Sex Addiction

“Nothing makes us so lonely as our secrets.”

-- Paul Tournier

Sex Addiction

“I’ll just do this for a few minutes.”

That’s how the cycle often begins. Whether it’s browsing porn or scrolling through a dating app, the person tells themselves they’ll stop shortly. Hours later, they may still be caught in a binge—searching for the right images to achieve a sexual high or pursuing sexual connection despite earlier intentions to stop.

Many people with sex addiction promise themselves to cut back or quit altogether. They may delete downloaded porn, close dating profiles, or make heartfelt vows never to act out again—only to find themselves returning to the behavior. Over time, this loss of control can lead to serious consequences, including job loss, relationship damage, financial strain, emotional isolation, or actions that conflict with one’s values, ethics, or even the law.

It’s important to say clearly: most people are able to enjoy sexual activity without becoming addicted. However, as a therapist, I have worked with many individuals who cannot stop their sexual behavior despite mounting consequences and sincere efforts to do so.

Some people desperately want help and feel trapped by their behavior. Others are deeply entrenched in denial and do not yet recognize the damage their actions are causing. In those cases, sobriety is unlikely until the person becomes willing to face that denial.

What is sex addiction?

There has been understandable confusion around the term sex addiction, and it is sometimes applied too broadly.

Engaging in kink, BDSM, fetish interests, or cross-dressing does not automatically indicate addiction. Likewise, people who feel shame or distress because their sexual behavior conflicts with their moral or religious beliefs (often called moral incongruence) are not necessarily sex addicts.

The World Health Organization recognizes Compulsive Sexual Behavior Disorder (CSBD) in its diagnostic manual (ICD-11). While the DSM-5 did not include a diagnosis for hypersexual disorder, many clinicians believe this has limited research and treatment access for individuals whose sexual behavior has become genuinely compulsive and harmful.

Across all addictions—not just sex addiction—three core criteria are typically present:

Intense preoccupation or obsession with the behavior
Inability to stop or reliably control the behavior
Ongoing negative consequences, such as relationship problems, work difficulties, emotional distress, financial strain, or legal risk

What happens in the addictive cycle?

The limbic system of the brain remembers what previously brought relief, pleasure, or escape—regardless of long-term consequences. When a person feels stressed, bored, lonely, angry, or overwhelmed, the brain pulls toward the familiar behavior that once soothed those feelings.

Acting out is rarely a single, isolated decision. It is often part of a ritualized, trance-like state that can begin days before any sexual behavior occurs. During this trance, the person may become increasingly intolerant of anything that threatens to interrupt the cycle.

How do I know if I have a sex addiction?

I use structured assessments such as the Sexual Dependency Inventory (SDI 4.0), the Sexual Digital Media Inventory (SDMI), or the Sexual Addiction Screening Test (SAST). Additional measures may be used to assess trauma, depression, anxiety, or other contributing factors.

Are there other factors to consider in diagnosing sex addiction?

Yes. Sex addiction should never be treated as a one-size-fits-all diagnosis.

High-risk sexual behavior can also occur during manic episodes in Bipolar Disorder, in self-injurious patterns associated with Borderline Personality Disorder, or in dynamics sometimes referred to as love addiction. Trauma—particularly sexual abuse—may also play a significant role, as some individuals repeat patterns in an attempt to regain control over what was once uncontrollable.

A careful, nuanced assessment is essential.

How do you regard sex addicts?

My highest aim is to offer compassion without minimizing responsibility.

Many people struggling with compulsive sexual behavior carry enormous shame and despair. Adding more shame only fuels the cycle, as acting out becomes a way to numb that pain. At the same time, sex addiction is not an excuse for sexual harm, harassment, or the avoidance of consequences.

With those boundaries clearly stated, I offer the same care and respect I would to any client whose life has become unmanageable.

If you—or someone you love—are wondering whether sexual behavior has crossed the line from choice to compulsion, help is available.

You can contact me at tim@martintherapy.com.