It was about 15 years or so ago that I was first told by a therapist that I had a sex addiction. I thought he was crazy. Sure, I was in the process of getting divorced for a second time because I was having multiple affairs that were compulsive in nature, and yes, I had lost jobs because of my out-of-control behavior that was related to sex. I lied constantly, and was deeply ashamed of my behavior. I was miserable because of it actually. That was all true. But still, the words “sex addict” sounded ridiculous to me.
I kept on acting in the same manner until the label “sex addict” did not seem quite so ridiculous anymore. The years went on and things continued to get worse, and I continued to unravel. Ten years ago I flew out to Los Angeles for the first of a few stays in rehab for sex addiction. I was going to the Sexual Recovery Institute, which was founded by Robert Weiss, LCSW. Next to Dr. Patrick Carnes, who is the inarguable big dog in the field, Weiss is probably the world’s foremost expert on sex addiction. Anyone who wants to know more about Weiss and his work should check out his books Sex Addiction 101 or Always Turned On.
Weiss has an impressive resume. He has established and overseen addiction treatment programs for many high-end treatment facilities, including Promises Treatment Centers in Malibu and Los Angeles. He has also appeared as an expert on the intersection of human intimacy and digital technology for The New York Times, The Los Angeles Times, The Daily Beast, CNN and many others.
Mr. Weiss was kind enough to chat with me about where sex addiction was back then, and the unique problems that come with being a sex addict today.
As far as the awareness of sex addiction has come over the years, it seems that many people still don’t think sex addiction exists. How much has the awareness of this issue changed as of late?
I think it has changed profoundly. Of course there is still a ways to go. Sadly it didn’t make the DSM five years or so ago, which I think was a purely political decision. There was no political will among the U.S. clinical committee to look at sexual behavior as a problem. That version of the DSM took out any reference to sex addiction, other than a symptom of another disorder. To the average person on the street, any person could be a sex addict, because hypersexuality, sexual compulsion, they don’t have any real criteria-based diagnosis. So what this really means is, if I don’t like what you are doing sexually, I can say that you are a sex addict. That could be that you are interested in men, or feet, or shoes, or that you have sex outside of marriage—we have no formal criteria. It can be used as a moral or religious slur. Anyone can come along with a religious or moral slur and say, “Oh you are a sex addict,” and no one can say you are not because we don’t have an official diagnosis. It used to be the same way with alcoholics. They used to be thought of as bums, like a man lying in the gutter with a bottle. I think in future generations, people will think of sexual addiction differently, but it has already changed so much.
Of course shame is a huge thing with all of this. I remember being so ashamed of myself when I was active. How much is shame a problem for people with sexual compulsions? What can we do as a society to help people open up about their sexual compulsions to loved ones and therapists?
Again, I think it is generational. What I read about sex growing up as opposed to what your average 15-year-old does now is so different. There is much more access to sexual content and sexual experience in this generation. I grew up in the Eisenhower suburbs in New York. No one talked about sex. We live in a different culture now. I don’t think this will be an issue for much longer. I sometimes see the problem in another way. As a therapist, people might say I am just in it for the money, or I am anti-homosexual or anti-kink—like I am the sex police, so people are afraid of being pathologized. And it is true that some sex therapists are what I would describe as unethical, and they take their religious issues into it. For example, a guy could love his wife and kids and have an affair with a guy. In that situation, an unethical or incompetent therapist could say, “Okay, we will work on this as an issue of sex addiction,” but it isn’t sex addiction. It could be an orientation issue, or a gender issue. In some parts of the clinical world, we that work on sex addiction are thought of being judgmental and conservative.
You mentioned that there is no concrete agreed upon diagnosis. What kind of discussions have been had around the clinical standard of sex addiction?
Well much of it comes down to training. If everyone is well-trained, the standard should be similar across the board. Is the behavior attached to mania? OCD? Kink? Is it offending? Is it attached to one’s sexual template which we can’t change, or is it perhaps related to trauma that we can help with?
What about the issue of paraphilias? Are those a problem if just in thought and not in action? How much harder are they to treat?
If it isn’t offending behavior, it is not a problem in either thought or action. If a guy is into feet, that isn’t a problem. The problem is more a person’s acceptance of their own arousal. If you look at kink and paraphilias—and again I am not talking about offending paraphilias like being attracted to kids, for example—orientation as well as paraphilias are fixed and unchanging. If you like being submissive and you can figure out a way to be that in a way that is comfortable and safe, then you should feel good about yourself. Maybe there is a way to turn the volume down, where you can have vanilla sex and still be submissive. If you have a panty fetish, and there is a way to indulge in that without walking into someone else’s place and stealing their underwear, then that is fine. Those things are fixed. The most important thing is not orientation, but integrity. You need to find a way to talk to your partners about those things and not hide them.
How do you feel about the advances of digital technology, and the interaction between sexual technology and addiction?
What has happened in the last 25 years has changed everything. So much of what turns people on has become immediately accessible, at no cost, with a fair amount of anonymity. In 1987 if I wanted to get laid, I had to go to the bar, talk to someone, work on my game—do I look good enough—and so on. Now I can just go on Tinder or Grindr and have someone at my house to have sex almost immediately. It used to take social skills, and social vulnerability, and time to have sex. That is all gone now.
I don’t have to have a social skill-set to have sex. I don’t have to have assertiveness. I don’t have to read social cues. It is the same thing with porn. You used to have to actually go to the porn store to buy a video in a paper bag and bring it home. Then there are a limited number of images in a magazine or a video, and of course you would get bored with that and eventually put the magazine down. There is always something else to find on the Internet. You might run into someone you don’t want to see at the store, or what if your spouse or child finds all this stuff? There were so many decisions made around whether or not you wanted to do this. Even if you were away on business and wanted a prostitute, then you would have to go spend 20 dollars with the bellhop, and go to the red light district. Now, you just need to go on your phone and find an escort. There used to be a lot of energy needed to get from here to there—now it takes nothing.
For people that are compulsive or impulsive, this can be a huge issue. For an addict to have the ability to access people to hook up with on their phone is almost like a drug addict having cocaine in the medicine cabinet, so the problem really becomes around accessibility. For women too, often they used to feel embarrassed about going to buy porn. Now they just download it. There is a reason that Fifty Shades of Grey sold so well. Women not having to go to a bookstore and walk to the counter with soft-core porn was a huge thing.
I think we have a new population of people who have compulsive sexual problems. Sex addicts usually have some form of trauma or attachment issue, but there is a new group of younger people who just do a lot of porn. They don’t bother going on dates and avoid all of that social awkwardness that most of us go through in high school, because they just use porn. Then they get to be 23 and have no sexual experience at all, and some don’t even get erections around an actual woman because it isn’t their sexual template, the porn is. This group, in my experience, needs a whole new form of treatment than the typical sex addict. It is much easier to treat, but I think we will see more and more of these people. It is a whole new population.
What is the likelihood of recovery? How does that compare to other addictions?
It is hard to know the exact stats around recovery because, again, we don’t even have a concrete definition for who suffers with it in the first place. This is a different kind of problem than one with drugs or alcohol. A sex addict is always challenged with avoiding the occasional slip. The important thing to remember is keeping your integrity. Gained integrity is more important than sobriety.
Founder of the Sexual Recovery Institute Robert Weiss tells The Fix how sex addiction is more real—and more treatable—than ever. Being a sex addict today has its own unique problems. It was about 15 years or so ago that I was first told by a therapist that I had […]