Need treatment? Find help or get online counseling right now!

Comments on
No Sex Please, We’re Psychiatrists


Last week we learned that the proposed diagnosis of Hypersexual Disorder, more commonly known as sexual addiction, would not be included as a criteria-based diagnosis in the forthcoming DSM-5. As I have written previously, I did not expect Hypersexual Disorder to “make it” into the DSM-5 as a standalone diagnosis. I did, however, expect it to be listed in the Appendix of next spring’s publication as a potential diagnosis requiring further research. Lamentably, the APA apparently lacks the political will to even consider the idea that consensual sexual behavior, for some people, can be problematic. Frankly, the organization’s decision has left me (and a whole lot of other highly trained, eminently reasonable, forward-thinking mental health and addiction professionals) feeling frustrated, disappointed, and downright angry.

10 Comments to
No Sex Please, We’re Psychiatrists

The comments below begin with the oldest comments first. (If there's more than one page, click on the last comments page to jump to the most recent comments.) Jump to reply form.

  1. One problem in today’s society is the lack of spiritual life to confront various emotional/psychological/sociological problems. Our entire culture is focused on sex, money and power, which gives a very limited approach to living a healthy life.
    In the past, many great men referred to being religious in their decisions. Today, everybody is afraid to talk about one’s soul. I’ve seen that those kinds of people don’t have much peace and happiness. One can obtain a strong foundation with a belief in a spiritual life.

  2. Sex and Love Addicts Anonymous (SLAA) is a 12-step program with an exceptionally good book put out by The Augustine Fellowship. Those who do not believe that sex and love can be addictions might consider what happened in San FRancisco when the AIDS epidemic began. Even knowing that their sexual behavior could kill them, thousands of men could not change their promiscuous behavior. I was there. I saw friends die. This is a very serious problem, that can only become worse as society drifts further from old morality ideas and sanctions hooking up at early ages. ETC.

    I had this discussion last week with a counselor friend who was not so sure sex could be an addiction. It most assuredly is for most “sex workers,” who started their “careers” as sexually abused children and went on from there in a downward spiral….I’ve heard recovering alcoholics say that the basis of their drinking was to get uninhibited enough to indulge their sex addictions.

    70% of the DSM5 deciders, as I understand it, have ties to BigPharma. They’d like to pharmacize addiction treatment, but there’s no way to do that with sex and other process addictions.

    So much to think about.

  3. The question is……what do you tell those people now? What does it matter if the disorder isn’t listed in a book?

  4. Well said, Rob! As a specialist helping the partners of these sex addicts, not only do we not have a recognized disorder to research and treat (thus the APA invalidates the experience of the person with the addiction) we are no closer to recognizing and validating the destructive effects of this disorder on their loved ones. Families are frequently rocked and destroyed by the effects of this addiction, in many ways more so than in response to other addictions. Now we tell them that the APA refuses to recognize the source of their pain as real…what a crazy-making situation for all involved. Thanks for voicing this concern Rob. I’m grateful that there are a growing number of us who specialize in helping this population! Barbara Steffens PhD LPCC.

  5. A lot of hypersexuals will be happy to get medication for the depression and continue their sic habits. Its when things go wrong and you really need support from family and friends and your crippled emotionally because your friends and family are sic too the trouble starts.

    Let them eat cake said the Queen to the prince. Dr. Rieds study got 86 views on You tube and the Chinese pony dance guy got 860,000,000 views.. Our society is hypersexual disordered. Just look at all the gays taking over the entertainment industry. It was the high number of homosexuals in the study that spoiled the program.Their self-rightious c…. s that no one wants to deal with. That’s the way I see it.

    • I have been diagnosed as having symptoms of Hyper-sexuality … I have bipolar type 2 Disorder. I am not addicted to sex though. There doesn’t need to be a medication for me because the dope that is prescribed will kill any sexy feelings u may have anyway ( a positive side effect ) for me. Even when i’m hyper-sexual i don’t see a partner. Too much disinfo about this “disorder” floating around.

    • Whoa baby. Substitute “Jews” or “African-Americans” for the word “homosexuals” and “gays” in this post and this would surely have raised immediate hackles not just in me. Maybe it ought to come down. There is a better way to express sentiments of disappointment, I think.

  6. As a mental health professional with over 20 years of experience I must make some comments. Men and women both have the capacity to become addicted to anything including sex. But for very different reasons. Men seek to conquer. Women seek emotional intimacy. To have “sex” with another human being requires trusting the other human being. Trust develops over time. Emotional intimacy needs develop over time along with trust. Those who are “sex addicts,” what are they addicted to? What are they wanting?

    The DSM is medically-modeled based. What pill can be designed to turn off sexual need? A perfectly normal human need. What pill can be designed to only turn on this sexual need in a “normal” relationship? Impossible task. Hence, no inclusion in the DSM-V.

    This is my opinion.

