In today’s digitally driven world it can be difficult to distinguish between those whose involvement with online sexual behavior is recreational, those whose involvement is “at-risk,” and those who are cybersex addicted (those whose lives and functionality are negatively affected by repetitive online sexual activity). This is compounded by the fact that most of the people who are struggling with cybersexual activity who enter psychotherapy choose to talk about their symptoms (depression, anxiety, issues with sleep, inability to form lasting relationships, and the like) rather than their problematic patterns of cybersexual activity. Making matters worse, current therapeutic evaluation tools (standard bio-psycho-social assessments) typically do not ask clients much about their sexual lives or sexual histories, meaning these issues can easily go undiscovered and unaddressed (to the client’s detriment). This non-discovery is aided and abetted by the very nature of the Internet, which, in addition to being highly affordable and continually accessible, allows for relatively anonymous use, making it easy for cybersex abusers to keep their behaviors private and to psychologically compartmentalize what they are doing.
Of course, even those who compartmentalize their online sexual activity may only be casual or at-risk cybersex users, rather than addicted.
- Casual Cybersex Users are men and women who find online pornography, virtual sex, and digital flirting to be fascinating and fun. They get involved in these pleasurable distractions occasionally. Often their use is driven by curiosity and novelty. Their use may also be driven by life-stage events. For instance, they may engage in cybersexual activities more in late adolescence or after a relationship breakup. Casual cybersex users typically find cybersex to be an intermittent source of relaxation and fun, but ultimately not as meaningful and satisfying as in-person connections. As such, their interest in cybersex is not sustained over time.
- At-Risk Cybersex Users are men and women who go through periods of intense engagement with sexnology, perhaps using it as a distraction from emotional discomfort and other life issues. They may have addiction-like periods, but they can (and usually do) limit or stop their behaviors if/when they start to experience (or even to see the possibility of experiencing) adverse consequences. Sometimes at-risk users look a lot like addicted users, hiding the nature and extent of their cybersexual behaviors, temporarily ignoring potential and even actual consequences, and escalating the nature and extent of their use. What differentiates at-risk users from addicted users is at-risk users can stop the activity on their own while addicted users cannot. In other words, at-risk users retain control and choice over their engagement with cybersex. Addicted users do not.
- Addicted Cybersex Users are men and women who compulsively use digital technology as a means of engaging in sexual fantasy and activity, regardless of potential and/or actual consequences to them or others. These individuals repetitively use sexual fantasy and activity as a way to “numb out” and “not feel” stress and other forms of emotional discomfort. Typically they find themselves leading a double-life, separating their cybersexual activity from their work and home life—keeping secrets, telling lies, manipulating, juggling, minimizing, justifying, etc. Usually they lack empathy for those who are negatively affected by their cybersex addiction, including spouses and partners, kids, and employers. Sometimes they even blame their “need to escape” on the attitudes and actions of these other people.
Therapists: Dig for the Details
Although recreational, at-risk, and addicted cybersex users are three very distinct categories, it can be difficult to distinguish between them, as at-risk and addicted users who enter therapy rarely volunteer information about their sexual coping/compensating behaviors. Furthermore, the life concerns that these clients do bring us (and that are sought out by standard bio-psycho-social assessment tools) are often symptomatic and indicative of other psychiatric disorders (depressive disorders, anxiety disorders, and the like). It is tempting for therapists to take these clients at their word and to treat those more common maladies without deeper investigation into other potential problems.
This situation can be exacerbated by the fact that psychodynamic, narrative, Jungian, analytic, and other non-behavioral treatment methods, while highly useful when working with various forms of emotional instability and mood disorders, are not particularly helpful with behavioral compulsions and the various addictions. Therefore, an assessment that does not look in detail for behavioral/addictive problems will sometimes evoke a less-than-useful stance on the part of the treating clinician.
Of note: When a cybersex addicted client’s addiction is effectively addressed, symptomatic co-occurring issues like depression and anxiety often clear up of their own accord, or they at least more accurately reveal their origins—episodes of early-life trauma, for instance—which can then be dealt with more directly and effectively.
The issue of sex can be added to the client evaluation process by asking a few basic (non-intrusive, non-graphic) questions about sexuality. If answers to these questions raise red flags, further investigation is merited. Basic questions that typically prove useful include the following:
- Has anyone in your life ever expressed concern about your sexual or romantic activity?
- Are you concerned about any aspects of your sexual or romantic life?
- What do you do to temporarily escape unpleasant feelings? Some people eat, some people masturbate, some people exercise. What do you do?
- Do you keep secrets about your sexual or romantic life?
- Is there anything about your sexual or romantic life that others would find disturbing if they knew?
- Do you feel ashamed or uncomfortable with any aspect of your sexual or romantic life?
If the client answers in ways that indicate he or she might have an issue with compulsive cybersexual activity, you should most definitely continue with a deeper investigation. Among the most useful tools for this are the confidential, easily administered sex addiction screening tests found on the Sexual Recovery Institute website. If it does appear that your client has an issue with cybersex addiction, that individual is best referred to a sexual addiction treatment specialist. The websites of the International Institute for Trauma and Addiction Professionals and the Society for the Advancement of Sexual Health are both excellent sources for referrals. (Both groups offer training and certification in sex addiction treatment.) If you are interested in learning more about sexual addiction, my personal website presents information useful to both therapists and clients.