Sex Addiction or Sexual Compulsion?

This piece was originally published on the Blowfish Blog. I wasn't planning to reprint it here, since after it came out some errors in it were called to my attention (specifically on the neuroscience of addiction). But the Blowfish Blog archives are apparently no longer on the Internets, and the original piece is no longer available. So in the interest of completism and making all my published works accessible, even the ones I no longer totally support or that are no longer relevant, I'm going ahead and posting it here.

Let's start with something we can all agree on. Some people have a hard time controlling their sexual behavior. Some people have sex in ways that damage themselves, and damage others... and they keep doing it anyway. Some people pursue sex -- specific sexual activities, or just any kind of sexual pleasure generally -- in ways that seriously interfere with their lives: ways that screw up their relationships, or create financial hardship, or even injure their health. And despite this harm, despite the fact that their behavior is making them unhappy, they don't seem to be able to control themselves, and they keep doing it anyway.

I don't think anyone would disagree with that.

Does this mean these people are "sex addicts"?

My immediate answer is No.

And my non-immediate answer, my answer after long and careful consideration, is also No.

No, no, no, no, no.

Abso-fucking-lutely not.

The right word for this behavior is "compulsive." Or "obsessive." Or "fixated." Or "self-destructive." Or "harmful."

Why?

Why am I so passionately opposed to the very concept of "sex addiction"?

Why am I being such a stickler about this language?

Part of my problem is that the word "addiction" has a particular pharmacological meaning. It's a specific relationship to a particular set of drugs, such as heroin or cocaine or alcohol: needing higher doses to get the same effect, withdrawal symptoms when the drug use stops, etc. It's a fairly specific concept. And it's a different concept from compulsive behavior, or self-destructive behavior, or having a hard time stopping a certain behavior. To say that people are "addicted" when they're being compulsive about exercise, or working, or collecting things -- or sex -- is just not accurate.

But I'm not usually this much of a stickler about definitions. Quite the opposite. In fact, regular readers may be getting very confused at this point: I'm usually an ardent usagist when it comes to language, a descriptivist rather than a prescriptivist, and I've defended this non-stickler position with great passion and waving about of hands. I think words mean what they're generally understood to mean by most of the people using the language, and I think it's nonsensical to complain that a word "really" means X when most people speaking and hearing it think it means Y. I understand that the meanings of words change over time. And I'm generally fine when words with specific, technical meanings acquire different meanings in casual, colloquial conversation.

So why am I being a stickler about this one?

Why do I get my panties in a twist about the phrase "sex addiction"?

Partly it's because, although I am usually a happy- go- lucky usagist when word meanings change, I'm more of a stickler when a word's original meaning is useful -- and there isn't another word to replace it. (I object to the word "literally" being used as an intensifier, for instance, not because "that's not what the word really means," but because we don't have another word to express the concept that "literally" used to express.)

And this is definitely true about the word "addiction." The concept of "a specific pharmacological relationship to certain drugs, characterized by withdrawal symptoms, needing increasingly higher doses, etc." is a useful one. It's a very different concept from "any sort of obsessive or compulsive behavior that people have difficulty stopping." And while these two concepts are obviously related, the distinction between them is worth preserving.

But in the case of the word "addiction" -- and especially in the case of "sex addiction" or "porn addiction" -- there's another reason I'm being a stickler. And it's a far more important one.

The word "addiction" has, I think, certain implications. They're implications inherent in the original technical definition of the word, and they carry over into the colloquial, casual, non-technical use.

And they're implications I think are grossly inaccurate, wildly misleading, and seriously harmful when they get applied to sex.

The word "addiction" refers to a specific kind of relationship: not just with drugs, but with specific drugs. Some drugs are addictive -- others are not. Heroin and cocaine and alcohol, for instance, are addictive: marijuana is not. People can certainly form unhealthy relationships with weed -- but those unhealthy relationships don't include withdrawal symptoms, needing increasingly higher doses to get the same effect, etc. People can and do get those symptoms with heroin and cocaine and alcohol. That's what addiction means.

