Although the mental health field has long been convinced that people can be addicted to substances, the industry is divided about whether someone can actually be addicted to sex.Sex addiction treatment Georgetown Texas

Despite the debate among mental health professionals, however, and no matter what label is used to define an individual’s struggles, therapists are increasingly seeing clients who are struggling with sexual behaviors that have become unmanageable.

Still, it’s not easy to admit that you’re battling out-of-control behaviors of any kind, especially sexual. It takes great courage.

And you might wonder if you’re in the realm of addiction or whether you’re just intense. 

So how do you know whether your sex life has crossed the line from exciting to unhealthy?

Erotic appetites and sexual expression vary considerably across individuals. To say that there is one right or healthy way to be sexual is to deny what makes us truly human: our uniqueness. And our differences must be understood and honored (and not pathologized) when we seek to determine whether sex has spilled over boundaries that would contain it.

Do I have a sexual addiction? When sex becomes a problem

There are certain patterns of sexual behavior that can imprison us — the “sex addict” is trapped by the pursuit of mind-altering experiences that become increasingly elusive. Like any experience that is intensely pleasurable, sex can become the metaphoric tail we chase in the hope of something better  — it may be used to create moments of respite from the pain of our lives or it can be an attempt to feel more vividly alive.

There have been numerous attempts to establish criteria for problematic sexual behavior (Carnes, 1991; Goodman, 1998; Kafka, 2010; Rosenberg, Carnes & O’Connor, 2014). 

Here are a few criteria used:

1) There are failed attempts to resist the impulse to engage in certain sexual behaviors.

For example, at some point you might realize that you are watching pornography during most of your free time and you make a promise to yourself (and maybe to someone else) that you’ll stop. A week goes by and you end up viewing porn again. You inwardly rationalize, “It was only for a few minutes.” Two more days pass and you watch about an hour to “help unwind” from a stressful day. This pattern of intermittent use continues for some time before you fall back to watching several hours of porn almost every evening.

2) The behaviors associated with sex (thinking/fantasizing about sex; planning/pursuing it) interfere with other aspects of your life — for instance, the time spent researching and visiting escorts is prioritized over spending time with friends/family, or participating in hobbies you enjoy, or interferes with your job/career or meeting important goals.

3) You must increase the frequency of the sexual behavior or somehow increase the intensity of the experience (possibly through greater risk-taking) in order to achieve the desired effect.

In other words, what once brought you an emotional rush, excitement, or allowed you to escape into sex (thereby momentarily exiting the stresses/problems of your life) starts to flatline. As one client shared, “I used to get an anxious feeling in my stomach when I would search for porn online. Now I feel dead inside, but I do it anyway.”

4) You may know what you are doing is a problem for you, and it may be causing you significant emotional distress or negatively impacting your life in other ways, yet the behavior continues despite these consequences. 

In other words, you feel helpless to stop the behaviors that are wreaking havoc on your life. As a client once described, “It’s like I’m heading toward a cliff and I can’t take my foot off the gas pedal.”


Over the years I’ve had clients come to me concerned that they had a “sexual addiction.” Some simply had high libidos and desired frequent sex with their spouses/partners. Others had an affair and could not understand how they could have betrayed the person they love, so labeling what they did as the side effect of a “sexual addiction” became an easy explanation for uncharacteristic behavior.

Other clients were experimenting with different ways of being sexual that involved a heightened sexuality (rather than a problematic sexuality). And still others felt sexually free for the first time in their lives after feeling oppressed or closeted, and as a result, they were experimenting with their newly claimed sexuality. It would have been an injustice to label any of these individuals an addict.

But I have seen many in therapy who struggled with patterns of sexual acting-out that diminished their lives.

Individuals who feel consumed by out-of-control sexual behaviors (that they don’t necessarily always like but they feel powerless to stop) are in pain. They have become their own worst enemies. And they are in need of support and help. 

The above list is by no means exhaustive. It’s a starting point to help you reflect on your life and the role that sex/sexuality is playing in the overall picture of where you are and where you’d like to be.

Richard Nicastro, Ph.D.

Dr. Nicastro is a licensed psychologist in Georgetown. He sees individuals and couples and runs groups. For information about treatment for problematic sexual behaviors, visit Sex Addiction Group. Dr. Nicastro can be reached at (512) 931-9128 or

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