Sexual Addiction - A Controversial Issue

May 22, 2017
Johann Kassim

Addiction is a disease caused by a dopamine deformity in the midbrain. It can be aroused by substance use as in alcoholism and drug addiction. But, processes or behaviours have the same effect. As long as it is a dopaminergic process or one that excites the production of dopamine. For example, sexual activity, eating, shopping, and working. Dopamine is the brain's pleasure neurotransmitter. It is involved in the maintenance and production of pleasurable memories and experiences.

By this account, sexual addiction is an illness worthy of any diagnosis. Yet, in the field of mental health, it is still a controversial issue. It has been left out of the current DSM-V (Diagnostic and Statistical Manual of Mental Disorders). For more information on the DSM-V, click here.

Why has the DSM-V left out Sexual Addiction as a diagnosable illness?

The new DSM-V announced that Sexual Addiction is an undiagnosable illness. With this, sex addicts cannot use the diagnosis as means for aid such as with insurance companies. Also, therapists treating addicts with sexual problems have to find other means. For example, sex addiction therapists have diagnosed some clients as having personality disorders. Yet, this does not get to the core of their illness that resides in their hyper sexual tendencies.

Why all this trouble? Here are a couple of reasons honed by experts in the field:

The first reason is the lack of empirical evidence in diagnoses. The DSM(s) since 1994 have left out sexual addiction due to this reason. It states that there is not enough evidence to support it as an illness worthy of diagnosis. There is not enough research into the field to standardise the causes and symptoms.

Sexual addiction has oftentimes been used as an excuse for infidelity. With celebrities taking time out in rehabs for sex addiction treatment, it has had a bad rep. People do not take it as a serious illness and see it as part of celebrity hype. What's more, non-sex addicts have used it as a means to escape marital responsibilities.

This leads us to the next point. What is a sex addict? With varieties in cultural norms around sex, addiction is hard to pin down. Could addictive tendencies in one culture equal normality in others? Is addiction a creation of monogamous societies over polygamous urges? These ambiguities make the standardisation efforts for DSM more complex.

In turn, the DSM panel have learnt from history not to repeat mistakes. In 1980, it recognised Homosexuality as a mental illness via the DSM-III. We now know that this is not the case and this fact remains an embarrassing moment in DSM's history.  The panel fears a repetition of such misdiagnosis if it proceeds to list sex addiction in the DSM-V.

The People's voice: Sex as an addiction.

Sex addiction is still recognised by those who suffer from it as a reality. Despite the non-diagnosable status of sex addiction, sex addicts still feel the problem. They are still adamant that they suffer from an addiction as equal as any. There are five 12-step groups that treat sex addicts regardless of DSM-V. They are as follows:

Sex Addicts Anonymous (SAA)

SAAs have found their abstinence in stopping one or more specific sexual behaviours. They do not disregard sex altogether. Each member has the freedom to define their own abstinence. Abstention is seen as a means to discern between addictive and healthy sexuality.

Sex and Love Addicts Anonymous (SLAA)

The focus is given to both "sex" and "love" addiction. SLAA's aim is freedom from any sexual or emotional act that leaves the addict powerless. Any act wherein there is loss of control over rate, frequency, or duration of its occurrence.

Also SLAAs have found freedom in giving up acts that destroy the person from all aspects. Be they physical, emotional, mental, spiritual, or moral well-being. SLAA sobriety is based on self-identified bottom-line behaviours.

Sexual Compulsives Anonymous (SCA)

SCA has its origin primarily among gay or bisexual men. Today, anyone can join it regardless of gender or sexuality. Members develop their own recovery plan. They define sobriety for themselves. SCA believes in not repressing sexuality. But, it seeks its expression in ways that do not make unreasonable demands.

It seeks to enact life that's free from sexual acts that exhaust time and energy. Also, acts that leave SCAs in legal jeopardy. And acts that endanger the mental, physical, and the spiritual well-being of the addict.

Sexaholics Anonymous (SA)

SA has a narrow and strict definition of sobriety. Addiction is seen as an addiction to "lust", and not to "sex". Any form of sex with oneself or with partners other than a spouse is addictive. This means that the only permissible means for sex is in marriage. And that marriage is strictly defined as a heterosexual union between a man and his wife. Also, seeing that homosexuals must express complete celibacy. They must be abstinent from all sexual behaviours including masturbation.

Sexual Recoveries Anonymous (SRA)

SRA developed as a splinter group to SA. This was due to SA's strict and narrow conception of abstinence. SRAs seek the release from all compulsive and destructive sexual behaviours. They have found through their experience, sobriety includes freedom from masturbation. Also, abstinence from sex outside a committed relationship.

Is there hope for Sex Addiction in DSM-V, Section III?

The good news for sex addicts and therapists alike is that DSM-V has made room for "hyper sexual behaviour". It's indexed in section III. This section lists potentials for future DSM(s). Hopefully, with adequate research and support, sex addiction will be a diagnosable illness.

We leave it to your good conscience to decide whether sex addiction is a disease worthy of treatment. To those who have suffered from the woes of actual hyper sexuality, it is a disease.

The sense of suffering is real. We welcome any further questions you may have about this issue. Call us for more information, we would be happy to help.

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