Compulsive sexual behavior
What Sexual Scientists Know About...
Compulsive Sexual Behavior
Can sex become compulsive? Like most behaviors, sex can be taken to its obsessive & compulsive extremes. Sexual obsessions & compulsions are recurrent, distressing & interfere with daily functioning. Many people suffer with these problems but finding consensus about them among sexual scientists or treatment professionals is not easy. This makes it more difficult for those suffering from compulsive sexual behavior (CSB) to get the appropriate help they need. For those who want to know more about this problem, it is helpful to know about the types of CSB, the various theoretical viewpoints & treatment approaches. While there are many types of compulsive sexual behavior, they can be divided into two main types: paraphilic & non-paraphilic CSB. Sexual scientists have used various terms to describe this phenomenon: hypersexuality, erotomania, nymphomania, satyriasis & most recently sexual addiction & compulsive sexual behavior. The terminology has often implied different values, attitudes & theoretical orientations.
Paraphilic behaviors are unconventional sexual behaviors which are obsessive & compulsive. They interfere with love relationships & intimacy. While John Money(1) has defined nearly 50 paraphilias, the Diagnostic & Statistical Manual of Mental Disorders (DSM-IV) of the American Psychiatric Association has currently classifed eight paraphilias & these are generally considered the most common:
In the recent DSM-IV, the paraphilias are defined as "recurrent, intense sexually arousing fantasies, sexual urges, or behaviors involving 1) nonhuman objects, 2) the suffering or humiliation of oneself or one's partner, or 3) children or other nonconsenting persons... The behavior, sexual urges, or fantasies cause clinically significant distress in social, occupational, or other important areas of functioning (p. 522-523)." Some behaviors, such as sado-masochism when they are consensual & do not impair life functioning are not considered a paraphilia because they do not meet all the diagnostic criteria.
Nonparaphilic CSB involves conventional sexual behaviors which when taken to an extreme are recurrent, distressing & interfere in daily functioning. One example is given in the DSM under the category of Sexual Disorders Not Otherwise Specified. The authors of the DSM describe an example of "distress about a pattern of repeated sexual relationships involving a succession of lovers who are experienced by the individual only as things to be used" (p.538). Other forms of nonparaphilic CSB include: compulsive fixation on an unattainable partner, compulsive masturbation, compulsive love relationships & compulsive sexuality in a relationship.(3)
The Danger of Overpathologizing this Disorder
The possibility of overpathologizing this disorder is the main criticism given by those who do not believe in the idea of compulsive sexual behavior as a disorder. The pathologizing of sexual behavior may be driven by anti-sexual attitudes & a failure to recognize the wide-range of normal human sexual expression. This caution is important when assessing whether a person is engaging in compulsive sexual behavior. It is important for professionals to be comfortable with a wide range of normal sexual behavior - both in types of behaviors & frequency. Sometimes individuals with their own restrictive values will diagnose themselves with this disorder, creating their own distress. Therefore it is very important to distinguish between individuals who have a values conflict with their sexual behavior & those who engage in obsessive sexual behaviors.
A Conflict Over Values
There is an inherent danger in diagnosing CSB simply because someone's behavior does not fit the values of the individual, group or society. There has been a long tradition of pathologizing behavior which is not mainstream & which some might find distasteful. For example, masturbation, oral sex, homosexual behavior, sado-masochistic behavior (S-M) or a love affair could be viewed as compulsive because someone might disapprove of these behaviors. However, there is no scientific merit to viewing these behaviors as disorders, compulsive or "deviant." When someone is distressed about these behaviors, they are most likely in conflict with their own or someone else's value system rather than this being a function of compulsion.
Problematic Vs. Compulsive Sexual Behavior
Behaviors which are in conflict with someone's value system may be problematic but not obsessive-compulsive. Having sexual problems is common. Problems are often caused by a number of non-pathological factors. People can make mistakes. They can at times act impulsively. Their behavior can cause problems in a relationship. Some people will use sex as a coping mechanism similar to the use of alcohol, drugs, or eating. This pattern of sexual behavior can be problematic. Problematic sexual behavior is often remedies by time, experience, education or brief counseling. Obsessive & compulsive behavior, by its nature, is much more resistant to change.
Developmental Process vs. Compulsive Sexual Behavior
Some sexual behaviors might be viewed as obsessive or compulsive if they are not viewed within their developmental context. Adolescents, for example, can become "obsessed" with sex for long periods of time. In adulthood, it is common for individuals to go through periods when sexual behavior may take on obsessive & compulsive characteristics. In early stages of romance, there is a natural development period where an individual might be obsessed with their partner & compelled to seek out their company & express affection. These are normal & healthy developmental processes of sexual development & must be distinguished from CSB.
© 2001 Society for the Scientific Study of Sexuality