Sex Addiction Scam Exposed

[+ newguy]

Ever get sick of the notion of "sex addiction"?

 

Below is a worthwhile goodie exposing

a scam in this area.

 

Comments?

 

NG

 

https://drdavidley.wordpress.com

[rvwnsd]

I think he raises some good points. The "personal improvement" industry needs to create afflictions to keep themselves in business.

[Kenny]

There are many bad psychologists, but that doesn't mean that sex addiction is a scam or doesn't exist. As for the personal improvement industry "creating afflictions" to keep themselves in business, Dr. David Ley could just as effectively promote his business by being a contrarian.

[Rudynate]

It's another unfortunate abuse of the term "addiction." I certainly believe that a person's sexual conduct can be maladaptive, but that's pretty much a self-diagnosed problem.

[Kenny]

It's another unfortunate abuse of the term "addiction."

I don't think so. One can have a pathological relationship to a mood-altering experience -- gambling, for example -- just like one can have a pathological relationship to a mood-altering substance.

[Rudynate]

I don't think so. One can have a pathological relationship to a mood-altering experience -- gambling, for example -- just like one can have a pathological relationship to a mood-altering substance.

 

Addiction, in the strict sense, is a physical dependency . . . the nervous system must have the agent in order to function properly. I agree that one can have a pathological relationship to a mood-altering experience, but, in the absence of physical dependency on the substance that triggers the mood-altering experience, it is a compulsive behavior, rather than an addiction. Same with sex. There is no physical dependency, in the sense that the nervous system can't function properly without it. Maladaptive sexual behavior over which a person feels powerless is a compulsion. Words matter.

[+ newguy]

There are many bad psychologists, but that doesn't mean that sex addiction is a scam or doesn't exist. As for the personal improvement industry "creating afflictions" to keep themselves in business, Dr. David Ley could just as effectively promote his business by being a contrarian.

I always think of "addiction" as a term applying to chemical dependency, which is more biomedical in

nature. One can become addicted to opioids because of they way they bind to certain molecules in the brain, or become dependent on alcohol because of genetic reasons. How the term "addiction" became applied

to "behaviors" (e.g., sex addiction; gambling addiction; porn addiction) doesn't seem logical. One is not ingesting chemicals. Doesn't that other group of activities appear more like behavioral compulsions or psychological dependencies? In regard to Dr. Ley, your point about his being a contrarian may be on point. But how does that bring him psychotherapy clients? His contrarian views all focus on how persons with compulsions should "not" see chemical dependency therapists. If he is touting his own special competing brand of intervention, what specifically is it? I don't mean to sound contrarian myself--I think this is a fruitful discussion to have here, although probably of not interest to those with penis or ass addiction...

[+ newguy]

Addiction, in the strict sense, is a physical dependency . . . the nervous system must have the agent in order to function properly. I agree that one can have a pathological relationship to a mood-altering experience, but, in the absence of physical dependency on the substance that triggers the mood-altering experience, it is a compulsive behavior, rather than an addiction. Same with sex. There is no physical dependency, in the sense that the nervous system can't function properly without it. Maladaptive sexual behavior over which a person feels powerless is a compulsion. Words matter.

This is a superb analysis, and better than my own (above). Addictive substances which modulate the nervous system are one thing. Habits, compulsions, obsessions fall into a different category. Yes, terminology is critical.

[Kenny]

Addiction, in the strict sense, is a physical dependency

That's much too mechanistic a description for what is a very complex condition. If what you suggest is correct, then just one significant encounter with a drug could create a dependency, which is not the case.

 

Take the gambling example that I used: Addictive drugs and gambling rewire neural circuits in similar ways. That rewiring is the problem.

 

Addictive substances which modulate the nervous system are one thing. Habits, compulsions, obsessions fall into a different category.

 

Scientific American gives the recent history of professional consensus on why gambling addiction is not, in fact, merely compulsion or habit. It bears on sex addiction, too:

 

"In the past, the psychiatric community generally regarded pathological gambling as more of a compulsion than an addiction—a behavior primarily motivated by the need to relieve anxiety rather than a craving for intense pleasure. In the 1980s, while updating the Diagnostic and Statistical Manual of Mental Disorders (DSM), the American Psychiatric Association (APA) officially classified pathological gambling as an impulse-control disorder—a fuzzy label for a group of somewhat related illnesses that, at the time, included kleptomania, pyromania and trichotillomania (hairpulling). In what has come to be regarded as a landmark decision, the association moved pathological gambling to the addictions chapter in the manual's latest edition, the DSM-5. The decision, which followed 15 years of deliberation, reflects a new understanding of the biology underlying addiction and has already changed the way psychiatrists help people who cannot stop gambling."

