After the recent murders of eight people in Atlanta, law enforcement officials said the 21-year-old suspect claimed to be suffering from “sex addiction” and offered this as both an explanation for his behavior and proof that the killings—the victims of which included six Asian women—were not racially motivated.
Sex addiction, however, cannot explain or prove anything.
Why? Because sex addiction does not exist.
It’s not surprising to hear sex addiction offered as a justification for murder, as it has long been used as an excuse for behavior from the ordinary (cheating on your wife) to the reprehensible (sexual harassment). Over the years, when public figures like Tiger Woods, Anthony Weiner, or even Harvey Weinstein got called out for their behavior, their first instinct (or maybe their publicists’ first instinct) was to blame sex addiction and check into rehab. At the same time, Hollywood has used the concept as a plot for both raunchy comedies and Lifetime thrillers.
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Despite this media attention, sex addiction is not a legitimate psychiatric diagnosis. And many mental health experts fear that treatments for it—such as the program that the Atlanta suspect reportedly attended—do more harm than good.
It’s not an addiction
In everyday conversation, we use the term addiction to describe things we really like and don’t want to give up: I am addicted to ice cream; she’s addicted to her Peloton; he’s addicted to pizza.
The clinical definition is different.
Nicole Prause, a neuroscientist and psychologist who studies sex, told Rewire News Group that addiction “generally involves consuming a substance that evokes reward and pleasure initially,” but over time the motivation “changes to taking the substance to avoid negative physical and mental symptoms of withdrawal.” There are two other important components of addiction, according to Prause: Those with an addiction develop tolerance, which means eventually they require more of the substance to achieve similar effects, and the addiction leads to problems in their life.
Some researchers argue that sex—or, more often, pornography—qualifies as the kind of substance that triggers true addiction. They point to functional MRIs that show similar parts of the brain light up when viewing pornography as light up when taking cocaine. Prause does not deny this, but says it is somewhat of a meaningless finding.
“These are the same brain areas that become active when you view pictures of babies, for example,” Prause said.
Sex and porn use don’t meet the other elements of the definition of addiction—people typically continue to get pleasure from these activities, they don’t have withdrawal symptoms, and they don’t need more and more to get the same reaction.
Self-diagnosis based on guilt
Most “sex addicts” diagnose themselves. In a piece last week for the Conversation, Joshua Grubbs, a researcher at Bowling Green State University, explained that such self-diagnosis usually comes from a disconnect between one’s beliefs and behaviors. He writes:
“It seems that conservative moral beliefs about sexuality, particularly those associated with conservative religiosity, lead some people to interpret behaviors like even occasionally watching porn as signs of an addiction.”
These people actually watch porn less than others but feel worse about it, according to Grubbs.
The World Health Organization does recognize compulsive sexual behavior as a type of impulse control disorder that can include excessive masturbation, obsessive pornography viewing, or risky sexual encounters. The focus of the diagnosis, however, is not on the behaviors but on the compulsivity or impulsivity and the damage it is causing in the person’s life. Dr. Charles Moser, a clinician and author, uses the analogy of the person with obsessive-compulsive disorder who is compelled to wash their hands multiple times in a row. We don’t say that this person has a handwashing problem.
The truth, according to at least one study, is that 90 percent of people who seek treatment for sexual addiction have some other underlying mental health issue—most often depression. Hypersexuality can also be a symptom of the mania associated with bipolar disorder.
Treatment may be harmful
Unfortunately, if they seek treatment for sex addiction, they likely won’t find the help they need for these underlying disorders. Instead, they’ll find reinforcement of their negative feelings about themselves.
Prause explained that many of the treatment programs are secretive about their exact methods, but she has talked to people who have been through these programs and some clinicians trained to run them. She found they rely on shame—at least one referred to it as “pro-social shame”—to motivate behavior. But shame, not sex, is at the root of their suffering; adding more is not helpful.
Some programs, like Sex Addicts Anonymous (SAA), suggest a recovery similar to that of a 12-step program for alcohol or drugs. The first step of such a program, however, is to declare yourself powerless over your addiction, which is exactly the opposite of how experts want people to feel about or relate to sexual behavior.
Moreover, at the heart of these programs are value judgements about sex—who should (and shouldn’t) have it, with whom, in what way, and how often. SAA lets members define for themselves what behaviors they will abstain from once in recovery but offers examples that include common behaviors considered healthy by most, like “masturbation with pornography” or “masturbation with cross-dressing.”
Self-diagnosed sex addicts may also find an active community of peers online. Prause describes these forums as similar to incel communities, complete with toxic masculinity, rampant misogyny, and racism. She writes that these “porn addiction” forums simultaneously reinforce shame (by suggesting that viewing porn is evidence of a lack of self-control) and absolve the men of responsibility (by suggesting porn is a demon that controls them).
The myth of sex addiction is clearly dangerous. This pop-psych diagnosis perpetuates judgment about sexual behavior and can trap people in a cycle of shame and regret. And yet it continues to be offered as an excuse for behaviors that it neither causes nor explains.