Since this is my first online blog for Counselor Magazine, I thought it might be appropriate to briefly introduce myself and tell you a tiny bit about my background and therapeutic work. For the past twenty-plus years I have worked as a psychotherapist, primarily but certainly not exclusively treating men and women dealing with sexual and romantic addictions. I was among the very first trainees of Patrick Carnes, who pioneered the field of identifying and treating these maladies, and I have spent almost my entire adult life dedicated to helping individuals struggling with these and other disorders. To that end, in the early 1990s I opened the Sexual Recovery Institute in Los Angeles, a facility that has helped thousands of sex and love addicts find lasting sexual sobriety. SRI is still going strong today under the aegis of Element Behavioral Health. Elements also helps recovering sex and love addicts at The Center for Relationship and Sexual Recovery at The Ranch, in Nunnelly Tennessee, and at The Substance Abuse and Intimacy Disorders Program, at Promises in Malibu California. Today I serve as Senior Vice President of Clinical Development for Elements, overseeing and working closely with all three programs. I also travel regularly, both in the US and abroad, providing clinical multi-addiction training and behavioral health program development for the US military, treatment centers, and open-minded clinicians.
OK, enough about me. Let’s talk about sex addiction.
For this initial post, I think it might be wise to limit myself to simply providing a basic definition of what I am talking about when I use the term sex addiction. For the most part, the criteria for sexual addiction are similar to the criteria for any other addiction, including both substance addictions and other behavioral addictions like shopping, gambling, and the like. Essentially, addicts of all types experience the following:
- Ongoing obsession/preoccupation with their drug/behavior of choice
- Loss of control over use
- Directly related negative life consequences
Most people can readily understand an addiction to alcohol or drugs, as they’ve either experienced it themselves or seen it in others. However, many folks have difficulty wrapping their heads around the concept of a behavior as an addiction. This is especially true when the activity is a natural and even necessary part of life, as is the case with things like eating and being sexual. The main difference between healthy sex (or eating) and addictive sex (or eating) is addicts engage in the behavior compulsively as a way to “numb out” and “escape,” and they continue to do so even though their excessive behavior is creating significant problems in their lives – relationship issues, trouble at work or in school, declining physical and emotional health, financial turmoil, loss of interest in previously enjoyable activities, legal issues, and the like. In short, if a person is compulsively abusing sex (or any other potentially pleasurable behavior) as a way of self-soothing and/or dissociating from intolerable emotions and/or underlying psychological conditions (such as early trauma, attachment deficits, social deficits, depression, anxiety, and low self-esteem), that is an indicator of potential addiction.
Unfortunately, the people who constructed the DSM-5 chose not to include sex addiction (or “Hypersexual Disorder,” as the proposed diagnosis referred to the condition) as an official diagnosis. This is in sharp contrast to the American Society of Addiction Medicine’s open acceptance of behavioral addictions. The DSM’s behind-the-times approach is making it much harder for many therapists to identify and treat this very real issue. For now, clinicians who rely on the DSM, as many of us are forced to do by HMOs and insurance companies, can utilize the “impulse control disorders not elsewhere classified” diagnosis when dealing with sexual compulsivity.
In future blogs, I plan to provide further information about how to identify, diagnose, and treat sexual addiction. I will also write about love addiction, the impact of technology on addiction, the impact of technology on the formation of intimacy, and relationships in general. If there are other topics you would like me to address, or if you have questions about something I’ve written, please don’t hesitate to let me know via the comments section on my blogs or via LinkedIn, Facebook, Twitter, email, etc. Please know that I both enjoy and benefit from interacting with my fellow clinicians in this way. After all, the more we communicate with each other, the better off we and our clients will be.
Robert Weiss LCSW, CSAT-S is the author of Cruise Control: Understanding Sex Addiction in Gay Men and Sex Addiction 101: A Basic Guide to Healing from Sex, Porn, and Love Addiction. He is co-author with Dr. Jennifer Schneider of Untangling the Web: Sex, Porn, and Fantasy Obsession in the Internet Age and the forthcoming release, Closer Together, Further Apart: The Effect of Technology and the Internet on Sex, Intimacy and Relationships.