02 Jun

Thoughts on a critique of sex addiction

Posted By Politybooks

Barry headshotSince the late 1990s, I have been teaching an undergraduate course on the history of sex. Students are fascinated by the topic. They are open to the idea that homosexualities have a history, that heterosexuality and pornography are relatively modern sexual constructs, that we can talk of a period of sex before sexuality (the subject of my previous, co-authored, Polity book), and can grasp the rapidly shifting concepts of what we now call trans. However, despite a willingness to think historically and critically, they have remained resistant to any questioning of the viability of sex addiction and the sex addict as categories.

This is because the idea of sex addiction has become firmly entrenched in our cultural consciousness, to a point that it is simply taken for granted, an assumed – and uninterrogated – explanation for socially disapproved sexual behavior. Sex Addiction: A Critical History, by Barry Reay, Nina Attwood, and Claire Gooder, tells this short history. And it is a critical history. By the time that we had finished our project, the Emperor, as the old saying goes, was stark naked.

Usually in projects of this sort the topic becomes more complicated as their search, writing, and thinking progress. But we found the opposite. Things became clearer and clearer. The sex addict did not exist before the second half of the twentieth century. Now the notion of perceived, out-of-control, sexual behavior is a cultural common place. The claimed disorder is used constantly: to account for the actions of celebrities, to summarize the theme of a movie, to condemn the effects of pornography, to sell treatment programmes, as a rationalization for arange of perceived complaints that could be explained by other diagnoses.

Although sex addiction is a spurious ailment, it has to be taken seriously as a phenomenon. Rarely has a socio-psychological discourse taken such a hold on the public imagination. Its success and unquestioning acceptance at the academic level is remarkable too – which should be noted before any judgments about its role in the media and popular culture.

Though definitely in a minority, there are critics of the concept: Lennard Davis, Janice Irvine, Helen Keane, Marty Klein, David Ley, Charles Moser, and Jerome Wakefield spring to mind. But ours is the first sustained history of sex addiction and the sex addict.

What, in summary, are some of our findings?

1. We dispute the claim that the concept of sex addiction has a long history. Effectively, sex addiction begins in the twentieth century. What came before bears little relation to modern notions of sexual excess.

2. While we explore the influential role of Patrick Carnes in the establishment of what has been termed the sex addiction industry from the 1980s onwards, we have found that it had earlier origins: in the 1970s with therapeutic self-help groups and in the work of Jim Orford, Stanton Peele, and Lawrence Hatterer, but even earlier with 1950s and 1960s pulp fiction.

3. We set out the central tenets of sex addiction as a malady, how the disease has been defined, built and reinforced through an industry of therapists and therapy-speak; in workbooks for addicts and partners, and textbooks for clinicians; through websites, and social networking services. What we call Addictionology 101.

4. We discuss the cultural habituation of the concept, and the role of the press, Internet, TV, film, literature, and even library classification in this process, and the manner in which the supposed malady has become the unthinking default explanation for any kind of promiscuous or obsessive sexual interaction.

5. We deal with the sexual stories in sex addiction’s celebrity literature, interrogating the actual content and context of these claimed instances of sexual addiction: from Bill Clinton to Mike Tyson, from Russell Brand to Tiger Woods. We analyze the non-celebrity chronicles that have been harnessed to the machine of the therapy industry, and also the numerous guides for the families and partners of sex addicts. Ironically, for those offering hope and release from the disorder of sexual excess, some of these memoirs contain prose almost as explicit as offerings on the pornographic market.

6. We interrogate the contradictions in the actual definitions and diagnoses of this claimed disorder. What is truly remarkable is that investigators have spent so much time and energy devising tests for a syndrome without actually questioning the veracity or viability of the thing being tested. But we take nothing for granted in our book, detecting diagnostic vagueness, imprecision, confusion, and weird scales of measurement, what one study has termed ‘many conceptions, minimal data’. Tellingly, this is discussed in a chapter called ‘Diagnostic Disorder’.

7. The same muddled thinking is reflected in actual therapy, also discussed, where there is little or no scientific, peer-reviewed evidence that any of the treatments for sex addiction have been effective. This includes the role of psychopharmacy. Indeed the use of drugs, given contestable diagnoses and the likelihood (as we see it) that the ailment is fictional, makes for some worrying scenarios.

8. We consider (amidst all this scientific imprecision) the unsuccessful quest by sexual addiction (as ‘hypersexual disorder’) for inclusion in the ‘Psychiatric Bible’, DSM-5 (2013), and its earlier bids for diagnostic legitimacy and the substantial insurance treatment reimbursement and research dollars that would have accompanied such recognition.

This book is a critical history of an archetypically modern sexual syndrome – an examination of the power of an idea and its social context. We argue that this strange history of social opportunism, diagnostic amorphism, therapeutic self-interest, and popular cultural endorsement is marked by an essential social conservatism: sex addiction has become a convenient term to describe disapproved sex.

Perhaps those who suffer from ‘sex addiction’ should read our book before embarking on costly and unverified therapy.

Barry Reay is one of the most foremost and influential historians of sex and sexuality, and holds the Keith Sinclair Chair in History at the University of Auckland. His book Sex Addiction: A Critical History co-authored with Nina Attwood and Claire Gooder will be published by Polity in June 2015