What Is Compulsive Sexual Behavior?
Compulsive sexual behavior is a term used to describe an unhealthy obsession with sexual activity and behavior that is often difficult to control. It can cause some distress to the affected person and destroy relationships and other aspects of life.
What Are Some Other Names for Compulsive Sexual Behavior?
Compulsive sexual behavior is also referred to as:
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Sexual addiction.
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Hypersexuality disorder.
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Excessive sexual desire disorder.
Who Is Affected by Compulsive Sexual Behavior?
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Gender: Both men and women may display traits of compulsive sexual behavior. However, the condition seems to be more prevalent in males than females.
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Sexual Orientation: All sexual orientation types may be affected by compulsive sexual behavior.
How Is Compulsive Sexual Behavior Classified?
Compulsive sexual behavior is classified as:
Paraphilic Behaviors: Behaviors that fall outside of the norm for sexual behaviors.
These include:
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Sexual Masochism: Intentional participation in sexual activities that involve being treated in a derogatory manner or hurt and abused to experience sexual excitement.
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Sexual Sadism: Infliction of abuse and suffering (physical or psychological) on another person to experience sexual satisfaction and excitement.
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Exhibitionism: Exhibiting one's genitals or private parts to adults or children of the opposite or same gender in an attempt to shock or surprise.
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Voyeurism: Deriving sexual pleasure from watching a person who is naked, disrobing, or engaging in sexual activity.
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Fetishism: Experiencing intense sexual arousal from focusing or obsessing on non-genital areas and objects.
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Transvestic Fetishism: Erotic interest and obsession with cross-dressing.
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Pedophilia: Perverted sexual interest towards children or minors.
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Frotteurism: Rubbing one's genitals against a non-consenting individual in an attempt to experience sexual excitement.
Non-Paraphilic Behaviors:This refers to the frequent practice of common sexual behaviors, including:
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Compulsive masturbation.
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Frequent extramarital affairs.
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Excessive pornographic use.
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Paying prostitutes for sex.
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Frequent visits to strip clubs.
What Causes Compulsive Sexual Behavior?
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Illnesses: Patients with tumors and neurological conditions such as epilepsy and dementia may display hypersexual behavior.
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Medications: Patients on medications for Parkinson's disease may also show hypersexual behavior.
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Hormonal Changes: The role of sex hormones is not correctly understood, but it is known that testosterone levels affect sexual functioning so any variations may contribute to compulsive sexual behavior.
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Chemical Imbalance in the Brain: Chemicals that affect and regulate a person's mood, such as serotonin and dopamine, may influence compulsive sexual behavior when present in high levels.
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Brain Pathway Changes: Compulsive sexual behavior can change brain circuits and pathways over time, leading to the need for more explicit sexual content and practices to achieve sexual satisfaction.
What Are the Risk Factors for Compulsive Sexual Behavior?
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Health: Mental health conditions like anxiety and depression can be especially problematic and cause compulsive sexual behavior.
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Substance Abuse: Patients with a history of substance abuse tend to become addicted to various sexual practices.
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Access to Sexual Content: The easy access that people have to sexual content, including imaginative and intensive images, videos, and text, makes it easy to form an addiction.
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History of sexual or physical abuse.
What Are the Signs and Symptoms of Compulsive Sexual Behavior?
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Sexual Fantasies and Behavior: The patient experiences intense, uncontrollable sexual urges and fantasies that affect their lives and relationships.
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Remorse: The patient engages in the behavior when the urge begins since they feel driven to do so. However, they regret the action immediately afterward and experience feelings of guilt.
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Escape Tactic: In some people, compulsive sexual behavior is a means to escape from feelings of loneliness, anxiety, and depression.
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Relationship Issues: Patients have difficulty getting rid of the habit and consequently suffer in personal and professional relationships, and they find it hard to form or maintain relationships.
How Is Compulsive Sexual Behavior Diagnosed?
1. Psychological Evaluation: A psychological evaluation performed by the doctor or therapist will usually involve diagnosis based on criteria as per the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), a publication of the American Psychiatric Association (APA).
2. Screening Instruments: Screening instruments are usually questionnaires that assess addiction based on the patient's responses. This can often mean that misdiagnosis is possible since the questionnaires rely on the patient's honesty. Some of the screening tests that might be used are:
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The Sexual Addiction Screening Test: A self-report checklist for symptoms, consisting of 25 items. This helps identify risky behaviors predisposing to sexual addiction and compulsive sexual behavior.
