Hypersexuality Disorder or Sex Addiction?

A couple walks upstairs, only their legs and feet showing.While Tiger Woods’s sexual experiences have ended up all over the news, the psychiatric task force charged with creating the next edition of the “bible” for counselors and psychotherapists, the Diagnostic and Statistical Manual of Mental Disorders (DSM) is completing work on their current update (the last edition came out back in 1994).

In a recent article for the Los Angeles Times, Dr. Allen Frances, who chaired the 1994 panel, laments that the DSM “goes too far in creating disorders.” He says that the panel tried hard to be conservative but “inadvertently contributed to three false ‘epidemics’—attention deficit disorder, autism, and childhood bipolar disorder.” “Clearly,” he writes, “our net was cast too wide and captured many ‘patients’ who might have been far better off never entering the mental health system.”

I’m blogging about this today because the sexual disorders section includes some diagnoses that have been particularly controversial in light of Tiger’s “misadventures” (as one columnist labels his behavior).

Now please understand that, as a clinician, I’m not big on diagnosing “disorders.” I’ve watched in horror as pharmaceutical companies churned out expensive psychotropics to treat “disorders” such as “premenstrual dysphoria.” Their attempt to increase profits by extending the reach of medical psychiatry and pharmaceutical intervention into what Frances calls “the ever-shrinking domain of the normal,” has successfully convinced many people that they have a “disease” instead of an understandable reaction to the challenges of life as we know it.

One of the new “sexual disorders” is the so-called hypersexuality disorder (HD). Dr. Frances casts an especially jaded eye on HD saying that it will, “bring great comfort to philanderers wishing to hide the motivation for their exploits behind a psychiatric excuse.”

Was Tiger Woods sincere in his self lacerating public apology last week? I don’t know. What I do know is that sex does become a problem for some men and women, and clearly Mr. Woods’s sexual behavior did create problems for him—big ones. In the future he might be able to call on HD as an excuse, but I suspect what’s going on for him is really sex addiction.

People often roll their eyes at the idea that sex can be addictive. The definition that I use for addiction is this: “a pathological attachment to a mood altering experience.” The mood altering experience may be caused by ingesting a drug, or other substance. For some people, it’s caused by the rush, or the biochemical high, created by the risk and exhilaration of sex, or romance, or risky behavior like that of Tiger Woods.

Dr. Patrick Carnes, pioneer of sex addiction treatment, calls addiction “an illness of escape. Its goal is to obliterate, medicate, or ignore reality.” I call it a dis-order of intimacy. It’s an alternative to letting oneself feel hurt, betrayal, fear, or the most painful emotion of all—loneliness and isolation.

When the “attempt to obliterate, medicate, or ignore reality” becomes habitual or impossible to stop, we have a mental health impairment known as addiction. It usually begins simply—reality becomes too much to bear so we escape through drugs, alcohol, food, or sex.

Remember what I said earlier about sex addiction being an intimacy disorder? Most sex addicts come from families in which members are disengaged from one another. One important way to check reality and stay emotionally stable is to share with others and find out their perception of a situation. This requires and creates a capacity for intimacy. Abuse and neglect deepen the distortion of reality for kids from disengaged families—they conclude they don’t matter. They find ways, like masturbation, to deaden the anxiety that they feel, and they do so more and more compulsively.

I don’t know if Hypersexuality Disorder will be accepted as part of the DSM. I do know that recognition of sexual addiction, whether it’s called that, or sexual compulsivity, or HD, could be of benefit if it helped more of us to recognize that sexual and relationship recovery is possible. I know that Tiger Woods is getting treatment for it right now and I hope that his recovery will be an inspiration to others whose lives are plagued by the destructive effects of sex addiction.

© Copyright 2010 by Jill Denton, LMFT, CSAT, CCS. All Rights Reserved. Permission to publish granted to GoodTherapy.org.

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

  • Leave a Comment
  • Frances W.

    March 5th, 2010 at 11:33 PM

    Tiger Woods’ press conference was the most orchestrated act I’ve seen on TV since Clinton denied sleeping with Lewinsky. All you had to do was look closely at his eyes to see no glint of sincerity or remorse in them. I agree with Dr Frances and his assessment on that if Woods is an example.

