Sexuality Treatment

Treatment for compulsive sexual behavior typically involves psychotherapy, medications and self-help groups. A primary goal of treatment is to help you manage urges and reduce excessive behaviors while maintaining healthy sexual activities.

People with other addictions, severe mental health problems or who pose a danger to others may benefit from inpatient treatment initially. Whether inpatient or outpatient, treatment may be intense at first. And you may find periodic, ongoing treatment through the years helpful to prevent relapses.

Finding the right kind of help
If you have compulsive sexual behavior, you may also need treatment for another mental health condition as well. People with compulsive sexual behavior often have alcohol or drug abuse problems or other mental health problems that need treatment — especially obsessive-compulsive behaviors, anxiety or a mood disorder such as depression.

Seeking help for a sexual behavior can be difficult because it’s such a deeply personal matter. Try to set aside any shame or embarrassment and focus on the benefits of getting treatment. Remember that you’re not alone — many people struggle with sexual urges that are extremely powerful and difficult to manage. Mental health providers understand this and are trained to be understanding, discreet and helpful. Keep in mind, what you say to a doctor or mental health counselor is kept confidential except in cases where you admit to planning or committing a crime or harming yourself or someone else.

Psychotherapy
Several forms of psychotherapy may help compulsive sexual behavior. These include:

• Psychodynamic psychotherapy. This form of psychotherapy focuses on increasing your awareness of unconscious thoughts and behaviors, developing new insights into your motivations, and resolving conflicts.
• Cognitive behavioral therapy. This form of therapy helps you identify unhealthy, negative beliefs and behaviors and replace them with healthy, positive ones.
• Group therapy. You meet regularly with a group, under guidance of a mental health professional, to explore emotions and relationships.
• Family therapy or marriage counseling. Compulsive sexual behavior affects the entire family, so it’s often helpful to involve your partner or children in joint therapy sessions.

Medications
Certain medications may be helpful because they act on brain chemicals linked to obsessive thoughts and behaviors and reduce the chemical “rewards” these behaviors provide when you act on them. Which medication or medications are best for you depends on your overall situation and other mental health conditions or addictions you may have.

You may have to try several medications, or a combination of medications, to find what works best for you with the fewest side effects. Medications used to treat compulsive sexual behavior are often used primarily for other conditions. They include:

• Antidepressants. Those most commonly used to treat compulsive sexual behavior are selective serotonin reuptake inhibitors (SSRIs). These include fluoxetine (Prozac), paroxetine (Paxil), sertraline (Zoloft) and others.
• Mood stabilizers. Examples include lithium (Lithobid).These medications are generally used to treat bipolar disorder (manic depression), but may reduce uncontrolled sexual urges.
• Naltrexone (ReVia). This medication is generally used to treat alcoholism and blocks the part of your brain that feels pleasure with certain addictive behaviors.
• Anti-androgens. These medications reduce the biological effects of sex hormones (androgens) in men. One example is medroxyprogesterone (mud-rok-see-pro-JES-tur-own). Because they reduce sexual urges, anti-androgens are often used in men whose compulsive sexual behavior is dangerous to others, such as pedophilia.
• Luteinizing hormone-releasing hormone (LHRH). This medication may reduce obsessive sexual thoughts by reducing the production of testosterone.

Self-help groups
Self-help and support groups can be effective for sexual addiction and dealing with all of the issues it can cause. Most are modeled after the 12-step program of Alcoholics Anonymous (AA). In addition to helping you make changes directly, these groups can help you learn about your disorder, find support and understanding in your condition, and identify additional treatment options and resources. These groups may be Internet based or have local in-person meetings or both. If you’re interested in a self-help group, look for one with a good reputation and that makes you feel comfortable. Such groups don’t suit everyone’s taste, so ask your mental health provider about alternatives.

• COSA
• Sex Addicts Anonymous
• Sex and Love Addicts Anonymous
• S-Anon International Family Groups
• Sexaholics Anonymous
• Sexual Compulsives Anonymous
• Sexual Recovery Anonymous

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