Sex Addiction and its controversy
In July 2021, we set out to better understand what sex addiction is. It's a challenging topic with much controversy around it, which requires the conversation to be held from a place of compassion.
As this month's Carnal Theory guest Dr. Kate Balestrieri shared, “there is no formal diagnosis right now in the DSM5, which is the manual that mental health providers use to formally diagnose people, and the reason for that is because there’s such a marked difference of opinion even within the mental health communities. Part of why I think there’s so much debate about whether on not ‘sex addiction’ is real is because there can be a lot of stigma and shaming attached to the addiction model.”
Being a potential addiction, compulsive sexual behavior has the power to impact people’s lives in deep ways. So, as you read through this newsletter, we urge you to keep an open mind and abstain from judgment—mental illnesses are real and many people struggle with them.
DISCLAIMER: We are not doctors and you should consult your doctor or health care professional before applying any of the following information into personal practice. The information shared in this newsletter and our social platforms comes from careful research and is curated to provide insights into the world of sex addiction. If you think you or a loved one may be a sex addict, please seek professional help.
Why Sex Addiction?
My Sex Bio’s existence is rooted in the need for talking about sex more often and openly in our societies. All the shame and stigma surrounding sex and sexuality already make it taboo to talk about “normal” sexual encounters, which impacts the way we all receive sex education throughout our lives. We all have experienced the consequences of this situation; we’ve had questions and nowhere to go to get reliable answers
Now imagine what this lack of conversation can do to people who struggle with sex in one way or another. UKCP Accredited Sexual and Relationship Psychotherapist Paula Hall stated that “sex addiction thrives in secrecy and shame and, until we as a society can start talking about it openly and non-judgementally, the problem is going to continue to grow.”
According to Elizabeth Hartney, BSc., MSc., MA, Ph.D, “regularly experiencing sexual desire, physical sexual arousal, sexual relations, and achieving orgasm is considered the norm for both sexes, despite the fact that people who never experience difficulties at any of these stages of the sexual experience are in the minority. In general, having less sexual desire and activity is seen as a greater problem than having more sexual desire and activity.”
This is a conversation long overdue. We owe it to ourselves as a society, and especially to community members who struggle with sex addiction.
Obsession, Compulsion and Addiction
Most of the controversy surrounding sex addiction has to do with what to call it; understanding the concepts of obsession and compulsion in relation to addiction can make this controversy easier to navigate.
Obsession is defined by the APA Dictionary of Psychology as a “persistent thought, idea, image, or impulse that is experienced as intrusive or inappropriate and results in marked anxiety, distress, or discomfort.” According to Steve & Alan Sussman from the Departments of Preventive Medicine and Psychology at the University of Southern California, compulsion may be defined as “an intense egodystonic (separate from self) urge to engage in a simple, repetitive activity, to remove anxiety.” Registered MBACP Loraine Cairns points out how addiction, on the other hand, denotes “the fixated relationship between a feeling and a substance or behaviour. These feelings fall into two main categories: seeking a positive feeling, and avoiding a negative feeling.”
DIFFERENCES
SIMILARITIES
🔸 The path to compulsion might differ from the path to addiction. A compulsion can develop as a response to an obsession.
🔸 Compulsive behaviors are performed to get rid of the anxiety produced by an obsession.
🔸 A compulsion, as opposed to an addiction, will not feel pleasurable in itself. It will only provide a “temporary removal of anxiety.”
🔸 Addictions are about pleasurable experiences, more specifically about getting adrenaline and dopamine into your system.
🔸 Obsession, compulsion, and addiction are behaviors/thoughts you cannot control nor discontinue.
🔸 All three can interfere with normal, everyday life functioning.
The Controversy: Sex Addiction, CSBD or Hypersexuality?
According to PsychCentral, sex addiction is formally known as “compulsive sexual behavior disorder (CSBD) or hypersexuality” and it “refers to a long-standing pattern of repetitive sexual behaviors, fantasies, and urges.”
What’s particular about these urges is not only that they are repetitive, but also that they may translate into difficulties in your relationships and daily tasks. PsychCentral points out how “CSBD involves a variety of complex and intense unwanted sexual behaviors and fantasies that, at times, may become harmful to you and others.” CSBD can make these urges the center of your life, potentially leading you into leaving other aspects of your life unattended.
