Frequently Asked Questions
"Like an alcoholic unable to stop drinking, sexual addicts are unable to stop their self-destructive sexual behavior. Family breakups, financial disaster, loss of jobs, and risk to life are the painful themes of their stories.
Sex addicts come from all walks of life - they may be ministers, physicians, homemakers, factory workers, salespersons, secretaries, clerks, accountants, therapists, dentists, politicians, or executives, to name just a few examples. Most were abused as children - sexually, physically, and/or emotionally. The majority grew up in families in which addiction already flourished, including alcoholism, compulsive eating, and compulsive gambling. Most grapple with other addictions as well, but they find sex addiction the most difficult to stop.
Much hope nevertheless exists for these addicts and their families. Sex addicts have shown an ability to transform a life of self-destruction into a life of self-care, a life in chaos and despair into one of confidence and peace."
- Patrick J. Carnes, Ph.D.
Author of "Out of the Shadows," 1992
- What is sexual addiction?
- What is sexual anorexia?
- Sexual dependency vs other addictions
- How many people are affected by sexual addiction?
- What are multiple addictions?
- Are more sex addicts male or female?
- Why don't sexual addicts "just stop" their destructive behavior?
- What about AIDS and the sexual addict?
- How is Sexual Addiction diagnosed?
- What are the behavior patterns which may indicate sexual behavior?
- What is the role of Cybersex?
- What help is there for Sexual Addiction or Sexual Anorexia?
- What treatment is available for sex addiction?
- Are sexual addicts ever cured?
- Is there any help available for the partners of sex addicts?
What is sexual addiction?
Sexual addiction is defined as any sexually-related, compulsive behavior which interferes with normal living and causes severe stress on family, friends, loved ones, and one's work environment.
Sexual addiction has been called sexual dependency and sexual compulsivity. By any name, it is a compulsive behavior that completely dominates the addict's life. Sexual addicts make sex a priority more important than family, friends, and work. Sex becomes the organizing principle of addict's lives. They are willing to sacrifice what they cherish most in order to preserve and continue their unhealthy behavior.
No single behavior pattern defines sexual addiction. These behaviors, when they have taken control of addicts' lives and become unmanageable, include: compulsive masturbation, compulsive heterosexual and homosexual relationships, pornography, prostitution, exhibitionism, voyeurism, indecent phone calls, child molesting, incest, rape and violence. Even the healthiest forms of human sexual expression can turn into self-defeating behaviors.
What is sexual anorexia?
Sexual anorexia is an obsessive state in which the physical, mental, and emotional task of avoiding sex dominates one's life. Like self-starvation with food or compulsive dieting or hoarding with money, deprivation with sex can make one feel powerful and defended against all hurts. As with any other altered state of consciousness, such as those brought on by chemical use, compulsive gambling or eating, or any other addiction process, the preoccupation with the avoidance of sex can seem to obliterate one's life problems. The obsession can then become a way to cope with all stress and all life difficulties. Yet, as with other addictions and compulsions, the costs are great. In this case, sex becomes a furtive enemy to be continually kept at bay, even at the price of annihilating a part of oneself.
Specialists in sexual medicine have long noted the close parallels between food disorders and sexual disorders. Many professionals have observed how food anorexia and sexual anorexia share common characteristics. In both cases, the sufferers starve themselves in the midst of plenty. Both types of anorexia feature the essential loss of self, the same distortions of thought, and the agonizing struggle for control over the self and others. Both share the same extreme self-hatred and sense of profound alienation. But while the food anorexic is obsessed with the self-denial of physical nourishment, the sexual anorexic focuses his or her anxiety on sex. As a result, the sexual anorexic will typically experience the following:
- A dread of sexual pleasure
- A morbid and persistent fear of sexual contact
- Obsession and hyper vigilance around sexual matters
- Avoidance of anything connected with sex
- Preoccupation with others being sexual
- Distortions of body appearance
- Extreme loathing of body functions
- Obsessional self-doubt about sexual adequacy
- Rigid, judgmental attitudes about sex
- Excessive fear and preoccupation with sexual diseases
- Obsessive concern or worry about the sexual activity of others
- Shame and self-loathing over sexual experiences
- Depression about sexual adequacy and functioning
- Self-destructive behavior to limit, stop, or avoid sex
Sexual anorexics can be men as well as women. Their personal histories often include sexual exploitation or some form of severely traumatic sexual rejection-or both. Experiences of childhood sexual abuse are common with sexual anorexics, often accompanied by other forms of childhood abuse and neglect. As a result of these traumas, they may tend to carry dark secrets and maintain seemingly insane loyalties that have never been disclosed. In fact, sexual anorexics are for the most part not conscious of the hidden dynamics driving them.