  • michelle

    March 6th, 2010 at 2:54 AM

    not everything needs prescription drugs and even if it is so, cure is not always guaranteed especially so for these kind of problems…what is actualli required is for someone to better understand the person and his problem and to guide him with his expertise and knowledge of the problem…this can go a long way and be more effective if the guidance is taken at the initial stages of the problem itself.

  • Kelli

    March 6th, 2010 at 10:58 AM

    Woods is an a**, plain and simple- tired of the excuses for cheating on the wife

  • Katt R.

    March 6th, 2010 at 11:43 AM

    Even though it may be a disorder, it will definitely not sustain if the person does not want it to continue…after all, selfdetermination and self-control are real things and are not just hypothetical…I would not be considerate to such a person thinking that it was all a ‘disorder’.

  • susan

    March 7th, 2010 at 12:45 AM

    it would not be fair to call any wrong action of a person as a psychological problem… this, if extended, can actually go on and cover the various crimes committed by criminals all ove the world and say that they committed the crimes due to some newly found psychological disorder and hence they must not be punished!

  • Ellen

    March 7th, 2010 at 9:51 AM

    I don’t really care about Tiger Woods’ personal life- I agree with him that this is a matter which should be between he and his wife. It is not up to us to judge or decide what works best for them in their specific relationship. With that being said though I do have to make the comment that for all of those out there who are in such a snit about what he has done, that just goes to show what happens when we set up these unrealistic expectations for the stars and athletes that we see on tv. These are not the people we should be looking up to because they are human and are bound to make mistakes in life too. If this was your personal role model and you are sad over this then that is your fault. Look to someone in your life who has made a meaningful and personal touch on your life, not someone you just happen to idolize because they play a mean round of golf. We set ourselves up to be disappointed when these are our heroes in life. But the thing is that real heroes will never let you down.

  • ASmom

    March 7th, 2010 at 8:16 PM

    Has Dr Frances any idea how offensive his remarks about false epidemics are to parents of these children? There is NOTHING false about the problems my son faces and I deeply resent his remarks. The problems are real even if his ideas about categorization hold any truth.

    Aspergers Syndrome was described by Hans Asperger way back in the mid 1940’s and is not some new trendy idea pulled out of thin air. We families spent too many years denied services and help because there was never enough awareness of AS and now we have that and it’s a name that’s recognized he wants to take it away? Shame on him.

  • AR

    March 8th, 2010 at 12:51 AM

    I just think it comes down to a particular case and a blanket rule for all would be unsuitable… two person behaving in a similar manner but due to different reasons and in different conditions – cannot and should not necessarily be treated as exactly the same cases and this needs a lot of attention to particular cases all over.

  • Kayla

    March 8th, 2010 at 1:32 PM

    The internet and the ready access to online pornography has really seemed to up the cases of sex addicts over the last several years. Or at least it has become a great excuse for them to use when they get caught.

  • Ralph

    May 8th, 2010 at 6:05 AM

    How can anyone judge someone if they haven’t been in the same situation themselves? Most of us are “normal” folks of average income. Give yourself a virtually unlimited income and worldwide fame and tell me you would never give in to constant temptation, no matter what form it comes in. I say leave Tiger Woods alone and let him play golf. I “try” daily to improve myself mentally physically emotionally and spiritually and I think Tiger does too. Don’t you think the world would be a better place if EVERYONE focused more on what’s wrong with themselves instead of what’s wrong with everyone else?

  • Ray Traver

    February 12th, 2013 at 9:23 AM

    I have been married to my highschool sweetheart for over 30 years. I haved loved for intensely for all those years. I still do even though I found out that for 15 of those years she had full blown affairs( long term) with 3 different men. She is a very intelligent professional woman who, when she was with me and my daughters, seemed to be a committed, loving wife and mother. Then, as we began our careers, she started in with the very risky and uncharacteristic behavior that haunts us to this day.

    She started her affairs when she was 2 months pregnant( unprotected ). She took my baby with her to a hotel with him. She lied about going to conferences to meet him. She had him at our house. and on and on… Finally, 8 years ago, she stopped having sex with them. But she still emailed, talked and met with them until I found out.

    She has no excuse other than she got caught up in it and couldnt stop.

    we are saving our marriage. I do actually still love her even though she shredded my heart. She is working hard on her problem and has been loyal to a T since I found out. Hope it lasts but I will try.

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