March 16, 2010

New critique of proposed hypersexuality disorder

Although the construct of hypersexuality is becoming popular with clinicians, strong empirical evidence for its validity is lacking, according to a new critique in the Archives of Sexual Behavior. The author, Jason Winters, is a research psychologist involved with the High Risk Sex Offender Program of the Forensic Psychiatric Services Commission in Vancouver, BC.

As with other disorders being proposed for DSM-5, due out in 2013, the boundary between normalcy and supposed pathology is fuzzy and arbitrary, writes Winters. Findings from a recent Internet survey he conducted suggest that more than four out of every ten men and one out of five women might meet the "excessive sexuality" criterion, operationalized as an average of seven or more orgasms per week.

And if behaviors that interfere with other responsibilities are evidence of pathology in the sexual realm, why not create formal mental disorders for other types of preoccupations? For example, why not pathologize a tenure-track professor who prioritizes academic work over family and friends? (I was glad Winters did not mention excessive blogging as an example of a potential mental illness, but then I remembered that Internet Addiction has already been proposed for the DSM.)

The criterion of engaging in sexual behavior to enhance mood is similarly problematic:
[I]f we are to accept that repeatedly engaging in sexual behaviors to enhance mood is symptomatic of a distinct sexual disorder, then we must also be willing to accept that repeatedly engaging in non-sexual rewarding behaviors for a similar effect is symptomatic of other corresponding mental disorders…. [But] the DSM does not include disorders of watching too much television, or shopping, exercising, or working too much.
As Winters points out, an unstated bias against sexual expression outside of a traditional monogamous marital dyad seems the basis for calling some sexual behaviors -- such as one-night stands, anonymous sex, and multiple partners -- evidence of disease.

Ultimately, he concludes that while excessive sexuality may be problematic and distressing for some, and in such cases merits clinical attention, a new diagnosis may be of "dubious value."

Except, I might add, to the civil commitment industry, increasingly desperate for new diagnoses to justify the civil commitment of sex offenders who do not qualify for recognized mental illnesses.


Anonymous said...

I think your slam against the "civil commitment industry" is misplaced.

I think the deeper issue is the one you speak to directly above it: the unstated bias against sexual expression outside the marital dyad. The problem here is that while there might be a majority of people who reject that bias there is no consensus either within psychology or in the public at large as to where you draw the line. Pedophilia now a disorder yet homosexuality is normal when for most of American history the exact opposite was the case.

The civil commitment industry is just a derivative of the fact that psychology as a profession is in sexual disease industry, and has been from the very beginning. An honest look at the last 100+ years should tell us that this has been not only a disaster for most people caught up in it, it's been a huge mistake on the part of psychology to have ever traveled this road.

iquanyin said...

it seems to me there's an even deeper unstated bias: against pleasure. the idea of doing something repeatedly seems to be considered a sign of illness somehow. that's absurd. it's as if the field is suspicious of enjoyment. what are they actually saying, that somehow nature is mistaken, and that things should only be done for "rational" reasons and only in "approved" amounts or your ill? that seems an illness, perhaps "pleasure-aversel personality disorder." the arrogance of presuming to know the right amount of sex or any other thing our very being is designed to seek and enjoy astonishes me. further, i don't even agree that there are objective things that "should" take precedence over other things. what i mean is, it might not seem ideal for a professor to place his work over his family, and sure it's not a balanced lifestyle, but who's to say ultimately that it's wrong or right? for whom? the family? the prof himself? society as a whole? as measured by what, exactly? what if his focus on work yields a cure for cancer, and his kids and wife, tho missing him, go on to have ok lives. then is it disordered? and so on.

and the proposed numbers here: hilarious. so some think if you have sex once a day (or is masturbation included?), that might be an addiction. um, right guys. would it be an addiction for a happily married couple who've been doing it like that for 30 years? or only for single people? what about live-ins?

the whole thing -gambling addiction, internet addiction, sex addiction -- is silly. it lacks both common sense and usefulness, and the potential for harm is apparent.