Sex and the Executive: The Drama of Sexual Addiction
Sex and the Executive: The Drama of Sexual Addiction
Compulsive behavior, attachment wounds, and the longing beneath the pattern
This article sheds light on the problems associated with sexual addiction, using a lengthy case example of a businessman prone to this disorder. It asserts that when sexual thoughts and activities completely consume a person's life, the pattern may be understood as compulsive sexual behavior. These individuals seem unable to stop or change their sexual behavior patterns despite the consequences, using sexual activity as a form of self-medication to manage underlying emotional conflicts. The article points out how this behavior can have a destructive effect on relationships, work, finances, legal standing, and health.
Kets de Vries draws an important distinction: if sex isn't a shared act between two people, it promotes solitary arousal that precludes care and intimacy. Sex addicts, he argues, confuse sensuality with sexuality — where sexuality refers to the physiological responses of stimulation, sensuality includes a real appreciation of the other person. Underneath compulsive sexual needs, there appears to be a deep desire to be loved and to assuage feelings of loneliness.
Read the full article at SSRN →"The clinical picture Kets de Vries describes — compulsive sexual behavior driven by underlying shame, loneliness, and an unmet hunger for genuine intimacy — is one I encounter regularly in my work with men. His psychodynamic reading of the executive case resonates: what presents as sexual compulsivity is often, at its root, an attachment wound. The men who come to my practice carrying this pattern are not struggling with sex. They are struggling with vulnerability and the terror of real closeness.
The work is relational, not behavioral, and it requires a clinical environment where shame can be examined without judgment. That is exactly the work this practice is built for. If what Kets de Vries describes sounds familiar — if you recognize yourself in the patterns he outlines — know that effective, confidential support is available. Recovery is possible, and it begins with a single conversation."
Clinical Director, District Counseling and Psychotherapy at Joseph LaFleur and Associates
Washington, DC · 23 years in practice
Kets de Vries uses the term "sexual addiction" in its psychodynamic and descriptive sense — not as a formal diagnostic claim. The clinical terminology has evolved since this framework was developed, and differs between the United States and the country where this article was written.
"Sexual addiction" is not a recognized diagnosis in the DSM-5 (the American Psychiatric Association's primary diagnostic manual). The APA formally rejected a proposal for "Hypersexual Disorder" in 2013, citing insufficient evidence of a distinct clinical syndrome. Clinicians treating compulsive sexual behavior in US practice typically use Compulsive Sexual Behavior Disorder (CSBD) — recognized under ICD-11 (the WHO's international classification, code 6C72) as an Impulse Control Disorder — alongside colloquial frameworks such as 12-step programs (Sexaholics Anonymous; Sex and Love Addicts Anonymous). The US has not yet completed the transition to ICD-11; full federal implementation is expected in the late 2020s.
France uses the ICD system — not the DSM — as its primary diagnostic framework. Under ICD-11, which took effect January 1, 2022, Compulsive Sexual Behavior Disorder (Trouble du comportement sexuel compulsif, 6C72) is formally recognized as an Impulse Control Disorder. Kets de Vries writes from INSEAD's Fontainebleau campus within this clinical tradition. His use of "sexual addiction" reflects a psychodynamic descriptive lens consistent with the organizational psychology literature — not a departure from French diagnostic practice.
What the terminology debate cannot obscure is the human reality this article describes with precision and compassion. The clinical insight stands independent of the label.
Kets de Vries, Manfred F.R. Sex and the Executive: The Drama of Sexual Addiction. INSEAD Working Paper No. 2024/25/EFE. April 15, 2024.
Available at SSRN: https://ssrn.com/abstract=4794608
DOI: http://dx.doi.org/10.2139/ssrn.4794608
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