Is any type of obsessive sexual behavior really an addiction? The addiction model often fails to fully address sexuality and behaviors. There is a broad spectrum of healthy and unhealthy sexualities and behaviors.
Let's look at the traditional views on sexual behavior and determine where any form of sex becomes harmful.
Problematic Sexual Behaviors (PSB) involve an excessive preoccupation with sexual urges, fantasies, or behaviors that escalate over time, becoming difficult to control. PSB is also called hypersexuality disorder, sexual compulsivity, or sexual additions, and can include certain paraphilias (sexual interests or urges that are outside common practices and atypical in nature).
The term PSB originally describe sexual behaviors in children that are outside the developmental norm of a young person. They can be self-directed or towards others involving developing sexual organs of the body (genitals, buttocks, anus, breasts). These behaviors can be non-contact such as conversations, gestures, or virtual. The difference in PSB in adults has escalated to causing harm to self or others, causing significant distress, and negatively affecting one’s health, job, relationships, or other parts of life.
No matter the name, all PSBs are not about sex/orgasm, the behaviors are about what the entire process is doing for the person. Like alcohol or any other addiction: It is a symptom of deeper wounds or trauma, PTSD, stress, power, control, loss, grief, false sense of intimacy/love. PSB is also similar to substance abuse as more frequent use or behaviors create a tolerance, requiring more intense, riskier, or length of time in the behavior for satisfaction.
CRITERIA:
- Being engaged for longer periods over time.
- Efforts to cut down or stop fail or sporadic success.
- An inordinate amount of time is spent to plan, engage, and ‘recover’ from behaviors.
- Social, occupation, recreation/hobbies are reduced or abandoned.
- Behavior continues despite persistent physical or psychological problems.
- Recurrent use results in failure of obligations.
- Continue despite consequences/problems.
- Tolerance: Increased amounts of use, intensity, risk, interest, or stimuli to get ‘high”. Or...more and more for same effect or effect is reduced with prolonged use. Tolerance and Withdrawal are not required for Diagnosis.
- Withdrawal; Irritability, depression, anxiety, and other physical symptoms do exist at varying degrees.
- Maladaptive pattern of use.
- Creates isolation.
- Suicidal ideation similar to those with substance abuse diagnosis.
- Behaviors engaged in to reduce anxiety or internal stressful states.
- Results in guilt, shame, continued use, and incredibly difficult to stop.
- The distress does not help regulate the sexual behaviors.
Treatment
Treatment for compulsive sexual behavior typically involves psychotherapy, medications and self-help groups. A primary goal of treatment is to help you manage urges and reduce excessive behaviors while maintaining healthy sexual activities.
If you have compulsive sexual behavior, you may also need treatment for another mental health condition. People with compulsive sexual behavior often have alcohol or drug abuse problems or other mental health problems, such as anxiety or depression, which need treatment.
People with other addictions or severe mental health problems or who pose a danger to others may benefit from inpatient treatment initially. Whether inpatient or outpatient, treatment may be intense at first. And you may find periodic, ongoing treatment through the years helpful to prevent relapses.