Sex addiction has become an often-used term in the media recently, but what  does it actually mean? People who work with all addictions see common characteristics which include the inability to stop a behavior regardless of the consequences, preoccupation with the “drug” of choice, a secret double life which is hidden from even the closest relationships, and intense feelings of shame and anger after using (along with other symptoms of withdrawal). For sex addicts, sex is the drug of choice and a destructive web in which their life gets caught. Typical behaviors can include extended and compulsive use of pornography, masturbation, prostitution, sex shops and clubs, online chat rooms and video, multiple and consistent affairs and anonymous sex. Many sex addicts also experience the loss of time when acting out (they don’t realize they’ve spent all night acting out until the sun comes up), their behaviors becoming “worse” (longer periods of time, riskier or more deviant behavior) because the high isn’t as good as it once was, and a variety of consequences including relationship conflict or financial, physical, and emotional problems. Quite often other addictions may also be present and even contribute to sexual problems – alcohol or drugs being the “primer” for sexual forays, thousands of dollars being spent on books, movies, and prostitutes, or a binge eater who also struggles with pornography.

The people who struggle in these ways are often portrayed by our world as stupid or crazy (why would he/she do that!) or immoral and depraved people (the common picture people think of is the “guy in the trench coat”). The reality is that these people come from all walks of life and usually are isolated, feeling empty and hurting. While the behavior they engage in may be devastating to others and themselves, sex is the only thing that provides momentary pleasure and escape from the overwhelming stresses and loneliness of life. Many feel completely disconnected from themselves and others. Sex addiction, therefore can also be defined as an intimacy or relational disorder. Instead of healthy and fulfilling relationships with others and themselves, sex addicts primary and sometimes only relationship is with their hidden world of sex. Healthy and real intimacy contains a lot of relational and emotional risk and unknowns, whereas their sexual behavior is always available and provides a somewhat consistent experience. The picture on the internet is never going to say no, will never reject or disagree, and is completely disposable with no strings attached.

Treatment

I see sex addiction treatment as two-tiered. On the first tier, there are practical and specific interventions geared towards dealing with the behavior and thinking surrounding the addiction. This is where my former training with Patrick Carnes provides structure as well as knowledgeable and research-based interventions. Patrick Carnes is a well-known researcher and author who has been studying sex addiction for over 40 years. His “task-centered approach” is based on his research and has proven to greatly increase the success of recovery if followed (see his book Don’t Call it Love). Many of the materials I use are linked to these 30 tasks which provide a roadmap towards recovery from the addiction.

The second tier of sex addiction recovery focuses on the relational difficulties present for most addicts. Many sex addicts find it extremely challenging to be truly vulnerable, not just with what they’ve done, but who they are – their thoughts, emotions and desires. Vulnerability is at the heart of intimate relationships but it also leaves us open to being rejected by others. For addicts, this fear of rejection can lead to avoiding any situation or relationship where they are not in control. Addiction provides a false sense of control through always providing something without ever asking for any vulnerability in return. The addiction essentially becomes the “intimate relationship”. What follows is often a life of isolation, both from others and within themselves. I believe this aspect of recovery is much harder, but also is the one that will provide lasting change. Recovery is not just about getting “sober”, but developing awareness and the capacity for intimacy in other relationships. This is intricately tied to healthy sexuality and a healing of the whole person. Sobriety is key and needed, but healthy sexuality and relating is the goal. It takes courage in the face of risking, patience to overcome a multitude of challenges, strength to be honest in taking responsibility and kindness towards your authentic self and others.

Together, these two tiers of recovery can transform a life of isolation, fear, and out-of-control behavior into a life of rich connection and healthy relating.