Dr. Carnes book, Sexual Anorexia, focuses on the suffering of the sexual anorexic. Sexual anorexia is as destructive as the illnesses that often accompany it, and behind which it often hides, such as alcoholism, drug addiction, sexual addiction, and compulsive eating. It resides in emotion so raw that most sufferers would wish to keep it buried forever were it not so painful to live this way. Sexual anorexia feeds on betrayal, violence, and rejection. It gathers strength from a culture that makes sexual satisfaction both an unreachable goal and a nonnegotiable demand. Our media focus almost exclusively on sensational sexual problems such as rape, child abuse, sexual harassment, or extramarital affairs. When people have problems being sexual, we are likely to interpret the difficulty as a need for a new technique or a matter of misinformation. For those who suffer from sexual anorexia, technique and information are not remotely enough. Help comes only through an intentional, planned effort to break the bonds of obsession that keep anorexics stuck.
This book is intended as a guide to support that effort. The early chapters help the reader understand sexual anorexia: how it starts, and how it gathers such strength. The last twelve chapters present a clinically tested and proven plan for achieving a healthy sexuality. This program has worked for many, many people. It is safe. It is practical. It works if the sufferer follows the guidelines and has the appropriate outside support. It will not be easy because the obsession was created in the first place by intimate violations and shattered trust. Yet step by step, healing can be effected so that the sufferer can learn to trust the self as well as others.
Recognition of sexual addiction by the professional health care community
Sexual addiction was first brought to the forefront in Dr. Patrick Carnes' 1983 book, Out of the Shadows: Understanding Sexual Addiction (Hazelden). Since then, thousands of people have come forward seeking help, and more and more professionals are being trained to identify and treat sexual addiction.
The Society for the Advancement of Sex Health was created in 1987 to serve as an independent clearing house for information on sexual addiction and treatment options. One of SASH's missions is to decrease the stigma surrounding sexual addiction problems and treatment. They may be contacted at:
The Society for the Advancement of Sex Health
P.O. Box 725544
Atlanta, Georgia 31139
1-770-541-9912
e-mail-sash@sash.net
Medical and clinical research appears each quarter in Sexual Addiction and Compulsivity; The Journal of Treatment and Prevention published by Taylor and Francis. For further information contact:
Taylor and Francis
1101 Vermont Ave., N.W., Suite 200
Washington, DC
1-800-272-7737
For a recent listing of relevant articles about sex addiction see the Sexual Resource section.
Sexual dependency vs other addictions
Sexual addiction can be understood by comparing it to other types of addictions. Individuals addicted to alcohol or other drugs, for example, develop a relationship with their “chemical(s) of choice” – a relationship that takes precedence over any and all other aspects of their lives. Addicts find they need drugs merely to feel normal.
In sexual addiction, a parallel situation exists. Sex – like food or drugs in other addictions—provides the "high" and addicts become dependent on this sexual high to feel normal. They substitute unhealthy relationships for healthy ones. They opt for temporary pleasure rather than the deeper qualities of "normal" intimate relationships.
Sexual addiction follows the same progressive nature of other addictions. Sexual addicts struggle to control their behaviors, and experience despair over their constant failure to do so. Their loss of self-esteem grows, fueling the need to escape even further into their addictive behaviors. A sense of powerlessness pervades the lives of addicts.
How many people are affected by sexual addiction?
Estimates range from three to six percent of the population.
What are multiple addictions?
National surveys revealed that most sexual addicts come from severely dysfunctional families. Usually at least one other member of these families has another addiction (87%).