So as a result, we tend to see addiction as being a problem that's rooted in the substance itself. We tend to see addiction as a problem, not with the quirks of the human brain, not with the way certain human brains deal with certain drugs, but with the drugs. We're obviously not very consistent about this -- we happily demonize heroin and cocaine, while we have a much more accepting attitude towards alcohol -- but we still tend to see the harmful potential of addictive drugs as somehow inherent in the drugs themselves. Maybe we shouldn't -- okay, we definitely shouldn't -- but we do. And while this isn't the most useful attitude towards drugs humanity has ever come up with, there is a grain of truth to it. Our relationships with addictive drugs are different from our relationships with non-addictive drugs. Or they often are. I certainly don't think it makes sense to demonize addictive drugs... but I do think it's reasonable to acknowledge that they often have a different effect on us, and to set them apart in some ways.

But this is a very, very bad approach to take when we're talking about sex.

And it's an approach that feeds into our culture's existing demonization of sex. The concept of "sex addiction" treats sex as an experience that is inherently harmful: an experience that has financial disaster and screwed-up relationships and ruined health somehow inherent in the experience itself.

When we're talking about people having a hard time controlling their sexual behavior, "compulsive" or "obsessive" are much better words. Because when we talk about compulsive or obsessive behavior, we understand that the problem doesn't lie in the specific thing being obsessed about. We understand that people can get compulsive about anything: work, exercise, eating, falling in love, collecting Simpsons memorabilia. In fact, we understand that people tend to get compulsive about positive, pleasurable experiences, experiences that are central to human existence. We don't blame work or exercise, food or love, for the fact that some people get compulsive about them.

And sex should be in that category. It's not a substance, like heroin or alcohol, that people can form pharmacological dependencies on. It's a fundamental human behavior, like eating or working or falling in love: a behavior that, tragically but understandably, some people get destructively compulsive about.

But when we talk about "sex addiction" -- as opposed to "sexual compulsion" -- it places the blame on sex itself. It treats sex, not as a positive and necessary part of human life that can sometimes go wrong, but as a dangerous and harmful substance: best avoided entirely if at all possible, to be treated like a minefield if you absolutely have to engage with it.

And that's both denigrating to sex, and flat-out mistaken.

I would never deny that sex can be harmful. Anything can be harmful. And I think it's quite possible that sex has more potential to cause harm than many other human behaviors. Sex is a powerful drive, an irrational, deeply ingrained, lizard-hindbrain urge: it has hundreds of millions of years of evolution powering it, and our fears and desires and feelings about it run deep and hard. We're not going to be as smart or as self-controlled about it as we are about, say, collecting Simpsons memorabilia. Strong drives have more potential to go wrong, and to go wrong more badly. That's true of hunger, and fear, and pleasure, and competition, and family loyalty, and love: these experiences are powerful -- which means they have more power to screw us up.

But these experiences are also our most fundamental ones. They have the power to harm us, of course -- but they also have the power to give us joy, to inspire us towards greatness, to take us out of ourselves, to connect us with our future, to keep us alive, to engage us with the world.

We're not going to cope with the problems they create by treating them like poison... as if evil and destruction were woven into their very core.

Comments

[Aardvark Cheeselog]

I am not sure from your introductory remark just what part of this you want to retract, so maybe this comment is superfluous, but: the word "addiction" has never had the kind of reality-based technical meaning you seem to be attributing to it here. In connection with drug use, the concept is arguably a reification just as much as the idea of a "sex addict" is.

[Nathaniel]

For the unenlightened, what changes or amendments would you make to this article?

[John the Drunkard]

Thanks Greta;

Remember, it wasn't so long ago (early '80s) that cocaine was described as 'non-addictive' because it didn't match opiates' withdrawal symptoms.

Another point: one of the most consistant behaviours of addicts is RESUMING USE after complete withdrawal. Even the most artful heroin user cannot guarantee a continuous supply; most junkies go through withdrawal many times, alcoholics regularly go on the wagon.

