Unlike for alcohol or drug addiction, there is no formal diagnosis for Sex Addiction in the American Psychiatric Association’s Diagnostic Statistic Manual (DSM IV). According to Chester Schmidt, chair of the DSM-IV Sexual Disorder Work Group, there is “no scientific data to support a concept of sexual behavior that can be considered addictive. (1)” Schmidt believed that what is called sex addiction is more likely a symptom of other psychological problems like depression, obsessive-compulsive disorder, or bipolar disorder.
According to Benoit Denizet-Lewis (2), "Believers in a sex-addiction diagnosis point out that for many years, doctors and psychiatrists similarly dismissed alcoholism, refusing to accept that it was a serious problem in itself, not merely a symptom of something else." Many of practitioners in the sexual addiction field are hopeful that the DSM V, which is due out in 2012, will include expanded diagnostic choices for process addictions, including sex, gambling, spending, eating, and/or religion addictions. According to Elizabeth Hartney, "a working group of professionals has recently suggested diagnostic criteria which may be considered for the next edition of the manual, due to be published in 2012."
According to John M. Grohol, Psy.D. (3) "What is both amazing and a little disturbing, however, is to see entire professional societies, such as the Society for the Advancement of Sexual Health, spring up around a disorder that isn’t even officially recognized as such. And despite no clinical agreed-upon criteria for sex addiction, the Society estimates that 3 to 5% of Americans have it." According to the Mayo clinic, sex addiction is estimated to affect 3 to 6 percent of adults in the United States.
Because sex is a part of normal human functioning, it is difficult and at times a scientific challenge to compare sexual addictions to chemical addictions. Both "normal" or pathological (addictive) sexual patters are open to diverse and often controversial definitions. Clearly, factors such as personality, psychopathology, gender differences, sexual preferences, cultural differences, socio-economic status, and other "filters" have made a clear consensus for a definition of sexual addiction that much more challenging. Making matters even more complicated is the fact that topic of sexual deviance and/or sexual pathology remains as one of the most taboo topic in our society. Individuals with a sexual addiction are often the subject of ridicule and harsh judgment, whereas others suffering from drug/alcohol or other more accepted process addictions, ie gambling, spending, elicit more social acceptance.
Another ironic twist is that the co-founder Alcoholics Anonymous, Bill Wilson, was considered a sex addict. According to biographers and Alcohol Anonymous historians, Bill Wilson not only was an alcoholic, but was also a sex addict. Wilson was flirtatious, had multiple affairs, and according to biographer, Susan Cheever (4), "had an inability to regulate his behavior with women” and was “often accused of groping and unwelcome fondling,” However, he was married to the same woman for 53 years.
Until sex addiction is formally included in the DSM V, we currently derive a "diagnosis" through assessments protocols specifically designed for this addiction. Such protocols are provided by specially trained qualified mental health practitioners. Clinicians, such as myself, utilize uniquely designed instruments that are designed to collect relevant information necessary for a diagnostic conclusion. Information collected during the assessment includes: sexual history, drug/alcohol history, psychosocial assessment, mental health history, and other relevant information. Additionally, an assessment involves interviews with the client, affected partners, i.e. spouse or partner, and if possible, mental health providers who have or who are providing services to person being evaluated.
According to data collected by Patrick Carnes, many sex addicts also have other addictions. For example, in Carnes' research, of the individuals who were diagnosed with a sex addiction, 42% were chemically dependent, 38% had an eating disorder, 28% were compulsive workers (workaholics), 26% were compulsive spenders, and 5% were compulsive gamblers. Ruling out cross addictions is an important component of the assessment. Because of the high prevalence of cross addictions, the sex addiction evaluator must have a background in the general field of addictions.
When a cross addiction is present, it is important to identify which addiction requires attention first. This is crucial when it is determined that the sex addict is also addicted to a drug/alcohol. In these cases, detoxification (detoxing) of the drug may require medical services in order to ensure that the client physical health is not compromised. The experience of physical withdrawals can potentially create medical risks.
As many practitioners and sex addicts know, that despite a formal recognition of this disorder, it is indeed very real. Lets the intellectuals battle out what is and what is not a diagnosis. In the meantime, lets provide the much needed services to those who are suffering from this disorder.
(1) (http://psychcentral.com/blog/archives/2008/09/30/is-sexual-addiction-real/)
(2) www.americaanonymous.com
(3) psychcentral.com/blog/archives/2008/09/30/is-sexual-addiction-real
(4) http://nymag.com/nymetro/arts/books/reviews/n_9880/
(5) http://edition.cnn.com/2008/HEALTH/09/05/sex.addiction/index.html
(6) http://addictions.about.com/od/sexaddiction/a/sexaddiction.htm
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