‘Sexual Addiction’ Concepts & Controversies Ben Hughes IRCHSS Scholar Social Work and Social Policy Trinity College Dublin Overview • Historical Context • Characteristics • Development • Critique • Clinical Practice • Sexual Health Policy • Questions Methodology Ongoing Research Study 44 Treatment providers 45 Self-identified ‘Sex Addicts’ Pilot, Focus, Interviews, Questionnaires Historical & Cultural Context Excessive Sexual Behaviour Moral, Medical, Addiction, Psychiatric Disorder Contemporary Terminology Sexual Addiction, Hypersexuality, Compulsive Sexual Addiction ‘Any sexually-related, compulsive behavior which interferes with normal living and causes severe stress . . . .’ Carnes (1983) Characteristics Out of Control Self Destructive Desire to Limit Coping Mechanism Increasing Amounts Mood Changes Neglectful Not due to Drug Use or Medication Behavioural Expressions • Masturbation Pornography Sexual Behavior with Consenting Adults Cybersex Telephone Sex Strip Clubs, Adult Stores Other • Normative • • • • • • Development of Concept 1. Socio-Cultural 1960s -1980s: Sexual Revolution - Sex Negative Period 2. Medicalisation Human Conditions vs Treatable Disorders: Addiction Medicine 3. Moral Religious Decline: Rise of Political Conservatism & Moral Rigidity Recreational – Commitment ethic Facilitated - Sexual Addiction Abandon Critique Socio-Medical Construct Pathologises Non-Conventional Sex Inaccurate ‘Diagnosis’ Hypersexuality - Physiological & Psychological Managed = Hypersexuality Discontinues Underlying Issues Remain Unresolved Sexual Addiction Useful ‘Diagnosis’ Or Label which ‘threatens the civil rights of sexually variant people’ Hart & Wellings (2002) Implications of Diagnostic Labels Reductionist vs Expansive View of Sexuality Anti Sex Culture & Minorities ‘Re-Diagnosed’ Medicalisation Surveillance & industry expands Clinical Practice Not Presented Disclosure, Not Recognised Symptoms: STD’s, Genital Injury, Abuse, Depression Pre Disposing Factors Home, School, Religion, Cultural Motivation Escapism, Emotional Regulation, Power, Intimacy Differential Diagnosis Medical conditions & hypersexuality Attend to concurrent psychiatric disorders Is it an independent or a coexisting condition or...? Sexual Health Policy UK The National Strategy for Sexual Health & HIV ‘Better prevention, better services, better sexual health’ (2001) Healthy Lives, Healthy People (2010) White Paper Integrated Model: confidential, non-judgmental, health promotion & prevention New Sexual Health Policy due in 2012 ! Towards a New Vision Professional Training Theoretical, Personal, Clinical Current Perception Disease, Abuse, Crime, Harassment, Offenders Happiness Factor Pleasure, Intimacy, Diversity, Relational ,Emotional Thank You Bibliography & Resources Questions Irish Research Council for the Humanities & Social Sciences Bibliography / Resources Carnes, P. (1983). Out of the Shadows: Understanding Sexual Addiction. Minnesota: Hazelden. Carnes, P., & Schneider, J. (2000). Recognition and Management of Addictive Sexual Disorders: guide for the primary care clinician. Lippincott's Primary Care Practice 4(3), 302-318. Conrad, P., & Schneider, W. (1992). Deviance and Medicalization: From Badness to Sickness. Philadelphia: Temple University Press. Kafka, M. (2010). Hypersexual Disorder: A Proposed Diagnosis for DSM-V. Archives of Sexual Behavior, 39(2), 377-400. Klein, M. (2006). America's War on Sex: The attack on law, lust and liberty. Wesport, CT: Praeger. Levine, M., & Troiden, R. (1988). The Myth of Sexual Compulsivity. Journal of Sex Research, 25(3), 347-363. Peele, S. (1989). Diseasing of America: Addiction Treatment Out of Control. Lexington, Mass.: Lexington Books. Schneider, J. P. (2005). Guidelines for Psychiatrists Working With Patients with Sexual Addiction. Psychiatric Times, 22(13), 64-64,66,71. Tiefer, L. (2002). Sexual Behaviour and its Medicalisation. BMJ, 325(7354), 45.