There is some controversy in the counseling world over whether sex and porn addictions should be recognized and treated. The primary objection raised by opponents of sex addiction services is based in a cultural sensitivity to pathologizing or moralizing anything sexual; and for good reason. For decades, individuals who experienced same-sex arousal were treated as degenerates in our country. They were written off either as maladaptive biological anomalies or morally bankrupt and spiritually inferior.

Long and swerving has been the effort to engender understanding and compassion in the eyes of our culture on the subject of sexual experience; it is a struggle that remains incomplete. Regardless of political or religious worldview, understanding the underpinnings of any kind of sexual experience must be a work of compassion and humility. But has our struggle against meanness and our desire to defend the innocent developed into a paranoia that denies help to those suffering unjustly at the hands of trauma and dependency? There may be reason to believe that it has.

Opponents of sex addiction treatment see themselves as freedom fighters. They are skeptical of anything that guides or restricts sexual expression. But freedom is precisely what the addict does not have. Opponents of the idea of sexual addictions want people to be free to live out their sexual lives the way they want. Sex addiction therapists want precisely the same thing for their clients.

The man who is looking down the barrel of his second divorce, who is going to lose his children, the career he’s labored for since his youth, and his connection to yet another partner, all because, despite his desperate attempts to stop, he cannot help meeting with a prostitute twice a week, is not a man experiencing sexual freedom. Neither is the woman who cries alone in her apartment after her 24th anonymous hookup this month. She is desperate for intimacy, trapped in a pattern of power-seeking behaviors she learned in her abuse as a twelve year-old, and she is the furthest thing in the world from being sexually free and alive. To the contrary, when she attempts sex in the context of genuine intimacy and vulnerability, she feels emotionally closed off and sexually numb. By their own assessment, these men and women do not engage in these behaviors because they want to do so, they engage in them because they have to in order to function.

Sex addiction therapy, like all other therapies, is concerned primarily with freedom. The man who uses sex with his wife to regulate his own emotions, but who longs to learn to experience sex with her differently, is not free to be himself sexually; he is in bondage and oppressed. It is only from a position of freedom that one is able to choose with efficacy the behaviors in which she would like to engage and to eschew the behaviors which do not align with her own goals and desires. Morally right sexual behavior is never defined by a sex addiction therapist. Prescriptions and proscriptions concerning what to do with sexual freedom is a values conversation; these are categorically not the concern of the therapist. Rather, sexual addictions, like all other addictions, are defined by the individual experiencing them. Clients identify for themselves which behaviors they want to reduce, eliminate, or experience differently.

So what is an addiction? How do you know it’s an addiction and not just a bad habit? According to the International Institute for Trauma and Addiction Professionals, those struggling with undesired sexual behaviors can identify the struggle as an addiction by meeting 3 of the following 10 criteria:

1. Powerlessness/Loss of ControlDefined by a clearly identified behavior that you do more than you intend or want.
2. Compulsive BehaviorA pattern of out of control behavior over time.
3. Efforts to StopRepeated specific attempts to stop the behavior which fail.
4. Loss of TimeSignificant amounts of time lost doing and/or recovering from the behavior.
5. PreoccupationObsessing about or because of the behavior.
6. Inability to Fulfill ObligationsThe behavior interferes with work, school, family, and friends.
7. Continuation Despite ConsequencesFailure to stop the behavior even though you have problems because of it. (social, legal, financial, physical, work)
8. EscalationNeed to make the behavior more intense, more frequent, or more risky.
9. LossesLosing, limiting, or sacrificing valued parts of life such as hobbies, family, relationships, and work.
10. WithdrawalStopping behavior causes considerable distress, anxiety, restlessness, irritability, or physical discomfort.

Men and women suffering from these criteria deserve freedom and healing, but they often find themselves abandoned by a culture that is afraid to talk about sex being a problem. Whole-hearted, integrated, and healed adults are free. They are free, not to choose their feelings, but to choose their behaviors. They can move towards sex when they want and set it aside when they want. They are free to use sex to enrich their lives in the way they choose, rather than being at its mercy as their lives fall apart.