Help for individuals struggling with Out of Control Sexual Behavior, Hypersexuality or "Sex Addiction"
Hypersexuality or "sex addiction" is not actually a clinical diagnosis in the DSM (the U.S.'s clinical diagnostic manual). However, it's an idea that has gained popularity. It is also know as sexual compulsivity, sexual impulsivity, and out of control sexual behavior, among others.
Research shows the etiology (underlying cause) of concerns related to "out of control" behavior is quite variable. Each person has a different mix of concerns that brought them to these behaviors. Hypersexuality is actually better seen as a symptom not a unified syndrome. Proper treatment for sexual addiction requires first and foremost proper diagnosis. Treatment then is individualized and unique to each person. Someone who's underlying concern is obsessive compulsive disorder will have a different course of treatment than a person who's underlying concern is major depressive disorder.
Potential concerns that can lead to a diagnosis or contribute to out of control behavior include:
Depression and other mood concerns (mania, hypomania, dysthymia, and depression episodes)
Anxiety and related concerns (social phobia, social anxiety, post traumatic stress disorder, obsessive compulsive disorder, generalized anxiety disorder, and others)
Alexithymia (inability to identify emotions, a symptom which underlies other clinical disorders)
Personality concerns (low flexibility in personality style, low problem-solving ability, struggles with seeing how one's actions impact others)
Cognitive concerns (trouble processing, problem solving and other concerns related to thinking)
Impulsivity issues (such as ADHD)
Compulsivity concerns (such as obsessive compulsive disorder)
Substance use concerns
Shame - an unpleasant emotion that can drive unwanted behaviors even without a mental health diagnosis
Autism and subsequent struggles with connection and social skill in regard to sexual health
Dissociation (disconnecting from oneself and one's experience, often a symptom related to trauma, anxiety, or depression)
Naturally high appetite for sexual activity combined with cultural sanctions that increase shame (this combination can increase one's experience of loss of choice or control, given the intensity of the emotions involved)
Trouble regulating emotions
Trouble regulating emotions related to sexual excitement - what sexologist call the "dual control model" of sexual regulation. This model focuses on excitation and inhibition processes. Often sexual behavior that seems "addictive" is trouble with the inhibition process or the "brakes." (Of note, sexology looks at low desire as a flip side of this process. Low desire is often a concern with the excitation process or the "gas" in the sexual desire system.)
An unidentified, hidden, avoided, undesired, or suppressed unconventional turn-on that drives behavior (being attracted to a different body-type, turn-ons related to risk, danger, or breaking taboos for example).
Existential concerns (facing loss, aging, death, loneliness, taking responsibility for our life choices (especially the mistakes), coming to terms with unsatisfying relationships, resolving boredom, finding new dreams when old dreams may not come to fruition, and more)
Relationship concerns: desire mismatch, unsatisfying partner sex, unhappiness in the relationship
Dr. Minten is trained in mental health, clinical sexology, and addiction treatment. In her treatment process you will receive an assessment to determine underlying concerns. Individual treatment plans, depending on your needs, may be a mix of interventions such as motivational interviewing, DBT, EMDR, existential, insight-oriented, family/relationship therapy. When relevant, a referral to a psychiatrist for medication could be adjunct therapy. A strong focus on emotions, which drive behavior, will be a core aspect of treatment. Often additional sexual and mental health concerns co-exist with hypersexuality, and these additional sexual and mental health concerns will be treated as well. Our therapy is based on a definition of sexual health that acknowledges the fragility and diversity inherent in human sexuality.
Sexual health is a state of physical, mental and social well-being in relation to sexuality. It requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence.
-World Health Organization
At New Leaf we view sex and erotic health as a fundamental, beneficial, and critical aspect of human life.
Sex is not just about performance. Though sex therapists readily work with concerns related to desire, arousal, orgasm, and other performance issues, sex therapy embraces a view of sex as part of human nature, a mixture of pleasure and connection, and performance is not the ultimate goal for all sex therapy clients. We consider goals such as sexual empathy, sexual sense of humor, self-acceptance, capacity to navigate inevitable ups and downs in performance, a deeper understanding of one's erotic map and how to use this map to experience pleasure even when pleasure is not from "typical" experiences or responses, tools to navigate self-criticism and shame, pleasure and touch that are not focused on orgasm as a goal, accepting aging and the changes to our lives and our bodies, connecting with our erotic and sexual nature in new and playful ways, improving authenticity and communication, and more.
