How do you know if you or someone you love is a sex addict or if they need sex addiction counseling? This is not an easy question to answer. Sex addiction is a fairly new term and can be especially hard to wrap one’s head around. And sex is not something we can simply abstain from in the way that an alcoholic might abstain from drinking.
A relatively new term
The term sex addict didn’t start being used in the 1970s, initially by members of Alcoholics Anonymous who noticed that their sexual behavior was out of control in much the same way their drinking was. I first learned about sexual addiction in graduate school when I read Patrick Carnes’ book Out of the Shadows, which was the first book ever written on sex addiction. Since then there’s been a lot of research and writing on the subject. Most experts believe anywhere between 3% and 6% of adults in the United States suffer from sex addiction.
But most people are confused about what sex addiction is and what it means to be a sex addict. Professionals who diagnose and treat sex addictions use a similar model to what we use for addictions to substances like drugs and alcohol. On the most basic level, we believe someone has a sex addiction if their sexual behavior causes them “clinically significant impairment or distress” – in other words, if they feel bad or shameful about their sexual behavior and/or it causes problems in some area of their lives.
Symptoms of sex addiction
Though not always the case, people with sex addictions usually will experience some of the following: repeated failed attempts to stop or reduce the frequency of the behavior; over time the behavior happens more frequently or with greater intensity; spending more and more time either thinking about the behavior or engaging in the behavior; and the sexual behavior creates problems in one or more area of their lives – financial problems, legal problems, relationship problems, or problems at work.
What is often confusing about sexual addiction is that it can take many different forms depending on the addict. For some, the sexual addiction is in the form of compulsive and problematic use of pornography. For others, the addiction can take the form of repeated affairs or hiring prostitutes. There’s a wide range of sexual behaviors that can be sex addictions, but the common factors are that the person feels badly about what they do or that it causes problems in their life.
Not an official diagnosis
Sex addiction is not an official clinical diagnosis. At least not yet. The American Psychological Association considered adding it to the most recent version of its diagnostic manual in 2013 but chose not to, feeling that not enough clinical research had been conducted. Many clinicians think it will be added as an official diagnosis the next time the manual is published. In my 25 years of working with addictions of all kinds, I’ve come to believe sex addiction is a real addiction, and I've seen hundreds of addicts benefit dramatically from counseling.
But because sexuality can be expressed in so many forms, sex addicts have to define what sobriety means to them, and this is different for every addict. For someone whose addiction takes the form of extramarital affairs, for example, sobriety would include sex with his wife, and addictive behavior would likely mean fantasizing about anyone other than his wife and any sex or flirting with anyone other than his wife. It should be noted that not all cheaters are sex addicts. For an addict whose addiction is in the form of masturbating to pornography, sobriety might include sex with his wife or partner, and addictive behavior would include looking at porn, thinking about porn, and certainly masturbating to porn. Not all men who look at porn are sex addicts. Remember: in order for someone’s sexual behavior to be an addiction, they must either feel badly or shameful about it or it must cause some sort of ongoing problem in their lives.
For more information, visit my Sex Addiction Counseling page.
Feel free to contact me with any questions.