However, not everyone agrees that this kind of struggle with sex should be considered a compulsive disorder altogether. Elizabeth Hartney, BSc., MSc., MA, PhD., mentiones how “it has been argued that, although sex addiction shares features of both an obsessive-compulsive and an impulse control disorder, it does not fit neatly into either category.”
Experts disagree about whether it's possible to become addicted to sex. Some argue that accepting the term “sex addiction” doesn’t allow for “enough differentiation between similar conditions” that could look like it. Examples of that are, according to Elizabeth Hartney, hypersexuality related to bipolar disorders, personality disorders, some forms of depression, and PTSD.
For many licensed professionals in the field of mental health, sex addiction is real and should be taken as such. As defined by Relationship Support Service Relate, sex addiction is “a term that describes any sexual behaviour that feels ‘out of control’. It’s not the behaviour itself that defines it [...] but rather the dependency on it to numb out negative emotions and difficult experiences." According to NHS, that sexual behavior can be understood as “sex with a partner, but it can also mean activities such as pornography, masturbation, visiting prostitutes or using chat lines.”
Did you know...the term “sex addiction” existed in the past in the Diagnostic and Statistical Manual of Mental Disorders (DSM), but around the 90’s it was taken out? Some argue it has not been incorporated again because of political and cultural reasons. Some people are reluctant to pathologize sexual behavior between consenting adults, reasoning that there’s enough shame attached to sexualituy already. Others worry that sexual offenders could use such diagnoses to excuse their inappropriate behavior and avoid legal consequences.
From here on, we will be addressing sex addiction mainly from the perspective of therapists and professionals in the field of mental health who are treating people for sex addiction and are seeing their patients struggle with what they deem to be a legitimate addiction.
How to Know it Has Crossed into the Realm of Addiction?
“Sex addiction is not defined by the amount or type of sexual activity involved, but by the particular relationship the person has to compulsive sexual experiences,” says Dorothy Haden, LCSW. What makes an addiction an addiction is the reason why people keep engaging in said behavior despite the impact that it has on their everyday-lives. The impact is often negative and destructive and the reasons can be traced to a wide array of emotional issues.
Drawing a line to try and establish how much sex is too much is tricky since individuals can hold differing views about what classifies as sex and about the number of encounters they consider excessive. It’s too much when YOU feel it’s too much, and it could be an addiction or compulsion if it starts to keep you from showing up in your daily life.
There are, however, some indicators of a sex addiction, according to MayoClinic and Addiction Center. It could be a sex addiction if you find yourself...
🔶 Continuously engaging in sexual activities, despite wanting to stop
🔶 Neglecting other obligations in the pursuit of sex
🔶 Having a preoccupation with having sex, even when it interferes with daily life, productivity, work performance, and so on
🔶 Using compulsive sexual behavior as an escape from other problems, such as loneliness, depression, anxiety, or stress
🔶 Constantly engaging in risky sexual behavior that can challenge your health, relationships, job, financial stability, or legal situation
Misconceptions about Sex Addiction
There are three main misconceptions about sex addiction, according to therapist Sam Tielemans on We Heart Therapy:
🔶 Sex addiction is about sex.
“Underneath the acting out behaviors, people struggle with emotional issues such as trauma, or shame, or faulty core beliefs,” says Tielemans. Robert Weiss LCSW agrees with this view by saying that “sex addiction is not about sex or orgasm. It is about the search for sex and desire for orgasm. It’s a process addiction.”
🔶 “Sex addiction doesn’t exist; it’s not real.”
It seems to be that the experience of the professionals working one-on-one with people who struggle to control themselves around sex is that people can indeed present behaviors towards sex that are typical to an addiction.
🔶 “Once an addict, always an addict.”
According to Tielemans, this way of thinking “minimizes the brain and person’s ability to heal.” We know that thanks to neuroplasticity, our brains can modify themselves throughout our entire lifespan. It’s always possible to learn and unlearn.
If you come across a person who is or might be struggling with sex addiction, keep these three items in mind. Validate their feelings, encourage them to seek help and to think of their behavior’s underlying reasons. Why do they do it? Robert Weiss LCSW mentions how “underlying attachment disorders, early sexual trauma, sometimes they have developed mental or personality-based issues, all of which lead them away from intimacy and toward intensity.”
