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The Myth of Sex Addiction Hardcover – Mar 9 2012
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Ley, a clinical psychologist and director of a behavioral health clinic, examines the position that the diagnosis of sex addiction is heavily influenced by social norms and values and is not a legitimate medical condition. He shows how what is labeled sex addiction is based on culture's social norms and covers a multitude of mostly male behavior. The fact that this behavior may be in conflict with social norms does not mean the individual has a psychiatric condition. In addition, the author argues, telling people their behavior is uncontrollable is a self-fulfilling prophecy. In chapters with titles like "Gender and Libido" and "Ignored Aspects of Masculinity," Ley examines the range of male sexuality and how that range is different from that of females. When norms are set based on female behavior, normal male behavior can be construed as pathological. "The label of sex addiction," writes Ley, "undermines our efforts to enforce expectations of responsibility, holding ourselves, and especially men, responsible for their choices and actions." The writing style is personal and easy to follow, and the book is well referenced with frequent case histories to clarify points. Summing Up: Highly recommended. (CHOICE)
Sex addiction and its attendant diagnosed celebrities and reality TV shows may have been wholeheartedly embraced by the media, but this work of pop psychology takes issue with what clinical psychologist Ley (Insatiable Wives: Women Who Stray and the Men Who Love Them) deems a dubious disorder. Here, Ley asks whether sexual addiction is really a bona fide ailment or merely a "culturally bound concept reflecting changing social views of sexuality rather than medicine or scientific research." Ley suggests that the label of "addiction" removes the issue of morality from the conversation, whereas in fact--whether we like it or not--he asserts that "sexual behaviors involve choice." However, Ley acknowledges the appeal of calling it an addiction, quoting an anonymous ex-spouse of a so-called sex addict, who affirmed that it would've been easier to cope with her husband's serial infidelity had it been the product of impulses literally beyond his control. Ley makes a thoughtful and persuasive argument, using case studies and ample references to the work of other psychologists to flesh out his case. While serving as an excellent resource on sex addiction, Ley's study also sheds light on the myriad cultural and sociological factors that influence relationships. (Publishers Weekly)
Ley has clearly thrown down the gauntlet, and hopefully the debate will continue. (CNN)
I cannot stress enough how important this book is, not just to the helping professionals but to the general public who get the read and hear (incessantly) about someone famous who is called a "sex addict"....If you are a teacher, therapist, or just a sexual person, I cannot encourage you enough to read this book. It contains an enormous amount of data, is well written, and has a great index and endnotes. (Electronic Journal Of Human Sexuality)
For anyone who has cringed once too often at the term “sex addiction”―or questioned the blanket use of “addiction” as an explanation for behavior that is really a matter of moral choice―Ley’s demolition of the bad science and worse reasoning behind the sex addiction industry will be refreshing. (The Weekly Standard)
Dr. David Ley raises crucial questions in his latest book―questions that demand serious consideration before we allow American society to drift even further toward declaring all pleasure potentially dangerous and pathological. Ley shows that the puritanism underlying our politics may also be distorting our medical sciences. This book is well informed, well argued, and well worth your time. (Christopher Ryan Ph.D, Co-author of Sex at Dawn: The Prehistoric Origins of Modern Sexuality)
David Ley's book raises one important question after another about the nature of sexuality, the social phenomenon of "sex addiction," and the effects of our pathologizing so much of Americans' sexual feelings and behavior. (Marty Klein)
This book’s exploration of the available science will fascinate any reader. Beyond observing that there is no credible body of evidence to support the notion of sexual addiction, David Ley describes many historical problems in attempting to define it.... Ley’s writing style is highly accessible and entertaining. The structure and layout are excellent. He is meticulous in providing citations for his assertions, often preferring direct quotes to summaries. (ATSA Fourm)
About the Author
David J. Ley is a clinical psychologist in practice in Albuquerque, New Mexico. He provides clinical and consultative services in numerous other states. Dr. Ley currently serves as Executive Director of a large outpatient behavioral health agency in Albuquerque and maintains a current caseload of clients. He is the author of Insatiable Wives: Women Who Stray and the Men Who Love Them (Rowman & Littlefield, 2009).
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Three fundamental issues seem to run through the debate, as follows.
