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Sex Addiction

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SEX ADDICTION

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Tame the Dragon

Sex Addiction

How To Heal From Sex Addiction

Hypersexual disorder, which includes Compulsive Sexual Behaviour (or more commonly termed Sex Addiction), is possibly one of the most contentious issues in psychosexual counselling communities.

There doesn’t seem to be much consensus around how much sex, is too much sex. Kinsey tried to define it as seven or more orgasms per week. Kafka recommended defining it as daily orgasms for a period of 6 months or longer. The problem is if that were the case, an awful lot of people would be suffering from something that didn’t necessarily bring them any discomfort. Even the DSM-5 (The Diagnostic and Statistical Manual for Mental Disorders, 5th Edition) has rejected the proposed criteria that was put forth to them for the last edition.

The most crucial point to consider is harm. The question is whether your sexual thoughts and behaviour harm you or others, and whether you have control over those thoughts and behaviour.

The approach I take to treating Compulsive Sexual Behaviour or Sex Addiction, focuses on evaluating whether or not any harm takes place, whether you have control, and how to prevent harm and help you be in charge of your sexuality in a healthy way.

If you feel that you are currently suffering from Sex Addiction or that you’re actions are beginning to feel like Compulsive Sexual Behaviour, please feel free to contact me or schedule a Free Initial Consultation to talk about ways I could be of assistance.

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How Can I Help You?

I have helped many clients heal from compulsive behaviour and regain a sense of peace and control in their lives, without having to feel like their sexuality is lost or diminished.

I’ll work as an experienced central agent in your treatment. In therapy, we’ll work through the psychological causes and effects of Sex Addiction / Compulsive Sexual Behaviour together, and continue counselling until you reach the point of renewed peace and control.

We’ll also investigate any physiological causes. I’ll refer you to private or NHS medical professionals I know and trust in the way of identifying and treating the physiological aspects. Together, we’ll provide you with a range of options available to you, while eliminating any harm the condition may have done to that point.

In counselling, you’ll have a safe space to discuss your concerns, and gain the information and confidence you need to flourish.

What is Low Libido / Low Sex Drive?

Because the ICD-11 (The WHO International Classification of Diseases, 11th Edition) definition does not try to specify a specific number of orgasms in the diagnoses of Compulsive Sexual Behaviour, and because the definition focuses on the wellbeing of the individual and their loved ones, I find this definition to be most helpful:

“Compulsive sexual behaviour disorder is characterised by a persistent pattern of failure to control intense, repetitive sexual impulses or urges, resulting in repetitive sexual behaviour. Symptoms may include repetitive sexual activities becoming a central focus of the person’s life to the point of neglecting health and personal care or other interests, activities and responsibilities; numerous unsuccessful efforts to significantly reduce repetitive sexual behaviour; and continued repetitive sexual behaviour despite adverse consequences or deriving little or no satisfaction from it. The pattern of failure to control intense, sexual impulses or urges and resulting repetitive sexual behaviour is manifested over an extended period of time (e.g., 6 months or more), and causes marked distress or significant impairment in personal, family, social, educational, occupational, or other important areas of functioning. Distress that is entirely related to moral judgements and disapproval about sexual impulses, urges, or behaviours is not sufficient to meet this requirement.”

A word on what is Compulsive Sexual Behaviour is NOT. Some clients seeking advice will report that they feel embarrassed or pressured due to having higher libidos than their partners. On occasion, their partners shame them or complain because of their sexual advances. It’s important to understand that there is a lot more at play when this is the case, and that it doesn’t necessarily point to Sex Addiction or Compulsive Sexual Behaviour. Please contact me to discuss the differences, how to evaluate, and what can be done. I don’t charge for initial calls.

When is it Time to Seek Help?

The questions below are NOT designed to diagnose a particular condition. However, if you feel that you meet the criteria, please contact me to discuss more around diagnosis and treatment.

How many of the questions below would you answer ‘Yes’ to?

