Harvey Weinstein, recently accused by dozens of women of varying degrees of sexual misconduct, including rape, is seeking treatment for sexual addiction. And the public is up in arms about this, with a lot of people screaming that he should be in jail, not treatment.

Well, maybe he will end up in jail. But not until his behaviors are fully investigated, charges are filed, trials are held, and convictions are obtained. Until then, he’s free to walk the streets, and I, for one, would rather see him in a treatment center than on a beach in Malibu. In the controlled environment of a treatment center, there is much less chance of him engaging in further bad behavior, and a much greater chance of breaking through the denial and narcissism that has fueled his behaviors.

But is Weinstein really a sex addict? Or is he simply trying to use “addiction” as an excuse?

NOTE: Sexual addiction is never an excuse for bad behavior. Sex addicts are fully responsible for the consequences of their actions. Moreover, part of the process of healing from sexual addiction is admitting what you’ve done, taking responsibility, and accepting the consequences.

So, which is it with Weinstein – addict or offender?

  • Sex addicts: Men and women who are obsessed with and engage in sexual fantasies and behaviors even when they don’t want to and are experiencing negative consequences as a result. Whether it’s looking at online porn, sexting, chasing sex via hookup apps, or any other behavior, they can’t stop themselves. They repeatedly try to cut back or quit, but they can’t, even when their lives are coming apart at the seams as a result. They are primarily motivated by a desire to not feel emotional discomfort, including the pain of underlying psychological conditions such as depression, anxiety, attachment deficit disorders, and unresolved early-life or severe adult trauma.
  • Sexual offenders: Men and women who purposefully engage in nonconsensual sexual activity. Sex offenders violate the rights and boundaries of others, and the laws of their state/country. Sexual offending involves nonconsensual forms of sex—sex with those who don’t want it, sex with those who don’t know it’s happening (voyeurism), sex with those who are too young to consent (including viewing pornography featuring minors), sex with those who are mentally incapacitated and therefore can’t consent, and sex by force. Sex offenders are primarily motivated by a desire to control, abuse, and/or harm other people

Despite the clear distinctions between sexual addiction and sexual offending, it is possible for an individual to be both. In fact, there is a significant crossover between the two populations, mostly because sexual addiction, if left unchecked and untreated, tends to escalate over time, and for some offenders this can lead to (usually lower level) sexual offending. For instance, a porn addict might eventually dabble with illegal imagery as part of his addiction, and a compulsive webcammer might escalate to real-world exhibitionism as part of his addiction.

The primary difference between a sexually addicted sex offender and a more traditional sex offender, particularly when they are engaging in the same or a very similar behavior, is motivation. Sex addicts are driven by a desire to escape emotional discomfort, whereas more traditional sex offenders are driven by a desire to control, abuse, and/or harm other people.

Where Harvey Weinstein falls on the addict/offender spectrum remains to be seen. The good news is that wherever he lands on that spectrum, there is a decent chance he will respond positively to therapy. In fact, nearly all sexual addicts and most sexual offenders, once they start with a properly directed treatment protocol, tend to make significant (though usually imperfect) progress.

But how, you might ask, would a guy like Harvey Weinstein—a serial sexual harasser and offender—benefit from addiction treatment? Why would an addiction treatment facility even admit him and try to treat him?

Well, let me first say that rehabs, the name commonly used to refer to addiction treatment facilities, are fully functioning mental health hospitals. As such, they are equipped to handle the full gamut of mental health issues, and they do so on a regular basis. Almost nobody walks in the door just because they’re addicted. They’re also depressed, traumatized, anxious, and behaving badly in all sorts of ways. It is the treatment center’s job, first and foremost, no matter what it is that brought an individual into treatment, to perform a full clinical assessment so we can see and understand what we are dealing with. If the client really is an addict, we’ll treat it. If not, we’ll help the client in whatever ways are appropriate and likely to be useful. At the very least, we can work through the client’s denial to help him understand what he’s done, how his behavior has impacted others, and what he can do to live a better life moving forward.

So, is Harvey Weinstein in sex addiction treatment because he’s trying to look sympathetic, or does he really want help with his behaviors? I say who cares. When a guy like Weinstein comes into treatment, he’s in crisis. He might even be having suicidal ideation. And it’s my duty, as a therapist, to help him in whatever ways I can. I will perform an assessment, work to stabilize the client, and then we will look at the client’s cognitive distortions around his behavior—how he views his actions vs. how the rest of the world views his actions. As we move forward, the client may be remorseful and responsive to treatment, or not. But we don’t know until we get there.

Generally, whether dealing with sexual addiction or offending (or a combination thereof), the most effective treatment methodology is a mix of cognitive behavioral therapy (CBT), social learning, psycho-education, and external support. Sometimes selective serotonin reuptake inhibitors (SSRIs) are utilized in conjunction with other forms of treatment, as these antidepressant medications, as a side effect, can reduce a person’s sex drive. Many sex addicts and sex offenders also benefit from 12 step sexual recovery meetings, which provide both guided recovery and social support. Sex Addicts Anonymous, Sexual Compulsives Anonymous, Sex and Love Addicts Anonymous, and Sexual Recovery Anonymous are excellent recovery programs for sex addicts. Sexually addicted offenders are welcome in most groups.