Sex Addiction & Sexual Anorexia

Sex addiction is a condition marked by obsessive thinking about sex and by a persistent compulsion to engage in sexual behavior in spite of negative consequences.

These are the essential characteristics of sex addiction:

  • As compulsion, the addiction is experienced by the addict as contrary to his free choice.  The addict feels driven, almost against his own will, to engage in the behavior which he knows from painful experience is likely to lead to suffering.  In fact, he is compelled by forces he does not understand, to continue to act out sexually.  He attributes these failings to forces outside of himself, or to being a very sexual person, or to his own weakness, or to moral failings, or perhaps even to the demonic.  The urge to engage in the behavior is experienced as more powerful than the person's ability to resist the impulse.
  • As obsession, the addiction is characterized by prolonged periods of time thinking about sexual behavior, planning sexual acting-out, resisting the urge to act-out sexually, and then dealing with the aftermath of having engaged in the sexual behavior.  This obsessive thinking keeps the addict from being fully present to self or others, blocks the experience of authentic feeling, and keeps the addict from confronting the truth of one's history and present situation. The obsessive thinking is the precursor to the sexual acting-out and itself constitutes an escape or avoidance of painful realities.
  • The addict experiences a loss of control in the area of her addiction which spills over into her daily behavior. The sex addict is unable to predict with any degree of certitude whether he will be able to get home from work without cruising for sex, whether she will be able to keep her promise of fidelity to her partner, whether he will be able to keep his promise to himself of spending only thirty minutes more in the sex chat rooms or be up again to four in the morning.
  • The addict continues to engage in the behavior, over and over again, in spite of negative consequences.  Like  the heroin addict who continues to use in spite of increasing shame, physical illness, financial ruin, alienation and incarceration, the sex addict continues to act-out in spite of  humiliation, shame and guilt, loss of family and other relationships, social isolation,  financial loss, occupational impairment, spiritual bankruptcy, depression,  sexually transmitted disease and sometimes even arrest.
  • As the addict's brain habituates to the release of endorphins and to the sensation of euphoria produced by sexual acting-out, she is driven to act-out for increasingly longer periods of time and often in increasingly risky ways in order to achieve the same effect. In chemical dependency circles this dynamic is referred to as tolerance.  Eventually, the addict's acting-out can fail him completely so that even when he no longer experiences the pleasurable, euphoric release he still is compelled to act-out.
  • Like the person addicted to alcohol or other substances, the sex addict experiences symptoms of withdrawal when she abstains from sexual acting-out.  For the sex addict, withdrawal can include anxiety, irritability, depressed mood, fits of rage, hyperarousal, and sleep impairment.
  • The desire to continue to act-out, and the twin false beliefs that life is not worth living without engaging in his sexual behavior and that stopping is well-nigh impossible, result in delusional thinking.  The addict minimizes his own behavior.  In his own mind, he remains vague about how often he has cheated on his spouse, how many hours he has lost in cyberspace, how much money he has spent.  The addict also is in denial about the consequences of his addiction – about how much he has lost, or injured himself, or hurt others as a result of his behavior.  And like the alcoholic who does not realize that others know that he has been drinking, the active sex addict lacks the awareness that would have him cover the tracks which lead to his addiction being exposed.  That consciously unintended exposition can lead to major humiliation and devastation, but it also provides opportunity for healing and a pathway to recovery.
  • How does one determine if he/she is sexually addicted?  There are many written tests that can be taken to help you ascertain if you are sexually addicted. Essentially it boils down to this: if you are troubled by your sexual behavior, and if that sexual behavior has harmful consequences in your life, and you have tried unsuccessfully to eliminate or significantly reduce that behavior, chances are you are addicted to sex.

    There are exceptions to this – for example, a man who is gay and is married to a woman and finds himself compelled to seek out another man for sex, may or may not be addicted. And then there are people who are obsessively, excessively troubled by sexual behaviors and thoughts that most of us would consider normal – that is, their compass for determining healthy sexual behavior may be too rigid and punitive.

    Goal of Treatment for Sex Addiction

    The goal of treatment for most sex addicts is to establish increasing freedom from the compulsion to engage in the destructive sexual behavior. This entails a process with very specific actions to be taken. These actions include breaking through denial and minimization to get clarity around the extent of the sexual behavior, coming face to face with the negative consequences of the behavior and the likely future consequences of the behavior, and understanding the reasons for one’s past failures in trying to eliminate or manage the behavior.

    A second but equally important goal of treatment is to develop a healthy sexuality which includes a new understanding of sex and its purpose as well as new behaviors which are life-enhancing, nurturing and conducive to genuine intimacy.

    In most cases, abstinence from sex is not the goal of treatment. We are not seeking to turn you from an active sex addict into a sexual anorexic. Indeed, beneath the surface of many sexually addicted persons are people who are afraid of truly intimate sex, who avoid really intimate sex with their spouse or partner as if it were the plague. We seek, rather, to help you let go of the addictive behavior and to confront whatever is beneath the veneer or persona of the active addiction. We seek to help you to turn and face whatever the addiction has been helping you to run from.

    One way of seeing the development of any addiction is to view it as an adaptation to a situation, event, or emotion that a person could not handle. So he/she learned to turn to a chemical or a behavior to cope with, avoid, or medicate the underlying pain which threatened to overwhelm the person. And using that substance or behavior works. The drug addict is no longer in physical pain. The alcoholic’s anxiety is significantly reduced by drinking. The sex addict feels strong and powerful and passionate in his acted-out fantasy instead of feeling less-than and weak and shut down.

    The problem of course is that the addictive behavior on which you are relying brings with it damaging consequences. A related problem is that the addiction is progressive, that because of the addictive mechanism known as tolerance, the brain needs more and more of the substance or the chemicals released by the addictive behavior to attain the same result. What worked last year to help you avoid your pain does not work as efficiently this year.  Indeed, your growing addiction, your “acting-out” of your suffering, begins to cause you more suffering than it actually helps you to avoid or mitigate.

    Sexual Anorexia

    Sexual anorexia, the compulsive effort to control or extinguish sexual desire and behavior, is another unskillful albeit adaptive attempt to manage one’s suffering. Like sex addiction, it is another way of trying to avoid or control pain, anxiety, shame, or other reality.  It too fails because it does not directly address the reality of the suffering underlying the “acting-in” of the anorexic behavior. It is an attempt to avoid it.

    Only the direct confrontation with the underlying pain or uncomfortable emotion leads to sustained freedom from compulsive behavior. Sexual acting-out and sexual anorexia are habitual ways of avoiding difficult affects like shame.  Of course, one can only tolerate so much of that pain at a time. That is why early attempts at recovery are more often than not marked with setbacks and slips which must be viewed as learning opportunities. “We seek progress rather than perfection.” And one can learn to gradually increase one’s capacity to face and experience painful emotions and realities.

    As human beings we are communal beings. We are not supposed to be able to get better by ourselves. We need others. We need others to not collude with us in avoiding the pain, avoiding the truth of what at some level we know, but to support us in turning toward, confronting and processing difficult truth. A good therapist has done a lot of that inner work himself and knows how to go with you to that place of discomfort and to support you as you process your emotions and your pain.


    Contact Bill Lent

    (646) 322-1582