The Myth of Sex Addictionby David J. Ley
In this controversial book, David Ley debunks the myth of sex addiction, showing how labeling it a disorder has wrested responsibility away from philandering men and excused their bad behavior as being out of their control. He takes on those who would label it a disease and challenges us to reexamine our approach to male sexuality.See more details below
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In this controversial book, David Ley debunks the myth of sex addiction, showing how labeling it a disorder has wrested responsibility away from philandering men and excused their bad behavior as being out of their control. He takes on those who would label it a disease and challenges us to reexamine our approach to male sexuality.
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The Myth of Sex Addiction
By David J. Ley
ROWMAN & LITTLEFIELD PUBLISHERS, INC.Copyright © 2012 Rowman & Littlefield Publishers, Inc.
All right reserved.
Chapter OneHow Many Definitions Do You Need?
The History of the Sexual Addiction Concept
If I had an hour to solve a problem I'd spend fifty-five minutes thinking about the problem and five minutes thinking about solutions.
In these days of the 24-7 news cycles, with paparazzi photographers and reporters gleefully trampling through flower beds to get risqué photos of celebrities in compromising positions, one is hard pressed to find someone who hasn't heard of the concept of sexual addiction. Sex addiction is an intuitively appealing concept that disintegrates into a morass of conflicting and ill-defined concepts. The concept seems to make sense, that sex, like drugs or alcohol, feels good. And because it feels so good, it also makes sense in the values of our Puritan-descended society that too much of it must inherently be bad for you.
The advent of the Internet has ushered in an era in which we have incredible access to sexually oriented materials and can develop sexualized relationships with other people more easily and anonymously than ever before. As a result of this easy, cheap, and anonymous access, we hear about men in our churches and communities who lose their jobs and families from constantly viewing pornography on their computers, and we wonder at the terrible power that sexual stimulation must hold over our thoughts and feelings, not to mention our behaviors.
Most people recall those early days of puberty, when our hormones raged through our bodies and we found our genitals responding in new, fascinating ways, ways that were often equal parts of ecstasy, fear, embarrassment, and shame. A simple fact, supported by a wealth of research, is that people in Western society treat their sexual urges as secretive. Even though the great majority of people masturbate and begin masturbating in adolescence, few people are willing to openly admit to sexual self-pleasure. As people mature, their willingness to admit to masturbation increases, and many will admit that they have lied about it in the past, for fear of embarrassment, judgment, or rejection.
Most adults today also keep their sexual fantasies secret, rarely sharing them with any other person, even their spouse or lovers. Many people in our culture feel a strong sense of fear and shame around sexuality and believe that sexuality is a force that must be denied, controlled, and suppressed, lest it take over their lives and actions. It is this false, intuitive belief, that our sexuality has a tinge of danger, with which the concept of sexual addiction connects so strongly.
Ana Catarian Bezerra is a thirty-six-year-old Brazilian woman who recently won the legal right to masturbate at work while looking at online pornography. Diagnosed with hypersexuality, apparently related to a medical condition and hormonal imbalances, Ana feels the need to masturbate frequently throughout the day, a behavior which has, understandably, interfered with her work as an accountant. But the Brazilian courts considered her needs a medical condition covered under Brazilian law and required her employer to accommodate her medical disability, allowing her the freedom to self-stimulate in her office at work while watching pornography on her work computer.
The concept of sex addiction has a long but troubled history. Though the idea has been around for a long, long time in one form or another, this history reveals the alleged disorder as a cultural and moral concept, not based on science or medicine. Unfortunately, the theories embedded within this framework have been irretrievably muddied and confused by centuries of conflicting and overlapping approaches. Although the current sex addiction concept was really sparked by the writings of Patrick Carnes, PhD, in the 1980s, the underlying premise stretches back much further. The history and origins of the concept reveal clearly the moral and social values that are embedded throughout the theory of sexual addiction.
Addiction literally means to devote oneself to something, to give it a place of preeminence in one's choices. Historically, the concept and term first appeared in Roman law, meaning to surrender to a judgment. The word slowly changed in use, coming to describe a person's sense of devotion to something, an activity or interest.
In the 1600s, Christian clergy first advanced the notion that alcohol addiction reflected a disease. Today, the concept of addiction is intrinsically linked to morality and judgment of socially unfavorable behaviors. In fact, it was only in the twentieth century that the word addiction was first restricted to drugs, specifically heroin.
In modern use, addiction is defined as physiological dependence on a substance, which comes from the chronic use of the substance. Current thinking on addiction has broadened a bit, as research and better understanding has revealed that there are some substances which appear to be addictive but do not generate the levels of physiological dependence that alcohol does. For instance, marijuana does not appear to have any physiological withdrawal symptoms. When people quit marijuana "cold turkey," they complain about difficulties sleeping, relaxing, and socializing, complaints related to the social and psychological role that the drug has taken on in their life. But there does not appear to be any evidence that the body develops a physiological dependency upon the drug the way it does with alcohol or heroin.
