Sex addiction, also known as sexual dependency or sexual compulsivity is described as “any sexually-related compulsive behavior which interferes with normal living and causes severe stress on family, friends, loved ones, and one’s environment” (Blum et al., 2012, p. 37).
Features may include:
- Compulsive engagement in compulsive sex, with mental obsession
- Urges or craving for compulsive sex
- Need to engage in compulsive sex more to achieve the desired effect
- Engages in compulsive sex when feeling distressed and/or to avoid feelings (e.g., sad, anxious, jealous)
- Continuing compulsive sex despite negative consequences (e.g., health, work, or relationship issues)
- Loss of control over sexual activity with failed attempts to cut down
- Withdrawal symptoms (e.g., restlessness, irritability, or anger) when unable to engage in compulsive sex.
Diagnostic Considerations:
Clinicians treat people who describe their experience as “sex addiction,” though it is not yet included in the national and international diagnostic manuals. When the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) was last revised, there was not sufficient research to include the subcategory of “sex addiction” (American Psychiatric Association, 2013, p. 481), though lay persons use these terms, and the afflicted are seen by clinicians. It is not unusual that client issues and clinical work precede research. Time lags in research are estimated to be between 15-20 years (Slote Morris, Wooding, & Grant, 2011). Knowledge will continue to evolve through outcomes of research.
Sex addiction is coded in the International Classification of Diseases, 11th Revision (ICD-11; World Health Organization, 2018) as compulsive sexual behavior.
Sex addiction often co-occurs with adjustment disorders, depression, anxiety, eating disorders, substance use or other behavioral addictions such as online gambling, cybersex or other disruptive, impulse-control, and conduct disorders. When applicable, counselors often diagnose these other disorders.
Treatment:
Treatment for sex addiction varies dependent on factors including co-occurring disorders. Common psychotherapeutic approaches support emotion regulation enhancement, coping, calming, and communication skills, relationships, conscious awareness of attachment issues and style, appropriate responses to physical and psychological cues such as triggers for sex, and a new relationship with sexual activities.
References:
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Author.
Blum K., Werner T., Carnes S., Carnes P., Bowirrat A., Giordano J., Gold M. (2012). Sex, drugs, and rock ‘n’roll: hypothesizing common mesolimbic activation as a function of reward gene polymorphisms. Journal of Psychoactive Drugs, 44, (1), 38–55.
Slote Morris, Z., Wooding, S., & Grant, J. (2011). The answer is 17 years, what is the question: Understanding time lags in translational research. Journal of the Royal Society of Medicine, 104, 510–520. https://doi.org/10.1258/jrsm.2...
World Health Organization. (2019). International statistical classification of diseases and related health problems (11th ed.). https://icd.who.int/