Sex Addiction and Healthy Sexuality

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Recovering from sex addiction can be a challenging process. Overcoming the withdrawal from the addictive behaviours, learning new coping skills, and repairing past damage requires a lot of effort and persistence.

An equally challenging task in recovery is establishing a healthy sexuality. With recovery, one important goal is to establish a healthy sexuality that leads to greater connection with ourselves and others. 

In this article, I will describe the barriers to healthy sexual intimacy in sex addiction, and discuss some components of healthy sexuality.

Challenges to Healthy Sexual Intimacy

Erectile Dysfunction. Addiction to sex, especially internet pornography, can cause erectile dysfunction and delayed ejaculation. Erectile dysfunction occurs with sex addiction as a result of changes in the brain. For more information on erectile dysfunction, visit Gary Wilson’s website.  

Altered arousal template. From an early age, our sexual experiences influence what we find sexually arousing. According to Carnes (2010), the smells, sights, sounds, and images that accompany sexual experiences become encoded on what he calls an arousal template. These elements become etched into our sexual memory and when re-experienced, increase sexual arousal.

When sex addiction develops, arousal templates can be altered to the point where a person’s sexual preferences may conflict with their personal values. This can also include confusion about sexual orientation. One of the main reasons for this is because of tolerance. Most addictions involve the escalation of intensity in order to achieve same effect, and sex addiction is no different. In order to obtain the ‘hit’ or ‘charge’ associated with sex addiction, many people need to increase the intensity of their sexual experiences. That is, they tolerate to the same sexual images or behaviours, find them boring, and look for more exciting opportunities. For example, a straight man may get bored of heterosexual sex and try having sex with another man, or a woman may ask her sexual partner to hurt her during sex.  

When a person with sex addiction has intercourse with their spouse, it may be difficult to become sexually aroused because this experience differs vastly from the person’s current arousal template. Many men and women tell me that they love their partners deeply and yearn for physical intimacy, but their bodies have been conditioned to find other material sexually arousing. 

Insecurities related to sexual inexperience and body image. Many of my clients have reported troubles with romantic relationships starting in adolescence. This lack of romantic success led to frustration and isolation, further escalating their sexual addiction. As my clients reached early adulthood, they felt painfully shy and inadequate around love interests, and used pornography to fill the void.

Further complicating matters was that they felt pressure to live up to unrealistic standards of male prowess as depicted in pornography. Many of my male clients appear anxious and confused about ‘what women want,’ and feel that their physical experience will be judged by others.

Another factor that contributes to low sexual confidence is a lack of emotional and physical nurturance in childhood. It is not uncommon for clients with sex addiction to describe their families as showing little affection. As a result, the person living in this environment may not have learned the social skills necessary to bond to others, and may find sexually addictive behaviours a safer alternative. I have also noticed that many clients who have also been bullied have issues with body image and self-worth.

As a result of these issues, people may be intimidated about entering into a sexual relationship with a partner. Healthy sexuality also requires being vulnerable, and this is difficult to do if you are fearful of rejection and judgment.

It should also be noted that people who have experienced the above issues may also struggle with an intense fear and avoidance of sexual experiences, also known as sexual anorexia (Carnes, 1997).

Defining Healthy Sexuality in Recovery

The topic of healthy sexuality is vast and complex, and reaches far beyond the content of this article. I have included a few ways that you can begin to evaluate your sexuality using a few ideas from the recovery literature.

The SAFE sexuality mnemonic is great for helping to determine if your sexual behaviour is healthy:

  • Secret. Sex isn’t safe when it’s a secret
  • Abusive. Sex doesn’t involve hurting self or others
  • Feel bad. Sex isn’t something we do only when we feel bad about something
  • Empty. Sex isn’t safe when it’s empty of a relationship

In addition to the safe strategy, healthy sexuality is based on the following domains (Carnes, 1997). 

  • Nurturance –the capacity to care for self and others
  • Sensuality – the use of the senses, emotions, spirit to connect sexually
  • Self-image – a positive view of self, including your sexual side
  • Self-definition –a clear sense of self and boundaries in sexual activities
  • Comfort –the ability to be comfortable with yourself and others
  • Passion – the ability to express and receive deep feelings of desire about the relationship and sexual experience
  • Knowledge – education on sexuality in general and your own preferences
  • Relationship – the capacity to have intimacy and friendship in one relationship
  • Partnership – the ability to be linked together but also have separate functions and identities
  • Non-genital sex – the ability to express affection without the use of the genitals
  • Spirituality – the ability to connect sexual desire to the greater purpose of one’s life                                            

Contrasting Sex Addiction and Healthy Sexuality 

Healthy sexuality differs from sex addiction in several important ways. First, healthy sexual intimacy is based on intimacy, that is, communicating openly and allowing yourself to be vulnerable in a relationship. Sex addiction is based on fantasy and intensity. Although healthy sexuality can involve feelings of passion and fantasy, the relationship is grounded in care and authenticity.

Healthy sexuality is about connection, whereas sex addiction is about disconnection from self and others. Healthy sexuality involves engaging in nurturing acts such as cuddling and holding hands, whereas sex addiction often involves pursuit of a sexual high. In healthy relationships, sex is about give and take between two people. With sex addiction, the addict is mainly concentrated on meeting their own needs in a ritualized way.

So to summarize, I’m going to draw upon Wilson’s TED talk on pornography to illustrate some components of healthy sexuality:

  • Courtship
  • Being touched
  • Smells
  • Pheromones
  • Emotional connection
  • Interaction with a person

Carnes, P. (1997). Sexual anorexia: Overcoming sexual self-hatred. Center City, MI: Hadelden. 

Carnes, P. (2010). Facing the shadow: Starting sexual and relationship recovery. Carefree, AZ: Gentle Path Press.