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The Narcissism of Sex Addicts and Some Strategies for Therapists

Guest post by: Linda Hatch PhD, CSAT,

Narcissism Equals Low Self-Esteem

A majority of sex addicts behave in ways that are seen by others as narcissistic. Narcissistic personality traits are often described in terms such as grandiosity, self-centeredness and over-entitlement. This suggests the narcissist has an inflated sense of self-worth. In fact the opposite is true.

Most narcissism is actually a defense system. The narcissist has acquired a façade of superiority and self-sufficiency as a defense against unconscious feelings of inadequacy and unworthiness. This defense is often bolstered by career success or being prominent in the community. This self-image is flimsy and superficial, but it is felt by the narcissist-addict to be his or her true self.

As such, this false self protects the addict from experiencing his or her vast reservoir of unhappiness and insecurity.

Narcissism and Sex Addiction Feed One Another

Narcissism and sex addiction are fellow travelers because they feed on each other. Both draw on the addict’s core beliefs about being unlovable, unworthy and alone. Narcissistic over-entitlement allows the addict to feel justified in his or her sexually addictive behavior and avoid the shame that would otherwise surround the behavior, and sex addiction leads the addict into a progressively more isolated and self-centered life in which his or her narcissism reigns supreme.

Sex addicts do not meet their emotional needs in real relationships but rather in the fantasy laden encounters of their addiction. The acting out sex addict is the consummate narcissist who controls the whole show and thus stays safe.

Narcissists Are Very Fragile

Anything that challenges the brittle façade of self-worth can be felt as an unforgivable wound. When reality impinges on the narcissistic sex addict—for example, when the addiction is discovered or the addict gets in trouble—the addict may become all the more defensive and resistant. When the narcissist-addict’s fragile self-concept is undermined, he or she is at risk of becoming alternately enraged and suicidally despondent.

The negative reactions of others don’t fit into this individual’s reality. This helps explain the phenomenon seen in celebrity sex scandals, where the celebrity seems not to “get it” even after he or she is exposed and vilified in public. This individual has constructed a self-image and is unconsciously attempting to deny the assault and keep that self-image intact.

Expect Narcissistic Addicts To Do the Following:

  • Feel unsafe in any relationship including therapy, and be poised to quit if they let you in at all
  • Want to control therapy and resist learning anything from you or a sponsor, feeling that it puts them one down
  • Need to feel admired, and possibly get insulting or aggressive in response to unflattering input
  • Not want to look inside and attempt dodge or derail you with distractions or charm.

Therapeutic Strategies to Use With Narcissistic Sex Addicts

  • Be your real self, a la Carl Rogers—warm, empathic and genuine
  • Acknowledge as a matter of fact how highly painful it is for them to feel criticized by anyone
  • Treat their narcissism as the norm for sex addicts, which takes the sting out of it and opens the topic to education through humor
  • Return often to the process between you; don’t be derailed, but point to their dodging with respect
  • Accept up front that therapy is uncomfortable and that they may either be in a big hurry or feel like bailing out
  • See the strengths in patients that they can’t see in themselves

An Interesting Twist

In working with a seriously sexually addicted and highly narcissistic patient it may actually be easier for that person to accept residential treatment than outpatient therapy. They may feel that the rehab option is less personal and at the same time more prestigious. If they can get with residential treatment that’s great; your job as a therapist will be so much easier later on.

The Narcissism of Sex Addicts and Some Strategies for Therapists

Robert Weiss PhD, LCSW

Robert Weiss PhD, LCSW is Chief Clinical Officer of Seeking Integrity Treatment Centers. He is an expert in the treatment of adult intimacy disorders and related addictions, most notably sex/porn/relationship addictions along with co-occurring drug/sex addiction. A clinical sexologist and practicing psychotherapist, Dr. Rob frequently serves as a subject matter expert for major media outlets including CNN, HLN, MSNBC, OWN, The New York Times, The Los Angeles Times, and NPR, among others.Dr. Rob is the author of Prodependence: Moving Beyond Codependency, Out of the Doghouse, Sex Addiction 101, and Cruise Control, among other books. He blogs regularly for Psychology Today and Psych Central. His podcast, Sex, Love, & Addiction, is rated as a Top 10 Addiction Podcast for 2019. He also hosts a weekly live no-cost Webinar with Q&A on A skilled clinical educator, Dr. Rob routinely provides training to therapists, hospitals, psychiatric organizations, and even the US military. Over the years, he has created and overseen nearly a dozen high-end addiction and mental health treatment facilities across the globe. For more information or to reach Dr. Rob, visit You can also follow him on Twitter (@RobWeissMSW), LinkedIn (Robert Weiss LCSW), and Facebook (Rob Weiss MSW).

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APA Reference
Weiss PhD, R. (2012). The Narcissism of Sex Addicts and Some Strategies for Therapists. Psych Central. Retrieved on February 17, 2020, from


Last updated: 6 Sep 2012
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