It is currently suggested that there are three areas of behavior consistently affected by addiction: managing and responding to motivation-reward, regulating and modulating one's emotions and emotional behaviors, and the ability to inhibit and restrict one's impulses. Thus, a much broader modern definition of addiction now suggests that addiction is a brain disorder, one reflecting the progressive and cumulative changes that occur in an individual's brain over time and with continued use of a drug. In this model, alcohol is addictive as a result of the neurological and cognitive changes that occur in the brain as a person uses alcohol on a progressive daily basis. The brain must adapt to the presence of alcohol in the blood and body fluids.
* * *
Traditionally, the medical field has classified a substance as addictive if users of it demonstrate a few specific things:
1. Increased use of the substance is required in order to achieve the same results as when the user first began to use the substance. This is commonly known as tolerance and reflects the body and brain's adaptability and ability to more effectively process the substance out of the body, and/or to accommodate to and overcome the effects of the substance.
2. Evidence of physiological dependence upon the substance, such that the body and brain are affected by the absence of the substance. This is manifested in symptoms such as withdrawals or delirium tremens (DTs). These symptoms show that the body has adapted to the presence of the substance within the body so much that when the substance isn't there, the body has trouble readjusting.
3. Continued use of the substance, despite increasingly severe social, biological, and legal consequences.
4. An inordinate amount of time and resources spent on using, obtaining, or recovering from the substance. In other words, this substance begins to "take over" the individual's life.
* * *
As our conception of the ideas of dependence and addiction has broadened, there is ever-broadening pressure to include more things within the umbrella of addictions in order to change the way such behaviors are perceived. In 2011, the American Society of Addiction Medicine released a new, controversial definition of addiction, calling it a "chronic brain disorder and not simply a behavioral problem involving too much alcohol, drugs, gambling or sex." The intent of the ASAM's new definition was to increase the understanding of addicts' problems as a result of disease rather than poor choices. Similar attempts to identify behavioral issues as brain disorders have been criticized as well-meaning, but unsupported by research, where biological markers of disorders still remain elusive. In other words, while issues in the brain may contribute to problems such as addiction, to assert that their origin is demonstrably rooted in the biology of the brain is an overstatement. Early psychiatric texts stated that drug addictions were usually symptomatic of a disordered and deficient personality. But now, rather than characterizing heroin addicts as junkies and druggies, the mental health treatment field sees them as people afflicted with the effects of an illness that demands empathy and support. When we discuss treatment needs of heroin users and describe their needs as driven by a chronic illness akin to diabetes, it changes the conversation, as well as the social approach to the behavior. As a result, we as a society are more likely to support the provision of treatment rather than punishment.
But the concept and term of addiction has played an inconsistent role in Western mental health. It has often been argued that the word addiction has too many implied meanings; it is too vague and nonspecific, too all encompassing, and too simplistic to explain the complex aspects of sophisticated behaviors. Nowhere is this more clear than in the application of the concept of addiction to sexuality, and the general medical view of sexuality overall.
In 1760, Swiss physician Samuel Tissot published a monograph entitled L'Onanisme, where he argued that masturbation deprived the body of essential fluids contained in semen and thereby led to numerous illnesses, notably problems of memory, headaches, and other nervous disorders, including even such problems as gout and rheumatism. Tissot's work was accepted as a scientific treatise and influenced the thinking of medicine for the next two centuries.
A few years later, Dr. Benjamin Rush, who was a signer of the Declaration of Independence, labeled numerous antisocial behaviors as diseases and recommended abstinence and bloodletting as appropriate treatments. Indeed, Dr. Rush's contributions are specifically cited by current supporters of the sex addiction concept as part of the rationale for creating a diagnosis. But these citations neglect to mention Dr. Rush's recommended treatment of leeches and bloodletting. Rush also believed that masturbation was the cause of poor eyesight (Rush literally started the "you'll go blind" myth), epilepsy, poor memory, and tuberculosis. Rush argued that women were particularly vulnerable to the ill effects of masturbation, which would leave them feebleminded and susceptible to evil.
Richard von Krafft-Ebing was a nineteenth century German psychiatrist who was one of the first physicians to describe the various fetishes and perversities of human sexuality. Krafft-Ebing gave names to these patterns of behaviors, such as naming sadism after the Marquis de Sade and his predilection for inflicting pain and suffering as a part of sex, or masochism after Leopold von Sacher-Masoch and his love of being beaten, whipped, and humiliated.
Krafft-Ebing first described and labeled the conditions of nymphomania and satyriasis. His descriptions set the stage for years to come. He described satyriasis as a condition in which a man was "forever disposed to the peril of committing rape," by virtue of being in a constant "rutlike" condition, often with a permanent erection. Krafft-Ebing believed that they are a risk to children and to engaging in exhibitionism, public sexual behaviors, and frequent masturbation. Nymphomania was characterized by women who "were a toy in the grip of a morbid imagination which resolves solely around sexual ideas.... Even in their sleep they are pursued by lascivious dreams."
