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Sex and Pornography Addiction
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What is the definition of sex addiction?
Is sexual addiction a disease?
Why donít sex/pornography addicts just stop after they realize it is causing problems?
Why can't I stop masturbating?
How do you know if you are a sex addict?
What is the difference between 12-step, self-help groups like Sex Addicts Anonymous, and professional addictions treatment?
What are the key ingredients for successful recovery from sexual addiction?
Is there an addictive personality?
I think I might have a sexual addiction problem. What should I do?

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Sex and Pornography Addiction FAQs

A. Tom Horvath, Ph.D., ABPP, Kaushik Misra, Ph.D., Amy K. Epner, Ph.D., and Galen Morgan Cooper, Ph.D. , edited by C. E. Zupanick, Psy.D.

Sexual addiction refers to a preoccupation with sexual thoughts or sexual behavior to the extent that this preoccupation continues even though it causes substantial harm. This harm may include: 1) risky, dangerous, or unhealthy sexual behaviors; 2) damage to interpersonal relationships and/or the avoidance of meaningful intimate relationships; 3) financial consequences; 4) legal consequences, or, 5) a failure to fulfill important life roles such as employee, student, spouse, parent, friend, etc. Sexual addiction does not refer to any particular type of sexual behavior, a high degree of sexual desire, or the frequency of sexual activity. Sexual addiction is indicated when someone experiences a reduced control over sexual behavior despite negative consequences. Examples of these consequences include: arguments with a partner over excessive pornography use; losing a job because of inappropriate sexual behavior in the workplace; and health, legal, and financial problems.

Sexual addiction falls into a specific category of addictions called activity addictions (or behavioral addictions). In our topic center on addiction, we define addiction:

Addiction is the repeated involvement with a substance or activity, despite the substantial harm it now causes, because that involvement was (and may continue to be) pleasurable and/or valuable.

This definition of addiction includes four key components:

1. Addiction includes both substances and activities (such as sex and gambling).
2. Addiction leads to substantial harm.
3. Addiction is repeated involvement despite substantial harm.
4. Addiction continues because it was, or is pleasurable and/or valuable.

You can read more about this definition of addiction in the section entitled, "What is sex/pornography addiction?"

There are at least four primary ways to understand sexual addiction:

1. Sexual addiction is a biological problem.
2. Sexual addiction is a psychological problem.
3. Sexual addiction is a social or cultural problem.
4. Sexual addiction is a spiritual problem.

You can learn more about these four ways of understanding sexual addiction in the section entitled, "What causes sexual/pornography addiction?"

Recent research suggests the causes of addictions, such as sexual addiction, are heavily influenced by our biology. When viewed in this manner, sexual addiction might be considered a disease. However, there is no medical "cure" for sexual addiction. Yet, every day people recover from sexual addiction. The different ways that people recover from sexual addiction rely on psychological, socio-cultural, and spiritual solutions. Therefore, viewing sexual addiction as a disease is too simplistic. When sexual addiction is viewed as a disease, there is one dividing line. Either you have a disease, or you do not. However, we know people experience varying degrees of difficulty with addictions ranging from none to severe. Additionally, people may experience addiction problems during different periods of their life. A disease concept of addiction does not account for the full range of addiction-related problems that may come and go as people move through their lives. Similarly, it does not account for the many non-medical solutions to recovery from sexual addiction.

Of course, people do indeed stop, but it can be quite difficult for a number of reasons. Some of these reasons are due to the way addictions, such as sex addiction, cause changes to the brain. Stopping an addiction requires significant behavioral change. Behavioral change of any sort can be quite difficult. There are psychological reasons for this difficulty. For more information, see the section entitled, "How do you get addicted to sex/pornography?".

You may also be interested to read more about addiction and the perceived loss of control in our addictions topic center.

If you truly feel you cannot stop masturbating, you are describing the compulsive quality of many addictions. If masturbation has become a compulsive habit, then it is quite likely that you may be developing a sexual addiction.

Initially, masturbation may have served as a pleasant form of self-pleasuring, particularly when no partners were available. This is generally considered a healthy, normal practice. However, like all addictions, sexual addiction develops gradually. For many people, masturbation can be an enjoyable and periodic activity. However, some people use sexual arousal and orgasm as a means of coping with unpleasant feelings and stress. Other people may have difficulty forming and maintaining intimate, interpersonal relationships. Poor coping skills and poor interpersonal skills can lead to the compulsive masturbation. When masturbation is repeatedly and consistently chosen over sex with a partner, it may indicate a problem is beginning to develop.

