Is Sex Addiction Real?

​​Written by Sexual Wellness Institute Owner and Therapist, Amanda Holmberg, MS LMFT

As a Minnesota sex therapist, I often encounter clients grappling with the term "sex addiction." It's a phrase that stirs up strong emotions and evokes vivid images in the media and popular culture. For some, it represents an uncontrollable urge to engage in sexual behaviors, while for others, it can signify a moral or social failing. However, when we turn to scientific research and clinical practice, the term "sex addiction" is increasingly seen as an inaccurate and problematic label. Let's delve into why this term doesn't hold up under scrutiny from a scientific and therapeutic standpoint and why we need a more nuanced, evidence-based understanding of human sexuality.

The Roots of the "Sex Addiction" Concept

The concept of sex addiction gained traction in the 1980s and 1990s, particularly in the wake of high-profile cases and media portrayals. Prominent individuals, such as public figures and celebrities, admitted to having “sex addiction,” which only added to the narrative that excessive sexual behavior was a sign of a serious, diagnosable disorder. Books, documentaries, and therapies marketed to address "sex addiction" created a framework where sexual behavior was likened to substance abuse or gambling addiction.
The basic premise behind the term is that some individuals experience an overwhelming compulsion to engage in sexual activity, leading to negative consequences in their personal, professional, or social lives. However, as we explore the science of human sexuality, we quickly discover that the label doesn’t align well with what we know about sexual behavior and mental health.

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The Problem with "Addiction" in the Context of Sex

Addiction is defined as a psychological condition characterized by compulsive engagement in a behavior despite negative consequences. It usually involves an escalating pattern of use (e.g., with drugs or alcohol), where the individual builds tolerance and experiences withdrawal symptoms when they can’t engage in the behavior. These elements—tolerance, withdrawal, and escalation—are hallmarks of many well-established addictions, such as substances or gambling. This research study was the first to look at these concepts with folks trying to abstain from pornography for 7 days. They concluded that there were no negative abstinence effects (like withdrawal) for these people.  
While some people may experience difficulty controlling their sexual behavior, the idea that sexual desire or activity can be analogous to drug addiction doesn't hold up scientifically. There’s no evidence to suggest that sexual behavior operates on the same neural pathways or mechanisms as substance addiction. Unlike substances, sex is a basic human need and a fundamental part of our biology.
Furthermore, the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which is used by mental health professionals to diagnose psychiatric disorders, does not recognize "sex addiction" as a formal condition.

Is There Really a "Compulsion" to Have Sex?

Many who identify with the term “sex addiction” report feeling a compulsion or an uncontrollable urge to engage in sexual behavior. However, it’s crucial to distinguish between compulsivity and desire. Sexual urges are natural, and at times, they can be intense. But feeling driven to act on sexual impulses is not inherently pathological. It is when those urges lead to distress, harm, or dysfunction in life that they may be indicative of something more complex—such as anxiety, trauma, or attachment issues. Ie: wanting to have sex or masturbate is completely normal!
In therapeutic settings, it’s often more productive to explore the underlying psychological and emotional factors contributing to a person’s sexual behavior. For instance, some individuals may engage in high-frequency sexual behavior as a way of coping with trauma, loneliness, stress, or unresolved emotional pain. In such cases, what we are really dealing with is not "addiction" but maladaptive coping mechanisms that require addressing the root causes.

The Danger of Pathologizing Normal Sexual Behavior & the Role of Shame

One of the most concerning aspects of labeling someone as a “sex addict” is the risk of pathologizing normal variations in sexual behavior. Human sexuality is diverse, and people’s desires and behaviors vary widely. For some, a high libido and a strong desire for frequent sex are part of a healthy sexual identity. For others, less frequent sexual activity or celibacy may be the norm. These variations do not necessarily indicate a psychological disorder.
By labeling individuals with high sexual desires or varied sexual practices as "addicts," we risk reinforcing harmful stigma and shame around sexuality. This can lead to unnecessary therapy, medical treatments, and even self-loathing when what may actually be needed is a deeper understanding of one’s needs, desires, and boundaries. 

A More Helpful Approach: Understanding the Underlying Issues

As sex therapists, our goal is not to label or stigmatize our clients but to help them identify and understand their sexual values. Rather than focusing on a “diagnosis,” it’s more beneficial to look at the following areas:

1. Patterns of Behavior: What is the pattern to all of this? Do you tend to turn to masturbation when you’re bored, when you have a bad day at work, or maybe when you have a fight with your partner? Figuring out when and why you engage in behaviors you’d like to reduce or eliminate is often one of the first steps.
2. Emotional Regulation: Is the individual using sex as a way to cope with emotional distress, stress, or unresolved trauma? Therapy can help develop healthier coping mechanisms.
3. Relationship Dynamics: Are there issues within the person’s relationships that are contributing to their sexual behavior? For example, feelings of inadequacy, lack of intimacy, or poor communication can lead to problematic sexual behavior.
4. Sexual Consent and Boundaries: Is the behavior consensual, respectful, and safe for all parties involved? Therapy can address concerns related to consent and understanding boundaries.
5. Addiction vs. Coping: Is the sexual behavior an attempt to regulate emotions or fulfill an unmet need, rather than the result of a compulsive addiction? Understanding this distinction helps avoid unnecessary pathologizing.

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Values-Based Treatment in Sex Therapy

Sexual values-based treatment for issues often called "sex addiction" focuses on helping people connect their sexual behaviors with their core values, rather than treating it as a compulsion or disorder. This approach encourages individuals to explore their beliefs about sex and how those beliefs shape their actions. By identifying what matters most to them—like respect, trust, intimacy, and mutual consent—people can make more thoughtful choices about their sexual lives. Instead of labeling sexual behavior as an addiction, this method empowers individuals to take control and create healthier, more meaningful relationships, both with themselves and with others. It’s about living in a way that feels true to one’s values and promoting overall sexual well-being.

Consider Sex Therapy in Plymouth, MN

Our sex therapists want to help you address sexual concerns here in Plymouth, or anywhere in the state with online therapy in Minnesota. Get started by following these simple steps:

1. Contact the Sexual Wellness Institute to set up your first appointment.
2. Meet with one of our skilled sex therapists for an intake appointment.
3. Begin building better communication with your partner, overcome sexual concerns and experience new fun and intimacy in your relationship!​

Other Mental Health Services in Minnesota

In addition to sex therapy, our LGBT & polyamory friendly sex therapists provide a wide range of mental health services at our Plymouth, MN counseling office. Other services include couples therapy & marriage counseling, EFT, evidence-based couples therapy, EMDR & sexual trauma therapy, as well as, teen therapy. In order to help serve the mental health needs of all those living in Minnesota, we also offer online counseling & sex therapy. We also provide a variety of helpful tips on our mental health blog. Please feel free to reach out with questions, or if you would like to schedule an appointment to begin working with a skilled sex therapist! Your sex life can be amazing. Sex therapy can be a part of that process for you.

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