Sex Addiction Part 2

I recently had a mini-debate with someone in regards to whether or not the word “addiction” was an appropriate word to describe the phenomenon of “sex addiction”. In this section, I will discuss why I think “addiction” is not a suitable word, the other party’s counterargument and my following counterarguments. Please read "Sex Addiction Part 1” first. It explains what the phenomenon of “sex addiction” is, its relation to medicalization, how it reinforces sexual scripts and gender stereotypes, etc.

So I think a great way to start would be to define the word “addiction”. Now, when most people think of an addiction, they think about withdrawal symptoms and trying to quit and being unable to, but that’s not the whole story. Nick Heather, in his article, “A Conceptual Framework for Explaining Drug Addiction,” describes addiction in three parts: “(1) the level of neuroadaptation, (2) the level of desire for drugs and (3) the level of ‘akrasia’ or failures of resolve” (3). To clarify, an individual becomes addicted to a something when they resolve to stop, but fail many times, when they build up a tolerance and suffer from withdrawal symptoms upon trying to stop, and experience neuroadaption, which is when their brain changes permanently as a result of taking the drug. Common examples of permanent changes to the brain would be a decrease in dopamine production or a decrease in gray matter as a result of using the substance, that causes your body to need the substance in order to maintain a state of 'normal' (for lack of a better word at the moment) that non-substance users experience. My argument is that becoming “addicted” to sex is impossible because one cannot become addicted to behaviors. Behaviors do not cause neuroadaption and there has been no empirical evidence that the desire for lots of sex or having lots of sex causes physical changes in the brain. Two counterarguments I have seen for this were “Well, sex releases dopamine so can’t someone become addicted to that release?” and “I stopped having sex for a while and I suffered from withdrawal symptoms. I felt terrible.” To counter the first argument: Yes, sex results in a release in dopamine, many daily activities do. Dopamine is a neurotransmitter that is essential in learning and in making sure we continue to do things that are beneficial to our survival, like eating and having sex. Dopamine is related to feelings of pleasure and its release serves as a reward to the body for performing essential tasks so the individual will continue to do it in the future. However, the release of dopamine does not automatically result in addiction. The release of dopamine in the brain experienced through daily activities is a normal dosage that the body is naturally used to. However, the amount of dopamine released into the system when taking something like cocaine is well over and beyond the amount the body is used to. Cocaine inhibits the reuptake of dopamine, allowing the neurotransmitter to flood the brain. As a result of this unnatural flood of dopamine, the brain decides that it does not need to produce its own dopamine anymore. Now the brain is changed permanently and the user’s dopamine levels are below the norm without the drug. The individual no longer feels naturally rewarded without the drug. This is why many drug users say they need the drug to feel normal. In regards to the second argument, the difference between the experiences one might have after not having sex for awhile versus not taking a drug is that one can actually potentially die from the latter. In their article, “Myth of Sexual Compulsivity,” Martin P. Levine and Richard R. Trioden  agree with me stating: “First sex is not a form of addiction…Sex is an experience, not a substance. Although sexual experiences may be “mood altering,” abrupt withdrawal from sexual behavior does not lead to forms of physiological distress such as diarrhea, delirium, convulsions or death. Vomiting induced by fear of giving up a learned pattern for dealing with anxiety (such as having sex) is not the same thing as vomiting induced by physiological withdrawal from a physically addicting substance” (357). In light of these facts, the word “addiction” is not appropriate and the phenomenon does not fulfill all the necessary requirements to be referred to as such.

Moving away from the biological to more cultural/social perspectives, I want to discuss the main counterargument of the individual with whom I had the mini-debate with. His argument was that discounting the appropriateness of the disease model of addiction in regards to this phenomenon creates a stigma against those who suffer from it. He also specifically mentioned a moral stigma being directed to these individuals as well. My argument is that the term “sex addiction” and all of the connotations and meanings surrounding it create and reaffirm stigmas and stereotypes rather than erasing them. In “Sex Addiction Part 1,” I discussed how individuals who label themselves as ‘sex addicts’ tend to believe that medicalizing this phenomenon removes all the moral judgment and stigma that they otherwise might suffer as if medicine is somehow immune to social influences and morals. I further argued that this is not the case (see post for more). The diagnosis for “sex addiction” actually creates distinctions between “good” sexual behaviors/fantasies and “bad” sexual behaviors/fantasies. “Good” sexual behaviors/fantasies usually exist within the context of heterosexual sex in a heterosexual marriage or committed relationship. Anything else is usually labeled “bad”. Levine et al continues this train of thought, saying, “In addition, as conceptualized professionally, sexual addiction is currently the only type of ‘addiction’ in which the addict is not expected to give up [their] ‘drug’ of choice as a part of the ‘treatment’. As long as sex is ‘used’ in appropriate contexts (such as marriage, a committed relationship), the addict has been ‘cured’. Note that sexual expression is condoned when it occurs in the social contexts that affirm the traditional sexual order, but medicalized as an “addiction” when it falls outside existing norms” (357). Not only does “sex addiction” stigmatize certain sexual behaviors, but it also reaffirms gender stereotypes (see part 1). Another thing to think about is the connotations behind the word “addiction”. Calling this phenomenon/construction an addiction, even amongst lay people in daily life, is not beneficial to those who suffer from it. The word “addiction” is associated with drugs, especially hard drugs that have no real beneficial qualities, due in part to their addictive aspects. It can be implied from this comparison that sex is also inherently bad. We all know this isn’t the case. Sex is generally good. It’s just that when a person feels like that they HAVE to have sex all the time or find themselves constantly thinking about it and it causes them distress or inhibits other aspects of their life, sex becomes negative to them in that situation. In that specific case, the individual should go see a sex-positive therapist as I stated in Part 1. However, we should be careful of the words we use. Words are important. They hold ideas behind them and the words that become commonly used are extremely powerful and we should take care to use words that do not have serious negative effects on the issues we care so dearly about. The term “sex addiction” may be comforting to some on an individual level, but it strengthens societal anxieties about sex by painting different aspects of sexuality in a negative light.

A quick note (more of a P.S.): So I used to subscribe to the term “sexual compulsion” as a substitute for “sex addiction”. After doing the research for and thinking about this blog post, I realized that I was focusing too much on terminology without looking at the bigger picture. Although the term “sex compulsion” fixes the addiction definition issue, it is just as guilty for painting sex in a negative light. Now, I think that giving this phenomenon a special medical name individualizes it and ignores the social issues. I’d rather it not be named and believe that, in therapy, societal factors should be taken into account along with the person’s individual experiences.