Sobriety in Sex Addiction
Since addiction is defined qualitatively instead of quantitatively, sobriety will look different for everyone. Sexual sobriety’s goal According to Bill Herring LCSW is to “manage sexuality in a manner that is safe, sane and healthy” for the addict, and is defined by Robert Weiss LCSW as “a mutually agreed upon, clear, written and signed behavioural contract based on the goals of the addict.”
Herring says, “there is a profound difference between true sobriety and mere abstinence.” (It’s important to note however that most recovery processes will require some period of abstinence before achieving sobriety.) “From this perspective, sobriety is much more than staying away from unwanted behavior. It includes a deep sense of serenity and a consistent ability to ‘live life on life's terms,’ often with deep connections with other people and a sense of meaning in daily life.”
A sexual sobriety contract might have two lists: the “I Want to Stop” and the “I Want to Add'' list of behaviors. The behaviors to stop are usually the ones that are compulsive and that the addict can identify are hurting themselves and others. The behaviors to add, with the help of a professional, will be situations addicts are most likely missing out on in the pursuit of sexual gratification. This could mean spending more time with their children or fostering true intimacy with their spouses, which aligns with Sam Tielemans, LMFT’s perspective: “sobriety isn’t the cure for addiction...it’s connection.”
Betrayal and Sex Addiction: Loving a Sex Addict
“Betrayal is the greatest source of pain to any addict’s spouse—particularly sex addiction. It’s not so much about the addict’s drinking, using, spending, sexing etc. that causes the most hurt to a loving spouse—it’s the lying, broken promises and loss of trust,” says Robert Weiss LCSW.
Imagine finding out that your spouse of 10 years, your best friend, this person you trust to your bones, has been having sex with other people on a regular basis when it was never part of your relationship agreement, and they can’t stop, even though they may truly want to…
People who love sex addicts often go through a shocking experience: everything about their spouse suddenly starts to look fake. They may constantly bring up what happened—and that doesn’t mean they are crazy; they could be experiencing hypervigilance, a natural response to extreme emotional trauma.
Matthew Tull, PhD points out “hypervigilance is about more than just being extra vigilant. It is a state of extreme alertness that undermines quality of life. If you are hypervigilant, you are always on the lookout for hidden dangers, both real and presumed.” It is the body’s way of protecting you from dangerous situations, and it’ll cause you to be extremely aware of your surroundings. It can make you exhausted and impact your ability to show up in your every-day life.
So, how can you support a sex addict’s spouse? For starters, never tell them they “should have known,” nor treat them like “crazy” people. Understand that they are processing their experience in a human, natural way. Listen to and validate their feelings. Allow them time to grieve.
If you come across someone who might be struggling with betrayal or if you are yourself, they or you...
CAN BENEFIT FROM
WON’T BENEFIT FROM
🔸 Concrete direction regarding self-care, health issues, talking to family, etc.
🔸 To be educated about addiction, disclosure, family dynamics and support
🔸 Your reality and feelings to be held and validated
🔸 Social support from professionals, peers and family (where useful)
🔸 Disclosure and clarity from your loved one
🔸 Hope
🔸 Being “calmed down” out of it
🔸 Being told to look at your part or responsibility
🔸 Talking about your past or family history
🔸 Talking explore your sexual or romantic life
🔸 Being labelled or told there’s something wrong with you
🔸 Being judged for deciding to stay
It’s important to understand that, as a human being processing betrayal as “collateral damage” of your loved one’s addiction, you need support. As much as the person suffering from addiction needs professional help, you need help to figure your way out of this situation.
You can choose to stay or leave the relationship, but do not forget to heal. Remember, addictions can be overcome if there is will to do so. As a partner, you have no control over one aspect: your partner’s addiction. It is not your fault and it is not your responsibility to solve. They are the only ones who can take action.
Sex Addiction and the Internet
Today, thanks to the wonders of the internet, we face what’s called “the triple A influence:” accessibility, affordability and anonymity. From pornography to cybersex, engaging in sexual behaviors and acitvities has become incredibly easy. While some argue that porn and sex addiction are different addictions, some definitions of sex addiction include cybersex, dating apps and pornography. Sometimes engaging in these behaviors can be what ultimately leads to sex itself, and/or what starts the spiral of addiction.
