Can we consider sexual addiction as an addictive disorder?

This letter discusses whether sexual addiction can be considered as an addictive disorder. Sexual addiction as a particular behavior that feels driven, entails harmful or unpleasant consequences, functions to reduce anxiety or other painful effects, and, unlike compulsive behavior, functions to produce pleasure or gratification. The lack of a clear distinction between addiction and drug dependence is indicated by the fact that two typical characteristics of drug dependence in the DSM-5 are withdrawal and tolerance, and several psychobiological studies have attributed little significance to these two physical features. The description of addiction is focused on different psychological features: early trauma, alexithymia, and a tendency to dissociation. From this perspective, in sexual addiction, chronic relational traumatic experiences can lead to the structuring of unnameable and unsymbolized emotions residing in implicit memory that, when triggered by stressful conditions, elicits a state of disorientation, physiological hyperactivity, and inexplicable pain. A reformulation of the diagnostic criteria of addictions is needed to improve the treatment of these disorders and to enhance the effectiveness of the work being carried out in the field of mental health.