Is Sex Addiction Real?

by Dr. Tammy Nelson


Is there such a thing as sex addiction? 

Can someone become compulsive about sex, using it to avoid feelings and responsibilities?  Yes.  Can sex be a way to numb out and avoid being in a true intimate relationship?  Of course.  Can sex be something to obsess about? Can it interfere with your marriage?  Your job?  Can you overspend on sex?  Can you have sexual experiences that you would rather avoid, feeling powerless over your behavior and causing shame and embarrassment to rule your life?  Yes to all of the above.

So why should there be a question abou why sex addiction even exists?

In the world of psychotherapy, there are several schools of thought about this.  As of now, sex addiction is not a true diagnostic category.  There is no code for diagnosing someone with sex addiction like there is for manic depression, eating disorders, or other psychiatric illness. 

Yet many compulsive dysfunctions started this way, without diagnostic criteria that were agreed to by a majority of the psychological community.  Giving things a label helps professionals to come up with criteria to diagnose a problem; it helps to provide treatment to deal with the pain. 

Perhaps the problem is not that there is no formally agreed upon diagnostic criteria for sex addiction, but rather that there is little written or researched on how to treat it.

Without a prognosis predetermined by a history of treatment methodology, we dont know what will work and what wont.  So, frankly, we dont know what hurts.  And we dont want to screw anyone up.  We are – perhaps – and this is just a guess – tip toeing around the diagnosis because we would then have to work up treatment plans and methods to help sex addicts, and this is more difficult than it sounds.

Famous people on tv and in the press and even in books are working hard right now to provide good care and treatment of sexual compulsion.  Sometimes we watch this and its more like a train wreck than treatment, and sometimes the care and respect for the patient is amazingly and sensitively rendered and one has to wonder if this in and of itself is what provides the cure.

Maybe in the relationship the therapy is provided.  Its in this therapeutic milleux, the space between client and therapist, healer and receiver, patient and doctor, that the real healing begins.  When the compulsion to act out with the body and the senses can be turned down a notch and the real people can sit across from one another and be SEEN the work begins.  Perhaps this is the first step.

Is sex addiction real? 

Ask the sex addict.

Ask the therapist treating their partners and families.

Does it matter what we call it?

What really matters is how we treat it.

Let the diagnosticians figure out the details.

Meanwhile, I have my next patient in the waiting room biting her nails.  She’s waiting for me to open my office door.  She’s scared, and she’s hiding her face behind her hair.   I gotta go.

Passionately yours,

Dr. Tammy Nelson


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