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Addicted to love?

Debate simmers over whether sex addiction truly exists

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Hello. My name is Brian and I am a sex addict.

It never occurred to me that I might be addicted to love. But then Marty Klein, a sex therapist in Palo Alto, Calif., and author of the book "America’s War on Sex," asked me to take a Web screening test created by Patrick Carnes, the best-known popularizer of the "sex addict" idea.

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I answered all the questions as honestly as I could, but some seemed awfully vague — "Do you often find yourself preoccupied with sexual thoughts?" — or rather commonplace — "Have you subscribed to or regularly purchased or rented sexually explicit materials (magazines, videos, books or online pornography)?" But then Carnes’ definition of sex addiction itself can be vague: "Sexual addiction is defined as any sexually-related, compulsive behavior which interferes with normal living and causes severe stress on family, friends, loved ones and one's work environment."

That may seem specific but it all depends on how one defines "compulsive" and the effects on others who may or may not be disturbed by another’s sexual proclivities.

Anyway, here is what I was told: "We have compared your answers with people who have been diagnosed with sex addiction. Your answers HAVE MET a score on [the] basis of six [of] the criteria that indicate sex addiction is present."

Don’t feel bad, Klein told me. He often asks professional audiences to take the same test and a lot of them come up sex addicts, too, which may say something about therapists, but more, perhaps, about the test.

In fact, though the terms "sexual addiction" and "porn addiction" are often bandied about, and though the famous (including a certain former President and many of Hollywood's leading men) are often labeled sex addicts, neither term is a recognized diagnosis in the DSM, the bible of psychiatric medicine.

Experts just can't agree on whether sexual addiction is a real problem. This week, for instance, the Society for the Scientific Study of Sexuality is meeting in Indianapolis to discuss, among other things, the topic of sexual addiction. Some argue that there is no such thing, and that terms like "sexual addiction" and "porn addiction" are unhelpful at best, dangerous at worst. The argument is not just about word choice.

“Sexual addiction was invented by Patrick Carnes,” Klein argues. In his book, he labels porn and sex addiction “ridiculous,” and says that the terms have been used as part of an overall strategy to demonize sexual expression by what he calls the “sexual disaster industry.” The goal, he believes, is to build an aura of fear around any activities, such as porn consumption, homosexual sex and premarital sex, that do not conform to the beliefs of those who oppose those activities.

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Daniel Linz, a psychologist at the University of California at Santa Barbara who studies communication, law and society with an emphasis on sexuality, largely agrees with Klein. "We tend to call things addictions that have unfavorable connotations or behaviors that some in society regard as being unacceptable. We do not talk about Sunday afternoon football addiction, money addiction, or a workaholic as people who need treatment like a cocaine addict. We tolerate a certain level of obsessiveness. But this is not the case with more deviant activities. We do not approve of constant viewing of sex. So we pathologize it."

Carnes, who has a Ph.D. in counselor education, does pathologize deviancy. He believes sexually addictive behaviors fall into 10 distinct types: fantasy sex, seductive role sex, voyeuristic sex, exhibitionistic sex, paying for sex, trading sex, intrusive sex, anonymous sex, pain exchange sex and exploitive sex.

Ken McGill, director of the Gentle Path program, a treatment center created by Carnes (who has been on vacation and whose office declined to make him available for an interview, saying that McGill can speak for him), argues that sexual addiction is not only real, but often creates the very same behaviors displayed by crack, heroin or meth addicts. These behaviors lead to habits destructive to jobs and family life or to the creation of shame and guilt. About 350 patients have come through the Hattiesburg, Miss., program, he says, and between 70 percent and 80 percent of them "are maintaining their sobriety."

The fact that sex addiction and porn addiction are not in the DSM is not terribly relevant, he argues, because "addiction is not in the DSM either."

Carnes argued the same thing in a 2003 article as part of a special report by the Sexuality Information and Education Council of the United States. "The DSM’s system is … best viewed as a ‘work in progress’ rather than the ‘bible' … It condenses the criteria for addictive disorders — such as substance abuse and pathologic gambling — into three elements: Loss of control (compulsivity), continuation despite adverse consequences, and obsession or preoccupation." For many people, upwards of 6 percent of the U.S. population and growing, he insists, all three elements are present in sex addiction.

Little research
But despite being the leading advocate of the sexual-addiction model, Carnes has a very brief record of research publication and McGill admits that Gentle Path’s results have not been peer-reviewed. "We have not published the research, but I do interact with our alumni … We are moving to scientifically gather data."

This lack of hard research has fueled the controversy and left the field open to sometimes fantastical statements, especially, Klein argues, among those advocating a conservative moral or religious view of sexuality.

McGill says that Gentle Path has no particular religious outlook, but Carnes’ views have been enthusiastically embraced by social conservatives and anti-porn, anti-premarital sex advocates. For example, an organization called Aware, an abstinence-only sex education group based in Washington state, linked to from the Web site for Gentle Path Press, the publishing arm of Carnes’ sexual addiction treatment business, declares that, "Porn can be very addictive. Images viewed for only a few seconds can produce a structural change in the brain and body that may last a lifetime."

There is no scientific evidence for this claim, Linz says. Any strong image will leave memory traces, he explains, but such images could be of love, war, a favored pet, great art or Linda Blair spinning her head in "The Exorcist."

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