Many people dismiss sex addiction as a futile attempt to give legitimacy to what is simply irresponsible or greedy behavior. Others say that those who deny sex addiction’s legitimacy are unaware of or indifferent to the emotional pain frequently reported by both those who experience sex addiction and their loved ones.
Background
Sex addiction is not a new concept. Historical records dating back to ancient Rome and second century Greece report excessive sexuality, also known as hypersexuality or hyperaesthesia, in men and nymphomania or furor uterinum (uterine fury) in women. The modern concept of sex addiction was popularized by Patrick Carnes, PhD, author of “Out of the Shadows: Understanding Sexual Addiction” (first published in the mid-1980s, revised in 2001, and revised again in 2014). Carnes and his colleagues have written several books on the subject, and tend to dominate popular understanding of sex addiction. However, others have also written extensively on the subject, including researchers and people who believed they had sex addiction. Some argue that, although sex addiction shares features of both an obsessive-compulsive and an impulse control disorder, it does not fit neatly into either category. Abroad range of specialists in the field believe the behavior is best described as an addiction, although most clinicians, even those trained in sexual disorders or addiction medicine, have little to no training in treating sexual compulsivity and cybersex addiction. In general, having less sexual desire and activity is seen as a greater problem than having more sexual desire and activity. This reveals a bias that challenges the recognition of excessive sexual desire or expression as a problem. In other words, regularly experiencing sexual desire, physical sexual arousal, sexual relations, and achieving orgasm is considered the norm for both sexes. However, a majority of people experience difficulties in these stages of the sexual experience. The development of drugs such as Viagra reinforce the view that one is not living a complete and happy life without regular, non-problematic sex. In our current sexualized climate, it is not surprising that many people become preoccupied with sex, and that some develop compulsive sexual behaviors.
Support for Sex Addiction As a Real Addiction
Research indicates that the same reward system in the brain is activated in sex addiction as in a number of other addictions, including drug addictions. This supports the idea that sex addiction has a similar physiological and psychological process as other addictions. Some authors argue that the existence of crossover addictions lends support to the legitimacy of sex addiction as a real addiction and that, if recognized, crossover risk can be addressed directly to prevent it from happening after treatment for other addictions. Sex addiction causes a great deal of distress to those affected and their loved ones. Sexual desire and expression in people with sex addictions are commonly reported to be unmanageable and unpleasant. Recognizing sex addiction means these people can get the help they need to overcome their addiction, and eventually resume enjoyable sexual relationships. At present, few readily accessible addiction services provide help for people with sex addiction. Recognition of sex addiction can allow sex addiction treatment to be included in community addiction services. If addiction services staff received specialized training in sex addiction, many more people could easily access help for sex addictions.
The Case Against Sex Addiction
An important criticism is that the sex addiction concept does not provide enough differentiation between similar conditions that might look like sex addiction, such as hypersexuality related to mania or hypomania in bipolar disorder; personality disorders; some forms of depression; and PTSD. For more mental health resources, see our National Helpline Database. Critics of the concept of sex addiction argue that it has grown out of a cultural focus which associates sex with danger, powerlessness, and victimization, and is merely a new way of making moral judgments about people who enjoy sex. As such, the concept of sex addiction can be used by people with a political and/or religious agenda. The concept of sex addiction has also been criticized for being based on the idea that some sexual experiences, for example, intimate relationship sex, are better than others. The argument is that these are moral rather than clinical arguments. At the other end of the spectrum, some people believe that a label like sex addiction can be used as an excuse for irresponsible sexual behavior, such as rape and child molestation. They argue that people who have committed sex crimes can hide behind the label of sex addiction to avoid taking responsibility for their actions. Finally, there is the argument leveled at all behavioral addictions—that addiction is about chemical dependency, and no matter how similar the patterns of behavior, addictions occur in relation to addictive substances and not behaviors.
Where It Stands
Sex addiction, or certainly excessive sexual behavior, is widely recognized in the media and in popular culture. The growth of the internet has led to an escalation of “cybersex addiction,” which includes both addictions to pornography and addiction to online sexual interactions with partners, including sex workers. Since its founding in 1987, the Society for the Advancement of Sexual Health (SASH) has provided up-to-date research to the public and to professional members who work with sex addictions. The society publishes the journal Sexual Addiction and Compulsivity: The Journal of Treatment and Prevention, and holds an annual conference to disseminate research findings on sex addiction. Since sex addiction isn’t an official diagnosis, it may be more challenging for people who experience it to seek and receive appropriate care. For this reason, many researchers urge healthcare practitioners to take sex addiction seriously and pay attention to it when it presents in patients.
