase in order to obtain the same level of satisfaction. Research suggests that the "high" obtained from the release of chemicals produced during sex, such as dopamine, serotonin, and oxytocin, is the same as that obtained from the use of drugs or alcohol and that this can lead to addictive behavior, especially when a propensity to addiction exists.

Common Behaviors/Symptoms of Sex Addiction

There is no single behavior pattern for sex addiction. However, a sex addiction might include some of the behaviors listed below, though certainly not all of them. A person experiencing sex addiction, for example, will not necessarily commit an act of infidelity or escalate to committing a sex offense or any type of crime.

  • Compulsive masturbation (self-stimulation).
  • Multiple affairs (extramarital affairs).
  • Multiple or anonymous sexual partners and/or one-night stands.
  • Consistent use of pornography.
  • Unsafe sex.
  • Phone or computer sex (cybersex, sexting).
  • Prostitution or use of prostitutes.
  • Exhibitionism.
  • Extensive dating through personal ads.
  • Voyeurism (watching others) and/or stalking.
  • Sexual harassment.
  • Molestation/rape.

Typically, a loss of control over sexual behavior, and negative consequences experienced as a result of the loss of control, indicate a sex addiction. Keeping one's sexual behavior secret, feeling shame or guilt regarding one's sexual activities, or attempting to change or modify sexual behavior but being unable to do so may also be signs that indicate an addiction.

 

"Normal" sexual behavior is not something that can be defined, as human sexuality can be expressed in numerous ways. A sex addiction is not indicated by fantasies or fetishes that some may consider unusual or out of the ordinary, pornography use (when usage is able to be controlled), frequent sexual thoughts (when the impulse to act on them is able to be controlled), frequent masturbation, casual sexual encounters (unless they form an addictive or otherwise harmful pattern), or any other sexual behavior that is not compulsive.

Therapy for Sex Addiction

Therapy for sex addiction differs from the treatment of other addictions in that complete sobriety is not the goal, as it often is with, for example, drug and alcohol addictions. Instead, goals are established in treatment: The person in therapy will generally work with the therapist to identify behaviors from which to abstain. In therapy, potential triggers or danger zones that may facilitate addictive behavior can also be identified and a plan to avoid these triggers developed. 

 

Therapy, such as cognitive behavioral therapy (CBT), can also help with the identification of automatic negative thoughts, so that any unwanted thought patterns that contribute to undesirable behaviors can be modified or stopped. A mental health professional might also assist with the exploration of the sexual history of the person in treatment and examine any patterns and rituals in that person's life that may contribute to the addiction. If sexual abuse or other neglect was experienced in childhood, the person can also discuss these in therapy, as past abuse may have an influence on current behavior.

 

When romantic or familial relationships have been affected by sex addiction, family and couples therapy can also be helpful during the recovery process.


If an addiction is severe enough to have an extreme negative effect on one's life, and outpatient treatment is not effective, intensive treatment at an inpatient rehab center may be recommended.

Treating Sex Addiction

In addition to therapy, support groups and accountability circles, where a small group of people help each other stick to recovery goals and sobriety standards, may also help in the treatment of sex addiction. A 12-step group, where a person is assigned a sponsor who has also experienced addiction and can be met with at any time, has also been shown to be helpful during the process of recovering from sex addiction.

 

There is no specific drug therapy for sex addiction, but SSRI (selective serotonin reuptake inhibitors) antidepressant medications and mood stabilizers have been found to be effective at reducing some of the urges to engage in addictive behavior. As depression commonly coexists with sex addiction, SSRIs can treat the symptoms of that condition, as well. In some cases, the sex addiction is treated as obsessive-compulsive behavior (OCD) would be, and medications such as Prozac and Anafranil may be prescribed to curb the compulsions. There is also research that suggests a pre-existing condition such as ADHD, when untreated, may lead to the expression of obsessive sexual behaviors. Medications that treat ADHD, such as Adderall and Ritalin, may also be prescribed to treat the underlying ADHD. These medications can often help resolve the manifestation of addictive behavior.

