The American Association of Sexuality Educators, Counselors, and Therapists (AASECT) has just released a short position statement that says:
It is the position of AASECT that linking problems related to sexual urges, thoughts or behaviors to a porn/sexual addiction process cannot be advanced by AASECT as a standard of practice for sexuality education delivery, counseling or therapy.
They join the American Psychiatric Association, who have rejected sex addiction as a diagnosis for forty years.
BUT, SO MANY MEN ARE REPORTING IT, SURELY IT’S REAL
It’s complex to dig to the bottom of, I think. Taking “porn addiction” as an example, I think we would have to be quite bull-headed to say that compulsive internet use doesn’t exist. We see it all around us… and that includes social media, gaming and all the (porn) tube sites.
One of the most important theories of addiction is a progression from impulsivity (related to positive reinforcement) to compulsivity (related to negative reinforcement). Drugs are addictive because if you stop taking them your body starts shutting down until you get them again. The internet and porn don’t do that.
But, then again, neither does gambling and we talk about gambling addiction when really what we probably mean is “compulsive gambling”.
This is not a new issue. We’ve been asking whether violent games have cognitive effects or lead to more violence in society since Space Invaders, whether porn has effects on the brain since the 1970s and whether casinos lead to compulsive gambling every time a casino applies for a license somewhere.
The theory of escalation (“I started off watching vanilla sex and now I can’t get off unless there’s a gimp hanging from the ceiling”) has been with us so long because I think it makes a lot of logical sense. We see that process in addictive drugs, and isn’t dopamine addictive? Drugs need increasingly heavy hits for the same effect, so shouldn’t porn be the same?
Maybe part of the answer is that dopamine is not addictive, but some people will seek it out compulsively?
And, even if we say that addiction and compulsion are the same thing, does it follow that we require bigger and bigger hits to get the same rewards? Do gamblers move from the slots to the roulette wheel to the poker table just to get the same kick? Or can they stay at the slots? Does someone who is into pegging videos need to progress to speculum and fisting videos? Or do they continue to get the same kick when they find a new pegging video?
We could certainly say that internet use (in whatever form) can be problematic for someone prone to compulsive behaviour, but there is very little evidence to support that idea that it needs to escalate.
SO, WHERE DID THE IDEA OF SEX ADDICTION COME FROM?
Sex addiction is a social phenomenon, not a medical one. It’s a confusion of correlation.
People see therapists because they have a problem. So, what therapists see is a lot of people with problems, with no clear picture of healthy behaviour to use as a comparison point. Those who deal in sexual behaviour problems might notice that often the men also masturbate daily, or spend a lot of time looking at Pornhub, or have many sexual partners.
So, the problem is diagnosed as an unhealthy fixation with sex or with porn, even though many people have daily sex, or view a lot of porn, and experience no problems.
WHY SEX ADDICTION DIAGNOSIS CAN BE HARMFUL
Treatments or therapy for sex addiction are not treating the root problem.
For instance, one recent study of sex addicts in treatment showed that 90% had a major mental health disorder such as anxiety or depression, and 60% had a paraphilia, a fetish or a sexual disorder. But, these individuals were receiving treatment for “sex addiction” as opposed to their depression, anxiety or sexual disorder.
The sexual problems are only a symptom, and an indicator, of some other conflict, either in the person, or between the person’s desires and their social or relational context.
Beyond that, the treatments focus exclusively on controlling sexual behaviours and desires. Normative, healthy sexual desires (such as daily masturbation) are labeled and treated as a disease. That can have a deep effect on a person’s self image and their sexual shame.
SO, WHY DOES IT PERSIST?
Unfortunately, a whole industry has built up around sex addiction. From online gurus in the Incel or NoFap communities to compulsory “rehabilitation” therapy for paroled sex offenders who have been mislabeled “sex addicts”, it’s a lucrative industry and there are people out there making money off it.
It’s also an easy thing to hitch other causes to. It’s co-opted by anti-porn campaigners, conflated with sex trafficking and used as an excuse for censorship. It’s a convenient tool for obfuscating conversations around sex, when the real goal is to enforce sexual morality on society.
PEOPLE WILL STILL NEED HELP
For years the media has been covering sex and porn addiction as if they are real things, but this position statement by AASECT and the long-standing stance of the APA should send a signal through counselling communities that, at best, it’s built on quicksand.
But, it doesn’t negate the fact that sexual problems exist. Compulsive internet use is real, excessive drive for external validation through sex is real. Some people are not at peace with their sexual desires and there are people who use sex in unhealthy ways.
Hopefully this will mean important two things:
- that therapists will refocus on the root cause of struggles with sex, whether that is depression, anxiety or some kind of sexual disorder that needs to be brought to light
- that instead of taking an approach that encourages people to fear their sexual desires and needs, we see a much greater focus on positive and empowering messages
If we can do that, I think we are a step closer to bringing a wider sex-positive viewpoint to society in general.
feature image: detail from work by Edmond Simpson
Without sufficient specialized treatment services, relationships and families will continue to struggle, often in secret, with problems they are not adequately equipped to deal with. The semi-underground and often corrupt nature of the sex industry has rendered it useless in providing research or treatment funding or other supports for people who are harmed by its output. This differs from the gambling industry, for example, which has funded research into treatment and services.
