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Compulsive Sexual Behavior Or Sex Addiction?

Ninety nine percent of the population is sexually oriented. Unless you are part of the 1% of the population that is asexual, you are aware of the natural drives for sexual contact and how powerful that can be.

Sexual urges are a healthy part of the average adult’s life experience. If it weren’t for sex drive, none of us would be here. Our culture has progressed remarkably when it comes to talking about sex.

The topics that were once taboo have become commonplace in family discussions and even in group settings.

As our societal comfort level has shifted toward openness, so has our willingness to talk about sexual problems.

The Diagnostic And Statistical Manual has included sexual disorders for many decades. DSM 5 was released in 2013 and a lot of controversy broiled about whether to include Compulsive Sexual Behavior in the manual. It wasn’t added, nor was it given honorable mention in the “conditions for further study” at the end of the book.

The reason for this misdiagnosis is the fact that the contributors could not agree on the validity of it. Some firmly believed it was a valid diagnosis, based on the criteria for compulsive disorder. Others disagreed with the diagnosis, stating that it was more in line with addiction behavior, while others simply felt it was a matter of differing libido levels.

In June 2018, the World Health Organization updated the diagnostic codes.

The codes are periodically updated to reflect changes in the field of physical and mental health. This version, ICD-11, is widely used by physicians, psychologists and clinical social workers to assign billing and diagnostic codes for a variety of physical and mental conditions.

ICD-11 is different than previous versions because it included the diagnosis Compulsive Sexual Behaviors instead of Sexual Addiction. Just as there was controversy over the DSM-5 inclusion, this decision by the WHO is also controversial for the same reasons.

Regardless of the label, this condition can be destructive across the board for someone who struggles with it.

Not only does it impact relationships, it can affect health and even employment situations.

Often compulsive sexual behaviors accompany a constellation of other mental health challenges that can include mood disorder, anxiety, trauma history, addiction or other compulsive behaviors.

Compulsive sexual behavior is as much of a problem for those who struggle with it as other types of Obsessive Compulsive Disorders. A compulsion about sexual behaviors sounds a lot more fun than it is, in reality.

Those with compulsions are not enjoying their repetitious behaviors, they are tortured by them.

This is no different for people with compulsive sexual behaviors, who are obsessing about sexual acts and looking for avenues for sexual involvement constantly. An average person co-exists with their sexual desires; a person with compulsive sexual behaviors is driven by them.  

Typically, sexual urges are satisfied by orgasm and the urge for sexual release is quelled for a period of time that varies from person to person. Compulsive Sexual Disorder does not take a rest.

A person with this condition, if unmanaged, can become so preoccupied by the pursuit of sexual partners or sexual release that they neglect commitments to people and responsibilities.

Compulsive sexual behaviors mimics addiction; it becomes the primary relationship and it interferes with normal life functioning.

Also, much like with addiction, sex becomes the focus of thought. The primary motivator is the next fix; this is true across the spectrum of all addictions whether substance or behavioral in nature.

Maybe both ways of thinking about excessive sexual behaviors is true; perhaps it is a compulsive behavior disorder based on the addiction to the feel good hormones it releases in the brain. The way it is treated is the most important factor.

Those who are working on recovery from Compulsive Sexual Behaviors can utilize a two prong approach in terms of treatment. The benefit of identifying this condition under two umbrellas is the ability to treat it in a comprehensive way.

Treating it as an addiction affirms the necessity of a risk-aversion or abstinence mode with a focus on taking specific steps toward recovery.

Similar to AA or NA, Sex and Love Addiction Groups are widely used to help people who struggle with this addiction. It is a safe, anonymous place to communicate openly about the challenges of this condition and to help keep one another honest.

Treating Compulsive Sexual Behavior as a type of Obsessive Compulsive Disorder is beneficial because it hones in on the underlying thoughts and feelings that accompany the behavior.

Cognitive Behavioral Therapy is a common treatment for the disorder and this, alongside addiction-style treatment, is a double-whammy for improved prognosis.

How To Get Started

If you are concerned about your sexual behaviors and recognize some of the symptoms within yourself, it is important to address it to improve your quality of life. Ignoring Compulsive Sexual Behavioral disorders and hoping they will “just go away” is another type of avoidance.

Often people don’t reach out for help due to embarrassment, shame or fear of it becoming public knowledge. Keep in mind that mental health professionals are bound to a code of confidentiality. Support groups are also advised of maintaining confidentiality and this is a code that members hold as a sacred part of the group process.

Compulsive Sexual Behavior is not something you should try to deal with alone.

When we are accountable to others (either via a group, an individual counselor or a trusted friend) we are more likely to hit pause before acting out on an urge.

Sexual behaviors can be a tricky condition to treat, since sex is a normal part of life. In this way, it is as challenging as an Eating Disorder, since abstinence is often not a realistic expectation. While we don’t “need” sex to live, as we do food, it is a normal part of the human experience.

Many Sex and Love Addiction groups expect abstinence as a management tool for the condition, just as Alcoholics Anonymous does. Some find abstinence to be the best tool to maintain control of their disorder, and others are more focused on harm reduction.

Whether your preference is abstinence or reducing the negative impact of your sexual behaviors, identifying the problem and working toward solution is a good first step.

Locate a therapist who has experience with treating sexual disorders and establish goals related to your specific situation.

There are many great CBT workbooks to help you explore underlying thoughts and feelings. These books, in conjunction with therapy services, will be a useful way to explore the purpose that compulsive sexual behavior serves in your life.

It will also be helpful to consider exploring ways to get your emotional needs met and to learn stress management and emotional regulation skills. In the addiction-format of treatment you will learn valuable urge-surfing skills, which can apply to any type of addiction to get through difficult moments and urges to act out.

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