I recently came across an article on sex addiction by therapist Dr. Marty Klein. Sex addiction is a tricky topic in the therapeutic world. There is no current standardized definition of what sexual addiction is, nor is sexual addiction included in the American Psychological Association’s Diagnostic and Statistical Manual of Mental Disorders. There is very limited research being conducted on the topic, and no statistically significant findings to date. There are no criteria for diagnosing sexual addiction. As Dr. Klein explains, the most well-known diagnostic test for sexual addiction is the Sexual Addiction Screening Test (SAST). The test is loaded with problematic questions that a great deal of the population would answer “yes” to. The history of sexual addiction is interesting as well; it was not a product of the sex therapy field, but rather conceptualized by an organizational psychologist with no training in human sexuality. While I disagree with Dr. Klein’s assertion that sex addiction’s dubious history means that it is not a true condition, it is clear that we need a much better understanding of sex addiction in order to help those who believe they are suffering from this affliction.

Dr. Klein claims that in his decades of practice, he has never seen a true case of sex addiction. Instead, he makes the distinction between addiction and choicefulness, arguing that those who claim to be sex addicts do not actually have problems restraining themselves from sex, but rather, have difficulties dealing with the consequences of their sexual decisions. Dr. Klein writes, “New patients tell me all the time how they can’t keep from doing self-destructive sexual things; still, I see no sex addiction. Instead, I see people regretting the sexual choices they make, often denying that these are decisions… someone who is unhappy with the consequences of their sexual choices, but who finds it too emotionally painful to make different choices.” Dr. Klein’s statements feed into a larger conversation of what addiction means, exactly. What is the true distinction between impulse and addiction? Does it matter if there is a genetic or biological component? What roles do regret and shame play? What’s the difference between feeling out of control and being out of control?

While I do believe that the human sexuality field needs to put more resources into better understanding sex addiction, I also get interested in how people describe their issues with their sexuality. Do they use the words sex addict, or do they say they have problems with sexual impulsivity? Do they feel unable to resist engaging in sexual activity, or do they focus more on the consequences of their actions? Is that person more inclined to use the words “sex addict” if they feel ashamed of the specific sexual behaviors they are engaging in? What does the person think their sex life will look like once they have “recovered”?

Do you think you’re a sex addict? Do you struggle with the consequences of your sexual decisions? Do you feel ashamed of your sex life? Do you find yourself wondering what is “normal” and what is not? Call (415) 658-5738 or visit my Appointments page to set up a consultation.