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How Real is Sex Addiction?

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Michael Fassbender plays a sex-obsessed suit in the hit movie "Shame' Photo via

By Anna David

12/11/11

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As for sex addiction and the DSM, Smith has his theories. “I think that the politics behind the resistance is that they don’t want, in situation like what happened with Jerry Sandusky, for him to be able to use sex addiction as an excuse. There’s also the insurance company battle—if sex addiction is accepted as an addiction, insurance companies are going to have to pay for its treatment.”

None of this bargaining and compromise comes as a surprise to sex addiction experts. “What goes on in the medical community is almost as political as what goes on in Congress,” notes Robyn Cirillo, a psychotherapist for over 30 years who practices in New York and specializes in trauma. Adds Alexandra Katehakis, the Clinical Director for The Center for Healthy Sex and the author of Erotic Intelligence (which lays out a healthy model of sexuality for sex addicts), “Clinicians always see what’s going on at the forefront before researchers catch up to it.” In other words, in the current day and age—when psychiatrists have become little more than medication dispensers who charge astronomical amounts to not even talk to their patients—it’s the therapists that are actually seeing sex addiction play out in the field.

The dangers of this political power play and the lack of understanding among the decision-makers are all too real. “The same thing happened with eating disorders,” Katehakis says. “For a long time, people said food couldn’t be an addiction—until the recent Yale University study proved that it is. But in the meantime, millions of people suffered and died from obesity.” Cirillo adds, “Alcoholism and homosexuality used to be thought of as things you should be able to control with your own willpower—alcoholism finally got put in the DSM just as homosexuality was taken out. But this was in the 1970s! Why did it take so long?”

 “Saying that sex addiction isn’t real is like saying that the world is flat,” says Shame director Steve McQueen.

When people therefore posit that sex addiction isn’t real—as David Ley, a clinical psychologist in New Mexico and the author of the upcoming book The Myth of Sex Addiction—has, it’s skewing facts and adding unnecessary complications to an already complicated issue. “Saying that sex addiction isn’t real is like saying that the world is flat,” says Shame director Steve McQueen, who, along with his co-writer Abi Morgan, interviewed numerous clinicians and sex addicts as research for the film. What surprised him the most as he talked to the people he ultimately based his film on was that “when people imagine sex addicts, they picture freaks but these were normal, everyday people—albeit people who suffered from immense self-loathing and shame.” (The movie title is no accident.)

Self-loathing and shame aren't new emotions to drug addicts and alcoholics—some of whom, in sobriety, discover they're addicted to sex (or food or gambling or fill in the blank with anything addictive). “I’ve never treated anyone who didn’t have a dual addiction,” says Dr. Paul Hokemeyer, a marriage and family therapist who specializes in relationships and addiction. Katehakis seconds this, adding, “People often have co-occurring issues.” While the sex-addiction-is-fake camp use this fact as part of their argument, it’s probably more helpful to advise sober people to be on the lookout for any potential obsessive or compulsive sexual behaviors that are making their lives unmanageable than to label them pejoratively as people with “major mental-health problems.” The good news, according to Katehakis, is that those suffering from sex addiction don’t always need to work a secondary program. “Many people who start applying the principles of recovery to their lives begin applying them to all areas of their lives,” she says. Still, she cautions, “Sex addicts often have high levels of compartmentalization so denial is possible.”

Still, when taking stock of sex addiction—on both the personal and clinical level—it’s important to stick to the facts. While the constant parade of sex scandals can certainly help edify the public about sex addiction (as Katehakis says, “Usually where there’s smoke there’s fire so if somebody is doing something once, they’ve probably done it twice or three times and can’t stop doing it”), tossing around labels willy-nilly doesn’t help anyone. “Sex addiction isn’t like diabetes,” Cirillo says. “A doctor can’t do a blood test and tell you whether or not you have it. Like with other addictions, it’s self-diagnosed. And when clinicians diagnose people, it’s dangerous because it scares them and is very shame inducing. The best we can do is educate people so that they know what is and isn’t proper therapy.”

If only she'd been around at The Meadows.

Anna David is the Executive Editor of The Fix and the author of the books Party Girl, BoughtReality Matters and Falling For MeShe's written about Tom Sizemore, Nic Sheff, and gambling addiction, among other topics, for The Fix.

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