Is Har­vey We­in­stein a sex ad­dict?

The Guardian Australia - - Environment / Science - Dean Bur­nett

Another day, another pow­er­ful man em­broiled in a sin­is­ter sex­ual scan­dal decades in the mak­ing. This time it’s pow­er­ful Hol­ly­wood fig­ure Har­vey We­in­stein. The moral, eth­i­cal and po­lit­i­cal as­pects of this whole mess have been cov­ered ex­ten­sively else­where, and will no doubt con­tinue to be so over the com­ing days and weeks.

How­ever, re­cent re­ports sug­gest that We­in­stein has checked him­self into a Euro­pean re­hab clinic for sex ad­dic­tion. This has been met with some not-in­con­sid­er­able cyn­i­cism, but, even if it is true, won­der­ing whether We­in­stein is a sex ad­dict over­looks a more fun­da­men­tal ques­tion: is any­onea sex ad­dict? Be­cause that di­ag­no­sis, as com­mon­place as it may seem, is far from es­tab­lished psy­chi­atric fact.

Many peo­ple do be­lieve sex ad­dic­tion is real and se­ri­ous prob­lem, while oth­ers dis­miss it out­right. De­spite it be­ing a widely-used term, it doesn’t fea­ture in ei­ther the DSMV or ICD-10, the two main sources for of­fi­cially-recog­nised psy­chi­atric dis­or­ders the world over (al­though that’s not a guar­an­tee of con­sen­sus

ei­ther). How can some­thing that seems, to many, to be so straight­for­ward be the sub­ject of so wide a de­bate? We all know what sex is, we all know what ad­dic­tion is, what’s the is­sue?

First, sex is a fun­da­men­tal drive in­her­ent in prac­ti­cally ev­ery hu­man. A large per­cent­age of our brain’s sys­tems are re­spon­si­ble for or at least in­volved in it. An un­der­ly­ing need to seek out sex and an abil­ity to en­gage in it as and when we like is a re­mark­ably hu­man trait (well, maybe bono­bos too). This has many sig­nif­i­cant con­se­quences for how our so­ci­eties and cul­tures work, but one rel­e­vant prob­lem is, at what point do you want sex toomuch? Be­cause that’s not an easy thing to pin down. Those who don’t sup­port the idea of sex ad­dic­tion of­ten ar­gue that it’s another at­tempt to pin a clin­i­cal di­ag­no­sis on “nor­mal” hu­man be­hav­iour (like the dis­pute around grief in the DSMV). Some even com­pare it to gay con­ver­sion ther­apy, in how it med­i­calises and tries to undo what is an ex­pres­sion of hu­man sex­u­al­ity.

How­ever, sud­den marked in­creases in strength or fre­quency of libido are of­ten la­belled hypser­sex­u­al­ity (pre­vi­ously known as nympho­ma­nia or satyr­i­a­sis for women and men re­spec­tively), which may seem like sex ad­dic­tion, but isn’t quite. It’s usu­ally recog­nised as part of a big­ger prob­lem, of­ten a per­son­al­ity dis­or­der or side ef­fect of med­i­ca­tions like hor­mone re­place­ment ther­apy or those used to treat Parkin­son’s. And even then, there are still those who main­tain that it’s within the nor­mal ex­pres­sion of hu­man sex­u­al­ity, even if it’s a no­table shift from what the in­di­vid­ual has demon­strated be­fore.

The ad­dic­tion side of things just makes it more com­pli­cated. There’s no doubt­ing ad­dic­tion is a real and de­bil­i­tat­ing thing, but much of the lit­er­a­ture is cen­tred around drugs and narcotics, un­der­stand­ably. Much of the fo­cus is on the dopamine re­ward cir­cuitry in the brain. Put sim­ply, the dopamine-pow­ered re­ward path­way in our brain is what causes us to ex­pe­ri­ence plea­sure when­ever we do or ex­pe­ri­ence some­thing our brain recog­nises as pos­i­tive or ben­e­fi­cial and wants to en­cour­age us to do again. Eat some­thing when par­tic­u­larly hun­gry? Re­ward. Scratch an itch? Re­ward. Have a suc­cess­ful sex­ual en­counter and in­crease your chance of re­pro­duc­ing? Re­ward.

