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Is Sex Addiction a Real Addiction?

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Updated July 31, 2010

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Sex addiction is a phenomenon we are hearing more and more about these days. Of all the addictions, sex addiction is most commonly the butt of jokes such as, "If I was going to have any addiction, I'd go for sex addiction."

Many people dismiss sex addiction as a futile attempt to give legitimacy to what is simply irresponsible or greedy behavior. Others say that those people are unaware of or indifferent to the emotional pain that is frequently reported by those who consider themselves sex addicts and their loved ones.

Latest Developments

Sex addiction gained widespread attention in 2009, when actor David Duchovny -- apparently happily married with a family -- surprised the world by publicly admitting to being a sex addict and going into rehab. Toward the end of the year, many speculated whether or not golfer Tiger Woods was a sex addict, after several women claimed to have had extra-marital affairs with him.

The Internet has led to an unprecedented amount of pornographic material being made available to anyone with a computer. Many people are bombarded with advertising for pornographic and commercial sex sites without even seeking them out. Many more people are being exposed to pornography than ever before, including children and adolescents, and the nature of the web makes it difficult (if not impossible) to censor or place limits on the nature or amount of what is portrayed.

At the same time, there is increasing concern about online pornography addiction, which far outstrips the provision of support for people who feel their pornography use is excessive, unmanageable, or causing them problems. Without sufficient specialized services, relationships and families will continue to struggle, often in secret, with problems that they are not adequately equipped to deal with. The semi-underground and often corrupt nature of the sex industry has rendered it useless in providing research or treatment funding or other supports for people who are harmed by by its output. This differs from the gambling industry, for example, which has funded research into treatment and services.

Background

Sex addiction is not a new concept. Historical records dating back to ancient Rome and second century Greece report excessive sexuality, also known as hypersexuality or hyperaesthesia, and nymphomania or furor uterinum (uterine fury) in women.

The modern concept of sex addiction was popularized by Dr. Patrick Carnes, author of "Out of the Shadows: Understanding Sexual Addiction," and clinical director of sexual disorders services at a clinic in Arizona. Carnes and his colleagues have written several books on the subject, and tend to dominate popular understanding of sex addiction. However, others have also written extensively on the subject, including both researchers and people who believe they have suffered from sex addiction.

Goodman argued that, although sex addiction shares features of both a compulsive and an impulse control disorder, it does not fit clearly into either category. He suggested that it is best described as an addiction and proposed diagnostic criteria that mirror the criteria for alcohol and substance dependence in the DSM-IV (the reference for clinical diagnosis).

Sex addiction is not included in the DSM-IV, despite a number of conditions relating to limited sexuality -- such as hypoactive sexual desire disorder and sexual aversion disorder -- being included.

This belies a bias that challenges the recognition of excessive sexual desire or expression as a problem. In other words, regularly experiencing sexual desire, physical sexual arousal, sexual relations, and achieving orgasm is considered the norm for both sexes, despite the fact that people who never experience difficulties at any of these stages of the sexual experience are in the minority. In general, having less sexual desire and activity is seen as a greater problem than having more sexual desire and activity.

Over the past century, society has become increasingly permissive, with various aspects of sex and sexuality forming the basis for many types of entertainment. In recent decades, the pharmaceutical industry has supported this, with the development of drugs such as Viagra reinforcing the view that one is not living a complete and happy life without regular, non-problematic sex. In this climate, it is not surprising that so many people are becoming preoccupied with sex, and that those who might in the past have succumbed to other pleasures are developing compulsive sexual behaviors.

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