Narcissistic sex addicts like Mason74, who use grandiosity and a facade of self-confidence to present as though they are indestructible, are perhaps the most difficult to treat. Mason74 is charismatic, convicted and charming. He attends an online SSA (Sex Addicts Anonymous) meeting and when it\u2019s his turn on the virtual floor, he starts out by joking with the group that it isn\u2019t his fault that he always gets the girl. He says that whether he wants it or not, women end up following him home; they just can\u2019t get enough. This isn\u2019t great for his marriage, he admits, but his wife really loves him and would \u201cnever leave.\u201d Mason says he partly believes he\u2019s a sex addict because he\u2019s never had to try\u2014something he likes so much \u201cjust comes too easily\u201d for him. He confesses that this isn\u2019t great for his career either, but his company, he says, could never replace him, so even though he\u2019s been caught downloading pornography more than once on the office computer, he walked away with nothing more than a written reprimand. His wife has caught him cheating twice (he\u2019s cheated far more than twice), but he agreed to attend couple\u2019s therapy (which he thinks is a joke). His struggles nevertheless, are real, he says. He can\u2019t seem to say no to sex with women and his porn use has gone from a few times a week to a daily practice. Mason sometimes wastes hours of his day, he says, and when he finally shuts off the screen, he has no idea where the time went. His addiction is getting in the way of things he\u2019d much rather be doing. After the sharing portion of the meeting, a member of the group asks Mason if he has considered individual psychotherapy. He has not. \u201cNothing is wrong with me,\u201d he says, \u201cbesides the fact that I have this one bad habit.\u201d But Mason\u2019s habit is a genuine problem for many, and his nonchalance and grandiosity comprise a defense mechanism used by many who share it. Link Between Narcissism and Sex Addiction A large number of sex and pornography addicts display narcissistic traits. This can make treatment difficult, perhaps especially because narcissists are disinclined to acknowledge their problem. They express self-absorption, in their sex lives and elsewhere, often making the clinical process difficult. In June 2014, the Journal of Sex & Marital Therapy published a study that examined the occurrence and degree of narcissism in male and female subjects with sex addiction. The authors of the study\u2014Thomas Edward Kasper, Mary Beth Short, and Alex Clinton Milam\u2014used three metrics for narcissistic traits: the Narcissistic Personality Inventory (NPI), the Pathological Narcissism Inventory (PNI) and the Index of Sexual Narcissism (ISN). The study revealed that those subjects, male and female, who had viewed Internet porn at any time in the past scored higher on measures of narcissism. And those subjects who currently viewed Internet porn (on a regular basis) scored highest of all, particularly on the NPI and the ISN. The PNI measurement was also higher but did not reach a benchmark for statistical difference. Narcissism a Defense Mechanism for Many Sex Addicts It\u2019s easy to believe that addicts engage in their addictions out of sheer hedonism\u2014simply for pleasure\u2019s sake. But to understand addiction, it\u2019s important to recognize the addict\u2019s underlying need to escape, to disconnect from others and to avoid pain. Sex addicts in general, and narcissists in particular, utilize fantasy and intense sexual behavior not for gratification, but for control. Escaping the pain of the past through the intensity of the present allows the narcissistic sex addict a sense of power through emotional control, and power is the most important commodity the narcissistic sex addict has. The emotional validation and adulation a sex addict receives when someone chooses him or her as a sex partner is a rush. And for the pornography addict, the object is chasing the next perfect image, the next subversive shot\u2014nothing and no one else matters. Narcissistic sex addicts are perhaps the hardest to treat. They use grandiosity and a fa\u00e7ade of self-confidence to present as though they are indestructible, but this could not be further from the truth. Narcissism is a defense mechanism of the psyche; it protects what is, in truth, a fragile ego and a very low sense of self-worth. Most narcissists grew up with inadequate caregiving\u2014emotional or physical abuse, or inconsistent care or neglect\u2014and carry these wounds with them into adulthood. Their strong need for validation likely comes from the a lack of a coherent bond with mother or father (or other guardians). A strong sense of entitlement may also exist in individuals who were consistently provided for materially, rather than emotionally. The resultant emotional deficits may manifest as sexual addiction, but as hard as narcissism is to treat, it is not impossible. Those clinicians who have the most success approach their clients with compassion, non-judgment and honesty, and those sex addicts who express narcissistic traits who have the greatest degree of success are those willing to acknowledge their problem and to ask for help.