 

Gambling is a behavioral addiction, not a substance addiction. Sex addiction is likewise.

[Rudynate]

That's much too mechanistic a description for what is a very complex condition. If what you suggest is correct, then just one significant encounter with a drug could create a dependency, which is not the case.

 

Take the gambling example that I used: Addictive drugs and gambling rewire neural circuits in similar ways. That rewiring is the problem.

 

 

 

Scientific American gives the recent history of professional consensus on why gambling addiction is not, in fact, merely compulsion or habit. It bears on sex addiction, too:

 

"In the past, the psychiatric community generally regarded pathological gambling as more of a compulsion than an addiction—a behavior primarily motivated by the need to relieve anxiety rather than a craving for intense pleasure. In the 1980s, while updating the Diagnostic and Statistical Manual of Mental Disorders (DSM), the American Psychiatric Association (APA) officially classified pathological gambling as an impulse-control disorder—a fuzzy label for a group of somewhat related illnesses that, at the time, included kleptomania, pyromania and trichotillomania (hairpulling). In what has come to be regarded as a landmark decision, the association moved pathological gambling to the addictions chapter in the manual's latest edition, the DSM-5. The decision, which followed 15 years of deliberation, reflects a new understanding of the biology underlying addiction and has already changed the way psychiatrists help people who cannot stop gambling."

 

Gambling is a behavioral addiction, not a substance addiction. Sex addiction is likewise.

 

Your use of the word "addiction" is an outstanding example of what I call abuse of the word. Nearly one hundred years ago, Alcoholics Anonymous presented a definition of addiction that hasn't been improved upon. The language is a little dated, but it is succinct and says it all: "A mental obsession coupled with a physical compulsion."

[AdamSmith]

Gambling is a behavioral addiction, not a substance addiction. Sex addiction is likewise.

Your use of the word "addiction" is an outstanding example of what I call abuse of the word. Nearly one hundred years ago, Alcoholics Anonymous presented a definition of addiction that hasn't been improved upon. The language is a little dated, but it is succinct and says it all: "A mental obsession coupled with a physical compulsion."

With respect, it's difficult to see how the DSM-5 is a less authoritative clinical reference than the good-insights-for-their-day but frozen-in-time lay formulations of AA.

[Rudynate]

With respect, it's difficult to see how the DSM-5.

 

Not everyone agrees with everything in the DSM:

 

DSM-5: Science or Dogma? Even Some Establishment Psychiatrists Embarrassed by Newest Diagnostic Bible

[+ quoththeraven]

Not everyone agrees with everything in the DSM:

 

DSM-5: Science or Dogma? Even Some Establishment Psychiatrists Embarrassed by Newest Diagnostic Bible

 

Of course not. But language, at least, evolves. Whatever the professionals make of it, words get used in a less precise, more metaphorical way all the time.

 

At the very least, both DSM-V and brain plasticity (which no one other than Kenny has discussed) suggest this is not the open-and-shut, black-and-white case others are making it out to be. Sure, there are disputes and even "scams." That's true for all of this stuff, including the difference between addiction and dependence with regard to substance abuse and a whole host of issues around conditions such as depression, anxiety disorder, autism spectrum disorder (DSM-V somewhat controversially eliminated Asperger's as a separate diagnosis and folded it into ASD), dissociative identity disorder (which some experts still think doesn't exist), etc.

 

Honestly, this discussion seems to me to shed more heat than light.

[AdamSmith]

At the very least, both DSM-V and brain plasticity (which no one other than Kenny has discussed) suggest this is not the open-and-shut, black-and-white case others are making it out to be.

This is the heart of the question under discussion. My experiences have been that today there is broad professional consensus, from clinical researchers to the licensed social workers in local treatment centers, that both substance addiction and non-substance-related behavioral compulsions are related to physiochemical brain path changes.

[Rudynate]

This is the heart of the question under discussion. My experiences have been that today there is broad professional consensus, from clinical researchers to the licensed social workers in local treatment centers, that both substance addiction and non-substance-related behavioral compulsions can have physiochemical brain path manifestations.

 

A deeper understanding of the two pathologies doesn't mean that they are no longer two distinct pathologies. It just means that we know more about them. To me, modification of the CNS through repeated exposure to, an opiate, for example, is a different thing from modification of the CNS through endless repetition of a compulsive behavior.

