The diagnosis of sex addiction not only provides an excuse for predatory behavior but also stigmatizes and pathologizes non-traditional sexuality.
Last week Harvey Weinstein announced he was checking himself into rehab for sex addiction. His behavior is clearly problematic, but so is the use of the term “sex addiction.” And as a sex therapist, I’ve been battling this misunderstood and misused term for over a decade.
Not only is calling someone a sex addict a convenient way to write off being a sexual predator and lacking empathy, but it’s also an attempt at trying to rehab a career. Sex addiction is not real.
In the media, sex addiction is a relatively new concept, and is used as a culturally sanctioned shaming mechanism for people whose sexuality makes others anxious and eager to eradicate. It allows us to avoid exploring why our partner cheated on us, why we no longer have sex, why we hate pornography, or why sex scares us. If our partner or friend has sex more frequently than we are comfortable with, or in ways that upset us, we can just call them a sex addict and make the problem about them.
Thanks to the media, including favorite doctors like Dr. Drew and other therapists and experts untrained in sexology and sex therapy, sex addiction is seen as a real disorder and is assumed to be universally accepted by all those in the mental health world. It’s not. It’s been rejected by The American Psychological Association, The American Psychiatric Association, the DSM, and most importantly by AASECT (the prestigious international governing body that oversees sex therapists and sex educators).
Mental health diagnoses, in general, are built on white, male, cis, hetero values and are often colonizing and pathologizing of other cultural norms. They are historically bound, and change frequently based on anti-oppression work and changing politics. Diagnoses are social constructs and exist on a continuum; they aren’t concrete truths, but fragile ways of trying to explain behaviors that often stigmatize minorities. Diagnoses are historically most oppressive and abusive towards sexuality, and sexual minorities. There was a time when psychology saw masturbation, homosexuality, and transgender identity as disorders requiring therapy. Hopefully we are moving towards a place where we see that differences aren’t disorders, but can be strengths, and that sexual diversity is healthy and a beautiful part of life.
The sex addiction diagnosis has become a waste paper basket for all creative and non-hetero sexuality. I have worked clinically with many patients who spent years in sex addiction treatment (along with far too much money), and our work becomes about deprogramming all the sex shame that was instilled in them. I cringe and am saddened hearing about how they were told fantasizing during sex is cheating or a symptom of an intimacy disorder, when in fact it’s quite normal and healthy, and often prescribed by sex therapists to amp up arousal. Or that masturbating daily with porn is an addiction, versus part of the standard sexuality of American males, and often a great tool to help maintain long term monogamy and to explore diverse forms of sexuality.
One particularly disturbing clinical case was a client being forced into treatment by his wife—with the support of their couple’s therapist—because she found transgender porn in his browser search history. He was then sent for treatment for his “transgender sex addiction.” Ignoring the issue of a massive privacy violation by the wife, and the transphobia of all parties involved, this sex addiction treatment center framed a healthy and appropriate form of arousal and exploration as an addiction to be shamed and “cured.” Add to this list those buying sex or having multiple partners, and you will see that basically anything not traditional or seen as heterosexual is subject to pathologization.
The list of criteria for a sex addiction diagnosis shames diversity by characterizing health as being intercourse, monogamy, and families, and considering behaviors like gay and queer hypersexuality and non-traditional dating norms, solo sex, paid sex, and porn use to be abnormal. The sex addiction model proposes all American hetero values as healthy sex and ignores other sexual minority norms and values. This is prejudice and bigotry, plain and simple. Minorities do not and should not honor cultural majority puritanical definitions of how they should exist in the world, especially not sexually.
Sex addiction treatment then becomes about embedding the moral and social anti-sex status quo into the psyches of clients. One of my favorite shaming definitions for “sex addiction” provided by the sex addiction therapist camp is their statement that “healthy sex only takes place in a committed relationship.” If that were true, then most of America is having unhealthy sex as the majority of us are banging without marriage or commitment. This is a great example of the overt pathologizing of any sex that isn’t marital, hetero, or vanilla.
Many of the symptoms that are wrongly defined as a sex addiction are actually signs of a sexual-relational structure that is not working: mismatched sex drives or interests between partners, masturbation/porn phobia, or just plain old hating sex; or they are survival strategies to bring about dialogue and change in the system. Watching porn and masturbating daily, sex with sex workers, or cheating are not issues of a sexual addiction. Solo sex (masturbation) is good for self-soothing and stress release, paying for sex can be highly arousing, and cheating may mean that one is not meant for monogamy or needs to end a current relationship.
The fictional “sex addict” is a symptom of our sex-negative and sex-phobic culture. When it comes to sex, we are overregulated, over-contained, and over-shamed. Watch five hours of a baseball game or the Real Housewives and you are healthy, but watch five hours of porn and you are an “addict.” If a behavior becomes a pathology by just adding sex, then it’s about a fear of sex, period. The hegemony of the sex addict “treatment” perpetuates the toxic label of “addict.” This sex-negative cultural pathology is forced onto the psyche of “healthy” men (most diagnoses are men), then further traumatizes “clients” into sexual-relational 12-step programs where non-academics and professionals maintain a closed system of sexual “health” mythology.
Healthy sex is for self-soothing, entertainment, mood regulation, stress relief, bonding, friendship making, or intimacy building of all kinds. But it’s not an excuse for Mr. Weinstein’s alleged assaults or lack of morals and ethics, nor a solution for rape culture and sexism. So regardless of Dr. Drew’s TV shows recommending sex addiction treatment or the many treatment centers here in the U.S., sex addiction isn’t real. Stop stealing confused clients’ money in exchange for sexual anorexia, when what people truly need is better sex education, shame reduction, support and acceptance of porn use and nontraditional sex interests, discussion of the health of masturbation and non-monogamy, and understanding that there is no correct amount of sex to have.
Shame on any provider of “sex addiction” treatment. You are engaging in unethical and sexually traumatizing work that is supported by no one but yourself and your sex phobia. The real work is healing patients from cultural erotophobia, supporting the diversity of healthy sexual expression that can include porn, sex workers, and non-monogamy, and to liberate everyone from shame. If you have been diagnosed a sex addict, tweet me and I will undiagnose you for free!
By Dr. Chris Donaghue 11/14/17
Acknowledgment: The Fix.com
Dr. Chris Donaghue is a therapist, lecturer, educator, host of the “LoveLine” podcast, weekly expert on “The Amber Rose Show,” and frequent co-host on “The Doctors.” He is author of the book Sex Outside the Lines: Authentic Sexuality in a Sexually Dysfunctional Culture. Follow Dr. Chris on Twitter and Instagram.
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