Over the last 6 months, do you feel that you’ve engaged in excessively intense sexual fantasies, urges, or sexual behaviour?
Do you feel that you’ve become consumed by sexual fantasies or urges or by planning and engaging in sexual behaviour?
Have you engaged repetitively in sexual fantasies, urges, and behaviour to find relief from stressful events?
Have you engaged repetitively in sexual behaviour while disregarding the risk for emotional or physical harm to self or others?
Have you repetitively engaged in sexual fantasies, urges, or behaviour in response to dysphoric states? (e.g. anxiety, depression, boredom, irritability)
Do you feel like you’ve been unsuccessful at your efforts to control or significantly reduce excessive sexual fantasies, urges, or behaviours?
Do you feel distressed or that intensity or frequency of the sexual fantasies, urges, or behaviour has impaired your social, occupational, or other important areas of functioning?

What Causes Compulsive Sexual Behaviour/Sex Addiction?

Compulsive Sexual Behaviour / Sex Addiction is caused by either psychological or physiological reasons. Even when it is caused by physiological factors, there is always a psychosexual element that must be addressed to treat the condition successfully.

Physiological causes of Compulsive Sexual Behaviour / Sex Addiction are usually due to medications, illicit drugs, neurological conditions, or hormone imbalances.

Psychosexual causes of Compulsive Sexual Behaviour / Sex Addiction are exceptionally intricate and difficult to decode. Pinpointing the exact triggers can only happen through a process of reflection and counselling. Causes can include relationship problems, mania or hypomania, cyclothymia, schizoaffective disorder, depression, feeling inadequate, sexual fears, rejection, sexual/emotional trauma, performance anxiety, low self-esteem, guilt, pornography, and a range of other factors. It takes time and skill to reveal the different layers of the psyche that are affected, and the reasons one thinks are the cause, very rarely actually are.

Identifying the underlying causes, both physiological and psychosexual, is only half the battle won. Only through a balanced approach that addresses all causal factors and symptoms, can you achieve true healing and freedom.

How is Compulsive Sexual Behaviour/Sex Addiction treated?

First, it is vital to begin healing the psychological damage already caused as well as to safeguard against any future psychological damage that would have been done.

During the counselling process, we’ll discover the underlying causes in your past and present, and devise practical frameworks to resolve them together. This process may not be quick, but it is guaranteed to work.

Simultaneously, through a process of careful elimination, physiological causes must either be identified or ruled out.

CAUTION: Several biological treatment options are available. However, every single one has the potential for severe, permanent, life-changing side-effects. I cannot recommend highly enough that you exhaust psychosexual counselling as a treatment option. If not with me, then with another qualified counsellor. Psychosexual counselling for Compulsive Sexual Behaviour or Sex Addiction can be extremely successful and empowering to the individual and their loved ones. If you have previously tried biological treatment options and are currently suffering from their harm, please contact me immediately.

I will work as a central agent in your treatment. We’ll continue working through the psychological causes and effects of Hyper Libido until arriving at a point where you feel entirely at peace again. At the same time, we’ll investigate any physiological causes together. I’ll refer you to medical professionals I know and trust in the way of identifying and treating the physiological aspects. Together, we’ll provide you with a range of options available to you that are safe, while eliminating any harm the condition may have done to that point. If you require medical treatment, I’ll work with you to select the correct treatment provider, as well as to counsel you through the process successfully.

What to Expect From Treatment?

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Psychosexual Counselling

Free Initial Consultation

Our initial consultation should last around 30 – 45 minutes. We’ll have the opportunity to discuss your primary concerns and reasons for seeking treatment, and what the outcomes are that you’d like to achieve.

I’ll explain more about myself, my professional experience, and how we’ll work to achieve your goals. We’ll go over the costs of treatment and make sure that an option is available to you that is affordable and sustainable. I’ll also explain a little more regarding the technical aspects of online counselling and explain the best ways to set up the software options available.

Assessment Sessions

1. &nbspPhysiological Assessment Session

We’ll consider your full medical history; however, below is a sample of the types of questions that we’ll be exploring:

How long has the compulsive sexual behaviour been occurring?
Describe what happens when you have intercourse?
What happens when you try to masturbate?
(M) Do you have morning erections?
(F) Are you aroused in the mornings?
(M) Do you have difficulty achieving or maintaining your erection?
(M) If so, at which point do you lose your erection?
(F) Do you experience vaginal dryness?
How often do you feel your libido is too high?
(M) How rigid are your erections?
(M) Does your penis have a bend, twist, or curve when it’s rigid?
(M) Have you ever had any serious testicular trauma?
What medications are you currently taking?
When last did you have your hormone levels examined?
How regularly do you check your blood pressure?
Do you often have palpitations?
Have you before, or are you currently using any drugs (including cannabis)?
Do you take any opiate pain killers (or have you before)?
How much alcohol do you consume?
Do you smoke?
(M) How regularly do you attend a prostate examination?
(F) How regularly do you attend a pelvic exam?
Are you currently overweight?
How would you describe your level of fitness?