Masturbation is often coupled with pornography, fetishes, and/or high degrees of fantasy. When sexual arousal and orgasm are repeatedly associated with fantasy, pornography, or fetish objects (such as shoes), it becomes more difficult to enjoy sex with a partner because real human beings cannot match or compete with a self-created sexual fantasy world.

Addiction is defined as the repeated involvement with a substance or activity, despite the substantial harm it now causes, because that involvement was (and may continue to be) pleasurable and/or valuable. If you are questioning whether you may be developing a problem with masturbation, you may want to review the section, "What is sexual/pornography addiction?". There is a list of harmful costs of addiction contained in that article. If some of these harmful costs apply to you, it would be wise to consult a professional for additional assistance. Your healthcare provider or your EAP professional may be able to refer you to an addictions specialist. Our topic center on healthy sexuality and sexual problems.

There are at least two ways to decide whether you might be a sex addict: 1) a formal diagnostic assessment performed by an addictions specialist; or, 2) an informal self-assessment.

Sexual addiction is a specific type of addiction called an activity addiction. To perform an informal self-assessment you can use the definition of addiction and evaluate your own behavior according to this definition. In our topic center on addiction, addiction is defined as:

Addiction is the repeated involvement with a substance or activity, despite the substantial harm it now causes, because that involvement was (and may continue to be) pleasurable and/or valuable.

In the section entitled, "What is sex/pornography addiction?", we listed the many types of substantial harm that meet this definition of addiction. You could use this list to decide if your sexual behavior meets this definition of addiction. Addiction differs from "behavin' badly" because it means someone is repeatedly involved with a substance or activity despite substantial harm.

The second way to decide if you have a sexual addiction is to request a formal assessment by an addictions specialist. If you are concerned about the possibility having any type of addiction problem, it may be wise to ask your healthcare provider or EAP specialist for some guidance. They can refer you to an addictions specialist who will help you make an accurate assessment.

First, there are two basic types of self-help support groups:

1. Self-empowering support groups
2. 12-step support groups

Addiction is similar to many other types of problems. Some people require professional assistance, while other people do not. 12-step groups (e.g. Sex Addicts Anonymous; Sexaholics Anonymous; Sex and Love Addicts Anonymous; Sexual Compulsives Anonymous) are non-professional groups. One of the primary differences between 12-step support groups and professional treatment is the issue of confidentiality. Professional healthcare providers are required by law to maintain confidentiality. No such assurances exist in non-professional groups. Because some forms of sexual addiction may include illegal, dangerous, or shameful activities, the issue of confidentiality may be a very significant one. Laws regarding confidentiality vary from state-to-state. Some types of illegal activities and disclosures made during a therapy session are not protected by confidentiality. If you decide to pursue professional treatment, you should be sure to ask your therapist about the limits of confidentiality.

Another significant difference is that professional healthcare providers rely on science and research to guide their methods. 12-step support groups rely on spiritual solutions. These differences have led to a great deal of unnecessary controversy between supporters of science and supporters of 12-step groups. It is perfectly fine to integrate spiritual and scientific solutions. We developed a guide to help you set up your own personal program of recovery.

There are four key ingredients for successful addictions recovery. This is true whether someone is attempting independent recovery, or relying on professional help. These are:

1. Humility
2. Motivation
3. Sustained effort
4. Restoring meaning and purpose to life

Of these, motivation is perhaps the most essential. It is important to note that motivation can be strengthened. Therefore, even if someone is initially unsure about whether s/he wants to give up their addiction, they can increase their motivation. This is done by conducting a realistic appraisal of the costs and benefits of continuing the addiction. One technique that helps people make an accurate appraisal is called motivational interviewing. You can read more about these four key ingredients and motivational interviewing in this section.

Personality refers to a unique and enduring pattern of thinking, feeling, and behaving. Contrary to popular belief, research has been unable to identify an “addictive personality.” Most of the research regarding addiction and personality traits has been conducted with people who have alcohol use disorders. Despite the lack of support for an “addictive personality” there are some personality traits that are more commonly observed in people with addictive disorders. The most common of these personality traits include nonconformity; impulsivity; sensation- or thrill-seeking; negative affect (e.g., depression, anxiety); low self-esteem; and an external locus of control.

There are many different types of help available from self-help groups to professional treatment. We have created a personal action plan for recovery for those people who would prefer the self-help approach. We have also developed guidelines for choosing treatment options for those people who prefer professional assistance. The most important thing to do is take some action, rather than just wondering about it. Although thinking about a problem usually precedes doing something about it, the bottom line is that action is what creates the desired change.