Julie can pinpoint the moment her addictive, obsessive relationship to sex began. She was 14, and had just been raped. The following evening, in a daze of confusion and pain, she went out, picked up a man, and had sex with him—she thinks now that she did it that night to try to regain a sense of control over her sexuality. But over the next 15 or so years Julie (not her real name) would enter a spiral of drink, drugs, and more and more sex.
“I started having more partners, sleeping with other peoples’ partners; I had women, I had orgies, I started compulsively masturbating,” she says. “I kept looking for a bigger and bigger kick.”
Sometime around the age of 30, having spent years engaging in risky behaviour that took its toll on her relationships and her career, Julie walked through the door of her first Sex Addicts Anonymous meeting and began the process of getting her sex life under control.
Although Julie, now middle-aged, has kept her sexual behaviour in check for years, when I made contact with her, the first words she used to identify herself were “sex addict”—not unlike someone who’s been sober for years, but still identifies as an alcoholic.
Julie is far from alone. Sex addiction is reported to be on the rise in countries from India (where Sex Addicts Anonymous just founded its first chapter) to the U.S. In the U.K., demand is so great that one psychotherapist recently told a newspaper she was training 600 therapists a year in sex-addiction counselling.
So it might come as a surprise that, officially, sex addiction isn’t actually a thing.
“We don’t offer treatment for that,” says Michael Torres, a CAMH spokesperson. After a little prompting he explains. “Addiction to sex doesn’t appear in the DSM so is not considered a diagnosis.” (The best they can do is put you down for a bit of OCD or bipolar disorder.)
DSM stands for Diagnostic and Statistical Manual of Mental Disorders. Published by the American Psychiatric Association, it is the holy book of shrinkdom. If your problem isn’t in there, it doesn’t officially exist. The APA is currently updating the good book (the fifth edition is due in May) and for a while it looked like a few pages might be reserved for “hypersexuality”, but in December, news emerged that it would probably not make the grade. In the eyes of the APA, and by extension, medical bodies in Canada, you can’t be a sex addict. And if sex addicts don’t exist then there’s no reason for provincial health plans to cover treatment.
Part of the reason the disorder hasn’t made it to the DSM is that it’s almost impossible to define any behaviour a sex addict engages in that some non-addicts don’t. On diagnostic questionnaires, a man who visits a prostitute, or a wife who cheats on her husband, are considered to be engaging in “risky or illegal behaviour,” while any teenage boy with an internet connection probably ticks the box for “compulsive masturbation.” Online tests to determine whether you’re a sex addict are hilariously out of date—you can almost hear the author of one twirling her pearls, breathlessly asking whether you’ve ever gone online to find a hookup.
According to David Norris, a counsellor at the private Bellwood clinic near Steeles and Victoria Park, sex addiction is a real and treatable condition, and he suggests that much of the discussion of the subject has more than a whiff of moralizing to it. “I think there is a real stigma out there still that is slowly changing, but it is still very prevalent,” he says.
For Norris, the reasons that sex addiction is so hard to define are also the reasons it’s so hard to treat. Unlike substance abuse, where the goal is total sobriety, few people want to become completely abstinent from sex.
Bellwood offers the recovering sex addict everything from a once-a-week chat with a therapist to a three-week all-inclusive rehab vacation. As one recovering addict told me, Bellwood is the “Rolls Royce” of treatment options in Toronto—with a price tag to match. Paying hundreds or thousands of dollars a month is only possible if you’re a sex addict who also runs a bank, so Norris recommends his clients also join a free 12-step program like SAA or Sexual Compulsives Anonymous.
Whether sex addiction is officially recognized or not, the pain and suffering of the SAA and SCA members I spoke with is real. One said, “People think of it as a moral failure, but to us it is a disease,” and all claimed that having a judgment-free zone for support and guidance was crucial in getting their lives back on track. As Julie puts it, “Going to SAA saved my life.”