  7. I met a man in AA,took him for coffee,after 30 min of conversation,I told him, “L.,you’re more than a penis” (and I am not a ‘professional’);later I told him his sexual addiction was more of a problem than his 45+yrs.of drug addiction.I tried to ‘work’ with him for 6 yrs.,tolerating his ‘porn’,his sex toys(pumps,pills)his unrelenting focus on and use of every possible wiles to draw me into his scenario,nothing helped.Agreed,there are no pills to take,he couldn’t/wouldn’t give up his obsession,liquid substitutes can be offered the alcoholic,diets for the food addicts,what can be used as a substitute for sex for the sexually addicted? I fear he may have resumed his drug addiction after 5 yrs. of sobriety.I feel hopeless.

  8. The case you presented has a sexually deviated person, and may not be hypersexual.

  9. Hi Robert,
    Well done article. I’m also amazed that sexual addiction is not in the DSM 5. I’ve worked with a number of sex addicts and they certainly fit the criteria of addiction. the struggles some of these clients go through is heart breaking for them. To me it defies logic not to include sexual addiction. I would love to see this changed.

  10. I wouldn’t be so quick to chalk it up to politics. The DSM-5 examiners must not have liked the design of the research study by Reid, et. al. The thing to do is go back to the drawing board and start over. It seems to me what would be decisive would be some sort of factor analysis for the hypersexuality which would factor out all the usual suspects when someone presents with compulsive sexual symptoms. OCD, high anxiety, bipolar disorder, etc.

    As sexologist Dr. Marty Klein writes: “Those who are really sexually compulsive are typically psychotic, sociopathic, character-disordered, etc. Some of these people have impaired reality testing. Others have absolutely no concern about the consequences of their behavior. Dr. Renshaw states that “undifferentiated sexual urgency is a symptom of manic-depression.” These people don’t need help laying off one day at a time. They need deep therapy, medication, structured behavioral interventions, or other intensive modalities. The University of Minnesota’s Dr. Eli Coleman, for example, reports treatment success with lithium, comparable to the clinical results lithium produces with other compulsives.”

    The thing to do is prove him wrong, but doing a study with sufficiently well designed parameters that these other factors can be controlled for. I look forward to seeing that study, and looking at the results.

  11. When I hear someone talking about the proposal of the sexual addiction model for inclusion in DSM, I often think of a more general problem. According to the theory of sexual addiction, sexual behaviour becomes pathological when it meets certain criteria. Implicit in this approach is an assumption that there is (to cite your blog “Hypersexual Disorder/Sexual Addiction: Useful Diagnosis or Judgment?”) a “range of human sexual behavior [that] is neither problematic nor evidence of an addiction.” In contrast to this point of view, some Russian antisexuals claim that sexual drive itself is an addictive disorder. From these positions, the very desire for sex is a psychiatric symptom. Unfortunately, the forums of antisexuals are neither led by professional sexologists nor meant for them. The community consists of lay people who are not engaged in serious sexological research.

    Dr. Weiss, could I ask you about your professional opinion apropos of antisexual’s conviction? Why limit the concept of sexual addiction to particular sexual manifestations? Why not admit that sexual drive and the sexual addiction disorder are the same thing? Some facts (e.g., AVEN) witness that sexual drive is not a universal need just as the desire for drugs. When we compare any form of sexual behaviour with the life of asexual people, the signs of addiction (as understood by Aviel Goodman, for example) seem to be present. Besides, the identification of sexual drive with sexual addiction makes it possible to avoid one of the main difficulties which the Hypersexual Disorder diagnosis is associated with, namely: demarcation between pathological and non-pathological sexual behaviours. But neither ICD nor DSM considers sexual drive an illness. What are the grounds for the belief that the concept of addiction cannot be applied to sexual drive as a whole?

  12. Very early in our marriage I realized that my spouse was way more than just “interested” in porn. I sought mental health help for myself….but really wanted us to work on this together. However, in a society that is so accepting of sexual content in almost all venues….even after he had actually been diagnosed with “sexual addiction” it seemed that no one other than our therapist and I considered it to be harmful. After over 30 yrs of dealing with all kinds of situations…i finally cut all ties with him. I later met a wonderful man who I know loves me and that I am what he needs for his sexual needs as well…it is not only a travesty that those suffering from this condition generally does not get help…but it is a travesty for their partners and their children. It took me years to be able to feel confident that I was attractive and that someone found me to be all they needed in the “sex department”. Whoever makes the arbitrary decisions about what illnesses constitutes what need to research a lot more and hear from real victims before deciding. It hurts more people than they realize.

 

Join the Conversation!

We invite you to share your thoughts and tell us what you think in this public forum. Before posting, please read our blog moderation guidelines. A first name or pseudonym is required and will be displayed with your comment. Your email address is also required, but will be kept private. (Please note that we use gravatars here, which are tied to your email address.) A website/blog/twitter address is optional.

Post a Comment: