Overcoming Compulsive or Addictive Sexual Behavior

Overcoming Compulsive or Addictive Sexual Behavior

People can become addicted to chemicals such as alcohol, nicotine or heroin, but can someone be addicted to love, sex, masturbation or pornography?

The World Health Organization defines addiction as “a pathological relationship with a mood-altering experience or thing that causes damage to the individual or others.” By those criteria, sexual arousal or orgasm could be addictive. Sexual addiction, however, isn’t recognized as a mental disorder.

Whether you call it an addiction or not, if sexual thoughts or actions are causing significant distress or problems, it’s time to get help. An estimated six percent to eight percent of Americans are believed to be “sexual addicts,” according to the National Association of Sexual Addiction Problems. Both men and women can be affected.

Often, people with difficulty controlling their sexual behavior will deny and ignore the problem, especially if the compulsive sexual behavior is being used to cope with stress. Partners or spouses may be the first to spot the trouble, and can encourage them to seek professional help.

Treatment may include talk therapy and medical treatment for underlying problems, such as depression or obsessive compulsive disorder.

Warning signs

People who exhibit compulsive sexual behavior lose some self-control and can’t resist impulses and temptations. More and more time is spent thinking, planning and fantasizing about particular sexual behaviors. A person who is addicted to sex may withdraw from friends, family and even primary sexual partners, such as spouses. Addicts may need increasing stimulation to feel sexually satisfied, and they take greater risks to health, career and personal relationships.

The pursuit of this mood-altering high through sexual behavior can result in people needing increasing amounts of sexual activity to get the same result, according to Dana Putnam, forensic psychologist and founder of onlinesexaddict.com. After periods of abstinence, people with this kind of sexual compulsion may experience withdrawal symptoms and cravings for sexual activity. They tend to be secretive about behaviors and fantasies, show personality changes and often lead secret lives.

According to Patrick J. Carnes, Ph.D., a leading scholar in the field who’s written several books on the topic, these behaviors are signs of sexual addiction:
· Patterns of out-of-control sexual behavior
· Severe consequences due to sexual behavior
· Inability to stop despite adverse consequences
· Persistent pursuit of self-destructive or risky behavior
· Ongoing desire or effort to limit sexual behavior, sexual obsession and fantasy as a primary coping strategy
· Increasing amounts of sexual experience because the current level of activity isn’t sufficient
· Severe mood changes related to sexual activity
· Inordinate amounts of time spent in obtaining sex, being sexual or recovering from sexual experiences
· Neglect of important social, occupational or recreational activities because of sexual behavior.

This list must be examined within the context of each person’s situation. Obviously there can be severe consequences due to sexual behavior or severe mood changes related to sexual activity without sexual addiction.

Obsessive sexual thought patterns – even if people don’t exhibit related behavior – should also be considered a sign, according to Richard Leedes, Ph.D., a leading researcher. Obsessive thoughts alone can interfere with daily functioning.

For some people who feel like they can’t get enough, the Internet is their outlet. Nearly nine percent of respondents in a study conducted by Dr. Al Cooper, Editor of Sex and the Internet: a Guidebook for Clinicians, showed signs of online sexual compulsivity. Dr. Cooper described the Internet as a “triple-A engine” of access, affordability and anonymity. Depressed or irritable feelings from a bad day may prompt someone who is addicted to go online to escape negative emotions. The study found women more likely to visit chat rooms, while men visited pornography sites.


People with sexual addiction may lack the ability to experience responsiveness and affirmation in the real world, Dr. Richard Leedes found in his research. The great majority of people he studied had difficulty with attachment – establishing and maintaining intimate, loving relationships. People with sexual addictions also may be insecure or anxious about relationships, he found.

People with sexual addiction may be more comfortable relating to people as sexual objects, rather than human beings with thoughts and emotions. When exposed to stressful situations, sexual addicts manage their anxieties through fantasy, as a secure base in an insecure world.

A sexual addiction also could be in response to physical, sexual, family or social trauma. Other factors include:
· Biological factors, including testosterone or serotonin levels
· Personality disorders
· Mood and anxiety disorders
· Substance abuse.


Licensed mental health professionals can guide people with problems controlling their unwanted sexual fantasies and behaviors to healthier ways of sexual relating. If you have a sexual addiction, before beginning treatment, ask your mental health professional to discuss treatment methods and any training he or she received in sex therapy. Treatment of sexual addiction is an evolving field and not all therapists are well-versed in it. A licensed sex therapist could be the right choice. A psychiatrist also may be consulted, especially if an underlying disorder, such as depression, requires medical treatment.

If your spouse has a sexual addiction, you may want to seek professional guidance for yourself as well. You may need help managing your emotions and behavior. It’s important to remember that you can’t control your partner’s behavior, but you can control the way you relate to those behaviors.

A therapist may choose to use guided imagery, asking the person to visualize a situation, object, person or place, to help the person focus on the thoughts and feelings that go along with the person or thing. This technique allows the person to examine those feelings and mentally rehearse new ways of behaving.

Through guided imagery, the therapist may try to reduce the impact of sexual fantasies by developing feelings of compassion toward the targets or “victims” of these fantasies. Victims can include people pictured in pornography, particularly children and those photographed without their knowledge. If someone is an exhibitionist, the victim would be the person he exposed himself to.

This type of treatment works best when it’s combined with helping sexually addicted people understand why their fantasies developed. Guided imagery may lead people to see themselves establishing comfortable relationships with people, not objects of sexual fantasies.

People with sexual addictions may choose to enter a twelve-step program. The 12-step approach, like the one used by Alcoholics Anonymous, is spiritually based, though not on any specific religion. The program instructs people to accept responsibility by admitting wrongs and defects and make amends. They also turn over control to a higher power and admit their powerlessness. Members are encouraged to develop their own sexual recovery plan, and to define sexual sobriety for themselves.

A person seeking help may choose one or a combination of these treatments, although more research is needed to determine which are most effective.

After a period of recovery, relapses may be a concern. A therapist can help set up a relapse prevention program, designed to identify trigger situations and emotions. People with sexual addictions often aren’t conscious of behaviors that place them at risk of relapse, so they need help developing short- and long-term ways of coping with stress. Studying how they slip can provide useful information and help recovering people learn that such sexual urges intensify and then subside. In time, people learn to say to themselves, “This storm will pass. I’ll just wait it out.”

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