[AdamSmith]

A deeper understanding of the two pathologies doesn't mean that they are no longer two distinct pathologies. It just means that we know more about them. To me, modification of the CNS through repeated exposure to, an opiate, for example, is a different thing from modification of the CNS through endless repetition of a compulsive behavior.

My understanding is that both substance addictions and behavioral compulsions manifest in identical pathological changes in the mesolimbic dopamine reward pathway.

 

They also respond similarly to the same treatment regimes for long-term recovery and relapse prevention (abstinence commitment, cognitive behavioral therapy, etc.), once the short-term physiological problems of withdrawal have been managed in the case of substance addiction.

 

So I'm not sure how yours is not a distinction without a difference.

[+ quoththeraven]

A deeper understanding of the two pathologies doesn't mean that they are no longer two distinct pathologies. It just means that we know more about them. To me, modification of the CNS through repeated exposure to, an opiate, for example, is a different thing from modification of the CNS through endless repetition of a compulsive behavior.

 

From what I understand, the scientists disagree. Neural modification is neural modification irrespective of how it occurs.

 

Moreover, once it occurs, it's not clear that the best way of treating it is necessarily dependent on how it occurred. As I've been told with regard to my foraminal stenosis, it doesn't much matter if it first affects my nerves and then my muscles or vice versa; the end result is the same and the treatment is the same regardless.

 

That is why this strikes me as a largely irrelevant argument over semantics that is more an airing of opinions than facts. I'm not an expert either, but I've read about brain plasticity in Cordelia Fine's Delusions of Gender (not even a particularly recent book), which explains how brain plasticity works and how it alone could be the reason for differences disclosed by PET scans of the brain of cismen and ciswomen. It seems to me that the discussion here takes the same sort of "common wisdom" approach as the commonly-held belief that these brain studies prove anything.

 

Which is all a more long-winded way of saying what Mr. Smith just did while I was editing this.

[Rudynate]

foraminal stenosis,

 

You have spinal stenosis?

[+ quoththeraven]

You have spinal stenosis?

 

Cervical. It causes pressure on the nerve going to my dominant (left) hand. I strongly suspect that neural rewiring as a result of putting up with it too long without proper diagnosis or treatment is the primary cause of my chronic fatigue, pain and fibromyalgia.

 

At this point, the symptoms of the stenosis itself have been dealt with, so generally speaking no more numbness or pain in the hand, but the results remain.

[Rudynate]

Cervical. It causes pressure on the nerve going to my dominant (left) hand. I strongly suspect that neural rewiring as a result of putting up with it too long without proper diagnosis or treatment is the primary cause of my chronic fatigue, pain and fibromyalgia.

 

At this point, the symptoms of the stenosis itself have been dealt with, so generally speaking no more numbness or pain in the hand, but the results remain.

 

 

I had lumbar spinal stenosis.

[Kenny]

I'm also skeptical of a HuffPo article about "Some Establishment Psychiatrists" challenging the DSM-5 that goes on to quote exactly one.

 

A more accurate, contextually appropriate headline: "DSM-4 Editor Questions DSM-5 Edition." Make of that what you will.

[+ quoththeraven]

I had lumbar spinal stenosis.

 

I notice you use the past tense. Was it resolved by surgery?

[Rudynate]

I notice you use the past tense. Was it resolved by surgery?

 

It's a long story, involving plenty of opiates, many epidural steroid injections, two surgeries and much rehab. Yes, today I am largely symptom-free.

[+ quoththeraven]

It's a long story, involving plenty of opiates, many epidural steroid injections, two surgeries and much rehab. Yes, today I am largely symptom-free.

 

In my case, the condition still exists, but the symptoms are mostly gone with the help of occupational therapy and the use of thicker, softer pens (something the therapists insisted on). However, I have other issues which cause neck pain (bone spurs, damage to discs) that aren't as easily resolved.

[Rudynate]

In my case, the condition still exists, but the symptoms are mostly gone with the help of occupational therapy and the use of thicker, softer pens (something the therapists insisted on). However, I have other issues which cause neck pain (bone spurs, damage to discs) that aren't as easily resolved.

 

It's interesting. My chiropractor ordered a spine x-ray not long ago. She sent it to a chiropractic radiologist for an expert reading. I have one or both of disc disease or joint disease at nearly every level of my spine, but largely no symptoms.