Sex addiction. Is it a thing? Dr. Drew Pinsky bet his showbiz career on it. But David Ley, a New Mexico-based clinical psychologist specializing in sexual health, begs to differ. Ley holds forth that the concept of sex addiction is nothing but a myth, and a dangerous and reprehensible one at that. He wrote a book, critics took him to task, and major controversy (and vitriol) ensued. He is colorful, charismatic, and he takes a strong stance. I spoke to him at length about sexual proclivities and social mores, and what it really is that gets our collective panties in a twist.
Have you always focused on issues of sexuality? What got you interested in sex in the first place? Professionally speaking, that is.
I’ve always been interested in sexuality, professionally. I started working with sexual offenders, many years ago, but over time, people and colleagues started bringing me lots of sex-related issues, even those that didn’t involve crime or abuse. The reality is that most therapists and doctors receive very little training in sexuality, so it’s easy for them to run into issues that are beyond their understanding or competence. Gradually, I learned that there were lots of people who needed help, but couldn’t be open with their therapists for fear of being judged about their sexual behaviors, desires, kink, or alternative lifestyle. I try to help those folks. Besides, with the name Ley, I was either destined to be a politician involved in a sex scandal or a sex doctor. I think I made the best choice.
Totally. You’ve been widely criticized for calling sex addiction a myth in your book, aptly titled, The Myth of Sex Addiction. What was the catalyst for taking this position?
I come from a very traditional scientific and clinical background. There, sex addiction is simply regarded as pop psychology with little substance or merit. After I wrote my first book, Insatiable Wives, I was invited to speak about it, but people were more interested in the stance I took against sex addiction in one case study I described. I was frankly surprised to find that so many people considered the concept of sex addiction to be worthwhile. Now, I try not to be arrogant, so I spent some time exploring whether they were right and I was wrong. Ultimately, after reading all of their writing, their poor research, and interviewing sex addiction clinicians and their patients, I came to the conclusion that not only was this concept unfounded, but that it was unhelpful therapeutically, and actually damaging to patients. I believe that the concept of sex addiction, and the industry that supports it, represents the worst of sexually suppressive, stigmatizing biases and morals.
Did you know you’d stir up such controversy? Was that sort of the point?
I didn’t expect or intend controversy. I do love being the little boy in the crowd, who calls out, “The emperor’s not wearing any clothes, and I can see his ding-a-ling!” I was expecting some attention, but nothing like the vitriolic and reactionary response I’ve gotten. Since I wrote the book, clinicians and people around the world have come to me and said they agree with me, but were afraid to speak up. The sad reality is that the sex addiction industry and their “true believers” are a reactionary, loud, aggressive group who attack those who challenge their beliefs. They rely on the sex addiction concept for their income, and often for their own peace of mind. Most defenders of sex addiction’s validity identify as sex addicts. Kind of a conflict of interest, isn’t it? So when someone like me says, “Whoa there, big fella, I don’t think the science supports what you are doing and saying,” they react like I’m challenging their religion or politics. In fact, I think that’s why this controversy is so polarized. Their belief in sex addiction is more like a faith, or an ideology. It’s not a scientific or medical theory.
From what I’ve read, it seems like your viewpoint on sex addiction, or the mythology thereof, is pretty male-centric. Do you believe that men are more under attack than women when it comes to understanding sexual behavior?
Oh, women definitely had their time in that ugly light. Women who were called nymphomaniacs had awful things done to them [like] lobotomies, clitorises surgically removed, rape, shaming as sluts —awful, awful things. But, since AIDS came on the scene, and the social view of masculinity shifted, male sexuality is now regarded as inherently dangerous, uncontrolled, and immoral. Men are viewed in the current light as constantly being right on the edge of rape. I think this view is biased, but further, I think it’s dangerous, and actually makes men more likely to act out in angry, desperate ways. I see many men who don’t understand their sexual urges, their aggression, and their temptations, and feel tremendous shame about them. When you add in the fact that the sex addiction industry aggressively shames gay and bi men, we really do see that there is an ugly, unhealthy, social view of men and male sexual drive. Groups like the XXX Church view male homosexuality as the result of watching too much porn, and bi men who are living in the closet are prime fodder to be told that their sexual desires are the result of illness. As a clinician, I find that reprehensible. We’re not supposed to say that someone is ill just because society doesn’t like the way they think, feel or behave. This might sound grandiose, but I think this fight is important to prevent societies from using the power and respect of medicine and healthcare as a way to control people.
I feel like it was about 20 years ago that the term “sex addict” started getting tossed around. I remember some really bad made-for-TV movies. Then Oprah started talking about it and everyone listened because, well, she’s Oprah. Then, of course, there was Dr. Drew.
You’re about right. It was in the early 80s that the idea broke on the scene. Bill Clinton’s blowjob in the White House triggered lots of media attention. Even though Kennedy had sex in every room of the White House and around the world, with different women in every country, Clinton was called a sex addict for his dalliance with Monica [Lewinsky]. What changed wasn’t the behavior of these men, but the social view of male sexual behavior, and whether such infidelities by the powerful were excusable.
