Further Reading


Last Magazine (formerly LM), Summer, 2000, p. 56

Sex, Drugs and Dependency

When does too much of a good thing become a 'behavioural disease'?

Stanton Peele
Morristown, NJ


'Forbede us thyng, and that desiren we', according to Chaucer. Despite this law of human behaviour, Americans — and following behind them, the British — are often afraid of their impulses. In the USA, we have strict laws to prevent people from drinking. For example, only those 21-years or older can legally purchase alcohol in this country. Compared with most other countries, both Britain and the USA are highly restrictive in drug regulation.

With drugs and alcohol, both the UK and USA are exploring the boundaries of how to prevent people from doing things many have an urge to do. But the area of human behaviour representing the strongest human urges, and where regulation may most conflict with human nature, is sexual behaviour. Both countries, like most societies, have a variety of laws and customs aimed at telling people how they must curb their sexual desires.

The problem with getting people, adolescents and adults both, to avoid engaging in sex is that for the most part the activity involves no illegal paraphernalia that can be confiscated. And it is hard to restrict people from acting however they want within private premises. How, then, are we to convince average youths not to do something we think they shouldn't? Moral strictures for some time played this role. That is, people hopefully wouldn't have sex because it was immoral and against religious principles. But, as we know, religion doesn't carry the weight it once did.

And, in sex as in many areas, medical science has taken its place. This includes threatening young people and others that sex holds out the risk of transmitting AIDS and other sexual diseases.

But the USA has invented an entirely new area of medical science to assist in regulating people's behaviour — behavioural diseases. In the USA, physicians, psychologists and others explain that the reason people misbehave is often because they have diseases. These diseases include alcoholism, drug dependence, shopping compulsion, gambling addiction, and so on. Once something that people shouldn't do at all or that they often do in excess is constructed as a disease, really everything they do too much of can be fitted into a disease category.

One such new area of disease involves sex. There are 12-step support groups based on the principles of Alcoholics Anonymous concerning sex. Learned psychiatric texts have been written about sexual addiction. A journal entitled Sexual Addiction and Compulsivity is published by the National Council of Sexual Addiction/Compulsivity. And there have been a string of best sellers about sexual addiction — indeed, these books seem to be selling better than those on alcoholism and other, more historic, 'addictive diseases'. To name but a few of these titles: The Clinton Syndrome: the president and the self-destructive nature of sexual addiction; False Intimacy: understanding the struggle of sexual addiction; The Final Freedom: pioneering sexual addiction recovery; Hope and Recovery: a twelve step guide for healing from compulsive sexual behavior; She Has a Secret: understanding female sexual addiction.

With uncontrollable addictions such as alcohol, drugs and gambling, the only answer is to abstain entirely. Thus, although we have supposedly moved from religion to science when we label strong urges about which society disapproves as diseases rather than as sins, the bottom line is quite similar in each case: 'Avoid this temptation at all costs, or you risk perdition'. In the case of avoiding HIV infections, the idea is to avoid promiscuous sex. That is, if one sticks with a known partner, the risk of HIV is greatly attenuated. It is sleeping with strangers that creates the danger of infection. And promiscuity is at the root of the risk of finding inappropriate partners — like the kind of woman by whom Michael Douglas was pursued in Fatal Attraction. Likewise, people in sexual addiction groups and readers of books on the topic are cautioned to form stable relationships, to restrict sexual activity within marriage, and to avoid promiscuity -- which is the prototype of addicted sexual behaviour.

Indeed, a strong moral element appears in much of the literature about sexual addiction. The 12-step approach itself, the key to American treatment of addiction, emphasizes a 'higher power' and 'spirituality'. The titles of many sexual addiction books in the area emphasize spirituality, and others approach sexual addiction from an out-and-out religious perspective, like Breaking Free: understanding sexual addiction and the healing power of Jesus. Mark Laaser, an activist in the sexual addiction field, has written Faithful and True: sexual integrity in a fallen world. A pioneer in the field of sexual addiction, Patrick Carnes (who runs the premier sexual disorder clinic in the USA), has organized the Interfaith Sexual Trauma Institute, involving 'work on sexual trauma within a faith context'.

Carnes created the first sexual addiction center in the USA, and wrote some of the first books in the area (along with my own Love and Addiction, which appeared in 1975). Carnes' books include Contrary to Love: helping the sexual addict (1989), Don't Call It Love: recovery from sexual addiction (1992), Out of the Shadows: understanding sexual addiction (1992). His 1997 book, entitled Sexual Anorexia: overcoming sexual self-hatred, marked a change in the terminology around sexual addiction. Anorexia, of course, refers to the starvation of self most often characteristic of emaciated young women. These women express control of their confusing lives through refusing to eat. Likewise, it turns out that rather than having too much sex, many people are turned off to sex. Apparently, the sexual addict field was missing many customers by emphasizing only those who gave in to their sexual urges.

'It's an obsession that can then become a way to cope with all stress and all life difficulties', Carnes wrote in Sexual Anorexia. 'It is usually rooted in childhood trauma — abandonment, betrayal, sexual abuse or a profound rejection by a loved one. As a result, the anorexic unconsciously commits never to combine intimacy and sexuality'. As with eating disorders, people often express sexual dysfunction by alternating excess with abstinence. Why would people behave this way? Possibly because they feel guilty about having sex. After they engage in this unwanted behaviour, they then flagellate themselves and avoid the activity — until pressure builds up and they give vent to their desire once again.

Indeed, this is often how alcoholics drink. Somehow, navigating the path between desire and self-destructive excess has not become easier, despite decades of concentration in the USA on addiction treatment and 12-step self-help groups. Perhaps the very act of labeling ordinary urges as diseases contributes to the difficulties many people have in coming to grip with their sexual selves.