in Homework, Thoughts

Does Sexual Addiction Exist?

This is from a paper I wrote for my Human Sexuality class last fall. The most marks that were knocked off of it were based on my over-reliance on John Davies as a source, and I figure I could probably use some of William Glasser’s work as additional reference, but the fact is that there just isn’t much out there on this view, since it is not a very popular one – a lot of people base their careers (or adversities) off of what I’m warning against. My hope is in the very least that people pay more attention the complexity of this issue rather than oversimplify.

We live in a highly addicted society.  There are drug addicts, smoking addicts, gambling addicts, alcoholics, workaholics, shopaholics, et cetera.  Ever since Carnes wrote his book Out of the Shadows in 1991, it seems like sexual addiction is everywhere.  Western society is highly and intensely sexual after all, but exactly how accurate is it to attribute repetitious sexual behavior to external factors, as if the person involved had no choice otherwise?

One of the most common confusions about psychology is the understanding and assessment of addiction or addictive behaviors.  Many people have an opinion of addiction as something which enslaves the victim, rendering the addict helpless, hopeless and blameless, and that this process occurs in most people who have ever found themselves in an addictive cycle.  This public perception is fueled by vaguely thin self-help (pop) psychology, often portrayed in “media presentations which seek to reduce the issue to a single, instantly comprehensible message” (Davies, 1997).  In the realm of drug abuse alone, many seem to adopt an oversimplified stance of deterministic behavior as the result of automatic addiction.  When talking more specifically about the realm of sexual addiction, it becomes even more difficult to adequately describe.  The DSM IV does not include the term sexual addiction, and therefore any reference to its prevalence is merely speculative.  The goal of this paper is to examine and address the issue of use and misuse of the term sexual addiction among psychological communities and the media, and to understand the flaws of a preference for an attributive method of diagnosis in the absence of empirical scientific data.

First it must be examined how sexual addiction is commonly defined in contemporary psychology.  Patrick Carnes, who is arguably the most widely revered authority today on the subject of sexual addiction, equates it with the drug or alcohol dependency.  “The alcoholic’s relationship with alcohol becomes more important than family, friends, and work.  The relationship progresses to the point where alcohol is necessary to feel normal. To feel ‘normal’ for the alcoholic is also to feel isolated and lonely, since the primary relationship he depends upon to feel adequate is with a chemical, not other people.” (Carnes, 2001)  He sees sexual addiction as parallel.  He explains it as being “like” when a drug alters a chemical in the brain, but instead it is a sexual experience that alters the brain.  The relationship with the mood altering experience, argues Carnes, is what replaces a normal healthy relationship, and then out of that an addictive cycle forms.  Dr Goodman of The Psychiatric Times agrees, writing that sexual addiction is classified by two distinct features: “1) recurrent failure to control the sexual behavior, and 2) continuation of the sexual behavior despite significant harmful consequences.” (1998)  The brain becomes so intertwined with this reaction when that stimuli is presented that it begins to seek out many different and sometimes creative ways to elicit the same sensation.  The destructive behavior, which could be anything from masturbation to extra-marital affairs, can ruin relationships and families, as well as individual lives.  “Thus, as in our definition of addiction, the relationship is with sex – and not people.” (2001) Carnes writes that the ‘addict’ (speaking almost as if the state of the person is different than before the person exerted the compulsion) has an entirely different belief system and set of goals, while perceiving a different reality than he previously did.  Decision making, problem solving, interpretation, deriving meaning from life, and establishing priorities are all facets of this belief system.  Out of distorting those faulty beliefs comes a distortion of cognitive functioning, and major details might be overlooked in making decisions, and rationalization occurs to help the ‘addict’ deal with the continued bad decisions.

