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  • What Is Sex Addiction?


    Like an alcoholic unable to stop drinking, sexual addicts cannot control their self-destructive sexual behavior. Family breakups, financial disasters, loss of jobs, and risk to life are the painful themes of their stories.

    Sex addicts come from all walks of life – they may be ministers, physicians, homemakers, factory workers, salespersons, secretaries, clerks, accountants, therapists, dentists, politicians, or executives, for example. Most were abused as children – sexually, physically, and emotionally. Most grew up in families where addiction flourished, including alcoholism, compulsive eating, and gambling. Most grapple with others with other habits. Sex addiction is the most difficult to stop. 

    Much hope nevertheless exists for these addicts and their families. Sex addicts have shown an ability to transform a life of self-destruction into a life of self-care, a life in chaos and despair into one of confidence and peace.”

    – Patrick J. Carnes, Ph.D. 

    Author of Out of the Shadows


    Sexual addiction is any sexually related, compulsive behavior that interferes with everyday living and causes severe stress on family, friends, loved ones, and the work environment. Sexual addiction has been called sexual dependency and sexual compulsivity. By any name, it is a compulsive behavior that completely dominates the addict’s life. Sexual addicts make sex a priority more important than family, friends, and work. They are willing to sacrifice what they cherish most to preserve and continue their unhealthy behaviors, the organizing principle of addicts’ lives.

    Dr. Patrick Carnes estimates that three to six percent of the population faces sexual addiction. It remains unclear whether one gender has a higher incidence of sexual addiction than the other. Research by Dr. Carnes shows that approximately 20 – 25% of all patients who seek help for sexual dependency are women. (This same male-female ratio is found among those recovering from alcohol and drug addiction and pathological gambling.)


    No single behavior pattern defines sexual addiction. Even the healthiest forms of human sexual expression can turn into self-defeating behaviors. These behaviors, when they have taken control of addicts’ lives and become unmanageable, include compulsive masturbation, compulsive heterosexual and homosexual relationships, pornography, prostitution, exhibitionism, voyeurism, indecent phone calls, child molesting, incest, rape, and violence. A mental health professional should carry out an actual diagnosis for sexual addiction, the following; their patterns can indicate the presence of sexual addiction. Individuals who see any of these patterns in their own life or in the life of someone they care about should seek professional help.

    • Acting out: a pattern of out-of-control sexual behavior. Examples may include:
    • Compulsive masturbation
    • Indulging in pornography
    • Having chronic affairs
    • Exhibitionism
    • Dangerous sexual practices
    • Prostitution/Sex Workers
    • Anonymous sex
    • Compulsive sexual episodes
    • Voyeurism
    • Experiencing severe consequences due to sexual behavior and an inability to stop despite these adverse consequences.  Don’t Call It Love, Patrick Carnes, 1991, the book states that some of the losses reported by sex addicts may include:
    • Loss of partner or spouse (40%)
    • Severe marital or relationship problems (70%)
    • Loss of career opportunities (27%)
    • Unwanted pregnancies (40%)
    • Abortions (36%)
    • Suicide obsession (72%)
    • Suicide attempts (17%)
    • Exposure to AIDS and venereal disease (68%)
    • Legal risks from nuisance offenses to rape (58%)
    • Persistent pursuit of self-destructive behavior.
    •  Even understanding that the consequences of their actions will be painful or have dire consequences does not stop addicts from acting out. They often seem to have a willfulness about their activities and an attitude that says, “I’ll deal with the consequences when they come.”
    • Ongoing desire or effort to limit sexual behavior. Addicts often try to control their behavior by creating external barriers to it. For example, some move to a new neighborhood or city, hoping that a new environment removed from old affairs will help. Some think marriage will keep them from acting out. An exhibitionist may buy a car in which it’s challenging to act out while driving. Others seeking control over their behavior try to immerse themselves in religion, only to find out that, while religious compulsion may soothe their shame, it does not end their acting out. Many go through periods of sexual anorexia during which they allow themselves no sexual expression. Such efforts, however, only fuel the addiction.
    • Sexual obsession and fantasy as a primary coping strategy. Though acting out sexually can temporarily relieve addicts’ anxieties, they still spend inordinate amounts of time in obsession and romance. By fantasizing, the addict can maintain an almost constant level of arousal. Together with obsessing, the two behaviors can create a kind of analgesic “fix.” Just as our bodies generate endorphins, natural antidepressants, during vigorous exercise, our bodies naturally release peptides when sexually aroused. The molecular construction of these peptides parallels that of opiates like heroin or morphine but is many times more powerful.
    • Regularly increase the amount of sexual experience because the current activity level is no longer sufficiently satisfying. Sexual addiction is often progressive. While addicts may be able to control themselves for a time, inevitably, their addictive behaviors will return and quickly escalate to previous levels and beyond. Some addicts begin adding other acting-out behaviors. Usually, addicts will have three or more behaviors that play a crucial role in their addiction—masturbation, affairs, and anonymous sex, for instance. In addition, 89% of addicts regularly reported “bingeing” to the point of emotional exhaustion. The emotional pain of withdrawal for sexual addicts can parallel the physical pain experienced by those withdrawing from opiate addiction.
    • Severe mood changes related to sexual activity. Addicts experience intense mood shifts, often due to the despair and shame of having unwanted sex. Sexual addicts are caught in a crushing cycle of shame-driven and shame-creating behavior. While guilt drives the sexual addicts’ actions, it also becomes the unwanted consequence of a few moments of euphoric escape into sex.
    • Inordinate amounts of time spent obtaining sex, being sexual, and recovering from sexual experiences. Two sets of activities organize sexual addicts’ days. One involves obsessing about sex and time devoted to initiating sex and being sexual. The second requires time spent dealing with the consequences of their acting out: lying, covering up, shortages of money, problems with their spouse, trouble at work, neglected children, and so on.
    • Neglect important social, occupational, or recreational activities because of sexual behavior. As more and more addicts’ energy becomes focused on relationships that have sexual potential, other associations and activities—family, friends, work, talents, and values—suffer and atrophy from neglect. Long-term relationships are stormy and often unsuccessful. Because of sexual over-extension and intimacy avoidance, short-term relationships have become the norm. Sometimes, however, the desire to preserve an essential long-term relationship with a spouse or children, for instance, can act as the catalyst for addicts to admit their problem and seek help