Dual addictions include sexual addiction and:
- Chemical Dependency (42%)
- Eating Disorder (38%)
- Compulsive Working (28%)
- Compulsive Spending (26%)
- Compulsive Gambling (5%)
Sexual addiction and abuse
Research has shown that a very high correlation exists between childhood abuse and sexual addiction in adulthood.
Sexual addicts, both men and women, who have reported experiencing:
- Emotional Abuse (97%)
- Sexual Abuse (83%)
- Physical Abuse (71%)
There is a growing body of evidence that early child abuse, especially sexual, is a primary factor in the onset of sex addiction. It appears that biological shifts occur in the brain which heightens the brain's arousal mechanisms as well as limiting the ability to inhibit behavior.
Are more sex addicts male or female?
It remains unclear whether one gender has a higher incidence of sexual addiction that the other. Research by Dr. Carnes shows that approximately 20 - 25% of all patients who seek help for sexual dependency are women. (This same male-female ratio is found among those recovering from alcohol addiction, drug addiction, and pathological gambling.
As once was the case with alcohol addiction, many people cannot accept the reality that women can become sexual addicts. One of the greatest problems facing female sexual addicts is convincing others that they have a legitimate problem.
The great irony is that sex addiction in women appears to be increasing. In recent, very large studies of on-line behavior, 40% of those struggling with sexually compulsive behavior are women.
Why don't sexual addicts "just stop" their destructive behavior?
Sexual addicts feel tremendous quilt and shame about their out-of-control behavior, and they live in constant fear of discovery. Yet addicts will often act out sexually in an attempt to block out the very pain of their addiction. This is part of what drives the addictive cycle. Like other forms of addiction, sex addicts are out of control and unable to stop their behaviors despite their self-destructive nature and potentially devastating consequences.
Key to understanding loss of control in addicts is the concept of the “hijacked brain.” Addicts essentially have rewired their brains so that they do behaviors (drinking, drug use, eating, gambling, and sex) even when they are intending to do something quite different. The triggers to these maladaptive responses are usually stress, emotional pain, or specific childhood scenarios of sexual abuse or sexual trauma. Breakthrough science in examining brain function is helping us to understand the biology of this disease.
What about AIDS and the sexual addict?
As a function of their denial system, sexual addicts often ignore the severe emotional, interpersonal, and physical consequences of their behavior. Addicts are so entrenched in maintaining their behaviors that environmental cues which would signal caution and danger to most non-addicted people are lost to them. Such has been the case with the HIV virus and other dangerous, sexually transmitted diseases (STDs).
Sexual addicts are focused on getting a sexual "fix." They may occasionally consider the possible consequences of their activities, but in the throes of the addictive cycle, rational thinking is seldom, if ever, present. Often dismissing the potential danger of their behavior, addicts will embrace an anxiety-laden situation to enhance their sexual high. Avoiding reality and disregarding personal safety and health are typical symptoms of sexual addiction, and they put sexual addicts at grave risk for contracting one of the many disabling STDs, including HIV.
Fear of being infected with the HIV virus and developing AIDS is not enough to stop an addict intent on being anonymously sexual, picking up prostitutes, or having multiple affairs with unsafe sex partners. Even the potential of infecting a loved one with as ATD is often not enough to stop addicts from acting out. In fact, sexual addicts may find ways to act out even more intensely after such sexual practices in order to help drown out the shame and guilt of an overloaded and repressed emotional life.
Despite the frequency and range of their acting-out experiences, sexual addicts are often poorly informed about sexuality in general. An important part of their recovery process is learning about healthy sexual practices: behaviors which are connecting and affirming rather than shaming and guilt inducing. In addition, sexual addicts often need to be taught about safe sexual practices, basic self-care, and health concerns.
How is Sexual Addiction diagnosed?
Often sexual addicts don't know what is wrong with them. They may suffer from clinical depression or have suicidal tendencies. They may even think they are losing their minds.
There are, however, recognizable behavior patterns which indicate the presence of sexual addiction. Diagnosis should be done by a mental health professional trained in carrying out such diagnoses.
