Am I a Sex Addict? The Ten-Question Test

An essential point first

The ten questions

Why the tenth question is not counted

The tenth question is there because of something the diagnostic criteria say explicitly, and which is easy to miss.

ICD-11 states that distress arising entirely from moral judgement and disapproval about one’s own sexual impulses, urges or behaviours is not sufficient for this diagnosis. In other words: feeling ashamed of wanting something is not the same as being unable to stop doing it.

This matters clinically, and it matters practically. A good number of the men who arrive convinced they are sex addicts are describing an ordinary sexual life held against a standard they inherited and never examined — from a religious upbringing, from a family where the subject was unspeakable, sometimes from a partner’s distress. The suffering is real. The compulsion is not there. Treating the first as though it were the second does harm, and it is one of the reasons the language around sex addiction is argued about at all.

So if you answered yes to the tenth question and little else, what you are dealing with is probably shame rather than compulsion, and shame has its own treatment.

Does this cover porn addiction too?

Yes. The same ten questions apply whether the behaviour is pornography, paying for sex, affairs, apps, or some combination that has shifted over the years. Porn addiction is the form most men arrive describing, partly because it is the most available and the easiest to hide, and the criteria do not distinguish between them. What they look at is the relationship to the behaviour, not its content.

The one thing worth saying specifically about pornography is that escalation tends to be more visible there than elsewhere. Material that would once have been enough stops working, and what replaces it is often something the person finds disturbing about themselves. That escalation is a feature of the pattern rather than a revelation about who you are, and it is the sixth question above.

What the criteria actually describe

Frequency is not the measure. This is the most persistent misunderstanding, and it sends people to the wrong conclusion in both directions.

What ICD-11 describes under 6C72 is a pattern over at least six months in which a person repeatedly fails to control intense sexual impulses, the behaviour becomes a central focus of life to the neglect of health, personal care, interests and responsibilities, numerous efforts to reduce it have failed, and it continues despite adverse consequences or despite producing little satisfaction.

Two features of that are worth reading twice. Continuing after real cost is one. Continuing when it has stopped being enjoyable is the other. Together they describe something that has moved from pleasure to relief, which is the shape addiction takes whatever the substance or behaviour.

Where it sits, and why the name is argued about

Compulsive sexual behaviour disorder sits in ICD-11 under impulse control disorders, not under addictions. That placement is deliberate and contested. The DSM-5 does not include it at all, having considered and declined hypersexual disorder in 2013.

Both of those facts get used as arguments that the thing does not exist. That is not what they mean. They mean that clinicians disagree about mechanism and about language, in a field where the evidence is still thin and where moral assumptions have historically contaminated the research. The disagreement is real. The men sitting in my consulting room describing a life organised around something they cannot stop are also real.

I use the word addiction here because it is the word people search for and recognise. What I treat is the pattern, whatever it is called.

What the behaviour is usually doing

In twenty-five years, the thing I see most consistently is that the sexual behaviour is not primarily about sex.

It is doing a job. Most often regulating a state: anxiety that has nowhere to go, a loneliness that predates the marriage, anger that cannot be expressed anywhere else, or a flatness that nothing else reaches. That is why the eighth question asks whether you turn to it when you feel bad rather than when you want sex. The answer to that single question tells me more than the frequency ever does.

It also explains why willpower fails so reliably. Blockers, rules and promises are addressed to the behaviour. If the behaviour is the only thing managing an unbearable state, removing it without replacing its function leaves the state, and the state wins.

If you recognised yourself

This responds to treatment, and the men who come to me have usually spent years believing otherwise — that it was a character defect, or proof of something rotten, rather than a pattern with a shape and a way out.

The work is not primarily about stopping, though stopping is part of it. It is about what the behaviour has been doing, what it has been protecting against, and what has to be built so that it is no longer needed. Where there is trauma underneath, which there often is, EMDR may form part of it. Where it sits alongside drinking or drug use, which it frequently does, addiction is one of this practice’s core specialisms and the two can be treated together rather than sent to separate people.

Sessions are in central London at Fitzrovia, and online. Entirely confidential, and discussed with no one.

A first appointment is confidential and usually available within two days.

Dr Philippe Jacquet is a UKCP registered psychotherapist, a Jungian analyst and an HCPC registered art psychotherapist, with twenty-five years of clinical practice. His Professional Doctorate in Analytical Psychology at the University of Essex examined male eating disorders from the perspective of analytical psychology. Registration can be checked on either public register.

Further reading: sex addiction and pornography, and what recovery actually means.