     Sexual addiction can be understood by comparing it to other types of addictions. Individuals addicted to alcohol or other drugs, for example, develop a relationship with their “chemical(s) of choice” – a relationship that takes precedence over any other aspects of their lives. Addicts find they need drugs merely to feel normal. In sexual addiction, a parallel situation exists. Sex – like food or pills in other habits” and addicts become dependent on this sexual high to feel normal. They substitute unhealthy relationships for healthy ones. They opt for temporary pleasure rather than the deeper qualities of “normal” intimate relationships. Sexual addiction follows the exact progressive nature of other habits. Sexuhabits struggle to control their behaviors and experience despair over their constant failure to do so. Their loss of self-esteem grows, fueling the need to escape even further into their addictive behaviors. A sense of powerlessness pervades the lives of addicts.


    Sexual addicts feel tremendous guilt and shame about their out-of-control behavior, and they live in constant fear of discovery. Yet addicts will often act out sexually to block out the very pain of their addiction. This is part of what drives the addictive cycle. Like other forms of addiction, sex addicts are out of control and unable to stop their behaviors despite their self-destructive nature and potentially devastating consequences. Essential to understanding the loss of control in addicts is the concept of the “hijacked brain.” Addicts have rewired their brains to do behaviors (drinking, drug use, eating, gambling, and sex) even when they intend to do something entirely different. The triggers to these maladaptive responses are usually stress, emotional pain, or specific childhood scenarios of sexual abuse or sexual trauma. Breakthrough science in examining brain function is helping us to understand the biology of this disease.


    Unlike recovering alcoholics who must abstain from drinking for life, dual addicts are ld back into an everyday, healthy sex life much like those suffering from eating disorders must relearn healthy eating patterns. Treatment programs for sexual addiction include patient, outpatient, after-support, and self-help groups. Treatment programs also offer family counseling programs, support groups, and educational workshops for addicts and their families to help them understand the facets of belief and family that are part of the addiction. There are several treatment centers throughout the world that offer treatment options. Contact the International Institute for Trauma and Addiction Professionals (IITAP) at (480)575-6853 or [email protected].


     Like other types of addicts, some sexual addicts may never be “cured.” Sexual addicts achieve recovery, but maintaining that recovery can be a lifelong, day-by-day process. The Twelve Step treatment approach teaches addicts to recover “one day at a time” – concentrating on the present, not the future.


