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‘Sex Is Never the Problem; Sex Is Always a Symptom’

Psychologist David Ley aims to bust the myth of sex addiction

While traveling the country researching his first book, about men who wanted to watch their wives have sex with other men, clinical psychologist David Ley heard a lot about sex addiction—often from the wives who weren’t interested in cuckolding their husbands, and assumed something was wrong with them. Though Ley knew the science behind “sex addiction treatment” was virtually nonexistent, those stories motivated him to dig deeper into the issue.

Today, Ley’s 2012 book The Myth of Sex Addiction is widely held up as an argument against the sex addiction treatment industry, including rehab centers that charge clients a ton of money to be cured of their supposedly uncontrollable sexual appetite — as opposed to the underlying mental health issues that may be causing that appetite.

“Sex is never the problem,” Ley believes. “Sex is always a symptom.”

Now the executive director of New Mexico Solutions, a large outpatient mental health and substance abuse program in Albuquerque, Ley doesn’t accept sex or porn addiction as a viable diagnosis for any of his patients. And while he believes the majority of people in the sex addiction industry are well-intentioned, he considers their methods harmful and, in many cases, unethical.

“We should require therapists who are providing sex addiction treatment to fully inform their patients that it’s an experimental diagnosis not accepted by the American Psychiatric Association,” Ley says. “We can’t bill insurance companies for the diagnosis, and that’s significant.”

Dr. David Ley. Original Image via @drdavidley / Twitter

Ley believes labeling certain behaviors as indicators of sex addiction undermines men’s personal responsibility and reinforces a culture of sexual shaming. For Ley, there’s always a diagnosis beyond sex addiction — one that the sex addiction treatment industry typically ignores.

After spending years as a general mental health practitioner, what inspired you to focus on sex?
In about 2008, I was clinically depressed myself. I needed something to really bite into that was fulfilling for me, and something I could pursue independently. I had been working with alternative sexuality folks for a long time as part of a larger practice, and I always wanted to write a book, so I decided to write one about the cuckold fetish. When I first met these couples — many of whom had been married 20 or 30 years and had lived very healthy lives — I still thought: “Wow, that’s pretty crazy.” Despite all the positive things I knew about them, I still made the knee-jerk assumption that their sexual lifestyle was unhealthy.

How did you encounter sex addiction as part of that research?
In that book, Insatiable Wives, I describe one guy who had blown through three marriages because he was desperate to see his wife have sex with other men. The wives didn’t want to do it; as such, they and their therapists were the ones who diagnosed him as a sex addict. I commented in the book that I didn’t think sex addiction was his issue. That comment generated a lot of response because, at the time, few clinicians were willing to say, “Sex addiction isn’t real.”

Psychologists and sex therapists began reaching out to me to say, “I’m so glad you’re saying this because I’ve always thought sex addiction was bullshit, too. But I was scared to say it because of the aggression with which people who believe in sex addiction come after you.” Now, however, there are a lot of us challenging the concept.

What’s the difference between the way you treat patients who claim they’re addicted to sex versus the way “sex addiction treatment experts” do?
One of the differences is I’m looking at these problematic sexual behaviors within a bigger picture. It’s often a result of their own moral or religious conflict or an indicator of a personality disorder. Again and again, these men who self-identify as sex addicts come from moral or religious backgrounds and are ashamed of their sexuality. In most cases, they’re not having as much sex, masturbating as frequently or watching as much porn as other people who don’t identify as sex addicts.

I’m a traditionally trained therapist, so I don’t look at too much sex, masturbation or porn consumption as the cause. Instead, I see them as symptoms. If someone walks through the door and is sneezing, I’m not going to diagnose them with a sneezing disorder. I’m going to try to figure out what the real problem is and then treat them appropriately. When you walk into the door of a sex addiction facility, they’re always going to say, “Ah-ha, sex is the problem.”

Does this create a sample bias for the people at those facilities attempting to treat sex addiction?
Yeah, the sex addiction therapists aren’t treating the people I see. They don’t see schizophrenics or bipolar patients. They don’t see swingers, women who claim to masturbate every night as a way to fall asleep or kinky folks who have made sexuality a significant and healthy component of their lives.

