A couple holds hands on the beach.Sex addiction occurs when an individual’s preoccupation with sex negatively impacts their daily life. Sex addiction can have many social consequences, sabotaging one’s intimate relationships, friendships, and career. It can also increase one’s risk of unplanned pregnancies and sexually transmitted infections. 

Sex addiction is a treatable condition. A compassionate therapist can help individuals understand and manage their sexual compulsions. Some individuals also benefit from medication and support groups. In severe cases, rehab for sex addiction may be necessary. 

THERAPY FOR SEX ADDICTION

Perhaps one of the first things a mental health professional will do is make sure a person’s sexual disinhibition truly stems from an addiction. Someone whose hypersexuality is a result of mania or Alzheimer’s will require different treatment than someone with a sex addiction. It is important to understand the cause of the behavior to determine the best treatment strategies.

A mental health professional might then assist with the exploration of a person’s sexual history. Together, they may examine any patterns and rituals in the person's life that may contribute to the addiction. If neglect or sexual abuse was experienced in childhood, the person can also discuss these in therapy, as past abuse may have an influence on current behavior.

Research has identified several effective therapies for sex addiction.

  • Cognitive behavioral therapy (CBT) can help a person identify automatic negative thoughts that may lead to undesired sexual behaviors. A person can then learn to counter these thoughts and stop the behavior.
  • Psychodynamic therapy would address how a person’s childhood experiences influenced their emotional development and attachment styles, especially in regards to intimate relationships.
  • Motivational enhancement therapy (MET) can help individuals increase and maintain their motivation to change their sexual behaviors, even when cravings are strong.
  • Couples therapy can be especially helpful when sexual addiction has sabotaged a romantic relationship.
  • Group therapy can help individuals feel less isolated or ashamed by introducing them to others experiencing similar issues. 

In many cases, sex addiction co-occurs with another mental health issues such as depression. These additional issues can make sex addiction symptoms worse. As such, a therapist will likely work on treating the diagnoses in tandem.

OTHER TREATMENTS FOR SEX ADDICTION

A man opens up during a support group for sex addictionIn addition to therapy, support groups can also be helpful during the process of sex addiction recovery. A support group is a small collection of people who help each other stick to recovery goals. Some support groups use a 12-step program similar to that of Alcoholics Anonymous. 

If an addiction has a severe negative effect on a person’s life and outpatient treatment is not effective, then they may need to get inpatient treatment. A person doing inpatient therapy will likely take up temporary residence at a rehab center. Trained staff will monitor the person and provide them with intensive therapy. The length and cost of sex addiction rehab varies widely between individual cases. A mental health professional can help individuals pick the most appropriate program.

MEDICATIONS FOR SEX ADDICTION

The Food and Drug Administration has not approved any specific drug therapy for sex addiction. However, there are some medicines which can help with symptoms.

Studies suggest SSRIs (selective serotonin reuptake inhibitors) and mood stabilizers can help reduce some of the urges to engage in sexual behaviors. They can reduce both impulsive and compulsive urges. SSRIs can also treat depressive symptoms, which commonly coexist with sex addiction.

Naltrexone is often used to treat impulse control issues such as pathological gambling or kleptomania. Research shows it can also treat sexual addiction, especially when paired with an SSRI. 

Prognosis of Sex Addiction Treatment

Therapy for sex addiction differs from the treatment of other addictions in that complete abstinence is not the goal, as it often is with, for example, drug and alcohol addictions. Instead, the person in therapy will generally work with the therapist to identify specific behaviors they want to quit. For example, a person may set a goal to stop soliciting sex from strangers and to only be intimate with people they know personally. A therapist can help the person identify potential triggers that may facilitate addictive behavior and develop a plan to avoid these “danger zones.”

The success of sexual addiction treatment can depend on several factors, including:

  • Which behaviors the person is trying to quit.
  • Whether the person has a history of sex offenses.
  • Whether the person has an additional mental health diagnosis.

In general, treatment works best when the individual wants improvement for themselves, as opposed to receiving outside pressure to get help. 