To help professionals determine whether a sexual addiction is present, Dr. Carnes has developed the Sexual Addiction Screening Test (SAST), an assessment tool specially designed for this purpose. It is available for self-assessment on www.sexhelp.com.
What are the behavior patterns which may indicate sexual behavior?
While an actual diagnosis for sexual addiction should be carried out by a mental health professional, the following behavior patterns can indicate the presence of sexual addiction. Individuals who see any of these patterns in their own life, or in the life of someone they care about, should seek professional help.
1. Acting out: a pattern of out-of-control sexual behavior
Examples may include:
- Compulsive masturbation
- Indulging in pornography
- Having chronic affairs
- Exhibitionism
- Dangerous sexual practices
- Prostitution
- Anonymous sex
- Compulsive sexual episodes
- Voyeurism
2. Experiencing severe consequences due to sexual behavior, and an inability to stop despite these adverse consequences
Some of the losses reported by sexual addicts include:
- Louse of partner or spouse (40%)
- Severe marital or relationship problems (70%)
- Loss of career opportunities (27%)
- Unwanted pregnancies (40%)
- Abortions (36%)
- Suicide obsession (72%)
- Suicide attempts (17%)
- Exposure to AIDS and venereal disease (68%)
- Legal risks from nuisance offenses to rape (58%)
3. Persistent pursuit of self-destructive behavior
Even understanding that the consequences of their actions will be painful or have dire consequences does not stop addicts from acting out. They often seem to have a willfulness about their actions, and an attitude that says, "I'll deal with the consequences when they come."
4. Ongoing desire or effort to limit sexual behavior
Addicts often try to control their behavior by creating external barriers to it. For example, some move to a new neighborhood or city, hoping that a new environment removed from old affairs will help. Some think marriage will keep them from acting out. An exposer may buy a car in which it's difficult to act out while driving.
Others seeking control over their behavior try to immerse themselves in religion, only to find out that while religious compulsion may soothe their shame, it does not end their acting out.
Many go through periods of sexual anorexia during which they allow themselves no sexual expression at all. Such efforts, however, only fuel the addiction.
5. Sexual obsession and fantasy as a primary coping strategy
Through acting out sexually can temporarily relieve addicts' anxieties, they still find themselves spending inordinate amounts of time in obsession and fantasy. By fantasizing, the addict can maintain an almost constant level of arousal. Together with obsessing, the two behaviors can create a kind of analgesic "fix." Just as our bodies generate endorphins, natural anti-depressants, during vigorous exercise, our bodies naturally release peptides when sexually aroused. The molecular construction of these peptides parallels that of opiates like heroin or morphine, but are many times more powerful.
6. Regularly increasing the amount of sexual experience because the current Level of activity is no longer sufficiently satisfying
Sexual addiction is often progressive. While addicts may be able to control themselves for a time, inevitably their addictive behaviors will return and quickly escalate to previous levels and beyond. Some addicts begin adding additional acting out behaviors. Usually addicts will have three or more behaviors which play a key role in their addiction—masturbation, affairs, and anonymous sex, for instance.
In addition, 89% of addicts reported regularly "bingeing" to the point of emotional exhaustion. The emotional pain of withdrawal for sexual addicts can parallel the physical pain experienced by those withdrawing from opiate addiction.
7. Severe mood changes related to sexual activity
Addicts experience intense mood shifts, often due to the despair and shame of having unwanted sex. Sexual addicts are caught in a crushing cycle of shame-driven and shame-creating behavior. While shame drives the sexual addicts' actions, it also becomes the unwanted consequence of a few moments of euphoric escape into sex.
8. Inordinate amounts of time spent obtaining sex, being sexual, and recovering from sexual experiences
Two sets of activities organize sexual addicts' days. One involves obsessing about sex, time devoted to initiating sex, and actually being sexual. The second involves time spent dealing with the consequences of their acting out: lying, covering up, shortages of money, problems with their spouse, trouble at work, neglected children, and so on.
