Sex Addictions


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    Michael E. Holtby, LCSW, BCD

About 40% of my private practice caseload (and growing) is with individuals who have a presenting problem of a sexual addiction. This is a very unique specialization for which few psychotherapists have any specialized training and experience. My training has been through a number of workshops, including with Patrick Carnes, Ph.D., who is considered the foremost authority on this subject. At this point I serve as a regular clinical consultant to the Colorado State Health Department staff whose clients have contracted sexually transmitted diseases. I have also encountered sex addicts in my work with a Diversion Program for the City Attorney's Office (arrests of straight men who solicit prostitutes, and gay men who have sex in parks and pornographic bookstores). My work has extended to some professional sex workers, swingers and poly amorous couples.

The DSM-IV, the Diagnostic & Statistical Manual has yet to recognize sex addiction as an actual diagnostic category. And yet I believe it is a real phenomena which affects both men and women, gay and straight; much the same way as an addiction to drugs, gambling, or alcohol. The ritual of pursuing sex creates an altered state which is a coping strategy to help people avoid the pain and stress of their past and/or daily lives.


Over-all Internet usage has increased 107% in the last five years, now encompassing 68% of American households. Twelve percent of all Internet  websites, and one in four of all search engine requests are sex-related in nature. At $12 billion in the U.S., the revenue produced from these sites exceeds the revenues of all the professional football, baseball and basketball franchises combined. Forty million U.S. adults regularly visit sex-related websites, and one in three of those visitors are women.

Internet sex addiction is a reality, and it has exploded with the availability, anonymity, privacy, affordability and fantasy provided by the Net. If you are reading this asking yourself if this is a problem for you, ask yourself:

1. Am I spending more time and/or money than I intended on sex-related sites?

2. Am I using it for sexual hook ups – more than I am dating?

2. Do I feel I need to keep my sexual behavior a secret?

3. Am I you using sex as a distraction from problems or relieve feelings of loneliness, or depression?

4. Have I unsuccessfully tried to control or stop sexually acting out?

5. Have I risked or experienced negative consequences with my job, my partner, my health or the law?

There are now two excellent books to help you both assess whether sex is a problem in your life, and also what to do about it. The first one is: In The Shadows of the Net, by Patrick Carnes, David Delmonico and Elizabeth Griffin (Hazeldon, 2001). Carnes is considered the pioneer of the concept of sex addiction. His first book , Out of the Shadows, was first published in 1983, and introduced the idea into the popular culture. This book specifically deals with Internet sexual behavior.  The second book is the first about sex addiction as it relates specifically to gay men, and was just published in July of this year: Cruise Control by Robert Weiss (Alyson Books, 2005). Weiss is in Los Angeles at the Sexual Recovery Institute. The foreward to his book is by Patrick Carnes, who heartily endorses Weiss’ work.

If there is any question in your mind, if you are curious about the subject, or if you are the partner of someone whose sexual behavior concerns you, I would highly recommend either or both of these books.

This is an addiction with much shame and stigma attached to it, and for that reason involves a great deal of secrecy. However, it is a condition you can leave behind. As compelling as you may experience it to be, you aren't condemned to a double life. Seek help either through a therapist, a Sex and Love Addicts Anonymous Group or both!


Are You A Sex Addict? Take the Carnes SAST

Learn More About My Work With Sex Addicts

Learn More About My Diversion Program for Vice Squad Arrests


On the Internet:

Internet Sex Addiction Questionnaire

The Sex Addiction Cycle

National Council on Sexual Addiction and Compulsivity

Sex Addicts Anonymous (SAA_

Sexaholics Anonymous (SA)

Recovering Couples Anonymous (RCA)

S-ANON International Family Groups



Last messed with August 24th, 2005

Copyright(c) 2001 Michael E. Holtby, LCSW. All rights reserved.