    Partners of sexual addicts, like partners of alcoholics, can also benefit from counseling and support groups. Usually, these partners are codependents, and they, too, suffer from the extreme adverse effects of the addiction. Inpatient and outpatient programs, counseling, and support groups can help them regain control of their lives and support their partner’s recovery. Partners of sexual addicts, like partners of alcoholics, can also benefit from counseling and support groups. Typically these partners are codependents, and they, too, suffer from the extreme adverse effects of the addiction. Inpatient and outpatient programs, counseling, and support groups can help them regain control of their lives and support their partner’s recovery.


    1. Take the Sexual Addiction Screening Test (SAST) at

     2. Contact a Certified Sex Addiction Therapist (CSAT) for help. You can find a therapist in your area by calling (800)708-1796 or visiting www. 3. Twelve-step programs (see Resource Guide).

    4. Visit to browse the online catalog for books and tapes which will help you understand sexual trauma.

    The first step in seeking help is to admit to the problem. Though marital, professional, and societal consequences may follow, admission of the problems must come, no matter the cost. Fear of these consequences, unfortunately, keeps many sexual addicts from seeking help.

    Many sources of help are available to provide information, support, and assistance for sexual addicts trying to regain control of their lives.


    • Sex Addicts Anonymous (SAA) P.O. Box 70949 Houston, TX 77270 (800) 477-8191 E-mail: [email protected] Society for the Advancement of Sexual Health (SASH) P.O. Box 725544 Atlanta, GA 31139 (770) 541-9912 Email: [email protected]
    • Sex Compulsives Anonymous (SCA) P.O. Box 1585 Old Chelsea Station New York, NY 10011 (210) 828-7900
    • Sex and Love Addicts Anonymous (SLAA) 1550 NE Loop 410, Ste. 118 San Antonio, TX 78209 (212) 439-1123 Email: [email protected]
    • National Council for Couple and Family Recovery P.O. Box 410586 St. Louis, MO 63141 (314) 997-9808 Email: [email protected]
    • S-Anon Family Groups P.O. Box 5117 Sherman Oaks, CA 91413 (818) 990-6910
    • Codependents of Sex Addicts
    • (CoSA) P.O. Box 14537 Minneapolis, MN 55414 (763) 537-6904


    • A Gentle Path Through the 12 Steps, Patrick Carnes
    • Contrary to Love, Patrick Carnes
    • Cruise Control, Rob Weiss
    • Disclosing Secrets, Deborah Corley & Jennifer Schneider
    • Don’t Call it Love, Patrick Carnes
    • Facing the Shadow, Patrick Carnes
    • In the Shadows of the Net, Patrick Carnes, David Delmonico & Elizabeth Griffin
    • Mending a Shattered Heart – A Guide for Partners of Sex Addicts, Stephanie Carnes, Ed.
    • Open Hearts – Renewing Relationships with Recovery, Romance & Reality, Patrick Carnes
    • Out of the Shadows, Patrick Carnes • Ready to Heal – Women Facing Love, Sex & Relationship Issues, Kelly McDaniel
    • Sex Addicts Anonymous • Sexual Anorexia, Patrick Carnes
    • The Betrayal Bond, Patrick Carnes
    • The Clinical Management of Sex Addiction, Patrick Carnes & Kenneth Adams, Eds.
    • Untangling the Web: Sex, Porn and Fantasy Obsession, Robert Weiss & Jennifer Schneider
    • When He’s Married to Mom, Kenneth Adams
    • Women, Sex and Addiction, Charlotte Kasl
    • 6 Principles for Achieving Personal Balance, James B Lewis
    • Silently Seduced, Kenneth Adams
    • Recovery Start Kit, Patrick Carnes, Ph.D.


    Patrick J. Carnes, Ph.D. (2008)

    Carnes, P. J., & Adams, K. M. (Eds.). (2019). Clinical management of sexual trauma. Routledge.

    Carnes, P. J., Green, B. A., Merlo, L. J., Polles, A., Carnes, S., & Gold, M. S. (2012). PATHOS: A brief screening application for assessing sexual addiction. Journal of Addiction Medicine, 6(1), 29.

    Rosenberg, K. P., O’Connor, S., & Carnes, P. (2014). Sex addiction: An overview. Behavioral addictions, 215-236.

    Carnes, P. J., Hopkins, T. A., & Green, B. A. (2014). Clinical relevance of the proposed sexual addiction diagnostic criteria: relation to the Sexual Addiction Screening Test-Revised. Journal of Addiction Medicine, 8(6), 450-461.

    International Institute For Trauma Addiction Professionals (IITAP)