Description of the Problem

The assessment of sex addiction can be very difficult, and it is a controversial issue among sex counselors. Sometimes what is diagnosed as sex addiction is actually a symptom of another illness, such as bipolar disorder. More often, people are labeled sex addicts because they do not conform to traditional sexual values - they have multiple sex partners, their sexual interests are nonstandard, etc. This is an area where personal and cultural biases can creep into treatment easily.
But it is also true that some people are compulsively driven to sexual behaviors that can impair and even destroy the quality of their lives and seriously hurt those around them. The symptoms of sex addiction may include:

• engaging in sexual behaviors of which you personally disapprove
• engaging in sex even when you don’t want to, i.e., compulsivity
• jeopardizing and/or harming your job, your relationships, and/or your health by your sexual behavior
• engaging in sexual activities that expose you to possible arrest
• escalation of sexual behavior, e.g., finding that it takes more and more frequent contacts, or more extreme contacts, to ‘satisfy’ you. For example, you may be a gay man compulsively having unprotected risky sex with multiple partners; or a heterosexual man unable to control his use of 900 numbers; or a heterosexual woman driven to ‘pick up’ strange men and go to their homes for sex.

Sexual addiction can put your career on the line – you cannot control your obsession with internet pornography even when you are doing it at work. It can destroy a love relationship, particularly when kept a secret for a prolonged period. At worst it can put addicts at risk of fatal disease or violence.

Treatment approaches

The most important part of treatment is diagnosis, nowhere more true than when dealing with sex addiction. At The Oikos Institute we will help you assess whether your concerns about your behavior are indications that you have an addiction or simply reflections of what others think or what society wants you to do. If your behavior is compulsive, the first line treatment approach will usually consist of cognitive behavioral therapy, some type of group interaction, whether a twelve-step group or a counseling group or other type of support group for sexual addiction, and quite possibly psychotropic medication. Medication can help lessen the frequency of urges to ‘act out’ and thoughts about acting out, thus giving you a bit more control over your impulses. Just as substance abuse treatment is often enhanced by group support, so is counseling for sex addiction: feeling that you are struggling along side of others with the same problem is comforting, and other addicts will often notice when you are in danger of relapse long before anyone else can.

Cognitive-behavioral counseling will help you clarify your reasons for stopping the addiction, strengthen your resolve, and set your goals. Goal-setting is particularly difficult for sex addiction, since few people want long-term celibacy, so ‘abstinence’ is not possible; and there is no one definition for ‘healthy’ sexual behavior, so goals are totally individualized. We will help you analyze what your sex addiction “did for” you: often your sexual behavior substituted for other kinds of intimacy, served as a tension release, perhaps boosted your ego, and once you identify these things you can find healthier ways to get your needs met. We also work closely with your partner/spouse if you are currently in a relationship you want to salvage; we can help educate loved ones, help with what is often a deep sense of betrayal on the part of the mate, help find out how his or her needs can be met in a way that is healthy for you as well. Since many of our therapists have training in sex therapy, we are uniquely suited to help sex addicts build a positive sexuality as well as to do sex therapy for couples in which one person is an identified sex addict.