How Real is Sex Addiction?

By Anna David 12/11/11

Newsweek says sex addiction is rampant, Salon insists it's a myth. What's the truth? Our resident expert tries to get to the bottom of this shadowy subject.

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

You can’t turn on your television, click on a website or see a movie at the multiplex these days without tripping over sex addiction. From the brilliantly disturbing NC-17-rated Shame—with its attendant Oscar buzz and star-making performances—to Bad Sex, the Logo reality show about sex addicted liars, cheaters and misogynistic loners (Logo wording, not mine!) to the hype about the upcoming sex addict dramedy Thanks for Sharing, sex addiction has certainly become our cause du jour. It’s safe to say that when squeaky-clean Gwyneth Paltrow signs up to play a nymphoniac, the issue’s gone mainstream.

But how much of the noise about sex addiction is accurate and how much of it is pop culture hysteria? In other words, with Newsweek declaring sex addiction an epidemic and Salon countering with a piece that it’s not even real, what’s the real story? 

When I was about four years sober, I was diagnosed as a sex addict. Here's how it happened: I was in a therapy session one day that ended where it usually did: with the revelation that I had trouble with boundaries because I grew up in a family that also had trouble with them. My therapist—a lovely, brilliant woman who I am still in touch with today—recommended I deal with it by attending a weeklong retreat called “Survivors,” which was part of the program at The Meadows rehab in Wickenburg, Arizona. Survivors, she explained, was a requirement for everyone enrolled in their 28-day inpatient drug and alcohol rehab, though denizens of the outside world were also encouraged to attend. The name Survivors sounded a bit daunting but the site for it simply stated that it was a workshop that "investigates the origins of adult dysfunctional behaviors by exploring early childhood trauma that has led to various addictions, depression, eating disorders and painful relationships." Because a week in Arizona sounded nice, because of how much I trusted my therapist and because I’m always, arguably to a fault, looking for ways to try to improve myself, I signed up.

The only way to get the AMA to endorse addiction medicine as a new specialty was to exclude sex addiction altogether.

By the end of the week, my group leader had diagnosed me as a sex addict.

“Me—a sex addict?” I’d cried. “I don’t even have that much sex!”

“I realize that,” he’d responded, answer at the ready. “That’s because you’re partially a sexual anorexic.”

A sexual anorexic—a term that was new to me that week—is, for the uninitiated, “an obsessive state in which the physical, mental, and emotional task of avoiding sex dominates one’s life” (at least according to Patrick Carnes, a sex expert who had been, until 2004, the Clinical Director for Sexual Disorder Services at The Meadows). I told the counselor, Clint, that this wasn’t accurate either. “Oh yes it is,” he’d said. Which made me wonder: was I, to spin a line from When Harry Met Sally, not having sex with men without my knowledge?

What had happened between the first session—when Clint had told all 50 or so of us that we were suffering from Post-Traumatic Stress Disorder (PTSD) from our respective childhoods—and the last, when he’d singled me out as someone who “needed” to “immediately” sign up for their 28-day program?

In my opinion, a lot of silly stuff. There was a lot of hearing that we'd been terribly emotionally abused by our parents even if we felt we hadn't been, a lot of hitting of chairs with felt bats, a lot of throwing of Kleenex across the room (the chairs were meant to be the people who’d hurt us, I believe, and the Kleenex symbolic of us letting go of our issues), a lot of holding of stuffed animals that were supposed to symbolize our inner children (I recall the term “little Anna” being used more than once). Everyone else seemed to love it—tears were shed, epiphanies were reached, fences with family members who weren’t in the room were magically mended. Only I remained dry-eyed, feeling foolish.

We never really talked about sex but Clint asked us to fill out questionnaires about our sex lives and then drew conclusions from what we’d written. Why he determined that I was the one suffering from sex addiction—as opposed to say, the dental hygienist who’d lost her job because having sex with her coke-addicted, abusive boyfriend had caused her to test positive for cocaine—was never made clear. I asked him if it was because I talked about sex on TV and wrote about it in articles and he assured me it wasn't. I think it might have had to do with the fact that he theorized (incorrectly, as it turned out) that I had the spare $40,000 sitting around to pay for the month-long treatment The Meadows offered (and he insisted I needed).

So why do I tell you this embarrassing story about one of the more disturbing weeks of my life? Because sex addiction is, in my opinion, an extremely serious disease—one I learned a lot more about as I went to 12-step S meetings after my Meadows experience trying to see if I had it. After not relating at all in the SLAA meetings—I’d sit next to women who were counting how many days it had been since they’d publicly masturbated—I sought out a meeting for sexual anorexics. Listening to a group of people share about how they’d sometimes have trouble leaving the house for up to six months at a time, I counted the minutes until I could leave. I didn’t relate but I kept going, telling myself I must just be in denial—like any number of alcoholics I’d met who insisted they were fine. I was diagnosed with this, I kept thinking. I must have it. After six of the most depressing months of my life, I finally quit that 12-step program, and have felt relieved ever since. (I’m not saying the sex programs don’t help many people—I personally know some who have been transformed by them—but the pain of forcing yourself to go to a program because you’ve been told you should even though everything in you tells you it’s not for you is all too real.)

So what is and isn’t real in terms of sex addiction and its ancillary terms? While reputable publications claim that sex addiction isn’t real—touting the fact that it was rejected from the Diagnostic and Statistical Manual of Mental Disorders (otherwise known as the DSM) as proof—the truth is far more complicated. Essentially, as Cupid’s Poisoned Arrow author Marnia Robinson explained in a recent Psychology Today post, the only way to get the AMA to endorse addiction medicine as a new specialty was to exclude sex addiction altogether. “You don’t want to sacrifice the good for the perfect,” says Dr. David E. Smith, the Alternate Delegate to the American Medical Association’s House of Delegates in 1992, when the decision was made. “Our big battle was to get addiction accepted as a medical specialty and to have smoking included in that.”

Smith, who started the Haight Ashbury Free Clinic in 1967 and currently chairs the Adolescent Addiction Medicine program at Newport Academy, very much believes sex addiction is real but says that the fight that tobacco companies were putting up meant that negotiating was a necessity. “When we said smoking was addictive, they countered with, ‘You call everything addicting: surfboarding, sex…’” Smith recalls. “We would have fed into the tobacco industry’s well-funded fight to get addiction medicine thrown out altogether [if we hadn’t done it this way].”

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Anna David is the New York Times-bestselling author of multiple books about overcoming difficulties and coming out on the other side: the novels Party Girl (HarperCollins, 2007) and Bought (HarperCollins, 2009), the non-fiction books Reality Matters (HarperCollins, 2010), Falling for Me (HarperCollins, 2011), By Some Miracle I Made It Out of There (Simon & Schuster, 2013) and True Tales of Lust and Love and the Kindle Singles Animal Attraction (Amazon, 2012) and They Like Me, They Really Like Me (Amazon, 2013). Find Anna on LinkedIn and Twitter.