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Sexual Addiction

Patrick J. Carnes, Ph.D., Out of the Shadows
“Like an alcoholic unable to stop drinking, sexual addicts are unable to stop their self-destructive sexual behavior. Family breakups, financial disaster, loss of jobs, and risk to life are the painful themes of their stories. Sex addicts come from all walks of life – they may be ministers, physicians, homemakers, factory workers, salespersons, secretaries, clerks, accountants, therapists, dentists, politicians, or executives, to name just a few examples. Most were abused as children – sexually, physically, and/or emotionally. The majority grew up in families in which addiction already flourished, including alcoholism, compulsive eating, and compulsive gambling. Most grapple with other addictions as well, but they find sex addiction the most difficult to stop. Much hope nevertheless exists for these addicts and their families. Sex addicts have shown an ability to transform a life of self destruction into a life of self-care, a life in chaos and despair into one of confidence and peace.”
Conservatively, at least 3-6% of the adult U.S. population struggles with sexual addiction.

What is Sex Addiction?

That is a great question! To help you with your understanding of sexual addiction, we would like to start by explaining the continuum that sexual behavior falls on.

First, if someone is engaging in no sexual behavior with him/herself or with a partner, then they would be abstinent (abstinence can also fall on a continuum of healthy & unhealthy behavior – see sexual anorexia below). Next, appropriate sexual behavior would be sexual activity within the confines of a committed relationship. The next level on the continuum would be acting out. This is the person who occasionally engages in sexual acting out either alone (with pornography and/or masturbation), or with a willing partner who is not his/her partner. Next, the person may start to abuse their sexuality through promiscuity or excessive masturbation. Lastly, that person may fall into the addiction category with their sexual behavior, the characteristics of which we will describe next (Ferree, 2010). The reason that we wanted to go through this continuum first is because we think it is important to recognize two things. First, that just because you are struggling with sexual integrity issues does not necessarily mean that you are a sex addict. Second, if you are struggling with sexual acting out, it is important to know that it is a slippery slope to addiction, so it is important to get help as soon as possible. If you don’t know which category you fall into, click here to take the Sexual Addiction Screening Test.

There are four main aspects that characterize a sexual addiction: compulsion, obsession, tolerance, and continuing despite adverse consequences. Compulsion is where the addict engages in the sexual behavior even when they don’t want to. Some addicts describe compulsion as “feeling driven” to act out. Let’s use John as an example. John signs onto his computer with his only intention being to check his email. When he sees an ad with a woman in a bathing suit, he experiences an overwhelming urge to surf the web for pornography, even though he promised himself and God he wouldn’t do that again. He feels powerless to stop.

The second characteristic, obsession, is when the addict is abnormally preoccupied with sex, to the point where other important aspects in their lives are ignored. Let’s take another example with Julie. Julie is having an affair with Bob, and she spends all of her time thinking about him, planning their next rendezvous, writing him secret emails, etc. to the point that her children feel abandoned by their mom because, even when she is with her kids, her mind is somewhere else.

A third characteristic is tolerance. Tolerance refers to the neurochemical process that happens through prolonged sexual acting out that tells the addict that they need more and more sex to accomplish the same “high”. Prolonged sexual acting out actually alters the brain chemistry. This means that sexual addiction is a progressive disease, where more and more acting out must be done for the addict to get the same high.

Lastly, a sexual addict will continue in his/her addiction despite adverse consequences. “Continuing to do something that harms you just doesn’t make sense; that is the hallmark sign of addiction” (Ferree, 2010). An example of this would be if a woman was engaging in heavy promiscuity. She goes to the doctor and finds out that she has an STD. She knows that this has come from her anonymous sexual partners, but continues in her sexual acting out anyway.

So, if you or someone you care about can see these characteristics as part of his/her sex life, what do you do? Well I have two words for you that will probably scare you to death, but they are vital to your recovery from this disease: tell somebody. You cannot do this alone. My guess is that you have tried a lot, and to no avail. This is because this fight is too big for just one person. You have to bring other people into your corner to help you get healthy. You have to face your biggest fear of someone finding you out head on.

