Whether you are the wife or husband, significant other or loved one of someone who engages in compulsive sexual behavior \u2013 or if you are the person with the problem yourself \u2013 you likely have a lot of conflicting emotions about the situation, and not the least of which is what you should or even coulde do about it. Amid the nagging doubts is the agonizing thought that maybe such behavior, especially if it has gone on for a long time, can\u2019t be stopped. But if it can be stopped, wouldn\u2019t you want to do everything in your power to help the individual (or you) overcome compulsive sexual behavior? Obviously, the answer is yes, you would want to. So the question becomes, can you stop compulsive sexual behavior? Let\u2019s take a closer look at what\u2019s involved. What is Compulsive Sexual Behavior? Getting down to basics, there\u2019s no single universally-accepted definition of compulsive sexual behavior. But there are some general statements that, taken together, form a definition that will likely suffice for our purposes. A person who is obsessed with sexual thoughts, feelings, or behaviors that affect his or her relationships, health, job, or other parts of life, he or she may have compulsive sexual behavior. You may have heard the terms hypersexuality, sexual addiction, or nymphomania used to describe what is considered compulsive sexual behavior. These are all appropriate terms for sexual behavior that has become obsessive. In fact, it\u2019s the obsessiveness that gives it away. What may begin as normal sexual behavior somehow crosses the line into obsession. It may also involve fantasies or actions and activities that are far outside the bounds of what is considered culturally, legally, and morally sexually acceptable behavior. Activities that May be Warning Signs of Compulsive Sexual Behavior Looking at the subject of compulsive sexual behavior, it\u2019s important to clarify what types of feelings, thoughts, or activities may be warning signs that there\u2019s a problem. It may, in fact, be something other than what you think. In reality, compulsive sexual behavior includes a number of different behaviors \u2013 taken to extreme. Here are a few examples: \tMultiple sexual partners or multiple extramarital affairs \tSex with anonymous partners or prostitutes \tDeliberately avoiding emotional attachment in relationships \tFixation on a partner that is unattainable \tExhibitionism \tMasochistic or sadistic sex \tFrequent use of pornographic materials \tUse of commercially available and sexually explicit phone and Internet services Symptoms of Compulsive Sexual Behavior Let\u2019s be honest. Everyone may have, at one point or another, had a desire to check out pornographic sites on the Internet, or flipped through Playboy or Hustler or some other sexually explicit magazine. This certainly doesn\u2019t mean that the person is engaging in compulsive sexual behavior. And how many of us haven\u2019t fantasized over an individual who may be completely unattainable, having vivid and sexually-explicit dreams of the person that frighten or even embarrass us when we are awake? We can\u2019t help what pops up in our nighttime dream state. It\u2019s what we do when we are awake that makes the difference. If the person is totally unattainable \u2013 he or she is married, engaged to or going out with someone else, is our supervisor at work, has stated their lack of interest in us, or any other reason \u2013 pursuing that individual in real life is obsessive sexual behavior. So, once again, what may originate as normal sexual behavior becomes compulsive sexual behavior when it is taken to extremes. When what we think, say, and do involving sexual behavior harms others and ourselves, it\u2019s compulsive sexual behavior. Of course, there are other compulsive sexual behaviors that are far beyond the bounds of what is considered normal and acceptable. These are called paraphilias, and include behaviors that range from cross-dressing to having sexual desires toward children (known as pedophilia). How do you know if what you \u2013 or someone you love \u2013 is struggling with compulsive sexual behavior? While they vary in severity as well as type, here are some common symptoms: \tEscape - Using compulsive sexual behavior as an escape from problems such as anxiety, stress, loneliness, or depression \tDifficulty with closeness \u2013 An inability or difficulty establishing or maintaining closeness in a relationship \u2013 even if you are married or otherwise committed to a partner \tContinued sexual behavior despite consequences \u2013 Continuing to engage in risky sexual behaviors despite serious negative consequences, such as losing a job, trouble at work, legal problems, jeopardizing an important relationship, the potential to give someone a sexually transmitted disease \tNo satisfaction in the behavior \u2013 Continuing the sexual behavior that you feel driven to do despite the fact that you derive no satisfaction from the activity \tLoss of control \u2013 Sexual thoughts and impulses intensify to the point where you feel you no longer have any control Questions to Ask Yourself If you are the person worried about whether or not you have a problem with compulsive sexual behavior, or you are concerned about a loved one or friend whom you suspect may have it, there are some questions that need to be answered \u2013 by that individual. The reason to ask these questions is that no one can just stop compulsive sexual behavior that