From Masturbation to Molestation: ‘Severity Levels’ in Sex Addiction

businessman watching porn on his phone

Two conference room tables have been pushed together to form a more intimate setting for a group to gather. In the room, there is a man who has a history of arrest and termination for public exposure and possessing child pornography. To his right is a woman who is recovering from drugs and alcohol, and who spent several years of her life moving from one anonymous sexual experience to the next.

Across from these two is a placid fellow with a close-cut crop. His problem is porn; even though he’s deeply religious, he can’t stop watching more and more violent porn and fears his wife will leave him soon. Also in the room is a woman wearing scrubs. She fears she falls in love too easily and that her relationships all share a degree of chaos and tension that frightens her, but appears to draw her in.

A handful of people gather in a room together and begin to recite “The 12 Steps of Sex and Love Addiction Recovery.” When it comes time to share, these group members, seated around those two conference room tables pushed together for added closeness, are introduced into the intimate lives of one another. Everyone there has a problem of sex and/or love addiction. No one’s problem is given less credence than another’s.

Three Levels of Severity

There exist three levels of severity used to describe sexually addictive behavior. Sexual addiction expert Patrick Carnes, Ph.D., in his groundbreaking book, Out of the Shadows: Understanding Sexual Addiction presented three categories of severity levels. Dr. Linda Hatch lists Carnes’ categories as follows:

Level One:

  • Masturbation
  • Affairs, chronic infidelity, romance addiction
  • Sexual relationships with multiple partners
  • Pornography use and collection (with or without masturbation)
  • Phone sex, cybersex
  • Anonymous sex
  • Prostitution – strip clubs

Level Two:

  • Illegal prostitution
  • Public sex (bathrooms, parks, etc.)
  • Voyeurism – online or live
  • Exhibitionism
  • Obscene phone calls
  • Frotteurism
  • Stalking behaviors
  • Sexual harassment

Level Three:

  • Rape
  • Child molestation
  • Obtaining and viewing child pornography
  • Obtaining and viewing rape, snuff pornography
  • Sexual abuse of older or dependent persons
  • Incest
  • Professional boundary violations (clergy, police officers, teachers, physicians, attorneys, etc.)

Level one behaviors are viewed by Carnes as essentially “victimless,” and as such, present few social consequences. Level two behaviors are more intense than level one, and may include victims (such as in the case of stalking behaviors or those who find themselves exposed to sex or nudity in public without their consent) but remain less severe than level three behaviors. Those behaviors falling into the third category are not only illegal, but are also categorically harm-inducing to victims.
The spectrum of sexually addictive behaviors ranges, therefore, from behaviors which may appear on the surface to be relatively minor in nature, such as compulsive masturbation, to those behaviors that are viewed as more than taboo, but criminal, such as rape or pedophilia. Because the range in behaviors is so wide, the nature of sexual addiction itself can be difficult to understand, and the stigma for those finding themselves in category one can be difficult to overcome, as it is attached to behaviors in higher categories.

Where Severity Levels Get Problematic

Consider the 40-year-old tax accountant who has been married five times and involved in several other long-term relationships, but has never been able to keep his promise of fidelity. Even while he chose monogamous unions, he cheated repeatedly on each of his partners with multiple other women and found himself unable to stop (even while it harmed him and his partners). And then there is the pornography addict who finds that after four years of a progressing addiction, he is unable to engage in personal relationships or even spend time with friends because his addiction occupies all of his time. He has been fired from two jobs for using porn at work. He looks at porn at minimum of six hours per day, seven days per week.

How does one compare the consequences of the addictions of these two individuals with another addict who has an addiction to making obscene phone calls every few days, and who has twice been to visit prostitutes? The consequences and consistency of behavior for this individual have been minor even while the behaviors rank higher in severity. Without actual or egregious harm being caused to another, in some instances, the degree of compulsion may outweigh the ranking of the behavior in terms of severity.

What is perhaps more important than arbitrary ranking is that any individual who finds her or himself battling sexual addiction is able to find the treatment she or he needs. When issues of severity do arise, such as when sexual addiction emerges as assault or child endangerment, the stigma against addicts does not prevent treatment from being examined. Both the victims and the addicts, in these cases, are harmed, just as society is harmed when sexual addiction is not given credence in the recovery communities.

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