Sex Addiction

Sex addiction, which is sometimes also referred to as “compulsive sexual behavior”, is when a person repeatedly experiences irresistible urges to participate in sexual activity despite the harmful consequences. Compulsive sexual behaviors can disrupt a person’s daily activities and cause distress; both to the person experiencing them, and those around them. Some people might also experience other related mental health conditions or symptoms, such as anxiety, depression, or substance abuse. Individuals of any sexual orientation or gender identity can experience sex addiction.

There is significant demand for help with sexual addiction, although it is not currently a diagnosable mental health disorder in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders), the tool that therapists use to diagnose mental health problems. This is a matter of ongoing debate.

Sex is often a fun and satisfying part of life, and it’s important to remember that a wide variety of sexual desires, preferences, and behaviors are considered normal and healthy. When compulsive sexual behavior becomes a recurring source of worry or interferes with day-to-day life, therapy – including, but not limited to, sex therapy – is one way to work towards healing.

How common is sex addiction?

It’s difficult to know exactly how prevalent sex addiction is because there is not a lot of data available. This may be because:

Sexual addiction is not a diagnosed mental health condition
People tend to be reluctant to discuss such personal and sensitive matters

However, a review of the existing research estimated that 3-6% of people experience sexual addiction (1). One study of university students found that compulsive sexual behavior was experienced by 3% of men and 1.2% of women (2).

Types of compulsive sexual behavior

There are a variety of sexually compulsive behaviors that people can have difficulties with. They are generally divided into two types:

Paraphilic compulsive sexual behavior: The DSM-5 includes several specific sexual disorders, called paraphilic disorders. These include exhibitionistic disorder and voyeuristic disorder, among others.
Non-paraphilic compulsive sexual behavior: These types of difficulties can be more difficult to identify as problematic because they are more common. Examples include compulsive masturbation, visits to strip clubs, paying for sex through prostitution, or excessive viewing of pornography.

Symptoms of sex addiction

Symptoms related to sexual addiction vary widely, but a few of the most common ones include:

Ongoing participation in sexual activity, fantasies and urges despite clear harmful or problematic consequences.
Being unable to control or stop the sexual behavior, even when the person wants to.
A strong, irresistible urge to participate in sexual behavior regardless of the consequences.
Spending a lot of time thinking about, or participating in, sexual activity, fantasies or urges.
Using sexual behavior as a coping strategy.

In addition, people might experience related symptoms, such as:

Anxiety or worry: You may experience anxiety or be preoccupied with your thoughts and worries about sex.
Sadness or depression: Feeling unable to control sexual behavior can lead to feeling sad, hopeless, or depressed.
Shame and guilt: People may feel shame or guilt about their sexual behavior. Additionally, stigmatization and skepticism surrounds an inability to control one’s sexual behavior. Some people dismiss sex addiction as a way of covering up for irresponsible behavior. This can also lead to feeling guilty or ashamed.
Relationship problems: The violations of trust can create conflicts between partners in intimate relationships, and compulsive sexual behaviors can prevent people from developing new relationships.

Treatment for sex addiction

If you are struggling with compulsive sexual behaviors, you might wish to consider one or more of these options:

Therapy. Find a therapist who can help you understand your challenges and find strategies for improving your related symptoms. You might work with a therapist on your own, or you and your partner(s) might choose to attend therapy together for help dealing with sexual addiction (see more tips below on selecting a therapist). Group therapy has also been suggested as a helpful treatment, as it can reduce feelings of shame and isolation (3).
Hotlines: If you’re having thoughts of suicide or need immediate support, you can always call the National Suicide Prevention Hotline at 1-800-273-8255. For help and advice you can call the Substance Abuse and Mental Health Services Administration (SAMHSA) national helpline at 1-800-662-HELP (4357).
Support groups: Many people find the experience of sharing and learning in a support group to be a beneficial experience. Sex Addicts Anonymous (SSA) is an example of a support group that uses a model similar to Alcoholics Anonymous to help people.

Therapy types for sex addiction

Therapists trained specifically in sex therapy are best equipped to treat sex addictions, as they are trained in identifuying the physical and emotional causess of the addiction.

Your therapist will work with you to decide the most appropriate type of therapy. Common types of therapy modalities for treating compulsive sexual behavior include:

What to look for in a therapist for sex addiction

There are several factors to keep in mind when selecting a mental health professional, including:

Education and credentials: Look for a licensed mental health professional who has specialized training in sex addiction and experience working in the area.

The American Association of Sexuality Educators, Counselors, and Therapists (AASECT) provides training and certification for therapists and is a good resource for locating and learning more about sex therapists.
Many therapists have a particular interest in helping people with sex-related concerns. They will often include this in their biographies so that it’s easy for you to find when searching for a therapist.

Personal fit: It’s important to find a therapist with whom you feel comfortable working. The trusting working relationship between you and your therapist, known as the “therapeutic alliance” can have a huge impact on the efficacy of therapy. Talking about sexual addiction can be confronting and some people may feel embarrassed, so you want to be sure that you are working with someone you feel comfortable with and trust.

Talk in advance: The best way to judge how you might feel about your prospective therapist is to ask for a preliminary phone call (you can do this with our vetted Zencare therapists). Most therapists will be happy to oblige. This gives you the opportunity to ask about:

Their qualifications
Their experience working with people with sex addiction
Any ongoing training they are undertaking in sex therapy or the treatment of sex-related concerns
What therapy with them will be like
Their participation in insurance plans and cost of therapy

Try to speak to a few different therapists before making your mind up.

New to therapy? Learn about how to find a therapist here.

Sources and references

(1) Karila, L. et. al., 2014 ”Sexual Addiction or Hypersexual Disorder: Different Terms for the Same Problem? A Review of the Literature”, Current Pharmaceutical Design
(2) Odlaug B.L., et. al., 2013, “Compulsive sexual behavior in young adults”, Ann Clin Psychiatry
(3) Schreiber L. R. N., Odlaug B. L. & Grant J. E. (2011). Compulsive Sexual Behavior: Phenomenology and Epidemiology In Grant J. E. & Potenza M. N. (Eds.), The Oxford handbook of impulse control disorders. New York: Oxford University Press
Derbyshire, K.L., and Grant, J.E., 2015, ”Compulsive Sexual Behavior: A Review of the Literature”, Journal of Behavioral Addictions
Wong, T.W., 2006, "Understanding and Managing Compulsive Sexual Behaviors”, Psychiatry (Edgmont)