Tuesday, February 14, 2006

No sexual addictions?

At WebMd Blogs: "Sexual Addiction: Real or Invented?" Here's Dr. Louanne Cole-Weston, PhD:
"I hold the viewpoint that the concept of sexual addiction was created by factions of the mental health community who were personally uncomfortable with robust sexuality and who possibly also wanted to create a new way of attracting therapy clients. The problem is, those who 'treat' sexual addiction, by their own admission, are treating something that is 'untreatable.' Read any of the literature from the sex addiction field and one finds that it cannot be 'cured.' That's a nice way to keep a full therapy practice..."


Blogger BiPolar Guy said...

Yeah, I've always been skeptical about the term sexual "addiction". Obviously coined by sexual aversion sufferers.

11:21 PM  
Blogger jw said...

I'm not so sure about this.

It seems to me, that porn as a tool to reduce emotional pain has a lot of power. So sexual addiction in the form of porn/masterbation is often a poor way --but a powerful way-- to deal with emotional pain.

I once had a boss who was forced by circumstance to start living on the streets at age 10. He raised himself on the streets of Montreal. In an average year, when I knew him, he would have over 150 sex partners. I think his high number of partners was (is?) a way of dealing with the emotional tragedy of his early life.

The whole thing is confusing ...


1:57 AM  
Blogger Joel said...

If there is an aversion to sex, then there must also be the other extreme -- excessive pleasure in the chemical reaction that is orgasm. I haven't run into too many such people, but they do exist. When combined with antisocial tendencies, you want to get away from them.

While I think we should be very careful of symptomizing everything a patient does or feels, I also want my psychiatrist/psychologist watching for strangeness that might be harmful to myself or others.

If you masturbate so hard that you need to go to the ER (it does happen) then there is a bona fide psychiatric emergency. If you just can't avoid hitting up on women and talking inappropriately about the size of your penis, there is a bona fide psychiatric issue. If you lie about it, it is worse.

Cole-Weston's argument sounds like Thomas Szasz in The Myth of Mental Illness, that groundbreaking work that led more than a few patients to stop taking their meds so they could enjoy their moods and then crash a car into a tree. "They're just misunderstood," the argument goes. Maybe we don't understand them fully, but we can clearly see the harm.

3:11 PM  
Blogger : Joseph j7uy5 said...

If there is any utility in the concept of sexual addiction, it is that the term might be acceptable to some patients, thus facilitating their entry into treatment. Other than that, it seems to have no use whatsoever.

The whole point of having a diagnosis is to be able to define a group of patients so that one can do replicable research, and then to transfer the results of that research to clinical practice.

If there is no standard, generally accepted definition of a diagnostic term, then it is not a scientific term; it is vernacular. Vernacular terms may have utility, but it would be a mistake to confuse a vernacular term with a scientific one.

11:32 PM  
Blogger Lynn Gazis-Sax said...

I'm ambivalent. I'm not sure whether "addiction" really is a useful analogy for sexual recklessness/excess/compulsion or not.

On the one hand, I think there's more going on than simply "robust sexuality." Some people pursue their favored sexual activity in ways even they find hurtful to themselves, but can't manage to stop.

On the other hand, is "sexual addiction" really the best way to describe what's going on? People do sexually reckless or hurtful things for a wide variety of reasons - a strong sex drive, a sense of entitlement based on position that lets them think they can get away with exploiting others, some other disorder such as mania or alcoholism that affects their ability to observe boundaries, or maybe problems such as depression or past abuse which affect their ability to set boundaries for what they don't want, etc. And I wonder whether the word "addiction" might obscure these diverse causes (which might call for diverse responses).

But then, going back to the other hand again, if some people experience their sexual activity as compulsive and out of control (and it seems that some do), "addiction" can be a reasonable word to describe that.

12:35 PM  
Blogger Joel said...

Hey, why no women participating in this conversation?

The part of this I don't like is the use of the term "addiction". Addiction implies a few things to me including ingesting or injecting a foreign chemical, willfulness in starting the disease, and an inability to stop because the body has become used to the behavior. (For bipolars, I should note, the starting of the behavior can be due to a compulsion.)

Addiction gets misused a lot. I've seen addicts and therapists torment people with mood disorders, suggesting that we get off on our depressions and our mixed manias. (Our straight manias feel ~good~.) Arguing for an addiction model for moods offers the cruel a handy guilt trip to fling and stick to the back of the mentally ill.

We're not like alcoholics or drug abusers. Some of us actually toughed it out and we didn't like the moods which just happened to us.

So the use of the word "addiction" may be both inaccurate and cruel. A thoughtless therapist might have coined it to keep up with the fashion of describing everything as addiction. I see my illness as just a disease, unelected by me and yet forced to endure until I got better meds.

I wish therapists would get their terminology straight so that they weren't continually confusing and tormenting us.

12:42 PM  

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