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  • Ryan O’Kelly, M.Div., LPC

Sexual Addiction: Is it really about sex or something else?

Updated: Oct 6, 2023

By Ryan O’Kelly, M.Div., LPC


“Is sexual addiction really about sex or something else?” It’s a question that I often must address in a first session with an individual or a couple in which the betrayal, secrecy, shame, and devastation that sexual immorality brings about in their lives and relationships. In order to explain what sexual addiction is, it may be helpful to first address a few common misconceptions that are presumed to be synonymous with sexual addiction:


  1. If a person enjoys sex and likes to have sex often, it does not automatically mean that they are a sex addict (Magness, 2013). I frequently hear from couples, often the wife expressing her concern as well as her exasperation about how her husband has “an extraordinarily high sex drive.” The frequency at which a person engages in sex has little to do with addiction—a person can have sex multiple times a day or long periods of time in between engaging in any sexual activity.

  2. A person who has broken their marital covenant through infidelity should not automatically be presumed to be a sex addict. Someone may have been unfaithful with multiple partners or multiple times and may not meet the criteria to be a sex addict (Magness, 2013).

  3. Sex addiction is also not solely defined by any particular behavior; meaning that if someone views hardcore pornography, visits strip clubs, visits massage parlors, engages in sexually explicit phone calls or text messages, sending and receiving sexually explicit photos or “sexting” through social media apps etc. does not necessarily mean they are a sex addict (Magness, 2013).

  4. Another common misconception is if a person has a specific sexual paraphilia or “taboo” sexual desires that by default means that they are a sex addict (Ex. sadism or masochism). Paraphilic disorders have their own clinical criteria that must be carefully assessed and are not synonymous with sexual addiction.

  5. “Men are the only ones that struggle with sexual addiction” is not only a misconception but a stigma that needs to be addressed. There are indeed women who battle with sexual addiction even though the affliction of sexual addiction seems to largely affect men. For this reason in the remainder of this article I try to use gender neutral phrases and pronouns for the purposes of confronting toxic shame, work toward redeeming this stigma, and encouraging both men and women who struggle with unwanted sexual behavior that they are seen, heard, not alone, and there is both hope and help if they are ready for healing and freedom.


Although all of these aforementioned issues may be present along with sexual addiction for some individuals, in and of themselves they do not automatically mean that a person is a sex addict. When clients share about their sexual struggles and these issues are identified, my “clinical radar” does go off but I ask a lot more questions to gain understanding so that I can better discern if sexual addiction is present and relevant. It is important to note that when counselors begin working with a client to address their unwanted sexual behavior we gather as much information about their life story which includes but is not limited to their relationship and attachment history, family of origin dynamics and known generational patterns, sexual and trauma history, specific acting out behaviors in the past and present, their awareness of their emotions and thoughts to better understand and discern if sex addiction is the primary goal to be addressed in counseling.


Primary Characteristics of an Intimacy Disorder


Patrick Carnes, one the pioneers of sexual addiction recovery asserts that if a person answers yes to three or more of the following characteristics or experiences they should consider speaking to a counselor trained in the field of sexual addiction recovery:

  1. If a person feels an uncontrollable or compulsive desire to engage in unwanted sexual behavior. The desire may feel so overwhelming that they may feel and believe as if they do not have a choice over their behavior. In addition, if the desire feels so overwhelming despite potential consequences that may result from the sexual behavior.

  2. If a person often finds their mind preoccupied with sexual thoughts, images, fantasies, scanning the environment for sexual/erotic stimulation.

  3. If a person hides, lies, deceives, or thinks of other ways to hide their sexual behavior because of strong feelings of shame, self-loathing, despair, guilt, and fear.

  4. If a person has sought help for sexual behavior they did not like.

  5. If a person’s sexual behaviors have emotionally hurt others and/or damaged relationships as a result of their behaviors.

