The formal, clinical term for sex addiction is Compulsive Sexual Behaviour Disorder (CSBD) which was recognised in 2019. CSBD can best be defined as an overwhelming and harmful preoccupation with sexual activity that begins to take priority over other aspects of life. This might involve pornography use, webcams and online chat, visiting sex workers, sexual saunas or massage parlours, cruising, anonymous sexual encounters, multiple affairs, cybersex, or, in some cases, sexually harmful or offending behaviours. It is important to recognise that neither the specific behaviour itself nor the frequency of the behaviour determines whether someone has a problem. Rather, it is the relentless pursuit of sexual experiences despite increasingly damaging consequences that becomes significant. Over time, this preoccupation can consume huge amounts of emotional energy, time and money. As a result, people often find that their work, physical and emotional wellbeing, relationships, family life and social functioning begin to suffer, sometimes severely.
Most people struggling with these behaviours will already have made repeated attempts to cut down or stop, only to find themselves returning to patterns they promised themselves they would never repeat. Many describe a painful sense that their behaviour is escalating beyond their control. They may feel trapped between the temporary relief or excitement that sexual behaviour provides and the guilt, shame or distress that often follows.
Shame frequently becomes an important part of this cycle. As behaviour increasingly conflicts with a person’s values, beliefs or sense of identity, shame can deepen. Yet shame itself often becomes a trigger for further acting out, creating a self-perpetuating cycle in which sexual behaviour is used to escape painful feelings, only to create more distress afterwards.
Debate continues around whether these difficulties should be conceptualised primarily as an addiction, a compulsive behaviour, an impulse control difficulty, or through other psychological frameworks. (If you want to find out more about our perspective on this debate, click here.) However, an increasing body of research suggests that for some individuals, sexual behaviours can activate reward and motivational systems in the brain in ways that resemble patterns seen in other addictions. Sexual arousal triggers powerful neurochemical responses associated with pleasure, anticipation and reward. For some individuals these processes can contribute to intense cravings and repeated patterns of behaviour that feel increasingly difficult to regulate. However, like all psychological difficulties, there is rarely a single explanation and biological factors are only one part of a much bigger picture.
Like many addictive and compulsive behaviours, problematic sexual behaviour often serves an important psychological function. It can become a way of coping with distress, loneliness, anxiety, trauma, rejection or difficult emotions. For some people, sexual behaviours become associated with comfort from an early age and begin to function as a refuge from the harshness or pain of life. There is, of course, nothing inherently wrong with turning towards sex for comfort or pleasure. Sex itself is not the problem, just as alcohol itself is not the problem for someone struggling with alcohol dependency. The difficulty arises when a person begins to feel dependent upon sexual behaviour as their primary way of regulating emotions or coping with life.
Recovery is therefore not simply about stopping behaviours. It is about understanding what those behaviours have come to represent and developing a healthier, more fulfilling and more rewarding relationship with sexuality, intimacy and self.
Until recently, the prevalence of CSBD was almost impossible to measure because of the shame, guilt and secrecy that surrounds the condition but recent research from the International Sex Survey has shown that 4.6% of the UK population are at risk of CSBD. If you think you may be one of them then you may find answering the questions on the Am I an Addict? page helpful.
At the Laurel Centre, we provide a range of specialist individual and group therapy services for people struggling with compulsive sexual behaviours and related difficulties. Our approach is compassionate, evidence-informed and shame-free, helping people understand the roots of their difficulties and build a healthier relationship with themselves, their sexuality and the people around them. Visit our services page to see how we can help you.
