Yes, Sexual Addiction Is Real

sex-addiction-realI recently came across two separate online posts stating that sex addiction was not a “true” addiction and should not be treated as such. Both pieces cited a recent UCLA study that compared the brainwaves of drug addicts to the brainwaves of “sex addicts” when both groups are exposed to images of their drugs of choice. The men and women conducting the study found that the brain responds differently to images of drugs than it does to images of sex. With the drug addicts there is increased brain activity, while “sex addicts” showed decreased brain activity.

I write “sex addicts” in quotes because it was the study’s conclusion that, because the brain responds differently to images of drugs than it does to images of sex, then sex addiction is a fallacy and the millions of men and women struggling to control their sexual behavior should not receive treatment similar to addicts but more similar to someone who struggles with biting his or her fingernails or twitching.

Before I move on I just want to point out a significant difference between exposing a drug addict to images of their drug of choice—cocaine, heroin, crack—and exposing a sex addict to images of his or her drug of choice—people having sex. I have yet to meet a cocaine addict who sniffs pictures, whereas I have met hundreds of men and women who masturbate compulsively to them.

Perhaps you can gather my own bias in writing this. I am a therapist and writer who helps people who come to the Faith and Sex Center deal with the effects of their compulsive sexual behavior and provides knowledge and support for overcoming addiction.

That’s what I do all week: work with men and women whose lives have been upturned or destroyed by sexual behavior.

Sexual addiction is not a fad like red velvet cupcakes. (Tweet This!)
This is a problem.
A clinical and social problem.

While I do not doubt the validity of the data gained from this study, I doubt the conclusions that have been drawn. If thousands of therapists offices are filling up daily with men and women who cannot control their sexual behavior, and if this behavior closely resembles addiction, then it’s addiction.*

That said, I was intrigued by some of the data that the study presents. Chiefly, I was intrigued by the notion that the brain waves of individuals who struggle with controlling their behavior with sexual material decreased when exposed to sexual images. As the press release accompanying the announcement of the study notes, “One would expect the brain to show high rates of activity when shown sexual images. In this study, a reverse effect was shown.”

Rather than discounting sex addiction as addiction, this data in fact supports it. I base this not only on much of the clinical experience I have had over the years but primarily on a great deal of the research I have read. Most sex addicts don’t want to be stimulated. If anything, they wish the opposite. They are trying to avoid a state of hyper-arousal, of emotional dysregulation. They want exactly what the UCLA study states is occurring in their brains when they look at sexual material—disengagement, numbness, hypo instead of hyper-arousal.

The other day I was leading group therapy at a drug and alcohol rehab. I show up there every Monday to work with clients regarding sexual behavior. Most of the clients are in their early twenties and every one of them uses pornography compulsively. At one point I asked, “Raise your hand if you prefer the feeling before and during orgasm.” A few hands went up. “Now raise your hand if you prefer the feeling after you have an orgasm.” Different hands went up. I then asked them what their drugs of choice were. The first group all said either gambling or amphetamines, i.e. uppers. The second group all said OxyContin or heroin, i.e. downers.

 It was very clear that different people are looking for different effects when using pornography (Tweet This!), and for many of them it is to achieve the exact state of mind that the UCLA study suggests is not akin to addiction. People do not use substances of abuse solely to be stimulated. A large percentage of addicts, especially late adolescents, use substances of abuse to completely check out. A recent Los Angeles Times article details the epidemic of heroin use by men and women in their teens and early twenties. I wonder how much pornography use, especially at a young age, plays a role in this epidemic. If porn use decreases brain activity, wouldn’t Oxycontin and heroin use be a next logical step in the regulation of emotions?

As I noted, this conclusion isn’t just based on my observations. There is plenty of research on this topic (I included a short list at the end of this post), research that explores the connection between childhood neglect and later sexual addiction. The sum total of these findings suggest that if a child is neglected, they must self-soothe; this self-soothing usually takes the form of dissociation, or checking out. What goes on in their brains is very much akin to the decrease in brain activity found in the UCLA study. As researcher and sex addiction therapist Alexandra Katehakis writes, “Habituation of the brain to the opioid-releasing state of dissociation as its ‘default mode’ of affect regulation predisposes the individual to addictive behaviors, including sexual addiction” (p. 7).

Again, the UCLA study offers some wonderful insight into how certain portions of the brain respond when exposed to sexual material; however, to draw the conclusion that a set of very real and observable behavior—that is, sexual addiction—isn’t what it is because only one small component of its functioning is different from other forms of addiction is not just fallacious; I believe it is irresponsible and, in the case of the lead author of this study, self-serving.

Yes, sexual addiction is real. And yes, there’s always real hope for the addict. (Tweet This!)

*Yes, I have my own bias in this discussion, but so too does the lead author of the UCLA study. Nicole Prause, PhD is the founder of Liberos, LLC, a consulting firm that provides expert testimony discounting “sex addiction” as a defense in legal proceedings. Dr. Prause benefits from discounting sex addiction. So too do insurance companies. If sex addiction isn’t addiction then they don’t have to pay for treatment.



Guigliamo, J. (2006). Out of control sexual behavior: a qualitative investigation. Sexual Addiction & Compulsivity, 13(4), 361-375.

Gunnar, M. R., Morison, S. J., Chisholm, K., & Schuder, M. (2001). Salivary cortisol levels in children adopted from Romanian orphanages. Development and Psychopathology, 13, 611–628.

Hagedorn, W. B. (2009). Sexual Addiction Counseling Competencies: Empirically-Based Tools for Preparing Clinicians to Recognize, Assess, and Treat Sexual Addiction. Sexual Addiction & Compulsivity, 16(3), 190-209.

Katehakis, Alexandra. Affective neuroscience and the treatment of sexual addiction. Sexual Addiction & Compulsivity 16:1 (2009): 1-31.

Nada-Raja, S. (2010). Perceived “Out of Control” Sexual Behavior in a Cohort of Young Adults from the Dunedin Multidisciplinary Health and Development Study. Archives of Sexual Behavior, 39(4), 968-978.

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