Sexual Addiction

San Francisco has long been a space of sexual exploration, diverse identities, and body autonomy. Here, sexuality is embraced in many forms, from monogamous relationships to polyamory, from vanilla to kink, from casual sex to long-term partnerships. However, for some individuals, sexual behaviors or desires may feel out of alignment with personal values, emotional well-being, or relationship dynamics.

Some people seek therapy to explore their relationship with sex, intimacy, and desire, while others come because they feel compulsively drawn to sexual activities in a way that creates distress or disrupts their lives. Regardless of your experience, therapy offers a non-judgmental space to understand your behaviors, reduce shame, and build a relationship with sexuality that feels healthy and fulfilling to you.

At CMP, we don’t pathologize sexual expression. We honor all genders, orientations, relationship structures, and expressions of desire. Therapy is about understanding your patterns, identifying what you want from your sexual and emotional life, and finding ways to integrate sexuality in a way that feels right for you.

 

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Quick Navigation

• What Is Sexual Addiction?
• Sexual Exploration & Compulsivity in San Francisco
• Sexual Addiction, Love Addiction & Porn Addiction
• Sexuality, Compulsivity & Other Mental Health Considerations
• Why People Seek Therapy for Sexuality & Compulsivity
• Types of Therapy for Sexuality & Compulsive Behavior
• Sexuality & Compulsive Behavior Through a Multicultural & Systems-Based Lens
• Next Steps

 

What is Sexual Addiction?

Sexual addiction, sometimes referred to as hypersexuality or compulsive sexual behavior disorder, is characterized by an individual’s persistent and escalating pattern of engaging in sexual activities, fantasies, or behaviors that are difficult to control, causing distress, and negatively impacting various aspects of their life, including relationships, work, and overall well-being.

Key features and signs of sexual addiction may include:

• Compulsive Sexual Behavior: An individual with sexual addiction often engages in sexual activities excessively and compulsively, even when they desire to stop or cut down.
• Escalation of Activities: Over time, there may be an escalation in the intensity or frequency of sexual activities, as individuals may continually seek novelty or intensity to achieve the desired level of arousal.
• Loss of Control: Individuals with sexual addiction may find it challenging to control their sexual impulses, leading to a sense of powerlessness and distress.
• Neglect of Responsibilities: The pursuit of sexual activities may lead to neglect of important responsibilities at work, in relationships, or in other areas of life.
• Negative Consequences: Sexual addiction often results in negative consequences, such as damaged relationships, legal issues, financial problems, or emotional distress.
• Preoccupation with Sex: Constant thoughts and preoccupation with sexual activities can interfere with daily functioning and mental well-being.

History of Sexual Addiction as Diagnosis

The concept of sexual addiction as a formal diagnosis has a relatively recent and controversial history within the field of psychology and mental health. Here’s an overview of its development and the ongoing controversy:

Early Emergence

The idea of sexual addiction began to gain recognition in the late 20th century. It was influenced by the broader understanding of addiction as a compulsive and pathological behavior pattern.

Sexologist’s Contributions

Pioneering sexologists like Patrick Carnes and Robert Weiss played significant roles in popularizing the concept of sexual addiction through their books and research. They argued that certain individuals displayed behaviors analogous to addiction when it came to sex.

Inclusion in Diagnostic Manuals

Despite being a subject of debate, sexual addiction was included in some versions of the Diagnostic and Statistical Manual of Mental Disorders (DSM), which is the primary diagnostic guide used by mental health professionals. In the DSM-III-R (1987), it was listed under “Sexual Disorders Not Otherwise Specified.”

Controversy and Criticism

Sexual addiction has faced substantial criticism from various quarters. Critics argue that it lacks a clear and universally accepted definition, diagnostic criteria, and empirical evidence to support its classification as a mental disorder. Many mental health professionals and researchers believe that excessive sexual behavior may be better understood as a behavioral or impulse control disorder.

