Sex addiction is a controversial diagnosis. Many experts, including the American Association of Sexuality Educators, Counselors & Therapists, assert that the notion of sex addiction may needlessly pathologize people and stigmatize healthy, normal behaviors.
Others point to the immense damage some sexual behaviors can cause, exposing a person to serious infections and potentially ending relationships, in saying that sex addiction is indeed real.
If you think you might be addicted to sex, here's what you need to know when evaluating treatment options.
Do I Need Sex Addiction Treatment?
There is no right way to have sex or to feel about sex.
"Our culture has a history of shaming expressions of sexuality that do not fit with puritan ideals or other cultural expectations. The truth is that any fully consensual, safe sexual practice is normal and healthy," says Jessica Goodnight, Ph.D., a licensed clinical psychologist in Atlanta, Georgia.
Goodnight emphasizes that sex "addiction" may conceal other issues. "I have worked quite a bit with trauma survivors who are concerned about their sexual behavior or are having sex compulsively," she explained. "Both trauma and cultural views toward sex can teach survivors that desiring sex is shameful, leading them to self-judgment for normal sexual behavior. Trauma can also teach survivors lessons that make it difficult for sex to be safe and consensual. For example, sometimes it's very difficult to express sexual boundaries when those boundaries have been violated repeatedly throughout your life."
The DSM-5 does not list sex addiction as a mental health diagnosis. However, many researchers argue that the effects of sex addiction on the brain are similar to those of other addictions. This means that what matters most are not the specific behaviors a person engages in, but how those behaviors affect their life.
Signs and Symptoms of Sex Addiction
"When I'm working with someone on a perceived sexual problem, I'm thinking of four questions. Does this person's sexual behavior align with their values? Is this person able to assert sexual boundaries? Is this person having safe and consensual sex? Is this person finding pleasure in desired sexual activity? If the answer to those is 'yes,' there isn't a problem," Goodnight offers.
Some indications you might have a problem include:
- Your sexual actions undermine your relationships or your health.
- You can't stop having sex that is inconsistent with your values.
- You are unable to assert clear sexual boundaries.
- You are harming others, such as by forcing them into non-consensual sex.
- Your sexual choices affect other aspects of your life. For example, a person who spends their savings on pornography or sex work may have a problem.
Options for Treatment
While some facilities offer inpatient sex addiction rehab, it's usually possible to treat sex addiction with outpatient support. You might find relief from:
- evidence-based therapy that helps you understand your sexual behavior and change it
- lifestyle changes that reduce temptation, such as blocking certain websites
- treatment for underlying conditions such as PTSD and depression
- medication to manage mental health diagnoses such as depression
- relationship counseling to address the fallout of compulsive sexual behavior
Choosing the Right Treatment
Goodnight argues that people seeking sex addiction treatment should consider their own values, and choose treatment options that conform to those values--rather than to broader societal expectations. Stigmatizing treatment can be harmful, and so can treatment that treats a person's own sexual ethics as trivial.
Some questions to ask when comparing treatment options include:
- Does this treatment provider share my values?
- Will I be exposed to sexual stigma and shame, or to treatment that helps me live more safely?
- What training do the treatment providers have?
- How will treatment fit into my life?
- Do I need treatment for a co-occurring condition, such as depression?
- Do I have a trauma history that may be affecting my sexual behavior? Can this treatment provider address my trauma?