As a licensed Marriage and Family Therapist, I have worked primarily with children, families, and couples. Though I have worked with clients suffering from addiction, I have yet to work with a client who identifies as a sex addict. There is a lot of shame around any type of addiction, but sex addiction in the American culture is regarded particularly poorly.
Working with a therapist certified as a sex addiction therapist is imperative to treating sex addiction. As you will learn throughout this article, there is special training and education required to become a CSAT, creating more successful treatment opportunities for sex addiction.
What is a CSAT
Certified Sexual Addiction Therapists are licensed mental health therapists, who in addition to their standard training, are also certified to treat sexual addiction. CSATs must have a Master’s degree in the mental health field such as counseling, psychology, social work, or marriage and family therapy. Therapists must be licensed and also have at least five years of clinical experience.
Once therapists have met these criteria, they can then apply for certification as sexual addiction therapists. Once their application is approved, they must complete four educational modules about sexual addiction. To keep their certification relevant, therapists must complete continuing education hours in the field of sexual addiction every two years.
Where can I find a CSAT Therapist near me?
Depending on where you live, finding a specialized therapist such as a CSAT may be challenging. Psychology Today provides a list of therapists, listed geographically, to help you determine if there is a therapist available in your area. They also list the therapists’ bio, their certifications, if they have a waiting list to see clients, and how much they charge for sessions. Sessions on average are about $150 per session.
Sexual addiction can be a difficult topic for some people to discuss and therefore online counseling may be a preferred form of treatment. At Regain.us, there are several CSATs to choose from and there are no waitlists. Counseling at Regain is affordable at only $60-$90 per week, making it much more accessible than traditional counseling costs.
This online platform allows for anonymity and confidentiality from the comfort of your own home. You can choose your counselor by reading bios and reviews from other clients, helping you find a better fit faster than traditional methods of selecting a therapist.
How do I know if I am a sex addict
It is important to note, the Diagnostic Statistical Manual of Mental Health Disorders, a textbook of guidelines for clinicians to diagnose mental health disorders, does not list compulsive sexual behavior (also referred to as sexual addiction) as a disorder.
However, the World Health Organization does recognize compulsive sexual behavior as a disorder in their International Classification of Diseases list (ICD-11). The ICD defines compulsive sexual behavior disorder as “a persistent pattern of failure to control intense, repetitive sexual impulses or urges resulting in repetitive sexual behavior. This behavior becomes a central focus of the person’s life to the point of neglecting health and personal care or other interests, activities, and responsibilities.” (Christensen, 2018)
Sexual addiction is not about promiscuity or how many sexual partners one has, nor is it about the quantity of sex or masturbation. The key element to determining if a person is a sex addict, is the negative ramifications the behavior is having in the person’s life, relationships, at work, and on their overall emotional well-being. Sexual addiction is considered problematic if the behavior has occurred over a duration of time, such as six months or more. Sexual addiction can include masturbation, sex-chatting online, watching pornography, and other sexual acts which don’t require another person to be physically present.
The person experiencing the sexual addiction has tried to change their behavior but is unsuccessful. They may have feelings of guilt, shame, embarrassment, and distress. They may also have experienced negative consequences of their behavior beyond the psycho-social aspects, such as getting an STD (sexually transmitted disease) or being arrested for engaging in criminal behavior.
Signs of a sexual addiction
- Engaging in risky sexual behavior such as not using protection with multiple people
- A pattern of cheating on partners despite wanting to be monogamous
- Criminal behavior such as exposing your genitals to another person without their consent
- Watching pornography excessively to the point it’s having negative consequences on your life
- Compulsive masturbation, feeling out-of-control urges to masturbate
- Numerous failed attempts to cease negative sexual behaviors
- Consumed by thoughts of sex to the point your daily life is impacted negatively
- Spending excessive amounts of money on sexual activities
- Feeling deep distress when you can’t engage in sexual activities and behaviors
- Lying a lot to participate in sexual behavior
Is sexual addiction like having a drug addiction
Though there is debate amongst clinicians and researchers about the definitions of sexual addiction and whether or not it should be classified with other addictions, there are many similarities.
