Fresh out of a difficult breakup and confused about his unrelenting desire to have more than one partner, 30-year-old podcaster Jamie, who's asked to use his first name only, quickly headed to a therapist. "I want you to make me monogamous," Jamie told his therapist.
For years, Jamie had struggled to stop thinking about sex — and sex with other people — whenever he was in a relationship — something Jamie, who's now polyamorous, didn’t realise was an okay way to feel. But there are real difficulties attached to his relationship with sex. "The therapist let me know she couldn’t ‘make me monogamous,' and instead suggested we worked through why I thought my sex life was problematic."
Some thorough self-exploration showed Jamie that he had been having sex when he didn’t even want to with people he didn’t like, to fill "a type of void." "After a good few sessions, a therapist gently showed me that I wasn’t having sex because I wanted to, I was doing it because I hated myself. And then I was diagnosed with sex addiction," says Jamie.
We all have an idea of what we imagine sex addiction is like. These perceptions come from celebrities like Russell Brand talking about his orgy orchestrated on a spongy mattress in sex addiction rehab, or Colin Farrell describing his "obsession with sex." While these difficulties are very real to the respective actors and should not be invalidated, a lack of understanding and poor education around sex generally has allowed highly publicised but inaccurate stories like these to represent what 'sex addiction' might look like.
And yet, ‘sex addiction’ is not even real. It is not a condition that is recognised by any scientific or medical community, including the World Health Organisation. Indeed, the term was even removed from the DSM-V by the American Psychiatric Association along with the term hypersexuality, in view of a growing body of research showing that 'sex addiction' is actually "no more than high libido coupled with low impulse control." The ASA's DSM-V is considered a definitive resource on mental disorders.
What Jamie and 30 percent of the male population (along with 30 percent of women) go through, is actually Compulsive Sexual Behaviour. Compulsive Sexual Behaviour is diagnosed in people who have poor impulse control around sex, which is when a person has trouble controlling their emotions or behaviours around sex even if they know they’re not right, and participate in negative and unwanted sexual situations. Silva Neves, a psychotherapist specialising in sexology, explains that "those impulsive behaviours have to be unwanted by the person themselves, not by an external source of judgement. The behaviours have to cause marked distress and impairment in people's life functioning. It is not about the frequency of behaviours, and it is not about people cheating or watching pornography, or about addiction at all."
Neves tells Mashable: "Although compulsive sexual behaviour may sound like an addiction, it is not because people's brains are not impaired. Many people do struggle with their sexual behaviours, but these problems are not an addiction. What they're really struggling with is repetitive and unwanted sexual behaviours that go against their own values."
The term 'sex addiction' is thrown around a lot but it hasn’t actually been endorsed by any scientific communities, including the World Health Organisation, as there’s a complete lack of evidence to prove its existence. Yet, with news stories about celebrity sex addicts, rampant misinformation about sex swirling continuously online, and the misconception that high sex drives are innately damaging, the term stays popular.
Something about the term 'sex addict' didn’t feel right at the time but who am I to argue with a doctor?
That doesn’t mean people don't struggle with sexual disorders. And unfortunately, it doesn’t stop people from being misdiagnosed with sex addiction. 25-year-old sex worker Chloe* knows this first-hand, having been incorrectly diagnosed with sex addiction by her GP (general practitioner). "I had a horrible ex-boyfriend who thought my sex drive was 'out of hand'. He called me a 'nympho' and couldn’t compute why I wanted my job and my personal life to revolve around sex." Chloe’s then-boyfriend pushed her to see a doctor, where the term ‘sex addiction’ was first said to her. She says "something about the term didn’t feel right at the time but who am I to argue with a doctor?" Like Jamie, Chloe was encouraged to try abstaining from sex. "It was literally impossible. I love sex and I didn’t want to give it up. I don’t think I had a problem, my GP was clearly basing my diagnosis on how much sex I was having," Chloe adds.It was two years later, when Chloe had left her boyfriend and made friends with other sex-positive people who shared her same interest in sex, that she realised she’d been misdiagnosed. "Being in a sex positive circle, there were plenty of people around me showing me there was nothing wrong with my sex drive. So what if I’m ‘obsessed’ with sex? Sex is great. What’s not to be obsessed with?" Chloe explains.
