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Sexual Addiction

Sexual Addiction


Although the term “Sexual Addiction” is used frequently in our culture, it is a lay term

and does not constitute a diagnosis recognized in the most recent edition of the Diagnostic and Statistical Manual for Psychiatric Disorders, which is the widely accepted diagnostic reference for the fields of psychology and psychiatry. Nevertheless, significant numbers of people report engaging in problematic sexual behavior, and psychotherapists frequently encounter patients presenting with compulsive sexual behavior.


Clinicians generally recognize that compulsive sexual behavior is characterized by a pattern of sexual activity that results in negative consequences in the patient’s life. Affected individuals report being unable to control their sexual urges, behaviors, and/or thoughts. This is a pattern of problematic sexual behaviors that is not caused by other problems, such as substance abuse, a medical condition (e.g., dementia) or a primary psychiatric disorder, such as a manic episode associated with bipolar disorder. Patients reporting compulsive sexual behavior are often concerned with the number of their sexual partners, their use of internet-based sex, unsafe sex, frequent one-night stands, patronizing of sex workers, inability to resist sexual impulses, unsuccessful attempts to control their sexual behavior, and/or repeated affairs. To be sure, many individuals occasionally engage in sexual behavior that they come to regret. However, to be considered for treatment, an individual must show a pattern of problematic sexual activity over time, difficulty managing their sexual behavior, significant negative consequences (such as relationship problems or legal consequences), and personal distress relating to these issues.


It is unclear what leads to compulsive sexual behavior. Theories include genetic explanations, neurological imbalances, learning processes that reinforce sexual compulsivity, personality disorders, and cultural trends. Treatment is often aimed at enabling the individual to bring sexual thoughts, feelings, and behaviors under more conscious control. Structured programs based on the twelve-step model popularized by Alcoholics Anonymous are common, but these issues are also often treated in individual psychotherapy, using insight-oriented psychotherapy, cognitive behavior therapy, or sex therapy.


The omission of “Sexual Addiction” from the DSM-V has been hotly debated among mental health professionals. Some psychotherapists have interpreted the American Psychiatric Association’s decision to omit this diagnosis from the DSM-V as a victory against a “sex-negative” (stigmatizing) diagnosis. However, many psychotherapists who are certified as sex addiction therapists have argued that the omission of this diagnosis from the DSM-V deprives affected patients from being properly diagnosed and treated.

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