What causes sex addiction?

5 June 2023

This is an issue that I've seen increasingly in my practice in recent years. Firstly, what is sex addiction? Although some people see it as an invented category used by Hollywood stars to justify their behaviour, for those suffering from it sex addiction is very much a reality.

And it's a reality that can cause them, and their partner if they have one, incredible stress and pain.

It describes any kind of sexual behaviour that feels out of control and is causing problems. This could include watching porn, paying for sex or sexting.

In recent years the understanding of addiction has broadened beyond substances, such as alcohol or drugs, to include mood-altering behaviours or activities, such as gambling and sex. 

Studies of the brain have found that behaviour addiction changes the brain's neural pathways. The addictive behaviour releases pleasurable chemicals that, over time, reduce the pleasure of other, more healthy behaviours, thus strengthening the addiction. The internet has turbocharged this process for some people, particularly when it comes to porn.

Traditionally, the reasons someone becomes a sex addict were seen as down to either early trauma in their life and/or attachment issues in their childhood. By trauma we mean things such as experiencing, or witnessing, physical violence, being a victim of sexual abuse, or some other traumatic event.

'Attachment'  refers to the relationship between a child and their parents or primary caregivers (the person who is the main parental figure for the child).  Attachment problems can include separation from parents or care givers, growing up in a family where one does not feel loved, or having a detached or inconsistent primary care giver.

Where there has been trauma and/or attachment problems, the child will often grow up not feeling good enough inside. This low self-esteem will also impact on the child’s ability to form healthy intimate relationships as an adult. 

In these cases, the individual may learn that some form of sexual behaviour can take away painful feelings temporarily and give them a feeling of being truly ‘alive’. It can also provide an illusion of intimacy, which may be missing in the individual’s normal life. 

Increasingly, however, there are people who get drawn into sex addiction not because of problems in their childhood but because it is so much easier these days to access porn and other sexual services. 

Paula Hall, author of Understanding and Treating Sex Addiction, says: “The reality of the Western world today is that ‘opportunity’ is everywhere and people, with or without a background of trauma and/or attachment difficulties, can now indulge their sexual desires and run the risk of becoming addicted.”

The good news is that psychotherapy, especially with a therapist who is experienced in working with sex addiction, can help. It is important to recognise, however, that the individual may also need to consider some form of group support, such as a 12-step group, or couple therapy. 

It is also important to recognise that making sustainable changes is a long-term process, as it can take three to five years for the brain’s neural pathways to return to normal after an addiction. It is a case of gradually developing internal resources and self-esteem so that one is less dependent on the addiction to manage one's feelings.