This week's segment of CBS Doc Dot Com sexual addiction, a subject about which I learned absolutely nothing in medical school and have not learned much more since. In researching the topic over the past week, I began to understand that it is extremely controversial, with experts not even agreeing about whether sexual addiction is a true addiction.
For one side of the definitional argument, I spoke to addictions treatment specialist Mavis Humes Baird, who is convinced that sexual addiction is a true disorder because people are in the throws of an impulse they can't control, that there are underlying changes in the brain that cannot be addressed by psychotherapy alone. She told me, "for example, if one of the partners in a couple is having affairs and they're not a sex addict, marriage counseling or family therapy is very effective. But if they're a sex addict, all the therapy in the world getting at problems in the relationship won't touch the addiction. One of the primary referral sources for sex addiction is couples counselors who have been doing attachment work with couples for years with the addiction going on unaffected and sometimes kept secret for all those years. You can't treat the sex problems between the partners until the addiction is treated. And that's done by a combination of specific treatment protocols, and 12-step program involvement, and sometimes medication."
On the other side of the definitional aisle is Dr. Herbert Kleber, Professor of Psychiatry at Columbia University Medical Center, where he is the Director of the Division on Substance Abuse. When I asked him about sexual addiction, he said: "Is it an addiction? I'm convinced gambling is an addiction but am agnostic about sexual addiction. Once you let one of them in the door do you let in shopaholics, kleptomaniacs, etcetera? Where do you draw the line?"