The Sex Myth: Why Everything We're Told Is Wrong (6 page)

When women approached doctors with concern about their desires, physicians saw the potential for severe nymphomania. Even behaviour as mild as a lascivious glance could be suspect. Women who did
not respond to treatment might be put in a mental institution. From that point on, their conditions often worsened.

The reports of nymphomaniacs in asylums were shocking – physical attacks, obscene language, violent masturbation. Increasingly this was seen not as an unusual result of extreme treatment
and incarceration, but as a possible outcome for
any
unchecked female libido.

The treatment of Miss T, even the use of leeches and acid, was not unusual for that time. The causes of disease were unknown, so doctors relied on remedies last updated in ancient Greece. They
thought disease came from the body being out of balance. Bloodletting and burning were supposed to bring back equilibrium. Cold water, sedatives, and – yes – a mild diet consisting of
breakfast cereals were supposed to produce positive, calming results.

‘After much soul searching, I have decided to take an indefinite break from professional golf,’ Tiger Woods announced in a press release on his website in December
2009. ‘I need to focus my attention on being a better husband, father, and person.’

The announcement followed revelations of the golf player’s private
life, in particular his numerous affairs. In spite of being married with children, Woods also
pursued sex with glamorous women, models, and hostesses. Woods cited sexual addiction as the cause of his straying and promptly checked in to a treatment centre in Mississippi.

Tiger Woods isn’t the only celebrity name to have been linked with sex addiction.
X-Files
actor David Duchovny has sought treatment for sex addiction; 80s rocker Rick Springfield
admitted to a time in his life feeling that sex was ‘the thing that you use to make you feel good’; Billy Bob Thornton; Russell Brand; Michael Douglas – Hollywood gossip is not
always to be believed but all have reportedly sought treatment for their private peccadilloes. But apparently, if the numbers are also to be believed, celebrities are not the only ones at risk.
According to the National Association of Sexual Addiction Problems, 6–8 per cent of adults are sex addicts.

‘I am deeply aware of the disappointment and hurt that my infidelity has caused to so many people, most of all my wife and children,’ Woods said in his public statement before
entering treatment. ‘I want to say again to everyone that I am profoundly sorry and that I ask forgiveness. It may not be possible to repair the damage I’ve done, but I want to do my
best to try.’

‘Sex addiction’, however, is not a term used as an official diagnosis in the American Psychiatric Association’s
Diagnostic and Statistical Manual
(DSM-IV), considered
the definitive word on psychological disorders.

‘Hypersexuality’ is the term the DSM-IV now uses that is closest in definition to what has historically been known as nymphomania in women and satyriasis in men. The World Health
Organization’s International Classification of Diseases (ICD-10), however, still lists nymphomania and satyriasis as subdivisions of the diagnosis ‘excessive sexual
drive’.
³²

In both cases, the terms refer to a desire to engage in sex at a level that is considered ‘abnormally high’ and ‘causes distress’. It is characterised by a hyperactive
sex drive and lowered sexual inhibitions. In the ICD-10 it falls under the category of ‘Sexual dysfunction, not caused by organic disorder or disease’, but the specific diagnostic
protocol are unclear. Is this then the ‘sexual addiction’ talked about so much in the press and, if so, are celebrities like Tiger Woods especially susceptible?

There are groups such as Sexaholics Anonymous, Sex and Love Addicts Anonymous, and Sexual Addicts Anonymous. These groups are very popular and they do appear to help many
people find some relief from their problems. But outside of the self-organising twelve-step groups, sexual addiction is also a multi-million-dollar industry. There are books and websites, treatment
centres and programmes, and of course private therapists advising concerned clients. Many people benefit from this concept, even though there is debate about whether or not it exists.

In his book
Tabloid Medicine: How the Internet Is Being Used to Hijack Medical Science for Fear and Profit
, Robert Goldberg, PhD, explains how these and similar suspect
‘syndromes’ are created. Turns out, the ‘manufactroversies’, or controversies motivated by profit or ideology to intentionally create public confusion about an issue, all
follow strikingly similar patterns described in Goldberg’s book.

First, a new problem is created by redefining terminology. For example, what used to be commonly thought of as serial cheating or poor impulse control or just a bad husband is redefined as a
‘sex addiction’. The redefinition creates the appearance of a surge in cases, since they will have gone from zero to everywhere, seemingly overnight. The beneficiaries? Pharmaceutical
companies, or anyone else with a health-related public agenda. In other words . . . Agenda Setters.

Then, self-appointed experts claim they have unique insight into the cause of the problem. And, in some cases, the experts have a financial interest in promoting their point of view, such as
books, grants, or treatments.

The next step is when the media gets interested. They need new stories, and want to be the first to break news. The pressure for reporting an exclusive, coupled with underfunded reporting, means
they often relay information – sometimes directly from PR releases – without checking the facts. And once something has been in the news, people assume it’s credible, and that the
media have done the fact checking for them. People who have heard the message often enough start to reframe their own behaviour according to these new definitions. Where before someone might have
been just a cheating jerk, he now can claim to be suffering from ‘narcissistic personality disorder’ or a ‘sex addiction’.

There is no denying that at least some of the people claiming a sex addiction are experiencing dangerous or worrying behaviour. Labels are useful, and have their place.
Defining terms for alcoholism and drug addiction, for instance, helps give a framework where genuinely self-destructive and antisocial behaviour can be addressed. Step One of any twelve-step
programme involves simply acknowledging that a problem exists. But is a fidelity problem
always
the same thing as an addiction? A rich guy cheating on his wife, that’s a tragedy for
the family, for sure. But are we calling someone an addict who is really just the equivalent of a social drinker, or an unpleasant drunk? There’s a line that gets crossed in addictions, and
it’s a pretty extreme one. I’ve lived with addicts and I’ve lived with cheaters. There is no comparison.

