I often come across people who have wrestle with the label of “addict” to define their problematic sexual behaviors. In a cultural time when sex is spoken about more freely and we are pushing back against past cultural norms, it can be a confusing endeavor to define your own personal values in this area and discern if behaviors are problematic.
To be honest, I have my own difficulty with the term “addict”. It can be stigmatizing, it has all sorts of negative stereotypes attached to it, and it is sometimes even overused to the point that it loses all meaning. Particularly in churches, the label of “sex addict” may be overused for individuals who struggle with lust or sexual sin.
Patrick Carnes, a pioneer in research on sex and love addiction, defines addiction as “a pathological relationship with a mood altering chemical or behavior.” In the context of sex and love addiction, Carnes developed a simple tool based on the CAGE alcohol abuse screening model to use to tell if your actions can be categorized under the umbrella of sex and love addiction.
Let’s say I have a client named Ann. Ann comes into my office and immediately starts off with, “I’m having trouble with this whole ‘addict’ thing. I mean, I really don’t think I’m an addict. There are people who are way worse than I am.” After asking a few more questions, I hear from Ann that she’s been viewing pornography daily, compulsively masturbating, and hooking up with men at work. Her husband has no idea this behavior is happening.
I may use Carnes’ screening tool in order to determine if Ann is struggling with sex and love addiction. He uses an acronym called PATHOS that covers the following six questions:
Preoccupied: Do you often find yourself preoccupied with sexual thoughts?
Ann tells me that she thinks about sex all the time, “but isn’t that normal?” While it would be odd not to think about sex at all, if you find that sexual thoughts and desires make up the vast majority of your thought content, this may be an issue. Similarly, if you obsessively avoid sex, this question still applies: a large amount of your thought content is still related to sex, even if it’s on how to avoid being sexual.
Ashamed: Do you hide some of your sexual behavior from others?
As mentioned earlier, Ann’s husband has no idea about the behaviors she’s been engaging in. When asked if she would tell him, she adamantly denies that it’s any of her husband’s business. This deception is often an indicator of some level of shame surrounding the behavior, or a knowledge that what is being done is at odds with her value system.
Treatment: Have you ever sought therapy for sexual behavior you did not like?
Currently, Ann has identified a treatment goal of wanting to “watch less porn,” as it often keeps her up late into the night, which makes her groggy and distracted at work the next day. While she didn’t come in saying she had an addiction, she did realize that some of her sexual behaviors were problematic and were affecting the rest of her life.
Hurt others: Has anyone been hurt emotionally because of your sexual behavior?
Ann may not think her behavior is affecting anyone, especially since her husband is unaware of what she’s doing. However, when we consider the time she takes away from her husband, the mood shifts and irritability that happen with addiction, the relationships she fosters without her husband’s knowledge – these things are affecting and hurting him, even if Ann does not see the full impact currently.
Out of Control: Do you feel controlled by your sexual desire?
When asked if she had ever tried to stop her behaviors, Ann mentioned a couple of times where she was able to go a few days without, but never longer than a week. She also mentioned that once she had the idea in her head to search for porn, it would just happen on autopilot, without making a conscious decision to act on that thought.
Sad: When you have sex, do you feel depressed afterwards?
Even though Ann didn’t initially mention any sadness after her sexual behaviors, through the course of therapy we found that she would often feel numb after her sexual encounters. We discovered this was a way in which Ann covered over her feelings of depression. This, in turn, worsened the depression as she distanced herself from her husband and any other relationships in her life.
While Ann’s story is fictional, this all too often is the experience of a sex and love addict, and he or she can feel as though they have nowhere to turn. However, there are many resources available for those who struggle with sex and love addiction – the first step is to share with your therapist so that he or she can come up with a plan together with you.