Being addicted to sex is a complex disorder that incorporates many aspects of your personality, bio-chemistry, socio-cultural environment, family-of-origin issues, thinking/feeling processes, self-esteem, and quality of relations with others. I see sex addiction as a prism; depending on the angle you hold it up to, it can look completely different.
The complexity of addicted to sex is shown by the fact that psychologists still don’t know if it’s a symptom of an obsessive-compulsive disorder, an impulse-control disorder, or an addictive disorder. The fact that it was only recently recognized as a distinct disorder means that not much substantive research has been done to understand this multi-dimensional condition.
We do know that sexual addiction represents an expression of the same processes of addiction that underlie all compulsive behaviors: an enduring, inordinately strong tendency to engage in some form of pleasure-producing sexual behavior to regulate unwanted emotional states that are painful and potentially overwhelming. Also common to all addictions, underlying the symptom of the sexual behavior are problems with self-care and self-regulation. Achieving a sense of “self-governance” is part of sex addiction treatment.
Being perpetually ensnared in the jaws of the addiction cycle (see the Sex Addicts Anonymous website for a discussion of the addiction cycle) with its loss-of-control, shame and distress, and negative impacts on work/relationships/finances/self-esteem, is demoralizing from the sexual addict’s perspective. Yet the perceived benefits seem to outweigh the high cost of the behavior, as you no doubt experience the lure of the sexual rush to be irresistible, regardless of the knowing consequences.
Therapy for sex addiction must address both the destructive addictive sexual behaviors as well as the underlying addictive process. The challenge of the sex addiction therapist who offers a sex addiction treatment program is that of presenting a variety of treatment approaches to accommodate and treat the addict on multiple levels. Treating sex addiction requires the development of concrete skills of an addiction counselor as well as the psychological sophistication to deal with the underlying issues.
Therapy for sex addiction, then, is most likely to be effective when it emerges from an integrated, comprehensive approach that brings together different treatment methods, is individually tailored to your personality and evolves as you progress.
If addiction to sexual behaviors is the tip of the iceberg, then the personality deficits, recurring self-defeating patterns, trauma from early life relationships with caretakers, unconscious conflicts and skewed perceptions about self and others represent the bottom of the iceberg. I contend that permanent freedom from enslaving, out-of-control, humiliating sexuality cannot be achieved unless the issues on the bottom of the iceberg are resolved.