I like how you said there is no real data to compare with a healthy sexual relationship, as I think it varies from person to person, couple to couple. When you survey society as a whole I would think we are in small numbers =)
It’s kind of odd that the headline of the article reads, “Why Has Sex Addiction Become Such a Problem?” when the article itself proceeds to dismiss the very idea of sex addiction, falsely and dangerously claiming that it is simply the “idea” of sex addiction that is the real problem. The article baits the reader with the usual tempting but irrelevant traps that allude to politics and morality, and an appeal to “a wider sex-positive viewpoint” while conveniently ignoring facts, research and reality.
The reality is that whether one defines compulsive use of pornography as an addiction or as something else, when one cannot control this behavior and it has significant negative consequences in a person’s life, it can become a huge problem. And there are vast amounts of empirical data and numerous studies showing the devastating impact that pornography use and other sexual behaviors, when engaged in compulsively, have on peoples’ lives and on society as a whole. (www.yourbrainonporn.com/relevant-research-and-articles-about-the-studies/). Those consequences cover all of the familiar territory that apply to compulsive gambling, substance abuse and other more “mainstream” addictions.
No one with a true and honest understanding of the problem of sexual addiction is viewing it through the lens of morality and politics. Ironically, the author is using those vehicles in the same fashion that he accuses those who believe sexual addiction is real: “a convenient tool for obfuscating conversations around sex.”
No one with a healthy, evidence-based perspective on sexuality, addiction and mental health is trying to stifle sexual expression, or the use of pornography. As for the argument that the root causes of sexual compulsivity need to be addressed, no one’s arguing with that either. A history of child abuse, neglect, trauma and unhealthy attachment styles, combined with mental-health challenges in adulthood (anxiety and depressive disorders, etc., as well as co-occurring addiction problems) all need to be recognized and treated. But so do the compulsive behaviors these problems often create, which end up ruining lives if untreated.
Finally, the notion that sexually compulsive behaviors do not escalate is simply untrue. Research has demonstrated conclusively that the addicted brain needs more and more of a particular substance or behavior — whether it’s alcohol, heroin, gambling or sex — to satisfy its reward mechanisms.
On the subject of research generally, it’s incredibly irresponsible, in my opinion, to lazily ignore the current scientific data simply to pursue a sex-positive agenda. No reputable person in the addiction and recovery communities is trying to ban pornography, deny people their freedoms, or impose a right-wing moral agenda. So let’s stop using those unfounded fears to minimize the reality of human suffering that results from behaviors that for many people have become difficult, if not impossible, to control. It’s possible to have a healthy, open and progressive approach to sexuality without denying the reality and severity of the problems associated with compulsive sexual behaviors.
The authors states that according to one survey, “90% [of people in treatment for sexual addictions] had a major mental health disorder such as anxiety or depression, and 60% had a paraphilia, a fetish or a sexual disorder. But, these individuals were receiving treatment for ‘sex addiction’ as opposed to their depression, anxiety or sexual disorder.” The author is making the unwarranted assumption that these individuals were not receiving treatment for anxiety or depression. In reality, I would venture to guess that many if not most of these individuals were actually receiving pharmaceutical treatment for depression and/or anxiety. Believe it or not, people can and do suffer from multiple emotional and mental and neurological problems which manifest as mood and/or behavioral problems. Secondly, the author seems to think that there is another form of effective treatment for ‘sexual disorders’ (like, say, pedophilia). But it is quite possible that the addiction recovery framework is the most effective treatment we have for sex offenders who have harmed children.
Finally, throughout this polemic, the author engages in a wishful thinking so common today among naive libertarians and anarchists — that addiction itself either does not exist or would not exist apart from underlying social problems or personal problems. It may be true that many people are not vulnerable to a drug addiction or sexual addiction, but some of us are — even with terrific health, and fulfilling social & personal lives, and careers. What defines addiction is not somebody doing something everyday or multiple times a day, but doing something compulsively and obsessively to the detriment of the people and things in their life that they value most. Addiction creates a continuously downward spiral in one’s quality of life.
I am not sure who wrote this post, but jesus how wrong it is. There is plenty of empirical studies to support the diagnosis of sexual addiction, more commonly referred to as hypersexual disorder. while not in the DSM-5, because the criteria is being discussed currently, it is commonly referred to as this.
APA and other agencies, many working therapists no longer subscribe as they have moved from a educational and unbiased view of psychology to a anthropomorphized base of politics and woke ideology. This article should be written to include empirical data, as your opinion is personal, not objectionable.
Sexual desire & needs are in all of us. Today porn & movies are full of every kind of sexual activity. We are aroused by watching & listening & then we act out. Once we do it becomes an addiction. We experiment into bondage, discipline, then S & M & we are total addicts. Many submit to being sexual slaves. Men and women! 70 or 14. Seduction becomes common. Sexual ownership is common.
There is no stopping this & it is growing fast. I see it as being totally acceptable now.