Indicators of Sexual Addiction

The sex addict uses sex as a quick fix, or as a form of medication for anxiety, pain, loneliness, stress, or sleep. Sex addicts often refer to sex as their “pain reliever” or “tension reliever.” In a popular novel, the heroine describes sex as “the thinking women’s Valium.” 3

Other indicators that sexual behavior may be out of control include: an obsession with sex that dominates one’s life, including sexual fantasies that interfere with work performance; so much time devoted to planning sexual activity that it interferes with other activities; strong feelings of shame about one’s sexual behavior; a feeling of powerlessness or inability to stop despite predictable adverse consequences; inability to make a commitment to a loving relationship; extreme dependence upon a relationship as a basis for feelings of self-worth; or little emotional satisfaction gained from the sex act.

Compulsive or addictive sexual behavior may take various forms, including what many regard as “normal” heterosexual behavior. The type of sexual activity and even the frequency or number of partners are not of great significance in diagnosing this problem. Some individuals have a naturally stronger sex drive than others, and the range of human sexual activity is so broad that it is difficult to define “normal” sexual behavior. What is significant is a pattern of self-destructive or high risk sexual behavior that is unfulfilling and that a person is unable to stop.

The first major study of sexual addiction was published by Patrick Carnes in 1991.4 It was based on questionnaires filled out by 752 males and 180 females diagnosed as sex addicts, most of them admitted for treatment in the in-patient Sexual Dependency Unit of a hospital in Minnesota. The others had at least three years of participation in one of the 12-step programs for recovery from sexual addition. Of the sex addicts in this survey, 63% were heterosexual, 18% homosexual, 11% bisexual, and 8% were unsure of their sexual preference .

The sexual addicts who responded to Carnes’ questionnaire were typically unable to form close friendships. Their feelings of shame and unworthiness made them unable to accept real intimacy. They were certain they would be rejected if others only knew what they were “really” like, so they found myriad obsessive ways to turn away a potential friend or loving partner. Despite a large number of superficial sexual contacts, they suffered from loneliness, and many developed a sense of leading two lives–one sexual, the other centered around their occupation or other “normal” activity.

In Carnes’ survey, 97% responded that their sexual activity led to loss of self-esteem. Other reported emotional costs were strong feelings of guilt or shame, 96%; strong feelings of isolation and loneliness, 94%; feelings of extreme hopelessness or despair, 91%; acting against personal values and beliefs, 90%; feeling like two people, 88%; emotional exhaustion, 83%; strong fears about own future, 82%; and emotional instability, 78%.

Carnes found that 42% of sex addicts in his sample also had a problem with either alcohol or drug dependency and 38% had eating disorders.

The roots of out-of-control sexual behavior may be quite varied. It may be caused by an underlying personality disorder, an “addiction” to sex, or a physical disorder. The traditional disorders of exaggerated sexuality, nymphomania in the female and satyriasis in the male, are believed to be caused by a disorder of the pituitary gland or irritation of the brain cortex by a tumor, arteriosclerosis or epilepsy. These physical disorders are rare. 5

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