Out of Control Sexual Behavior: Addiction or Offending?When It Comes to Sex, Confusion Reigns

After more than two decades spent treating both sexual addicts and the occasional offender, I’ve watched the field of sexual disorders assessment and treatment come very far in its understanding of both sexual addiction and sexual offending. Nevertheless, the general public is often wildly misinformed on both topics, as are at least a few clinicians. One of the most common misperceptions is that sex addicts and sex offenders are one and the same. This is most definitely not the case.

In reality, there are significant differences between sexual addicts and sexual offenders. Sex addicts are people who engage compulsively in one or more consensual sexual behaviors, continuing those behaviors despite directly related negative consequences – relationship woes, problems at work or in school, loss of interest in previously enjoyable activities, lack of self-care, declining physical and/or emotional health, financial issues, and more. Sex offenders often have similar symptoms, but their sexual activities are nonconsensual, violating the rights of others, breaking the law, or both.

  • Sexual addiction takes place within the context of a solo sexual act or in relationship with a consenting adult. Sexual addiction is motivated by a desire to not feel emotional discomfort, including the pain of underlying psychological conditions such as depression, anxiety, attachment deficit disorders, and unresolved early-life or severe adult trauma.
  • Sexual offending involves nonconsensual forms of sex – sex with those who don’t want it, sex with those who don’t know it’s happening (voyeurism), sex with those who are too young to consent (including viewing pornography featuring minors), sex with those who are mentally incapacitated and therefore can’t consent, and sex by force.

The confusion about what constitutes sexual addiction versus sexual offending is exacerbated by the fact that there are both clinical and legal definitions of sexual offending. The clinical definition of sexual offending is “nonconsensual sexual activity.” From a clinical perspective, sexual offending typically involves one or more of the following:

  • Exhibitionism
  • Voyeurism
  • Frotteurism (rubbing up against a nonconsenting person for sexual gratification)
  • Incest
  • Viewing, downloading, or creating child pornography
  • Rape
  • Sexual activity with a minor or a mentally disabled adult
  • Sexual harassment
  • Abuse of a professional role to obtain sex

The legal definition of sexual offending is sometimes quite different, and it varies by jurisdiction. For instance, a fully cognizant 18-year-old boy who has sex with his fully cognizant 16-year-old girlfriend after dating for more than two years might be perfectly fine in one state, but a serious felon in another. And even in states where this activity is criminalized, the punishment might vary significantly. Either way, from a clinical perspective this behavior is unlikely to be considered sexual offending.

Conversely, sexual addiction typically involves one or more of the following:

  • Compulsive use of pornography, with or without masturbation
  • Compulsive pursuit of and/or engagement in casual or anonymous sex, usually facilitated by dating websites and smartphone hookup apps
  • Multiple affairs and infidelities
  • Compulsive text and/or video chat with potential sexual partners, often culminating in mutual masturbation.
  • Compulsive participation in online virtual sex games (where users create avatars and then guide them through sexual escapades)
  • Compulsive use of teledildonic masturbatory devices, many of which sync themselves to sexual action taking place on a computer screen or via another teledildonic device
  • Compulsive pursuit of relationships and/or sex as a way to “feel better”

Put simply, sexual addiction may take away or diminish a person’s health, self-esteem, marriage, or job, and may personally offend many people, but seeking or having a lot of indiscriminate sex is not the same as sexual offending. Consider a male “peeper.” His behavior may or may not qualify as sexual offending. If he peers through his girlfriend’s window at 7 a.m. while she’s showering, and he does this with her permission because she thinks this behavior is hot, then he is not offending. If, however, he peers through an unknown woman’s window while she’s showering without her knowledge or consent, he is sexually offending. (Either way, the man’s behavior may or may not be part of a sexually addictive pattern; there is no way to know without significantly more information.)

Although many spouses and partners of sex addicts worry that their children or families might be at risk because there is a sex addict in the house, the reality is that most sex addicts are not sex offenders. Their sexual choices and activities, while painful, problematic, and destructive to existing relationships, are typically consensual and legal.

Where is the Overlap?

There are four basic types of sexual offenders: violent offenders, fixated child offenders, situational child offenders, and sexually addicted offenders (SASOs). Typically, most people think about only the first category if/when they picture sex offenders, even though these individuals comprise only a small fraction of the overall offending population. With the last of category, sexually addicted sex offenders, offending takes place as part of sexual addiction. At this point, it is impossible to know what percentage of sexual offenders are also sexually addicted, but one thing is abundantly clear: Not all sex addicts are sex offenders, and not all sex offenders are sex addicts.

Most of the time, SASOs don’t start out that way. They begin as run-of-the-mill sex addicts, fantasizing about and engaging in “vanilla” activities like viewing and masturbating to legal forms of pornography, engaging in consensual mutual masturbation via webcam, and having consensual casual or anonymous sex. Over time, however, sexual addiction, like all other addictions, can escalate. (Consider drug addiction, where hardly anyone starts out shooting heroin.) This means that over time sex addicts spend more time engaging in their addiction and/or they “raise the stakes” with more intense sexual activity as a way to enhance or maintain the neurochemical high their addiction provides. And suddenly they find themselves viewing illegal pornography, having sex in public, engaging in exhibitionism and/or voyeurism, hiring prostitutes, etc., any and all of which are behaviors that might shock and appall them if they stopped and thought about what they were doing.

Though a few sex addicts do escalate into sexual offending, most do not, and those that do only rarely commit what most people think of as serious sexual offenses. Usually SASOs hire prostitutes or engage in non-contact offenses like viewing illegal pornography. Violent and aggressive types of offending are rarely seen in sexual addicts, who in general are people who fear rejection and/or exposure and therefore prefer to use payment, seduction, and/or manipulation to gain access to consenting partners. As such, rape and hands-on child offenses are extremely uncommon in sexual addicts.

Regardless of whether their behaviors escalate into offending, sex addicts of all stripes typically respond well to evidence-based treatments that have proven effective with other forms of addiction (most often cognitive behavioral therapy coupled with group therapy, psychoeducation, and social learning). For more information about the treatment of sexual addiction, you may wish to read this blog. For more information about the treatment of sexual offenders, you may wish to read this blog.

 

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