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Psychotherapy debate: Is sex addiction a sickness, or an excuse?
By Melinda Beck
The Wall Street Journal
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Sex addiction seems to be popping up all over. Actor David Duchovny checked into a rehab facility for sexual addiction in August — just before the new season of his randy TV series “Californication.”

In her new book, “Desire: When Sex Meets Addiction,” Susan Cheever recounts having sex with men she barely knew at times of stress: “Moving men, doctors, lawyers, book salesmen — any man associated with a threatening change in my life became erotically charged, with predictable results.”

But is sex addiction a real disease, or just an excuse for behaving badly? How much is too much? When does preoccupation cross the line into pathology?

The psychotherapy community has been wrestling with such questions for years.

One camp thinks the very notion of “sex addiction” implies a narrow, moralistic view of what’s acceptable.

“There are millions of people stuck in unhappy relationships who go to massage parlors or the Internet and to demonize their sexuality is terribly unfair,” said Marty Klein, a licensed marriage and family therapist and certified sex therapist in Palo Alto, Calif. He said people who are unhappy with their sexual choices may be depressed or bipolar or need to face the fact that their relationships have failed, but the problem isn’t necessarily sex.

Sex addiction was listed in the official “Diagnostic and Statistical Manual of Mental Disorders III” in 1980, then dropped from the fourth edition in 1994, amid a wave of sentiment that only substances, not behavior, could be addictive. A task force is considering restoring it to the DSM V, but it could be a long debate.

The notion of sex addiction dates back to the ‘70s, when psychologist Patrick Carnes saw parallels with compulsive gambling: Addicts can’t control their behavior, continue despite negative consequences and spend excessive amounts of time pursuing the behavior.

“It’s not about hormones or being horny. It’s about using the excitement of sexual interaction to induce the neurochemical high that all addicts seek,” said Robert Weiss, head of sexual addiction programming at the Life Healing Center in Sante Fe, N.M.

“You need to ask yourself: Is this a secret? Are you spending money on it you don’t have? How does it affect your job or your marriage? What would happen if you were caught?” said Robin Cato, executive director of the Society for the Advancement of Sexual Health, an Atlanta group for professional therapists.

How many Americans are sexually compulsive?

There are no definitive numbers, but SASH estimates that 3 percent to 5 percent of Americans engage in what could be considered sexually compulsive behavior — and that it has ballooned in recent years because the Internet has made sex of all kinds accessible, affordable and anonymous.

“In 1985, if I wanted to watch porn, I had to get in my car and go to a video store,” says Weiss. “Now I can download it to my iPod.”

Therapists say addicts are frequently narcissists — that is, they constantly seek external validation because they are unable to generate their own feelings of self-worth.

They may seem egotistical, but they are emotionally empty and crave quick ego boosts — “like eating potato chips when you’re hungry,” says Weiss. Real emotional intimacy may be frightening.

“It’s scarier to be emotionally vulnerable with your spouse than it is to go downtown at 3 a.m. and pick up a hooker. She can’t hurt you if you don’t care about her,” he says.

Plenty of people have unmet emotional needs — why do only some turn to sexual compulsions? Addiction therapists say many of those who do were neglected or abused, or exposed to illicit images as children.

And needy people engage in all kinds of other compulsive behaviors — including workaholism and eating disorders, says Eric Griffin-Shelley, a psychologist in Lafayette Hill, Pa.

Men with sexual compulsive behaviors outnumber women about 5 to 1, and the numbers are reversed with eating disorders, according to Mr. Weiss. And women are more likely to be addicted to love than sex. “I know of women who’ll meet a guy and immediately wonder what color hair their kids will have,” says Dr. Griffin-Shelley.

Treatment for sex addiction has grown rapidly in recent years. Many therapists prescribe antidepressants, which can ease feelings of worthlessness and can damp sex drives.

Inpatient programs (about a dozen in the U.S. specialize in sex addiction) and outpatient therapists often work with 12-step programs specifically for sex addicts. (Therapists say it’s rare for attendees to use such meetings for quick hookups — scenes from “Nip/Tuck,” “Blades of Glory” and “Choke” notwithstanding.)



Are you an addict?



• Have you lost the ability to control your sexual behavior?

• Have you seen negative consequences as a result?

• Do you think about sex even when you don’t want to?

• If you said yes to any of these, some experts suggest seeking a professional evaluation.

