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Treatment of a Sex Addiction

Maya Malchin, Clinical Social Worker, Psychotherapist, MSW, Director of Addiction
13 May 2026

Sex addiction is a pathological condition in which the balance of sexuality as a healthy part of life is disrupted. There are three main types of sex addiction: addiction to sexual intercourse, addiction to masturbation, and addiction to pornography. The primary treatment for these addictions is cognitive-behavioral therapy (CBT), which aims to teach individuals how to live with urges and how to avoid “falling into the same traps” in the future. The goal of the process is to develop the ability to channel sexuality into a positive and healthy direction within a committed and intimate relationship. In recovery treatment, individuals are taught to enjoy sexuality rather than necessarily abstain from it—to appreciate touch, affection, hugging, and human warmth. The focus is on understanding the meaning of sexuality in life and seeing it as much more than a technical act. Reported treatment success rates range between 70% and 80%, depending on the individual’s motivation to change their situation.

The main challenge in treatment: shame, secrecy, and stigma

When it comes to treating individuals with sex addiction, the main barrier is the significant shame and secrecy surrounding the issue, which prevents both individuals and their families from seeking help. Additional factors also complicate treatment: social stigma and discomfort around inappropriate sexuality, which lead individuals and those around them to hide the problem. Unlike substance addictions, people with sex addiction do not use an external addictive substance. In addition, individuals may feel a need to convince themselves that “everything is fine” in order to suppress the pain and shame associated with the condition.

Types of treatment of sex addiction

Medication includes anti-anxiety drugs, as well as anticonvulsants such as lamotrigine (Lamictal), topiramate (Topamax), and gabapentin.   In this approach, the urge is viewed as a kind of epileptic-like episode, or irregular brain activity, similar to what happens when the brain cannot control the neural surge that produces epilepsy, and treatment is accordingly based on this understanding. An interesting study on this topic was published by the Department of Psychiatry at Stanford University, where a group of 24 patients were treated with Cipralex, with good results. Research into the expanded use of naltrexone and its potential adaptation for individuals with pornography addiction has been increasing. 

Group therapy for sex addiction reduces shame and isolation, helps identify triggers, improves impulse control, and supports relationship recovery. There are 12-step groups such as SAA and SA, as well as emotional therapy groups. 

Psychodynamic and dynamic therapy focuses on unconscious conflicts, early attachment patterns, self-image, and interpersonal relationships. It is particularly effective when sexual behavior stems from internal conflicts, experiences of rejection, or difficulties in emotional regulation. This type of therapy helps in understanding the personal meaning of the addiction and its connection to the patient’s psychological history. Studies have shown that psychodynamic therapy helps improve emotional regulation and reduce impulsive sexual behavior, particularly in men with childhood trauma.

Trauma-focused therapy is especially suitable for patients with a history of sexual abuse, maltreatment, or childhood neglect. Approaches such as EMDR, SE (Somatic Experiencing), or TF-CBT help process traumatic experiences and reduce the need to use sex as a coping mechanism. They also improve body awareness, self-confidence, and reduce dissociation.

Couples or family therapy is important especially when there is an active relationship or when children are affected. This type of therapy focuses on rebuilding trust, setting boundaries, improving communication and restoring intimacy. It helps partners understand addiction as a systemic issue rather than solely the “fault” of the individual. There are also specialized approaches such as PACT and Emotionally Focused Therapy (EFT), which work with attachment emotions and the sense of security in relationships. 

Mindfulness and body-awareness practices help strengthen impulse control, presence, and the ability to cope with difficult emotions. These techniques can serve as a particularly effective supplement for patients who struggle to automatically stop the behavior . 

Recommended integrative model

The combination of various types of therapy is recommended to improve the chances of success: 

  • CBT to reduce the behavior and create healthy alternatives.
  • Psychodynamic or trauma-focused therapy for in-depth processing of the roots of the addiction.
  • Support groups, such as SAA, to reinforce the sense of belonging and responsibility.
  • Medication when needed (SSRIs, mood stabilizers). 
  • Couples therapy when there is a need to repair a damaged relationship.

How to seek help for sex addiction

If you, or someone you know, is struggling with sex addiction, there are several steps that can be taken right now:

  • Look for a support group such as SA or SAA (Sex Addicts Anonymous). There are groups throughout the country, and participation is free of charge.
  • Contact a family physician through your health maintenance organization (HMO). If sexual activity is involved, it is important to undergo screening for sexually transmitted infections.
  • Reach out to a local addiction unit within the municipal welfare department in your city or region.
  • Contact public detox or addiction treatment clinics for professional consultation and support. It is important to know that treatment in the public healthcare system is free of charge. Private inpatient or treatment services involve costs that are paid by the patient.

Mental Health Hotlines of the HMOs