What Controversy?
Jan 13, 10- (by Mama MPJ)
- 4 responses

- Sober Salon
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As someone who lives with the reality of sexually compulsive behavior every day, I have to admit, articles like last month’s Forbes magazine piece on whether or not sex addiction exists make me roll my eyes. It’s always the same thing, “The idea of being addicted to sex is … quite controversial.” Which always misses the same point: the “controversy” (as I’ve said before) is over nothing more than semantics.
Yep, that big sex addiction controversy you hear about all the time. Contrary to what you’ve been led to believe, it’s not over whether or not it’s possible to have compulsions or self-destructive behavior around sex, but simply over whether or not those behaviors should be labeled with the word “addiction” instead of something like “obsessive compulsive disorder” or “impulse control disorder.”
Semantics are boring. Who wants to argue semantics? But does this condition even exist?! Now that’s catchy! That will sell magazines! So journalists slant the story in a way that implies that because some experts hesitate to call sexually compulsive behavior ‘addiction,’ there is no such thing as unhealthy or uncontrollable or self-destructive sexual behavior at all. And in doing so, they do the neurological equivalent of writing an article about coronary artery disease that implies that because some experts hesitate to call coronary artery disease ‘heart disease,’ there is no such thing as unhealthy arteries at all.
Consider the way this particular article frames one study about the brain science of sexual addiction, in which researchers compared people diagnosed with a particular subset of sex addicted behavior with others who were diagnosed with impulse-control disorders or attention deficit disorder, as well as a control group without any disorders:
“The subjects were asked to look at a flashing letter on a screen, and quickly press a button if they saw any letter other than ‘X.’ Patients who have impulse disorders usually press the button more often; this held true for both the patients who had traditional problems as well as the sexually compulsive people.
“Things changed, however, when the researchers had their subjects do this task inside an MRI machine. People with impulse disorders had reduced activity in the bottom front of the brain (as seen in previous experiments), but the people with sexual disorders had reduced activity at the top front of the brain, indicating that something different was going on. “
Look at the first paragraph very carefully. The study shows that patients who act in sexually compulsive ways — like those with ADD and other impulse disorders — behave differently in a scientifically measurable way than “normal” people who do not have impulse disorders. That’s extraordinary. But that’s not the information most people come away from the article with.
I could easily reframe the same study, without changing any of the actual data or facts to something more along the lines of what one would expect to read in an article about some less (pop psychologically) “controversial” diagnoses like bipolar disorder:
“The subjects were asked to look at a flashing letter on a screen, and quickly press a button if they saw any letter other than ‘X.’ As one might expect, patients who have impulse disorders as well as those exhibiting sexually compulsive behavior had similar problems regulating their behavior, and both groups tended to press the button more often than those in the control group.
“However, when the researchers had their subjects do this task inside an MRI machine, they found that, while the behavioral symptoms exhibited in the previous experiment were the same, the neurological underpinnings of the disorders differed. People with impulse disorders had reduced activity in the bottom front of the brain (as seen in previous experiments), but the people with sexual disorders had reduced activity at the top front of the brain. More research is needed to determine the role of the area at the top of the brain and the ways in which reduced activity in that area interferes with behavior regulation.”
Same story. Different slant. So, do you want to know where the real controversy is? Not among psychologists. Not among researchers. And certainly not among those struggling with sexually compulsive behavior or its effects. The controversy is purely among journalists and magazine editors, looking to make a buck.
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What a crock. It really gets old after a while - and irresponsible. Maybe this is a strange comparison, but the question “Does sex addiction exist?” reminds of the question “Do dogs have emotions?” Nobody who owns a dog needs to ask.
I love this. All those “Does sex addiction really exist?” articles are so triggering to me. I think it’s because, for me, it was such a long, difficult journey from realizing that something was very wrong, then finally finding an explanation that made sense (sex addiction), and then working to really understand the implications of that explanation. Sex addiction is dismissed as this overly simple sort of cop out, when, honestly, it would be so much easier if my husband was just a jerk. Accepting sex addiction isn’t the easy way out, it’s actually much, much more difficult than saying, “I just have a high sex drive.”
So, basically, I’m guilty of briefly wishing sex addiction (or sexual codependency) on the ignorant journalists who write this crap.
The controversy about sex addiction has high stakes because if it becomes an accepted psychiatric disorder, insurance will be required to pay for its treatment, even if 12 step programs work better than therapy. Whether medicalizing the condition a good thing or not is a matter of perspective, I guess.
Codependence isn’t an accepted medical condition, either. It’s not in the DSM and it’s “controversial” among therapists. That doesn’t make a difference for me. I think we codependents have lots of resources to draw on, the most important of which is other people who have recovered and can show us the way.
Not to be too much of a suck-up, but I feel that reading blogs like yours have helped me tremendously in making progress with my non-medically-accepted disease of codependency
I haven’t read the Forbes article and don’t plan on it, but actually finding biological differences in the brain of sex addicts vs. normal people is not that astounding. Violinists have much larger areas of their brain devoted to the left hand; those who meditate regularly have much larger areas of the prefontal cortex associated with compassion etc., artists have larger visual corteces, and so on. In all cases, teh behaviour leads to the difference in biology. Frankly it would be astounding if there were no difference in brain biology, because that would make sex addiction different than any other activity anyone engages in, whether voluntary or not. It’s become a given in neurobiology these days that you can physically change the structure of your brain by altering your behaviour.
So there’s that.
But while I agree with you that, on a behavioural level, the argument of “is this addiction or some other form of non-addictive compulsive behaviour” is semantic more than anything else, I think it’s important semantics. Addiction implies a disease model; it implies that the persons so afflicted have a medical condition that requires medical treatment, rather than a moral condition that requires a kick in teh ass, for instance. For a lot of people, that distinction is important–not only from an insurance standpoint (though I hadn’t thought of that, and it’s a good one).
Let me put it to you this way: people thought that ulcers were caused by stress for a long, long time, and as a result the people who suffered from them were given a whole lot of useless medical advice. And they continued to be sick. Then, lo and behold, someone who actually bothered to investigate it found out they were caused by bacteria. And if you took an antibiotic, you got better.
Wouldn’t more investigation of the root causes of any disorder be a good thing? Disorders of the front part of the brain (or prefrontal cortex) turn out to be very responsive to certain treatments including meditation. If they can locate the biological source of the problem, figure out what causes it, and devise an effective treatment, isn’t that a very good thing? Doesn’t a debate over whether it’s an addiction or not have a role in that? Because if it turns out not to be an addiction and they can put together an effective treatment … well. That’s good, isn’t it?