June 8, 2021

Diagnosing Sexual Addiction: Are You a Sex Addict?

With all addictions, a period of assessing the symptoms of the illness is usually part of Sex Addiction Recovery.

Below are the parameters of sexual addiction copied from the Sexual Addiction Screening Test by Patrick Carnes, the “granddaddy” of sexual addiction and author of “Out of the Shadows: Overcoming Sex Addiction”.

If at least three of these criteria are met, it is likely that you have the diagnosis of Sexual Addiction. Some of my clients have identified as many as seven of the criteria. See how you fare.

  • Recurrent failure to resist impulses to engage in specific sexual behavior.
  • Frequent engaging in those behaviors to a greater extent or over a longer period of time than intended.
  • Persistent desire or unsuccessful efforts to stop, reduce, or control those behaviors;
  • Inordinate amount of time spent in obtaining sex, being sexual or recovering from a sexual experience.
  • Preoccupation with behavior or preparatory activities.
  • Frequent engaging in the behavior when expected to fulfill occupational, academic, domestic c or social obligation.
  • Continuation of the behavior despite knowledge of having a persistent or recurrent social, financial, psychological, or physical problem that is caused or exacerbated by the behavior.
  • Need to increase the intensity, frequency, number, or risk of behaviors to achieve the desired effect, or diminished effect with continued behaviors at the same level of intensity, frequency, number or risk.
  • Giving up or limiting social, occupational, or recreational activities because of the behavior.
  • Distress, anxiety, restlessness, or irritability if unable to engage in the behavior. This is especially true for pornography addiction and sadomasochistic addiction to dominatrixes.
  • Ineffective efforts to stop, reduce or control those behaviors.
  • Inability to resist the impulse to engage in a specific sexual behavior (whether in “vanilla” sex addiction, fetishism, sadomasochism, exhibitionism or crossdressing).
  • Distress, anxiety or irritability because of actual sexual contact or potential sexual contact.

Typical of the diagnosis is binge-purge conditions. Here are the criteria that I use in my practice:

  • Intense pleasure at the time of sexual acting out followed by despair and shame at having done something that you had vowed not to do again
  • Periods of times when all sexual behavior and interest cease
  • Especially with fetishistic cross-dressers, a pattern of bingeing and buying clothes followed by remorse about acting out and the destruction of the female wardrobe, followed by the acquisition of another, new wardrobe. It’s a vicious cycle.
  • Sexual excess in some ways but, at the same time, completely nonsexual in other ways
  • Sexual binge-purge patterns with your life-partner.

Considering all the above factors should give you and your sex addiction therapist a guideline for how strong your addiction is.

As time is accumulated in sexual addiction recovery, your denial of the extent and magnitude of your sex addiction (or sexual compulsion) becomes clearer and clearer.

This can be a painful part of your recovery journey, but breaking the denial of the damage your sexual acting out has caused you and the people who care about you is indispensable for your getting free of the chains of sexual compulsion.