2. &nbspPsychosexual Assessment Session

We’ll discuss your history and background, along with questions that relate more specifically to Libido. A sample of the questions we’ll focus on are:

How are you currently managing your libido?
How much stress are you currently experiencing?
Do you have difficulty maintaining a relationship?
How would you describe your current relationship?
When did the Compulsive Sexual Behaviour begin?
(M) How frequently do you have unsatisfactory erections?
Do you feel your chest tightening when you think of sex?
How has your relationship(s) been going?
Are you worried about performing sexually?
(M) How often do you wake up with an erection?
(M) Do you have spontaneous erections throughout the day?
How would you describe the quality of your sleep?
(M) Do you struggle to achieve or maintain an erection when you are alone?
How much pornography do you consume?
(M) Do you have difficulty achieving/maintaining an erection when watching pornography?
(F) Do you have difficulty becoming aroused when watching pornography?
Do you have difficulty orgasming?
Do you often orgasm prematurely?
In your opinion, what is causing the compulsive behaviour?
How would you describe your self-esteem?
Have you experienced any sexual or emotional trauma in the past?
Are you worried your partner might find you inadequate?
How worried are you about rejection in general?
Would you describe yourself as being depressed?
Would you describe yourself as being manic?
Do you often have mood swings?
How difficult is it to focus during masturbation?
What are the thoughts/worries that your mind drifts to while masturbating?
When you are able to orgasm, how would you describe the quality of the orgasm?

Treatment Plan

We’ll work together to formulate a practical therapy plan for counselling sessions. You’ll very quickly begin to feel better and see a rapid improvement in the sense of peace you feel and your emotional health in general.

Sexual function is almost always affected by the level of happiness we experience in the rest of our lives. As such, we’ll focus not only on the sexual hurdles you’re facing, but also on improving the rest of your quality of life.

Depending on your circumstances, I may also ask you to conduct a blood test. This test is very affordable, can be done from the privacy of your home, and will remain entirely confidential. The results will show us a starting point for your general physical health. We’ll also find out whether your body is producing a sufficient amount of the correct hormones needed for sexual function.

Counselling Sessions

Our ongoing counselling sessions will continue working on improving the underlying issues that are the true psychological causes or reasons for distress. Our work will also ensure a vast improvement to your life in general, not just restricted to sexual function. There is no limit to the number of sessions we can have, but the process typically takes 12 – 20 sessions. We’ll work to overcome the obstacles you were facing, and explore the goals you’d like to achieve.

If a physiological component was an additional cause to Compulsive Sexual Behaviour, I’ll continue working with you throughout the counselling process to find the correct medical support, and guide you through any treatment that you may require.

Debriefing Session

At the end of the counselling process, we’ll review the work we’ve done and the progress you’ve made. We’ll revisit any outstanding issues and discuss methods to ensure that your confidence and success remain in place.

Follow Up

3 – 6 months following the conclusion of your therapy, we’ll schedule a follow-up session to make sure that everything has been going well. We’ll take this opportunity to discuss any new concerns you might have, or conclude our work together.

Physiological Treatment

CAUTION: When there is an underlying cause for a hyper-inflated libido (such as a hormonal imbalance, neurological condition, or psychiatric diagnosis such as Bipolar Disorder), we should aim to address and treat the underlying condition. In all other cases, I am vehemently opposed to any medical treatment that aims to lower libido for the sake of lowering libido when no underlying medical cause is present. Side-effects from these treatments are horrifically negative, life-changing, and can permanently damage your health.

When an underlying physiological cause does exist, the focus should be on treating the primary condition that the Compulsive Sexual Behaviour is a symptom of.

Hormone Balancing

A clear link exists between hormone levels and a healthy libido, arousal, orgasmic control, and a general sense of wellness. In the case of Compulsive Sexual Behaviour, your hormone levels may be unbalanced, causing the changes in desire.

