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Signs of Sexual Addiction (Based upon Patrick Carnes work)

1. Loss of Control
• Out of control sexual behavior predominates
• The addict cannot control the extent, duration and regularity of his/her
sexual behavior
• Behavior excesses continue despite clear signs of danger (consequences)
-- Compulsive masturbation
-- Compulsive pornography use
-- Chronic affairs
-- Exhibitionism: intrusive "flaunting/showing"
-- Dangerous sexual practices, i.e., asphyxiation
-- Prostitution
-- Anonymous sex (at porn shops, bars, etc.)
-- Voyeurism: intrusive "watching"

2. Continuation Despite Consequences
• Social Consequences
-- Loss of marriage/primary relationship, friendships and social networks
-- Problematic relationships with spouse, family and/or significant others
• Emotional Consequences
-- Depression, anxiety, fear, etc.
-- Suicidal thoughts, plans and/or attempts (70% have thought about it)
• Physical Consequences
-- Injury due to frequency and type of behaviors
-- Sexually-transmitted diseases
-- Unwanted pregnancies or abortions
-- Sleep disturbances
• Legal Consequences
-- Arrests for sexual crimes (voyeurism, lewd conduct, etc.),
-- Loss of job, licensure, and/or professional status
-- Sexual harassment charges
-- Fines, legal fees, probation, or incarceration
-- Being on the Sexual Offender Database
• Financial Consequences
-- Costs of pornography, prostitutes, and phone sex can cause financial hardships
-- Loss of productivity, creativity and/or employment
-- Loss of career opportunities
-- Bankruptcy

3. Efforts to Stop
• Repeated specific attempts to the behavior, which fail
• Even after multiple life changing consequences, the sex addict cannot stop
-- Leads to further frustration, anger, shame and depression (fueling further
episodes of addictive behavior)

4. Loss of Time
• Significant amounts of time lost doing and/or recovering from the behavior

5. Inability to Fulfill Obligations
• The behavior interferes with work, school, family, and friends
• High-risk behavior is continued despite responsibilities and expectations
• A pattern of broken promises and failures

6. Ongoing Desire or Effort to Limit Sexual Behavior
• Repeated but futile attempts to change, limit or stop addictive behavior
• Breaking promises to change, limit or stop behavior
• Cross Addictions: substituting or transferring another addiction to help stop
or control the sexual cravings
-- Workaholism
-- Overeating
-- Alcohol abuse
-- Illegal and prescribed drug abuse
-- Compulsive gambling
-- Religious Addiction
-- Romance addiction

7. Preoccupation (Obsession about or because of behavior)
• Sexual obsession and fantasy as a primary coping strategy
• Elevated levels of arousal are used to cover up feelings
• Sex becomes a primary drug to numb, "medicate" and/or regulate emotions
• Sex is used to block out painful and unpleasant memories
• Euphoric Recall or "Sex in the head" maintains the fix whenever needed
-- Secretive mental images of past sexual acting out, which is used to sexually
act out again
-- Its like having a personal collection of pornography to be used at any time

8. Escalation
• Amounts of behavior increase because the current levels no longer satiate
cravings
-- Higher "dosages" are needed to get the same feeling/excitement.
-- Can cause self injury
• Masturbation to the point of injury
• Asphyxiation
-- Increased levels create victims

9. Severe mood changes around sexual activity
• Depression, anxiety, anger, and other mood/affective states can result from
repeated failures to stop or control the addictive behavior
• 70% described chronic feelings of depression
-- Other chronic mood or affective states include:
• Anxiety
• Guilt and shame
• Anger at self and others
• Hopelessness and despair (monitor suicidal ideations)
-- Mood changes may be "medicated" (hidden) through the use of other drugs or m
medications

10. Compulsive Behavior
• Sexual behavior that you want to stop but you can't
• A pattern of out of control behavior over time
• Sex becomes the organizing principal of daily life
• Everything revolves around it
-- On sexual obsessions and fantasizing
-- On planning next event
-- On sexual acting out (some spend 8 hours a night on the internet)
-- On covering up or making up for lost time
-- Addressing consequences of sexual behavior

11. Losses
• Losing, limiting, or sacrificing valued parts of life
-- Hobbies, family relationships, and work
-- Loss of important personal, social, occupational or recreational activities
-- Loss of friends and family (loss of relationships)
-- Loss of long-term relationships
-- Loss of talents, goals, and personal and professional aspirations

12. Withdrawal
• Stopping behavior causes considerable distress, anxiety, irritability, or
physical discomfort.
• Usually lasts for about 14 days, but can be as long as 10 weeks
-- Insomnia
-- Headaches and/or body aches
-- High or low sexual arousal and/or genital sensitivity
-- Increased appetite for food
-- Chills, sweats, shakes and/or nausea
-- Rapid heartbeat and/or shortness of breath
-- Intrusive dreams
-- High level of anxiety and irritability
-- Emotional lability (roller coaster feelings)
• Some sex addicts with a chemical dependency report that withdrawals are worse
for sex addiction than for drug/alcohol addictions


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