Or is it "nothing more than a
pop-psychology phenomenon, serving only to demonize sex, enforce moral
views of sex and relationships and excuse irresponsible behaviors?"
Those are the fighting words of psychologist David Ley, who, in his rousing new book, "The Myth of Sex Addiction,"
expresses concern over the slippery ease with which America's
mainstream media and burgeoning "addictionology industry" have seemingly
conspired to transform a debatable diagnosis into a foregone
"There are real dangers inherent in the sex addiction concept," Ley writes. "I believe that for the field of health care, medicine, and mental health to endorse and reify a flawed concept creates a very dangerous slippery slope of moral relativism, where any socially unacceptable behavior is labeled a mental disorder subject to psychiatric treatment."
Ley has a point. While many are quick to put sex addiction in the same category as other addictions, it is still not recognized within the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders. As Ley maintains, "Sex has no tolerance or withdrawal effects. No one has ever died from being unable to have sex, nor has anyone ever overdosed from sex."
But is Ley going too far when he contends that the majority of men who enter sex-addiction treatment do so because they're in trouble with their wives for infidelity?
It's no surprise that many within the mental health community have taken issue with Ley's assertions.
"I have had dozens of patients every month sit in my office and cry, broken and desperate, because they can't stop going to prostitutes, or because they can't stop masturbating, or because their casual 'hookups' in bars are getting more dangerous and less appealing," says Dr. Tammy Nelson, a noted psychotherapist and author of "Getting the Sex You Want." "Are these men and women sex addicts?"
Many seasoned professionals would say yes.
Sex and relationship therapist Dr. Joe Kort points to the nuts and bolts of addiction, explaining that the main symptoms are loss of control, failed attempts to stop the unwanted sexual behavior, and a pattern of negative consequences such as anxiety, depression, legal troubles, sexually transmitted diseases and relationship problems.
In his view, sex addiction is a very real problem, and he takes issue with Ley's assertion that the "sex addictionologists themselves are true believers, and little that I say will shake their belief system, grounded as it is in rhetoric and pseudoscience."
"I am a CSAT-certified sex addiction therapist," Kort counters, "and these therapists are very serious about helping people with sexual suffering, and are very dedicated to high standards regarding treatment."
Still, many men seem quick to turn to a sex addiction diagnosis as a means of explaining away their bad behavior. Jonathan Alpert, a psychotherapist and author of the forthcoming "Be Fearless: Change Your Life in 28 Days," says, "I've had more and more males coming in to see me with the idea that they are a sex addict. This is largely fueled by the media, as it has become the diagnosis du jour. Way too many times, it is used as an excuse for someone who simply cheated on his significant other. Fact is, one act of infidelity doesn't make someone a sex addict; it makes him a cheater."
Addiction therapist Edward Ratush acknowledges that sex addiction has been over-diagnosed. But for that matter, so has depression. That doesn't mean the issue isn't very real.
"Yes, I do think it is possible to be addicted to sex," he says. "To need it even when you don't want it. To pursue it even at the cost of your health, happiness, relationships, and career."
Psychiatrist Gail Saltz goes even further, saying that sex addiction "could fit into numerous diagnoses: OCD, bipolar disorder, various personality disorders, etc. The goal is to help a patient see the cost, and to treat the larger diagnosis and the symptom itself. Most important is to avoid seeing a label as any sort of absolution from responsibility, the responsibility to get treatment and stop being destructive to yourself and others."
So is sex addiction for real? Is it a diagnosis? A symptom? A poor excuse for even worse behavior? Despite the bad behavior of certain Hollywood actors and politicians, perhaps, in the end, the label itself isn't what's important.
"Whatever we decide to call this stuff, 'sex addiction,' 'compulsive sexual behavior,' 'out of control sexual behavior,' or 'hypersexuality,' it does exist," says noted sex therapist Russell Stambaugh. "It can wreck lives, and it is wildly over-diagnosed and threatens to further marginalize sexuality in general and specific sexual minorities in particular. It is not sex negative to recognize that sex both causes harm sometimes, and can come from bad places."
Ley has clearly thrown down the gauntlet, and hopefully the debate will continue. What do you think? Is sex addiction a myth or the real thing?