There is a lot of debate about sexual addiction, with some therapists actually calling it a myth. I would suggest that these clinicians have never visited a 12-step sexual recovery meeting, sitting quietly and listening to the shame-filled, consequence-laden stories of the participants, and noticing the obvious similarities between sex addiction and other addictions.
That said, even the most ardent sex addiction naysayers will usually admit that plenty of people do engage in sexual behaviors compulsively and to their detriment. Sometimes these therapists don’t like the term “addiction,” thinking it creates a sex-negative, pleasure phobic vibe that they don’t like. So they want to call the issue anything but sex addiction.
Heck, even those who treat this issue don’t always agree on what to call it. Over the years, we have used all sorts of terms: sex addiction, sexual addiction, sexual compulsivity, hypersexuality, hypersexual disorder, and more. Even 12-step recovery groups can’t seem to agree on terminology. Depending on the fellowship, members might identify as sex addicts (SAA), sexually compulsive (SCA), sexaholics (SA), and sex and love addicts (SLAA). We also hear terms like sexually dependent, porn addicts, love addicts, relationship addicts, etc. In any given meeting one might hear several different identifiers. But members seem fine with that, accepting that whatever it is called, it’s the same basic disorder.
Regardless of the terminology that is used, the criteria used to assess for and diagnose the issue are always remarkably similar, boiling down to the following three benchmarks:
These, of course, are the same basic criteria used to identify alcoholism, drug addiction, gambling addiction, etc. (As you probably know, the DSM currently lists a specific number of criteria, to be present for a diagnosis to be given, but at the end of the day it still boils down to obsession, loss of control, and consequences.)
For what it’s worth, I prefer the terms sex addiction and sexual addiction because this is the language that the majority of my clients identify with and use when they describe their disorder. I also use terms like porn addiction, love addiction, relationship addiction, and sexually compulsive because some of my clients prefer them. My thinking is that if a client wants to describe his or her consistent, repetitive, destructive patterns of sexual activity as an addiction, or a compulsivity, or a dependency, or whatever, who am I to argue? My goal is to help the client with his or her problematic behaviors, not to lobby for a particular terminology.
That said, it would be nice if the therapeutic community could agree on a name and a specific set of diagnostic criteria. Until then, whatever we choose to call this debilitating disorder is OK by me, as long as we don’t try to sweep it under the rug and pretend it doesn’t exist. If we can recognize it, assess for it, diagnose it, and effectively treat it, we can effectively serve our clients—regardless of the nomenclature.
Robert Weiss LCSW, CSAT-S is a digital-age intimacy and relationships expert specializing in infidelity and addictions—in particular sex, porn, and love addiction. He is the author of several highly regarded books including his newest “Out of the Doghouse: A Step-by-Step Relationship Saving Guide for Men Caught Cheating”. He blogs regularly for Psychology Today, Huffington Post, Psych Central, and Mind Body Green. Follow him on Twitter @RobWeissMSW
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