Written by listed counsellor/psychotherapist: Philippe Jacquet MA UKCP BAAT HPC
12th February, 20140 Comments
Sexual addiction has been already established for some time as a problem of a medical nature, its effects extending as far as to perturb not only the individual's intimate life, but also all the other dimensions of his / her existence (social relations, professional life, physical integrity etc). However, there is no diagnosis termed sexual addiction in the DSM-IV.
The symptoms of this condition (which is also known as hypersexual disorder) have been specified by the American Psychiatric Association in 2010 and the condition will be included in the DSM-V. Here are the symptoms:
- For the duration of six months, the individual has intense recurring sexual fantasies, sexual needs and a sexual behaviour associated with at least four of the following criteria:
- An extreme amount of time spent on sexual fantasies while planning and realizing certain sexual activities;
- Engaging in the aforementioned behaviours as a way of responding to dysphoric states (anxiety, depression, boredom, irritability etc).
- Engaging in the aforementioned behaviours as a way of escaping stressful events in one's day-to-day life.
- Trying very hard to reduce or control sexual impulses, but with no positive result.
- Engaging in sexual behaviours that present both physical and emotional risks.
- Both the personal and social life of the individual have to suffer because of the addiction.
- The behaviour is not being caused by the use of certain medication or a pre-existing maniacal disorder.
- The patient is over 18 years of age.
The patient usually gets highly involved in activities such as: cybersex, multiple affairs, voyeurism, exhibitionism, excessive masturbation and generally every sexual activity that is compulsive.
There are some theories trying to explain the causes of this condition:
- Neurochemical theories: sexual behaviours that are being put into practice intensely and that hold ritualized patterns, help the individual in producing changes in his / her brain's chemistry, similar to a rush of adrenaline which implicitly are accompanied by powerful sensations that determine the individual to keep on repeating them more and more often (Earle, Crow & Osborn, 1989).
- Psychological distress theories: these are based on the idea that the family determines, to a great extent, the development of an individual's personality and his / her core beliefs. A family neglecting a child will affect the child's behaviour on a long term, with chances for him / her reaching adulthood and believing that the world around them doesn't care or value them, that he / she is a worthless human being and consequently, in order to battle the feelings of isolation, weakness and lack of worth, he/she will find refuge in addictive behaviours.
- Personal experience – 80% of sex addicts have been sexually abused during childhood (Carnes, 2001).
Carnes (2001) talks about an addiction cycle of the hyper-sexual disorder:
- Preoccupation: a physical state of restlessness during which the individual obsessively seeks sexual stimulation.
- Ritualization: the routine specific to each addict that guarantees that he/she will reach the desired sexual behaviour.
- Compulsive sexual behaviour: the sexual act itself, as if has been planned out in the previous stages.
- Despair: the feeling of being overwhelmed and that they will not manage to get rid of this sexual behaviour.
The risks associated with this addiction are not few in number. Many sex addicts engage in risky behaviours, such as unprotected sex and substance abuse, according to a study conducted by Kalichman & Cain (2004). On the other hand, couple relationships and family relations are heavily affected – the perturbing of intimate relations, exposing children to pornographic materials, conflicts (Schneider, 2007).
Treatment, as with other addictions, starts with acknowledging the problem and asking for help. The therapies designed for these cases aim to reduce shame, regulate affect and teach the patient to establish limits when it comes to expressing his/her sexuality (Adams & Robinson, 2001). 12 steps programs, as well as individual and couple therapy help the individual to accept him / herself as a person and to become socially reintegrated (Schneider & Schneder, 2007). In the same time, family members are important factors in the process of recovering from this addiction, with family therapy being often-times necessary.
Adams, K.A. & Robinson, D. W. (2001). Shame Reduction, Affect Regulation, and Sexual Boundary Development: Essential Building Blocks of Sexual Addiction Treatment, Sexual Addiction & Compulsivity: The Journal of Treatment & Prevention, 8 (1), p. 23-44, DOI: 10.1080/10720160127559
Carnes, P. (2001). Out of the Shadows: Understanding Sexual Addiction, US: Hazelden
Earle, R., Crow, G. M., & Osborn, K. (1989). Lonely all the time: Recognizing, understanding, and overcoming sex addiction, for addicts and co-dependents. Simon & Schuster.
Herkov, M. (2010). What Causes Sexual Addiction?. Psych Central. Retrieved on July 1, 2012, from http://psychcentral.com/lib/2006/what-causes-sexual-addiction/
Hypersexual disorder in DSM-V. Retrieved from
http://www.dsm5.org/proposedrevisions/pages/proposedrevision.aspx?rid=415 on 2nd of July, 2012.
Kalichman, S. C. & Cain, D. (2004). The relationship between indicators of sexual compulsivity and high risk sexual practices among men and women receiving services from a sexually transmitted infection clinic, Journal of Sex Research, 41 (3), p. 235-241
Schneider, J. P. & Schneider, B. H. (1996). Couple recovery from sexual addiction / co addiction: Results of a survey of 88 marriages, Sexual Addiction & Compulsivity: The Journal of Treatment & Prevention, 3(2), p. 111-126.
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