Let me state the following rather emphatically. There is no sex addiction! There is, however, an attempt to pathologize sexual behaviors society doesn't approve of, as when we “convince” the “sex-addict” that he/she does indeed have an “addiction”. No one has ever been able to convincingly tell me exactly what a sex addiction is all about. I understand sexual compulsion and associated dysfunctional behaviors….but not addiction.
Sexual behaviors that have gone out of control are part of the obsession-compulsion diagnosis, not “sex addiction”. I would hope that indeed this argument would finally end and that individuals with dysfunction could be helped without the help to a “media-base “diagnosis. I find this push towards a subjective-based, moral driven bogus classification puzzling. And indeed, many in the psychology field and many more in the sexuality field discount the diagnosis as bogus. It seems to me that most of the push for “sex addiction” comes from the social work field, for some strange reason, I wonder if this is not driven by some strange dogmatic (and restrictive) perspective on sex that classifies some behaviors as “good-sex” and others as “bad-sex” and ends up as self-fulfilling prophecy…. There's no baseline to measure sexual behavior; thus, there is no way to suggest when “addiction” occurs. Let's stick to the factual evidence, not some made-up suggestions of deviance based on a moral or social zeitgeist.
Some of what has been discussed here deals with dysfunction, NOT addiction.
Someone has suggested a new theory: Sex drive is a reflex
These drug reactions serve to show us that our sex drive is at least partly a function of our body chemistry. But emotions have a major role as well. We know that, instinctively—but now scientists are starting to try to explain it.
One theory is that sex is a reflex—automatic except that your emotions can override it.
The classic reflex test is the one where the doctor hits the tendon in your knee with a mallet, and the tendon contracts, all by itself. “Let's say the doctor is trying to do this test, and outside there's a robbery with gunshots,” posits Irwin Goldstein, MD, director of San Diego Sexual Medicine and the editor in chief of The Journal of Sexual Medicine. Your brain will override the reflex; your leg will stay still”.
Goldstein, a long time sexual researcher in the areas of sexual response and dysfunction, maintains that sexual behaviors can become compromised (either in hypersexuality or hyposexuality) by this reflexive process, NOT by any form of addiction. Moreover, since sex is motivational process, each individual has a particular affinity for much sex or less sex. We would never suggest that someone who has the urge of having sex once a year is dis-addicted, that would be silly.
Moreover, there isn't a benchmark for what constitutes “average” or “measurable” sexual frequency.
In the great diagnostic world of mental disorders, DSM, hypersexuality is described as:
- excessive time is consumed by sexual fantasies and urges, and by planning for and engaging in sexual behavior
- repetitively engaging in these sexual fantasies, urges, and behavior in response to dysphoric mood states (e.g., anxiety, depression, boredom, irritability)
- repetitively engaging in sexual fantasies, urges, and behavior in response to stressful life events
- repetitive but unsuccessful efforts to control or significantly reduce these sexual fantasies, urges, and behavior
- repetitively engaging in sexual behavior while disregarding the risk for physical or emotional harm to self or others
B. There is clinically significant distress or impairment in social, occupational or other important areas of functioning associated with the frequency and intensity of these sexual fantasies, urges, and behavior.
C. These sexual fantasies, urges, and behavior are not due to direct physiological effects of exogenous substances (e.g., drugs of abuse or medications), a co-occurring general medical condition or to Manic Episodes.
As e can see there is no attempt to connect this diagnosis with any form of “addiction” but rather with a preoccupation, which suggests a “compulsion” related to several causes. I think the key term here is “dysfunctional behavior” and not “addiction” per se. The diagnosis fits well with the concept of OCD, as follows:
- recurrent and persistent thoughts, impulses, or images that are experienced at some time during the disturbance, as intrusive and inappropriate and that cause marked anxiety or distress
- the thoughts, impulses, or images are not simply excessive worries about real-life problems
- the person attempts to ignore or suppress such thoughts, impulses, or images, or to neutralize them with some other thought or action
- the person recognizes that the obsessional thoughts, impulses, or images are a product of his or her own mind (not imposed from without as in thought insertion)
Compulsions as defined by (1) and (2):
- repetitive behaviors (e.g., hand washing, ordering, checking) or mental acts (e.g., praying, counting, repeating words silently) that the person feels driven to perform in response to an obsession, or according to rules that must be applied rigidly
- the behaviors or mental acts are aimed at preventing or reducing distress or preventing some dreaded event or situation; however, these behaviors or mental acts either are not connected in a realistic way with what they are designed to neutralize or prevent or are clearly excessive
B. At some point during the course of the disorder, the person has recognized that the obsessions or compulsions are excessive or unreasonable. Note: This does not apply to children.
