Sex addiction is a complex and often misunderstood condition which must be approached through appropriate, person-specific treatment.
Appropriate Treatment for Sex Addiction
With any addiction, it is crucial to find the appropriate treatment. This means working with professionals qualified in the specific area. How does a therapist become a specialist in the field of sex addiction?
“The founder of the primary approach to treatment, Dr. Patrick Carnes, created an organization called IITAP. They train therapists to become certified sex addiction therapists, CSATs. That training is very intensive: it requires attending four separate modules and thirty hours of supervision from a CSAT professional. It involves a lot of work on the Patrick Carnes Model. The model itself is also very intensive. It’s very structured in terms of the materials you use and the testing that’s done. It’s the standard approach with sexual addiction treatment.”
No Perfect Formula
However, there is no “one size fits all” method to achieve recovery through therapy. Successful treatment requires a client-centred approach, catered towards a person’s individual needs.
“With sex addiction, it’s so important to treat it specifically because there is so much shame around it, and such a great deal of misunderstanding. For example, I’ll hear from a lot of partners of sex addicts who may have gone to a therapist who encouraged them, ‘Well, maybe you just need to be open to your partner’s sexual interests.’ Which is actually very different, it’s not the appropriate treatment. It’s enabling the behaviour rather than recognizing that there might be a sexual addiction. There is so much stigma and secrecy around it. Obviously, sex is a normal, healthy human behaviour that can turn into an addiction, so there’s a lot of confusion around the issue and a lot of shame. That’s partially why there needs to be a slightly different approach.”
Sex addiction rarely only impacts upon one person. Good treatment acknowledges this, with those close to the person struggling with an addiction often involved. How is this incorporated into the process?
Therapy usually starts out as one-to-one. Then, if the person is in a relationship, the therapist will usually recommend that they also go to a CSAT therapist. There are some CSATs that specialize in working with partners. After there’s some stability and sobriety under the person’s belt, they will usually go as a couple to couples therapy with a CSAT.
It is crucial to identify an individualized behavioural addiction treatment based on your personal needs. This means someone struggling with sex addiction will work with qualified professionals to identify the underlying causes and the consequences of their addiction. They will achieve insights into triggers and warning signs to avoid relapses and, ultimately, to achieve healthy sexual relationships. How is this client-centred treatment established and implemented?
We’ll ask someone to complete an admission assessment, which will ask them, ‘What do you feel are your personal preferences, your personal needs, in therapy and in treatment?’ We ask very detailed questions about their background so we can get to know them and what might work best for them. Then when they come in, we do what we call a person-centric treatment plan, where we’ll ask about personal needs, personal barriers, any sort of learning challenges, and areas where they excel.
“We try to get an idea of who they are and how they learn best. This way, we can make sure treatment is defined towards them. With our support, define their own goals, and then we help to make them into something tangible and realistic. We want to be able to measure progress. This allows us to be specific about where we are and how we can continue to move forward. We make it really specific to the person.
Various Sex Addiction Triggers
Some people might have very specific arousal templates, as we call them. For example, a woman might have a fantasy of a certain type of man, and she may find herself constantly cheating on her partner with men who fit that description. We try to explore where that arousal template starts from and what this person is achieving through these affairs.
One of the unusual aspects of sex addiction treatment is that the objective is not lifetime abstinence, but achieving a healthier relationship with the focus of the addiction. How does this influence treatment?
It’s similar to working with someone with an eating disorder. Obviously you’re not going to have complete abstinence there. With the treatment for sexual addiction, there might be a period of abstinence- that’s usually recommended- but you have to keep in mind that someone is going to have a different experience to someone who can completely go without the substance they’re addicted to. That definitely changes the way you approach treatment. The focus is on finding a healthy relationship with sex and intimacy.”
Causes of Sex Addiction
As with any addiction, the causes of sex addiction are complex and often routed in deep psychological and emotional issues. Depression, anxiety and shame can all be catalysts for, as well as results of, sex addiction. This makes a holistic approach which addresses the underlying causes of the condition essential.
Sex addiction is an unusual pattern of rampant sexual behaviour that leads to immense complications in one’s life”. Seeking professional help is often the only way to avoid or overcome these complications.For a lot of people, it’s similar to a substance addiction. It serves to compensate for whatever is missing in a person’s life. If a person is struggling with depression or anxiety, they might use dating apps or chat rooms or pornography to make themselves feel better. That becomes their way to cope. This ultimately results in a dependency on that behaviour, which has serious consequences for their relationships.
Based In a World of Fantasy
Sexual addiction also involves elements of self-deception and projection. It is “based in a world of fantasy”. Rather than a need for the behaviour itself, it can be rooted in a person’s desire to see themselves in a certain way, or to avoid other issues in their life.
