Ariel Castro, the man who kidnapped and repeatedly raped three Ohio women for more than a decade, has once again asserted that he is not a "monster," but merely a sex addict -- this time at his sentencing hearing. Though I am not privy to the full facts of this case, nor have I spoken with Ariel Castro, it seems to me that his self-expressed self-diagnosis of sexual addiction is fairly typical of psychopaths -- who frequently attempt to win sympathy and pity in hopes of a reduced punishment. Or perhaps Castro simply believes that "sex addict" is a nicer term than "monster," the word currently being used by many in both the press and general public to describe him. The simple truth is there might or might not be an addictive element to Ariel Castro's horrific behavior; I couldn't say for sure without conducting a thorough, in-vivo assessment. Nevertheless, judging from the information presented in literally hundreds of well-researched media reports, Mr. Castro should most likely be categorized not as a sex addict but as a violent sexual offender (best defined here).
Meanwhile, Anthony Weiner and Eliot Spitzer are back in the New York political news groove, Weiner a relevant mayoral candidate, Spitzer legitimately vying for the office of comptroller. For the most part, Spitzer has been flying under the radar. Weiner, however, has been front and center, gobbling up media and social media gigabytes like so many Skittles. And despite recent revelations that the sexting which led to his 2011 congressional resignation continued for many months even after the scandal broke, he continues to deny that he is a sex addict. As with Castro, I've not performed a professional assessment, so I can't state with any certainty that Weiner is or is not a sex addict. Nevertheless, the fact that his problematic sexual behaviors continued even after he was found out is, in my experience, a strong indicator of addiction. It's a bit like an alcoholic who gets arrested for drunk driving and then, immediately after being released from jail, heads to the liquor store, or a gambler who loses his kid's college fund, gets confronted by his wife, and then applies for a bank loan the next morning so he can continue to gamble. Why do they continue their problematic actions even after they've been caught? They do it because they're addicted, and addictive behaviors are how they cope with life. The story is no different with Weiner, except his problem is sex rather than alcohol or gambling.
In addition to Castro's probable misrepresentation of himself as a sex addict and Weiner's probable misrepresentation of himself as not addicted, the field of sex and intimacy disorders is also dealing with confusion caused by a recent study suggesting sexual addiction might better be understood as a pathological variation of "high sexual desire."
Even Scientists Get It Wrong Sometimes
The research mentioned above looked at 52 men and women who'd self-reported "problems controlling their viewing of sexual images," asking questions about their sexual desire and behaviors and then monitoring their brain activity (using EEGs) while they looked at 225 images, some of which were of men and women being sexual together. Almost as soon as the study came out, scholars began to pick it apart. For starters, test subjects were not properly screened for sex or porn addiction. The volunteers were also not screened for co-occurring conditions that could interfere with the test results. Additionally, the survey questions focused on partner-sex while the brain scans measured responses to solo sex (looking at porn), even though there is a huge difference in how most sex addicts respond to in-person vs. online sexual experiences. Furthermore, the test subjects were shown only still images rather than the streaming HD videos that most were likely used to using. Then there is the fact that EEGs were used to measure subjects' brain activity. If you're not familiar, EEGs measure brain activity from outside the skull, making them the neurological equivalent of a blunt instrument. This is hardly definitive when looking at the complicated interplay of the numerous brain regions involved in the creation and expression of behavioral addictions (brain centers that deal with pleasure, mood, memory and decision-making, just to name a few).
Nevertheless, the press has latched on to this study, with some media members suggesting it is evidence that there is no such thing as sexual addiction. (Even the study itself does not argue for this.) At the same time, the press has also been widely reporting Castro's misguided sex addiction defense, along with Weiner's claims that his sexual peccadilloes are the result of a "blind spot" and that they are "in the past." So what is up with all this wonky reporting? Why do we constantly see all sorts of conflicting information in the popular and sometimes even the scholarly press? Obviously this occurs because there is a lack of understanding among the media, the general public, and even among some members of the clinical community about what sexual addiction really is, how it manifests, and its devastating effects.
The Real Dope on Sex Addiction
For starters, sexual addiction is not defined by either sexual offending (as Ariel Castro would have us believe) or having a high sexual desire (as the study would have us believe). Instead, sexual addiction is about escape and dissociation from life. Essentially, sex addicts are men and women who've learned to repeatedly self-medicate their depression, anxiety, boredom, low self-esteem, unresolved childhood trauma, and/or any number of other underlying conditions by numbing out via sexual fantasy and behavior. Alcoholics drink, drug addicts use, food addicts eat and gambling addicts place wagers for the exact same reasons. In other words, sexual addiction is the abuse of sexual fantasy and behaviors as a means of finding escape and emotional distraction.
