Last night, Nightline aired this eight-minute segment about sex addiction. It was—as is typical with stories about sex addiction—rife with misinformation, knee-jerk analysis, and lazy reporting.
Anchor Cynthia McFadden framed the segment by asking this highly unoriginal question: “Is sex addiction just an (pause, quick tilt of the head to signal an important word coming) excuse?” This is the preferred question of people who first contemplated the concept of sex addiction three weeks ago when they heard about Tiger Woods and haven’t dug very deep since. But let me try to answer the question: No, sex addiction is not “just an excuse.” You know what’s just an excuse? Promising you’ll stop tomorrow and then not stopping. Blaming your behavior on your “unusually high sex drive.” Blaming your wife/husband/partner for not having sex the way your favorite Internet porn star does, then using that as a rationalization to have unprotected sex with escorts/prostitutes and not tell your wife/husband/partner wife about it. Blaming the stress of your job for why you should be allowed to spend half your work days watching porn. Blaming the city where you live for routinely skipping out on friends or family to chase sex all day (“There are so many hot people in New York City, how can you not want to fuck them all?” is a common one).
Those are just few of the actual excuses that people make before their lives get small and depressing and pathetic enough to stop and say, “Wow, my life sucks. I’ve been making excuses and denying what’s really happening for years. History has proven beyond a reasonable doubt that I can’t seem to control this on my own. Maybe I need help. Maybe I am really addicted to this.” Calling something an “addiction” and seeking recovery from that addiction doesn’t mean that one gets to avoid taking responsibility for ones actions. The opposite is true. Recovery is about honestly taking responsibility, sometimes for the first time.
(There was a time in this country when we didn’t believe in alcoholism. That term was seen by many as an “excuse,” a way for people not to take responsibility for their actions. Now science and common sense tells us that some people are, indeed, addicted to alcohol and drugs. Next came gambling addiction. There is no substance involved, people argued, so can it really be an addiction? And won’t be abdicating personal responsibility if we call it an addiction? Well, now we know that some people are indeed addicted to gambling. To call oneself a gambling addict doesn’t mean you don’t have to pay back the money you owe. In fact, someone is much more likely to make restitution when they are in recovery.)
A minute into the Nightline segment, reporter Chris Connolly asks this nonsensical question: “If Tiger Woods is a sex addict, some say, well, who isn’t?” I’m not sure what Connolly is getting at, but if I had to wager an answer, I might say, “People for whom sex is still fun and meaningful instead of being sad and compulsive.” Connolly then goes on to wonder, “Others ask, is there even such a thing as sex addiction?”
Enter Dr. Marty Klein, a “sex therapist” and one of the country’s loudest critics of a sex addiction diagnosis. When Connolly tells him, “Some people describe thesmelves as sex addicts,” Klein responds with this zinger: “Well, some people describe themselves as being invaded by the devil, but that doesnt make it true.” The comparison is idiotic, not to mention a cheap shot.
Then, over some grainy photos of people smoking and drinking (not sure what the connection is to sex addiction), Connolly bonds with his skeptical viewers by saying, “The idea of sex addiction can sound like a get-out-of-the-doghouse-free-card, a medically certified, image-rescuing excuse for catish behavior.” Yes, Chris, it can sound like that, especially when you haven’t thought about it for more than five minutes or looked into the research and science behind it. But, as a reporter working on a story about sex addiction, you could, for example, have made the distinction between a celebrity who may be trying to rescue his image by going to sex rehab (although it’s debatable whether publicly copping to a sex addiction is the smartest way to rescue an image, which might explain why so few celebrities have done it) and the 99 percent of people who go to treatment who aren’t famous and don’t have an image to rescue.
Next, in an interview with a sex addiction specialist, Dr. Reef Karin, Connolly offers up more knee-jerk conventional wisdom. “A lot of people are thinking, sex addiction, that’s a way to take something that guys just normally do and turn into something that sounds like an illness. It’s like an excuse.”
Then it’s my turn. You can see me walking down the block with my dog, reading a book on the couch, and then trying to explain what sex addiction is actually like. I’m followed by Dr. Klein, who argues that sexually compulsive people should be treated for OCD, not sex addiction. “When people have obsessive-compulsive disorder, sometimes they wash their hands fourty times a day, and sometimes they act compusliveley sexually or on the internet,” he says. “We dont send people to hand-washing clinics, and we shouldn’t be sending people to sex-addiction clinics. People should be treated for obsessive-compulsive disorder.”
An argument can be made (and some people have made it) that sex addiction is a form of obsessive-compulsive disorder, but treating is as such has not proven effective, and most people who treat sex addicts have long moved past the OCD diagnosis. The truth is that Klein’s main problem with the concept of sex addiction is that he considers it to be sex-negative. The author of America’s War on Sex, Klein has devoted much of his career to fighting against the idea that any sexual expression beyond monogamy should be discouraged, feared, or stigmatized. (I actually share his belief that we have far too much hypocricy and misplaced morality around sex.) But Klein has let his political beliefs about sexual freedom keep him from accepting what most therapists and addiction researchers now understand: that sex and pornography can be addictive for some people.
(In my book, America Anonymous, I write about one addiction researcher—Dr. Peter Martin, a psychiatrist and the director of the Division of Addiction Medicine at Vanderbilt—who used to share Klein’s skepticism about sex addiction. Ten years ago, Martin would have dismissed any comparison between sexual compulsivity and alcoholism or drug addiction. Drugs and alcohol are foreign substances. Sex is natural—a basic biological drive. Clearly, Martin thought, a case of apples and oranges. But using MRI technology, Martin began studying how people’s brains react to sexually arousing images. He now believes that there are “many behaviors, including sex, that appear to be driven by the same brain mechanisms that drive addictions to drugs like cocaine and heroin.”)
When Klein is finished misrepresenting how sex addicts should be treated and Nightline has been sure to reference the comedy Blades of Glory, where Will Ferrell plays a sex-addicted figure skater, Karim and Connolly have the following exchange:
Karim: “I get asked a lot by men, ‘Doc, am I a sex addict?’ Most of the time I say, ‘No, you’re just a jerk.'”
Connolly: “Do you often have to disappoint patients by saying, ‘You’re not a sex addict.'”
Karim: “Yeah, I’ve had a couple of patients that I’ve been, like, ‘Okay, I’ve looked at your neuropsychological testing. You did not meet criteria for sex addiction’… He was super disappointed.”
It’s an odd and misleading exchange. For one thing, Connolly asked Karim if he often disappoints people by telling them they aren’t an addict. Karim says yes and then adds that he’s had a couple of patients like that. Often and a couple are worlds apart. The reality is that the vast majority of men are not eager to be called sex addicts and will go to remarkable lengths to a) hide their compulsive sexual behavior from their therapist, or b) convince their therapist that they may have a small problem with sex, but that they’re definitely not a sex addict.
Connolly’s question, and Karim’s answer, play right into the erroneous belief that people are banging down the doors of therapist offices and sex rehabs demanding to be labeled a sex addict in order to avoid taking personal responsibility for their behavior. Again, the opposite is true. Sex addiction is still highly stigmatized (when it isn’t being ridiculed), and though some people do find hope in a sex-addiction diagnosis and a course of treatment, the vast majority of sex addicts spend years denying that they have a problem or that they are truly addicted. Denial of one’s condition is probably the most common characteristic of all addicts. In her terrific book, Lit, Mary Karr quotes an addict friend of hers who puts it succinctly: “I have a disease whose defining symptom is believing you don’t have a disease.”