How to Understand Compulsive Sexual Behavior

By: Sam Louie MA, LMHC, S-PSB

If you’re struggling with compulsive sexual behaviors, then you may already have a good idea of what compulsive sexual behavior entails. There are a plethora of books that go into specific detail regarding the rituals, cycles, and origins of compulsive sexual behavior—so I’ll just briefly touch on the basics.

While the general public and therapeutic community embrace the validity of substance abuse and addictions to drugs, alcohol, and pain medication, issues like compulsive sexual behavior can be met with scrutiny. 

Issues like gambling, eating, and spending may be embraced as real issues, but compulsive sexual behavior remains highly controversial. This is probably due in part to the fact that sex can’t be separated from conscience. What I mean is our view of sex is values-laden. Whether personal, communal, cultural, or moral, people will have a number of varying responses as to what constitutes “healthy” and/or “unhealthy” sexual behavior.

At its core, compulsive sexual behavior can be seen as an intimacy or attachment disorder. Healthy people, when faced with life’s challenges, can connect deeply with another person on an emotional level (i.e., sharing feelings of sadness, despair, rejection, anger, etc.). People with compulsive sexual behavior, on the other hand, will hide and detach from emotional intimacy (out of a fear of rejection or abandonment) and instead rely on sexual behaviors and/or fantasies to assuage their emotions during stressful life circumstances.

Behaviors that are typical include the following (not an exhaustive list):

• Masturbation to sexual fantasies or pornography (compulsive to the point where the person is doing this more than he/she would like)

• Use of erotic massage

• Use of strip clubs, sex clubs, and/or other sexual environments

• Sex with prostitutes

• Cybersex, chatlines, etc.

• Casual hook-ups or anonymous sex

• Voyeurism, exhibitionism, and other sex-offending behaviors

• Affairs

Keep in mind for a person to truly have a problem, he/she has to engage in a pattern of these behaviors that is inconsistent with the person’s values, desires, and relational goals. While hard to assess immediately, they also must have relational deficiencies when it comes to emotional intimacy and use sex as a primary means for coping through life’s stressors. In short, someone who chooses to engage in casual hook-ups for pleasure is much different from someone doing similar behaviors but feels he has no choice but to engage in those behaviors. 

Etiology of compulsive sexual behavior

So what causes compulsive sexual behavior? I like to view it as an emotional intimacy disorder or an attachment disorder. They may struggle to share deeply or be vulnerable and trusting in relationships. 

The deficits in attachment come from a variety of sources. Here are some common ones:

• Emotional neglect

• Physical abuse

• Sexual abuse

• Lack of praise, hugs, or affirmation

• Shaming messages in childhood

• Lack of belief in one’s sense of unconditional love

• Rejection in significant romantic relationships

Consequently, with no understanding of true acceptance, they confuse sex with validation, affirmation, support, care, and love. Part of your recovery is dependent on your ability to be more self-aware regarding triggers that lead to a sexual acting-out ritual(s).