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Total Sexual Outlet: Total sexual outlet is a behavioral screening test that identifies seven sexual orgasms per week as indicative of at-risk behavior - such individuals may need further testing.
How Is Compulsive Sexual Behavior Managed?
Management of compulsive sexual behavior would rely on psychosocial therapy, pharmacotherapy, and self-help.
1. Psychosocial Therapy: Psychosocial treatment programs for compulsive sexual behavior are usually directed at identifying the beliefs and triggers that influence sexual urges. They also help to identify better alternatives and coping strategies.
The commonest psychosocial approaches are:
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Cognitive-Behavioral Therapy (CBT): CBT encourages people to find the triggers that precipitate unhealthy sexual activity in them. They are then given tools to cope better, such as redirecting their attention, or ensuring a lack of privacy, to prevent easy access to environments that facilitate such behavior.
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Psychodynamic Psychotherapy: Psychodynamic psychotherapy focuses on increasing the awareness of unconscious thoughts contributing to specific sexual behavior or behaviors. It attempts to allow the individual to gain fresh insight into their motivations and find solutions.
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Acceptance and Commitment Therapy: This therapy falls under the realm of CBT and focuses on accepting the intrusive sexual urges and thoughts that recur and committing to strategies that involve alternative actions.
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Family Therapy and Couples Therapy: These are useful in encouraging better relationships between partners and minimizing feelings of shame and guilt.
2. Pharmacotherapy: Medications have not yet been explicitly approved for compulsive sexual behavior. However, certain drugs used for different disorders might help with symptomatic treatment and treatment of underlying conditions:
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Mood Stabilizers: Valproic acid, Lithium.
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Opiate Antagonist: Naltrexone.
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Antidepressants: Selective serotonin reuptake inhibitors (SSRIs).
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Atypical Antidepressant: Nefazodone.
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Anti-androgens: Medroxyprogesterone acetate, Cyproterone acetate.
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Antiepileptics: Topiramate.
3. Self-help: Self-help would generally involve reaching out for help to self-help groups that may be conducted anonymously online or in person and provide:
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Knowledge and awareness of the condition.
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Resources for support.
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Options for treatment.
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Resources for coping.
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Behavioral change strategies.
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Help and support in case of relapse.
4. Surgery: This option is a rarely-used last resort. It involves castration to reduce testosterone levels and decrease urges. A surgical approach is helpful in those with paraphilic compulsive sexual behaviors rather than non-paraphilic compulsive sexual behaviors. It is mainly preferred for criminal offenders to discourage them from performing the same acts again.
How Can Compulsive Sexual Behavior Be Prevented?
Compulsive sexual behavior cannot be ascribed to a specific cause and is therefore difficult to prevent. However, certain practices and self-regulatory techniques can make a difference:
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Early identification and treatment of mental health disorders.
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Early identification and treatment of substance abuse issues.
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Getting help for sexual behaviors that pose problems.
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Avoiding situations that facilitate such behavior and put oneself and others at risk.
What Are the Complications of Compulsive Sexual Behavior?
Compulsive sexual behavior can affect the emotional, mental, interpersonal, and professional aspects of individual personalities and relationships:
1. Personal:
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Emotions: Patients may experience extreme guilt and shame at their actions.
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Disorders: The individual may develop mental health conditions such as severe anxiety, depression, and suicidal ideation.
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Substance Abuse: The individual may spiral into a constant drug and alcohol use cycle.
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Economic Issues: People who overspend on sexual imagery, media, and services may be financially unstable.
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Arrests: Frequent, uncontrolled sexual urges and drives may lead to sexual offense and eventual arrests.
2. Interpersonal:
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Partners and Families: Patients may have fractured relationships with their significant others and families.
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Sexually Transmitted Infections: Patients may contract and pass on sexually transmitted infections, leading to further relational problems and trust issues.
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Jobs: The focus on sexual stimulations and urges may take away from time spent working and decrease productivity, leading to lousy working relationships, a negative reputation, and job struggles.
Conclusion:
Struggling with compulsive sexual behavior can be difficult and lead to breakdowns in personal and interpersonal emotions and relationships. Therefore, it is essential to seek treatment if the behavior becomes a serious issue and to maintain an open, positive approach that will help to identify alternatives and adaptive techniques.
