Is Sexual Addiction A Feminist Victory?

Hanna Rosin, writing for Slate, thinks it might be, but allows she’s betting against the house:

When Tiger Woods checked himself into the Gentle Path sex addiction clinic, many women writers and activists reacted with suspicion and rancor. Lemondrop asked if the treatment is “merely a way for philandering men to pay lip service to their outraged wives?” Tracy Clark-Flory of Salon found the diagnosis “nothing short of maddening.” A group of female protesters in Australia showed up at a golf tournament carrying photos of Tiger with a purple pimp hat and a scepter, implying a certain winking noblesse oblige. Our own Amanda Marcotte wondered whether Woods had a disease or a “fairly typical set of attitudes about women coupled with a lot of opportunities.” Or, as she succinctly put it, are celebrities such as Woods who rack up the mistresses ” ‘addicts’? Or just pigs?”

It’s hard, admittedly, to sympathize with a man who asks his mistress to change her voice mail because his wife has stolen his phone. Especially when that man is a millionaire golfer who has profited from his clean, good-boy image. But with some historical distance, the situation seems less suspect. Not so long ago, there was no easy way at all to publicly shame a celebrity pig or even any ordinary pig. The term sex addict does some of that work, and its introduction into the psychiatric idiom could be considered an important moment in feminist history. Suddenly, certain brutish behaviors that used to be overlooked were exiled as abnormal. And in the clinical literature, the word promiscuous came to primarily describe not hysterical women but rather predatory men.

At least as far as the American Psychiatric Association is concerned, sex addiction doesn’t exist — at least not at this particular moment. In 1987, it appeared in the third edition of the APA’s Diagnostic and Statistical Manual, with the definition: “distress about a pattern of repeated sexual conquests or other forms of nonparaphilic sexual addiction, involving a succession of people who exist only as things to be used.” By the time the fourth edition emerged, it had been moved to a section marked “Sexual Disorders Not Otherwise Specified.” In other words, according to the best medical authorities, being a playa can be a compulsion, but not a full-blown addiction.

A new edition of the DSM is ue out in 2013. It’s worth wondering whether sex addiction will be restored to its former dignity, and if so, how it society might be affected.

The case for the existence of a full-blown sex addiction has a venerable history. It dates back to the 1970s, with Dr. Patrick Carnes’ publication of Out of the Shadows: Understanding Sex Addiction. To define the disorder, Carnes employed the following criteria:

Recurrent failure (pattern) to resist impulses to engage in acts of sex.

Frequently engaging in those behaviors to a greater extent or over a longer period of time than intended.

Persistent desire or unsuccessful efforts to stop, reduce, or control those behaviors.
Inordinate amount of time spent in obtaining sex, being sexual, or recovering from sexual experience.

Preoccupation with the behavior or preparatory activities.
Frequently engaging in sexual behavior when expected to fulfill occupational, academic, domestic, or social obligations.

Continuation of the behavior despite knowledge of having a persistent or recurrent social, academic, financial, psychological, or physical problem that is caused or exacerbated by the behavior.

Need to increase the intensity, frequency, number, or risk of behaviors to achieve the desired effect, or diminished effect with continued behaviors at the same level of intensity, frequency, number, or risk.

Giving up or limiting social, occupational, or recreational activities because of the behavior.
Resorting to distress, anxiety, restlessness, or violence if unable to engage in the behavior at times relating to SRD (Sexual Rage Disorder).

Now, I’m not sure how many points have to describe a person’s behavior before Dr. Carnes would return a diagnosis of “addicted.” Since the treatment, according to Rosin, involves living “a monk’s life, with no hint of sex or even masturbation allowed,” one hopes psyhciatrists don’t start handing out such diagnoses like business cards.

It would be worse still if the notion of sex addiction took such firm hold in the popular imagination that laypeople began equating a well-adjusted personality with a low sex drive. Once it enters everyday speech, clinical jargon can be a powerful weapon. Think of the word narcissist. Gore Vidal accused Norman Mailer of using it as a code for “homosexual.” Countless critics have imputed narcissism to President Obama, although they’re more likely to mean he wears Burberry and went to Harvard. Is it so very hard to imagine “Oh, my God! Get away from me, you friggin’ sex addict!” emerging as the go-to rebuff for any young man who’s picked the wrong moment to make his move?

Worse things have happened. Rosin recalls the stigma attached by Victorian society to “nymphomania”:

During the Victorian era, nymphomania became the catch-all term for a wide range of inappropriate behavior, from “lascivious glances” to extramarital affairs, writes Carol Groneman in Nymphomania: A History. Even wearing perfume was sometimes diagnosed as a symptom of “mild nymphomania.” The book describes the case of Mrs. R, a widow who, in 1895, blamed her “lascivious longings” on reading too many novels and going to too many gay parties as a young girl. It is with “the greatest difficulty that I could conduct myself in a decorous and ladylike manner in the presence of the other sex,” she lamented to her doctor, who prescribed leeches applied to the uterus and ice to the genital

At least judging by Marty Kafka, whom Rosin calls “the reigning expert” on sex addiction, diagnoses are applied with some care. Kafka’s patients seem to be hard cases, who “obsessively look at porn or bankrupt themselves on prostitutes.” Kafka insists that having had 18 mistresses — Tiger Woods’ count to date — is not, by itself, a prima facie case for sex addiction. On the other hand, Kafka would begin an examination of Tiger Woods by asking how often he has orgasms: “By the accepted definition, seven times a week consistently for six months would signal a problem.” Sounds a bit on the tyrannical side.

Granted, part of my uneasiness comes from the demographic breakdown. Ninety-five percent of people diagnosed with sexual disorders are male. The DSM-IV does list a hypoactive sexual desire disorder, which affects mostly women. According to a New York Times article titled “Women Who Want to Want,” the treatment regimen is far less Siberian than anything a male sex addict might have to look forward to. Psychologist Lori Brotto, who at 34 has won recognition as the world’s leading expert on hypoactive sexual desire disorder, oaches her patients through a set of exercises, in which they imagine themselves as highly sexual beings. Sex up your mind, the idea goes, and the rest of you might follow. It’s a far cry from lockdown. Perhaps unfairly, I find it terribly unfair.

I don’t doubt a certain number of people — okay, men — feel a strong compulsion to act out sexually, and that those who follow that compulsion can do enormous damage to their own lives and the lives of the people around them. I also agree that damning these people for cads is reductive, and wouldn’t likely prompt any behavioral changes. Still, I’m afraid the idea of sex addiction, if not the diagnosis itself, could fall into the wrong hands, and become a weapon in the ongoing gender wars. Once, back when I blogged on Open Salon, a woman posted an essay titled “So This Is What A Sexless Marriage Feels Like.” Broadly speaking, her husband hadn’t touched her in years. None of the respondents — most of whom were women –suggested the author arrange an appointment for him with Lori Brotto. A good number told her to have an affair.