1. What are the known causes of sexual addiction?

Sexual addiction is diagnosed when a person’s intense sex drive or obsession with sex interferes with different areas of that person’s life.

In my practice I’ve found multiples causes of sexual addiction—some more common than others:

– Having been abused or emotionally neglected as a child
– Having had parents with sexual problems
– Having ongoing feelings since the childhood of not being loved or wanted
– Having been raised in an environment with sexual abuse and domestic violence.
– Having the perception of being worthless

When one or more of the above causes occurs in a patient’s life, then often the result is a need to escape towards sexual gratification to avoid dealing with the constant pain. The fantasy of that next sexual encounter or sexual imaginary seen on the Internet can act to help reduce the anxiety associated with the patient’s feelings of not being loved, accepted, wanted, cared for, etc. Finding gratification in sex can lead to a repetitive pattern or an obsessive compulsive behavior. Remember the triggers could be different situations based on the patient’s childhood where he/she experimented that uncomfortable anxiety filled feelings described above.

2. Are there red flags or signs a person might recognize to seek treatment before the addiction gets out of control?

Absolutely. If an individual is constantly preoccupied with sex then that’s the red flag. If he/she regrets the amount of time and energy spent in pursuit sex, paying for sex that ultimately challenges your finances, having sexual or romantic behavior which is hurting your significant other, having difficulties stopping your sexual behaviors even when they hurt you, being involved with pornography, sex online, cruising social networks for sex, online hook-ups, — all indicate a possible addiction. If you find you are constantly having romantic problems, having serious problems stopping your sexual behavior, even when you know is inappropriate, anonymous or casual sex that keep you away for a long term relationship, sexual encounters in dangerous place, situations that potentially expose you to a sexually transmitted diseases, feeling sad after a sexual encounter, sexual behavior that interferes with your work performance or personal life, repeated experiences of unsafe sex, looking for cruising places to have sexual engage—if any of these characteristics fit you—then you might be a sexual addict.

3. What are the emotional drawbacks to sexual addiction?

Sexual addiction can lead to a low ability to concentrate, focus and motivate for their regular job, emotionally drained, difficulties to establish and retain a stable relationship, lack of spending quality time with family and friends, isolation behavior, constantly worrying that something negative is going to happen, insomnia, poor self-esteem, lack of confident, symptoms of depression as hopeless, helpless, feeling worthless, anxiety and in severe cases, sexual addiction can lead to depression and suicidal thoughts.

4. What are the physical drawbacks?

Because the sexual addiction is a compulsive behavior which lacks a logical thought process, it often leads to a lack of control which can be very dangerous. Sexual addicts are at a higher risk for sexually transmitted diseases like gonorrhea, syphilis, HIV, and others. The addict’s behavior can also put his/her spouses’ health at risk as well. Other physical problems can include genital injury due to the excessive masturbation or sadomasochistic sex.

5. How does sexual addiction affect married couples?

Sexual addiction can destroy a marriage. It often leads to a lack of intimacy and poor self-esteem for both partners. In some case, the spouse of the sex addicted partner doesn’t know how to deal with the problem and can end up developing some other type of addiction—such as alcohol, food, drug, gambling etc. The lack of communication can drain the emotional energy out of the marriage. The addiction can also lead to a high level of anxiety between the couple. Divorce is often the end result if the couple doesn’t learn how to confront or identify the problem.

6. How is it best for a spouse to cope with their spouse’s addiction?

The best way to cope is to communicate the problem to the partner. Expressing the evidence of the problem and that is necessary to look for professional help. This conversation will be very difficult because the sex addict is usually in denial. Sometimes sexual abstinence is necessary to contain the potential spread of a sexually transmitted disease until the sex addict is cleared for all STDs. The Spouse should investigate the couple’s financial statements to look for any unusual expense in the family budget and communicate to the partner that you are aware of some irregular expenses. If the partner is not willing to get help, the spouse has few options—and might consider a separation. Remember every situation is different, these are just some rough guidelines– we cannot generalize, that’s one of the reasons to look for professional help.

7. What are the treatment options?

The best way to approach to the treatment is to contact a licensed sex therapist. This professional will make an evaluation to consider the patient’s problem in order to see how far the patient is the addiction. After the evaluation, then there’s a need for a physical evaluation and treatment of any STDs. A residential program might be necessary if the case is very severe. A support group for sex addicts following the traditional 12-step program is very important as a part of the treatment. There are also support groups for the spouse and family so they learn how to deal with this situation. The medical treatments such as psychotropic medications prescribed by a psychiatrist is sometimes necessary to help to reduce the compulsive behavior. As you can see the treatment often requires is a multidisciplinary team.

8. How effective is the treatment? Is it temporary or long term?

The effectiveness of the treatment depends on the patient. Is difficult to pre-determine if it will be effective or not since every patient is unique. It should be noted, the treatment is long term for an intensive period of 6 months followed by psychotherapy for usually at least a year.

9. With sex being such a huge component of married life, how does one recover from sexual addiction and still maintain a sexual relationship with their spouse? Meaning, with drug and alcohol addiction a person is taught to refrain from using so with sex addiction, is abstinence recommended?

In that way, sexual addiction is similar to food addiction—you shouldn’t stop eating forever. Knowing that sex is very important part of the relationship, we need to evaluate the couple’s previous sexual activities. We look to see where they had real intimacy in their sexual encounters. During the evaluation, we sometimes consider prescribed abstinence as a part of the treatment. It is necessary for each partner to evaluate and think about their sexual values, concerns, activities, fantasies, and family sexual history. In general, an evaluation of both partners helps to yield a better outcome and help to avoid a future codependent role for the spouse.

10. Have the number of sexual addicts increased or decreased of the past decade and what do you think is the cause for the change?

The number of sexual addicts has increased during the past decade for different reasons. One reason for the increase is that today we have better diagnoses skills and improved reporting. The “bible” used by mental health professionals, the DSM-5 (The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) now recognizes sexual hyperactivity disorder. This change has made even more mental health professionals aware of sexual addiction. Another factor with possible links to the rise in sexual addiction cases could be the ongoing “sexualization” of our society; Access to sexual images and sexual encounters continues to increase. Computers, tablets, smartphones, with access to pornography and applications that make anonymous sexual encounters just one click away– have made escaping into a non-intimate sex world easier than ever before. For individuals suffering from emotional pain, an easy escape is difficult to resist, and the instant gratification that follows only speeds up the cycle leading to sexual addiction.