Sex Addiction?

I recently tried to read The Myth of Sex Addiction, by David J. Ley, Ph.D. (yet another one of those authors who feels adding “Ph.D.” to his name is important). I made it about fifty pages in, before I folded up my cards and went home.

Ley is hell-bent on decimating a straw man, the idea that one can be “addicted” to sex in a clinical sense. While there are many – Patrick Carnes, chief among them, who have peddled the story of sex addiction over the last thirty or so years, and while there are thousands of participants in various twelve-step fellowships who subscribe, more or less, to the theory that one can be “addicted” to sex, and that the modality of a twelve-step program can be helpful to “recovery,” I don’t believe there are any serious clinicians advocating the idea that one can be genuinely “addicted” to sex according to any standard definition of the word. Rather, what I think is widely understood is that compulsive sexual behavior (as with many compulsive behaviors) often produces symptoms that are very similar to the symptoms suffered by people who are, indeed, addicts.

Currently, people misuse the concept of “addiction” all the time, but in fact, there’s a fairly clear clinical definition of addiction which has two parts to it – first, the concept of physical dependence (one’s body comes to need the substance, and in fact gets ill without it); and second, the concept of tolerance (one’s body needs more of the substance in order to attain previous levels of effectiveness). In the absence of either of these conditions, one is simply not addicted. There’s a second, non-clinical, usage of the word, which is, “enthusiastically devoted to a thing or activity.” But this is a colloquial usage, not a medical one.

I’ve written elsewhere that I am, for all intents and purposes, an addict. What I mean by this is not that I am physically dependent on sex (while I think the drive to fuck is pretty irresistible, I think it’s a mischaracterization ever to refer to it as an addiction; ditto with food), or that I have a “tolerance” to sex (although I did find myself seeking ever greater thrills in my days of florid acting out). No, what I mean is that my behaviors mirrored, perfectly, the behaviors of an addict. If I read the Big Book, if I look at the behavior of addicts to alcohol, or sleeping pills, or heroin, my behaviors were the same – the lying, the resentment, the self-deception – you name it. So, to the extent that an addict is defined by her or his addiction, I was no addict; but to the extent that an addict is defined by her or his behaviors? Well, I was (am?) an addict, for sure.

Anyway, back to the book. The author’s premise is that those who would persuade us that sex addiction is a thing are shysters, peddling a dangerous lie for their own enrichment.

And to that I say, well, sure, maybe. I mean, yes, Patrick Carnes and his various facilities are money-making enterprises. And no, none of what they do is empirically validated. Literally. None of it.

Any more than is any other 12-step program. For a variety of reasons, I don’t believe there is any valid empirical support for the premise that 12-step programs are effective (let alone, that they are the most effective modality) in combating alcoholism, or drug addiction, or any other compulsive or addictive disorder. What there is is considerable anecdotal support for, and a lot of strong believers in, the cult of 12-steppery. And what I think is indisputable is that 12-step programs, whether for alcohol or for gambling or for sex, have helped some.

I think where people get a little fuzzy is when they get all absolutist – when they proclaim either that 12-step programs are the only means of treating addiction (or “addiction”), or when they get doctrinaire about the specific practice of 12-step recovery. For every alcoholic who has recovered in AA, there’s one (or two, or ten) who didn’t, and there may well be another one (or two, or ten) who managed to do it without AA. Similarly, in my time in the land of the 12-step sex fellowships, I met a few (just a few) people who had managed to rack up some considerable “sobriety.” Far more common were long-term sufferers, people who had been in the program for 2, or 5, or 15 years, and who had never been able to string together more than a few weeks, or months, or a year or two, of “sobriety” before “slipping.” (And who, it always seemed to me, were deprived of the opportunity to declare victory because they hadn’t attained “sobriety,” even though their lives no longer were unmanageable, even though, for the most part, they were no longer “powerless over lust.”)

I was always frustrated in my time in the program, first, because of the relative paucity of real role models – people who had “escaped” the “disease,” and second, because of the excruciating sex-negativity of just about everyone I encountered. Sex was seen by almost everyone I met as this torturous, miserable, force determined to make us miserable.


And this is a big but….

But, the program did help me get my shit together, to deliver myself to a place where, whatever my pathologies around sex, notwithstanding my undoubted hypersexuality, I no longer am, for the most part, powerless over sex. My life no longer is unmanageable.

