Facets of Sexual Addiction: Behavioral Problem

Posted on June 19, 2014


The mental health community is not of one mind as to whether or not sexual addiction is a real disorder.  I have worked with enough clients who are coping with compulsive sexual behaviors to be firmly of the opinion that this is a real addiction and not just people behaving badly.  The scientific data (e.g. brain scans of addicts) also supports this, but that is a topic for a future post.

There are a number of theories of marriage and family therapy.  Each has its view to the issues that impact couples and families, and each has its theory of how change happens in those relationships.  I am often reminded of Saxe’s poem about the six blind men and the elephant.  This not to assert that marriage and family therapy theorists are blind.  On the contrary, many have made great contributions. [1] My point is that they each have an element of truth, but the bigger picture contains all of those aspects.

Similarly when discussing sexual addiction, the topic and the disorder are multifaceted.  Treatment and recovery need to take into consideration the multiple dimensions involved.  Sexual Addiction is

•             A behavior disorder

•             A brain disorder

•             An intimacy disorder

•             A profound boundary failure

•             A family of origin disorder

•             A relationship disorder

•             A courtship disorder

•             A trauma response

•             A way of managing shame

•             A dysfunctional emotional regulation strategy


This post is the first in this series, so let’s start with the behavioral aspect.  There are films that one could have done without seeing, and one of those comes to mind here.  In the late 1980’s, John Ritter starred in a film called Skin Deep.  It has probably been 25 years since I saw the film so this is from memory.  I believe it was his therapist who said to Zach (Ritter) with regard to Zach’s sexual acting out, “How do you help an alcoholic?  The first thing you need to do is get him to stop drinking.”  Basically, this is an assertion that part of recovery needs to involve stopping the addictive behavior.

Like any addiction, with sexual addiction there is a behavior that is causing problems in one’s life.  Whether the acting out is compulsive porn viewing and masturbation, serial affairs, prostitutes, massage parlors, adult bookstores, swing clubs or a myriad of other acting out, with sexual addiction there comes a point at which one’s sexual behavior is creating a crisis in your life.  You need to get the behavior under control to be able to start the healing.  The issue with that is that if you could control the behavior, it wouldn’t be an addiction, now would it?  There exists simultaneously the need to recognize one’s powerlessness over the addiction and the need to take responsibility for recovery.

As I have previously pointed out, not everyone who views pornography or has an affair is a sex addict just a not everyone who drinks or gets drunk is an alcoholic.  However, if you are in crisis over your sexual behavior, it might be worth taking a look at your behavior.  These crises come in a number of forms.  The most common is that a partner has discovered something, and this has become relationship threatening.  Sometimes the crisis is a discovery of pornography on a work computer or the contraction of an STI.

So what does one do about the behavior one can’t control?  If this were a car commercial, this would be the point where we show on the screen “professional driver, closed course, do not attempt.”  Actually, you are welcome to attempt anything here (it won’t hurt you), but you might need professional support to get this under control.[2]  If you find a Certified Sexual Addiction Therapist (CSAT) trained therapist, there are assessment tools we can use that help identify the appropriate level of support to get the behavior under control.  Among the options are combinations of inpatient treatment, intensive outpatient treatment, individual therapy, group therapy, and support groups.  Don’t panic.  Most addicts do not need the inpatient level of care, but it is an option in situations where that level of care is needed for recovery.


If sexual addiction is present, the addict and therapist will work together on a sobriety development plan.  The sobriety development plan is not just about a list of things you don’t do anymore, it is about creating protection for yourself.  So, yes, there is a list of things you need to not do anymore (i.e. the abstinence list).  There is also a boundaries[3] list and a healthy life plan[4].  Ultimately, to control the behavior, one needs to be surrounded with a culture of support that aids in recovery.  If could have controlled this through your own resolve, you would have already done so.  You need a plan, and you need help.  Even if your sexual acting out is not an addiction, if your sexual behavior has created problems in your life, it is generally a good idea to get support from a therapist with experience in helping clients recover from such issues.


[1] As my former practicum supervisor pointed out about the MFT theorists, “We are standing on the shoulders of giants.”

[2] You might also need professional support to help your partner heal and stay around long enough for the relationship to recover.

[3] Addicts are usually neither good with boundaries nor very happy with boundaries.  The reality is that boundaries are your friends, not your jailer.  More about this in a future post.

[4] Sexual addiction recovery is about recovering your life, not just stopping problematic behavior.