For those unaware, one of the most hotly contested issues in sex therapy is whether or not sex addiction is a useful diagnosis and whether it even actually exists as a distinct addictive process in the first place. This controversy receives lots of coverage in the media and I am often contacted by journalists for expert opinions (check out this recent article in Prevention Magazine, for example, it’s pretty good).
I don’t think that anyone argues that sexual behavior can be problematic or feel “out of control.” Indeed, the Out of Control Sexual Behavior (OCSB) model is gaining a lot of traction in therapist circles. The main concern with the sex addiction model, however, is that by placing sexuality alongside toxic and dangerous substances such as alcohol and hard drugs, it unduly stigmatizes sexual expression as inherently dangerous, taking us back to the Victorian dark ages of sexual repression. For this reason, one of the common criticisms of the sex addiction field is that clinicians untrained in human sexuality diagnose and pathologize individuals who stray from heteronormative and mononormative sexual expressions as struggling with mental pathology. Of course, there must be a middle ground between unquestioning validation and trigger-happy pathologization. Earlier this summer, the World Health Organization (WHO) sought to find this median by releasing their latest International Classification of Diseases (ICD) 11.
There’s a lot that’s positive in the new ICD 11 classification, and also consistent with the American Association of Sex Educators, Counselors, and Therapist’s (AASECT) ‘s position statement on sex addiction (and I should know, I was one of four co-authors of the position statement). Let’s go through it […]