Sex Addiction and Accountability

Many celebrities have used a sex addiction diagnosis to justify having an affair. However, there is little to no research suggesting that sex addiction causes infidelity. Currently 16% of Americans engage in marital infidelity, while only 3-6% of people experience sex addiction. Even if most individuals with sex addiction had affairs (which they do not), the majority of people who cheat on their partners do not have a sex compulsion.

The same is true of sexual harassment, sexual assault, and so on. While sex offenders do have higher rates of sex addiction, most sex offenders do not have the condition. Sexual assault is generally more about power than sex itself. 

Sex addiction does cause cravings for sex which are hard to resist. However, sex addiction does not force a person to pursue sex in a way that hurts others. In fact, studies show the most common sexual compulsions are masturbation, pornography, and consensual promiscuity.  Having a sex addiction in no way erases a person’s responsibility to get consent.

CASE EXAMPLE OF SEX ADDICTION TREATMENT

  • Sex addiction as a coping mechanism: Ami, 26, enters therapy, reporting a depressed mood and suicidal thoughts. She tells the therapist that she has not been happy since her boyfriend of four years left her three months earlier. In order to combat loneliness, she has been meeting people in bars and having one-night stands nearly every night. She says she enjoys the act of sex but feels worse after her partner leaves. Ami also tells the therapist that she often becomes very intoxicated and engages in exhibitionistic acts. Though she often regrets the behavior, Ami finds it difficult to keep herself from repeating her actions, stating that she longs to feel wanted and loved. In therapy, Ami comes to realize her sexual activity is helping her to cope with the breakup, which she never fully grieved or got over. The therapist helps her to realize that while it is all right to feel sadness for the loss of the relationship, engaging in risky, promiscuous behavior will not help her to recover from the loss. Ami makes a goal of abstaining from sexual activity until she begins to date again. She also decides that she will no longer visit bars on her own to prevent herself from being triggered and repeating the pattern of one-night stands. Ami continues in therapy for depression and begins to learn healthier coping mechanisms.

References:

  1. Ajegena, B. K., Oti Baba, V., & Usman, B. A. (2018). Sex and sexual addiction in the United States of America: An overview of its epidemiology, management and prevention strategies. Journal of Addiction Research & Therapy, 9(5). Retrieved from https://www.omicsonline.org/open-access/sex-and-sexual-addiction-in-the-united-states-of-america-an-overview-of-its-epidemiology-management-and-prevention-strategies-2155-6105-1000366-105540.html
  2. Brain activity in sex addiction mirrors that of drug addiction. (2014, July 11). Retrieved from http://www.cam.ac.uk/research/news/brain-activity-in-sex-addiction-mirrors-that-of-drug-addiction#sthash.3dUKxI0G.dpuf
  3. Carnes, P. (2012). Sexual Addiction, Assessment & Treatment [PowerPoint]. Retrieved from http://www.iitap.com/images/SexAddiction101.ppt
  4. Derbyshire, K. L., & Grant, J. E. (2015, May 27). Compulsive sexual behavior: A review of the literature. Journal of Behavioral Addictions, 4(2), 37-43. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4500883
  5. Dryden-Edwards, R. (2014, July 10). Sexual Addiction: Get Facts on Treatment and Recovery. Retrieved from http://www.medicinenet.com/sexual_addiction/article.htm
  6. Kafka, M. P. (2010). Hypersexual disorder: A proposed diagnosis for DSM-V. Archives of Sexual Behavior, 39(2), 377-400. doi:http://dx.doi.org/10.1007/s10508-009-9574-7
  7. Klein, M. (2003). Sex addiction: A dangerous clinical concept. SIECUS Report, 31(5), 8. Retrieved from http://www.ejhs.org/volume5/SexAddiction.htm
  8. Nordqvist, C. (2017, December 20). What Is Sexual Addiction? Retrieved from http://www.medicalnewstoday.com/articles/182473.php
  9. Wang, W. (2018, January 10). Who cheats more? The demographics of infidelity in America. Retrieved from https://ifstudies.org/blog/who-cheats-more-the-demographics-of-cheating-in-america
  10. Weiss, R. (2011, September 18). Can Women Be Sex Addicts? Retrieved from http://www.livescience.com/16113-women-sex-addicts.html