In 2009, sex addiction hit front page news when it was publicly revealed that Tiger Woods had cheated on his wife, Elin Nordegren. During a press conference, the pro golfer confessed to having attended a facility for the treatment of his sexual addiction and apologised to those he had let down.
Though Woods wasn’t the first celebrity to attribute extramarital affairs to sex addiction, his was one of the most well known cases. As more and more high profile infidelities were linked to sex addiction, the general public began to treat the diagnosis with a high degree of scepticism. Many believe it simply used as an excuse for bad behaviour. Disbelief in the validity of this addiction was even featured in the American cartoon South Park episode, in an episode titled “Sexual Healing.”
Unfortunately, denying the existence of sex addiction can have a very profound and negative effect on those who suffer from it, as many already have difficulty admitting to and coping with their problem.
What is Sex Addiction
Sexual addiction is characterised by engaging in persistent, compulsive, and escalating patterns of sexual behaviour, carried out regardless of negative consequences to oneself and others. Individuals suffering from sex addiction are consumed by sexual thoughts, so much so that other parts of their life are seriously affected. Over time, a person addicted to sex has to intensify their behaviour to achieve the same results. It is not uncommon for people with a sex addiction to deny they have a problem. Like all addictions, the negative impact on both the person addicted to sex and their loved ones increases as the disorder progresses.
Sexual addiction or compulsive sexual behaviour is not listed as a disorder in either the International Statistical Classification of Diseases (ICD-10),or the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Reasons for its omission include a lack of research and agreed-upon terminology. This is partially due to the diverse presentations of compulsive sexual behaviours — whether clinical features resemble an addictive disorder, an impulse control disorder, or an obsessive compulsive disorder.
Types of Sexual Addiction
Despite the lack of a formal designation, compulsive sexual behaviour is divided into two subtypes:
paraphilic and nonparaphilic.
Paraphilic disorders refer to behaviours which are considered to be outside of the conventional range of sexual behaviours, and cause personal distress, another person’s psychological distress, injury, or death, or a desire for sexual behaviours involving unwilling persons or persons unable to give legal consent.
Paraphilias recognised in the ICD-10 and DSM-5 include: exhibitionism, voyeurism, paedophilia, sexual masochism, sexual sadism, transvestic fetishism, fetishism, and frotteurism. There are other forms of paraphilias that exist but have not been yet recognised as clinical disorders, such as gerontophilia, necrophilia, zoophilia.
Non-paraphilic behaviours denote engagement in sexual practises that are readily available, such as:
- compulsive masturbation
- excessive use of pornography
- regularly attending strip clubs
- paying for sex through prostitution
- recurrent affairs
Some behaviours of those addicted to sex never progresses beyond non-paraphilic behaviours in their own homes, such as compulsive masturbation or the extensive use of pornography. For others, addiction entails engagement in illegal activities such as voyeurism, child molestation, or rape.
How Does Someone Become Addicted to Sex?
Experts have yet to pinpoint why some people become addicted to sex while others don’t. Like many other forms of addiction, a lot falls to the nature versus nurture debate.
Since some antidepressants and psychotropic drugs have been found to be effective in the treatment of sex addiction, researchers believe sex addiction may be linked to biochemical abnormalities or changes in the brain. Others hypothesise that it has to do with upbringing, as studies have found people addicted to sex frequently come from dysfunctional families, have a family history of addiction, or have suffered abuse.
What are the Complications of Sex Addiction?
One of the major hallmarks of compulsive sexual behaviour is sustained engagement in sexual activities despite any negative consequences — the same phenomenon seen in substance use and impulse control disorders.
When left untreated, compulsive sexual behaviour can result in the following:
- Loss of time and productivity due to large amounts of time spent viewing pornography or cruising for sexual partners.
- Financial losses owing to pornography purchase, strip club premiums, or prostitution fees.
- Legal consequences, including arrest for solicitation, stalking, rape, sexual abuse, exhibitionism and/or prostitution.
- Higher risk for sexually transmitted diseases (STDs) and for physical injuries due to repetitive sexual practises.
- Negative effects on the family and interpersonal relationships due to unhealthy/unrealistic expectations of sexual relationships, deception, secrecy, abuse and violations of trust.
Furthermore, since there are no substances to explain seemingly irrational behaviours — and the inability to control sexual impulses carries the stigma of depravity and moral selfishness — many people who are addicted to sex suffer feelings of shame, guilt, and poor self image. This often leads to severe anxiety, and even depression.
How do You Treat Sex Addiction?
Stigmatisation of sexual addiction in the media has unfortunately created an atmosphere that does not promote treatment and prevention. As a result, even when a person addicted to sex recognises their behaviour is out of control, seeking care is a decision faced with many hurdles.
There are various types of psychosocial treatments available for individuals suffering from compulsive sexual behaviours. They include:
- 12 step programmes, such as Sex Addicts Anonymous
- Inpatient and intensive outpatient treatment programmes focusing on identifying core triggers and beliefs about sexual addiction
- Individual psychotherapy, including counselling with experts in sexual addiction, cognitive behavioural therapy (CBT) and psychodynamic psychotherapy
- Family therapy and couples therapy
There are currently no European Medicines Agency (EMA) or US Food and Drug Administration (FDA) approved medications for compulsive sexual behaviours. Diverse classes of medications have been tried — including antidepressants, mood stabilisers, antipsychotics, and anti-androgens — based on clinical phenomenology and symptoms seen in other disorders. Though preliminary case reports and open-label trials that have been conducted, there have been no randomised, double-blind placebo-controlled trials published.
Sex addiction may not be widely accepted as a legitimate disorder, but its effects are felt clear across the globe. As more credence is given to its authenticity, and more people addicted to sex come forward seeking treatment, it is likely that the medical community will be forced to take stock of the evidence of sexual addiction — and do more to help those who need it.
If you or someone you love needs help, please contact one of the following resources for more information:
It might also be worth taking a look at this video on addiction – Everything we think we know about addiction is wrong.