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.