  6. After engaging in sexual activity, they often feel sad, down, depressed, irritable and/or are emotionally and relationally disconnected from others (summarized from Carnes, 2018, PATHOS Screening).


The unwanted sexual behaviors (aka. “acting out”) are the surface level symptoms that directly impact the lives of the person with the addiction and their partner; sadly the consequences may even extend past their marriage or relationship. Counselors whose focus is in treating sexual addiction, often describe sexual addiction as an “intimacy disorder.” The majority of sex addicts would describe and acknowledge that they have a very difficult time with identifying and expressing their emotions, thoughts, needs, and longings in intimate conversations not only with their spouse, if they are married, but is often extended to their friendships, work-related relationships, and family of origin relationships (Ex. parents, siblings etc.). If the person struggles with or perhaps feels inept at engaging in emotional and relational intimacy, which is frequently driven by the emotions of shame and fear–hence why sexual addiction is more accurately described as an intimacy disorder.


Depths of Recovery: Core Wounds and Neurological Pathways


Essentially, when a sex addict acts out they are not simply seeking to fulfill a lustful and selfish sexual desire to have an orgasm–what is happening simultaneously within their brain and deep inside their heart and soul is that they are desperately seeking to temporarily comfort or avoid the pain that are connected to what are called “core wounds.” These core wounds are typically formed from a combination of childhood experiences and patterns in the family of origin; other childhood experiences and relationships; traumatic experiences of varying kinds and degrees; early exposure to pornographic content or early sexual experiences; one’s relationship with God and how they truly perceive God’s attitude toward them; how one learned to care for their needs (physical, mental, emotional, relational, and spiritual) and the longings of our heart and soul when those needs and longings were not being appropriately and meaningfully cared for or met. In some ways, sexual addiction is often formed to help the person survive and cope because the core wounds must be either temporarily comforted, avoided, or healed through corrective relational experiences with God and others. Although when the person reaches adulthood which includes adult relationships, roles, and responsibilities, the “pseudo” comfort and avoidance that the compulsive behaviors once provided will no longer work nor can the consequences of the compulsive behaviors be avoided, hidden, or minimized.


It is important to understand that similar to other addictions (Ex. drugs, alcohol, food, gambling, video games etc.), sexual addiction has a very real neurological pathway that is reinforced each time the person engages in the unwanted sexual behavior. One of the first objectives in sexual addiction recovery is to “detox” or abstain from the unwanted behaviors because it allows the brain to heal by slowly “pruning” or closing down the neurological pathways that are involved with the addictive behaviors. The neurological pathways not only hold the behavioral patterns but thoughts/images, emotions, body sensations, and relational patterns that are all interconnected within the sexual addiction cycle. That is why Paul instructs fellow Christians in Romans 12:2, “Do not conform to the pattern of this world, but be transformed by the renewing of your mind. Then you will be able to test and approve what God’s will is—his good, pleasing and perfect will.” (emphasis added, NIV). I challenge clients from the start of their recovery journey that “recovery” is much more than just not acting out–recovery involves each realm of their personhood: physical, mental/neurological, emotional, relational, spiritual, and re-directing and submitting their will to God’s will.


Suggested Resources


Sexual addiction recovery requires that the person struggling with the addiction not only avoid acting out at all costs. The recovering addict must be intentional to learn and gain understanding of their specific addictive cycle and underlying core wounds. They must engage in both introspection, reflection, prayer, accountability, as well as giving and receiving emotional and relational support. If they are married or in a committed relationship they must also learn to gain not only understanding but more importantly empathy and compassion for how their sexual behavior and choices have resulted in their significant other being harmed. Below I’ve listed some resources that I would encourage both the recovery addict, their betrayed partner, or for the person who is curious to better understand how to address their own sexual struggles.


Organizations and Websites

  • Pure Desire Ministries: Pure Desire is a Christian organization that provides counseling for individuals, couples, and support groups as well as provides a variety of helpful resources including their Podcast.

