In David J. Ley’s recently published book, The Myth of Sex Addiction, Dr. Ley argues that the concept of sexual addiction is based on questionable research and subjective moral judgments. He believes that labeling problematic sexual behavior as addiction undermines the individual’s personal responsibility for that behavior.
He also believes that the sexual addiction treatment “industry” is driven by economic greed.
Sadly, sexual addiction is not a myth and the treatment “industry” is barely in its infancy. As a licensed sexual addiction specialist with over 20 years experience in the field of sex and intimacy, I have seen thousands of individuals whose sexual behaviors satisfy every criteria of addiction.
These individuals—both men and women—act on those sexual behaviors repeatedly and, once headed down that path, without the ability to stop. They also develop a tolerance to their sexual activities, most often causing them to engage in those behaviors for longer periods of time or to seek out more intensely arousing situations, images, etc.
To say that these people are not suffering from an addiction is to deny reality. There is a great deal of solid research on this topic today – and likely it would rock Dr. Ley’s world to spend a few weeks in a sexual addiction treatment center where those men and women we call sex addicts are working hard to eliminate their patterns of sexual acting out, which are nearly always tied to early-life trauma, abuse, neglect, and other childhood injuries.
It is important to note that the assessment and treatment of sexual addiction is not based on what turns someone on (like fetish behavior), nor is it defined by who turns someone on (man or woman, transgender, younger, older, etc.). Sex addiction is not about moral judgment or what others believe your sexual behavior should be. And it is not solely a men’s issue.
Sexual addiction is diagnosed by repetitive patterns of problematic sexual behavior that cause profound negative consequences to the life of the individual. These individuals continue their problematic sexual behavior patterns despite loss of relationships, disease transmission, arrests, etc.
Dr. Ley is correct in saying that the DSM does not list sex addiction at this time. However, it is being considered for the upcoming DSM-5, to be released in 2013. (Sexual addiction was in previous iterations of the DSM.) And let us not forget that the DSM is not always accurate. Consider that both the DSM-I and DSM-II listed homosexuality as a mental illness. Today, only an unethical or extremely conservative, religiously based clinician would subscribe to that theory.
Dr. Ley seems to be of the opinion that since sex does not introduce a foreign substance into the human body, it can’t be an addiction. Yet gambling is commonly recognized as an addiction, one that is listed in the DSM (as pathological gambling), and no foreign substance is introduced there. Gambling addiction, like sex addiction, is all about fantasy, euphoria, and emotional escape.
Dr. Ley is equally misinformed about the nature of sex addiction. (In fact, he seems to not understand the nature of addiction in general.) He states: “There’s no evidence of a tolerance effect with sex. An orgasm never stops feeling good.” What Dr. Ley fails to understand is sex addiction is not about orgasm per se, much like gambling addiction is not about winning or losing.
Like all process or behavioral addictions, sex addiction is a process that utilizes fantasy-based euphoria and ritualistic behavior to escape and/or manage what feel like intolerable emotions, stressors, and psychological conditions. Sex addicts engage in their addictive behaviors as a temporary distraction from loneliness, low self-esteem, anxiety, depression, and other triggers related to past emotional and/or physical trauma.
Ultimately, the rush of orgasm for the sex addict is as meaningless as the rush of cocaine for the drug addict. The real drug is fantasy and the behaviors that reinforce those fantasies—and these “drugs” are self-produced in the brain. You don’t need a needle, pill, or drink to stimulate addictive patterns.
Click here to listen to a recent debate between Dr. Ley and I on KPCC radio.