In Chinese there is a saying:
(sān rén chéng hǔ). Roughly translated, it means ‘three men
make a tiger’. The idea is that once you’ve heard about something from three different people, you’re likely to take the story as truth without any other evidence. It only takes a
handful of persuasive voices to convince people that something exists, even if it may not.

One of the people most influential in the area of ‘sexual addiction’ is Dr Patrick Carnes, who co-founded the Gentle Path sex addiction programme at the Mississippi treatment centre
that Woods entered. Since 1992 he has written seven books on the topic and numerous articles. He wrote the definition of sexual addiction for the
Comprehensive Textbook of Psychiatry,
and
established the treatment protocol.

His Wikipedia page also notes that he was awarded the distinguished Lifetime Achievement Award of the Society for the Advancement of Sexual Health, a society he co-founded in 1987.

On his website, Carnes gives a more explanatory definition of sexual addiction than either the DSM-IV or the ICD-10. He begins by saying that it is not about a single behaviour. But he does
confirm that it includes some, and/or all, of the following: ‘compulsive masturbation, compulsive heterosexual and homosexual relationships, pornography, prostitution, exhibitionism,
voyeurism, indecent phone calls, child molesting, incest, rape and violence.’

Undoubtedly child molesting, incest, rape, and violence are wrong and should be causes for concern, regardless of whether they happen once or repeatedly. But surely those should be addressed by
criminal
law. And putting masturbation in the same category? Isn’t that a little . . . nineteenth-century thinking?

So, while some of the behaviours Carnes lists are clearly worrying, they are also extremely varied, perhaps too varied to fall under the same diagnostic umbrella. Is masturbation really somehow
related to child molestation? If so, Carnes doesn’t say how. Nor am I aware of any scientific evidence to suggest that this is the case.

Carnes developed the Sexual Addiction Screening Test, a diagnostic tool that aims to assess behaviour that may indicate a sex addiction. (It’s unusual, even in a newly defined
psychological disorder, for one person to have contributed so much to the definition and the diagnosis, not to mention the treatment criteria.)

The diagnostic test is disconcerting at times. Consider, for instance, a few yes-or-no questions:

Because the answers are yes or no, there’s no room for interpretation. For instance, the child of very conservative parents may well hide sexual behaviours. Hiding your
homosexuality from homophobes, in the narrow way the question is phrased, could potentially indicate you are a sex addict. And asking whether anyone has used fantasy as a way to escape problems . .
. isn’t that more or less the definition of a fantasy?

Other questions address things that are increasingly acceptable to many people, and probably done by most. ‘Have you spent considerable time surfing pornography online?’ Since porn
accounts for a large amount of paid content available online, then yes, you can assume a lot more people do it than are willing to be called addicts. Also, how much is ‘considerable’
time? Ten minutes? An hour? Ten hours? Without a guideline as to what the terminology means, it’s ripe for inflation and misinterpretation by its users.

Ditto ‘Have you regularly engaged in sadomasochistic behaviour?’ Hmm – does anyone care to define what is meant by ‘regularly’? Are we talking once a year, or once
a day? I mean, is a gift pair of handcuffs
on Valentine’s Day the slippery slope to residential treatment? Or is there even a definition for what the test considers
‘sadomasochistic’? One person’s saucy spank is another person’s hard-core kink. As with the criticism of female sexual dysfunction studies, it pays to be sceptical of data
collection that relies on broad generalisations and ill-defined categories of severity.

Other questions in the self-assessment quiz seem to come across, perhaps unwittingly, as judging activities that most people would consider normal and not necessarily sexual. ‘Have you
used the internet to make romantic or erotic connections with people online?’ Now, there’s a question that risks judging the millions of people who have found fulfilling relationships
via the internet and labelling them as addicts. And why the internet is singled out for special attention is unclear. People have been finding ways to date and mate with strangers since well before
the world wide web.

But asking these questions about online interaction specifically feeds into the impression many articles give of sex addiction as a ‘new’ or ‘emerging’ phenomenon.
There’s no reason that would be true. After all, sex isn’t new; availability of multiple partners isn’t new. Why would sex addiction be any newer than alcoholism? Suggesting that
internet technology and other modern accoutrements might be a source of the syndrome does not make sex addiction more plausible. That would be like saying alcoholism only exists because of
off-licences.

Other questions seem likely to cause distress: ‘Have you stayed in romantic relationships after they became emotionally or physically abusive?’ I was once in an emotionally abusive
relationship for years. My reasons for staying had nothing to do with sex and everything to do with fear. People stay in abusive relationships for all kinds of reasons, and I doubt those reasons
are erotic. How does the crippling fear of leaving an abuser make someone a sex addict?

My favourite, clearly, is the question that asks, ‘Have you been paid for sex?’

That makes no sense. Since when does being paid for something equate to a pathological obsession with it? You wouldn’t screen people with suspected eating disorders by asking, ‘Have
you ever been a waitress?’ You wouldn’t suss out potential alcoholics by asking if they had ever worked behind a bar.

Another problem is that the test doesn’t specify if you’re meant to give answers about what you do now, or about what has ever happened in the past. It
doesn’t distinguish between happened before and happening now. Hands up who has ever walked out of a sexual encounter unfulfilled, or regretted a particular choice of partner. Isn’t
that part of learning about life and relationships? Answer the questions in the broadest way possible and we’re probably all sex addicts.