Elizabeth Hartney, BSc., MSc., MA, PhD. acknowledges that:
🔶 The Internet has led to an unprecedented amount of porn being made available to anyone with a computer.
🔶 Many people are bombarded with advertising for porn and commercial sex sites without even seeking them out.
🔶 Many more people are being exposed to porn than ever before, including children and adolescents, and the nature of the web makes it difficult (if not impossible) to censor or place limits on the nature or amount of what is portrayed.
🔶 It is easy to find and conduct an online affair, or online dating through sites such as Tinder.
This is why, now more than ever, the world requires both proper sex education and more ethical consumption and creation of pornography and online content. Sex education to understand that porn is a performance, a type of entertainment, and ethical pornography to allow people to see sex scripts away from the objectification of humans and closer to the portrayal of respect.
Personal Stories
Erica Garza’s: “I felt like I needed to have a combination of shame and pleasure in order to feel satisfied with a sexual experience. And so if I didn’t use protection, it was something I felt really bad about because I knew I should be treating my body better. I knew that something could happen, and I couldn’t believe I was putting myself in those destructive situations—but it felt too good not to.”
Jasmine Banks': “Did you know that living through the trauma of repeated infidelity poses risks to your emotional and physical health, and being gaslit by someone with sex addiction can result in a PTSD-like trauma? I didn’t either until my psychologist asked me how I was dealing with the reverberations of trauma. I retorted, “what trauma…that was his problem…” but just as those words escaped my mouth I began to realize the ways in which I’d been impacted by my ex-husband’s addiction.”
Frankie’s: “I could only function and carry on with my day if I knew when I was going to get my next hit of sex. It was such a priority to me, I'd plan that over work, self-care or going out. I’d call in sick to work or cancel meeting friends if I could have sex. I’d make sure it happened every day. It gives you such a high and, when it starts to fade, you want more. About a year into the addiction, I realized I actually wanted a relationship. I wanted someone to love me... but a lot of the guys I was sleeping with obviously just wanted a quick s**g. I got very depressed, but I still couldn’t escape the addiction.”
Mary P. Jones’: “I was heartbroken to lose the marriage that I thought I had and learn that the person I considered my closest and most trusted friend would hide behavior that was so critical to my own ehealth and well-being. [...] I did decide to stay with my husband, and the key to that was my husband’s complete dedication to working on this recovery. We have had to make recovery work our first priority; we know that without it we will lose everything else in our lives.”
Jacob’s: “I would make these pacts with myself: I’m going to stop. It would last a day or two and I’d be back at it again. I was acting out with other people, or porn, or masturbation, almost daily.
Carnal Theory:
“Compulsive sexual behavior, also called sex addiction, is subjective, and it’s an emotional regulation strategy; that’s long term problems outweigh the short term relief provided.”
– Kate Balestrieri
Dr. Kate Balestrieri is a Liscensed Psychologist, Certified Sex Therapist, Certified Sex Addiction Therapist, couples therapist, and founder of Modern Intimacy. Tune in wherever you listen to your podcasts to learn more about her theory!
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Writing Prompts:
Take what you’ve learned through our social media, Carnal Theory interviews, this newsletter, blog and more to inform your inner reflection and self-exploration:
📝 How often do you express yourself sexually in physical ways other than genitally?
📝 What challenges do you encounter when communicating sexual limits?
📝 Do you experience shame or disgust while touching your own body? If so, where might that come from?
This voluntary monthly prompt invites you to explore your sexual biography.
Tips on exploring this: Set aside 20 minutes with your phone on silent and relax in a comfortable space with a pen and paper. Go slow. Start with what comes to mind from your first read of the prompt. Continue writing from your stream of consciousness.
Mantra of the month
When I close my eyes and take deep breaths I can see my wisest self. I will use this ritual to guide my decisions.
Listen to our “Addiction” playlist on Spotify
At My Sex Bio, we believe:
☮ By removing the shame and fear around sex and sexuality, each of us can live a more authentic, peaceful life.
☮ Sex education and empowerment are vehicles for peace. Internally, then globally.
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