Sexual addiction or hypersexuality is defined as a dysfunctional preoccupation with sexual fantasy, often in combination with the obsessive pursuit of casual or non-intimate sex; pornography; compulsive masturbation; romantic intensity and objectified partner sex for a period of at least six months.
By definition, this adult obsessive pattern of thoughts and behaviors will continue despite:
- Attempts made to self-correct problematic sexual behavior
- Promises made to self and others toward sexual behavior change
- Significant, directly related negative life consequences in life and relationship stability, emotional and physical health concerns, or career and legal problems.
Sexual addiction can be considered a process addiction (as opposed to substance addictions such as drugs and alcohol), similar to gambling, binge eating or compulsive spending. As such, sexual addicts typically spend a much greater amount of time engaged in the pursuit of sex and romance (the process) than in the sexual act itself. They are addicted to the neurochemical and dissociative high produced by their intense sexual fantasy life and ritualistic behavior. This is their addiction.
What Sexual Addiction Is Not
The diagnosis of sexual addiction is not necessarily made if an individual engages in fetishistic or paraphillic sexual arousal patterns (e.g., BDSM, cross-dressing), even if these behaviors lead the individual to keep sexual secrets or feel shame, distress or “out of control.” Unwanted homosexual or bisexual arousal patterns also are not considered sex addiction per se. Sexual addiction is not defined by what or who the individual finds arousing, but rather by self- and other-objectified, repetitive patterns of sexual behavior utilized to stabilize distress and to manage emotional triggers.
In simple terms, most people don’t consistently utilize sexual arousal as a means of “feeling better” when having a bad day. Healthy people reach out to friends and intimate others for support when upset and also demonstrate a greater ability to self-soothe and tolerate emotional stressors than do sexual addicts.
Differential Diagnosis and Comorbidity
Sexual addiction can be viewed as an adaptive attempt to regulate mood and tolerate stressors through the abuse of intensely stimulating sexual fantasy and behavior. It is believed that sexual addiction is a dysfunctional adult response to innate personality, character or emotional regulatory deficits, as well as a reaction to early attachment disorders, abuse and trauma.
In order for the diagnosis of sex addiction to be made, professionals must first rule out concurrent drug abuse, as well as those major mental health disorders that also include hypersexuality as a symptom. Examples of these include bipolar disorder, obsessive-compulsive disorder and adult attention deficit disorder, all of which have hypersexual or impulsive sexual behavior as a potential symptom. Some individuals may have both a major mental disorder and sexual addiction, both of which need to be addressed, much as one might be both alcoholic and bipolar.
Why Seek Treatment?
Many sex addicts seek treatment for sexual addiction only after suffering significant consequences to their health, career, finances and relationships. Most men report initially seeking sexual addiction treatment to find relief and help with related negative life consequences such as pending relationship, legal or interpersonal crises, or threats of divorce or abandonment by a spouse or partner. Overt negative consequences related to sexual behavior, such as job loss and arrest, also drive individuals to seek treatment.
While not yet fully acknowledged as a legitimate mental health disorder in the clinical literature (reportedly due to a lack of research study), sexual addiction and hypersexuality nevertheless is becoming identified in the public consciousness as a legitimate neuropsychobiological disorder. This slow shift in consciousness regarding this disorder is largely due to the escalation of technology-driven sexual problems, the growth of international sexual recovery 12-step groups, evolving research study data, as well as the term “sex addiction” being consistently referenced in relationship to the highly publicized problem sexual behaviors of certain major U.S. political, entertainment and sports figures.