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"As a licensed professional counselor and a marriage and family therapist, I had run into the issue of sexual addiction several times. Up to about 18 months ago, I under treated the men who saw me in regard to this issue. Even though I had started an accountability group for men with sexual addiction almost 7 years ago, I really didn't understand how it was truly an addiction. Then I began to read books by Patrick Carnes and Mark Laaser. As couples began to visit me for counseling I began to ask questions about pornography or other signs of possible addictive behavior. I was amazed at how many couples had some form of addiction interfering with their marriage.
With the help of Mark Laaser's training program on Sexual Addiction, Freedom Begins Here, I now feel much more equipped to deal with those struggling with sexual addiction. We have, at Amarillo South Church, the only Christ centered sexual addiction group in the area. As I work with men individually, I now have a clear understanding of the addiction and what the process is for recovery. Thank you, Mark, for turning your personal struggles into a great ministry.
The most helpful part of the training was identifying the process needed for recovery and learning about the sexual addiction cycle.
Wib Newton
Licensed Professional Counselor
Marriage and Family Therapist
Amarillo South Church
Amarillo, TX |
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Last month we discussed the characteristics of sexual addiction and how those characteristics are manifested in people’s lives. This month we will begin to look at the diagnostic criteria for sexual addiction and some of the different ways sexual addiction is diagnosed. Some of this material is very clinical, but it is essential in understanding how to determine if someone is truly a sex addict.
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“All sinful behavior is a wrong attempt
at meeting basic needs. The essence of sin is man living independently of God, who has said that He will meet
all of our needs as we live out life in Christ.”
–Neil Anderson, Victory Over the Darkness |
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The diagnostic term “sexual addiction” is not
listed in the current Diagnostic and Statistical Manual (DSM IV) of the American Psychiatric Association. The
goal and likelihood is that the legal diagnosis will be available for licensed practitioners to use by the time
the DSM V is printed. The challenge for those behind the effort has been to formulate a list of criteria or
diagnostic traits that would merit professional diagnosis. Experts in the field have agreed on the following fifteen,
of which five need to be present in a client in order to diagnose sexual addiction.
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1. Sexual obsession and fantasy is a primary coping strategy
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This is often an attempt at healing wounds of loneliness, rejection, alienation, etc. Fantasy allows the person to be in control by changing feelings through escaping painful reality and creating desired outcome.
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2. Sexual behavior is central organizing principle of daily life
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Some addicts make their sexual desires the priority and focal point of their day, often placing them above work or family responsibilities. Some may even make career and home-location choices based on what will best meet these desires.
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3. Inordinate amounts of time spent in obtaining sex, being sexual, or recovering from sexual experience
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This includes time spent in fantasy, planning, pursuing, acting out, covering up, combating negative emotions and dealing with consequences. The addict often has little awareness of time when engaged in behavior, and therefore daily productivity suffers. |
4. Amount, extent, or duration of sexual behavior often exceeds what person intended
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An individual may log on to the Internet with the intent of reading the news for ten minutes and end up spending two hours viewing pornography sites. |
5. Severe mood shifts around sexual acting out
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Sexual addiction can almost be seen as a small form of manic depression because of the extreme highs and lows the addict may face.
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6. Withdrawal phases |
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Often there are escalating patterns of activity with intermittent phases of withdrawal, during which the addict may not be sexual at all. |
7. Persistent pursuit of self-destructive or high-risk sexual behavior |
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The presence of adrenaline may be a necessary component or enhancement to the sexual high. |
8. Persistent desire or efforts to limit sexual behavior |
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This is especially the case for Christians. Multiple attempts to overcome have failed. Many have tried accountability, prayer, bible study, fasting or Promise Keepers—and perhaps for a time experienced victory—but many return back to behavior and sink in failure. It is important to realize their need is much deeper than what simple answers, easy formulas, or Christian clichés can offer. |
9. Inability to stop despite adverse consequences |
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There are several far-reaching consequences to sexually acting out, however these do not compel addict to end behavior. Many addicts disassociate, forming a mindset that says, “I’ll deal with the consequences later.” Some simply are in denial of the consequences. |
10. Pattern of out-of-control (compulsive) sexual behavior for two years |
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Sexual sin and sexual addiction are not the same. It is one thing to engage in sexual sin, but if the behavior is not ongoing or out-of-control over time, it is not an addiction. (Note: With the Internet phenomenon of compressing time, the standard period it takes for the development of an addiction to Internet pornography is dramatically reduced to two months.) |
11. Pattern of alternating excessive control and out-of-control behavior for over five years |
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Some people go back and forth between sexual abstinence and sexual bingeing for years. 89% of addicts have reported to regularly bingeing to the point of exhaustion. |
12. Severe consequences due to sexual behavior |
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The possibilities of consequences are endless. It can be an eye-opening exercise for the client to list the consequences he has faced. |
13. Hierarchy of sexual acting out behaviors |
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This is the mindset that not all sexual behaviors are the same; some are worse than others. The Christian addict often ignores God’s standard that all sin is an abomination and inserts his own standard of varying degrees of sin. This is a means of justifying certain behaviors. For example, “Pornography and masturbation are okay as long as I don’t have an affair.” |
14. Important social, occupational or recreational activities sacrificed or reduced because of sexual behavior |
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For so many, sexual addiction is all-consuming. It requires addicts to give up time with their family, time at work, or time in their ministries for the sake of the addiction. Doesn’t that sound like the enemy’s work? |
15. Presence of any three or more of the following associated conditions: |
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A) Extreme social shame
B) Depression
C) Presence of other addictions
D) Has been or is currently a victim of abuse
E) Leading a double life
F) Sexualizing of nurture – Sex=Love
G) Has few or no non-sexual relationships
H) Suicidal ideation or attempt
I) Presence of sex-negative behavior
J) Denial
K) Intimacy disorder – codependent behaviors/approval disorder
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Although “sexual addiction” is not found in the current DSM, there is a list of related behaviors—both common and infrequent—that can be used as a reference and for practical, legal and insurance purposes in dealings with other professionals.
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Common Diagnoses
• Paraphilias
• Sexual Disorder NOS (not otherwise specified)
• Impulse Control Disorder NOS
• Bipolar Disorder or Cyclothymia
• Post Traumatic Stress Disorder (PTSD)
• Adjustment Disorder
Infrequent Diagnoses
• Anxiety or Mood Disorders
• Dissociative Identity Disorder
• Delusional Disorder
• Obsessive-Compulsive Disorder
• Gender Identity Disorder
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| Next month we will begin to discuss types of sexual behavior and the three levels of sexual acting out. We will also introduce the Sexual Addiction Cycle. To fully equip yourself, please consider ordering a Free DVD Demo of
Freedom Begins Here: Diagnosis and Treatment of Sexual Addiction.
We want to help you bring freedom to those who are suffering from the stronghold of sexual addiction. |