Relabeling as Hypersexuality

To address some of the concerns about the term “sexual addiction,” some experts and organizations have preferred to use the term “hypersexuality” or “compulsive sexual behavior disorder.”

Lack of Inclusion in DSM-5

In the fifth edition of the DSM (DSM-5) published in 2013, the concept of sexual addiction or hypersexuality was not included as a formal diagnosis. Instead, it was mentioned as an area in need of further research.

Sexual Exploration and Compulsivity in San Francisco: Unique Considerations

San Francisco is a city that celebrates sexual diversity and freedom. This openness allows people to explore their identities, desires, and relationship structures. At the same time, some individuals find themselves engaging in sexual behaviors that feel repetitive, compulsive, or disconnected from emotional fulfillment. Therapy can help individuals distinguish between meaningful exploration and behaviors that may be driven by emotional distress, unresolved trauma, or impulse control challenges.

The Intersection of Sexual Exploration and Compulsion

• Many people in San Francisco engage in alternative relationship styles, casual sex, or kink in ways that are intentional and fulfilling. Others may feel drawn toward repeated behaviors that bring momentary relief but lead to feelings of distress, secrecy, or disconnection.
• Some individuals may question whether their sexual behavior is driven by personal values or external validation, unresolved emotional pain, or past trauma.
• Therapy can provide a space to explore these dynamics, helping individuals clarify what they truly want from their sexual experiences and whether their behaviors align with those goals.

Technology, Accessibility, and Sexual Behavior

• Dating apps, social media, and easily accessible sexual content have changed the way people connect and interact. While technology offers new ways to explore intimacy, it can also lead to patterns of impulsivity, detachment, or excessive reliance on digital connections.
• Some individuals struggle with compulsive pornography use, excessive app-based sexual interactions, or difficulties forming in-person emotional connections due to reliance on digital platforms.
• Therapy can help individuals examine the role of technology in their relationships, explore their underlying needs, and establish healthier patterns of connection.

Stigma, Shame, and Cultural Narratives Around Sexuality

• People from religious or conservative backgrounds may experience conflict between their sexual behaviors and their upbringing, leading to cycles of secrecy, shame, or guilt.
• LGBTQ+ individuals, people practicing polyamory, and those in kink communities may struggle with external judgment or internalized shame, even when engaging in consensual and fulfilling sexual practices.
• Therapy can help individuals unlearn harmful messages about sexuality, find self-acceptance, and develop a relationship with their desires that aligns with their well-being.

San Francisco provides an environment where many forms of sexual expression are welcomed, but that does not mean everyone feels fully at ease with their own experiences. Whether you are looking to explore, set boundaries, or gain clarity, therapy can provide a space to process your relationship with sexuality in a way that feels aligned and empowering.

Person-Centered, Sex-Positive Approach to Sexual Addiction Therapy

A Person-Centered, Sex-Positive Approach to Sexual Addiction Therapy is a therapeutic framework that places the individual at the center of their own healing journey and acknowledges the importance of a positive and non-judgmental attitude toward their sexual experiences and desires. Here’s an explanation of this approach and its significance:

Person-Centered Approach

• Empowerment: In this approach, individuals are empowered to take an active role in their therapy. Therapists create a safe, empathetic, and non-judgmental environment where clients can openly discuss their concerns and experiences related to sexual addiction.
• Collaboration: Therapy is collaborative, with the therapist and client working together to explore the root causes of addictive behaviors, set goals, and develop strategies for change. Clients’ perspectives and experiences guide the therapeutic process.
• Unconditional Positive Regard: Therapists offer unconditional positive regard, meaning they accept and respect clients without judgment or criticism. This fosters a sense of safety and trust, which is essential for individuals to open up about their struggles with sexual addiction.