So I’m not sure what, if any, conclusions I have, other than these:

1) Don’t read The Myth of Sex Addiction. It demolishes a straw man in a way that’s not very interesting. Or readable.

2) When you read about sex addiction, understand that “sex addiction” is a metaphor – it is a way of calling up a number of useful associations and images and ways of understanding things very efficiently. But it’s not a precise, scientific, diagnostic term.

3) 12-step programs do help, have helped, thousands (hundreds of thousands?) of people.

4) Don’t believe the hype about 12-step programs. They’re not the only way – they’re one way. And they can be really helpful even if you don’t drink the Kool-Aid.


  1. N, your ability to understand, dicipher, own your past(present) sex addiction(for lack of a better phrase) is…and this is going to sound weird…but a turn on. To see(hear) a man who has dug deep to understand himself, his faults, his weaknesses and to overcome them is attractive.
    I’m probably not explaining this very well, and perhaps should have sent a private note, but your road to self discovery is inspiring. If only everyone understood themselves so well. Thank you, N.

    1. If only “understanding [myself] so well” resulted in anything other than… well, than understanding myself so well.

      And, for the record, I think I don’t understand myself particularly well. I think that what I understand particularly, unusually well, is how LITTLE I understand myself.

      But thank you!

  2. Your model of what defines an addiction is inaccurate. There is a third criteria that is medical and scientific criteria that is a brain disorder when a person’s neurological pathways are rutted in response to a process, and there becomes an inability to access the prefrontal cortex to make decisions that are in line with that person’s value system. Also, in the second of your two criteria for addiction you state that “one’s body needs more of the substance in order to attain previous levels of effectiveness.” There is absolutely and unequivocally a physical a well-documented physical and neurological withdrawal, and an escalation that happens with the behaviours in process addiction that requires greater and greater intensity to achieve the ‘high’ that substances produce in their addictions.

    1. I appreciate all of what you say, and agree with most of it, except for all the certainty. You write “there is a third criteria” – that’s not universally accepted. You use the word “unequivocally,” to describe something that actually is quite controversial.

      I agree that there are neurochemical changes that we only are beginning to understand in the minds of those struggling with “process addictions.” I agree that it’s possible that there are instances in which a physiological withdrawal occurs. You’re convinced. I’m not. That’s pretty much the state of the world on this issue: there are differences of opinion, and the addictionologists disparage and dismiss those who are more skeptical.
      I wrote this post YEARS ago, and my thinking has evolved a bit. I’m far less certain than I once was. But I’m nowhere near convinced of anything except that, ultimately, I don’t imagine this ever will be a question resolved by science. It is, ultimately, theological.

  3. Thank you for your respectful and measured response. There is a lot of very recent research about the neurochemical effects of both process and substance addictions. The burden of proof lies in the fact that the chemical releases in the brain effects are nearly identical for both. Social media’s ‘success’ is predicated on that very fact.

    I find it interesting that you call into question sex being an addiction, and yet my latest email from you is of explicit pornographic images that are clearly, for me at least, unquestionably objectifications of the women portrayed. I prefer to see people as people rather than bodies to be used for pleasure. For this reason I am unsubscribing from your blog. Wishing you well, and freedom from harm to both yourself and other.

    1. I’ve written a lot about objectification. My view of objectification is a bit more nuanced than yours. Objectification CAN be hot. Or, it CAN be damaging. A big part of the shame I wrestled with in the years before I started this blog derived almost directly from my mother’s having taught me the view you espouse: that objectification is, simply, bad, and damaging. It wasn’t until my early 40s that I learned that there are women who enjoy being objectified at times, in certain circumstances, and that objectification is, like so much, not always one thing or another. I’m sorry I so easily lost your interest, as you clearly are a thoughtful and engaged reader. In any event, I wish you well.


  4. I read the book few days ago, the only part I agreed with was the narrative that addressing oneself as an addict is harmful and how it could easily void someone of responsibility.

    But I agree like you said, I’m someone who faced the same sort of compulsiveness to sex, similar to alcohol or drug addict experience that I read on internet/forum/books. My behavior were the same.

    The author lost me when he started defending pornography as healthy. There were many scientific study done on the subject of porn that the effect has on the brain is scary. The author tend to strawman so much of his argument that I gave up reading halfway through.

    Thanks for writing this blog, it helps confirm my suspicion and I’m glad that the 12-step has helped you immensely. Keep up the great work

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