This morning, Alix at The Second Road forwarded me a link to an article about sex addiction by psychologist Michael Bader. When I saw the title (”Sex Addiction: A B.S. Excuse for Not Thinking“), I almost didn’t click through (the whole “excuse” thing is so tiresome) but I couldn’t resist some good blog fodder, so I did anyway. To my surprise, Mr. Bader wasn’t talking about sex addiction being an excuse for acting badly in addiction. However, not to my surprise, the article did focus on the same old semantic argument: “Sexual compulsions are real and they harm the person in their grip as well as others. But they shouldn’t be called addictions.”

Why not? The best point Bader makes (which I’ll get to in a future post) is that it (in his opinion) makes for less effective treatment. For today, I’ll stick with one of his two worst points, one that comes up in every critique of the concept of sex addiction: sexual behavior is just too complex — we all have too many different reasons for engaging in it and too many moral beliefs and hangups around it — for the label “addiction” to fit the way it does with drugs or alcohol.

Bader writes, “Current attempts at diagnosis focus on the extent to which sexual compulsions interfere with a person’s good judgment or are pursued despite obvious risks to health, job and family.” And continues:

“But how much risk does there have to be? If my lifestyle easily allows me to spend five hours a day surfing Internet porn or cruising for hookers, I may experience little risk but a high level of compulsion. If I feel too guilty to leave a terrible marriage and instead have a series of affairs, am I being compulsive or simply escaping a lonely existence? What about a priest who feels compelled to have sex, thereby risking his entire identity and belief-system; is he a sex addict or did he choose a ridiculously unhealthy lifestyle? Subjective experiences are clearly unreliable: Some people with very strict consciences and conservative backgrounds experience almost any sexual impulse as ‘out of control,’ while for others, living in a Fellini film would barely make the forbidden list.”

This conveniently ignores the fact that current attempts at defining alcoholism or drug addiction also focus on the extent to which these compulsions interfere with good judgment and are pursued in spite of other risks. In fact, every point Bader makes about sexually compulsive behavior could also be made of alcohol use: If my lifestyle easily allows me to spend five hours a day drinking, I may experience little risk but a high level of compulsion. If I feel too guilty to leave a terrible marriage and instead get drunk every night, am I being compulsive or simply escaping a lonely existence? What about a Mormon who feels compelled to have drink, thereby risking his entire identity and belief-system; is he an alcoholic or part of a “ridiculously” restrictive belief set?

Whether we are talking about an alcoholic whose difficult marriage “drives her to drink” or a sex addict whose difficult marriage “drives him to affairs,” the problem motivation and the degree to which the problem is situational is always going to be a little muddy, because human behavior, boundaries and tolerances are complex. That’s why, in the official DSM-IV definition of addiction (as I’ve mentioned before), much of the onus for determining whether or not behavior constitutes an addiction lies with the addict herself. Is the alcoholic drinking more than she wants to? Does she feel she’s unable to stop? That is: is she not happy herself?

Subjective experiences may be unreliable, but the fact is, there are no strictly objective measures for most mental health issues. Neurology is in its infancy and the brain’s inner workings are too poorly understood. There is no simple blood test or brain scan that can determine if someone is an addict or bipolar or obsessive compulsive or clinically depressed or anxious. Most diagnostic criteria are frustratingly vague and diagnoses are a combination of several different subjective impressions of the severity of the behavior, whether from a therapist or the patient him or herself.

The label “addiction” may or may not be a good fit, but if there’s anything I’ve learned from living with a self-proclaimed sex addict in recovery and working through my issues around that, it’s that sexual behavior — and our reasons for engaging in it — are no more or less complex than any of our other behaviors. And that the bottom line is not “Is this behavior a disease?” but “Is this behavior part of how I want to live my life and be the person I want to be, or not?”