We provide services for a variety of concerns, including:
A full range of mental health concerns (anxiety, trauma, depression and more)
Enjoying sex with the body we have
Resolving conflict about sexual behavior in relationships
Recovering sexual health from trauma, neglect, or abuse (physical, sexual, emotional)
Help for concerns related to pain during sex and sex play
Impulsive or compulsive masturbation
Compulsive or impulsive sexual behavior/hypersexuality(sometimes referred to as "sex addiction" in common language - see more below)
Kink/BDSM/Fetish etc. sexual and relationship health
Exploring sexual orientation (LGBTQIAP)
Relationship and sexual health in polyamorous relationships
Relationship and sexual health in swing and open relationships
Relationship and sexual health in other consensual non-monogamy arrangments
Relationship health for lesbian, gay, bisexual, asexual, pansexual, kink, and other sexual orientations
Relationship and sexual health for non-binary gender, transgender, genderqueer, intersex, women, men and other gender and sex identities and bodies
Performance concerns such as premature ejaculation/fast orgasm, inability to orgasm, delayed orgasms, concerns with arousal (keeping an erection or sustaining arousal)
Deepening intimacy and connection during sexual and erotic encounters
Deepening pleasure and playfulness/spontaneity during sexual encounters
Finding sexual and erotic health in recovery from substance abuse concerns
Finding sexual health and erotic intimacy with mental or physical health concerns
Exploring, understanding, and finding healthy ways to work with one's erotic map
Developing skills to have satisfying sexual relationships
Assisting couples in talking about sex and improving sexual communication
Recovering intimacy after an affair
Sex after cancer
Sex for differently able-bodied
Examining values and choices in one's sexual and relational life
Working through avoidance concerns
Challenging "turn-ons" that interfere with life (being attracted to someone or something that interferes with life activities or sense of self/integrity)
Increasing sexual empathy for increased pleasure and connection
Reconnecting sexually before, during, and after childbirth or bringing children into one's home (adoption, caring for children in a family system, etc.)
In addition to sexual health concerns, we provide support for gender health: exploring gender identity, supporting medical steps to transition, and more.
Sex therapy utilizes many disciplines to assist with sexual health concerns - medical, anthropological/sociological/cultural, psychological, spiritual, and historical. Thus board certification, which includes coursework and supervision along with continuing education requirements, allows clinicians to assist with sexual and erotic health concerns from a broad base of knowledge and experience. Challenging typical but inaccurate and unhelpful advice and our culture's deeply ingrained myths and beliefs about sex is critical to sexual health. Human sexuality is essentially variable and vulnerable - quite different that portrayed by media and other common sources of information. Good sex is not necessarily "typical" sex or the sex we often see in movies, TV, etc. Good sex is not about what "men" and "women" want. Good sex is personal, based on the individuals involved, and may not be ordinary or typical in any sense or may be in every sense. An orgasm from a foot massage is still an orgasm, and may be more pleasurable to the person.
One would expect that millions of years of evolution produced a very reliable human reproductive system with build-in redundancies, resulting in a robust sex drive, unfailing physiological mechanisms, and simple, consistent patterns of reproductive behavior and responsiveness...
In reality, however, humans exhibit an enormous variety of sexual behaviors and preferences, while population studies reveal a surprisingly high prevalence of sexual problems and dysfunctions. Clearly, human sexuality appears to be characterized by diversity and fragility rather than by evolutionary conformity and sturdiness.
(Verhulst & Reynolds, 2009, p. 320)
It’s no longer enough to grab a bite then go home and do a little shagging. Today, we have to understand why we do this, why our partner does this, how we can do it longer, more artfully, and more frequently, and why we are not doing it in with someone in a higher income bracket. As a result we mostly wind up doing it with ourselves.
We’ve been entered against our will in some sort of sexual Olympics, when all we ever wanted was a three-legged race at the company picnic.