Maryland Bar Bulletin
Publications : Bar Bulletin : March 2014


Self Help Groups Available


  • Dr. Carnes, Out of the Shadows: Understanding Sexual Addiction.
  • Robert Weiss. LCSW, CAS and Jennifer Schneider, MD, PhD, Untangling the Web - Sex, Porn, and Fantasy Obsession in the Internet Age.

According to Dr. Patrick Carnes, the founder of the International Institute for Trauma and Addiction Professionals, sexual addiction is defined as any sexually related compulsive behavior which interferes with normal living and causes severe stress on family, friends, loved ones, or one’s work environment.

Sexual addiction is sometimes referred to as sexual dependency or sexual compulsivity. By any name it is a compulsive behavior that completely dominates the addict’s life. Sexual addicts make sex a priority, making it more important than family, friends and work. Sex becomes the organizing principle of addicts’ lives. They are willing to sacrifice what they cherish most in order to preserve and continue their unhealthy behavior.

Background Information

  • It is estimated that three to six percent of the U.S. population suffer from sexual addiction. That’s about 17 to 37 million people
  • Although it has traditionally been considered a middle aged male dominant addiction, females now represent more than 20 percent of the affected population.
  • Sex addiction does not discriminate. It crosses all educational, socioeconomic, racial, and sexual-orientation lines, but one commonality among addicts is a sense of shame.
  • There has been progress in the medical field, which includes sexual addiction being diagnosed as a disorder and having treatment options available.
  • In the past ten years treatment options have gone from fewer than 100 therapists to more than 1,500 with treatment centers specializing in sexual addiction.

What Causes Sexual Addiction?

Sexual addiction, just like any addiction, is very complex. It is thought that a combination of factors including biochemical abnormality, or other brain changes, family history, and abuse increase risk. Dr. Carnes reports that sexual addicts typically come from severely dysfunctional families. Usually at least one other member of these families has another addiction (87 percent). Another study showed that 82 percent of sex addicts report being abused. Dr. Carnes found that 42 percent of sex addicts also were dependent on alcohol or drugs, and 38 percent had eating disorders.

Like any addiction, such as food, drugs, or alcohol, sex addiction changes brain chemistry and provides a “high” that the addict is dependent on to manage their life. The sexual addict becomes dependant on the “high” to feel normal. They use sexual activity to seek pleasure, temporarily manage their feelings, as well as to manage outside stressors such as work or interpersonal difficulties. They use unhealthy relationships and sexual behavior as a quick and temporary way to feel better. As the illness progresses, like the alcoholic needs more alcohol, the sexual addict acts out more sexually, with more intense and riskier behaviors to seek the same “high”.

The progression of sexual addiction is the same as any addiction. The sexual addict is unable to control their behaviors. They may feel shame, isolation, or despair, which causes them to seek out sexual behaviors even more to escape these feelings. This destructive cycle leads to being powerless over their addiction and their lives.

How is a Sexual Addiction Diagnosed?

A diagnosis for sexual addiction should always be made by a mental health professional. The following is a combined list of behavior patterns provided by Dr. Carnes and criteria adapted based on chemical dependency information that may indicate a sexual addiction. If you or anyone you care about can identify with these patterns you should seek professional help.

  • Acting out: a pattern of out-of-control sexual behavior.
  • Experiencing severe consequences due to sexual behavior, and an inability to stop despite   these adverse consequences such as broken relationships, problems at work, or potential health risks.
  • Being preoccupied with or persistently craving sex; wanting to cut down and unsuccessfully attempting to limit sexual activity.
  • Persistent pursuit of self-destructive behavior: Spending considerable time in activities related to sex, such as cruising for partners or spending hours online visiting pornographic Web Sites.
  • Ongoing desire or effort to limit sexual behavior.
  • Sexual obsession and fantasy as a primary coping strategy.
  • Regularly increasing the frequency of sexual experience because the current level of activity is no longer sufficiently satisfying, such as more frequent visits to prostitutes, excessive masturbation or more sex partners.
  • Severe mood changes related to sexual activity.
  • Feeling irritable when unable to engage in the desired behavior.
  • Inordinate amounts of time spent obtaining sex, being sexual, and recovering from sexual experiences.
  • Neglect of important social, occupational, or recreational activities because of sexual behaviors.
  • Thinking of sex to the detriment of other activities or continually engaging in excessive sexual practices despite a desire to stop. 

Sex Addiction and the Internet

Searching the web for porn does not make someone a sex addict, although the ability to access the Internet so easily and from many devices has sexualized people in ways not previously possible, and allows individuals easy and fast access to sexual sites. Many of these sites are not only easy to access, but are also free. According to the watchdog Internet Filter Software Review, more than 40 million people in the U.S. access more than four million porn sites. Individuals who may not have accessed porn in the past, because it was more difficult to obtain, are now easily able to access it and some are finding themselves having a sexual addiction. 

Treatment for Sexual Addiction

There are many options for treatment for sexual addiction including inpatient, outpatient, aftercare support, and self help groups. Treatment is also available for family members including education, counseling, and support groups. Addiction is a family disease, and it is important for the family and the addict to understand how the addiction affects everyone to get well. Unlike the alcoholic or addict where recovery involves abstinence the goal for the sexual addict’s recovery is to be led back to a healthy sex life. The sex addict’s recovery is similar to someone suffering with an eating disorder learning to eat healthy.

LAP offers free, confidential counseling. Jim Quinn, LAP Director, can be reached at (443) 703-3041 or  Lisa Caplan, Program Counselor, can be reached at (443) 703-3042 or

Lisa Caplan, LCSW-C, CAC, is Program Counselor for the MSBA Lawyer Assistance Program.

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Publications : Bar Bulletin : March 2014

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