Oestrogen

Oestrogen therapy is usually the hormone referred to when speaking of Hormone Replacement Therapy for women. However, Oestrogen plays an enormous role in the sexual function of both men and women. Oestrogen levels that are too low tend to cause mood swings, fatigue, sadness, depression, and lowered libido. Oestrogen levels that are too high tend to cause anxiety, mood swings, irritability, and irrational thinking patterns. Medication does exist to help balance Oestrogen levels for both men and women, although, you should only do this under the careful supervision of an endocrinologist.

Testosterone

Testosterone is usually the hormone we think of in terms of regulating sexual function, both in men and women. “Normal” Testosterone levels vary from person to person. However, Testosterone levels that are elevated beyond your usual levels may result in an elevated sex drive. It is also useful to test Free Testosterone levels as this may be elevated in addition.

How is a Hormone Imbalance Diagnosed?

The sad fact is that hormonal imbalances are very seldom diagnosed correctly. Most doctors receive little to no training on optimal hormone levels unless they specifically opt to specialise in that field.

When doing blood tests for hormone levels, I always advise testing for the following:

Testosterone, Total
Testosterone, Free
Testosterone, Bioavailable
Oestradiol (Sensitive)
Steroid Hormone Binding Globulin (SHBG)
Dihydrotestosterone (DHT)
Full/Complete Blood Count (FBC/CBC)
Follicle Stimulating Hormone (FSH)
Luteinising Hormone (LH)
Prostate Specific Antigen (PSA)
Metabolic panel

If your GP is hesitant to prescribe the correct tests on the NHS, or if you prefer to handle the testing privately, I work with a reputable laboratory that will conduct the tests for you. Please contact me to order a finger-prick test kit (circa £150) that can be done from the comfort of your own home. Based on the results, I can refer you to a network of physicians I know, trust, and have experience working with.

Even if you aren’t suffering from a hormonal imbalance at the moment, knowing your healthy baselines may be extremely helpful in the future.

Other Underlying Causes

During our assessment sessions, we’ll discuss any risk factors that may indicate a physiological cause to the elevated libido. It’s vital to ensure that if a physiological cause exists, it’s identified and treated in parallel to your psychosexual therapy.

Because the potential array of physiological causes is relatively wide, I can help you to prioritise the order and types of specialists to approach for diagnosis and treatment, as well as to refer you to physicians I know and trust (both on the NHS and privately).

Preliminary bloodwork is always a good starting point and I can either write to your GP on your behalf to request this, or assist you in getting an affordable home test kit through a reputable laboratory that I regularly use. This is useful if you’d prefer to get the tests done with greater expediency and privacy.

If you’d like more information on the successful treatment of Compulsive Sexual Behaviour / Sex Addiction, please contact me to schedule a Free Initial Consultation.

Client Feedback:

“When I contacted James at first, I was ashamed of my sexual behaviour and worried that sex would ruin my life. Everything revolved around the next orgasm. I consumed hours of porn every day. I flirted with every attractive woman that I got close to. I spent a fortune visiting strip clubs and sex workers. And I nearly ruined my marriage.

I tried anonymous sex addiction 12 step programs and I thought it worked, but after a few months I just fell back into feeling consumed by sex every day. Nothing worked.

Therapy took time and it definitely wasn’t easy. James helped me first to figure out that nothing was physically wrong with me. We got some blood tests and then he referred me to a great doctor who helped me check that nothing was physically wrong. At the same time we had more counselling sessions. He never made me feel ashamed. After a while I began feeling better and stronger and had the energy to really begin changing my life.

I thought it would just be more how-to guides on things I should avoid or how to control my mind. But it wasn’t like that at all. Even when the sessions were about deep or difficult topics, he always made it feel light and like change was possible. He helped me to understand the things in my past and subconscious mind that were causing me to behave this way. I learned A LOT about all kinds of compulsive behaviour and how to manage it. And he helped my wife and me to reconnect and work through a lot of the pain I caused her together.

It’s been almost a year since I last saw James and I wanted to write this so that anybody who ever feels like I did knows there’s hope. My life has been completely overturned for the better. Sometimes my urges still get a little out of hand, but I’m never out of control anymore. Sex has become something that I enjoy and use to share my life and love with. I don’t wake up anxious anymore and I get to focus on all the things in my life that matter to me, of which sex is now only one aspect.”