Is a furtive interest in pornography evidence of sex addiction? When do sexual desires become sex addiction? Experts debate whether there is such a concept as sexual addiction, but few dispute that sexual thoughts and behavior can become problematic for some people, destroying relationships and careers and leaving sufferers drowning in shame.
You write that some people with a strong interest in sex worry that they may be addicts. Should they?
Not really. In fact, my hope is that people with a strong interest in sex find healthy ways to indulge and enjoy that interest. It is only when a behavior gets out of control and causes consequences that we start to think about addiction. Sex addiction has nothing whatsoever to do with who or what it is that turns a person on. The simple truth is that sex addiction is not defined by how much sex or even the type of sex a person has, just as alcoholism is not defined by how much you drink or what kind of alcohol you consume. The defining factor—for all addictions—is how the activity affects your life. If someone is preoccupied to the point of obsession with sexual fantasy and activity—solo or with others, has repeatedly tried and failed to quit or cut back, and is experiencing negative consequences as a result, that raises red flags for sexual addiction. Otherwise, sex addiction is probably not the issue.
What led you to write this book?
There is not enough understanding, compassion, or direction for people who struggle with sexual addiction. What I see instead is repression, humiliation, shame, and avoidance. Plus, I see a lot of misinformation from therapists who simply don’t understand sexual addiction. I know this problem inside and out, along with the early-life traumas that typically precede it, and I know this not just professionally but personally, having struggled with sex addiction since adolescence, when it developed as a form of self-soothing while growing up with mentally ill parents. I know what it takes for an addict to change problematic patterns of sexual behavior and to develop a healthier, happier, more fulfilling sexual and romantic life. This book is a way to share that knowledge with the people who need it.
Who would benefit most from the book?
Sex Addiction 101 and a companion workbook are written to help sex addicts, their families, and clinicians. Throughout, I try to present a hopeful tone, letting people know that sex addiction is not a life sentence and that healing is possible.
What is the most surprising thing you discovered in researching this book?
There is a great deal of evolving neurobiological research that supports the concept of sex as an addiction, like substance addiction or gambling addiction. I find the research fascinating, as it speaks to the common origins of addictive behavior. There is also a large literature documenting the co-occurrence of sex addiction with substance abuse, eating disorders, and early-life trauma.
There’s an ongoing debate in the field of psychology about whether hypersexuality is an actual addiction or disorder. What do you say to those who doubt that it is?
Part of the debate over sex addiction stems from the lack of a DSM-5 diagnosis. This lack hardly means the disorder doesn’t exist. Remember, the DSM did not include a diagnosis for alcoholism until the 1970s, but that didn’t stop countless thousands of people from self-identifying as alcoholic, undergoing treatment with forward-thinking therapists, and finding help in 12-step recovery. Eventually, the DSM caught up with reality, and now there is an official, and readily accepted, diagnosis for substance use disorder. With sex and porn addiction I think we are seeing a similar progression. Until the DSM catches up to the rest of us regarding sexual addiction, I choose to trust the research, the clients seeking help, and the treatment successes I have seen over the past three decades.
How does hypersexuality impact long-term intimate relationships?
Sex addiction for those in a long-term intimate relationship leads to painful violations of trust, loss of emotional intimacy, and loss of connection. Moreover, sex addicts in general experience depression, anxiety, loss of self-esteem, lack of self-care, problems at work or in school, financial issues, legal woes, declining physical health, and more. In addition to the loss of trust, intimacy, and connection, any and all of these other consequences can negatively impact a primary romantic relationship. Still, about 85 percent of the couples I work with stay together for at least two years following treatment, not only dealing with compulsive sexual behavior but rebuilding relationship trust and intimacy.
How would your book help the partners of people with hypersexuality?
Far too often addiction treatment focuses almost exclusively on the addict and his or her problem. I wanted to also provide insight, support, and guidance for the spouse. To this end, I’ve dedicated a chapter to betrayed partners, explaining the basics of sex addiction and digital age infidelity, validating their emotional lability, and pointing them toward the help that is available for them. The goal is to educate loving spouses while normalizing their experience, letting them know they’re not alone and that plenty of assistance is available.
There’s a workbook that accompanies your book. How did you develop those exercises and how would people benefit from them?
The workbook is built on research-based addiction treatment methods and more than 25 years of professional and clinical experience. The highly refined exercises have, over the years and in various forms, helped thousands of men and women heal from sex, porn, and love addiction.
Why is it important to separate discussions of morality from discussions of hypersexuality, and why is that so hard for many to do?
Sex addiction therapists are not the sex police. It is not our job to judge or pathologize patterns of sexual arousal that may be unconventional or atypical. We do not bring cultural, moral, religious, or other judgments into the therapy space. As clinicians, we tend to be quite sex-positive, encouraging all sexual activities that are not obsessive, out of control, or creating profound negative consequences. Nevertheless, some people do think that sex addiction therapists want to pathologize unconventional sexual behaviors, forcing preconceived moral, cultural, or religious values onto the vulnerable, people who are already tortured by their own shame. Nothing could be further from the truth. Properly trained and certified sex addition therapists do not pathologize any specific sexual desires or behaviors, so long as they are consensual and legal.
What is the most important message you want to get across to people through this book?
I want people to understand that sex addiction is a debilitating but treatable disorder typically driven by shame, self-hatred, and unresolved early-life attachment traumas. With proper treatment and ongoing attention, the disorder can be put into remission and sex addicts can move forward into a healthier, happier, more fulfilling life—and that includes their sexual and romantic life.
If you had one piece of advice, what would it be and to whom would it be aimed?
One of the first things I tell anyone who thinks that he or she might be a sex addict is to not worry about never having sex again being a condition of recovery. Unlike sobriety for alcoholism and drug addiction, sexual sobriety is not defined by long-term abstinence. Rather, sex addiction treatment addresses sobriety much as it is handled with eating disorders—another area in which long-term abstinence is simply not feasible. Instead of permanently abstaining from all sexual activity, recovering sex addicts learn to be sexual in non-compulsive, non-problematic, life-affirming ways. Many find that their sex life is far more enjoyable and fulfilling in recovery that it ever was in their addiction.
What would you like to see happen as a result of your book?
It would be nice if it would quiet the debate on whether sex addiction is a real disorder, but that’s probably asking too much. What I really want to do is help people who are suffering, along with those who treat them, by giving them basic information, guidance for recovery, and hope for the future.
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Sex Addiction 101