Beware of attaching medical labels to what is really just bad behaviour

Iam not convinced that “sex addiction” should be considered a mental disorder any more than homosexuality, or indeed heterosexuality.

For a start, it is something of a misnomer because the term “addiction” normally applies to the hijacking of brain circuits that have evolved to reward behaviour that helps us (or more precisely our genes) survive. Sexual intercourse is high among the list of such behaviours and, for men especially, this includes multiple partners.

Of course, a powerful drive toward sexual novelty can be very inconvenient socially and disruptive to family life, as Tiger Woods discovered. It can also lead to charges of sexual harassment and assault, as Harvey Weinstein found out.

In such instances, psychotherapy taking the form of training in selfcontrol or even medication that reduces sex drive may well be helpful. Some men undertake such “rehab” in the hope of repairing their marriage or persuading a court to be lenient.

However, there is a danger in attaching medical labels to what is really just bad behaviour in that it may provide the “afflicted individual” with a kind of excuse that to some extent “lets them off the hook”.

It helps them to evade responsibility for their actions, while adding nothing of scientific value. Pharmaceutical companies seek to cash in by developing drugs aimed at these newly identified disorders and insurance companies reinforce the fiction by demanding an official “diagnosis” before shelling out for treatment. In some ways, the religious concept of “sin” was more apt because what we are talking about is actually immoral behaviour rather than a medical illness.

The idea of “sex addiction” (called “hypersexuality” in the DSM-5 Diagnostic system) derives partly from feminist demands that men stop their philandering.

Unfortunately, it is describing male-typical, testosterone-driven tendencies, albeit sometimes in exaggerated manifestation.

When they become problematic it may well be appropriate to offer some kind of treatment.

However, the first principle of psychiatric treatment is that it must be determined to be in the interest of the patient themselves, not others who might want them restrained.

Dr Glenn Wilson is a Fellow of the British Psychological Society and former visiting professor of psychology at Gresham College, London