“A lot of sexual addiction, or sexual acting out, is based on fantasy. It’s an escape from real life, and it also helps the person to feel like they are their most desirable self. It’s not reality. For example, I’ll have clients say, ‘I’ve had a fight with my partner, and they don’t really understand me,’ and they’ll go to an escort or web cam worker who makes them feel really special, and they feel like they really care. This is a total fantasy, an escape.
Sex addiction can also involve an exposure to dangerous situations. Is this sometimes part of the drive of the addiction?
Absolutely. You hear about these really successful people putting themselves in really dangerous situations where they could be caught. The adrenaline of it, and the secrecy, is a part of the addiction. People expose themselves to risks. They often won’t use protection, and they’ll have multiple partners who are sex workers. The risk involved in that is part of the addiction.
Fantasy and Pornography in Sex Addiction
The accessibility of pornography has had a significant impact on sex addiction and the treatment around it. As noted on Verywell Mind, “there is increasing concern about online porn addiction which far outstrips the provision of support for people who feel their porn use is excessive, unmanageable, or causing them problems”.
However, treatment has in fact adapted to address the issue. Laura notes that people dealing with compulsive sexual behaviours can have differing relationships with pornography.
Most people with sex addiction do abuse pornography, but a lot of the time if their sex addiction is based more in relationships, or acting out in a relationship context, it’s a little bit different. For them it’s more about the affairs, it might be more about going to see escorts.
With pornography it’s more opportunity-driven. It’s so accessible. Especially for young people, they’re so exposed to it from a younger age that they develop this dependency without even realizing it. But the problem with pornography is that it appeals to the brain so much, especially for young men. In terms of evolutionary theory, you want to have as many partners as you can so that you’re spreading your seed, so to speak. When men are watching porn, in their heads it’s as though it’s a different partner each time, so it’s actually appealing to that evolutionary instinct. Whereas if you have the same partner for many years, in that part of your brain, the excitement may naturally begin to fade. The sort of dependency Laura describes will often require professional treatment to overcome.
Legitimacy and Perception of Sex Addiction
Sex addiction is often approached more dismissively than other forms of addiction. It is sometimes seen as an excuse for sexual behaviour or a celebrity issue. This stigmatizes the problem and adds to the shame and secrecy around it. This makes a non-judgmental, understanding approach focused on the underlying causes of the addiction essential. Laura believes that, while there is still stigma around the issue, we have made substantial progress. How would she address remaining skepticism?
The legitimacy of the condition is evident in the way the person engages in the behaviour. I hear clients telling me that they have a partner at home who they love, they have a good job, they have a lot to lose, yet they cannot stop themselves acting out sexually. They feel a lot of shame and disgust about themselves, and a short time later they find themselves acting out again. This is clearly compulsive behaviour. And ultimately, how does questioning its legitimacy help? It just makes it more difficult for people to receive the help they need.
The celebrity aspect is also significant. Sex addiction has only come to prominence for much of the broader public in relatively recent times (Verywell Mind identifies the 2009 stories around David Duchovny and Tiger Woods as the first time widespread attention was focused on the issue). While one might think the stories of celebrity addiction might have a damaging or sensationalizing effect on the public perception of the issue, Laura has a different perspective.
I think it’s really important when there are celebrity cases, because it normalizes it for people. When I talk to clients, they can understand a situation like with Tiger Woods. He had a beautiful family, and a picture perfect life with so much success, but still risked it all. Everyone saw the consequences of what happened, when everything came to surface. Why would someone so successful, with everything they could ever want in the world, be behaving in this way if it weren’t compulsive? It doesn’t make sense. The extent of the consequences can show you when it’s an addiction. It’s repetitive and compulsive. Without help, it’s usually only a matter of time until the person gets into serious difficulties.
Effects of Sex Addiction
However, some people do use sex addiction to try to justify bad behaviour. There are people who will claim sex addiction as an excuse, to avoid experiencing the consequences of their actions. That’s not the same as having a sex addiction. It’s very different than simply struggling with monogamy- that’s natural and a lot of people go through it. A sex addiction is a much more serious and compulsive issue.” The way in which the addiction functions also affirms the legitimacy of the condition. As Verywell Mind point out, “Research indicates that the same reward system in the brain is activated in sex addiction as in a number of other addictions, including drug addictions, supporting the idea that sex addiction has a similar physiological and psychological process as other addictions.
For people struggling with sex addiction, the necessary help for sex addiction treatment is available at our inpatient addiction treatment centers. If you or someone you know needs help, Trafalgar Addiction Treatment Centres and our highly qualified team are here to provide it.