Neves says that people are often misdiagnosed with 'sex addiction' because many therapists are still trained in this old-fashioned concept, unfortunately. "There are also online tests such as 'Am I a sex addict' that people can do and self-diagnose. But those online tests have no basis in science," he tells us.
For some, the ‘sex addiction’ term isn’t a problem. "I don’t mind being called a sex addict personally," says Jamie. "It’s easier to explain to people and I feel like if it creates awareness, it can be a good thing."Words carry a lot of weight, and referring to this disorder incorrectly as an ‘addiction’ has led to many patients being treated incorrectly, according to Neves. Often, patients are recommended to practice permanent abstinence, a method that lacks a much-needed nuanced approach to sexuality. Neves explains that many people use sex and masturbation to soothe themselves from unpleasant emotions, underlying psychological disturbances or post-traumatic stress, and no one should be made to refrain from it.
26-year-old engineer Chris was incorrectly diagnosed by two separate GPs with sex addiction, finding out three years into his treatment that it wasn’t an addiction at all. "I was floored when I switched therapists and she informed me that it wasn’t a real thing. I’d been in and out of 12-step programmes — the kind of ones you get for drink and drugs — and every doctor I’d seen had told me to stop watching porn, wanking, and having sex as much as possible. They expected me to do that basically forever as well," he tells Mashable. "It was honestly disheartening. I never stayed on track with abstinence and I always felt like it was my fault, like I was doing something wrong. And obviously that would make abstinence even harder," he says. “I saw a psychotherapist who told me I never should have been doing that, and that I had compulsive sexual behaviour which wasn’t an addiction. It was so upsetting."
This strain of shame, which can dig deep into our psyches and wreak havoc, can also cause problematic sexual behaviour. Neves says “the acute shame is what keeps sexual behaviours problematic, because shame needs to be soothed.” Those who are labelled a sex addict and then essentially banned from sex will be trapped in a loop of unjust shame.
It’s down to us to decide what does or doesn’t fit into our sex lives, not anyone else. So unless abstinence or any other big changes to your sex life are on your sexual bucket list, they have no place as a treatment. Neves adds that "compulsive sexual behaviours can be treated with a sex-positive, sexology-informed approach that helps people understand their erotic mind as erotic awareness kills sexual compulsivity."
If you’re suffering with a dependency on sex or a sex life that you’re finding damaging but difficult to pull away from, he suggests "investigating the function of sexual compulsivity." Ask yourself, is the sexual behaviour there to soothe an underlying problem or unresolved trauma, or it there a conflict between the sex you want and enjoy, versus the sex you’re actually seeking? "Then treat the underlying causes, rather than trying to control behaviours on the surface."
The mere suggestion of a person being addicted to sex contributes to the shame and stigma we already attach to sex in society. The concept that a person’s desire for sexual connection can go ‘too far’ or be ‘too high’ or ‘too low’ leads sexually active people to have confused ideas about what 'normal sex' might look like, proving just how much we need to move away from the idea of ‘normal’ and ‘abnormal’ sex at all. This, along with our notorious lack of sex education, make the perfect breeding ground for sex-negative judgments.
Sex is shrouded in shame, myths and misinformation. As Neves puts it, "It is easy for people to believe that they're 'wrong' or 'broken' if they don't have what society deems as 'healthy sex' — which is basically vanilla heterosexual sex, missionary position with a scented candle of the frequency of not too much, not too little.” Sex is not like gambling or substances. It’s one of the most human, connective experiences we can engage in. And to hold real people with various sexual identities and tastes to a false idea of "normal sex" and punish them with sex prohibition rooted in bad science, is nothing short of joyless.
*names have been changed at interviewees' request.
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