First, is a moral agenda driving much of the discussion, forcing some people to see their perfectly healthy consensual activity as wrong, thereby causing much unnecessary distress and the seeking of expensive therapy? The answer that Dr Ley gives is a very convincing `yes'. However, does everyone who claims, or appears, to have an addiction fit this category? I would say `no'.
Secondly, do (so-called) sexually-addicted people have free will and agency over their behaviour or have they lost control? Here Dr Ley sails into rather treacherous waters, since the issue of free-will and determinism is one that has eluded philosophers from at least the time of the ancient Greeks. There is simply no answer to it. However, there are answers to the related question - does what you believe about free-will and determinism make a difference to how you behave? It appears that it does, so a belief in free-will might give some people a realistic sense of agency.
Dr Ley appears to recognize the limits of the notions of free will, when he writes (page 173) "When these chemicals are raging in our brain, we can often do nothing but think about our new lover...". Can sexually-addicted people restrain their behaviour and thereby show themselves in one sense to be in control? Yes, Dr Ley and I agree here - they can, as indicated by, say, their controlled use of a car in finding their next sexual outlet or their restraint in the face of, say, a potential police raid on a brothel. But so can heroin addicts show great skill and control in, say, house-breaking or forging checks. The compulsive hand-washer can show restraint under some conditions as can even to a very limited degree the sufferer from Tourette's syndrome. The issue is surely that in all such cases there is (i) the imposition of a goal that arises outside the conscious mind and against the will and (ii) distress is involved in resisting its pull. How much stress is involved to define an addiction or compulsion is surely not something for which a scientific answer can be given.
Thirdly, the issue of whether sex can be classified as a potential addiction is equally elusive and not open to absolute scientific arbitration. It all hinges on first articulating the properties of an unambiguous addiction, such as to heroin. Then we need to see how many of these defining features are shared with sex. It depends upon your cut-off point for how many boxes and which boxes need to be ticked in order to include sex as being usefully classified as potentially an addiction. I recall that the tobacco industry tried desperately to convince us that nicotine was not addictive, whereas addiction researchers know otherwise. As the researcher Donald L. Hinton argues, consider two people spending hours on the Internet, wishing that they could quit but finding it impossible. According to DSM-5, the first is gambling for money and would be classified as an addict, whereas the second is gambling for the perfect porno image and would not be classified as an addict. This makes no sense to me.
Evidence published since this book appeared shows changes in the dopaminergic regions of the brain of sexually addicted people, somewhat comparable to that of chemical addiction (see Donald L. Hinton, amongst others). Is this a box to tick? I would say so.
On page 79, Dr. Ley argues: "One hundred percent of the people who seek sex addiction treatment have some other major mental illness, including alcohol and drug addictions, mood disorders, and personality disorders." He does not give a citation for this claim. R.C. Reid and B.N. Carpenter give the figure of 38% as those patients with no other disorder apart from hypersexuality. We do not know how many, if any, of the parallel disorders were the consequence of the hypersexuality, as opposed to the assumption that they lie in its causation. Although I am not a clinician, I would suggest that someone presenting with combined sex and cocaine addiction (both engaging brain dopaminergic systems) would need to have both activities addressed.
On page 101, Dr. Ley writes: "What are the environmental and personal factors that lead some individuals to choose sex, or alcohol, or drugs, or gambling in response to their brain's functioning, and what are the things that lead other people with that same type of brain chemistry to be able to overcome those predispositions, and not engage in such addictive or destructive behaviors?" A good question and I would suggest an early potent exposure to the object of the later addiction plus run-away dopamine sensitization as a positive feedback system (see recent studies by Marco Leyton and Paul Vezina).
In short a very good read, best done with some caution.
Frederick Toates, Emeritus Professor of Biological Psychology, Open University, UK.
Gloria Brame, Ph.D.
The problem here, is that he's demonizing a group that already has immense shame and fear, and now he is telling them, "you have a moral failing." The premise, arguments, and logic, are self-serving and indicates a lack of experience with those he talks about.
I am concerned that those with a sexual compulsion who read this book, would feel hopeless, and spin back into an acting-out pattern. It is difficult to discern how this book is helpful to anyone other than Dr. Ley.
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