Sexual health is a state of physical, emotional, mental, and social well being in relation to sexuality; it is not merely the absence of disease, dysfunction, or infirmity. Sexual health requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination, and violence. For sexual health to be attained and maintained, the sexual rights of all persons must be respected, protected, and fulfilled.[1]

Sexual Addiction

Sexual addiction is a psychological condition in which an individual has an inability in managing his or her sexual behavior. Sexual addiction can take many forms, ranging from sexual acting out with others to compulsive masturbation and use of pornography. Some clinicians prefer to call the condition sexual dependency or sexual compulsivity. The existence of the condition is not universally accepted and is the subject of continuing debate. Some proponents offer an addiction model, which they define by analogy to substance addiction; while others offer lack-of-control models, which refer to it as “sexual compulsivity” and offer definitions based on obsessive-compulsive disorder (OCD).

A conservative estimate of those who could meet the criteria for sexual addiction and compulsivity is that of about 3 – 5% of the United States population. This is most likely a very conservative estimate, since these numbers are based on individuals who seek treatment. Based on alcohol and drug statistics, we do know that more people suffer from this problem, than actually seek treatment. These percentages may be based on what we currently understand sexual addiction and compulsivity to be, and should not be interpreted as unchanging truths.(SASH)

Patrick Carnes, a proponent of the idea of sexual addiction, proposed using the following criteria:

• Recurrent failure (pattern) to resist impulses to engage in acts of sex.
• Frequently engaging in those behaviors to a greater extent or over a longer period of time than intended.
• Persistent desire or unsuccessful efforts to stop, reduce, or control those behaviors.
• Inordinate amount of time spent in obtaining sex, being sexual, or recovering from sexual experience.
• Preoccupation with the behavior or preparatory activities.
• Frequently engaging in sexual behavior when expected to fulfill occupational, academic, domestic, or social obligations.
• Continuation of the behavior despite knowledge of having a persistent or recurrent social, academic, financial, psychological, or physical problem that is caused or exacerbated by the behavior.
• Need to increase the intensity, frequency, number, or risk of behaviors to achieve the desired effect, or diminished effect with continued behaviors at the same level of intensity, frequency, number, or risk.
• Giving up or limiting social, occupational, or recreational activities because of the behavior.
• Resorting to distress, anxiety, restlessness, or violence if unable to engage in the behavior at times relating to SRD (Sexual Rage Disorder).

Hypoactive sexual desire disorder

Hypoactive sexual desire disorder (HSDD), is considered as a sexual dysfunction and is listed in the DSM-5 as a sexual disorder. HSDD is characterized as a lack or absence of sexual fantasies and desire for sexual activity for some period of time and effects both men and women. For this to be regarded as a disorder, it must cause marked distress or interpersonal difficulties and not be better accounted for by another mental disorder (i.e. depression), a drug (legal or illegal), or some other medical condition.

There are various subtypes. HSDD can be general (general lack of sexual desire) or situational (still has sexual desire, but lacks sexual desire for current partner), and it can be acquired (HSDD started after a period of normal sexual functioning) or life-long (the person has always had no/low sexual desire.)

Treatment

HSDD, like many sexual dysfunctions, is something that people are usually treated for in the context of a relationship. However, treatment for this disorder could and should be treated whenever it has been an issue for the client. This approach may prevent the failure of future relationships. Typically, the therapist tries to find a psychological or biological cause of the HSDD. Sometimes this is possible and sometimes it is not. If the HSDD is organically caused, the clinician may try to deal with that through referrals to specialized treatment professionals. If the clinician believes it is rooted in a psychological problem, they may recommend and persue therapy for that. Treatment generally focuses more on relationship and communication issues, working on non-sexual intimacy, challenging negative beliefs about sex or education about sexuality may all be possible parts of treatment. Sometimes problems occur because people have unrealistic perceptions about what normal sexuality is and are concerned that they do not compare well to that, and this is one reason why education can be important. If the clinician thinks that part of the problem is a result of stress, techniques may be recommended to more effectively deal with that.

If you are struggling and looking for a sexual health therapist, contact JLS Consulting oday to learn more about what one-on-one therapy can do for you.

[1] Report of a technical consultation on sexual health. Geneva, World Health Organization, 2005.