Terms such as sexual addiction, sexual compulsivity and hypersexuality do not provide an adequate understanding of why people struggle with sexual behavior. While there is no doubt that people can, and do, struggle with various aspects of their sexuality, the causes of these difficulties are complex, multifaceted and interconnected. Some people develop a problematic relationship to sexual behavior as a result of un-addressed histories of physical and sexual abuse; turning to sexual behavior as a way to avoid and distract themselves from the emotional injuries that these events have caused. Others may struggle with issues of mental illness, such as bipolar disorder, or other mood disorders, which result in periods of intense sexual activity, or lack-there-of, as a symptom of these painful psychiatric conditions. 

Sometimes an un-addressed conflict in ones intimate relationship can result in a partner turning to pornography, prostitution or some other form of sexual behavior, as a passive, or passive aggressive, expression of dis-satisfaction within the relationship. In other situations, one partner may be interested in exploring various aspects of their sexuality and has not yet developed the skills required to share these desires with their spouse, and, when discovered, results in one partner feeling angered and betrayed and using this information to label their partner as a "sex addict".  Others have reported that they do not know why their behavior has become unmanageable, and report an intense sense of shame and isolation as a result of feeling unable to stop the behavior they, or others, have identified as problematic. 

Compounding the above reported scenarios is the reality that many mental health, and medical providers, have not had adequate, let alone comprehensive, training AND supervision in the area of identifying, discussing and treating concerns related to struggles and difficulties with human sexuality; often resulting in professional discomfort, lack of accurate information and poorly formulated diagnoses that do not take into account historical, relational, social, psychological or developmental considerations that may be contributing to the individuals presenting struggle.

As in all aspects of psychotherapy, and life, there is no one size fits all. Some client's have done quite well in obtaining support and addressing the complexities of their behavior through the use 12-step programs such as Sex and Love Addicts Anonymous, while others have reported that they do best in either individual or couples therapy.  

A comprehensive treatment for compulsive sexual behavior begins with hearing your concerns, learning about the impact the behavior has had on your life, relationships and sense of self, and developing a treatment plan that is tailored to you specifically and developed to facilitate the changes that you wish to achieve. 

Suggested readings

Carnes, P. (2001). Out of The Shadows: Understanding Sexual Addiction (3rd ed.). Center City, MN: Hazelden.

Carnes, P., Delmonico, D., L., & Griffin, E. (2001). In The Shadow of The Net: Breaking Free of Compulsive Online Sexual Behavior. Center City, MN: Hazelden.

Coleman, E. (1995). Treatment of compulsive sexual behavior. In Rosen, R. C., &  Leiblum, S. R. (Eds.), Case Studies in Sex Therapy (pp. 333-349). New York, NY: Guilford Press.

Morin, J. (1995). The Erotic Mind: Unlocking the Inner Sources of Sexual Passion and Fulfillment. New York, NY: Harper Collins.

Moser, C. (1999). Health Care Without Shame: A Handbook for the Sexually Diverse and their Caregivers. San Francisco, CA: Greenery Press.

Hall, K. (2007). Chapter 12: Sexual Dysfunction and Childhood Sexual Abuse. In  Leiblum, S., R. (Ed.). Principles and Practice of Sex Therapy (4rd ed.). New York, NY: Guilford Press.

Kasl, C. D. (1989). Women, Sex and Addiction: A Search for Love and Power. New  York, NY: Harper Perennial.