Source: The Society for the Advancement of Sexual Health

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Sex addiction seems to be popping up all over. Actor David Duchovny, seen here in July, checked into a rehab facility for sexual addiction in August — just before the new season of his randy TV series “Californication.” (AP Photo/Joel Ryan)
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Reader comments on this story - 17 total

Note: All views and opinions expressed in reader comments are solely those of the individual submitting the comment, and not those of the Pantagraph or its staff.

T wrote on Oct 3, 2008 4:21 PM:

" I am in control of my addiction..... So tell me if you you take double the dose of Viagra does that mean it will last for 8 hours? YIPPIE!!!!!!!!!!!!!!! Who would ever complain about that? "

Meh wrote on Oct 3, 2008 8:38 AM:

" isabelle, I think Brenstalka is trying to fill the void left by BN Republican. "

Brenstalka wrote on Oct 2, 2008 4:04 PM:

" klm, maybe natural for heathens who want disease. It's dirty, uncomfortable, and promotes further sin. "

Annienap wrote on Oct 2, 2008 4:04 PM:

" I think it's an excuse and I think it's selfish. People will use any excuse to do WHAT THEY WANT TO DO and blame everyone else around them for what they did. For 5 years I worked with a woman whose husband was supposed to be 'sexually addicted.' She didn't really 'buy it' either, but participated in his 'sexual addiction therapy' which initially lasted for two years. Of course, then there were SA meetings for the rest of their lives. As she always said - if he really didn't WANT to do it, he wouldn't do it. "

noone wrote on Oct 2, 2008 2:55 PM:

" if it lasts more than 4 hours, call more ladies "

isabelle wrote on Oct 2, 2008 2:38 PM:

" Brenstalka, I hope you're being sarcastic. "

klm wrote on Oct 2, 2008 1:18 PM:

" Brenstalka,
Your views are un natural. Sex is as much a part of life as eating or sleeping. "

Brenstalka wrote on Oct 2, 2008 1:08 PM:

" PWNZILLA, sex is unnatural and leads to diseases like herpes, AIDS, and children. No thanks! "

dabejomi wrote on Oct 2, 2008 11:36 AM:

" GOOD GRIEF!!!
Okay...so let's just say that all of our actions are a disease, so we don't have to live up to our actions and take responsibility for ourselves!!!!! Good grief...we have choices to make and a free will!!!! Stop making excuses for lack of self-control! "

PWNZILLA wrote on Oct 2, 2008 11:11 AM:

" Brenstalka....Sex can be disgusting and perverted, and even evil when it comes to certain situations. But sex is also beautiful....I have two beautiful kids because of it, and I dont see them as disgusting...or created from perversion. And if sex is never discussed, then it just keeps us ignorant. I think politics is digusting at times...and it still needs to be discussed. Keep a closed mind, and it will get you no where in life. "

PWNZILLA wrote on Oct 2, 2008 11:05 AM:

" I think its quite possible that it could be a disease. At least I believe it is in Susan Cheever's case. I think that Mr. Duchovny feels that his new show plays a large part in his addiction, and if thats the case he should either no longer do the show, or get a divorce...cause if the show intensifies his desires, then the marriage will fail. I would say that it is too new of a disease to quite justify calling it that.....but sex has been around since the beginning of time, and people have been drawn to it since then. Its all about self control, as it is with any disease as this. They need to find a way to fill those desires without hurting the ones they love, or themselves. "

Brenstalka wrote on Oct 2, 2008 10:56 AM:

" Sex is disgusting and perverted. I don't think it should be discussed... EVER! "

Gov't oppressed Mule wrote on Oct 2, 2008 10:46 AM:

" It is truly a sickness. It is a vice, just like gambling and drugs. If you can control yourself there is no problem, but as is common in America, no one has any self control. "

ONLY IN AMERICA wrote on Oct 2, 2008 10:40 AM:

" It's not a sickness if you marry the right Gal.... but, it's like playing the lottery!!! "

ONLY IN AMERICA wrote on Oct 2, 2008 10:30 AM:

" If it last for more than 4 hours see immediate medical treatment..... "

Scapegoat wrote on Oct 2, 2008 10:25 AM:

" Amazing that these people never seem to be addicted to sex with their spouse. "

Dr.Orangutan Chief Cardiologist Miller Park Zoo wrote on Oct 2, 2008 10:14 AM:

" Also, David loves bones and hates cats in his distinctive Pedigree commercial trying-to-sound-dumb voice. "Mmmm, bones". "
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