After surrendering their vibrators and porno DVDs, the stars of VH1?s “Sex Rehab with Dr. Drew” have chain-smoked their way through three long, sexless weeks of treatment. The motley crew of pseudo-celebrities — including a porn star, a beauty queen and an obscure rock musician — have stripped their emotions bare in nationally broadcast group therapy, tearfully sharing stories of past abuse, anonymous sex, hours upon hours of smut surfing and, above all else, consuming shame. But here’s a question that the show, which ended its first season Sunday night, never bothered to ask: Are these people really addicts?
Since the term was coined in 1983, “sex addiction” has become so embroidered in our self-help vocabulary that most of us stopped questioning it. The term gets bandied about whenever Bill Clinton logs extracurricular time with an intern or Eliot Spitzer gets caught having sex in his socks or David Duchovny separates from his wife. Recently “Sex Rehab” host Dr. Drew Pinsky made headlines by suggesting that Tiger Woods has a sex addiction. It’s become the go-to defense for extramarital affairs (I’m not an asshole; I’m an addict!) and been sold to “Oprah” viewers eager to diagnose their porn-loving husbands as both addicts and assholes.
Patrick Carnes, the leading expert in sex addiction, defines it as “any sexually related, compulsive behavior which interferes with normal living and causes severe stress on family, friends, loved ones, and one’s work environment.” But here’s the tricky part: What’s the difference between the symptom of a compulsive disease and a disease itself? Repeatedly lathering up in the sink is a sign of OCD. We don’t call those people hand-washing addicts, now, do we? Unlike most addictive substances, sex can’t be smoked, snorted or mainlined. The term isn’t recognized in the DSM (the Diagnostic and Statistical Manual of Mental Disorders), the bible of therapists everywhere (although along with other controversial diagnoses, like those relating to gender identity, sex addiction is being debated for a new version). But for many sex educators and sex-positive experts, hearing the term spoken about so casually, so frequently, is nothing short of maddening.
“People can behave in compulsive, self-destructive ways,” popular Savage Love columnist Dan Savage writes in an e-mail. “It is possible to fuck too much, or fuck too many people, or fuck your life up fucking. But sex isn’t a chemical substance. It’s not a drug.”
Addiction experts argue it’s the hit of dopamine delivered during orgasm that is abused. (Similar arguments are used to explain gambling and shopping addictions.) But equating those “powerful hoo-haa endorphins,” as Savage puts it, with harder substances like crack is “just ye olde sex negativity on display.”
Other skeptics take issue with the model for sex addiction diagnosis. An online test designed by Carnes casts a wide, sweeping net in its search for signs of the condition. Anyone who enjoys regular masturbation, has a porn collection, or indulges in an active fantasy life will likely be labeled a potential addict … potentially in need of Patrick Carnes’ services.
Richard Siegel, a licensed sex therapist, says he frequently comes across “normal, healthy college-aged guys” who have been unfortunately convinced by “flimsy pop psychology” tests that they are sex addicts for simply masturbating every day. When “Sex Rehab” star Nicole Narain, she of the Colin Farrell sex-tape fame, went on “The Joy Behar Show” in November, she complained about staying in bed all of one day to masturbate. This gave longtime sex writer (and former Salon columnist) Susie Bright a good laugh. “It is of the same tradition of hair growing on your palms from masturbating too much! It’s a werewolf fantasy,” she said.
Says Savage, “We live in a culture that’s torn between titillation and condemnation — that’s Dr. Drew’s whole shtick, actually. Titillate and condemn, condemn and titillate.”
The sex addiction world does indeed seem scolding and puritanical at times. Carnes’ screening test asks whether your sexual behavior has “hurt anyone emotionally,” whether you have used sex and “romantic fantasies” as “a way for you to escape your problems” and whether you “feel controlled by your sexual desire.” Pain, fantasy, desire — these are all normal parts of sexuality. Similarly, the test asks about paying for everything from a dating site to a dirty magazine. As for having a healthy and moderate interest in polyamory, swinging, BDSM, strip clubs, bath houses? Fuhgettaboutit. The truth, says Savage, is that “sex addiction” is merely a clinical euphemism for “sex they disapprove of for moral reasons.” As Dr. Marty Klein, a sex therapist and the author of “America’s War on Sex: The Attack on Law, Lust and Liberty,” once wrote: “These people are missionaries who want to put everyone in the missionary position.” ...
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