Is Sex Addiction a Real Addiction?

Case For

Research indicates that the same reward system in the brain is activated in sex addiction as in a number of other addictions, including drug addictions. This supports the idea that sex addiction has a similar physiological and pychological process as other addictions.

People with sex addiction often have concurrent substance and/or behavioral addiction problems, or "cross over" to other addictions when they attempt to overcome their sex addiction. Some authors argue that this lends support to the legitimacy of sex addiction as a real addiction and that, if recognized, cross-over risk can be addressed directly to prevent it from happening after treatment for other addictions.

Sex addiction causes a great deal of distress to those affected and their loved ones. Sexual desire and expression in people with sex addictions are commonly reported to be unmanageable and unpleasant, in stark contrast with the way that healthy sexual experiences are reported, which are typically described as fulfilling and satisfying both physically and emotionally. Recognizing sex addiction means these people can get the help they need to overcome their addiction, and eventually resume enjoyable sexual relationships.

At present, few readily accessible addiction services provide help for people with sex addiction. Recognition of sex addiction can allow sex addiction treatment to be included in community addiction services. With specialized training in sex addiction being provided to addiction services staff, many more people could easily access help for sex addictions.

Case Against

An important criticism of the sex addiction concept is that it does not provide enough differentiation between different conditions that might look like sex addiction, such as hypersexuality accompanied by mania or hypomania in bipolar disorder; character disorders; personality disorders; some forms of depression; OCD and PTSD.

Critics of the concept of sex addiction argue that it has grown out of a cultural focus which associates sex with danger, powerlessness, and victimization, and is just a new way of making moral judgments about people who enjoy sex. As such, it can be used by people with a political and/or religious agenda to be negative about sex.

There is also a risk that the label of sex addiction might pathologize normal sexual desire and behavior, making healthy people appear to have an illness that does not exist. The concept of sex addiction has also been criticized for being based on the idea that some sexual experiences, for example, intimate relationship sex, are better than others. These are argued to be moral rather than clinical arguments.

At the other end of the spectrum, some people believe that a label like sex addiction can be used as an excuse for irresponsible sexual behavior, such as rape and child molestation. According to this criticism, people who have committed sex crimes can hide behind the label of sex addiction and avoid taking responsibility for their actions. These acts are deemed to be inexcusable, and the idea that that a sex addiction diagnosis encourages pity and sympathy to people who do not deserve sympathy is also inexcusable.

Finally, there is the argument leveled at all behavioral addictions -- that addiction is about chemical dependency, and no matter how similar the patterns of behavior, addictions occur in relation to addictive substances and not behaviors.

Where It Stands

Sex addiction, or certainly excessive sexual behavior, is widely recognized in the media and in popular culture. The growth of the internet has lead to an unquantified escalation of "cybersex addiction," which includes both addiction to pornography and addiction to online sexual interactions with partners, including sex workers. Still, the psychiatric community has been hesitant to acknowledge excessive sexuality, in and of itself, as a disorder.

In 1987, the Society for the Advancement of Sexual Health (SASH) was founded to provide up-to-date research to professional members who work with sex addictions, and to the public. They publish the journal Sexual Addiction and Compulsivity: The Journal of Treatment and Prevention, and hold a conference annually to disseminate research findings on sex addiction.

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