Dr. Karen Gless, Ph.D.
Sex Therapy Doctor
Relationship Concepts

Dr. Karen Gless, PhD, MFT, RN

Relationship and
Marriage Counseling

I have a private psychotherapy practice in San Diego, California, for more than 14 years. I help my patients
deal with problems in their relationships and in their sex lives. Feel free to contact me at

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"Thanks again for everything – You really made a difference in our lives". Alice and Paul

"You were the first to give us tests to help us understand ourselves and each other. We saw several therapists and you were the first one to help us". Sheila and Henry

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Karen Gless, Ph.D.

As a sex therapist I often work with people who are worried that they are addicted to sex. Some of them do have a problem with compulsive sexual acting out while others are worried about normal behaviors. This article is about the difference between normal and addictive sexual behavior. In the following article the names and circumstances have been changed to conceal patients’ identities.

I first met Lisa when she came in for couple counseling with her husband. From their outer appearance they were an average, happy couple. But Lisa and George hid a deep, dark secret. It seemed like their sex life was all right except that George had occasional erection problems, which they both blamed on the stress of his job. Like a lot of people they avoided discussing their feelings about sex.
The problem started to come out when Lisa discovered a huge phone bill because George had been calling 900 phone sex numbers. When Lisa confronted him, he admitted that for sometime he felt driven to masturbate in unusual places, fortunately without being caught. Lisa was beside herself. She felt embarrassed, hurt, angry and confused.
George and Lisa were not the first couple I had seen in therapy because of compulsive sexual behavior. I had seen many others and all seemed to express the underlying problem in a different way. Some sexually exposed themselves in public, some sought out prostitutes, others had a multitude of lovers. But whatever the behavior, they all experience a basic emptiness inside that they are trying to fill with compulsive, risky sexual activity. The cause of the emptiness may be depression, low self-esteem, attempting to counteract feelings of guilt or negative childhood sexual experiences.
In therapy George and Lisa found a safe place to talk about things they had never let themselves discuss before. In addition to poor self-esteem and intense guilt, George had depression. His depression caused him to be angry with Lisa and he used this to rationalize his behaviors. By being honest with himself, George soon discovered a renewed sense of self and a closeness with Lisa he never thought possible. He stopped his compulsive behavior and went on to have a happier marriage than they had before these troubles began.
I have also worked with many individuals who thought they had a sexual addiction problem, but really all they needed was adequate information to know they were quite normal.
For example, an 18 year old with a healthy libido may masturbate twice a day. If he is socially active, engages in sports and gets good grades in school, his behavior would be normal for this time in his life.
Some therapists say there is no such thing as an addiction to sex and the problem is really compulsive behavior, but it doesn’t matter what you call it, the problem can be devastating to a relationship.
How do you distinguish between normal sexuality and compulsive or addictive sex?
Addictive sex is not determined so much by the amount of sexual activity, which can vary from person to person, but by how it fits in a person’s life. Is it a pleasurable expression or are you trying to fill some empty space inside yourself? Take the same 18 year old. If he had told me he stayed home to masturbate instead of having a normal social life I would have said his sexual behavior was compulsive.

If you are concerned that you or your mate might have problems with sexual addiction or compulsive behavior, the following questions can be helpful in identifying potential problems.

Do you feel your sex drive is completely out of your control?
Do you often feel empty or bad, especially after orgasm?
Are you doing something illegal just so you can feel sexually excited?
Are you consumed by sexual thoughts and feelings, yet are way beyond your teens?
Would you be embarrassed to disclose the amount of sexual behavior or the kinds of sexual behavior you engage in?

If you answered “yes” to two or more of the above questions, you or your mate may have a problem with compulsive or addictive sexual behavior. The best way to find out for certain is to discuss your concerns with a professional therapist.