doesn\u2019t want to. And in many cases, they can\u2019t do so at all without professional help. In other words, a person needs a skilled therapist in order to work his or her way through the reasons for the compulsive sexual behavior, and to find healthier ways to live and express sexuality. It\u2019s very important to remember that sexual urges can become more intense and frequent over time. Just telling yourself that you will stop and being convinced that you can do so out of sheer willpower is often doomed. That\u2019s because of the powerful nature of these urges. The best time to seek help is when the individual first recognizes that he or she has a problem. So, ask yourself (or give these questions to someone who indicates they are struggling with this problem): \tDo I try to hide my sexual behavior from others, from my family, friends, co-workers? \tDo I find that sex is constantly on my mind \u2013 even when I don\u2019t want to think about it or try to distract myself? \tAm I able to control my sexual impulses \u2013 so that I don\u2019t act upon them? \tAm I getting in trouble as a result of my sexual behavior \u2013 is it hurting my relationships, jeopardizing my job, getting me arrested? Experts recommend that immediate treatment be sought by anyone who is suicidal or expresses having thoughts of suicide, thinks they may cause harm because of their uncontrollable sexual behavior, or has bipolar disorder or problems with impulse control and feels that their sexual behavior is getting beyond their control. What Causes Compulsive Sexual Behavior? Researchers have been studying this for years, trying to come up with the reasons for compulsive sexual behavior. There are a lot of different theories, but no clear answers. The causes may be from: \tImbalance of brain chemicals \u2013 Some researchers believe that an imbalance of brain chemicals called neurotransmitters \u2013 such as dopamine, seratonin, and norepinephrine \u2013 may be related to compulsive sexual activity. These same brain chemicals also help in mood regulation. \tDiseases or health problems affecting the brain \u2013 Some health problems or diseases affecting the brain are thought to have an impact on the development of compulsive sexual behavior. Huntington\u2019s disease, dimentia, and multiple sclerosis have been associated with compulsive sexual behavior. Patients treated with dopamine agonist medications for Parkinson\u2019s disease may begin to experience compulsive sexual behavior. \tLevels of sex hormones \u2013 Androgens, which are sex hormones that occur in men and women and play a vital role in sexual desire, may play a role in compulsive sexual behaivor, although it is unclear how. \t\u00a0Brain pathway changes \u2013 Many treatment professionals believe that, over time, the addiction of compulsive sexual behavior may cause changes in the brain\u2019s neural circuits. These are the network of nerves that permits brain cell inter-communication. As a result of these brain pathway changes, unpleasant reactions can occur either when compulsive sexual activity is engaged in or when it is stopped. What Makes Compulsive Sexual Behavior Worse? There are several risk factors that make compulsive sexual behavior worse, or may even precipitate a problem. These include alcohol and drug abuse problems, any history of physical or sexual abuse, and having another psychological condition \u2013 such as impulse or mood control disorder, or some other mental health problem. When Enough is Enough Sometimes it takes a lot of accumulated negative consequences for an individual to finally come to the realization and acceptance of the fact that they do have a problem with compulsive sexual behavior. You can\u2019t force the individual to arrive at this recognition. They have to do it on their own. You can present evidence, arrange an intervention, come together as friends and family to try to encourace the individual to get help, but if that person doesn\u2019t want to accept, or feels he or she isn\u2019t ready yet, no amount of talk with make a difference. When is enough too much? At what point does a person say that it\u2019s time to get help? It\u2019s a different scenario for everyone. It may be that the individual feels the weight of so much hurt that caused to loved ones as a result of compulsive sexual activity. It could be following multiple arrests, increasing legal bills, crushing financial debt (some of which is caused by expenses related to compulsive sexual activity), unwanted pregnancy, contracting HIV\/AIDS or other sexuall-transmitted disease. Perhaps the final straw is the overwhelming feelings of guilt, shame, remorse, and low self-esteem over what the person\u2019s actions have done to the family. Maybe trying to escape through alcohol and drugs just adds yet another layer of addictive behavior to the compulsive sexual behavior \u2013 and the light finally comes on: it\u2019s time to get help. The Important First Steps to Getting Help Making the decision to seek treatment is the biggest hurdle. Once you, or the person who believes he or she is engaged in compulsive sexual behavior, arrive at this decision, the next few steps are critically important. There are several places to start, but it has to begin somewhere. Do whatever works best for you, but do it. Talk with your family doctor and have a thorough physical exam. This can rule out any underlying mental or physical condition that may be causing or exacerbating your behavior. You may be referred to another