The debate on what is ‘sex addiction’ is still a hot topic in our field. Many people absolutely believe in treating sexual compulsivity with the addiction framework. However, a growing number of clinicians are moving away from the addiction model as there is now a large body of clinical evidence that supports sexual compulsivity to be quite a different phenomenon from addiction. Studies and research done in this area show a lack of scientific evidence that sexual compulsivity is an addiction.
Many studies cited in support of the addiction model are conducted with confirmation bias, without enough critical thinking and ignoring the knowledge of the sexology field.
So why do we still call Compulsive Sexual Behaviours ‘sex addiction’?
‘Sex addiction’ is a term that was born in the 80’s in Mid-West America. The religiosity is strong in that part of the world and the term flourished at the time when people were scared of sex during the AIDS crisis. But now we have new knowledge on sexual functioning and sexual behaviours. We have more and more science on sex and the brain. Our understanding of the problem has evolved exponentially since the 80’s, yet the old-fashioned term remains. And the addiction-focused treatment remains.
Isn’t it time to update our clinical language and treatment?
As a field that continues to learn and evolve, we have changed many terms in the past. We have changed ‘impotence’ with erectile dysfunction. ‘Retarded ejaculation’ with delayed ejaculation. We challenge words like ‘frigid’. We fight against body shaming and female sexuality shaming. We are more mindful of pronouns. We changed the word ‘manic depressive’ for bipolar disorder and ‘hysteria’ to stop pathologising women.
As psychosexual and relationship therapists, I believe it is time to finally embrace the field of sexology and offer clients the appropriate modern treatment. I believe it is time to leave the term ‘sex addiction’ behind, belonging to the list of old-fashioned words.
At the very least, we should be calling it Compulsive Sexual Behaviours as there is now a diagnostic criteria for it. The diagnosis for the disorder is hard to meet, leaving many people without a word for their sexual behaviour struggles. I propose we call it problematic sexual health behaviour. Or as Doug Braun-Harvey and Michael Vigorito prefer to call it: Out-of-Control Sexual Behaviours. These modern terms seem to be more inclusive and less pathologising as they do not imply a disorder, but rather a sexual health problem.
Psychosexual and relationship therapists should be the ones at the front of this new wave of clinicians treating this specialist presentation. The Contemporary Institute of Clinical Sexology is offering a unique 3-day training to update the knowledge of compulsive sexual behaviours to modern understanding. During this training, you will learn how to treat sexual compulsivity safely, efficiently with tools immediately applicable to your existing clinical practice.
I’m looking forward to seeing you there.
Silva Neves
