Consider how the following progression of access to sexual imagery and contact over time might affect someone vulnerable to compulsive and addictive sexual behavior:  

Sexual Access Timeline

1. Prehistory to approx 1890 – cave art, prostitution, affairs, harems, compulsive masturbation to fantasy

2. 1890 to late 1970’s – photographic porn, film, porn theatres, strip clubs, adult bookstores

3. 1977 -1990 – VCR & Beta, Phone Sex

4. 1990 – 2004 – Bulletin Board (BBS), Chat Rooms, Porn Websites, Web cams, Craig’s List, interactive online sex, online hook-ups and prostitution sites

5. 2004 to the present – Smartphones with GPS locators, Social Networking (facebook, twitter, linkedin), Virtual World Sex, Sexting

6. And coming to your way very soon … Virtual Sex

Instant Problem

Note above how the explosion of modern world technology has fueled an equally exponential growth of access to graphic pornography and recreational sex partners. Think about the fact that over the many millennia it has taken for the brains, relationships, morality and ethics of mankind to develop, our sexual behavior was basically limited to art, cheating, imagination and self-stimulation. Yet in a period of little more than 100 years we have arrived at the point of near instant entry to explicit imagery and sexual partnering (for cash or free).

Looking beyond the sad mess of Former Congressman Weiner’s recent sexting scandal, today’s as yet under-the-radar, but evolving sexnologies are about to make texing nudie pics to strangers as old-school as focusing a 35-mm camera.

Last fall while researching the effect of social network and smart-phone technologies on sexual addiction, I came across what appear to be some of the first products specifically designed and mass-produced for purchasers to engage in virtual sex. Called Teledildonics, these white plastic gadgets are described by the manufacturer as “hardware components that can, when hooked up the Wii platform, allow remote partners to simultaneously enjoy each others physical stimulations.”

As reports that “Congressman Anthony Weiner heads to rehab” continue to dominate headlines (and the Twitter-sphere), I am receiving an increasing number of media calls asking to explain exactly how sex addiction treatment works.  While many believe that “Men In Power” heading to rehab is a blatant attempt to “help their image” or somehow excuse their bad behavior, I can promise you that rehab isn’t intended to serve either of those purposes.

Pre- Rehab: Crisis (in this case “Weinergate”)

The initial need for any addiction treatment – whether sex, gambling, food, drug or sex rehab – is most often born out of a crisis. For those attending sexual addiction treatment the crisis tends to be related to their profound betrayal of primary relationships, but problems can also center on health, work, legal or financial issues that have come about due to their sexual behavior problem. Sometimes a crisis is created to get someone to go into rehab and this is called an Intervention.

As if the past few weeks hadn’t served up enough tales of savvy, political figures behaving badly, now we have a real weiner-roast of a story. Following in the wake of Bill Clinton, Elliot Spitzer, Marc Sanford, Chris Lee, Larry Craig, Arnold Schwarzenegger, and IMF Chief Dominique Strauss-Kahn, married Congressman Anthony Weiner’s admission of his recent Calvin-clad sex-tweets sent to several woman, none of whom who happened to be his new wife, offers up yet another example of how far a man can fall in pursuit of a sexual high.

And here, as in previous high profile cases the same questions arise:

What do you think?

Just as concrete and predictable diagnostic criteria help medical professionals determine whether your burning stomach pain is a case of chili-induced heartburn or appendicitis, so do categories of well-researched mental health symptoms provide the scientific underpinning for the identification of psychiatric and emotional disorders. New mental health diagnosis are not arbitrarily determined, but come about as consistent sets of reliable sample data are codified through years of repeatable clinical research and study.

This is the science of diagnosis.

The Diagnostic and Statistical Manual of Mental Disorders or DSM, renewed or revised in sporadic 10 to 20 year increments is, as every trained psychotherapist knows, the diagnostic ‘bible’ of mental health. In 2013, the American Psychiatric Association (APA) through their various working groups and committees will deliver a shiny new DSM 5, the formal guide that will differentiate and re-standardize our definition of mental health for at least a decade to come.

Like it or not, there is no single work more important to the daily practice of mental health diagnosis and treatment in America than the DSM. Though some clinicians consider the book demeaning as it purports to apply broad labels to the behavior of individual human beings, the DSM remains the authoritative guide to mental health diagnosis and its influence cannot be underestimated. The codification and language of the upcoming DSM 5 will come to establish not only what is considered mental health from pathology, but will also help determine and recategorize our systems of insurance reimbursement and legal casework along with the content and organization of counseling psychology education for a generation to come.