If sex addiction is a myth, why do so many people cling to the diagnosis?
Before writing the book, I didn’t understand that people are afraid of sex because they’ve been taught to fear their own sexualities. People think if they like sex too much they might lose control. The second thing, which I also didn’t realize in beginning of my research, is that most people who treat sex addiction identify as sex addicts themselves. They’re sex addicts in recovery who get their own sexuality under control through the model of sex addiction. Then they become crusaders in helping others. So when people challenge the notion, it becomes a challenge to their whole identity. Others outside of the sex addiction industry are scared of sex, and so, the idea of sex addiction helps manage that fear. It’s a morality-based, sexually conservative model that’s incredibly subjective.

And the term is used in mainstream media all the time, which only makes it seem more “real.”
The science behind it is what I call Valley Girl science: Well, sex is like alcohol and drugs, so that makes sex addiction real. But sex is not like alcohol or drugs. It’s poor science, but unfortunately it has tremendous pop-media appeal and acceptance.

What does the idea of sex addiction have to do with men taking accountability for their own sexualities?
There were a number of things going on when sex addiction was born. One of those things was the shift in our society that was brought about by feminism. For millennia, our society has excused male sexual privilege and allowed powerful, wealthy men to have harems and mistresses. But in the 1970s and 1980s that began to change; men were no longer allowed different rules than women. A good example of this is Bill Clinton versus John F. Kennedy. Kennedy had more sex than Clinton in the White House, but nobody ever called him a sex addict. Clinton, though, got a famous blowjob and former President Gerald Ford called him a sex addict, along with other people working in media. Why? Because society was no longer willing to allow powerful men to just kind of get away with their sexual infidelity.

The idea of sex addiction was born to call that misbehavior and lack of responsibility a disease. It gave society a way to shame and punish that behavior, but it also gave these men a way out. Now, men get in trouble for cheating and they can say, “Oh, I’m a sex addict.” It’s a stage show. They go into a treatment program for which there is absolutely no evidence of efficacy and leave saying, “I’m better now.” A lot of the sex addiction clinicians out there are only seeing men, since 90 to 95 percent of these alleged addicts are men.

What other common characteristics are shared among people who term themselves sex addicts?
One of the most significant studies on this topic found that more than half of the sex addicts in treatment were white men making more than $85,000 a year. Last year, I published a study where we looked at cases throughout the U.S. where sex addiction had been claimed in court, and there was one cluster of cases involving individuals who went before licensing or bar associations and claimed sex addiction. These are pharmacists, doctors and lawyers who got in trouble for their sexual behaviors and claimed sex addiction. Not a single one of the cases that I could find involved a woman claiming to be a sex addict in order to preserve her license.

Is the sex addiction excuse often effective in court in cases like that?Last year, here in New Mexico, there was an obstetrician who got in trouble for having sex with patients. Allegedly, he was having sex with one patient while another patient was in the hospital giving birth to a baby he was supposed to deliver. The complaints were filed, and the Medical Board allowed him to keep his license so long as he went to sex addiction treatment. That’s a real problem for me.

Does accepting sex addiction as a reality ever pose any threat to people besides the self-proclaimed sex addicts?
These days, I’m hearing a lot about folks who are pedophiles and sex offenders enrolling in sex addiction treatment. This is incredibly worrisome because, I’ll say it again, there’s absolutely no evidence that sex addiction treatment works. However, there’s good evidence and research about what kind of treatment for sex offenders does work. So, in some cases, the public is being put at risk when we send sex offenders off to sex addiction treatment centers.

And, as an expert witness in court, you offer your perspective in hopes that happens less and less?
Typically, I’m brought in on such cases to testify that sex addiction is not an accepted diagnosis. It doesn’t meet legal criteria for expert testimony. People who are providing sex addiction treatment are doing so basically in an experimental mode, so much so that in a lot of ways, sex addiction treatment is kind of the equivalent of homeopathy. Just because people believe it works doesn’t mean it does, and it doesn’t mean that we should be supporting this as an excuse or as a treatment.

In a way, the idea of sex addiction is often a distraction. Sex addiction is so accepted in our society that men and women don’t know not to believe it, and so, when they’re told they’re sex addicts by therapists they trust, they don’t know that the therapist is making that diagnosis on bad science. If mental health therapists did a better job treating sexuality issues, or even asking about a patient’s sexuality, patients would have better options. We aren’t allowing conversations about personal responsibility and mindfulness when it comes to sex because we’re saying sex is bad. That’s ultimately where I disagree with the sex addiction industry: I don’t believe there is a right amount of sex and a wrong amount of sex and that people need to fit these imagined models in order to be healthy.

Tierney Finster is a writer-actress-model-activist from the San Fernando Valley.

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