What drugs of abuse like heroin do is es­sen­tially hi­jack this sys­tem, trig­ger­ing it di­rectly so we ex­pe­ri­ence in­tense plea­sure in re­sponse. So, of course, we end up wanting to do that again. The prob­lem is, the brain isn’t static; it changes in re­sponse to per­sis­tent cir­cum­stances, and this very much hap­pens in ad­dic­tion. The brain it­self is “rewired”, the con­nec­tions be­tween the re­ward path­ways and those ar­eas gov­ern­ing mo­ti­va­tion and be­hav­iour are warped, so our drive to sus­tain the ad­dic­tion ends up tak­ing prece­dence over all other con­cerns, be they le­gal, so­cial, bi­o­log­i­cal, you name it. And even­tu­ally, the brain de­vel­ops such a tol­er­ance to the drug that it no longer re­sults in any plea­sure, but an ab­sence of it causes hideous dis­com­fort and stress. It’s no longer about plea­sure-seek­ing, but pain-avoid­ing.

It’s harder to see how sex fits in with this. Yes it’s very plea­sur­able, and there are re­ports of peo­ple seek­ing out sex the way a drug ad­dict seeks out a fix; by any means nec­es­sary, in the most squalid of con­di­tions, with lit­tle re­spect or even aware­ness of the law. Be­haviourally, that would fit the cri­te­ria of an ad­dic­tion. But, the data is less sup­port­ive. Some stud­ies have re­vealed that, of a large group of men who pur­port to be sex ad­dicts, only those ex­pe­ri­enc­ing se­ri­ous psy­cho­log­i­cal is­sues met the strin­gent cri­te­ria. Another study re­vealed that those who claim to be sex ad­dicts don’t show the ex­pected brain ac­tiv­ity, in­dica­tive of ad­dic­tion, when ex­posed to erotic or porno­graphic im­agery. These stud­ies are them­selves de­bat­able though. What cri­te­ria are they us­ing to de­fine “sex ad­dic­tion” if there’s no ac­cepted ver­sion? Is view­ing ex­plicit im­agery suf­fi­ciently like the ac­tual act of sex to pro­duce the same ac­tiv­ity in the brain? This is highly de­bat­able.

One likely is­sue here is that, un­like with drug in­take, the hu­man brain has many so­phis­ti­cated sys­tems for en­cour­ag­ing and reg­u­lat­ing sex and sex­ual be­hav­iour. It’s not a for­eign sub­stance be­ing ar­ti­fi­cially in­tro­duced, it’s some­thing deeply en­trenched in our DNA. It’s the rea­son we haveDNA, in many ways. Parts like the amyg­dala reg­u­late how and when we want sex, the or­bitofrontal cor­tex helps keep a rein on our libido, and so on. This all means that sex in­flu­ences our be­hav­iour in nu­mer­ous sub­tle (and less sub­tle) ways. So, de­scrib­ing some sex­ual be­hav­iours as ad­dic­tion and not oth­ers is a tricky task, and thus far not one that has suf­fi­cient ev­i­dence to be read­ily ad­dressed.

Those who claim to be sex ad­dicts are usu­ally a) men, and b) show be­hav­iours more in-keep­ing with para­philic dis­or­ders and the like. These aren’t great, but they’re not ad­dic­tion.

Cyn­ics ar­gue that a rich, pow­er­ful man caught up in sex scan­dal claim­ing to be a sex ad­dict is just a copout. Ad­dic­tion isn’t nice. It doesn’t af­fect ev­ery­one the same way, but it’s usu­ally pretty de­bil­i­tat­ing. It strips away most, or all, of your dig­nity, your abil­ity to think ra­tio­nally, your pre-ex­ist­ing pri­or­i­ties. A gen­uine sex ad­dict would be in thrall to their ad­dic­tion, and wouldn’t be overly choosy about how they sat­isfy it. While it’s im­pos­si­ble to say for cer­tain with­out know­ing all of the facts, it’s hard to ar­gue against the cyn­ics.

Dean Bur­nett dis­cusses is­sues like ad­dic­tion and sex­ual mo­ti­va­tion in his bookThe Id­iot Brain, avail­able now in the UK and US and else­where.

Har­vey We­in­stein at the Van­ity Fair party in Bev­erly Hills in Fe­bru­ary 2016. Pho­to­graph: Axel Koester/Cor­bis via Getty Im­ages

Peo­ple say the brain is the big­gest sex or­gan, but look­ing at it di­rectly can be some­thing of a mood­killer. Pho­to­graph: ake­sak/Getty Im­ages/iS­tock­photo

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