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What Is Sex Addiction?

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Updated August 31, 2013

Despite a wide acceptance by the media, there is no agreement among bio-medical and social science researchers regarding sex addiction. It's been a popular concept for decades but still hasn't made it into the Diagnostic and Statistical Manual of Mental Disorders (DSM). Some debate the proper definition and others believe that the very idea of an addiction to sex is misguided and not helpful to those who need help.

There is general agreement that some people have problems controlling their own sexual activities or behaviors despite many efforts and obvious negative consequences of the behaviors. These problems may be mild or seriously debilitating. While there is no doubt that some people engage in out-of-control sexual behavior, there is enormous disagreement about whether or not such behavior should be called sex addiction.

The 'Popular Definition' of Sex Addiction

You may have read about sex addiction in the media, either in the context of one celebrity having a sex addiction, or in an article about how the Internet is turning us all into sex addicts. The definition of sex addiction most often used in this context developed out of a vocal movement of therapists, community organizations, and religious groups led by Patrick Carnes who first articulated his vision of "sex addiction" in his book Out of the Shadows: Understanding Sexual Addiction.

On Carnes’ website he describes sex addiction this way:

"Sexual addiction is defined as any sexually-related, compulsive behavior which interferes with normal living and causes severe stress on family, friends, loved ones and one's work environment.

Sexual addiction has been called sexual dependency and sexual compulsivity. By any name, it is a compulsive behavior that completely dominates the addict's life. Sexual addicts make sex a priority more important than family, friends and work. Sex becomes the organizing principle of the addict's lives. They are willing to sacrifice what they cherish most in order to preserve and continue their unhealthy behavior."

The main feature of Carnes' definition is inability to control one’s sexual behavior, which also includes thinking and fantasizing about sex too much. In this formulation sexual activity and even the desire for it creates a “high” which Carnes and his colleagues equate with a drug high. The addiction is evidenced by the fact that people will engage in risky, hurtful behaviors despite understanding the negative consequences that will result.

There are many problems with the concept of sex addiction. Most importantly, there is not enough empirical research to back up this definition and the majority of “evidence” given by those who subscribe to this definition consist of stories from therapists who, we’re told, have worked with clients and successfully treated them.

How Common Is Sex Addiction?

If you’re someone who is worried about their ability to control sexual thoughts, desires, and activities, this may be something you want to know, but unfortunately there isn’t a good answer. First, it’s impossible to know how many people share an experience (like sex addiction) if we don’t agree on what that experience is. Secondly, the unscientific estimates vary wildly from therapist to therapist and from one newspaper article to the next. Estimates from the sex addiction camp range from 6–10% to 45% of the American population having a sex addiction.

Causes of Sex Addiction

Theories as to what causes sex addiction or out-of-control sexual behaviors depend to some extent on the definition one subscribes to. Causes that have been cited (but never proven) include psychological causes (e.g. inability to control impulses, sex as a way of dealing with depression or anxiety, sex as a coping mechanism), bio-medical (faulty neurotransmitter regulation, in rare cases some neurological or psychiatric disorders) and social/relational (problems with intimacy, communication problems, discrepancies of sexual desire, increased access to sexually explicit material). Many sex addiction writers often suggest a relationship between sex addiction and childhood sexual abuse, and between sex addiction and current drug abuse.

Other Definitions of Sex Addiction

Researchers who reject the idea of an addiction model have used other terms over the years, including:
  • compulsive sexual behavior
  • impulse control disorder
  • hypersexaulity
  • nymphomania
  • styriasis
  • out-of-control sexual behaviors

From the perspective of an individual struggling with a behavior they feel like they can’t control, what you call it may seem less important than how to stop it. But definitions are important as they often influence treatment. For example if you define sex addiction by the amount of sex you have, treatment will be designed to reduce your frequency of sexual behavior. If you define sex addiction as an inability to experience intimacy, treatment will try to build one’s capacity for sexual intimacy.

I Don’t Care About Definitions, I Think I’m a Sex Addict

Broadly speaking, if you are struggling with out-of-control sexual behaviors and think you may be a sex addict, it is always a good idea to consult with a licensed therapist. A lucrative industry has developed around the sex addiction model and you can easily find a therapist who is "certified" to treat sex addictions. The problem is that these therapists may not have training in sex therapy and may, in fact, have no education in human sexuality. While many therapists deal with sexual issues with clients, if you're looking for someone who has specialized in sexuality you should seek out a certified sex therapist. At a minimum make sure you understand the training and credentials of whoever you work with before engaging in treatment.

Sources:

Bancroft, J. & Vukadinovic, Z. “Sexual Addiction, Sexual Comulsivity, Sexual Impulsivity, or What? Toward a Theoretical Model” The Journal of Sex Research Vol. 41, No. 3 (2004): 225-235.

Gold, S.N. & Heffner, C.L. “Sexual Addiction: Many Conceptions, Minimal Data” Clinical Psychology Revie Vol. 18, No. 3 (1998): 367-381.

Klein, M. “Sex Addiction: A Dangerous Clinical Concept” Electronic Journal of Human Sexuality Vol. 5 (2002) Accessed September 26, 2008.

Langstrom, N.L. & Hanson, R.K. “High Rates of Sexual Behavior in the General Population:Correlates and Predictors” Archives of Sexual Behavior Vol. 35, No. 1 (2006): 37–52.

Roller, C.G. “Sex Addiction and Women: A Nursing Issue” Journal of Addictions Nursing Vol. 15 (2004):53–61.

Salisbury, R. M. “Out of Control Sexual Behaviours: A Developing Practice Model” Relationship Therapy Vol. 23, No. 2 (2008): 131-139.

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