Why There’s No Such Thing As Sex Addiction—and Why It Matters

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The young man who killed eight women at three massage parlors near Atlanta last week says he is a sex addict, haunted by his perverse desires and driven to desperation by evangelical Christian beliefs.

This is a perfect time to review why the concept of “sex addiction” is so terribly unhelpful—and potentially dangerous for some people.

The concept was invented in the 1980s by Patrick Carnes, a prison addictionologist with no professional training in human sexuality. It quickly caught on with the public, and with many marriage counselors—who usually get no training about everyday sexual feelings, desires, and behaviors.

Or the shame, guilt, and terror that can go with them for some people.

Tellingly, the concept of sex addiction never caught on with the one professional group who have training, expertise, and experience in working with sexual issues—sex therapists.

Sex therapists see plenty of compulsive and impulsive behavior around sex, almost endless infidelity, lots of men misusing pornography or going to sex workers, women and men troubled by their fantasies, preferences, and desires. People who are, in fact, almost paralyzed by sexual shame, guilt, and terror.

But we have clinical tools much more sophisticated than the concept of sex addiction, and we have more effective treatment strategies than dooming people to weekly groups, literally spending the rest of their lives in recovery from a lifelong “disease.”

Who Are “Sex Addicts”?

We’ve learned a lot about people who call themselves sex addicts.

Some of them have a diagnosable mental health problem: obsessive-compulsive disorder, bipolar disorder, Asperger syndrome, borderline personality. Some self-identified sex addicts are crippled by enormous levels of anger or low self-esteem.

These people may make many bad choices involving sex, but they don’t have a sex problem—just as someone with OCD who washes their hands 30 times a day doesn’t have a hand-washing problem.

Some people who call themselves sex addicts act impulsively, like children: if they want something, they just grab it. These people flirt, or go to prostitutes, or wake their partners for sex at 3am, or masturbate instead of going to work—despite promising themselves or others that they won’t. When confronted, they apologize, swear they won’t do it again—and then do.

They don’t have a sex problem. They haven’t learned how to manage their impulses. Some of these people are so narcissistic they don’t think they should have to.

Some people who call themselves sex addicts are in a couple with someone who doesn’t want sex much, or doesn’t want much variety or the one special thing the “addict” really wants. They build up a mountain of resentment, and instead of leaving the relationship or engaging in productive marital conflict, they become freelance sexual operators, whether with sex workers, colleagues, or whomever.

And now we come to perhaps the largest group of would-be sex addicts, which includes the alleged murderer.

These are people who experience their own sexuality as dangerous, as outside the realm of what’s normal. Their fantasies, their desire to masturbate, their curiosity about one or another taboo, their wish to simply know what other people do or feel in bed—they experience themselves as degenerate, not deserving of comfort or compassion or connection.

And that can drive people crazy.

Crushed By A Perfectionist Church

It’s even worse if these people are pressured by a demand that they be pure—by a strict ethnic culture, a punitive God, or a perfectionist church.

That was what apparently crushed alleged murderer Robert Aaron Long—strong (though fairly common) sexual desires combined with a church that believed such desires were perverse and unchristian.

In the old days, these people might go into exile, or do arduous purification rituals, or they might project their disgust with themselves onto a wife or children with abuse or violence. Such people have always had the option of escaping their pain with alcohol.

And now they have another option—identifying as sex addicts. They acquire the core belief that they’re out of control, which can be comforting when compared to the alternatives—being sinful, being disgusting, or being extraordinarily selfish, carelessly hurting those they love.

As a sex addict, they are welcomed back into the human race. They have the dignity of a “disease;” they have an instant community of other addicts; and they can disown their urges as not theirs, but as “the addiction speaking.”

Crucially, “sex addicts” are immediately offered a container for their devastating shame. They get to share their horrible secrets and receive genuine sympathy. They’re told that they’re OK, and that with enough work, their sexuality won’t be so powerful anymore. For these people, that’s something to look forward to.

Alleged murderer Robert Aaron Long was a member of Crabapple First Baptist Church, which strictly prohibits sex outside of marriage. Mr. Long had previously checked himself into a Christian rehab clinic in order to combat what he perceived as an addiction. It clearly didn’t relieve his internal torment. That’s no wonder, given the church’s statement about Mr. Long’s “perverse sexual desires.”

So if I see patients damaging their lives with bad sexual decisions, and I don’t call it sex addiction, what do I call it? One of the following:

a) Typical human sexuality, with repetitions driven by shame;
b) A diagnosable mental health disorder, such as Asperger syndrome;
c) Someone in a problematic relationship that they won’t confront directly;
d) Someone drastically squeezed between their internal sexual architecture, the belief that they’re degenerate, and external pressure to be pure;
e) Someone with an alcohol or drug problem, which allows them to make sexual decisions they wouldn’t make when sober.

Ultimately, what I and other sex therapists see is people who keep making sexual decisions whose consequences they regret. And they keep making those same decisions with the same regrettable consequences. That’s not an addiction–it’s a recognizable feature of being human, whether the decisions are about eating cookies, buying sweaters, staying up too late on a weeknight watching TV, or breaking a vow to meditate every day.

That is, repeatedly making sexual decisions whose consequences you regret does not make you a sex addict. It makes you a flawed person who needs to change—whether your relationship, your integrity, your church, your alcohol use, or your mental health problem.

How do I and other sex therapists treat this?

If we see untreated depression, anxiety, or other mental health problems, we treat that—often with a combination of therapy and medication. 

With everyone else, we do therapy. We help people, often quite substantially. 

When we’re done, they aren’t lifelong addicts in lifelong recovery. They’re adults who have a different view of themselves, who feel human, whose impulses aren’t so urgent, who make better decisions, who aren’t perfect—and who can accept that. Uncrippled by shame, they have more integrity, and are far more likely to keep their promises. They no longer see their sexuality as dangerous.

They’re cured. They’re not addicts anymore.

They never were.


If you like this, you’ll enjoy my piece at

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