Is it Really Sex Addiction?

April 20th, 2010 | Posted by in Sex Addiction

It seems that lately you can’t turn on a television or pick up a newspaper without encountering some news item on the latest public figure entering treatment for sex addiction. It begs the question – is it really sex addiction, or just one (or several) random indiscretions?

The following information is excerpted from an article in the June 2008 issue of Counselor Magazine by nationally known sex addiction expert, Patrick Carnes, PhD, CAS, director of the Gentle Path program at the Pine Grove Behavioral Health Center in Hattiesburg, Miss. To view the archived article in its entirety, visit Counselor Magazine

Certain key questions will help determine if you need to do further assessment for sex addiction:

n  Has the patient a history of seeking help for sexual issues? A high probability exists that the patient more than likely has been talking to others about the problem for some time.

n  Has the patient a history of shame and deception around these issues? A characteristic of most sex addicts is hidden, secretive behavior. This is not about cultural perception, inhibition or lack of sexual awareness. It is a pattern of having to hide something that is clearly self-destructive.

n  Is there preoccupation? The patient will report difficulty in setting aside sexual thoughts to the extent that obsession prevents normal life functioning and meeting of routine obligations. The clinician can assume the brain has achieved a new “set point” which interferes with decision making. These “judgment errors” are core to the addiction process.

n  Are there consequences? Loss of control is one of the key signs of addiction’s presence. Choices that clearly will have bad consequences; promises to self and others to stop; and inability to learn from past behaviors become important elements in life unmanageability. The term “compulsive behavior” is used in this context as one of the critical signs of addictive illness.

n  Are family members or friends upset over sexual behavior? Relationship disturbance is one of the high correlates of sex addictions presence.

n  Is there significant affect disturbance? Depression and suicidal ideation lead the list of collateral problems sex addicts walk in with. Grief, trauma, and guilt often fill in behind despair.

If these key issues are present, the clinician may wish to use standard diagnostic criteria for assessing the patient for sex addiction, the Sexual Addiction Screening Test (SAST). These criteria parallel the criteria used for substance abuse and pathological gambling, and have been used for some time to diagnose sex addiction (Carnes, 2000; Carnes, 2003). This test and other information on sex addiction can be found at

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