Sexologists and mental health experts do not agree on the definition, causes, or treatments of “Sexual Addiction”. Indeed, there is disagreement as to whether or not such a specific phenomenon exists. Impressive theories exist which suggest that sexual addiction is caused by underlying personality disorders and various other mental illnesses. Others subscribe to an “addictions model” and offer conceptualizations and treatments that are similar to those used to treat alcohol, drug, or other behavioral addictions. However, the purposes of this article are to offer a common definition of a psychological and behavioral problem that definitely does exist and describe ideas that will be necessary for the effective management of this issue.
Sexual addiction might be described in practical terms as a phenomenon whereby individuals engage in sexual thoughts and behaviors which are not adaptive and result in some degree of “mis-management” of the individual’s sexuality. Such mismanagement is usually a product of poor judgment and poor behavioral choices about sexual activities. Sexual addicts often take unnecessary and increasing levels of risks related to sexual behavior and they take actions that threaten their general health, marital and family relationships, job and career status, financial status, and psychological well-being.
Even though sexual addiction is a general mismanagement of one’s sexuality, psychologists who treat this condition are aware that it is necessary to understand the cause or causes of the individual’s problem. For some individuals, there are aspects of mental conditions that create or exacerbate the problematic behavioral patterns. For example, an underlying obsessive compulsive disorder or, obsessive compulsive personality disorder may be a contributing factor. For others, who may struggle with sexual addiction and who might demonstrate the same or similar sexual behaviors, obsessive compulsive disorder might not exist at all. Some sexual addictions suffer also from features of narcissistic personality disorder. In yet another example, a professional psychological assessment might reveal a history of an addictive process. Thus, the current sexual addiction might be just the most recent of a series of behavioral addictions that has manifested in the individual’s life. In such a case, it is not uncommon for an individual with a sexual addiction to suffer concurrently, from alcohol and/or substance abuse. Accordingly, the substance abuse often exacerbates the problematic sexual behaviors.
Therefore, even though the troublesome behaviors of the sexual addiction may be similar across several cases regardless of their causes, effective treatment and sustainable self-management of these issues requires that the treating professional, and the individual being treated understand why this mismanagement is occurring in the individual’s life. Because of the complexity of sexual addiction, with its various origins and sources that contribute to and exacerbate the conditions, an effective treatment will likely include a multi-modal treatment approach including strategies based upon cognitive-behavioral psychotherapy, behavioral approaches to treating addictions, and psycho-dynamic strategies. Since individuals suffering from sexual addiction are often married, marriage and relationship counseling is often necessary. Similarly, other forms of counseling and support are often required because of the financial, occupational, and legal conflicts that arise from the sexual behavior mismanagement and its consequences.
After the sexual addiction is identified and at least some of the “root causes” and dynamics of the condition are understood, the appropriate treatment strategies can be designed to meet the specific nuances of the individual’s sexual addiction process. Individual psychological treatment is necessary, along with other forms of external support provided by marital therapy and support group participation.
Critical to the recovery from sexual addiction for the individual is the penetration of the denial that usually accompanies this condition and the acknowledgement that mismanagement is solely the individual’s responsibility and recovery (and future adaptive management of one’s sexuality) is also the individual’s responsibility. Thus, effective management will require the individual to have important insights as to any psychological “driving forces” behind the sexual mismanagement. Similarly, it is important for effective self-management for the individual to understand the complex “dynamics”, or process, of the sexual misbehavior in order to preclude, interrupt, or recover rapidly from a destructive pattern of behavior.
Overcoming sexual addiction and effective self management stands in contrast to the management of some other behavioral “disorders of excess”, whereby one might learn to “quit” smoking cigarettes or drinking alcohol. In such cases, the individual ceases a behavior and consequently, their general health and well-being improves. Most individuals will likely prefer to learn to manage their sexuality adaptively and effectively to such extent that they can enjoy a satisfying and healthy sex life. With greater understanding, comes greater self-confidence, which creates better judgment, which leads to self-management, which leads to fewer life conflicts, which leads to a greater sense of life fulfillment, and so on.
D. Jerome Meers, Ph.D.
Consulting Psychologist
