Sunday, December 27, 2009

Controversy over sexual addiction

Many of you who read this blog know that I specialize in both sexual addiction, sexual compulsivity and sexology. I try to look at sexual practices, fantasies and behaviors from a positive perspective as much as possible. The debate around sexual addiction is growing. Sexologists and sex addiction therapists often disagree with one another.


Can there be a middle ground? I think so.

To find this middle ground we have to look at all the issues around sexual addiction and compulsivity as well as those individuals who are acting out their own narcissism, childhood sexual abuse or simply are immature and want to have a lot of sex without regard for others.
In my practice I see much more of those who are experiencing loss of control over their sexual behavior and are horrified by those they have hurt around them--including themselves.
First there was this article in a blog called, "The Salon"

By Tracy Clark-Flory

It's spawned a VH1 show and an excuse for Tiger Woods. But some experts balk at the idea of being hooked on nooky.

Since the term was coined in 1983, "sex addiction" has become so embroidered in
our self-help vocabulary that most of us stopped questioning it. The term gets
bandied about whenever Bill Clinton logs extracurricular time with an intern or
Eliot Spitzer gets caught having sex in his socks or David Duchovny separates
from his wife. Recently "Sex Rehab" host Dr. Drew Pinsky made headlines by
suggesting that Tiger Woods has a sex addiction. It's become the go-to defense
for extramarital affairs (I'm not an asshole; I'm an addict!) and been sold to
"Oprah" viewers eager to diagnose their porn-loving husbands as both addicts and
assholes.

A problem with news reports and journalism on sexual addiction or any other controversial issue is getting the facts correct. So another journalist posted a correction of what the, "The Salon" reported.

Fact Checking Sex Addiction Coverage
by Benoit Denizet-Lewis

Every couple of years, when a celebrity actor goes to sex addiction
treatment or a celebrity golfer sleeps with dozens of women who are not his
beautiful model wife, the media “rediscovers” sex addiction. Predictable
questions are bandied about: Is sex addiction real? Can someone be addicted
without a substance? Isn’t sex addiction just a clever excuse for whoring
around/irresponsible behavior? What’s next—an addiction to reading blogs?

In recent days, Salon and Slate—online magazines that I’ve contributed
to—have entered the fray. Slate published a piece that covers familiar
ground,
arguing that “our enthusiasm for labeling new forms of addictions
seems to have
arisen from a perfect storm of pop medicine,
pseudo-neuroscience, and misplaced
sympathy for the miserable.” Salon’s
story, which quotes me, strives for some
pseudo-balance but is still deeply
unsatisfying.

There have been many
articles/television segments
about Tiger Woods/sex addiction in the last week,
but one man can only take
so much lazy, knee-jerk journalism. For the sake of
time, I’m restricting my
analysis to the the Salon piece, which is far from the
worst but which
quotes several anti-sex addiction “experts” who don’t know what
they’re
talking about (on this issue, at least). In bold are portions of the
story,
followed by my analysis.


Whatever is decided to call this problem, the truth is that it exists. It causes men and women to behave sexually in ways that are out of integrity with themselves and their lives.




2 comments:

Steve said...

I see common threads between these public conversations about sex addiction and long-standing tensions in the broader addiction treatment field, where the 12 Steps and evidence-based treatment have often been at odds with each other.

The VH1 show didn't help things on that front, either, by opening each episode with a voice-over by Dr. Drew to the effect that sex addiction is deadly just like drug addiction. Offered without clarification (that I've been able to find) or evidence, it comes across as more hyperbolic than helpful.

Another striking anecdote, for me, was the group therapy session when various items were placed in high-risk to low-risk groupings. Sex toys, erotica, and a laptop were brought out. For some in the group, use of any computer sounded very risky, and the therapists seemed to concur that abstaining form internet use was necessary. One person spoke up about his career having a significant online component.

Again, no evidence or further clarification was offered... do most sex addicts need to avoid careers which include online work in order to be healthy? What is the quality of the evidence on that?

Overall, the diversity of issues among the participants in the show was eye-opening. For example, one person talked about using online erotica for 12+ hours daily, avoiding social contact. For a couple of others, the core concern seemed to be compulsively seeking anonymous encounters.

In the context of that diversity, it struck me as incongruent that the voice-overs preferred to oversimplify that sex addiction is a more unitary thing, and all of the addicts had similar, expected experiences in treatment.

My preferences: De-emphasize addiction, focus more on identifying and treating compulsive behavior, and speak directly about evidence.

Dr. Joe Kort said...

Steve, I completely agree! Thanks for your input. It was too superficial. I found it to be a great start and I agree not all sexually compulsive people have to give up sex toys or sex work. That would be too simplistic.