As a psychologist and a Certified Sex Addiction Therapist (CSAT),  I work with sex addicts almost every day.  I assess symptoms of “sex addiction” by thoroughly examining their relational, romantic and sexual behavior. If they are dealing with symptoms of sex addiction, they will report some to many of the following: 

  • pre-occupation

  • loss of control

  • obsession with a person or sexual behavior

  • unsuccessful attempts to stop

  • progression in the frequency or intensity of the behavior 

  • excessive thinking about, planning for and engagement in their behaviors that cause significant difficulty or damage in one or several areas of their life

When I work with someone who complains of these problems, early on in treatment, I am on the hunt for evidence of conscience, remorse or essentially, their own appropriate shame. By appropriate shame, I mean the type of shame most of us feel after having broken an important self-held value, e.g. “I am good to my word”, “I don’t push or violate others’ physical boundaries”.  For most people, guilt and shame provide the energy and motivation necessary to change.  We change at the speed of pain.  Shame, like all emotions, is felt through a variety of bodily sensations and the head interprets it.  If it isn’t activated in the body, it won’t end up being interpreted accurately by the brain.

It is generally accepted that sex offenders don’t register shame and have incredibly thick denial, violating others’ boundaries with impungity in the quest to fulfill their desires.  They show no real remorse for their victims.  In contrast and in my experience, sex addicts often exhibit some to a great deal of denial, but the niggling feeling of shame in their gut gets them to my office – hopefully with a huge desire to get out of the pain from violating their own values and boundaries.  I asked one of my clients “why now”?  What provided the real motivation to change and he said he couldn’t cause any more pain to his wife  When someone with  conscience tells a story of harming another emotionally or physically, it is not uncommon for their face to flush, their head will bend forward and eye contact will be difficult.    

While it’s impossible to diagnose anyone from media reports alone, I watch these accused folks and have only been heartened by one or two who at least seem to be capable of connecting with their own appropriate shame.  Others possess complete denial and resort to victimhood – more typical of offenders.  It is crucial for adequate treatment to have an accurate diagnosis of sex addiction vs. sex offending.

Although a person can show characteristics of both sex addiction and sex offending, the difference between sex addicts and sex offenders is essentially the existence of the emotion of shame.  The presence of appropriate shame is the evidence of conscience.  Watching the reports of sexual offense or harassment in the media, I am very curious to watch the behaviors and words of the accused – I am looking for evidence of even a modicum of shame.   I have sat across from folks that have sexually offended others.  After describing mild to severe violation of other’s boundaries, their simulated and restricted or flat emotion belies their inability to feel shame, or to truly feel how it must be to be in the place of the person that they offended (aka empathy).

I hold hope that at least some of these accused folks, and the others that are sure to be revealed as survivors feel rightfully emboldened to tell their stories, will show accountability and (most importantly) appropriate shame.  Shame that turns to appropriate remorse and a desire to make amends or repair is the best catalyst to healing and changing their unhealthy sexual behavior and re-connecting the to their loved ones and their community.