Identifying and treating sex addiction can be a real challenge for both patients and professionals. People with sex addiction, particularly women, do not always recognize that compulsive sexual behavior is the root of their problems, and even when they do, it is often very uncomfortable for people to talk in detail about their sex lives. Furthermore, many professional counselors are not fully at ease asking the kind of probing questions about sex that are necessary in order to diagnose and treat sexual addiction. Patients and Even Clinicians May Avoid Talking About Sexual History Sex addiction often presents somewhat differently in men and women, with women more likely to suspect that they have chronic relationship problems rather than sex addiction. This makes them less likely to seek professional help and less likely to discuss their sexual behavior when they do get counseling. Avoiding treatment is also a problem for many women who know they have a problem with sex but are extremely ashamed of it because of the way our culture stigmatizes female sexuality. Ideally, professional counselors would carefully dig down to the root of the problem even when the patient is not fully aware of it or comfortable discussing it. But even licensed and practicing clinicians are not always comfortable asking detailed questions about a patient\u2019s sexual history, or they are not willing to do so unless there is a clear indication. Sex Addiction Is Under-Recognized, and Clinicians Do Not Want to Alienate It is partly a matter of under-recognition. Although sex addiction diagnosis has increased significantly in the past decade or so, it is still new enough and unusual enough that many counselors will not have come across a case of sex addiction in their practices. As a result, when one does appear it can be challenging for them to recognize the signs. Some counselors are also concerned about their clients\u2019 comfort levels and hesitate to push the topic in the direction of sexual history unless there is a clear need. Establishing trust between patient and counselor is an important part of successful treatment for any psychological disorder, and counselors do not want to threaten that relationship and have their patients feel that their counseling sessions are not a safe place. Of course, there are ways to make therapeutic spaces safe and relatively comfortable places in which to talk about sex, but it takes skill and care to do so. Patients May Never Get Help If Clinicians Do Not Recognize Sex Addiction In the counseling world, there are growing numbers of certified sex addiction specialists who can provide experienced treatment for patients or partners dealing with sex addiction. However, it is still important that clinicians who do not have this specialty learn to understand and recognize sex addiction. Otherwise, those patients who seek personal or relationship counseling without realizing that sex addiction is their underlying problem will never be referred to the specialists who can truly help them. Clinicians who are unfamiliar with sex addiction can also make the opposite mistake, assuming that sex addiction is all about sex and an overactive libido. However, once sexually compulsive behaviors have been identified as a problem, counseling for sex addiction will often cover ground that is very familiar to any professional therapist. Traumatic family histories and destructive thought patterns often form the foundation of sex addiction, with sexually compulsive behaviors simply the means of acting out in attempts to compensate for serious intimacy struggles.