Sex Addiction? 6% May Have It, but Experts Doubt It Exists

As many as 6% of Americans may be so obsessed with sex it interferes with their lives, but experts can’t agree how to treat these “sex addicts�--or even if they’re addicts.

Eli Coleman, a pioneer in the field, says there’s no question that sexual addiction exists, and that his patients include men who are “masturbating 10 to 15 times a day resulting in physical injury, hiring prostitutes on a daily basis, (or having) multiple anonymous sexual encounters without regard to risk of health or commitments to family or relationships.�

The concept has become increasingly popular in recent years, spurring the creation of self-help groups modeled after Alcoholics Anonymous. Mary Ann Miller, a psychologist who founded the Chicago chapter of Sex Addicts Anonymous, has estimated that up to 6% of Americans are addicts.

However, sociologists Martin P. Levine and Richard Troiden wrote in the August issue of the Journal of Sex Research that the sex-addict theory amounts to “transforming sin into sickness.�

‘You Can’t Be Addicted to Sex’

“There’s no such disease as sexual addiction or sexual compulsion. It doesn’t exist,� said Levine at Bloomfield College in New Jersey. “You can’t be addicted to sex. Addiction is a physiological dependency on a substance.�

He and Troiden, of Miami University in Oxford, Ohio, wrote that “the invention of sexual addiction and sexual compulsion as ‘diseases’ threatens the civil liberties of sexually variant peoples� like homosexuals.

“Mental health professionals must remain cautious about endorsing concepts which may serve as ‘billy clubs’ for driving the erotically unconventional into the traditional sexual fold,� they cautioned.

Although not addictive in the chemical sense, “these behavior patterns are pathological, self-defeating,� said Coleman, a psychologist in the University of Minnesota Medical School’s human sexuality program. “These individuals display hypersexuality in response to feelings of anxiety, depression or loneliness. Many describe a sexual act as a ‘fix’ to some very negative feeling. But this relief is short-lived and negative feelings recur.�

Dr. Theresa Crenshaw, a San Diego physician and sex therapist who served on President Reagan’s AIDS commission, said the sex addicts she treats “want help. They don’t like the behavior. It is not ordinarily a diagnosis superimposed from the outside. . . .

Underlying Problem Ignored

“It’s a compulsive behavior pattern the person continues to repeat in spite of disruption to marriage or primary relationships, in spite of self-disgust.�

Levine said self-help groups like Sex Addicts Anonymous and Sexaholics Anonymous simply try “to shut down the sexual behavior and not deal with the underlying problem� for those who are unhappy because their frequent sexual behavior violates moral standards.

“It used to be that people said, ‘The devil made me do this.’ Now they say, ‘My disease made me do this.’ If you enter the role of being a sick person, you’re not responsible for the behavior, he said.

“The treatment is to get them to repress their sexuality--restrict their sexual experience only to an emotional relationship, preferably marriage. The problem is it doesn’t deal with the underlying forces that make them feel so worthless about themselves.

“It’s their sense of worthlessness that pushes them to engage in sexual behavior that violates their values. If you remove that behavior, you remove the only comfort or antidote they have for their misery.�

Coleman said he and other sexual addiction therapy pioneers agree that underlying feelings of worthlessness must be treated and that “none of them advocate simply suppression of sexual behavior.�

Treatments such as the 30-day sexual dependency program at Golden Valley Health Center near Minneapolis “help people learn how to be sexual in healthy ways,� while self-help groups let sex addicts know they aren’t alone and encourage members to obtain professional therapy, said Coleman, who lectures there.

No Unanimity of Treatment

But “there is no unanimity of treatment,� he said. “Some view this as a psychiatric condition and treat it with medications. Others treat it with psychoanalytic or behavioral therapy. Others adapted the methods of treating alcohol addiction.�

Levine said the sex-addiction-compulsion concept “appeals to most Americans because . . . if you’re engaging in behavior that traditionally has been defined as sin, transforming it into a disease absolves you of any moral failing.�

Coleman insisted that sex addicts who seek treatment are accepting responsibility, and self-help groups “do not relieve them of responsibility, but they do try to relieve them of shame.�

Levine said that when a disease-linked label like “sex addict� is applied to people, they can be forced to get treatment. And the notion of addiction can be used to justify attacks on homosexuality and other sex outside of marriage, he said.

No Objective Criteria

A person’s sexual behavior should be considered a problem only if it makes him or her unhappy, involves an unwilling partner or directly harms others, he said.

Coleman acknowledged that researchers “do not have any objective criteria to say who is sexually compulsive or addictive,� so such labels “could be used as a measure of sexual oppression of sexual minorities.�

Levine and Troiden view the notion of sexual addiction as a product of increasingly conservative American values, a backlash to the sexual revolution of the 1960s and 1970s, the upsurge in Christian fundamentalism, increased emphasis on monogamy and commitment, and fear of AIDS, herpes and other sexually transmitted diseases.

Hypersexuality “was a psychological and medical issue long before it was politicized by those who feared it could be misapplied to them,� Crenshaw said. Some homosexual men resist the notion of addiction because it threatens what they consider their right to anonymous sex with multiple partners, she added.

‘Reasonable’ Arguments

Levine said his own homosexuality didn’t influence his opinion. The term sexual compulsion was coined by homosexual therapists to explain why some gay men continued to engage in unsafe sex with multiple partners despite the deadly threat of AIDS, he added.

“The points Levine and Troiden raise are reasonable ones,� said Paul Abramson, editor of the Journal of Sex Research and a psychologist at UCLA.

Abramson said their essay “will force a re-evaluation of the concept of sexual addiction and compulsivity. This article has engendered a lot of debate about the feasibility of using such a label for the purpose of maligning a sexual life style.