Sexual Addiction Criteria

Posted on June 21, 2012


One of the most painful traumas that occurs in marriage is when one (or both) partners is acting out sexually outside of the relationship.  This can take many forms (e.g. pornography, affairs, online relationships, phone sex, prostitutes, etc.).  Often there is a compulsive aspect to the acting out.  Though not all sexual acting out is indicative of an addiction, very often sexual acting out and sexual addiction are found together.  The criteria for sexual addiction parallel those of substance abuse and pathological gambling (Carnes, 2012).  The criteria list is taken from Carnes (2012).

  • Loss of Control – Often indicated by a pattern of one doing more than one intended to do or wanted to do.
  • Compulsive Behavior – The pattern has become out of control over a period of time.
  • Efforts to Stop – Attempts to stop the behavior have failed.
  • Loss of Time – significant amounts of time are lost either doing or recovering from the behavior.  We sometimes speak of “real time” vs. “addict time.”  Often the one acting out loses track of time while engaged in the behavior.
  • Preoccupation – The behavior becomes an obsession to where one is spending increasing time thinking about acting out or making plans for acting out.  It becomes the obsession that is “driving the bus.”
  • Failure to Fulfill Obligations – Acting out sexually begins to interfere with other areas of life (work, school, family, and friends).  It becomes difficult to fulfill obligations.
  • Continuation Despite Consequences – Common to most addictions is that the behavior continues in spite of the problems encountered as a result of the behavior.  Problems may include social, legal, financial, physical, and career problems.
  • Escalation – Just as tolerance is an indicator of alcohol dependence, sexual addiction often is characterized by behavior becoming more intense, more frequent, or more risky.
  • Losses – “Losing, limiting, or sacrificing valued parts of life such as hobbies, family, relationships, and work” (Carnes, 2012).
  • Withdrawal – Another parallel to substance dependence; “stopping behavior causes distress, anxiety, restlessness, irritability, or physical discomfort” (Carnes, 2012).

If any of these criteria are present in one’s life, assessing one’s acting out for sexual addiction is appropriate.  Carnes (2010) developed a task based approach to treating sexual addiction.  The first task is “Breaking Through Denial.”  This comes with the realization that one’s life and behavior have become unmanageable.  The Sexual Addiction Screening Test (SAST) is a quick diagnostic instrument and is available free of charge at  The test has been validated with both addicts and non-addicts.  It can be taken anonymously in about 5 minutes.

The course of recovery generally begins with a “developing stage” in which one begins to recognize the problem.  Often it takes the crisis/decision stage for one to seek help.  Something bad happens (loss of job, arrest, or other problem develops) or a partner makes a discovery (affairs, pornography, online relationships) that results in a wake-up call.  Help is available.  This generally takes the form of individual therapy combined with group support.  It is not an easy process, but reclaiming one’s life and returning to sexual and relationship health is possible.


Carnes, P. (2012). Certified sex addiction therapist CSAT: Module 1 training manual. Carefree, AZ: International Institute for Trauma and Addiction Professionals.

Carnes, P. (2010). Facing the shadow: Starting sexual and relationship recovery (2nd ed.). Carefree, AZ: Gentle Path Press.

“I work with individuals, couples, and families to help develop secure connections
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Scott Wood is a registered marriage and family therapist intern (IMF67385) and is supervised by Dr. Melinda Reinicke, Psychologist (Psy11011).