Sex addict.  Those two words conjure up an image of a wild-eyed man hell-bent on getting his sexual needs met, cheating on his wife, and exploiting other women.  Nothing can stop him in his search for the ultimate sex high.  Like an alcoholic on a bender, the sex addict has no control over himself or his urges.  His need for sex grows without limit.  He can never be sated.  He must have sex or his body will cry out with need.

Really?  That’s not what I see.  When a so-called sex addict comes into my practice, I usually have before me a man who:

• Was exposed to pornography at a young age

• Learned to cope with many adolescent challenges by looking at porn
• Used porn to “self-medicate” stress, anxiety, and depression
• Has difficulty sustaining an intimate connection with his partner
• Doesn’t readily share what will turn him on
• If not yet partnered, may have social anxiety or feel unlovable
• Has a partner that doesn’t understand his sexual needs
• May have been sexually abused and is now trying to figure out how sex is supposed to work
• Is confused by his own secretive nature about sex
• May use porn to satisfy a need for sexual arousal that his partner doesn’t understand

My preferred label, if one must used, is “problematic sexual behavior.”  Usually, what makes the sexual behavior a problem is that it interferes with a person’s relationships or ability to function in other ways.

A man that pays a prostitute instead of talking to his partner about his real sexual needs is avoiding conflict or embarrassment.  If the secret behavior is revealed, the focus is on the fact that he had sex with another woman, and not on other, perhaps deeper problems that may exist.  A man that works at home and misses calls while looking on the computer may be underachieving at work; why is that?  A man that never dates despite his desire for companionship and hides behind his computer screen has another type of problem.

As a psychologist and AASECT-certified sex therapisty approach to treating problematic sexual behavior is unique to each individual.  I don’t sell a fancy program or follow a set course of therapy.  I want to work with someone to understand what function pornography or other types of sexual behavior serve in their life.  When do they look at porn?  What is the trigger?  What do they gain?  Lose?  If they weren’t looking at porn, what might they be doing instead that would make them feel better about themselves?  How is affecting their relationship, if they are in one?  If not in one, is using pornography holding them back?  If so, how?

Who comes in for help with problematic sexual behaviors?  All kinds of people, from high-powered executives to students, from newly weds to men in their 70s, from atheists to pastors.  Often they come in alone, forced by their partner.   For all of them, my goal is a better understanding of one’s sexual behaviors, one’s intimate needs, one’s relationships, and one’s choices when it comes to pursuing pleasure of all types.  If possible, I want to meet with the partner so that they can be part of the process of learning about sexual health, as well as help them process any feelings of anger, hurt, or betrayal.

If you have given yourself the label of “sex addict,” I’d ask you to look behind those words and give yourself the opportunity to learn how to get more of what you really need to be happy, without hurting yourself or your partner in the process.

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