So, then I’m thinking a lot about sex addiction as portrayed in the media. The dark and claustrophobic movie Shame with Michael Fassbender takes a clear and unblinking stance on the issue of sex addiction. I was reading a review of Lars Von Trier’s Nymphomaniac in which the reviewer lumped “sex addiction” in with fetishes and BDSM, and then called it the “more worrisome side of sex,” which I thought was interesting in a confusing sort of way.
The media lives off of portraying a dark, scary, anxiety-producing view of sex. They want you to be nervous about sex, so they can sell you shit when you tune in to Dr. Drew, or Oprah, especially Western media. The movie Shame is not called that by accident. Shame is a moral attitude reflecting social issues, not medical ones.
Frankly, the media and movies reflect our social consciousness. There are as many movies like Friends With Benefits and No Strings Attached, which explore the question of whether sexual fidelity and monogamy are really necessary and inherently healthier. Right now, our society is really struggling with our sexual values. The gay marriage debate, popularity of Fifty Shades of Grey, [and] the porn debate, all reflect our social struggles with changing sexual values. Sides are squaring off, labeling sex as scary and dangerous, versus the idea that it is merely another part of life which can be as healthy as the person having it. Our movies and media are simply an expression of that dialogue.
How do you differentiate between addiction and disorder?
The word addiction is like the word “moron.” Both once meant something precise in medical language, but were slowly corrupted by social use so that they no longer were precise or clear enough. Modern mental health and scientific theories rarely use the word ‘addiction’ any longer because it’s become so vague and meaningless. If you can be “addicted” to Chapstick, smartphones, tanning beds, etc., then we are really only using the word to describe “any problematic repetitive behavior that somebody doesn’t like.”
Secondly, the use of the word addiction implies that we know what the cause is —in this case, sex or porn. But all the research shows that the actual causes of these problems are social attitudes towards sex; conflict within a relationship about sex/sex frequency; underlying mental health issues such as personality disorders; or moral conflicts. At this point, the null hypothesis is still that there is no “disorder” here, but that what we are seeing is the result of the above issues. Until that null hypothesis is disproven and the evidence shows that a separate disorder is the best explanation, we can’t – shouldn’t – jump on the sex addiction bandwagon. To do so is to replicate the history of medicine where we believed that masturbation was dangerously unhealthy and weakening, that homosexuality was a disease, and that women who enjoyed sex [the way men did] were mentally disturbed.
So, when do fantasies become unhealthy, if ever?
We simply don’t know. It’s surprising perhaps, but think about it: fewer than 10% of people ever share their deep, dark, sexual fantasies with their husbands or wives. Think they tell us doctors, who are going to diagnose them for it? Not a fucking chance. Research is showing that many people have very rich, even sometimes disturbing, sexual fantasies but are perfectly healthy people. Brett Kahr [a British psychotherapist] examined the sexual fantasies of thousands of people. He concluded that there was no such thing as a normal fantasy, and the only unhealthy fantasies were ones that were two-dimensional and lacking detail. Fantasy appears to be a way we work things out, relieve anxiety, deal with cognitive and emotional struggles. While some fantasies are scary to hear, there’s actually no real evidence that those fantasies lead to people acting in unhealthy, dangerous ways. This is surprising, because we normally view these unhealthy-seeming fantasies as dangerous. Compared to things like poverty, general mental health, isolation, a sense of fulfillment and accomplishment, sexual fantasies have very little impact on why people do what they do. Focusing on scary fantasies is a “sexy,” attention-getting, anxiety-producing way to drive and shift social and media dialogue away from addressing the things that really count.
In some ways, it seems like “sex addiction” is sort of a catch-all phrase labeled as a disorder.
Damn straight. The addiction industry has now spawned the “process addiction” industry, which sells snake oil. They promote the untested, unproven, and frankly dangerous perspective that 12-Step approaches are the best “treatment” for any problematic behavior. It’s about money, media and morality, and about giving people an easy [and] simplistic answer, which seems true, but is really just a distraction.
I’m thinking of the feminist movement and the LGBTQ community and their allies. All of a sudden, things are changing pretty quickly. Some things, anyway. As a psychologist, how have you come to understand sexual relationships in today’s society?
Wait, I’m supposed to understand relationships? Really? Shit. I fucked that one up.
This is a big social dialogue. I’m just a silly psychologist. My job here is to keep from making this moral, social argument into a medical or mental health one. It’s not. Keep it out of my diagnostic catalogue. Don’t pretend it’s a medical issue so that we can treat it, medicate it, suppress it in treatment facilities, or distract from the moral conversations that have to happen.
