The DSM threw out sex addiction, but should our culture do the same?
I’m sorry Tiger Woods. I’m sorry Anthony Weiner. I’m sorry Russell Brand, David Duchovny, Amber Smith, Eliot Spitzer and myriads of future celebrities that will undoubtedly grace us with on-air mea culpas and pleas of sex addiction—the latest edition of the DSM-5 may be shutting down your port.
It’s long been contested whether hypersexuality is actually a mental disorder, whether those claiming to have sex addiction really do have a variation in brain function or a unique chemical component that makes them kind of want to hump everyone in sight.
UCLA researchers seeking to find the answer took to studying so-called sex addicts who had trouble controlling how many sexual images they viewed. As it turns out, the brain scans didn’t reveal an indication of hypersexuality as much as a significantly high libido. So, what does that mean? Have we been typifying extremely horny people as sex addicts since 1983 when Patrick Carnes first introduced us to the concept? Did we diagnose eros as impulsivity because it was a neat buzzword?
Nicole Prause, leader of this study, says that the behaviors typical of a sex addict—unrestrained high-risk behavior sometimes leading to the collapse of marriages and wallets—could also be caused by non-pathological high sex desire. The study focused on 52 volunteers, 39 men and 13 women, ranging in age from 18 to 39, who reported having problems restraining themselves from looking at sexy pictures, which is something common for those diagnosed with hypersexuality. The volunteers filled out detailed questionnaires about their basest proclivities and behaviors.
The study used an EEG to measure brain wave responses after specific events, in this case looking at varying unpleasant and pleasant photos. Photos of car wrecks, prom photos, and money shots—the brain has a reaction to all. The researchers were keen on tracking what they call the P300 response, or the brain’s response 300 milliseconds after seeing an image. P300s have proven to be much higher when the brain is excited by new and interesting stimuli in previous studies (and for drug addicts, pictures of their go-to vice). But the results puzzled the scientists; the P300 level wasn’t spiking in correlation to reported severity of sex addiction like they thought it would. “In other words, hypersexuality does not appear to explain brain responses to sexual images any more than just having a high libido,” Prause concluded.
Wading through the science, what the UCLA study really just means is that the DSM-5 can keep sex addiction out of its pages for a while longer. There’s no biophysiological data to give it legs. We can’t tell if people are sick or just lascivious.
What is an addiction, anyway? We broadly classify it as continued and uncontrolled use of a substance or behavior despite known harmful consequences. Certainly sex can be filed there. The other, older and decidedly more clinical definition sees it as a compulsive need for and use of a habit-forming substance characterized by a built-up tolerance and by well-defined physiological symptoms upon withdrawal. Besides cracked knuckles from banging on doors, chafed skin from porn marathons, and becoming unpopular amongst friends, there aren’t any known bodily symptoms of withdrawal for sex addiction.
While some could argue sex addicts behave in increasingly escalating high risk behavior to have sex—there isn’t much of a built-up tolerance. Presumably, a penis and a vagina still can have an orgasm with the same amount of sex, unlike heroin addicts who need need more for their fix. Sex addicts just want it in binges, novel packages, obsessively, and insatiably. It’s not a drug that will give you the shakes and lead to death, and so, scientists might argue, it’s not a drug that can really get you hooked (the same argument holds for other purported addictions like food and gambling). Those we consider sex addicts might be just what they’ve always appeared to be before they got an umbrella: priapically-transfixed and helpless individuals.
What would it mean to the modern world if we eschewed the diagnosis of sex addiction away from the pearly gates of the medical world? Hopefully not the demise of nude Michael Fassbender vehicles and hopefully not the dismissal of those who speak out about their impulses in the hopes of getting treatment. After all, even if something isn’t clinical, it can still raise real issues. Culturally, we’ve felt safe with the term sex addict. It comforts us to have a boxed and bowed allotment for those with inexcusable behavior, behavior some people find reprehensible. Those in the spotlight Tweeting bumps in their boxer shorts and filtering through an endless line of mistresses grab the term by its neck and squeeze out an excuse. Maybe Don Juanism is a true power enslaving thousands or maybe sex addicts are just walking ids. If we lose the diagnosis, maybe the alternative is too culturally frightening, too invasive of the "family values" we work tirelessly to preserve. A group of healthy, normal-brained people who simply comply to their Dionysian impulses. We might be better off keeping our sex addicts.