When Is Sex An Addiction?

by Robert Weiss, LCSW, CSAT-S (See all authors)

From a therapist’s point of view, sex addiction is a dysfunctional preoccupation with sex that continues for a period of at least six months despite negative consequences and attempts to either quit or curtail the problem-causing behaviors. In other words, sex addiction is an ongoing, out-of-control pattern of sexual fantasies and activities that causes problems in a person’s life – much as alcoholism is an ongoing, out-of-control pattern of alcohol abuse that causes problems in a person’s life.

Generally speaking, sex addiction, like other addictions, is diagnosed based on three primary criteria:

  1. Preoccupation to the point of obsession. Sex addicts spend hours, sometimes even days, fantasizing about, planning for, pursuing, and eventually engaging in sexual acts (with self or others). They often “lose time” when floating in their sexual obsession.
  2. Loss of control. Most sex addicts try, usually repeatedly, to either quit or cut back on their sexual fantasies and behaviors. Sometimes they even succeed for a short while. But before they know it, they are back where they started, losing themselves in sexual obsession.
  3. Negative consequences. Sex addicts typically experience the same basic consequences as other addicts – problems at work or in school, relationship woes, financial issues, declining physical and/or emotional health, loss of interest in previously enjoyable activities, isolation, arrest, etc.

If you identify with these three criteria, it is quite possible that you are sexually addicted. If so, you are probably compulsively engaging in one or more of the following activities:

  • Hour after hour of porn use, with or without masturbation
  • Compulsive sexualized use of hookup apps and similar technologies (dating sites, video chat, virtual reality sex games, sexting, etc.)
  • Constantly “hunting” for sex (cruising in the car for sex partners, surfing online for sex partners, hanging out in the steam room at the gym, etc.)
  • An ongoing pattern of intense and highly sexualized affairs or brief “serial” relationships
  • Consistently having casual and/or anonymous sex with people met online or in person
  • Consistently visiting strip clubs, adult bookstores/theatres, and other sex-driven environments
  • Paying for (or being paid for) sex, sensual massage, eroticized domination, etc.
  • A pattern of unsafe sex (unprotected sex, sex with potentially dangerous strangers, sex in public, etc.)
  • Consistently seeking sex without regard to consequences (damaged relationships, financial issues, arrest, etc.)

Of course, this listing of “typical sex addict behaviors” is wildly incomplete. In fact, it seems as if every sex addict I treat has found some new way to “act out” sexually. However, at least one or two of the activities listed above are nearly always listed among the behaviors that a particular sex addict struggles with.

If you are still questioning whether you might be a sex addict, the screening test that follows may help you decide. (This screening test is similar to the 20 question screening test that potential alcoholics are often given.)

  1. Do you find yourself spending increasing amounts of time looking at porn and/or engaging in sexual or romantic fantasy, even when you have other things to accomplish?

Yes/No (circle one)

  1. Have you promised yourself that you will stop viewing or using certain sexual sites or apps, only to find yourself back there again anyway?

Yes/No (circle one)

  1. Do you find yourself involved in hidden romantic or sexual affairs, either online or in person?

Yes/No (circle one)

  1. Do you extensively collect pornography or sexual contacts, storing images and videos, romantic emails, texts, etc.?

Yes/No (circle one)

  1. Do you find yourself habitually going online to see who might be available for sex and/or romance even when you don’t have time or it was not your clear intention to do so?

Yes/No (circle one)

  1. Have you had negative consequences at work, in school, in relationships, or in other important areas of your life related to your sexual fantasies and behaviors?

Yes/No (circle one)

  1. Has your focus on sex led to a decreased focus on friends, family, faith-based, and/or recreational activities?

Yes/No (circle one)

  1. Has your sexual behavior caused you to lose anything or anyone important to you (career, school, relationships, finances, self-esteem, health, freedom, reputation, etc.)?

Yes/No (circle one)

  1. Do you lie or keep secrets from those close to you about your involvement with pornography or your other sexual activities?

Yes/No (circle one)

  1. Have you found yourself covering up or hiding your porn use or some other sexual activity so that a spouse, coworker, family member, etc. won’t discover it?

Yes/No (circle one)

  1. If in a committed relationship, would your partner say that your sexual activity violates the underlying agreements surrounding your relationship (if he or she knew everything)?

Yes/No (circle one)

  1. Do you feel that your involvement with sexual fantasies and behaviors is interfering with your personal goals, such as developing relationships, healthy intimacy, and/or a family/community life?

Yes/No (circle one)

  1. Have you found yourself viewing sexual material or engaging in sexual activity that is illegal?

Yes/No (circle one)

  1. Have you heard complaints or concern from family and/or friends about the nature or the extent of your sexual activity?

Yes/No (circle one)

  1. Do you become defensive, angry, or ashamed when asked to look at, give up, or reduce your sexual involvement?

Yes/No (circle one)

If you did not answer yes to any of these questions, you are probably not a sex addict. If you answered yes to one or two questions, you are at risk for sexual addiction. If you answered yes to three or more questions, there is a good chance that you are sexually addicted.

Of note: An affirmative answer to question 13, regarding illegal sexual activity, is always a problem, even if you’re not a sex addict. If you answered yes to that question, you should absolutely seek confidential advice from a professional counselor who is skilled in handling these issues. However, if/when you do this, be aware that psychotherapists and other helping professionals have reporting requirements (that vary from state to state) when it comes to illegal sexual behaviors. You need to find out what these requirements are before you talk in detail about your issue.

If you believe you might struggle with sex addiction, I strongly recommend that you seek assistance via therapy with a Certified Sex Addiction Therapist (CSAT) and/or a 12-step sexual recovery group (either in person or through In the Rooms). Twelve-step sexual recovery groups include Sex Addicts Anonymous (SAA), Sex and Love Addicts Anonymous (SLAA), Sexaholics Anonymous (SA), and Sexual Compulsives Anonymous (SCA). Be aware that these groups are, in certain important ways, very different from one another. SLAA tends to have the most women; SCA tends to be the most gay-friendly; SAA tends to be very accepting and inclusive; and SA tends to be “heteronormative” in its approach (meaning its model of sexual sobriety is “no sex outside of a traditional male-female marriage”). Meanwhile, a Certified Sex Addiction Therapist can do an in-depth assessment of your life and your sexual behaviors, properly diagnosing (or not diagnosing) sexual addiction and then guiding you toward a happier, healthier life.