Like Rush and Tissot, Krafft-Ebing denounced masturbation as a destructive influence, which degraded humans, particularly men. Masturbation led to sexual and moral degeneration and even created pedophilia in men who masturbated too much. In an interesting irony, when Krafft-Ebing first published his book labeling deviant sexual behaviors as medical diseases, he was attacked by the "German purity leagues" for promulgating a view that such actions warranted sympathetic treatment rather than legal and social sanctions. Krafft-Ebing's opponents argued that these deviant sexual acts threatened the fabric of society and must be punished and condemned, not diagnosed and treated.
Before Tissot, masturbation was largely tolerated, accepted, and ignored. British nannies reportedly masturbated their young charges to help them sleep. But the medical world turned against masturbation, labeling it disease, sin, and sexual excess. The current prevalence of circumcision in the United States is largely due to efforts by the medical community to prevent masturbation by circumcision. Kellogg's Corn Flakes and graham crackers were both invented by physicians attempting to develop bland foods that would prevent overstimulation of the body and reduce desires to masturbate. Psychiatrists blamed masturbation for the development of sexual perversions, including homosexuality. Until 1968, masturbation itself remained a diagnosable disordered condition in the DSM. Sigmund Freud called masturbation "the primary addiction," arguing that all other addictions merely shadowed our human compulsion for sexual self-stimulation.
It is a fascinating contradiction that during this same historical period, American physicians engaged in manual stimulation of females' genitalia in order to produce "hysterical paroxysms" in their patients as a treatment for hysteria. This treatment actually prompted the development and invention of the first vibrators, which were originally steam powered, and whose use, first by doctors, and then alone at home, promised to bring vibrancy and health back to women. While sexuality (and the use of vibrators) has become far more accepted in our society, the beliefs of the antisex crusaders ultimately had a longer-lasting and more overt influence on the proponents of sexual addiction.
* * *
Wilhelm Reich was a psychoanalyst in Germany and New York in the mid 1900s. Reich believed that the orgasm was the healthiest tool in the medical pharmacopeia, and he invented what he called the "Orgone Energy Accumulator," though Woody Allen famously nicknamed it the "Orgasmatron." Actors and celebrities from Sean Connery to Norman Mailer and J. D. Salinger were devotees, believing that by going into these wooden cabinets, their sexual energies were vitalized and their physical and mental health magnified. At Reich's request, Albert Einstein studied his orgone box, attempting to explain its mysterious effects. After two weeks of testing, Einstein decreed the thing to have no effect at all. Reich's celebration of the orgasm, and by extension, human sexuality, was embraced by political activists of the 1950s and 1960s, who used his philosophies to justify their own sexual rebellion. At the encouragement of the American Medical Association, who were concerned about the sexual libertarianism that he exemplified, Reich was prosecuted by the federal government for making false claims about the orgone box's ability to prevent cancer. He died in prison after violating federal orders in the sale and manufacture of his orgasm collecting boxes.
* * *
Sexologist John Money suggests that physicians who linked masturbation, and sex in general, to physical disorders were actually mistaking the sex for the cause. In other words, Money suggests that the doctors were blaming sex for illnesses, when in fact it was sexually transmitted diseases, in the form of bacteria, that caused debilitating conditions such as syphilis and gonorrhea. After the discovery of the germs behind these diseases, and effective antibiotic treatments for them, the medical antagonism toward sex and masturbation steadily decreased, until things changed suddenly in the past few decades.
In the early 1980s, a prison psychologist named Patrick Carnes published the book Out of the Shadows. In it, Carnes described the sexual excess that he had seen in clients and the destructive influences it played in their lives. He applied the concepts and approach of the twelve-step model of Alcoholics Anonymous and describes the patterns of self-destructive, out-of-control sexual behaviors as sexual addiction. His book has sold widely and has been regarded as a groundbreaking piece of work that has influenced the field of addiction and mental health, and American society in general. In the years since, the concept of sexual addiction has spread through common language and popular culture.
Unfortunately, in contrast to medical diagnoses, which require specificity and diagnostic clarity in order to be useful, the specificity and clarity of the sex addiction concept has broadened over the years as popular culture applies it loosely. In medical treatment, diagnostic precision is critical. As a very basic example, while the effects of a virus and a bacterial infection of the sinuses may look similar, diagnostic precision is necessary to guide effective treatment. Antibiotics given to treat a misdiagnosed virus will have no effect other than perhaps to support the spread of antibiotic-resistant germs. Similarly, the gross lack of clarity of diagnoses and definitions of sexual addiction have led to an explosion of a bewildering variety of definitions and lists of sexual behaviors and problems, all lumped under the general and broad concept of sexual addiction.
In his books, Carnes suggests using the "SAFE Formula" to identify whether sexual behavior is addictive or not. If the behavior is Secret, Abusive (harmful), used to avoid painful Feelings, and if it is Empty (outside of a caring, committed relationship), then a sexual behavior is likely to be addictive, compulsive, and dangerous, according to Carnes.
Excerpted from The Myth of Sex Addiction by David J. Ley Copyright © 2012 by Rowman & Littlefield Publishers, Inc.. Excerpted by permission of ROWMAN & LITTLEFIELD PUBLISHERS, INC.. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
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