Do I Have A Problem With Sex Addiction?
Let’s break these two words down.
Whatever we become addicted to doesn’t start out as a problem. We made a choice that at the time seemed more like a solution. We felt comfortable, self-aware and in control.
The issue with addiction is when the solution becomes the problem. We realise that our choices bring consequences that weren’t meant to happen. We might be spending too much money, avoiding friends and family, or putting our physical or mental health at risk. But we do it anyway.
Sex between consenting adults is a worthwhile, healthy, exciting, dynamic, multi-dimensional gift that keeps on giving. Sex addiction isn’t.
What is it and how do you know?
Sex addiction is a young field of research. Most of it has been aimed at assessment – whether sex addiction is a ‘thing’ or not. The reason is not to deny that it exists but to gather as much knowledge in order to work out the best course of action to take.
But are we studying the same thing? If you review the last 20 years of research, you will discover that best practices for sex addiction are based upon a variety of uncontrolled studies and different frameworks. There is, however, a degree of consensus among practising clinicians that some approaches, such as psychotherapy, cognitive behavioural (CBT), acceptance and commitment (ACT) and group therapy show a reduction in symptoms over time.
So what does this tell us?
- There is no gold standard of care
- It is impossible to determine whether researchers are reporting on the same thing
- Sex addiction might exist on its own or it might be part of a wider behavioural pattern
- We might be spending time trying to identify the condition itself, rather than focusing on new outcomes or behavioural change
One way of defining sex addiction is called “Pathos” and is associated with the theory and practice of Patrick Carnes, the famous writer and practitioner in the sex addiction field. This Greek word comes from art and describes something which evokes compassion in others. The assessment helps to work out the extent to which a potential problem has become a problem.
- Do you often find yourself preoccupied with thoughts of sex? (Preoccupied)
- Do you hide some of your sexual behaviour from others? (Ashamed)
- Have you ever sought help for sexual behaviour you did not like? (Treatment)
- Has anyone been hurt emotionally because of your sexual behaviour? (Hurt)
- Do you feel controlled by your sexual desire? (Out of control)
- When you have sex, do you feel depressed afterwards? (Sad)
By answering these questions honestly, you can work out if there is a good enough reason to get in touch with us. You don’t have to have answered ‘yes’ to all the questions to seek help.
Plenty of other Mood & Sexual Compulsivity Inventories exist. Some are more specific than others. Each one is best used as preparation for a discussion than as an end in itself.
Sexual Compulsivity Scale
This is a brief, readily understandable measure that is widely used for research. Whilst initially used with gay and bisexual men, it is now used across other populations as well.
Sexual Symptom Assessment Scale (SSAS)
This is designed to measure “the current severity and frequency of sexual urges, fantasy and behaviour”. It measures changes in addictive behaviour over time.
Sexual Addiction Outcomes in Routine Evaluation
This assessment was developed by the author and expert, Dr Thaddeus Birchard and has been credited with demonstrable gains in well-being and reduction of addictive processes.
Cognitive and Behavioural Outcomes of Sexual Behaviour Scale
This measures the consequences of sexual addiction and looks at differences in levels of expressed worry and concern.
Compulsive Sexual Behaviour Consequences Scale
This also assesses the experience of behavioural consequences but looks at their degree rather than simply their presence or absence.
What does having sex addiction mean?
Addressing sex addiction is about finding ways to stay stopped. It is also about creating a formulation. What set this up? What is it replacing? How can you create a new way of thinking and acting that has less sensitivity and more specificity?
With sensitivity, you are thinking about the likelihood of your acting out and the way things trigger you to make such choices. Specificity is thinking in more detail about these triggers and the types of outcomes that result. A good therapist will be curious about this. They will act like a helpful detective who is on your side. They’ll be careful with all the details so the real picture can emerge.
When getting help for sex addiction, the professional you work with is helping you to discover the extent to which your addiction covers a behavioural pattern. Dr Thaddeus Birchard describes the behavioural pattern for sex addiction as:
- Out of control and preoccupying
- Something you try to stop but can’t stay stopped
- Harmful consequences result from it
- It anaesthetises negative feeling states
That last point is the answer to why sex addiction isn’t about sex, it’s about behaviour. Behavioural patterns – if they have lasted a long time – can feel as familiar to us as our personality.
We might describe ourselves as an “addicts”. This is because we have spent so long finding a way to cope with the intolerable – something we don’t like about ourselves, something that happened to us, or both – we have come to believe that we are what we do.
Behavioural patterns are also implied in the term “acting out”. This isn’t something that describes bad behaviour (that’s “acting up”) but could be used to describe your behaviour when times are bad.
“Acting out” is a way to describe an addictive process. Imagine you are an actor preparing to perform. You repeat behaviours you have rehearsed many times before and know how to do well. You are so well practised that it convinces other people and feels like you. With addiction, sometimes it’s easier to pretend and let the same performance go ahead like it’s always done.
If you decide to get some help with sex addiction, it is important that you choose the right help. You are part of the decision-making process to determine the best recovery plan and the right intervention for you. Be sure to ask our team for the right treatment option for you.