If you don’t think you are at a point where you can tell people in your life, start out with going to a therapist and telling him/her, or go to a Sexaholics Anonymous group. Eventually, both your therapist and/or your 12-step group are going to require you to open up to the people in your life, but maybe this could be this first step in your recovery process.

Our hope for anyone struggling with this disease is to reach out. Stop living in the shadows and come into the light.

What is Sexual Anorexia?

As stated above, sexual abstinence also has a continuum of healthy sexuality and unhealthy sexuality. Some are abstinent due to personal and/or moral decisions, but others are abstinent due to an extreme aversion to anything sexual. This would be sexual anorexia. This condition goes far beyond inhibition or negative sexual attitudes. It is an obsessive state in which the thought of being sexual with oneself or others is almost unbearable. The anxiety produced is chronic and impacts one’s ability to do even some of the most basic social functions.If you are worried that you may be sexually anorexic, read through these criteria and look for any symptoms you may be experiences that would point to that diagnosis.

  • Recurrent pattern of resistance or aversion to any sexual activity, intiative, or behavior. The pattern extends beyond behavior to include any activity related to sex or any efforts to initiate sex. A core antipathy to all things sexual exists.
  • Persistant aversion to sexual contact evn though it is self-destructive or harmful to relationships. (Anorexics report many losses because sex was difficult or unbearable, including broken relationships and rejecting behaviors that others were not able to understand).
  • Extreme efforts to avoid sexual contact or attention including self-mutilation, distortions of body appearance or apparel, and aversive behavior (ex. self-cutting, extreme weight gain, and other delibrate efforts to make ones self unattractive).
  • Rigid, judgemental attitudes towards personal sexuality and sexuality of others. Anorexics are extremely critical of anyone doing anything sexual. They can sometimes come off as the “sex police” because of their intolerance of others’ attitudes, behaviors, dress, or activities. If they are sexual themselves, they have a great deal of shame over it.
  • Extreme shame and self-loathing about sexual experiences, body perceptions, and sexual attributes. Anorexics are often attractive people who experience extreme discomfort is this is noticed or acknowledged by anyone. Compliments become threatening. Sexual parts of the body are sources of deep shame.
  • Sexual aversion affects work, hobbies, friends, family, and primary relationships. Patients report having made significant and destructive work decisions because the potential for some sexual possibility existed. Hobbies were modified or abandoned. Friends were restricted or rejected. Family dynamics became dysfunctional because of tension around sexual issues.
  • Preoccupation and obsession with avoiding sexual contact. This obsession occurs to the point of loosing sleep and cause the anorexic to constantly be scanning people looking for potenial sexual approach, which is considered threatening.
  • Despair about sexual functioning, which can lead to depression and/or suicidality.
  • Avoiding intimacy and relationships out of fear of sexual contact.
  • Distress, anxiety, restlessness, or irritability because of sexual contact or potential contact.

What Do I Do Now?

If you think you may be struggling with either sexual addiction and/or anorexia, consult with a therapist about your potential diagnosis and future steps. However, these issues are very specific, and that means that they require a very specific treatment plan. So, make sure that the therapist that you meet with is a CSAT (Certified Sexual Addiction Therapist). You will know this by looking for the CSAT credentials after their name. A Certified Sex Addiction Therapist (CSAT) is a therapist that has a minimum of a Masters-level degree in psychology or a related field, is fully licensed or certified (depending on country/state) and has at least 5 years of experience in the mental health field. These individuals have completed 120 hours of in-person classroom work (in 4 stages of 1-week increments) and 30 hours of clinical supervision by a CSAT-S. These therapist have the most cutting-edge resources to be able to make your treatment process the most effective it can be. If you are interested in how Wayfare Counseling treats sexual addition, please check out our sex addiction treatment page.

More Resources

Spouses of Sex Addicts
Sexual Addiction Assessments
Sexual Addiction Treatment
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