Sex Addiction or Player? The Control Center

The Tiger Woods situation has put the spotlight on “Sex Addiction” and it currently shines bright. At the office water cooler, in bars, restaurants … people are asking the same question:

Is Sex Addiction for real?

Yes, the term “sex addict” can be conveniently used as a label for a husband who cheats on his wife or a girlfriend who cheats on her boyfriend or a celebrity who needs to go to rehab to “hide out” for a while because he was caught “doing something”. The disorder can be abused and it definitely has moral, political, social, and sometimes even religious implications.

But, it’s not primarily a moral problem, it’s a disorder of out of control feelings and behaviors that can have moral implications.

Sex addiction is not about how much sex you’re having, it’s about why you’re having the sex.

Currently, the term “sex addiction” is not recognized by the clinical manual DSM IV. In the medical field, clinicians and researchers prefer the term “Hypersexual Disorder” or “Compulsive Sexual Behavior” to describe the sexual fantasies, urges, and behaviors of a repetitive nature that often present in response to dysphoric mood states like anxiety, depression, boredom, and irritability. A typical person with compulsive sexual behavior has repeatedly tried to control their sexual behavior (masturbation, pornography, sexual behavior with consenting adults, strip clubs, prostitution, cybersex, etc.) but they simply can’t do it. As such, there is significant impairment in their social and/or occupational functioning that produces personal distress. Treatment providers that treat “sex addiction” often see tolerance (needing more and more of the behavior to get the same desired effect), withdrawal effects (anxiety, sleep difficulties, body aches, chills, headaches, etc.), a failure to fulfill role obligations, and many other symptoms commonly seen in chemical addictions.

Sex addiction epidemiology studies reveal approximately 3-6% of the population have the disorder. Unfortunately, because there’s not a lot of double-blind placebo controlled research studies on hypersexual disorder, the topic’s existence is under debate in the medical community. Some physicians do recognize the intense suffering and loss of relationships, marriages, jobs and even one’s freedom because of the disorder. Other physicians, however, feel that the disorder is simply made-up to justify bad behavior.

A few research studies on the topic of sex addiction have revealed executive function deficits (working memory, attention, cognitive flexibility, impulsivity, problem solving ability, etc.) in some sex addicts. Research studies measuring impulsivity have found significant differences in sex addicts vs. non sex addicts.

Obviously we need more research to solidify the existence of the disorder in the medical community but one thing is for sure, many people are suffering and could get help if they could overcome the shame, guilt, and stigma associated with their behaviors and symptoms.

Sex addicts come in many varieties which complicates the diagnosis. Some sex addicts are primarily impulsive, others are more obsessive, many have suffered trauma and many (60-70% according to some studies) have co-morbid psychiatric disorders (disorders that co-exist with sex addiction including clinical depression, anxiety disorders, ADHD, bipolar disorder, personality disorders, and eating disorders.)

So back to the original question: Sex Addict or Player?

Let’s analyze a typical “Player”. A player is usually a man or woman who needs to connect with a member of the opposite sex in order to validate themselves and at least temporarily provide more self worth. The validation usually doesn’t last very long and it often needs to be fed on a regular basis by many different people which is why players move on from person to person. The typical player is thinking short term and is usually pretty insecure, doesn’t handle rejection very well, has a narcissistic tone about them, and needs to be validated to feel worthy. The player status of some individuals is just a “phase” for attention while others sometimes end up being lifetime players unless they get some help from friends, family, or a therapist.

A “Sex Addict” likewise needs validation and is probably quite insecure and has difficulties with self worth. The difference, however, the typical “sex addict” is sick … and has significant difficulties establishing emotional intimacy and connectedness with others. They become desperate for connection and it plays out in their sexual behaviors that help them to cope/distract or escape from their suffering. Additionally, many sex addicts have mental health impairment that may be driving the sexual addiction.

It may take a good clinical interview, psychiatric assessment, psychological testing, and a full assessment/evaluation to really determine if someone is a “sex addict”. The threshold is high and the treatment is difficult.

A player, on the other hand, tends to be quite a bit healthier than a sex addict. They will still have problems with intimacy and self worth but they can usually hide behind their charm and function fairly well.

So, the next time someone says “that guy’s not a sex addict, he’s just a player” … the odds are they’re right. But remember, some “players” are actually “sex addicts” that have gone undiagnosed and need help.

Dr. Reef Karim
Director: The Control Center
Psychiatrist, Addiction Specialist, Relationship Therapist