What is sex addiction?

Addiction is a disease. Thus, sex addiction is classified as a disease. There simply has not been adequate research to classify problematic sexual behavior as a disease. There is no solid research at this time to suggest that someone can be “addicted” to sex the way they are addicted to alcohol and drugs. In some ways, whether we label it an addiction or not doesn’t matter. It’s a problem that needs to be treated. But it many ways, it does matter.

The term addiction or disease suggests that this is a lifelong issue, that one is an “addict,” and there is a sense of powerlessness and stigma connected to this term. The term addiction also suggests that it should be treated in a specific way; the same way we treat other addictions (i.e., abstinence). Given that we are all sexual beings (to some degree), is abstinence from sex really a practical solution?

If it isn’t an addiction, then what is it?

More research is needed to identify what exactly it is. We do know that people who self-identify as “sex addicts” do have a few things in common. Research supports that they are more likely to have high sex drives, are highly religious, and experience moral disapproval of their porn use. Until we have more data, many researchers and sex therapists classify problematic sexual behavior as just that, a problem. Not a disease. Not an addiction. Problematic sexual behavior is often called Out of Control Sexual Behavior (OCSB). The hallmark of OCSB is that it feels out of control.

How is sex addiction or Out of Control Sexual Behavior (OCSB) treated?

If the research community can’t agree on what it is (an addiction, a problem, a disorder), that makes it quite difficult to do good research on how to treat it. Currently, treatment depends on how the therapist classifies the problematic sexual behavior. If the therapist sees it as an addiction, they’ll treat it like they treat addictions. If they see it as a problem, they’ll treat it like a problem. I treat it as a problem and follow the treatment protocols developed by Drs. Doug Braun-Harvey and Eli Coleman.

Treatment involves identifying your sexual cycles. In other words, what steps do you typically take to engage in the problematic sexual behavior? For many people their cycle starts with negative emotions (sad, anxious, angry) and to cope with those emotions they seek out sex or pornography use. Once we have an idea of your cycles, then we look for off-ramps (ways to get off the cycle once it starts). Off ramps might include learning to tolerate those negative emotions (distress tolerance), challenging irrational thoughts (cognitive behavioral therapy), setting boundaries (like a pornography filter on your phone), or simple distraction. When you have a few solid off-ramps in place, we spend time identifying your sexual values and assessing how these values fit with your sexual behaviors. Ultimately, the goal is to develop and maintain a healthy sexuality that is consistent with your sexual values.