Sex Addiction: Is It Really An Addiction?

Dr. Jon LaPook On The Medical Community's Stance

(CBS)  This week's segment of CBS Doc Dot Com examines sexual addiction, a subject about which I learned absolutely nothing in medical school and have not learned much more since. In researching the topic over the past week, I began to understand that it is extremely controversial, with experts not even agreeing about whether sexual addiction is a true addiction.

When most people hear the term, they usually think they know what's meant by sexual addiction. They may think of someone (usually a man) who has an incessant need to make sexual conquests, sometimes despite his own best intentions.

But even back in the days when Sam Malone got this diagnosis on the old TV show "Cheers," it was clear that a real definition was lacking. In 1998, two researchers published an article entitled "Sexual addiction: many conceptions, minimal data."

As Erick Janssen, Ph.D., Director of Education & Research Training at The Kinsey Institute, explained to me in an email: "We do not have a generally accepted definition of 'sex addiction.' It was originally approached as involving some kind of 'inability to adequately control sexual behavior,' but this is, as you can tell, not a very objective definition. According to some, sexual addiction seems in the eye of the beholder, or in the eyes of his or her therapist."

For one side of the definitional argument, I spoke to addictions treatment specialist Mavis Humes Baird, who is convinced that sexual addiction is a true disorder because people are in the throes of an impulse they can't control, that there are underlying changes in the brain that cannot be addressed by psychotherapy alone. She told me, "for example, if one of the partners in a couple is having affairs and they're not a sex addict, marriage counseling or family therapy is very effective. But if they're a sex addict, all the therapy in the world getting at problems in the relationship won't touch the addiction. One of the primary referral sources for sex addiction is couples counselors who have been doing attachment work with couples for years with the addiction going on unaffected and sometimes kept secret for all those years. You can't treat the sex problems between the partners until the addiction is treated. And that's done by a combination of specific treatment protocols, and 12-step program involvement, and sometimes medication."

But Ms. Baird also told me it's not listed in the current version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) and that there's a struggle about whether it will be included in the next edition. One crucial repercussion of not being listed in the DSM-IV is that the exclusion makes it more difficult for patients to receive reimbursement for treatment. Some researchers hypothesize that sexual addiction, substance abuse, and gambling share neurochemical changes in the brain-underlying problems with brain wiring and nerve transmitters such as dopamine. For many of those researchers, it would seem to follow that treatment should be covered as other addictions are.

On the other side of the definitional aisle is Dr. Herbert Kleber, Professor of Psychiatry at Columbia University Medical Center, where he is the Director of the Division on Substance Abuse. When I asked him about sexual addiction, he said: "Is it an addiction? I'm convinced gambling is an addiction but am agnostic about sexual addiction. Once you let one of them in the door do you let in shopaholics, kleptomaniacs, etcetera? Where do you draw the line?"

Dr. Janssen echoed Dr. Kleber's skepticism, telling me: "There are no reliable prevalence statistics on sexual addiction. That is, it has not been measured in representative samples of men and women. A few studies in non-representative samples have concluded that it could involve 5-10 percent of the adult population. Most sex researchers prefer to not use that term, instead relying on terms like 'sexual compulsivity' or 'sexual impulsivity' to reflect people's experiences and actual behaviors.” Dr. Kleber and his colleagues wrote a classic article in which they argued that drug dependence was a "chronic medical illness" and not just a "social problem." The implication was that you could no more "snap out of" drug dependence than diabetes, asthma, or high blood pressure.

But Dr. Kleber is not convinced that what he calls "controversial addictions" to sex, the Internet, food, and shopping are true addictions. "We don't know enough about what goes on in the brain with these disorders. Do we include all of them, some of them? At this point, the jury is out."

Whatever the jury ends up saying about disease classification and underlying brain biology, one thing seems clear to me: for people suffering from this problem - and for their loved ones - the pain and the need for help are quite real. This is a disorder that desperately needs more research.

For an overview interview with Mavis Humes Baird on the subject of sexual addiction, click here

For an interview with Ms, Baird about the relationship between Internet pornography and sexual addiction, click here

For an interview with a self-described recovering sex addict, click here

For an interesting WebMD article on the subject, click here

For a good review of the concepts of sexual addiction, sexual compulsivity, and sexual impulsivity, click here

[salifeline]

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[HGOODGUY]

IS SEX AN ADDICTION AT 70 YEARS OLD???

OH GOD--I HOPE SO!!!!!

[prepare4battle]

Basic needs can turn into addictions when you over-endulge and obsess over them. No one questions whether there is such thing as food addiction. Food is a basic need and we are only satisfying a basic need right?

Sex addiction is real and there are many who will attest to that fact, except no one wants to admit to being addicted to porn. Drugs, alcohol and food are easier to admit to in public. Who wants to admit to having the need to watch porn and masturbate? No one. This secret sin keeps growing because of the shame involved.

Read my article on the attack strategy of pornography. http://abattleplan.com/

[orthotox]

God, I'm getting CBS addiction. Time to go!

[rushlimpdrug]

Although I am 4'-2" and 527 lbs. the women find me attractive.

This makes me think they are addicted to me. Either to my
personality or my physique. Don't know which buth they are
definetly addicted.

I hope it doesn't become a problem.

Gotta go get a donut.

