The Complicated Truth About What It Means To Be A "Sex Addict"

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In the trailer for the new season of Keeping Up With The Kardashians, Scott Disick passionately tells the family: "I'm a sex addict!" This is a new revelation for Disick, and could possibly be his way of explaining certain behavioral patterns that have gotten him in trouble in the past — but is sex addiction really a thing?
"Sex addiction" (a.k.a. compulsive sexual behaviors, hypersexuality, hypersexual disorder, or nymphomania), can be a complicated concept in the clinical sense, because researchers debunked the idea that sex can be an "addiction" a few years ago. Most experts now agree that compulsive sexual behaviors exist (and can be very problematic), but they have trouble throwing around the word "addiction," because these behaviors don't present themselves in the same way as well-established addictions, like addictions to drugs or alcohol. "'Sex addiction' is widely used as a metaphor for out-of-control sexual behavior," says Eli Coleman, PhD, LP, professor, Director, and Chair of the University of Minnesota Program in Human Sexuality. "The term is misleading, and I feel it's unfortuante." The more precise term? Compulsive sexual behavior (CSB).
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In 2013, researchers from the UCLA looked at the brains of so-called "sex addicts" to see how they responded to triggers (like porn). In theory, their brains should have reacted the same way to seeing a photo of a naked person as the brains of people addicted to drugs would to seeing a photo of drugs. But this wasn't the case. The people in the "sex addiction" category didn't have any neurological reaction to the images. Instead, researchers have found that CSB is similar to other compulsive disorders, like obsessive compulsive disorder (OCD).
But just because "sex addiction" likely isn't real in the purest sense, that doesn't mean it's not distressing. CSB is defined by an obsession with sexual thoughts, urges, or behaviors that causes the person distress or negatively affects their health, job, and relationships, according to the Mayo Clinic. A 2003 study from the University of Minnesota found that an estimated 5% of the population meets the criteria for a compulsive sexual disorder. Some people with CSB have intense preoccupation and obsession with sex, while other people are just lacking impulse control, Dr. Coleman says. "It's something that's really very disruptive to an individual's life, and there are many serious consequences to the people around them."
Even if it seems like no big deal, using the correct terminology for CSB goes beyond quibbling: The more we understand it for what it is, the sooner more effective treatments can be developed. Dr. Coleman just completed a study to understand the brain mechanisms behind CSB, and none of his findings fit an addiction model. "There's a lot of discomfort with the term sexual addiction, because it equates it to drug and alcohol addiction," Dr. Coleman says. When you call something an addiction, that implies that the way you treat it is with abstinence, he says, but that just wouldn't work with sex because it's so vastly different. "People can abstain from alcohol and drugs to help with the connection between the substance and the receptors in the brain, but people can't abstain from sex," he says.
Instead, you approach CSB treatment like you would an eating disorder, and help a person regulate behavior in more realistic ways, he says. That can mean medications to help regulate the neurotransmitters and psychotherapy to address what's driving the behaviors.
As for Disick, we can't assume we know what's causing his behavior (no matter how many episodes of KUWTK we've seen), and that's not just because we don't know him. "The behaviors may look the same in the end, but it's driven by different [brain] mechanisms," Dr. Coleman says. "They're not the same for everyone."
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