Unfortunately in response to this definition of sexual addiction as a comparison to drug addiction, clinicians and therapists, as well as the media, have created a kind of victimizing climate or zeitgeist within society.  In many cases sexual addiction is given a loose diagnosis which spirals the client (often cooperatively) into a deterministic frame of mind void of a feeling of any control or responsibility over the situation.  The book Getting Off: Pornography and the End of Masculinity, places blame on the sociopolitical balance for the prevalence of sexual addiction and pornography within society.  As a largely feminist book, it attributes sexually compulsive behavior to the aggressiveness of male domination and chauvinism.  Rather than attributing action causation to biological factors, it attributes a disposition to act to an ideology of aggressive masculinity.  “Pornography ends up being about men’s domination of women and about the ugly ways that men will take pleasure.”  (Jensen, 2007)  This is, unfortunately, an example of further straying from scientific evidence.  Given the thin resources available for legitimate biological evidence for a dependency on sexual acts, psychologists and therapists are left with tools for assessment that are far from scientific, and without even a working definition from the DSM, the psychological community should at least be skeptical, if not downright worried about the amount of victimization that occurs, and the integrity by which the system of diagnosis and treatment functions.

Carnes’ assessment of addiction as being equivalent to drug or alcoholic abuse might prove to be problematic, however.  “…research suggests a questionable correlation between the amount of drugs or alcohol a person uses and the severity of the associated psychological and social problems. Why then adapt this model of addiction to sexual behavior?” (Allgeier, 1996)  Understanding the attribution theory as described in John Davies’ 1997 book The Myth of Addiction might help define a more substantial reality about sexual addiction and compulsion.  Essentially, the attribution theory is meant to help discover how people explain or attribute their behavior; how people explain why they act the way they do, and whether this is an internal or an external source.  This has huge implications in the area of addiction.  If the perceived locus of control is based on an internal explanation, then personal control and responsibility is taken for actions, and rarely if ever is addiction said to be the cause of this person’s actions.  However if this locus of control is based on outside circumstances, it appears more like something is happening to the person outside of any controllable factors, as opposed to the person actually doing something.

Harold Kelley’s “ANOVA” (analysis of variance) model is an analytical tool that is meant to help explain the characteristics, trends, explanations and dispositions of a person’s actions.  It focuses on the causality of internal reasons rather than external.  Kelley introduced three factors, which interact to offer a type of explanation to be offered by the person involved.  They are: consensus, consistency, and distinctiveness.  A high consensus means that there are a lot of people doing something.  A high consistency means that the person is doing the action with regularity.  A high distinctiveness means that the person’s situation is particularly unique.  Rating a situation on these criteria might tell one a lot about the causation of the action.  [I acknowledge that the following argument uses the ANOVA model different than how it was originally developed, but I believe it provides a structure that can make logical applicable sense of the explanation of the process in discussion.] Let’s suppose that Tom looks at pornography on the internet, and there is information available about consensus, consistency, and distinctiveness of Tom’s looking up internet porn.  Many people that Tom knows also look up porn on the internet (high consensus), he looks up porn on the internet quite often (high consistency), and other than the porn habit, Tom does not act out his sexual exploits in other ways (high distinctiveness).  This would be a HI, HI, HI, or it would be said that Tom looks at internet porn because there is something about internet porn that makes a lot of people look at it on a consistent basis.  In other words, Tom’s explanation or attribution for his actions is externalized, blaming the porn and not the person.  So what if it is the porn and not person?  Many people share a similar struggle with a high consistency, so why would external reasons not be to blame?  Consider another scenario, where Tom looks at internet porn without knowing anyone else who does the same (low consensus), he does it quite often (high consistency), and he also is involved with prostitutes, and sometimes exposes himself in public (low distinctiveness).  Looking at LO, HI, LO, one would say that the problem is Tom, that all the acting out is distinctly Tom’s flaws, and that he needs to get his act together.  Depending on how the act of looking at pornography or talking to prostitutes is attributed, the blame for the action is shifted.  This can be shown by keeping the last example, but changing it to a high consensus – awareness that many others are acting out in the same way that Tom is.  Looking at HI, HI, LO, people would be less likely to say that it is a bad attribute or even a choice of Tom’s, but they might rather explain that there is some common factor that binds all of these cases together, and that they surely cannot all be responsible; there must be external forces at work.  People like Tom who act out in said ways probably like to hear that it is not his fault, so he can continue his pursuits with less personal guilt or anxiety.  One can see how Tom will so readily agree with external attribution findings, even if he knows that is probably not the case.  Tom acts the same in LO, HI, LO as in HI, HI, LO: the only difference is that the latter can have him placed in a 12-step program to combat his sexual addiction.  This is how a zeitgeist of victimization within a societal context occurs.  Given that there is so little written on sexual addiction, and given that there is no specific DSM diagnostic on the term, it seems that attributive factors are by and large what is determining the assessment of sexual addiction by psychologists and therapists.  “’Addiction’ it is argued, is primarily an explanation derived according to the principles of attribution theory, rather than the principles of ‘science’ as normally conceptualised … As such it is primarily a functional, or ‘preferred’ form of explanation.” (Davies, 1997)

