In the sex therapy community, sex addiction is one of the most controversial topics. Some professionals see validity in labeling compulsive sexual behavior as an addiction. Others identify that some people are contending with a problem with sexual behavior that is out of control. Then there are professionals who don’t believe that sexual compulsivity exists at all.
For those who are in need of help, the professional discourse can make things confusing. It can be complicated to identify the best therapeutic direction to take. For gay men, it can even be more confusing. Many of the most intense psychotherapy debates surrounding sex addiction involve the treatment of gay men. Those who are advocates of the gay community identify a history of therapists who use Sexual Orientation Change Efforts (SOCE) treating homosexuality like a treatable illness. This pseudotherapy is considered unethical, harmful, and even traumatic by almost every major medical, counseling, and psychological board. For gay men, there is caution, and sometimes there is even suspicion in making a therapeutic choice.
Today, psychology has come a long way from its roots of harmful practices towards gay men. However, there are remnants that are still around. Many gay clients are looking for a professional who they know that they can trust. One who will respect the circumstances that are specific to this community, but also a professional who will respect self-determination. When it comes to sexual compulsivity, these clients have to contend with sexual stereotypes and self-acceptance. They need a professional who can help them through this. When the professionals focus too heavily on the debate, and not on the needs of this community, the individuals of the community are the ones who will suffer.
Differing Professional Opinions on Sexual Addiction
Sexual addiction is described as compulsive, repetitive engagement in sexual behavior that is damaging to a person’s relationships and life. Opinions within the therapeutic community on sexual addiction vary greatly. On one end of the therapeutic spectrum, there are professionals who are completely against defining any compulsive behavior as an “addiction”. For the critics of sexual addiction treatment, this perspective has been further validated by the American Association of Sexuality Educators, Counselors, and Therapists (AASECT) releasing a position statement on this topic. In this statement, AASECT openly disagrees with characterizing compulsive sexual behavior as an addiction. They don’t deny that it exists, but report that they can’t subscribe to naming these behaviors an addiction at this time.
Then there are the proponents of sex addiction who identify repetitive, compulsive, out-of-control behavior as one that matches the definition of addiction. They hear the benefits that clients report from engaging in addiction-based support groups. They also report benefits in their clients with utilization of motivational interviewing and relapse-prevention. The most well known professional group that represents these professionals is the International Institute of Trauma Addiction Professionals (IITAP).
There is also a lot of middle ground in these opinions as well, which can make the topic of sexual addiction complex. There are controversies relating to the definitions of healthy sexual behavior. There are also controversies surrounding the misrepresentation of non-traditional relationship styles and sexual expressions. To add to these layers, advocates and scholars on both sides regularly disagree, which can make the lines surrounding addiction blurry.
For those who need help for a problem with compulsive sexual behavior, these arguments can make finding help confusing. All of the mixed opinions on sexual addiction can make it complicated to determine if the sexual behavior is out-of-control or “normal.” A person can completely destroy their relationship with a sexual behavior that is compulsive, and find a therapist with the opinion that this was never out-of-control to begin with. On the other hand, a person could be engaging in normal, harmless, human sexual expression, and find a therapist who would be quick to call this a “sexual addiction”.
Gay men who are dealing with compulsive sexual behavior are especially vulnerable to such confusion. There are therapists who tell gay men that they are being “too traditional” and “too uptight” when they have a problem with a partner who compulsively cheats. Some of these men are dealing with a serious problem in their relationships, and want to salvage this, but struggle to find help. Then, there are men who are identifying their attraction to other men, but not yet ready to accept a label of gay or bisexual. They are at risk of getting involved in pseudotherapies that claim that they can change their sexual orientation. Unfortunately, some of these professionals will call these clients “addicts.”
This confusion and vulnerability of gay men makes it significant for therapists to come together. A divided therapeutic community leads to a decreased understanding of sexual behavior. To best understand any issue, professionals with different opinions and backgrounds have to come together. They can ask each other tough questions, for the betterment of the field, but even more importantly, the betterment of the treatment of the clients who need help.
At this time, both ends of this argument create an environment that discourages open discussions. The discussions aren’t really discussions at all. The professionals who are supposed to help clients in need are struggling with their own egotism and battle for dominance. Of course there are outliers who want to bridge the divide, but they’re in the minority at this time.
Although it hasn’t happened yet, when my colleagues are able to have these open discussions about sexual compulsivity, I know that they will create definitions that promote clarity, rather than confusion. In regards to the treatment of gay men, it will help them by identifying what is problematic, with protocols and definitions that become increasingly based in fact. This unity will also promote a unified war against therapists who use sexual addiction therapy as a disguise to shame their gay clients into wanting to change their sexual orientation.
Michael J. Salas is a counselor in Dallas, Texas who specializes in relationships and sexuality. Read more about his specialties and counseling perspectives at vantagepointdallascounseling.com.