By Michael Ian Rothenberg, PhD, LCSW
Introduction
Dr. Michael Ian Rothenberg, LCSW holds a faculty appointment at the University of Central Florida School of Social Work where he teaches courses in Human Sexuality and Child Abuse Treatment and Prevention and is the Founder and Clinical Director of the Center for Counseling and Sexual Health of Winter Park (Orlando), Florida where he provides counseling and therapy for straight, LGBT, gay, lesbian, bisexual and transgender adults, children and adolescents and specialized treatment for sexual addiction, pornography addiction, hypersexual behaviors and male survivors of childhood sexual abuse. Dr. Rothenberg has served as a keynote speaker, conference presenter, guest lecturer and panel participant at venues including Yale University, Peking University (Beijing, China) and The German Society for Social-Scientific Sexuality Research (Munich, Germany).
Q. Dr. Rothenberg, there is some controversy about the definition of sexual addiction and whether the condition is a true addiction. How would you define it?
It is quite true that the definition of sexual addiction is often debated and steeped in controversy. As a clinical sexologist, who has treated many hundreds of people who struggle with these very specific challenges, I define sexual addiction as a recurrent phenomenon characterized by steadily increasing patterns of sexual thoughts and behaviors that lead to negative consequences for individuals as well as for their significant others.
In my professional practice, I most often see clients whose sexual addiction is a neurochemical response to ever increasing levels of anxiety and stress in their lives.
Q. How difficult is this condition to treat?
Though not an insurmountable problem, sexual addiction can, in fact, often be quite difficult to treat depending upon several factors including the length, severity and intensity of unwanted sexual thoughts and behaviors. It is not unusual for treatment for sexual addiction to last anywhere from several months to, sometimes, years. As a clinician, it is vitally important that I diagnose, treat and help the client to understand the triggers that fuel the sexual thoughts and behaviors. These triggers can often include anxiety, depression, loneliness, boredom, anger and the effects childhood trauma and sexual abuse.
Q. Are men more likely to have the condition than women?
Though women can, and do, struggle with sexual addiction, most of the clients who seek treatment at The Center for Counseling and Sexual Health are, indeed, men.
Q. Is any particular age group more affected?
The recurrent sexual behaviors and thoughts that are the hallmark of sexual addiction, unfortunately, do not discriminate by age. I have worked, regularly, with clients whose ages have run the gamut from young teens to octogenarians and all ages in between.
Q. Can sex addicts be successful in other areas of their lives i.e., at work, etc.
Most definitely, as many of the individuals who are struggling with sexual addiction are, in fact, very highly successful in other areas of their lives. Those who struggle with unwanted sexual thoughts and behaviors regularly include business and community leaders, politicians, lawyers, doctors, entertainers and others in traditionally high stress positions.
Q. What type of person with the condition is most likely to be successfully treated?
I do strongly believe that all individuals have the capacity to be successfully treated. I generally employ a cognitive-behavioral approach in treating sexual addiction and find that those individuals who do well with this therapeutic methodology have very positive outcomes.
Q. Can sexually addiction wane as the person ages? In other words are there many 60-year-old sex addicts?
People are sometimes quite surprised to learn that many older individuals do often struggle with these challenges as well. The severity and intensity of sexual thoughts sometimes actually increases with age and does, sometimes, correspond with a decline in sexual performance and sexual functioning. I often provide sexual addiction treatment for individuals in their sixties, seventies and eighties.
Q. When “cured” of this addiction, is the person likely to fixate or another behavior?
Some individuals do suffer from obsessive sexual thoughts and compulsive sexual behaviors and, sometimes, their sexual fixation is replaced by different thoughts and behaviors that serve a similar purpose.
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