Like most addictions, sexual addiction can have a major negative impact on one’s life. The person experiencing the addiction feels out of control. They may want to stop their behavior but can’t.
In this way, sexual addiction is very similar to being addicted to substances. There are 12-step programs for people who identify as sex addicts. Some therapists may even recommend attending one of these groups as an adjunct to therapy.
What Causes Sexual Addiction
There still needs to be more research conducted in the field of sexual addiction to determine the causes of sex addiction. Thus far, there does appear to be a biological component, such as brain chemistry imbalances. Sex and sexual activities tend to result in a physiological positive sensation and a release of dopamine.
Dopamine is a brain chemical generating feelings of happiness, warmth, euphoria, and contentment. The release of dopamine can feel like a “high” and therefore can be a motivating factor to seek out behavior resulting in this “rush.”
There is some evidence that suggests elevated hormones can play a role in sexual addiction. A small study was published in the Endocrine Society’s Journal of Clinical Endocrinology and Metabolism. They found that men who were sex addicts had higher levels of the hormone oxytocin. (Society, 2022)
There is also evidence and research demonstrating that those who have experienced head trauma may have an increased risk for sexual addiction. We know the frontal lobe of the brain is responsible for controlling impulses. When this area of the brain gets damaged, people with frontal lobe injuries may not be able to suppress their impulses, in some cases, leading to sexually compulsive behavior.
There are also other areas of the brain that can be traumatized and this trauma can lead to sexually compulsive behavior. “Involvement of deep hemispheric structures including the pituitary gland, amygdala, thalamus, and hypothalamus can lead to disruption of normal hormonal mechanisms and disinhibition of behavior.” (Essien, 2008)
Healing from sexual addiction
The first step to ending a sexual addiction is realizing you need help. Most addictions require the help and support of others. Rarely are addictions treated successfully individually. Sexual addiction treatment works best with the help of a therapist, specifically a certified sexual addiction therapist.
Cognitive behavior therapy
Cognitive behavior therapy (CBT) is used with many clients for a variety of reasons and is often a preferred modality for treating compulsive sexual behavior. The therapist will work with the client to learn about their thoughts and behaviors related to their compulsions. Once those thoughts and behaviors are identified, the therapist and client will then work together to determine if those thoughts and behavior are serving the client or are detrimental to the client. Together they would then work on challenging those thoughts and behaviors and developing more adaptive positive thoughts and behaviors.
Coping and Support
Feeling as though you are the only one experiencing this addiction can lead to feelings of poor self-worth. It is helpful to learn about others going through this process and how recovery works for them. It may be helpful to join a sex addicts support group to learn more. For those not ready to take that step or for those who prefer more anonymity, there are many books and articles about sexual addiction to help you learn more.
Managing stress is important for everybody regardless of whether we are sexually compulsive or not. Managing your stress is imperative to a healthy life, both emotionally and physically. Yoga, meditation, walking in nature, swimming, and many other activities can provide stress relief to support you during and after your recovery.
You and your therapist will collaboratively devise a treatment plan to follow. This plan might include cutting off triggers that lead to compulsive behavior. For instance, part of your treatment plan may include discontinuing watching pornography or ceasing visits to sex-chat sites.
Recovery is possible, many people who are in recovery lead very happy lives and are grateful for a “new” beginning. Growth is rarely linear, and relapse tends to be part of recovery. Be patient with yourself and rely on your support system to help you through these difficult times.
Support is available
If you are reading this article because someone you know or love is a sex addict, there is help available for significant others as well. Certified sexual addiction therapists are also trained to support those affected by others’ sexual addiction. They are well versed in how this type of addiction can affect family systems and relationships.
You may see a CSAT with your partner or as an individual. Whether you are seeking treatment for yourself or as a significant other, be proud of yourself for taking this very important step to recovery. Recovery is possible with support.