[ireallydoknow]

Pscychodiagnostics (i.e., the latest variant of the DSM) has become worse than "psychobabble." Under pressure from many sides, it has become a political statement. Few folks are aware of the minimal training in mental health that is required to practice psychiatry (typically, 3 years of largely inpatient -- psych hospital -- experience, less that an undergratuate BA/BS -- and typically NO training beyond cursory overviews in psychotherapeutic approaces). They view the world through the lense of their inpatient experience (a tiny fraction of the impaired population). The "boards" for psychiatry are well known to be the easiest to pass among the "medical" specialties. Hence, many foreign MDs (who often even have problems with English) gravitate to this field. As a result (and with pressure from insurance companies) they employ a simplistic approach to human problems -- a pseudoscience of sorts -- the DSM, the "bible" of mental disorders. To exist (read, "to get paid"), a disorder must be included in this manual. Inclusion is based upon a "reliablity" factor found among a few naive studies, representative of the mental health field's concept of "research" (this is not physics!). You can read this manual yourself. You'll be amazed at its simpistic inadequacy. In short, whether your sexual activities cause you problems is what matters. Defining it as a "mental disorder" (whether it finds its way into the DSM) is moot. It only matters for the guy getting paid. If he wants paid bad enough, you'll get a diagnosis of some sort (e.g., a relatively rare disorder called "Bipolar" -- the pre-DSM III manic depression -- is in vogue now, especially among foreign psychiatrists). You will probably be given a script (that's all they do) for an antidepressant (tyically contraindicated for manics, but don't worry. They (the SSRIs -- from Prozac to Lexapro, etc.) have little effect except for the lucky few). Out of the visit you will probably be sent to someone who can help you.

[12345-908903]

More psychological psycho babble BS. Anything to create work and make a buck. Wall Street not the only people out of control.

[sly_64]

It's not an addiction, it's just a hell of a lot of fun !!!! It keeps me in a good mood always.

[displeased]

If I have an accumulation of sperm I need to release every 4 to 8 hours that is not an addiction. To describe the release of sperm accumulation as an "addiction" it's as moronic as saying that anyone who urinates every 4 hours is addicted to urination.
Posted by PhilistineTheArtLover

That sounds like an excuse. I've never heard of the necessary release of sperm every 4 to 8 hours. If you spend most of the day looking at porn and then spank the monkey every 4 hours, then you probably have an addiction.

[Dgunner]

HMMM! Al l these years I tought I was just taking up the slack.

[startide-2009]

It's "in the throes" of... not "in the throws of". I'd expect more from a doctor than reliance on Speelcheeker.

[gman1951]

So when is sex "NOT AN ADDICTION"?.....once a week, twice, three....six? I think it's all in the eyes of the unwanted; the person who does not like it very often. I was married to a woman who did not care how often. We divorced and my next girlfriend liked it every nite. Now I am with a lady who can take it or leave it { I think the later is what she really likes!} I miss the sexual connection!!!! Am I a pervert for wanting it often? Oh well if I can get it daily...I WILL TAKE IT!

[airboatboy]

Yes it is a problem and yes it is real. My ex has this problem to a very real extreme, to the point of masturbating at home and work several times a day. It has even cost him several jobs.
Posted by debinok1 at 6:05 PM : Jun 4, 2009

He didn't work at fast food restaurants, did he?

[bajajohn1]

Where the White women at?

[missbug1984]

Sex is a physical addiction. A physical addiction is defined when physical withdraw symptoms are present when the chemicals/action is no longer present. Being a former sex addict, I know that people truly addicted to sex may experience physical withdraw symptoms. Every time I would quit, I would get a migraine. If I went longer, I would develop a lack of focus. When I had sex again, the problems would go away.

[cmc1227]

If it's an addiction, where are the dealers?
Posted by Slrman

Pimps and Hookers?

[erasmus111]

Our societies problem is the emasculation of men...the feminist movement ...

Posted by TheStolenGiraffe at 5:37 PM : Jun 4, 2009

I was just about to agree with you when I read this, but then as I continued on, and read this:

".....has made it immoral for us to sleep around with many women, when it seems that this type of behavior is nature's intention."


I realized that you are an idiot.

[billpl-2009]

at least there's a cure

.....marriage

[debinok1]

The term "$ex addiction" is not really accurate. The addiction is not to the actual $ex act but to Porn and Masturbation. The people with the problems do this to the exclusion of all other forms of Sexual interaction. Yes it is a problem and yes it is real. My ex has this problem to a very real extreme, to the point of masturbating at home and work several times a day. It has even cost him several jobs.

[leogorky]

Well, that's not true in every case..it's not just porn and masturbation.

[TheStolenGiraffe]

Our societies problem is the emasculation of men...the feminist movement has made it immoral for us to sleep around with many women, when it seems that this type of behavior is nature's intention. Why else would women outnumber men 3 to 1 on this planet? It is our job to fertilize the eggs and populate the earth for our survival; our primal instincts urge us to do so. It seems natural for us to be addicted to sex because its our bodies telling us to reproduce.

Thanks to contraception we now have sex for pleasure instead of procreation and it's now a matter of satisfaction rather than survival. As far as I know, our instincts can't distinguish between reasons we're having sex for, so when we have the urge for sex and act on it we end up accomplishing nature's intentions without the intended result of reproduction.