Shame is characterized by a feeling of overall worthlessness or despair about being a good or worthwhile person. For the sex addict, engaging in destructive, compulsive behaviors such as seeing prostitutes, maintaining multiple affairs, or masturbating night after night to pornography, results in shame about these acts and becomes the inner core of feelings of being defective in some way.

An example of sexually destructive behaviors and shame is “Joe” a 46 year old married man with three children. Unknown to his wife, he has a pornography collection of hundreds of images stored on his computer which he uses for daily masturbation. Joe has been making sexual contacts with women through the Internet over the past 2 years and has begun to meet some of them for clandestine sexual encounters. Joe rationalizes his behavior by concluding that no one is hurt or in some way directly affected. The shame evolves through the continued dishonesty with his family and associates.

Secrecy is the centerpiece of sex addiction. Because the sexual behavior is so potentially damaging if revealed, the addict spends a lot of energy “managing” his/her life by lies and manipulations.

Cheryl, a 45-year-old lesbian in a long-term monogamous relationship. Despite this, she seeks anonymous sex in the same night club where she has been arrested for lewd conduct just 2 months before. Though promising herself she would never return there, that she was done with having sex with strangers, she continues to engage in these sexual behaviors. Despite these misguided and naïve promises, she continues to place herself in these settings bringing the risk of disease into her relationship. The secrecy emerges when she is not honest with her partner and begins to become very creative in clouding her unknown lifestyle.

Abusive sex includes manipulations or lying in order to be sexual. This includes exhibitionism, sexual harassment, and rape. Sexual partners are being abused when they are invited into situations they do not fully understand, when there is a clear inequity of power in a relationship or when the right of sexual choice is taken away.

Peter is a manager in a small corporation. He is known as “always being on the make.” As such, women at Peter’s company learned to be careful how they interacted with him. Peter didn’t see anything wrong with pats on the butt, commenting on a co-workers legs or breast size or making out with secretaries in the elevator at the company holiday party, though being careful that the women he approached didn’t work directly for him. Married for 15 years, Peter maintained several sexual affairs at work. In college, Peter had been kicked out of a fraternity when he was accused of having sex with a woman after she passed out from drinking. These are exploitive acts, they involve gestures of power.

As these examples illustrate, sexually addictive behavior is not based on a single incident or experience. Like any addictive condition, sex addiction evolves, matures and progresses. Intervention then, needs to be done professionally and with the utmost respect for confidentiality.