Sex Addiction in the Diagnostic and Statistical Manual (DSM)

Sex addiction is not recognized as a diagnosable mental health condition by the American Psychiatric Association’s Diagnostic and Statistical Manual (DSM). According to Chester Schmidt, chair of the DSM-IV Sexual Disorder Work Group, there is “no scientific data to support a concept of sexual behavior that is called sex addiction. It is more like a symptom of other psychological problems like depression, obsessive-compulsive disorder, or bipolar disorder.” However, the American Society of Addiction Medicine and the World Health Organization (WHO) both recognize the condition as an addiction.

 

Because there are no actual criteria listed for diagnosis—only typical behaviorsa “diagnosis” is currently derived through assessment protocols specifically designed for addiction. According to data provided by Patrick Carnes, founder of the International Institute for Trauma and Addiction Professionals, sex addiction should be treated as any other addiction, and many people who have sex addiction also have co-occurring addictions such as chemical dependency, eating disorders, workaholism, compulsive spending, and gambling, to name a few.

Case Example

  • Sex addiction as a coping mechanism: Ami, 26, enters therapy, reporting a depressed mood and suicidal thoughts. She tells the therapist that she has not been happy since her boyfriend of four years left her three months earlier, and that in order to combat loneliness, she has been meeting people in bars and having one-night stands nearly every night. She says that she enjoys the act of sex but that she feels worse after her partner leaves. Ami also tells the therapist that she often becomes very intoxicated and engages in exhibitionistic acts. Though she often regrets the behavior, she finds it difficult to keep herself from repeating her actions, stating that she longs to feel wanted and loved. In therapy, Ami comes to realize that her sexual activity is helping her to cope with the breakup, which she never fully grieved or got over. The therapist helps her to realize that it is all right to grieve and feel sadness for the loss of the relationship, but that engaging in risky, promiscuous behavior will not help her to recover from the loss. Ami makes a goal of abstaining from sexual activity until she begins to date again and decides that she will no longer visit bars on her own, in order to prevent from being triggered to repeat the pattern of one-night stands, and she continues in therapy for depression.

References:

  1. Bailey, C., & Case, B. (n.d.). Sexual Addiction - AAMFT Therapy Topic. Retrieved from http://www.aamft.org/iMIS15/AAMFT/Content/Consumer_Updates/Sexual_Addiction.aspx.
  2. Biederman, J., Newcorn, J., Rivinus, T. & Weiss, M. (n.d.). Adult ADHD: Effective Treatment Strategies. Retrieved from http://www.medscape.org/viewarticle/531493_7.
  3. Brain activity in sex addiction mirrors that of drug addiction. (2014, July 11). Retrieved from http://www.cam.ac.uk/research/news/brain-activity-in-sex-addiction-mirrors-that-of-drug-addiction#sthash.3dUKxI0G.dpuf
  4. Carnes, P. (2012). Sexual Addiction, Assessment & Treatment [PowerPoint]. Retrieved from http://www.iitap.com/images/SexAddiction101.ppt.
  5. Dryden-Edwards, R. (2014, July 10). Sexual Addiction: Get Facts on Treatment and Recovery. Retrieved from http://www.medicinenet.com/sexual_addiction/article.htm.
  6. Kafka, M. P. (2010). Hypersexual disorder: A proposed diagnosis for DSM-V. Archives of Sexual Behavior, 39(2), 377-400. doi:http://dx.doi.org/10.1007/s10508-009-9574-7
  7. Klein, M. (2003). Sex addiction: A dangerous clinical concept. SIECUS Report, 31(5), 8. Retrieved from http://search.proquest.com/docview/229589078?accountid=1229
  8. Nordqvist, C. (2014, September 9). What Is Sexual Addiction? Retrieved from http://www.medicalnewstoday.com/articles/182473.php.
  9. Weiss, R. (2011, September 18). Can Women Be Sex Addicts? Retrieved from http://www.livescience.com/16113-women-sex-addicts.html.

 

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Last updated: 05-28-2015

     

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