ADDICTION REC VERY FOUNDATION DIAGNOSIS July | August 2012

THE SEXUAL ADDICTION DIAGNOSIS: CLINICAL CONCERN OR PATHOLOGISING DIVERSITY? Sexual addiction, or hypersexual disorder, looks set to be formally recognised in next year’s Diagnostic & Statistical Manual of psychiatric disorders. Robert Weiss gives an introduction – to be followed by a more indepth explanation in the next issue and a workshop in November.

Is sex addiction real? Th ere will always be loved ones, but they disregard these risks as sexual tentatively embraced the concept. Recognising the controversy – as there should be – when any forms acting out becomes an increasing priority. Th ese need to address this issue, the American Psychiatric of inherently healthy human behaviour such as problem sexual behaviour patterns continue Association compiled an exhaustive literature eating, sleeping or sex are clinically designated as despite attempts to stop or change them, review – shout out to Dr Marty Kafka of Harvard pathological. Th e power to “label” should avoid regardless of related life consequences of broken for his dedicated eff orts – toward a potential turning social, religious or moral judgments into relationships, disease transmission or arrest. DSM-5 Hypersexual Disorder diagnosis (2013). diagnoses – as was homosexuality in the DSM-I Sex addicts live with the constant threat of Learn more at www.dsm5.org/proposedrevisions/ and DSM-II Diagnostic & Statistical Manuals. health, career and life goals lost to consistent, pages/proposedrevision.aspx?rid=415. But equal care must be taken to consider, secretive sexual acting-out. Like drug addicts, It might surprise some reading the diagnosis to research and even create diagnostic criteria to compulsive overeaters or gamblers, sex addicts will fi nd the focus of the problem relating as much to address situations where otherwise-healthy lose choice over their sexual decision-making. sexual urges and fantasy as to the sexual act itself. behaviours have gone awry, due to underlying Th e proposed behaviour specifi ers are intended psychological defi cits and past trauma. WHY ACT OUT WITH SEX? to integrate empirically based contributions Let us briefl y counter popular myth. A For reasons as varied as individuals, addictive from many perspectives, including dysregulation sexual addiction diagnosis is not determined by sexual behaviour is a neurobiologically-based of sexual arousal and desire, sexual impulsivity, what turns someone on (such as fetish behaviour drug of choice for emotionally-challenged people sexual addiction, and sexual compulsivity. or polyamory), nor is it defi ned by who turns who abuse sexual intensity and fantasy-based Part two of this article will review the need for someone on (man or woman, transgender, dissociation as a means of emotional regulation. a formal Hypersexual Disorder diagnosis, address younger, older, etc). It is also not derived from Th ese intellectually intact, but often related diagnostic myths and misunderstandings any specifi c moral, cultural or religious compass. emotionally bereft, people use planning and and discuss sexual addiction treatment. And it is not solely a men’s issue, gay or straight. sexual ritual to experience what might be termed Sexual addiction is diagnosed by repetitive “controllable intimacy” (prostitutes, abusing MEET THE AUTHOR IN NOVEMBER: patterns of problematic sexual behaviour in both porn, seeing prostitutes, having multiple aff airs), Weiss will fl y to London to run specialist men and women, over which s/he appears to situations off ering a temporary illusion of meeting workshops in early November, on behalf of have lost control. Th ese sexual behaviour patterns emotional needs without risking rejection, Elements Behavioral Health which is subsidising cause deeply negative consequences in the lives criticism or abandonment – implicit to all truly places at only £60 – or £40 for those who of those acting them out and intimate social and intimate partnerships. attended UKESAD 2012. To reserve your place, Some sex addicts also use sexual fantasy and see the details on page 16 of this issue. the sex itself as a means to self-regulate – gain control over – unconscious triggers to early abuse, ROBERT WEISS LCSW, CSAT-S has written three violation and neglect. books on sexual addiction and is expert on the juxtaposition of human sexuality, intimacy, and technology. He is founding director of The WHAT DOES THE FUTURE HOLD? Sexual Recovery Institute (www.sexualrecovery. Over the past 20 years the concept of “sex com) and director of Intimacy and Sexual addiction” has gained widespread media and Disorders Services at The Ranch in Tennessee public acceptance as well as grudging therapeutic (www.recoveryranch.com) and Promises legitimacy. Driven by a combination of media Treatment Centers ( www.promises.com). attention, the international rise of 12-step sexual He is a social worker, clinical psychotherapist and educator. A media expert for Time, recovery groups, fi lm depictions (Shame, I am Newsweek and the New York Times, Weiss a Sex Addict, etc), along with much-publicised has featured on CNN, The Today Show, problem sexual behaviours Oprah and ESPN. He is also the sex and of major international intimacy blogger for Psych-Central, an online political and sports fi gures, psychology site (@RobWeissMSW). the public appears to have Image: “XY”

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