Still and all; the reckless use of 'addiction' to describe compulsive behaviors is stupid and dangerous. Drugs are NOT 'all the same' and obsessive/compulsive behaviors are NOT the same as addiction.

Some of the problem is just trendy carelessness with words. Some is the pernicious 'therapising' of every problem. One-size-fits-all 'treatment' by pseudo-recovery 'professionals.' is a racket.

[Greta Christina]

For the unenlightened, what changes or amendments would you make to this article?

This is embarrassing to admit... but I don't remember exactly. The link to the original piece is broken, which means the comments correcting me are also missing, and I don't remember the precise content -- just that I got stuff wrong. If memory serves, it was along the lines of what Aardvark Cheeselog said: the distinction between addiction and compulsion is not as clear-cut as I'd thought it was, and there's some evidence that non-drug behaviors can act chemically in the brain in the same way as addictive drugs. But that's a reconstruction from memory, and I may not have it exactly right.

[Beth]

Hi Greta--

You stated that marijuana is not addictive; this is (mildly) incorrect. While some may make a distinction between physical vs psychological addiction, the fact of the matter is that the brain is part of the body. It's *all* physical. The withdrawals are so mild that many may not notice or correctly attribute the symptoms, but people are known to be grumpy, edgy, and have an overall unpleasant feeling upon cold-turkey cessation of regular marijuana use.

And I absolutely agree that calling it a sex addiction is crap. It's a compulsion and should be treated as such.

[Kerry]

I have to agree that some non-drug behaviors can have a similar chemical response in the brain. There have been studies linking the symptoms of love and how the brain processes love chemically with cocaine addiction. In this respect there certainly can be love addicts. I am unsure of whether sex can be an addiction though.
Link to abstract of a particular study:
http://onlinelibrary.wiley.com/doi/10.1002/cne.20772/full

[Gene C.]

This is the first entry of your blog I have read and I was stunned; it is profoundly insightful and so well-written that I now feel compelled to read all the previous posts. That's not meant as flattery but as a statement of fact. And that's all I have to say... for now.

[Chris]

Spot on

[MissCherryPi]

Have you read Marty Klein's article on this? It's old, but he's a clinical psychologist and might help if you are looking for more technical info. http://www.sexed.org/archive/article08.html

[Jurjen]

Re: Beth's point concerning the addictiveness (or lack thereof) of marijuana, I read a study commissioned some years ago by the Dutch ministry of justice (and I wish I could find it again) concerning chronic, heavy users of cannabis, and the findings were that such individuals almost to a man had several other substances and/or activities (notably tobacco, alcohol and gambling) they also indulged in compulsively.

The report therefore tentatively concluded that the cannabis itself wasn't the main problem, but rather the personalities of the users.

[deleted]

This comment has been deleted, as it was posted falsely and maliciously under someone else's name. -GC

[BH]

Really interesting point of view. I'm a recovering sex "addict" and must say that I tend to agree with most of this post.

I've never fully embraced the sex addiction terminology, although its become so popular that I find it hard not to use it. It does have negative connections though that I don't support at all. For starters, even as a recovering "addict", I'm still having regular sex, because I consider it normal to have sex with my girlfriend of more than 10 years.

I'm not going to stop doing that.

I would like to stop some of my compulsive behaviour. Like looking at porn, or going to strip clubs or brothels. Those things aren't useful or healthy and I don't really need them, but that's just a small part of a much bigger picture.

[Sex Addiction Treatment NYC]

I conceive this website has got some very great information for everyone. “There is nothing so disagreeable, that a patient mind cannot find some solace for it.” by Lucius Annaeus Seneca

[Thelma Jones]

If for you they are not sex addicts, for me, they are considered as one. No matter what they call themselves, I can still classify them as sex addicts. However, it is not an issue that must be ignored only. If they continue being one, they are prone to having diseases.