When I heard that David Duchovny -- former X-files hottie-turned-FILF and star of "Californication," in which he plays a sex-addicted Hollywood writer -- was checking himself in to a sexual addiction rehab clinic, my first thought was that it was a PR stunt to get some buzz for the series' return this month. Whether or not he went in for PR or for a porn addiction (as his spokesperson claims), what really got me was the fact that there is a sexual addiction rehab clinic in the first place. Well, holy shit: a concept which is, at best, a theory proposed and then ruthlessly promoted by a psychologist (Dr. Patrick Carnes) now has all kinds of people convinced that sexual addiction is a legitimate diagnosis. It is not. You will not find sexual addiction in the sacred book of psychiatric diagnoses -- the DSM -- and, therefore, without the APA officially recognizing a disorder AS a disorder, we must embrace the simple fact that there is no such disorder. OM. For the APA is all-knowing. Or at least, that's what psychiatrists and psychologists are supposed to accept.
(Being a sexologist, I don't have to accept anything but the evidence of sexological research and clinical experience. Tra la la.)
OF COURSE there are people who display addictive (or more accurately, obsessive/compulsive) behaviors in their sex lives. OF COURSE people have difficulty with impulse control (particularly when they are in denial), and make poor choices (especially when they are guilty or conflicted about their needs). But none of that is the same as an addiction which, in simple terms, is an uncontrolled and uncontrollable use of a harmful substance. Since sex is not a harmful substance, not even in big doses, I tend to view the whole sex addiction movement as quackery, and further proof that some psychologists will do anything to drum up business, in this case treating people for imaginary conditions.
IMO, addiction is some real serious shit, not a term to throw around, particularly when it comes to sex. Indicators for sex addiction should parallel indicators for substance addiction: the behavior is destroying or preventing them from forming intimate relationships; it is directly jeopardizing their job or otherwise negatively impacting their workplace performance; it is draining them financially; it is alienating friends/family; it is changing their personality; they have black-outs, fugues, or other episodes where they forget who they are.
Some of my clients have significant problems controlling their sexual choices. Indeed, some have been drug and alcohol addicts, with profoundly serious problems controlling their needs for immediate gratification in all realms (sex, food, spending, etc.). But in eight years of counseling, I have yet to see anyone I genuinely believed was a sex addict. Sex obsessive? PLENTY! Sexually repressed person with a personality disorder that mimics addictive behaviors? Oh yeah. Along with depressives, people who act out sexually to compensate for other problems, emotionally immature people, and a whole host of others who, for one reason or another, make bad bad choices when it comes to their sex lives.
But sex is not by nature a harmful substance. Nor is libido, much less sexual orientation, a one-size-fits-all proposition. Some people are wired to be horny day and night: if they don't have numerous orgasms in the course of a day they get cranky. Some people, on the other hand, are wired to want sex once a week, even once a month, even less. You can take drugs to ratchet the libido up or down but you can't alter the fact that sexual diversity is biologically normal.
In my practice I work on the underlying issues that make people make bad choices. We figure out how to control obsessions, how to overcome compulsions, and how to come to terms with whatever one's natural sexual identity might be (whether it's perpetually horny or seldom aroused), and then make healthful, rational and, hopefully, more rewarding choices. I wonder what they teach at sex addiction rehab clinics, though. If it's anything like Carnes' and his followers' teachings, it's going to be predicated on the ideas that sex is bad and too much sex is horrible; that porn is evil; that masturbation is wrong; that so-called perversion (i.e., SM) is sick; and that there is such a thing as a "normal" amount of sex that every person should have.
Sex therapies like these are not just pointless, in my opinion, they're damaging. They destroy self-confidence. They warp self-awareness. They treat symptoms, not the underlying issues. They offer fake treatments based on phony diagnoses to vulnerable people in pain.
But that isn't stopping even well-intentioned, usually pretty smart people from buying into the idea that if you're making bad sex choices, you're an addict. I was bummed to read the following in a Dear Margo column since she often gives pretty good advice.
When "Normal" Swings into AbnormalDEAR MARGO: I am a 23-year-old woman with an abnormal sexual appetite. I am currently dating five different men. I have one I refer to as "my pet" and one who is my "daddy." Sex consumes most of my thoughts most of my days. What was a minor interest when I was younger is now an all-consuming monster. I feel deviant and abnormal. I want to seek help, but honestly, I don't know what kind of help I should be looking for. Are there specific therapists for this, or would a regular psychiatrist be able to help? And I wonder if this all stems from not having a father growing up. I just need help.
--- ABERRANT AND HURTING
DEAR AB: The constructive part of your letter is that you know you need help. And yes, there are specific mental health professionals for your aberration, which is sex addiction. You can get a referral from your primary care doc, the American Psychiatric Association or the American Society of Addiction Medicine. There are also online support groups, which enable you to ask questions and also learn that you are not alone. As for your immersion in sex, it is seldom possible to pinpoint a single cause. I suspect growing up fatherless played a part in your dealings with men, but I can assure you that there are women who were raised as you were who are not "dating" five men and feeling as though sex is "an all-consuming monster." With guidance, you can become emotionally healthy, and I wish you luck.
--- MARGO, BENEFICIALLY
LINK
Where do I begin...first, no one can diagnose an addiction in the short form. See above for "addiction is serious shit." A person claiming to feel like crap about their sexual choices doth not make for a diagnosis. Second, see above: the APA doesn't recognize sexual addiction, so sending someone to the APA for diagnosis of a disease they don't recognize is not helpful. The online support groups she refers to are either run by Carnes and his followers or by people who have bought into Carnes' and his followers' beliefs. Most of all, however, Margo missed the most telling statement in the letter: "I feel deviant and abnormal."
Awwww. Give that girl a hug!!
If everyone who felt deviant and abnormal was a sex addict, I reckon we'd all be sex addicts in America, hurrah! (Sorry, British subjects, certainly don't mean to omit you from the Victorian brew of prudery in question.) I mean, who hasn't felt weird at least once in their sexual lives? Put another way, if you have NEVER felt dirty/nasty/weird during sex, you may have the world's most boring sex life.
Sounds more to me like what the correspondent needs is a little sexual enlightenment and perhaps a non-judgmental counselor, instead of one who assumes that there's something wrong with being a horny fuck-slut. Wake up and smell the pheremones, ladies: some of the happiest, most well-adjusted people in the world are horny fuck-sluts.
As if that wasn't demoralizing enough for a forward-thinking sex chick like me, then comes news that some twits have now come up with a new mental disorder:
Feel stressed if you can't get online? You could have 'discomgoogolation'Psychologists studying the high stress levels caused by internet dependency have dubbed the phenomenon 'discomgoogolation'.
They define it as a 'feeling of distress or anxiety when unable to gain immediate information access'.
Stick a fork in me, I'm done.
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