C. The obsessions or compulsions cause marked distress, are time-consuming (take more than 1 hour a day), or significantly interfere with the person’s normal routine, occupational (or academic) functioning, or usual social activities or relationships.
D. I another Axis I disorder is present, the content of the obsessions or compulsions is not restricted to it (e.g., preoccupation with food in the presence of an Eating Disorder; hair pulling in the presence of Trichotillomania; concern with appearance in the presence of Body Dysmorphic Disorder; preoccupation with drugs in the presence of a Substance Use Disorder; preoccupation with having a serious illness in the presence of Hypochondriasis; preoccupation with sexual urges or fantasies in the presence of a Paraphilia; or guilty ruminations in the presence of Major Depressive Disorder).
Firstly, I would like to suggest that there would be an economic disadvantage for those presently engaged in the business of treating “sexual addiction” if the diagnosis was to be disproven. Actually, it would be a financial catastrophe since so much and resources have devoted to this diagnosis.
Secondly, I think it would be disingenuous to suggest that those of us that opposed the diagnosis do so out of a lack of scientific information or erudite investigation of the topic. We are professional scientists with an eye for critical thinking and the scientific method.
Which brings me to the next suggestion.
Much of the inventions of sexual disorders or syndromes that have occurred in the last part of the twentieth century have been central to the attempted regulation of sexuality. To deny that fact would be ludicrous. Also, the application of the term “addiction” as a replacement to “compulsion” regarding sexual behavior reflects or ambivalence (and at times negative connotation) about sex, thus many therapists were quick to accept and adopt the term “sexual addition”. Not to forget that the term was based on the 12 step process that mirrored alcoholics anonymous “treatment” plan, which, as of today has had very limited success. I am quite familiar with this program, which I studied, and its ineffectiveness is most cases (did not say ALL cases, just that successes are too few and far in between).
So, we are left with a term that denotes a sociocultural construct of sexuality in which the boundaries behavior and mental illness (sexual addiction is often interchangeable with hypersexuality) which is value laden and has had many understanding throughout history. Thus the present concept of sexual addiction is a historical anomaly that has risen independent of laboratory or epidemiological data. Most often “sexual addicts” are married individuals that have “strayed” from their monogamous vows.
However, infidelity occurs for numerous reasons, ranging from personality factors (Orzeck & Lung, 2005) to evolution-based theories about how extra-partner relationships are natural while monogamy is unnatural (Barash & Lipton, 2001). It’s not surprising to find personality factors may influence “adulterous” behavior, because people who are more similar in personality are less likely to “cheat”. Also, and this is an important point, the diagnosis itself creates a label that affects negatively those that carry it. Many lives and many families have been destroyed by the mere fact that an individual was “categorized” as a “sexual addict”. Enter the therapist ready to “normalize” the sexual behavior of the individual and save the day. First it is necessary to give the dysfunctional behavior and thoughts a “name” so that the client may be able to have a point of reference throughout the therapy process. Oh yes, success must be measure by the client’s admission to the negative consequences of the behavior and “repent” and “modify” through some form of cognitive-behavioral process. Sounds to me that catholic confession and penitence would do the trick as well. Except that, in this instances, the guidance and collaboration of the therapist is necessary…for a price….However, the label never goes away and can carry detrimental consequences, some of them legal.
Do I think the most therapists are ill-intended in this respect? No, I don’t, I just think that bought into a system that perpetuates the diagnosis and will consider nothing else. I guess it’s a case of “joining them”.
Finally, many scientists and clinical therapists in the fields of sexology and psychology do not buy into the diagnosis and consider it offensive and counterproductive.
A clinical psychologist, David Levy, has produced the most up to date evidence for the deficiency of the diagnosis in a rather interesting book published in 2012, The Myth of Sex Addiction, I highly recommend it.
To wrap it up, these are some of the names of clinical psychologists, sexologist, and other scientists that consider the diagnosis of sexual addiction bogus.