Sex-Positive Approach

• Normalization of Desire: A sex-positive approach acknowledges that sexual desire and behaviors are normal aspects of human experience. It avoids pathologizing or stigmatizing natural sexual urges and preferences.
• Reducing Shame and Guilt: By promoting a sex-positive perspective, therapy aims to reduce feelings of shame and guilt that individuals with sexual addiction often experience. This helps clients address their concerns without unnecessary moral judgments.
• Holistic Understanding: The approach considers sexual health as an integral part of overall well-being. It recognizes that sexual difficulties may be intertwined with broader issues related to self-esteem, relationships, and emotional well-being.

Why It’s Important in Sexual Addiction Therapy:

• Reducing Stigma: A Person-Centered, Sex-Positive Approach helps reduce the stigma associated with sexual addiction. When individuals feel accepted and understood, they are more likely to seek help and engage in therapy without fear of judgment.
• Enhancing Self-Acceptance: By normalizing sexual desires and behaviors, this approach fosters self-acceptance. Individuals can begin to separate their self-worth from their addiction, which is crucial for recovery.
• Effective Exploration: A non-judgmental atmosphere encourages individuals to explore the underlying causes of their addiction more openly. This deep self-exploration is vital for understanding and addressing the roots of addictive behaviors.
• Promoting Healthy Sexuality: A sex-positive perspective allows individuals to work toward healthier, more satisfying sexual experiences, rather than viewing all sexual behaviors as problematic.
• Client-Centered Healing: This approach recognizes that every individual’s journey is unique. By letting clients guide the therapy process and respecting their autonomy, it increases the likelihood of therapeutic success.

Sexual Addiction, Love Addiction, Porn Addiction

Sex addiction, love addiction, relationship addiction, and porn addiction are terms used to describe patterns of behavior related to sexual or romantic pursuits, but they are distinct concepts with varying characteristics. h

• Love Addiction: Love addiction, sometimes called “obsessive love,” refers to an intense and compulsive preoccupation with romantic love and relationships. Individuals with love addiction often seek out romantic partners compulsively and may experience distress and dysfunction when not in a romantic relationship.
• Relationship Addiction: Relationship addiction is a term used to describe individuals who are compulsively drawn to romantic relationships and may struggle with dependency on their partners. They often fear being alone and may move from one relationship to another without much time for self-reflection or personal growth.
• Porn Addiction: Porn addiction, also known as compulsive pornography use, involves a persistent and uncontrollable pattern of consuming pornography to the detriment of other areas of life, such as work, relationships, or daily responsibilities.

There can be overlap among these behaviors, as individuals with one type of addiction may also exhibit traits or patterns associated with another. For example, someone with sex addiction may struggle with love addiction, seeking sexual encounters as a way to feel loved and validated.

Sexual Addiction and Other Mental Health Considerations

Individuals struggling with sexual addiction often face a range of mental health considerations and co-occurring issues that may complicate their overall well-being. These mental health concerns can be intertwined with the addiction and may include:

Depression

Many individuals with sexual addiction experience symptoms of depression, such as low mood, feelings of hopelessness, and loss of interest in activities. The distress caused by the addiction’s negative consequences can contribute to depressive symptoms.

Anxiety Disorders

Anxiety disorders, such as generalized anxiety disorder or social anxiety disorder, may co-occur with sexual addiction. Anxiety can stem from the fear of being discovered, the consequences of addictive behaviors, or the anticipation of engaging in sexual activities.

Trauma and Post-Traumatic Stress Disorder (PTSD)

Some individuals with sexual addiction have a history of trauma, including childhood sexual abuse or assault, which can contribute to the development of addiction as a coping mechanism. Trauma can also result from negative experiences related to the addiction itself.

Obsessive-Compulsive Disorder (OCD)

OCD may co-occur with sexual addiction, particularly when individuals experience intrusive and distressing sexual thoughts or engage in compulsive behaviors related to their addiction.

Borderline Personality Disorder (BPD)

Individuals with BPD may be at a higher risk of developing sexual addiction due to impulsivity, emotional dysregulation, and a pattern of unstable relationships.