  • Faithful & True: Faithful & True is a Christian organization founded by Dr. Mark and Debbie Laaser who are pioneers in the Christian sex addiction recovery community. They provide counseling for individuals, couples, support groups, and workshops. They provide many helpful resources.

  • HopeQuest Ministry Group: HopeQuest is a Christian organization in Woodstock, GA that provides treatment for sex addiction, substance addiction, and co-occurring mental disorders. The treatment options they offer include: residential treatment program, intensive outpatient program, outpatient counseling, and support groups.

  • Fight the New Drug: Directly from their website, “[. . .] is a non-religious and non-legislative nonprofit that exists to provide individuals the opportunity to make an informed decision regarding pornography by raising awareness on its harmful effects using only science, facts, and personal accounts.”

Podcasts

  • Pure Desire Podcast: The Pure Desire Podcast is a great learning and support resource for both the recovering addict and the betrayed partner. They often explain and help listeners apply some of their other resources (free and for purchase).

  • Betrayal Recovery Radio: The Betrayal Recovery Radio Podcast is a great learning and support resource for both the betrayed partner and the recovering addict. The host, Dr. Jake Porter, is well respected and experienced clinician in the field of Christian sex addiction and betrayal trauma recovery.

  • Faithful & True Podcast: The Faithful & True Podcast is a great learning and support resource primarily for the recovering addict but they also have many helpful and relevant episodes for the betrayed partner.

Books and Workbooks

  • Carnes, P. (2001). Out of the shadows: Understanding sexual addiction (3rd ed.). Hazelden. Dr. Patrick Carnes is one of the main clinical pioneers of sexual addiction recovery and has written many other helpful books and workbooks to help recovering addicts heal. Essentially, Out of the Shadows is the introduction to his model and theory of sexual addiction recovery.

  • Cusick, M. J. (2012). Surfing for God: Discovering the divine desire beneath sexual struggle. Thomas Nelson. A powerful and insightful book that comes from a primarily strong spiritual approach to sexual addiction recovery. Cusick offers many biblical insights and applications to recovery and reveals a pathway to identify the core wounds that drive sexual addiction.

  • Laaser, M. R. (2004). Healing the wounds of sexual addiction. Zondervan. This is another great book for the recovering addict to begin their journey of recovery and healing. Dr. Laaser also provides a section that focuses on helping pastors and priests who are struggling with sexual addiction and how church congregations can be supported when a church leader’s sexual immorality has impacted the church and community.

  • Magness, M. S. (2013). Stop sex addiction: Real hope, true freedom for sex addicts and partners. Central Recovery Press. This is another great book that provides a strong overview of both sexual addiction recovery and betrayal trauma recovery.

  • Stringer, J. (2018). Unwanted: How sexual brokenness reveals our way to healing. NavPress. If there was one book that I would strongly recommend, it is this one. Anyone who is struggling with unwanted sexual behavior and is ready to begin their journey of recovery and healing needs to read this book first. Stringer offers a wonderful integrative and holistic understanding of sexual addiction as well as provides insightful statistics and research.

  • Juergensen Sheets, C. & Katz, A.J. (2019). Help her heal: An empathy workbook for sex addicts to help their partners heal. Sano Press, LLC. I strongly recommend this workbook to the recovering addicts that I work with so that they can develop their empathy and compassion for how their behaviors and choices have impacted their partner.


Accountability and Blocking Software/Apps

(For a helpful summary breakdown of these software/apps use this link to Pure Desire Ministries or directly to their own website):



References


Carnes, P. (2018). PATHOS Screening Questionnaire. Dr. Patrick Carnes. Retrieved April 10, 2023 from https://www.drpatrickcarnes.com/am-i-a-sex-addict


Holy Bible. (2011). New International Version (NIV). Biblica.


Magness, M. S. (2013). Stop sex addiction: Real hope, true freedom for sex addicts and partners. Central Recovery Press.




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