considerably. Sex addiction is a huge problem in our society.
Is sex addiction a real disease?
As with alcohol and other drug addiction, sex addiction is generally treated using a “disease model.” However, like gambling addiction, it is a process or behavioral addiction that does not involve psychoactive substances. Whereas sex addiction causes changes in the brains of those afflicted with it, and its progression resembles a disease process, its classification as a disease continues to be controversial.
Accepting sex addiction as a disease may also give some sex addicts an excuse or rationalization for their behavior. Confronted with their sexual acting out they say, “I can’t help it, I have a disease.” Some partners of sex addicts think that referring to sex addiction as a disease minimizes addicts’ responsibility for their behavior. Although their compulsive behavior may be out of control, as stated earlier, sex addicts are always responsible for their behavior. It’s most accurate to consider sex addiction a disorder.
What are the criteria for diagnosis of sex addiction?
Currently there are no definitive diagnostic criteria for sex addiction. However, most sex addiction therapists look for the following in diagnosing sex addiction:
• Preoccupation with and frequent cravings for sex
• Obsessive thoughts about sexual fantasies to the point of excluding other thoughts
• Lack of interest in activities that once were important
• Desire to spend more time alone than interacting with others
• Engaging in excessive sexual behaviors despite efforts to stop and negative consequences associated with such behavior
• Neglecting obligations like work, school, or family in order to pursue sexual interests
• Feelings of irritability when not able to engage in sexual behavior
• Escalation of the scope of sexual behaviors or time spent pursuing and participating in sexual acting out
The presence of just a few of these is enough to indicate that a person should consider receiving treatment for sex addiction.
A recently developed screening tool called PATHOS32 is a brief questionnaire that health professionals can use to identify the presence of sex addiction. PATHOS is an acronym for six assessment questions:
P:Preoccupied—Do you often find yourself preoccupied with sexual thoughts?
A:Ashamed—Do you hide some of your sexual behavior from others?
T:Treatment—Have you ever sought therapy for sexual behavior you did not like?
H:Hurt others—Has anyone been hurt emotionally because of your sexual behavior?
O:Out of control—Do you feel controlled by your sexual desire?
S:Sad—When you have sex, do you feel depressed afterwards?
A positive response to just one of the six questions indicates a need for additional assessment with a sex addiction therapist. Answering yes to two or more is a strong indication that the person is a sex addict.
In Stop Sex Addiction33 I suggested a two-question assessment:
1. Have you engaged in sexual behavior that has harmed you or others?
2. Did you repeat that behavior?
Although not all who answer “yes” to both of these questions are sex addicts, when answering honestly, all sex addicts answer yes to both. How would you answer these questions?
Why is sex addiction not listed in the DSM-5?
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), is the comprehensive classification and diagnostic manual published by the American Psychiatric Association. Sex addiction was listed in the third edition published in 1980 but was removed in the fourth edition published in 1994. In preparation for the publication of the fifth edition in 2013, a committee of academic and clinical experts debated whether to include sex addiction in some form. There were several hurdles to overcome. First, the DSM does not use the term addiction. Alcohol and other drug addiction is covered under the term substance use disorder. The committee grappled with terms for out-of-control sexual behavior and finally settled on “hypersexual disorder.” They conducted clinical trials in conjunction with several treatment centers trying to amass the data needed to have sex addiction included in the DSM-5. In the end, there was simply not enough data for it to be included.
Regardless of its lack of inclusion in the DSM-5, those who struggle with problematic sexual behavior, those whose lives are negatively impacted by sexual acting out, and those of us who strive to help them have no doubt that sex addiction is a very real disorder.
What is the difference between sex addiction and love addiction?
Sex addiction and love addiction are both disorders of intimacy. Sex addicts tend to be more interested in specific sexual acts where love addicts are more interested in having a relationship with others. Some love addicts and some sex addicts will engage in sexual behaviors with multiple partners. And some sex and love addicts never engage in sexual behaviors with others. Dr. Brenda Schaeffer has written the seminal work on love addiction: Is It Love or Is It Addiction?34 I would encourage you to read it for a fuller explanation.
Love addicts look for the next relationship that is going to fill the void in their lives. They are continuously searching for an ideal person that will make their life more meaningful—that they think will make them whole. As they focus on their intended target, they may be very charming and solicitous. But when love addicts are successful in their quest they typically find that the person they pursued is not the right person for them after all, and begin their search all over again. Often, love addicts will not end that relationship so as to avoid being alone, continuing it as they seek a new ideal partner.
Also, some sex addicts choose to describe their addiction as love addiction in an effort to minimize their shame and the greater stigma associated with sex addiction.
What is the difference between sex addiction and being polyamorous?
Polyamorous means “many loves.” Although I (Milton) do not believe polyamory is healthy, a chief difference between it and sex addiction is in the presence or absence of honesty. Those who practice true polyamory believe in openness and transparency, including the knowledge and consent of all partners involved. Obviously, this is not the case with sex addiction, where so much of the relevant behavior is secretive and cloaked in dishonesty.
Using the label of polyamory in the attempt to dress up or rationalize sex addiction does not lessen its destructive impact on oneself or others.
Is there a relationship Between IQ and sex addiction?
There have been no published studies that indicate a relationship between a person’s level of intelligence and sex