Unfortunately, sex addiction can be difficult to diagnose, in part because some people use the term "sex addiction" to define any sexual behavior that doesn't meet their relationship, religious or cultural values. For instance: My church says that looking at porn is a sin, and my husband has looked at porn on two occasions. Therefore he must be a porn addict. Others, such as Anthony Weiner, avoid the sex addiction diagnosis, probably because they either don't wish to address/curtail their problematic sexual activity or they feel such a label might stigmatize them. Still others, like Ariel Castro, attempt to use "sex addiction" as a catch-all excuse for bad behavior. Occasionally these individuals really are sex or porn addicts, but just as often they are not. Either way, a diagnosis of sexual addiction is never intended to justify bad behavior.
Sex Addiction Is NOT...
When diagnosing sexual addiction, it is important to not only recognize what sexual addiction is, but what it is not. Things that do not define sexual addiction include:
- Sexual orientation: Same-sex arousal patterns are not a factor in the diagnosis of sexual addiction, even if those patterns are unwanted. Being gay, lesbian, or bisexual does not make you a sex addict any more than being straight makes you a sex addict.
- Concurrent drug use: Sometimes drug addicts become hypersexual when high, especially if they add Viagra, Cialis, or other sex-enhancing drugs to the mix. This does not, however, make these people sex addicts. If the compulsive sexual behavior occurs only in conjunction with drug use, a diagnosis of sexual addiction is not appropriate.
- Fetishes: Fetishes may cause a person to feel shame or distress, and even to feel out-of-control, but, like same-sex arousal patterns, fetishes are not indicators of sexual addiction. In other words, sexual addiction is not in any way defined by who or what it is that turns you on.
- Mania, OCD, adult ADD, etc.: Not everyone who is compulsively sexual is a sex addict, as hypersexual behaviors are legitimate symptoms of numerous disorders. Before a diagnosis of sexual addiction can be made, professionals must first rule out these other potential diagnoses.
- Sexual offending: As mentioned above, a small percentage of sexual addicts do escalate into offending behaviors. However, sexual addiction is not, per se, indicative of sexual offending (or vice versa). In any case, being diagnosed with sexual addiction is never an excuse for bad behavior; all addicts must take full responsibility for the hurt and pain they've caused.
The Importance of Getting It Right
Unfortunately, people both in and out of the clinical community can and do misuse the sexual addiction diagnosis. This sometimes occurs through ignorance; other times it is the result of a self-serving agenda. Whatever the reason, misuse of the sexual addiction diagnosis ultimately serves no one. Instead, it creates confusion and sometimes even acrimony. It also, at times, prevents people who really are sex addicts from getting the help they need. After all, nobody in his/her right mind wants to be lumped into the same category as a guy like Ariel Castro (who, again, is most likely not a sex addict). This would be doubly true for someone living his life in the public eye, as Anthony Weiner chooses to do.
Unfortunately, a blog like this one is merely a bucket of water tossed on the raging inferno of sex addiction misinformation. Most of the time a well-reasoned analysis of what sexual addiction is and is not such as this one (I hope) is seen and possibly read, but it is not viewed as sexy enough to be tweeted about, republished, or paraphrased and regurgitated in the popular press. This is unfortunate and in many ways discouraging, but it is not enough to stop those of us who treat sexual disorders from continuing to do so. After all, we see every day the havoc and damage that sexual addiction, sexual offending, and other intimacy issues wreak on individuals, families, and society at large. We cannot sit idly by and do nothing to help. It is my hope that with sexual addiction so firmly in the limelight at this particular moment that this article will finally help to clear up some of the common misconceptions about sexual disorders. Of course, only time will tell.
Robert Weiss LCSW, CSAT-S is Senior Vice President of Clinical Development with Elements Behavioral Health. A licensed UCLA MSW graduate and personal trainee of Dr. Patrick Carnes, he founded The Sexual Recovery Institute in Los Angeles in 1995. He has developed clinical programs for The Ranch in Nunnelly, Tennessee, Promises Treatment Centers in Malibu, and the aforementioned Sexual Recovery Institute in Los Angeles. He has also provided clinical multi-addiction training and behavioral health program development for the U.S. military and numerous other treatment centers throughout the United States, Europe, and Asia.