Conquering the Sex Addiction Monster

We are now learning that addiction is truly about failed bonding—it’s a relational problem. Those deemed “sex addicts” are people missing meaningful relationships and who lack an understanding of healthy sexuality. They are seeking outside their relationships what is missing inside of it, such as good sex, sexual chemistry, love, connection, bonding or stimulation. We need to treat the real issue; relational boredom and deprivation, loneliness, fear of sex, and poor sexual health education. It’s not about the flawed concept of being “hooked” on sex or arousal. I have never treated anyone diagnosed as a “sex addict” who was currently in a truly meaningful, stimulating, and arousing sexual-romantic relationship. Most “sex addicts” just need better sex positive sexual education.

Sex addiction diagnosis has become a waste paper basket for all creative sexuality, queer sex, and nonrelational heteronormative sexualities. Most sexual “acting out” is really due to the instability and boredom of monogamy and the ownership model of marriage. Sex cannot be contained, as sexuality has no interest in our socially constructed norms for relationships or our cultural, sex-phobic laws about sex work use and pornography. The sex drive is one of the most powerful drives and does not care about socially constructed barriers such as monogamy and our privileging and valuing of sex only when within a committed relationship. Our diagnostic system within psychology flaunts this problem, as its entire job is to align clients with heterosexual, male, American norms of health.

Sex addiction criteria and treatment is not a “view from nowhere with no politics” because all therapy is political, and no neutral therapy exists. We have to look at the founders of the sex addiction diagnosis and model for treatment to understand what anxiety or need their work is attempting to heal and protect, as we cannot split the creator from their creation. There remains a severe lack of actual, adequate, and advanced sex therapy, human sexuality, and sexology training in this bunch.

The future of sex addiction treatment is highly fragile due to the field’s attempts to formalize a sustainable model of treatment. The “personhood” of the field’s current practitioners is one full of histories of sexual chaos and phobia that bleed into their work and models of treatment. They project their own sexual anxieties onto their clients. Until the field of sexual compulsivity has therapists who are not afraid of their own sexuality, we will never have a treatment modality that doesn’t cause harm.

Don’t valorize sex-phobia by calling it “health” or “sobriety” because sex must be encountered. Read the sex addiction criteria list—it’s all diversity shaming (focused on intercourse, monogamy, family-centered, and anti-nonhetero norm, solo sex, paid sex, and porn). These are all American hetero values, and they ignore other sexual minority norms and values. This is colonization, and it’s prejudicial. Minorities do not and should not honor cultural majorities defining for them how they should be.

Sex addiction as a diagnosis and treatment carries a eugenic gaze and polices sexual diversity. This conversion and reparative therapy process, disguised as health, oppresses sexual minorities and sex radicals needlessly. My e-mail is frequently assaulted with invites to treatment centers, lectures, and programs that claim to cure porn use and BDSM interests, all of which require support and not shaming from clinical programming billed as treatment.

Sex addiction diagnosis is the direct result of colonization and is not resistant to culturally bound sexual requirements and values. Sex addiction treatment then becomes about embedding the moral and social anti-sex status quo into the psyches of clients. What is deemed a problem to fix depends on norms of the culture and context.

What hetero America calls addiction, other cultures and the field of sexology call “healthy pleasure.” The model lacks a vision for sexual health and sustainability of arousal and stimulation, all of which are the actual goals of sexual health. It is a historical, social, and moral product, and it is arbitrary.

