I recently tried to read The Myth of Sex Addiction, by David J. Ley, Ph.D. (yet another one of those authors who feels adding “Ph.D.” to his name is important). I made it about fifty pages in, before I folded up my cards and went home.
Ley is hell-bent on decimating a straw man, the idea that one can be “addicted” to sex in a clinical sense. While there are many – Patrick Carnes, chief among them, who have peddled the story of sex addiction over the last thirty or so years, and while there are thousands of participants in various twelve-step fellowships who subscribe, more or less, to the theory that one can be “addicted” to sex, and that the modality of a twelve-step program can be helpful to “recovery,” I don’t believe there are any serious clinicians advocating the idea that one can be genuinely “addicted” to sex according to any standard definition of the word. Rather, what I think is widely understood is that compulsive sexual behavior (as with many compulsive behaviors) often produces symptoms that are very similar to the symptoms suffered by people who are, indeed, addicts.
Currently, people misuse the concept of “addiction” all the time, but in fact, there’s a fairly clear clinical definition of addiction which has two parts to it – first, the concept of physical dependence (one’s body comes to need the substance, and in fact gets ill without it); and second, the concept of tolerance (one’s body needs more of the substance in order to attain previous levels of effectiveness). In the absence of either of these conditions, one is simply not addicted. There’s a second, non-clinical, usage of the word, which is, “enthusiastically devoted to a thing or activity.” But this is a colloquial usage, not a medical one.
I’ve written elsewhere that I am, for all intents and purposes, an addict. What I mean by this is not that I am physically dependent on sex (while I think the drive to fuck is pretty irresistible, I think it’s a mischaracterization ever to refer to it as an addiction; ditto with food), or that I have a “tolerance” to sex (although I did find myself seeking ever greater thrills in my days of florid acting out). No, what I mean is that my behaviors mirrored, perfectly, the behaviors of an addict. If I read the Big Book, if I look at the behavior of addicts to alcohol, or sleeping pills, or heroin, my behaviors were the same – the lying, the resentment, the self-deception – you name it. So, to the extent that an addict is defined by her or his addiction, I was no addict; but to the extent that an addict is defined by her or his behaviors? Well, I was (am?) an addict, for sure.
Anyway, back to the book. The author’s premise is that those who would persuade us that sex addiction is a thing are shysters, peddling a dangerous lie for their own enrichment.
And to that I say, well, sure, maybe. I mean, yes, Patrick Carnes and his various facilities are money-making enterprises. And no, none of what they do is empirically validated. Literally. None of it.
Any more than is any other 12-step program. For a variety of reasons, I don’t believe there is any valid empirical support for the premise that 12-step programs are effective (let alone, that they are the most effective modality) in combating alcoholism, or drug addiction, or any other compulsive or addictive disorder. What there is is considerable anecdotal support for, and a lot of strong believers in, the cult of 12-steppery. And what I think is indisputable is that 12-step programs, whether for alcohol or for gambling or for sex, have helped some.
I think where people get a little fuzzy is when they get all absolutist – when they proclaim either that 12-step programs are the only means of treating addiction (or “addiction”), or when they get doctrinaire about the specific practice of 12-step recovery. For every alcoholic who has recovered in AA, there’s one (or two, or ten) who didn’t, and there may well be another one (or two, or ten) who managed to do it without AA. Similarly, in my time in the land of the 12-step sex fellowships, I met a few (just a few) people who had managed to rack up some considerable “sobriety.” Far more common were long-term sufferers, people who had been in the program for 2, or 5, or 15 years, and who had never been able to string together more than a few weeks, or months, or a year or two, of “sobriety” before “slipping.” (And who, it always seemed to me, were deprived of the opportunity to declare victory because they hadn’t attained “sobriety,” even though their lives no longer were unmanageable, even though, for the most part, they were no longer “powerless over lust.”)
I was always frustrated in my time in the program, first, because of the relative paucity of real role models – people who had “escaped” the “disease,” and second, because of the excruciating sex-negativity of just about everyone I encountered. Sex was seen by almost everyone I met as this torturous, miserable, force determined to make us miserable.
And this is a big but….
But, the program did help me get my shit together, to deliver myself to a place where, whatever my pathologies around sex, notwithstanding my undoubted hypersexuality, I no longer am, for the most part, powerless over sex. My life no longer is unmanageable.
So I’m not sure what, if any, conclusions I have, other than these:
1) Don’t read The Myth of Sex Addiction. It demolishes a straw man in a way that’s not very interesting. Or readable.
2) When you read about sex addiction, understand that “sex addiction” is a metaphor – it is a way of calling up a number of useful associations and images and ways of understanding things very efficiently. But it’s not a precise, scientific, diagnostic term.
3) 12-step programs do help, have helped, thousands (hundreds of thousands?) of people.
4) Don’t believe the hype about 12-step programs. They’re not the only way – they’re one way. And they can be really helpful even if you don’t drink the Kool-Aid.