9. Neglect of important social, occupational, or recreational activities because of sexual behavior
As more and more of addicts' energy becomes focused on relationships which have sexual potential, other relationships and activities—family, friends, work, talents and values—suffer and atrophy from neglect. Long-term relationships are stormy and often unsuccessful. Because of sexual over-extension and intimacy avoidance, short-term relationships become the norm.
Sometimes, however, the desire to preserve an important long-term relationship with spouse or children, for instance, can act as the catalyst for addicts to admit their problem and seek help.
What is the role of Cybersex?
Today over 70% of sex addicts report having problematic on-line sexual behavior. Two-thirds of those engaged have such despair over their internet activities that have had suicidal thoughts. Sexual acting out online has been shown to manifest in similar off-line behavior. People who already were sex addicts find the internet accelerates their problem. Those who start in the on-line behavior quickly start to act out in new ways off-line. One of the pioneering researchers of this problem, the late Dr. Al Cooper, described on-line sexual behavior as the "crack-cocaine" of sexual compulsivity.
What help is there for Sexual Addiction or Sexual Anorexia?
- Take our online test, the SAST
- Contact a Certified Sex Addition Therapist (CSAT) for help. You can find a therapist in your area by calling 800-708-1796 or by visiting www. sexhelp.com
- Twelve step programs
- Visit GentlePath.com to browse the online catalog for books and tapes which will help you understand sex addiction and sexual anorexia.
Getting help: the first step
The first step in seeking help is to admit to the problem. Though marital, professional, and societal consequences may follow, admission of the problems must come, no matter the cost. Fear of these consequences unfortunately keeps many sexual addicts from seeking help.
Many sources of help are available to provide information, support, and assistance for sexual addicts trying to regain control of their lives. These include inpatient and outpatient treatment, professional associations, self-help groups, and aftercare support groups.
Sex Addicts Anonymous (SAA)
P.O. Box 70949
Houston, TX 77270
1-800-477-8191
e-mail: webmaster@saa-recovery.org
SASH
P.O. Box 725544
Atlanta, GA 31139
1-770-541-9912
e-mail: info@SASH.net
Sex Compulsives Anonymous (SCA)
P.O. Box 1585
Old Chelsea Station
New York, NY 10011
(001)210-828-7900
email: info@slaafws.org
Sex and Love Addicts Anonymous (SLAA)
1550 NE Loop 410, Ste. 118
San Antonio, TX 78209
212-439-1123
email: info@slaafws.org
National Council for Couple and Family Recovery
P.O. Box 410586
St. Louis, MO 63141
314-997-9808
email: nccfr@hotmail.com
What treatment is available for sex addiction?
Treatment programs for sexual addiction include patient, outpatient, and aftercare support, and self-help groups. Treatment programs also offer family counseling programs, support groups, and educational workshops for addicts and their families to help them understand the facets of belief and family like that are part of the addiction.
Unlike recovering alcoholics who must abstain from drinking for life, sexual addicts are led back into a normal, healthy sex life much in the way those suffering from eating disorders must relearn healthy eating patterns.
The staff at Gentle Path is trained to help individuals develop healthy, effective coping skills through interacting with others experiencing similar problems. Gentle Path is designed to set addicts on the road to recovery, to provide relapse prevention techniques, and to help them stay in recovery with the help of aftercare and Twelve Step recovery support groups.
Are sexual addicts ever cured?
Like other types of addicts, some sexual addicts may never be "cured." Sexual addicts achieve a state of recovery, but maintaining that recovery can be a lifelong, day-by-day process. The Twelve Step treatment approach teaches addicts to take their recovery "one day at a time" - concentrating on the present, not the future.
Is there any help available for the partners of sex addicts?
Partners of sexual addicts, like partners of alcoholics, can also benefit from counseling and support groups. Normally these partners are codependents, and they, too, suffer from the extreme adverse effects of the addiction. Inpatient and outpatient programs, counseling, and support groups are all available to help them regain control of their lives and support the recovery of their partner.
Codependents can find support by contracting:
S-Anon Family Groups
P.O. Box 5117
Sherman Oaks, CA 91413
818-990-6910
Codependents of Sex Addicts (CoSA)
P.O. Box 14537
Minneapolis, MN 55414
612-537-6904