|No Such Thing as a Diagnosis of Sex Addiction|
Did you know that there is no such thing as a diagnosis of "sex addiction?" You probably think I'm ignorant and have no business writing this newsletter if I would suggest such a thing. After all, there are countless pop psychology books on the subject, and you may attend one of the many 12 Steps groups for sex addicts. So what am I talking about when I say there is no such diagnosis as sex addiction?
When making diagnoses, all mental health professionals use the Diagnostic and Statistical Manual of Mental Disorders. Maybe you've heard of the "DSM." The DSM is a compendium of all recognized mental health disorders along with the criteria clients must meet to qualify for each diagnosis. You won't find sex addiction mentioned anywhere in this 900 page tome.
Why not? How could a disorder that causes so much pain and havoc be omitted from the DSM? It's not because experts are somehow unaware of the problem, nor do they deny that the people who fill the rooms at "S meetings" have a serious problem. Indeed, Meg Kaplan, Ph.D., a well-known expert at Columbia University, states not only that it's "clear that a condition of hypersexuality exists" but that "such a condition has been described for centuries." The problem is that relatively little scientific research has been conducted on this condition, despite what much of the popular literature would lead you to believe. As a result, experts have many questions, and they don't want to apply a label like "addiction" that is loaded with implications about the causes and characteristics of the problem. "Hypersexuality" is the term used by Kaplan and other experts because it simply describes the behavior ('hyper' meaning excess) without conjuring up ideas that future research could prove to be false. Hypersexuality is being considered for inclusion in the next version of the DSM. However, currently, hypersexuality is not a recognized diagnosis, and it is not clear whether hypersexuality will be included in the next version of DSM.
Although experts don't use the term sex addiction, at least not in formal writing, the term has become so common in lay usage that it would be silly for me to call it anything else when writing for a general audience. To promote clear communication, let me offer a definition of sex addiction. When I use the term, I am referring to any sexual fantasies, urges, or behaviors that:
1) occur with frequency and/or duration that far exceeds those that most people experience and
2) cause emotional distress to the individual or impair his/her relationships or work performance. A huge range of behaviors can meet these criteria, so sex addiction is a very broad term. Examples of such behaviors include excessive use of pornography or masturbation, frequent one night stands or visits to prostitutes, and serial affairs. The behaviors may occur in gay or straight individuals, and they may be considered normal (e.g., intercourse) or viewed as unusual by the general population (e.g., desire to expose oneself).
Next time, I'll talk more about the varied manifestations of sex addiction.