Diagnosis says nothing about the person or client and everything about the culture and individual prescribing this taxonomy. What many erroneously call “sex addiction” is actually sex without social rules. Sex is a truly a “complex outcome of a tension between biological sexual possibility and cultural constraints” (Laumann, Gagnon, Michael, & Michaels, 2000). Sex drive isn’t concerned with socialization and the arbitrary boundaries culture has set around sexual behavior. The erotophobic psychology and faux science of sex addiction uses labels and diagnoses as surveillance to cope with the continued tension of trying to determine a universal healthy sex. Sex is far too individual and contextual, with the impossibility of creating a universal or consistent operational definition. What may be healthy—which is a fully loaded political concept—for one individual in one context or culture may be unhealthy in another. One of my favorite shaming definitions for “sex addiction” provided by the sex addiction therapist camp is their statement that “healthy sex only takes place in a committed relationship.” If that were true, then most of Americans are sex addicts, as the majority of us are having sex without marriage or commitment. This is a great example of the overt pathologizing of any sex that isn’t marital, hetero or vanilla.

Sex drive is one of most powerful human drives, and relationships and sex are a primary organizing principle within socialization. Biology demands reproduction and arousal, while culture provides options and limits around how it’s expressed. We have to recognize that arbitrary rules governing sex are major health risks. Boundaries are needed, but not around harmless sexuality. This is similar to the concept of virginity and self-worth, which states that when you have sex you “give something away,” which is another negative social construction about sex—yet another made up theory to control the experience. It is sex shaming and an attempt to needlessly link confidently having sex with the fear of a mythic loss or reduction of self. The opposite is true. Sex can be a bridge to emotional bonding. It enhances us and allows for more intimacy, connections, and relationality in our lives. It can also lead to more relationships, as many have sex that leads to long-term healthy friendships. This is why healthy sex can occur outside of relationships. Many use sexuality as a way to build immediate intimacy and social connection.

Many of the symptoms that are wrongly defined as a “sex addiction” are signs of a sexual-relational structure that is not working, mismatched sex drives or interests between partners, masturbation/porn phobias or just plain old sex-hating. Watching porn and masturbating daily, sex with sex workers or cheating are not issues of a sexual addiction. Solo sex (masturbation) is good for self-soothing and stress release, paying for sex can be highly arousing, and cheating may mean that one is not meant for monogamy or needs to end a current relationship.

The sex addiction treatment field is quickly rendering itself irrelevant because it fails to provide a holistic perspective that can fully examine an individual’s sexuality without pathologizing nonnormative behaviors. The limited nature of the current treatment model is driving the collapse of itself as its inherent shaming tone and abusive clinical applications are no longer feeling good to clients and clinicians. The liberating voices of opposition from sexologists, sex therapists, and psychologists are driving the recognition of its limits and failures and most importantly freeing “sex addicts” from the dangerous edicts of the current sex addiction treatment model. The historical roots of the treatment model, the substance abuse model, and related Twelve Step programs are far from accurate or applicable to treat a healthy and omnipresent human drive. We all as humans must work to navigate this drive in a functional way and not split it off with a disease metaphor relegating sex to a place of shame and fear.

The future of sex addiction requires a reconfiguring of the current operational definition, although nonexistent clinically and diagnostically as the addiction field and media have definitely agreed upon a shaming set of criteria. Perspectives that allow for deviation from the current didactic, committed, hetero standard would need to be integrated to form a sustainable model for treatment of problematic sexual behavior (or as I call it, sexuality). 

Problematic behavior isn’t separate from sexuality. But the inherent flaw in a model of treatment is its attempt to objectify, concretize, and standardize behavior such as sexuality, which is highly subjective and situational, and definitions of health are bound within current culture and historical positioning. The history of sexology has shown us how the disorders and pathologies of the past have outgrown their labels and are now seen as both acceptable and healthy. Sex addiction’s attempt to delineate a healthy from unhealthy model of sex is impossible—it is a hopeless attempt to build a hierarchal ladder on solid ground that just cannot exist. Due to this, the sex addiction field will always fail to legitimize a consistent treatment model and definition of sexually addictive behaviors

Laumann, E. O., Gagnon, J. H., Michael, R. T., & Michaels, S. (2000). The social organization of sexuality: Sexual practices in the United States. Chicago, IL: University of Chicago Press.