1. Loss of Control
   • Out of control sexual behavior predominates
   • The addicts cannot control the extent, duration and regularity of his/her sexual behavior
   • Behavior excesses continue despite clear signs of danger (consequences)
     -- Compulsive masturbation
     -- Compulsive pornography use
     -- Chronic affairs
     -- Exhibitionism: intrusive "flaunting/showing"
     -- Dangerous sexual practices, i.e., asphyxiation 
     -- Prostitution
     -- Anonymous sex (at porn shops, bars, etc.)
     -- Voyeurism: intrusive "watching"

2. Continuation Despite Consequences 
   • Social Consequences
     -- Loss of marriage/primary relationship, friendships and social networks 
     -- Problematic relationships with spouse, family and/or significant others
   • Emotional Consequences
     -- Depression, anxiety, fear, etc.
     -- Suicidal thoughts, plans and/or attempts (70% have thought about it) 
   • Physical Consequences
     -- Injury due to frequency and type of behaviors
     -- Sexually-transmitted diseases 
     -- Unwanted pregnancies or abortions 
     -- Sleep disturbances
   • Legal Consequences
     -- Arrests for sexual crimes (voyeurism, lewd conduct, etc.),
     -- Loss of job, licensure, and/or professional status 
     -- Sexual harassment charges  
     -- Fines, legal fees, probation, or incarceration
     -- Being on the Sexual Offender Database
   • Financial Consequences
     -- Costs of pornography, prostitutes, and phone sex can cause financial hardships
     -- Loss of productivity, creativity and/or employment
     -- Loss of career opportunities
     -- Bankruptcy

3. Efforts to Stop
   • Repeated specific attempts to the behavior, which fail
   • Even after multiple life changing consequences, the sex addict cannot stop
     -- Leads to further frustration, anger, shame and      depression
     -- Frustration fuels further episodes of addictive behavior)

4. Loss of Time
   • Significant amounts of time lost doing and/or recovering from the behavior

5. Inability to Fulfill Obligations
   • The behavior interferes with work, school, family, and friends
   • High-risk behavior is continued despite responsibilities and expectations
   • A pattern of broken promises and failures

6. Ongoing Desire or Effort to Limit Sexual Behavior
   • Repeated but futile attempts to change, limit or stop addictive behavior
   • Breaking promises to change, limit or stop behavior
   • Cross Addictions: substituting or transferring another addiction to aid in stopping or controlling sexual cravings
     -- Workaholism
     -- Overeating
     -- Alcohol abuse
     -- Illegal and prescribed drug abuse
     -- Compulsive gambling
     -- Religious Addiction
     -- Romance addiction

7. Preoccupation (Obsession about or because of behavior)
   • Sexual obsession and fantasy as a primary coping strategy
   • Elevated levels of arousal are used to cover up feelings
   • Sex becomes a primary drug to numb, "medicate" and/or regulate emotions
   • Sex is used to block out painful and unpleasant memories
   • Euphoric Recall or "Sex in the head" maintains the fix whenever needed
     -- Secretive mental images of past sexual acting out, which is used to sexually act out again
     -- Its like having a personal collection of pornography to be used at any time

8. Escalation
• Amounts of behavior increase because the current levels no longer satiate cravings
     -- Higher "dosages" are needed to get the same feeling/excitement. 
     -- Can cause self injury
   • Masturbation to the point of injury
   • Asphyxiation
     -- Increased levels create victims 

9. Severe mood changes around sexual activity
   • Depression, anxiety, anger, and other mood/affective states can result from repeated failures to stop or control the      
     addictive behavior
   • 70% described chronic feelings of depression
     -- Other chronic mood or affective states include: 
   • Anxiety
   • Guilt and shame 
   • Anger at self and others
   • Hopelessness and despair (monitor suicidal ideations)
     -- Mood changes may be "medicated" (hidden) through the use of other drugs or medications

10. Compulsive Behavior 
   • Sexual behavior that you want to stop but you can't
   • A pattern of out of control behavior over time
   • Sex becomes the organizing principal of daily life
   • Everything revolves around it
     -- On sexual obsessions and fantasizing
     -- On planning next event
     -- On sexual acting out (some spend 8 hours a night on the internet)
     -- On covering up or making up for lost time
     -- Addressing consequences of sexual behavior

11. Losses 
   • Losing, limiting, or sacrificing valued parts of life
     -- Hobbies, family relationships, and work
     -- Loss of important personal, social, occupational or recreational activities
     -- Loss of friends and family (loss of relationships)
     -- Loss of long-term relationships
     -- Loss of talents, goals, and personal and professional aspirations

12. Withdrawal
   • Stopping behavior causes considerable distress, anxiety, irritability, or physical discomfort.
   • Usually lasts for about 14 days, but can be as long as 10 weeks
     -- Insomnia
     -- Headaches and/or body aches
     -- High or low sexual arousal and/or genital sensitivity
     -- Increased appetite for food
     -- Chills, sweats, shakes and/or nausea
     -- Rapid heartbeat and/or shortness of breath
     -- Intrusive dreams
     -- High level of anxiety and irritability
     -- Emotional lability (roller coaster feelings)
    • Some sex addicts with a chemical dependency report that withdrawals are worse for sex addiction than for 
      drug/alcohol addictions


Ross Rosenberg, M.Ed., LCPC, CADC
Clinical Care Consultants, PC
Arlington Heights / Buffalo Grove / Northern IL
3325 N. Arlington Heights Rd, Ste 400B
Arlington Heights, IL  60004
ClinicalCareConsultants@gmail.com
(847) 749-0514
Serving Northern Illinois