Any purpose of explanation for benefit of anything short of the person’s ultimate well-being is a dangerous pursuit in a field meant to help people.  A rejection of the scientific model for justification, ease of conscience, praise from the community, etc, sells not only integrity of the profession short, but could potentially hurt the people that seek to be helped.  Davies suggests that we perhaps settle with attributive explanations because it is easier to just go with societal norms, diagnose, and receive the paycheck.  “Describing a behaviour as compelled merely on a basis of observations that it happens with great regularity is an act of superstition, and has nothing whatsoever in common with normal processes of scientific deduction.” (Davies, 1997)  The basic decision, at least initially, to engage in sexual activity is essentially non-pathological, and therefore it is difficult to come to any consensus on attributive explanations on human choice behavior.  Even further than that, the philosophical grounds for perspective on why choices are made (e.g. free will verses determinism) are extremely difficult to come to an agreement on.  Within such a structure, there is too much about sexual addiction that hinges on guesswork than about psychology.  The psychological community, or the media for that matter, cannot rely solely on attributive strategies if it is going to legitimize sexual addiction as a disorder.

In conclusion, there certainly needs to be a reexamination of the method of how abnormal sexual behavior is attributed, and it must be put to question whether calling it ‘sexual addiction’ is even a beneficial assessment.  As the attribution experiment has shown, simply having a high consensus or not can be the difference between a person being thought of as making free choices or being deterministically addicted.  Given that sexual addiction is not specifically defined by the DSM IV and due to a lack of empirically defined biological factors, it would seem that the preferred method of diagnosis is based on attributive means: a method which, although it can be beneficial in its place, proves to be subjective and far from empirically sound.  Perhaps the biggest problem lies in creating a society from which everything is instantly and easily addictive, and people getting away with any kind of sexual behavior they choose to partake in, under the guise of being hopelessly and blamelessly addicted.  Davies writes that as we continue to treat problems “as if they were the domain of inadequate, sick or helpless people, the more people will present themselves within that framework”. (1997)   In regard to those involved in habitual abusing of drugs and alcohol, or those who feel like they need pornography or sexual gratification: I do not want to say that it is as simple as just stopping and moving onto something else like trading for another hobby.  Rather, it should be noted that we tend to oversimplify sexual behavior and compulsive behaviors, and to attribute behavior to an external locus of control and label it addiction seems hastily inconclusive, if not downright irresponsible.  Then again, perhaps we are addicted to addiction.

Carnes, P. (2001). Out of the Shadows: Understanding Sexual Addiction (3 ed.). Center City, Minnesota: Hazelden.

Davies, J. (1997). Myth of Addiction: Second Edition (1 ed.). New York: Routledge.

Goodman, A. (1998). Sexual Addiction: Diagnosis and Treatment. Psychiatric Times, 15(10), 1-7. Retrieved December 11, 2009, from http://www.psychiatrictimes.com/display/article/10168/55141

Jensen, R. (2007). Getting Off: (Pornography and the End of Masculinity) (1 ed.). Boston: South End Press.

Allgeier, A R.  (1996). Sexual Addiction: Disease or Denigration?  The Journal of Sex Research, 33(2), 166.  Retrieved December 15, 2009, from ProQuest Psychology Journals. (Document ID: 9845238).

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  1. Great job. Thank you for helping to get the word out about sexual addiction. I provide counseling for people suffering with sexual addiction and feel this addiction isn’t mainstreamed enough and many people suffer in silence or are not taken seriously when they try and discuss their addiction.