Substance Use Disorders

Substance abuse or dependence may co-occur with sexual addiction as individuals may use drugs or alcohol to cope with the emotional distress caused by their addictive behaviors.

Eating Disorders

There may be a comorbidity between sexual addiction and eating disorders, particularly when addictive behaviors are used to cope with body image issues or low self-esteem.

Relationship Issues

Co-occurring relationship problems, such as codependency or difficulties in forming and maintaining healthy relationships, are common among individuals with sexual addiction.

Self-Esteem and Self-Worth Issues

Low self-esteem and negative self-worth can both be a cause and a consequence of sexual addiction. These issues often require attention and healing in therapy.

Why People May Seek Therapy for Sexual Addiction: Benefits

Individuals may seek therapy for sexual addiction for various reasons, and the decision often stems from recognizing the negative impact of their addictive behaviors on their life.

Here are some common motivations for seeking therapy:

• Personal Distress: Feeling overwhelmed, anxious, or depressed due to the addiction’s consequences and recognizing that their sexual behaviors are causing emotional pain and distress.
• Relationship Issues: Struggling with conflicts, trust issues, or the breakdown of intimate relationships because of the addiction’s impact on their partner and family.
• Legal and Financial Problems: Facing legal issues, financial strain, or job instability resulting from the addiction, such as solicitation of sex workers or illegal online activities.
• Decline in Daily Functioning: Noticing a decline in overall life functioning, such as neglecting responsibilities at work, school, or home, as a result of preoccupation with sexual behaviors.
• Failed Attempts to Stop: Repeatedly attempting to control or stop the addictive behaviors on their own but being unsuccessful, leading to feelings of powerlessness.
• Health Consequences: Experiencing health issues related to the addiction, such as sexually transmitted infections, physical injuries, or adverse effects on mental health.
• Concerns About Identity: Questioning one’s sexual identity or values due to incongruence with the addictive behaviors.

Benefits of Seeking Therapy for Sexual Addiction

It’s important to note that recovery from sexual addiction is often a gradual process, and the benefits of therapy may manifest over time. Some of those benefits could include:

• Understanding and Insight: Therapy offers a safe and supportive space to explore the underlying causes and triggers of sexual addiction, providing individuals with greater self-awareness and insight into their behavior.
• Behavioral Change: Therapists use evidence-based approaches to help individuals gain control over their addictive behaviors and develop healthier coping mechanisms.
• Emotional Regulation: Therapy assists individuals in managing the emotional distress, shame, and guilt often associated with sexual addiction.
• Improved Relationships: Through therapy, individuals can work on repairing and rebuilding relationships damaged by the addiction, developing healthier communication and trust.
• Relapse Prevention: Therapists provide strategies to prevent relapse and maintain recovery, equipping individuals with tools to manage triggers and cravings.
• Enhanced Self-Esteem: Addressing the root causes of low self-esteem and self-worth often associated with addiction can lead to improved self-esteem and self-compassion.
• Holistic Well-Being: Therapy addresses not only the addiction itself but also co-occurring mental health concerns, promoting overall emotional and psychological well-being.
• Support and Accountability: Therapists offer a supportive and non-judgmental environment in which individuals can share their experiences, gain validation, and receive guidance.
• Reduced Legal and Financial Risks: Therapy can help individuals address the legal and financial consequences of their actions and work toward resolving these issues.
• Personal Growth: Ultimately, therapy provides an opportunity for personal growth and a chance to live a more fulfilling life free from the constraints of addiction.

Types of Therapy for Sexual Addiction

The effectiveness of therapy for sexual addiction can vary depending on individual needs and preferences. There isn’t a one-size-fits-all approach, but some therapeutic modalities have shown promise in treating sexual addiction. These include:

Cognitive-Behavioral Therapy (CBT)

CBT is a widely used approach for treating sexual addiction. It helps individuals identify and challenge distorted thoughts and beliefs associated with their addictive behaviors. By developing healthier thought patterns and coping strategies, individuals can gain better control over their impulses.