specialist for further examination and tests, to a psychiatrist, psychologist or other mental health provider. While you\u2019re with your doctor, ask about referrals to support groups, local providers, web sites or other resources. Once you get a referral or find a mental health provider, make an appointment and keep it. You want to find a psychiatrist, psychologist, or other mental health professional with experience in treating compulsive sexual behavior. Go to the government web sites or to agencies such as the Department of Health and Human Services or the Department of Vetarans Affairs. Ask for a referral to a mental health provider. Link up with local support groups whose focus is helping members overcome compulsive sexual behavior. These are available on the Internet, and include Sexaholics Anonymous, Sex and Love Addicts Anonymous, Sexual Compulsives Anonymous, and Sexual Recovery Anonymous. These groups, called 12-step groups, do not treat compulsive sexual behavior. Their focus is on providing support and encouragment to members who are committed to overcoming their compulsions. It\u2019s also a good idea to have a candid discussion with your spouse or partner about what you\u2019re trying to do. Enlist his or her support. Along with participation in a 12-step group, the encouragement from your family and loved ones is vital to your being able to stop your compulsive sexual behavior. But you may need more than this. You may need to go in for treatment at a specialized facility. Going for Treatment Use the same resources (family doctor, government sites and agency sites) to locate a treatment facility that specializes in treating individuals with compulsive sexual behavior problems. If you have other substance abuse problems in addition, look for faciities that treat multiple substance abuse and process addictions. If you have a co-occurring mental health disorder and substance abuse, look for a facility that can handle both simultaneously. Residential sex addiction treatment facilities may be the best solution, if your insurance covers such treatment or you can arrange special financing. You may need to get time off work to attend such treatment, although there are different time lengths of programs. You won\u2019t know until you check it out. When you go to a treatment facility \u2013 let\u2019s say it\u2019s a residential treatment facility \u2013 you will go through a thorough interview and evaluation. You will be asked a number of questions about your sexual activity, including how often it occurs, what triggers it, what makes it worse, problems your behavior has caused, any medications you take, if you have any other substance abuse problems. Diagnosing compulsive sexual behavior involves evaluation of many different aspects of your life, what you say bothers you, how your sexual activity has interfered with your life and those of others, just to name a few. Your actual diagnosis may be a subcategory of another condition, such as obsessive-compulsive disorder or impulse control disorder. It\u2019s important for you to answer all questions honestly and to the best of your ability. You may also be required to take some additional tests (especially if drug and alcohol abuse is involved). This is necessary so that a personalized treatment plan can be prepared for you. What\u2019s Involved in Treatment Treatment for compulsive sexual activity involves use of several different forms of psychotherapy, medications, and 12-step group meeting participation. Some forms of psychotherapy that may be used include group therapy, cognitive-behavioral therapy (CBT), psychodynamic psychotherapy, and family therapy or marriage counseling. In fact, you may be involved in several types of psychotherapy during your treatment program. Medications may be prescribed, depending on your overall situation and any other mental health conditions or addictions you have. These medications may include mood stabilizers, medication to reduce obsessive sexual thoughts by reducing the production of testosterone, anti-anxiety medications, anti-androgens (medication to reduce the biological effects of sex hormones in men), antidepressants, and naltrexone. The length of your treatment plan will be discussed with you before you begin treatment. You will be evaluated and your therapy (treatment modalities) modified according to your progress. You will be introduced to the concept and practice of attending 12-step meetings during your treatment and will be encouraged to continue participating in support group meetings after you complete treatment. The purpose of going through a formal treatment program for compulsive sexual behavior is so that you can learn about the disease, how to recognize and identify triggers, learn coping strategies to deal with urges, how to avoid risky situations, how to develop and implement goals that permit you to live a healthy and normal life. Can you stop compulsive sexual behavior? The answer is yes \u2013 if you are committed to doing so, seek help, stick with it, and build strong support networks to assist you in your long-term recovery. Remember, sex is a normal part of life. Unlike quitting drinking or doing drugs, your goal isn\u2019t complete abstinence from sex. It\u2019s about establishing and maintaining healthy behaviors that allow you to express normal sexual desires with consenting adults. Be prepared to give it time. This problem didn\u2019t occur overnight. It will take some time for you to overcome it. And you will.