Is ‘sex addiction’ really an addiction?

by jasonP

Many high-profile celebrities have recently been descried as ‘sex addicts.’ Their hyper-sexual behavior has ruined marriages and hurt loved ones, and wallpapered the supermarket checkout lines. But is this behavior really an addiction? Medical experts differ in their opinions.

The media calls it ‘addiction,’ but is that description crafted for celebrities that need to patch up their image after bad behavior? Most psychologists and psychiatrists contend that it is better described as ‘compulsive behavior,’ not ‘addiction.’ And some deny it is any disorder at all, but rather just bad choices. With all things psychological, there is probably no single classification or cause for hyper-sexual behaviors. There is certainly a wide spectrum of possibilities.

An article in the Milwaukee Courier claims that there is no such thing as sexual addiction. They feel that these cases are simply people behaving badly, choosing to exploit opportunity at the cost of others. Our natural born desire for lust and sex is something we choose to pursue or not, and people with excessive resources and opportunities will choose to act on those desires more often. That choice may hurt their image and sacrifice their integrity, so they use the term ‘addiction’ as an excuse.

The majority of the medical community prefers the ‘compulsive behavior’ model, characterized by behavior that the subject wishes to stop, but can’t, or behavior that causes the subject harm, or consumes too much time or energy. They feel that other classic aspects of ‘addiction,’ like withdrawal and physical dependency, are not presented.

A recent clinical study in rats, reported here, showed that a dysfunction in the medial pre-frontal cortex can can trigger compulsive sexual behavior. It is not clearly related to physical damage to the brain, but rather they suspect it is related to the interactions of chemicals in that portion of the brain. This research, along with documented cases of people becoming hyper-sexual after a head injury, point to the ‘compulsive behavior’ description of hyper-sexuality. The portion of the brain that normally enables a person to resist impulses and urges is not functioning properly.

In contrast, Psychology Today details their definition of ‘sex addiction,’ and claims that there can be symptoms of physical dependency, withdrawal, and tolerance (where the satisfaction from an activity is lessened over time, requiring more extreme activity for the same satisfaction). That article goes on to describe Symptoms, Causes and Treatments.

A key part of the debate comes down to treatment. The ‘addiction’ camp believes in a 12-step type program, that strives for control and abstinence, and lifelong recovery. The ‘compulsive behavior’ camp looks toward addressing the root causes of the behavior, and re-establishing normal sexual behaviors. With substance abuse, the goal is to never use addictive substances again, because they cause physical harm, and do no good. But healthy sexual behavior is important to happiness, health and intimate relationships, and patients may recover faster and better without the shame of the lifeling label ‘recovering sex addict.’

This year, the official manual of psychiatry is considering adding ‘hyper-sexual disorder’ as a mental illness. The debate still rages over whether this is an addiction, or a compulsive behavior. Hopefully, the increased media exposure will lead to the commitment of more effort and research to find better definitions and treatments.