Mindfulness-Based Cognitive Therapy (MBCT)

MBCT combines CBT techniques with mindfulness practices. It can be effective for addressing impulsivity and emotional regulation, which are common challenges in sexual addiction.

12-Step Programs

Programs like Sexaholics Anonymous and Sex Addicts Anonymous provide a structured, supportive environment for individuals to share their experiences, gain insight, and work on recovery steps. These programs often involve a sponsor system for added support.

Dialectical Behavior Therapy (DBT)

DBT is beneficial for individuals who struggle with emotion dysregulation, which can be a significant component of sexual addiction. It teaches skills for managing emotions, improving interpersonal relationships, and reducing impulsive behaviors.

Schema Therapy

Schema therapy focuses on identifying and challenging deep-seated negative beliefs and patterns developed in childhood. This can be particularly useful for individuals whose addiction is rooted in unresolved early experiences.

Sex Therapy

Sex therapists specialize in addressing sexual concerns, including sexual addiction. They can help individuals explore the emotional and psychological factors driving their addictive behaviors and work on healthy sexual expression.

Sexuality and Compulsive Behavior Through a Multicultural and Systems-Based Lens

Sexuality is shaped by personal experiences, cultural expectations, and systemic influences. For many, the way they engage with sex—whether as a source of pleasure, distress, exploration, or compulsion—is deeply connected to the messages they have received throughout their lives. Examining sexuality through a multicultural and systems-based perspective allows for a deeper understanding of how different communities experience desire, relationships, and behavioral patterns.

Cultural Messages About Sex, Control, and Morality

• Some cultures encourage open sexual expression, while others place strict limitations on what is considered acceptable. Messages around sex can be linked to morality, family expectations, or religious teachings, shaping a person’s internal relationship with desire and behavior.
• In some communities, conversations about sexuality are avoided entirely, leading to cycles of secrecy or repression that may later result in compulsive behaviors.
• Therapy provides a space to unpack these influences, challenge messages that no longer serve an individual’s well-being, and develop a framework for sexuality that aligns with personal values rather than cultural pressures.

The Intersection of Gender, Identity, and Sexual Expression

• Men, women, non-binary individuals, and trans people all experience different pressures and expectations around sexuality, performance, and intimacy.
• Many LGBTQ+ individuals struggle with conflicting societal messages about sex, whether due to hypersexualization, desexualization, or stigma surrounding non-heteronormative relationships.
• Therapy offers a space to process gendered and identity-based expectations around sex, intimacy, and emotional connection in a way that prioritizes personal well-being over external pressures.

Systemic Influences: Sex Work, Safety, and Legal Consequences

• Some individuals engage in sex work by choice, while others may feel pressured due to financial instability or systemic barriers to other forms of employment.
• Legal frameworks and societal norms treat different sexual behaviors unequally, disproportionately targeting marginalized groups in ways that impact their mental and emotional well-being.
• Therapy can provide a space to process experiences related to sex work, legal concerns, and the role of systemic barriers in shaping an individual’s relationship with sexuality.

Sexuality is never just an individual experience—it is influenced by family, community, history, and cultural narratives. Therapy provides a space to examine these influences, reclaim personal agency, and create a fulfilling and autonomous relationship with sex and desire.

Next Steps:

Find a San Francisco sexual addiction therapist who is ready to work with you.

The choice of therapy should consider individual needs, the severity of the addiction, co-occurring mental health issues, and personal preferences. Many individuals benefit from a combination of therapies tailored to their unique circumstances.

Moreover, the therapeutic relationship and the commitment of the individual to change play critical roles in the success of therapy. Therefore, the effectiveness of any therapy ultimately depends on the individual’s willingness to engage in the process and make necessary changes in their life.

Are you ready to find a therapist who can assist you in navigating issues around sexual addiction? Search our therapist directory today to find the one who is right for you. Or call us for more information.

 

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