Sexual Addiction

LEIGH FALLS HOLMAN, PH.D., LPCS, RPTS, NCC

PROCESS ADDICTIONS CHAIR,
INTERNATIONAL ASSOCIATION OF ADDICTION AND OFFENDER
COUNSELORS

Why assess/treat sexual addiction?

Physical consequences:
STDs
Unplanned pregnancies & complications of abortions
Rape and/or physical abuse
Physical injuries
Motor vehicle accidents when preocupied with sexual thoughts/activities
Abuse of substances that facilitate sexual performance/activity
Unnecessary surgeries
Psychological consequences:
Shame, guilt
Depression
Anxiety
Fear of being discovered
PTSD
Divorce/marital discord
Difficulty maintaining sobriety from drug/alcohol dependence or other addictions
Financial, legal, employment consequences:
Job loss (poor performance, attendance, acting out on the job)
Arrests
Financial cost of legal defense, psychotherapy, job loss, and money spent on the addiction.

Carnes research of sex addiction (1991, 1983)

97% report emotional abuse
87% report growing up in a family with other

addictions
81% report experiencing sexual abuse
72% report experiencing physical abuse
87% report coming from a disengaged family system
77% report coming from a rigid family system
66% report their families were rigd and disengaged

Personality Disorders & Sex Addiction

Avoidant sex addicts: anxious and act out sexually in

fantasy to avoid rejection

Dependent disorders use sexuality to capture
others in order to have a powerful person take care
of them
Borderline disorders act out sexually to punish or
reward and stabilize their emotional labiality
Histrionic disorders use sexuality manipulatively to
be noticed, but get anxious when it turns serious

Signs & Symptoms of Sexual Addiction

Going further with a sexual experience than intended
Using money for sex that you needed to buy something else
Lying about sex to someone you love or to soeone who trusts you
Pretending to be someone other than who you are in order to be

sexual
Did something sexual despite the threat of being caught
Became sexual despite the fear of STDs
Doing something you dont like in order to please someone else
Doing something that is sexually painful
Violated your beliefs
Avoiding social or family obligations to be sexual
Losing track of time because of sexual fantasies/activities
Sex becomes the central organizing principle in your life

Hunter (1992) Healthy Sexuality Screening:

Does the behavior agree with the persons values?
Is it safe?
Is it respectful of self & others?
Is it honest?
Is it spontaneous and playful?
Does it increase intimacy?
Are both partners free to choose?

Carnes (1991) Dont call it love

Addictive Sex

Feels shameful
Is illicit, exploitative
Compromises values
Draws on fear for excitement
Reenacts childhood abuse
Disconnects one from oneself
Creates world of unreality
Is self-destructive and dangerous
Uses conquest or power
Is seductive
Serves to medicate and kill pain
Is dishonest
Becomes routine
Requires double life
Is grim and joyless
Demands perfection

Healthy Sex

Adds to self-esteem
Has no victims
Deepens meaning
Uses vulnerability for excitement
Cultivates sense of being adult
Furthers sense of self
Expands reality
Relies on safety
Is mutual and intimate
Takes responsibility for needs
May bring legitimate suffering
Originates in integrity
Presents challenges
Integrates most authentic parts of self
Is fun and playful
Accepts the imperfect

Patrick Carnes: Levels of Sexual Addiction

Level 1: Behaviors regarded as normal, acceptable or

tolerable (i.e. Masturbation, compulsive relationships,

pornography, prostitution, & anonymous sex).

Level 2: Illegal behaviors that are clearly victimizing and are

regarded as nuisance crimes (i.e. Exhibitionism, voyeurism,

indecent phone calls, & indecent liberties (i.e. frouterism).

Level 3: Illegal behaviors that have grave consequences for

the victim and severe legal consequences for the offender

(Child molestation, incest & rape).

Paraphillias would fall under this category.

Addictive Behavior
Addictive behavior tends to progress over time
The addict will need more (amount, danger,

excitement, etc.) to get the same effect

Sex addicts are more likely to intensify their
preferred activity rather than switch to an unrelated
one.
Addicts who are compulsive at level 3 are also
compulsive at 1 & 2. Those who are compulsive at
level 2 are also at level 1.