According to a 2008 study, between 3-6% of Americans engage in compulsive sexual behavior (CSB), better known as sex addiction. Other studies cite similar statistics, and some addiction facilities cite even higher figures. Many people feel plagued by unwanted sexual feelings or by a desire to engage in sex or view pornography that feels compulsive.
Yet the American Association of Sexuality Educators, Counselors, and Therapists (AASECT) asserts there is insufficient empirical support for the existence of sex addiction. In 2017, the Center for Positive Sexuality (CPS), The Alternative Sexualities Health Research Alliance (TASHRA), and the National Coalition for Sexual Freedom (NCSF) echoed this sentiment in a statement published in The Journal of Positive Sexuality. The Diagnostic and Statistical Manual of Mental Disorders, 5 th Edition (DSM-5) does not list sex addiction as a diagnosis.
So what explains the discrepancy? Mental health advocates disagree on this, too. Sex addiction remains a controversial concept. One thing is certain, however: sexual behavior can cause difficulties in a person’s life even when their behavior does not rise to the level of an addiction.
Even if sex is not addictive in the traditional sense, people may still struggle with sexual behavior.
Is Sex Addiction Real?
Research on sex addiction is mixed. Some studies claim to have uncovered a fairly high rate of addictive sexual behavior. These researchers say sex addiction functions like other addictions, triggering a release of dopamine that causes a person to continually chase a sexual “high.” Like other behavioral addictions—shopping, gambling, video gaming—these studies say sex addiction can act like a drug and cause a person to make damaging and unsafe decisions.
Most bodies that research human sexuality, including AASECT, argue that the concept of sexual addiction is rooted in ideology, not science. They cite research finding no specific level of sexual activity that is inherently addictive or harmful.
A 2013 study looked at the brains of 52 people who said they struggled with sex addiction. Researchers used brain imaging to look at participants’ brains while they viewed sexually suggestive images. Contrary to what theories of sex addiction would predict, their brains did not behave in a way consistent with addiction. People addicted to drugs and alcohol show distinct brain patterns when viewing addictive substances. “Sex addicts” did not display these patterns.
It’s possible that sex addiction functions through different neural pathways or that the study was poorly constructed. It’s also possible that sex truly is not addictive.
Even if sex is not addictive in the traditional sense, people may still struggle with sexual behavior. There are many reasons to seek treatment for sexual issues. For example, a person might find that their sexual behavior is inconsistent with their values or that childhood guilt and shame undermine their ability to seek sexual fulfillment. Others may want to pursue non-normative relationships, such as open or polyamorous relationships, and wonder if doing so signals a problem.
It is important for people to be able to label their own behavior in a way that feels comfortable. If the sex addiction model fits, there’s no harm in identifying with it. For others, the notion of sex addiction—or the ideology that sometimes accompanies it—may feel stigmatizing.
Ideology and ‘Sex Addiction’
Sex is an inherently social activity that is heavily colored by social norms. In some cultures, polygamous relationships are common, while in others, having sex with multiple partners during the same time frame is stigmatized. Religious, cultural, and other ideologies are inextricably linked to people’s feelings about sex, sexuality, and sex addiction.
Many religious traditions have strongly advocated for the existence of sex addiction. In many cases, these religions also argue that pornography use, especially frequent pornography use, can cause addiction. Conversely, advocates who argue for greater sexual freedom and acceptance are less likely to accept the notion that sex can be addictive or that certain sexual practices are more likely to lead to addiction.
When evaluating addiction treatment programs or looking at your own behavior, it’s important to weigh the role ideology plays. A religious sex addiction program may draw more on its spiritual tradition than on empirical research. Likewise, a person’s internalized cultural values may cause them to feel guilty or ashamed of their sexual behavior even when there is nothing inherently wrong with it.
Signs Sexual Behavior Has Become a Problem
Because sex addiction is not a widely recognized disorder, different sources list different symptoms of the addiction. Sometimes ideology plays a role in the list of symptoms. For example, a religious sect that believes sex outside of marriage is sinful may list repeated sexual encounters outside of marriage as a sign of sexual addiction.
There is no empirically supported amount of sex or interest in sex that is inherently harmful or addictive. Having a high sex drive, multiple sex partners, or significant interest in sex does not mean a person has an addiction. Non-normative sexual interests, such as an interest in bondage or group sex, are common and do not mean a person has a sex addiction.
Instead, consider looking at how sex affects your life. People who find that sex damages relationships or self-esteem may benefit from therapy.
Some warning signs that sex may be a problem warranting treatment include:
- Continuing to have or pursue sex even when you do not want to. Note that this is sometimes also a sign of religiously induced sexual shame.
- Making sexual choices that consistently undermine a relationship.
- Being unable to succeed at work or school because of a preoccupation with sex.
- Needing to have progressively more sex to get the same “rush” that less sex once offered.
- Abusive or aggressive sexual behavior, such as coercing people into sex or having sex with underage children.
Seeking Help for Problematic Sexual Behavior
A therapist can help with problematic sexual behavior in many ways. Those include:
- Discussing sexual values, the role of childhood experience in sexual values, and how religious and cultural norms can affect sexual behavior.
- Helping a person engage in sexual behavior consistent with their values.
- Supporting people in relationships to negotiate sexual boundaries and recover from sexual transgressions.
- Reassuring clients that “normal” sexual behavior comes in many forms.
- Offering a safe space to explore sexuality and move beyond sexual shame.
Some mental health diagnoses can affect sexual behavior. For example, people with bipolar may become hypersexual during a manic episode. Therapy can also help with these symptoms.
Finding a therapist who shares your values about sexuality is important. To begin your search, click here.
References:
- AASECT position on sex addiction. (n.d.). Retrieved from https://www.aasect.org/position-sex-addiction
- Karila, L., Wery, A., Weinstein, A., Cottencin, O., Petit, A., Reynaud, M., & Billieux, J. (2014). Sexual addiction or hypersexual disorder: Different terms for the same problem? A review of the literature. Current Pharmaceutical Design, 20(25), 4012-4020. doi: 10.2174/13816128113199990619
- Keenan, J. (2013, July 24). Is sex addiction real or just an excuse? Retrieved from https://slate.com/human-interest/2013/07/sex-addiction-study-ucla-researchers-find-that-sex-and-porn-might-not-actually-be-addictive.html
- Kuzma, J. M., & Black, D. W. (2008). Epidemiology, prevalence, and natural history of compulsive sexual behavior. Psychiatric Clinics of North America, 31(4), 603-611. Retrieved from https://www.sciencedirect.com/science/article/pii/S0193953X08000725
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