Emily Jamea, Ph.D., is a sex therapist, author and podcast host. You can find her here each month to share her latest thoughts about sex.
When you think of sex addiction, do Hank Moody from Californication or Brenda Chenoweth from Six Feet Under come to mind? How about David Duchovny, who not only played Hank Moody but eventually admitted to his own personal sex addiction? Or Jada Pinkett Smith who admitted that she had battled sex addiction? There are a lot of pop culture and media portrayals of people who well, let’s just say, they’re addicted to love.
But how realistic is the information we’re getting — and is there really such a thing as sex addiction?
What is sex addiction?
“Sex addiction,” also known as compulsive sexual behavior or hypersexuality, is an overwhelming and uncontrollable urge to engage in sexual activities. This can include a wide range of behaviors ranging from excessive masturbation and watching porn to engaging in cybersex or having multiple sexual partners — even when they might be in committed relationships with someone else.
The key element that defines this condition is being unable to control your urges despite these actions harming your personal, professional and/or social life. People with sex addiction often find themselves in a cycle of craving, engaging in the behavior and experiencing guilt or shame afterward, only to repeat the process. This compulsive nature can interfere significantly with daily functioning and overall well-being.
Is sex addiction real?
Despite the popularity of the term sex addiction in the media, it’s important to note that it’s not an officially recognized medical term. And it does not appear in any of the standard manuals used to diagnose and treat medical and mental health disorders, including the Diagnostic and Statistical Manual of Mental Disorders (DSM).
There are several valid reasons for its exclusion, including:
1. There’s not enough research to suggest that the disorder manifests the same way as other addictions (e.g., alcoholism).
2. There’s a high chance of individuals being misdiagnosed due to bias. In other words, a more conservative therapist or physician may be more likely to diagnose someone with a sex addiction compared to a more progressive therapist or physician.
3. There’s concern that its inclusion would impact sentencing for sex crimes. In other words, it may make it easier to get reduced sentencing or an innocent conviction if someone can claim they suffer from sex addiction.
4. Most importantly, sexuality cannot be separated from morals and cultural norms. If we were to include sex addiction in the diagnosis manual, we’d run a risk of pathologizing sexual behavior that others deem completely healthy.
That being said, the World Health Organization does recognize compulsive sexual behavior as a mental health condition — and there is no doubt that many people struggle with sexuality in a way that feels compulsive. There are many reasons why you may be likely to experience out of control sexual behaviors.
1. Biological factors: Research suggests that there may be a genetic predisposition to addictive behaviors. Additionally, imbalances in brain chemicals such as dopamine, which is associated with pleasure and reward, can contribute to the development of compulsive sexual behavior.
2. Psychological factors: Mental health conditions like anxiety, depression and obsessive-compulsive disorder (OCD) are often linked to sexual compulsiveness. Individuals may use sex as a way to cope with these underlying issues, seeking temporary relief from emotional pain or stress.
3. Social factors: Early exposure to sexual content, experiences of sexual abuse or growing up in an environment where sex was either taboo or overly permissive, can also play a role. Social and cultural attitudes toward sex can influence an individual’s behavior and perception of what is considered normal or acceptable.
Recognizing the symptoms of “sex addiction” or compulsive sexual behavior
Identifying compulsive sexuality can be challenging because sexual behavior varies widely from person to person. However, there are specific signs and symptoms that may indicate there’s a problem:
- Preoccupation with sex: Constantly thinking about sex to the point where it interferes with daily activities and responsibilities.
- Escalation of behavior: Needing more intense or frequent sexual experiences to achieve the same level of satisfaction.
- Failed attempts to control: Repeated unsuccessful efforts to reduce or stop sexual behavior.
- Neglecting obligations: Allowing sexual activities to take precedence over work, school or family responsibilities.
- Risky behaviors: Engaging in unsafe or harmful sexual practices, such as unprotected sex with multiple partners or sex with strangers.
- Emotional distress: Experiencing guilt, shame or anxiety as a result of sexual behavior, yet feeling unable to stop.
If you or someone you know is struggling with out-of-control sexual behavior, it’s important to find a well-trained therapist (and know how to avoid seeing someone who may do more harm than good).
Can you treat sex addiction?
There are several popular “sex addiction” treatment options available, but it’s worth taking a look back at the fourth reason I listed for “sex addiction” being excluded from medical texts — morality. Research shows that 12-step programs or abstinence-based sex “addiction” treatment tends to do more harm than good. Since we don’t have enough evidence to suggest that compulsive sexual behavior should be thought of in the same way as a substance addiction, it shouldn’t be treated like a substance addiction. You can die from drinking too much alcohol. You can’t die from having too much sex. This is where the moral debate comes in.
There’s an emerging area of research looking at the intersection of perceived sex “addiction” and morality. These studies suggest that people are far more likely to label themselves with an addiction if their behavior falls outside their moral compass. If I had a nickel for every client I saw who labeled themselves (or was labeled by their partner) as a sex addict for having an affair or looking at porn, I’d be rich!
Any treatment provider who claims to treat sex “addiction” should be considered with caution. Instead, look for therapists who treat compulsive sexual behavior or out of control sexual behavior and can work with you to examine how your behavior may or may not fit with your moral values. Sometimes it’s worth reexamining moral values to see how changing them can help you feel better about your sexual choices.
Therapists who can assess whether treating underlying trauma, anxiety or relationship issues that can set someone up to experience sexuality in a way that feels out of control offer a more holistic approach.
Human sexuality is complex. In general, society is moving toward acceptance of a wider range of sexuality. By fostering a compassionate and informed approach, we can better support people who are struggling with compulsive sexual behavior and create an environment where recovery is possible. Understanding, empathy and access to appropriate resources are key to helping those affected regain control over their lives and build healthier, more fulfilling futures.