Oh, and I find the involvement of radical feminists like Gail Dines, [Andrea] Dworkin, etc., in the argument against porn to be extremely disturbing. They exemplify the view that male sexuality is dangerous and inherently immoral. They twist the concepts of addiction to serve their purposes, and they flat-out ignore the fact that pornography is good for society. Across the world, access to porn decreases sex crimes, rape, [and] sexual abuse. In contrast to the belief that porn causes rape, it actually prevents it far more often. If they really want to protect women and children, they should be arguing for greater access, not less. The recent British censorship movement is flat-out frightening. It’s based on moral concerns, masquerading as medical and social ones. And the bizarre feminist-conservative alliance is behind it.
You’ve said a couple of things in particular that have really gotten people’s panties in a twist. Like, “nobody’s ever died from having too much sex” and “orgasms never stop feeling good.” Playing devil’s advocate: I can hear people saying that a true addict doesn’t care what the consequences are, which, theoretically, and in the sense of “addiction,” can lead to unprotected or dangerous sex which could then lead to actual death. I can also hear people saying that an addict becomes desensitized in the same way that a drug addict’s tolerance becomes abnormally high, so that orgasms cease to truly feel good; it’s just about feeding the addiction.
For the record, I’m a Southern boy, and the phrase “getting your panties in a bunch,” is one of my all-time favorites.
The argument is so polarized and because I’m one of the only folks standing up to these moralizing, sensationalist, Chicken Little arguments, I’ve got to take strong stands. Nuanced arguments get lost in the dust.
Look, everyone has the sense that when they’re turned on [and] horny, they can do stupid stuff [like] have sex without a condom, with someone they don’t really like, [and] engage in behaviors they wouldn’t normally enjoy. As teens, many people try to stop masturbating. They all, universally, fail. This is a human reality – that sex and sexual arousal is rewarding, stimulating and affects our judgment.
When I was a kid, the Victoria Secret catalogue (OK, I’m older than that —the JC Penney lingerie section) would get me hard. Nowadays, it takes a wee bit more than that. Why? Not because of desensitization or addiction, but because of normal sexual development. When I was young, I might have an orgasm after only a few minutes, but as I’ve aged, I can last longer. Is that addiction? No, it’s normal sexual development and aging.
When the alleged effects of sex/porn addiction can be distinguished from these normative developmental processes, I’d be willing to consider them plausible. Until then, this is just what I call “Valley Girl Science.” [It’s] saying sex is “like” drugs and alcohol, and thus real. It’s not. They want to say sex is a disease, fine. Prove it. Not through analogy, but come up with their own real theories, test them, and show me the evidence.
You’re a psychologist with a special interest in sexual health who happens to be good looking. Does that ever make things weird in your personal life? (You can totally say, “no comment” and I promise I won’t assume that that means yes.)
Well, gosh. And you haven’t even seen me in real life, much less naked. I’m thrilled to be good looking! Thanks.
I try not to talk too much about my personal life because then it changes the conversation from the data towards the view that I’m simply defending my own sexual issues. However, over the years, the rabid, aggressive, angry sex addiction folks regularly accuse me of being a sex addict in denial – or even that my wife is a sex addict – and that’s why I’m against this. I think their arguments reflect their egocentrism and the power that their own anecdotal experiences have over their views of the world. Because their personal experiences disagree with the research, they figure the research must be wrong and they can’t understand that I’m arguing on the basis of objective research and scientific approach. But, you know, the world seemed flat until research proved it’s not. If someone isn’t willing to reconsider their opinions based on objective evidence, then we’re dealing with irrational beliefs.
Also, I have a physical disability. I was born with only one hand. As a disability, it’s obvious, though it’s really not all that disabling. As a child, I was bullied and treated as different. As a teen, I got in lots of fights when people bullied me, or my friends, for being different. There’s nothing I hate more than a bully who picks on other people’s differences. That’s what most of sex addiction theory and treatment is; they are saying, “Your sexual desires and behaviors should be more like ours, and there’s something wrong with you that they’re not.” So, from a personal standpoint, I’m standing up to that.
I’m really glad to be having this conversation because I think it’s an important issue to examine regardless of what side of the argument you’re on, so thanks for talking to me about it. Last question: what would Alfred Kinsey say?
Kinsey said it best: “The definition of a nymphomaniac [sex addict in today’s terms], is anyone who has more sex than you do.” The same level of subjective, stigmatizing, morally-driven sexual values were present in his day. His research led us to change our view of what was “normal,” or even common. Today, the explosion of the Internet has led to very similar changes as Internet communication and pornography are teaching us things about how sex, sexual desire, [and] sexual relationships actually work, as opposed to how we want them to work or think they should work.
These are very exciting times with big, dramatic shifts. Before I wrote my book, Insatiable Wives, describing permissive female infidelity and the “hotwife/cuckold” dynamic, nobody really took that phenomenon seriously. Today, it’s the second most popular form of porn on the Internet because it has tapped into powerful biological and psychological dynamics that I explained in that book. There are many more such things waiting to be discovered if we can suspend our biased views of what is “normal,” to explore what actually is happening in the bedrooms and minds of people.
Follow Dr. David Ley on Twitter: @DrDavidLey