This is an update on a diagnosis once proposed for the about-to-be-released DSM-V, “Hyper-Sexual Disorder”. It has been referred for further study. The American Psychiatric Association, publisher of the DSM-V, decided there was not enough supportive data to meet their standards.
Lack Of Supporting Research
My problem with the proposed diagnosis was not about the apparent lack of scientific support (the research on whether the brain becomes dependent on neurotransmitters produced during sex.) I have not seen all of that research, though there is plenty of it. Clearly, it didn’t meet the strict standard of validity to become a DSM/ICD diagnosis
Consensual Sexual Relationships
Rather, the problem I had then – and now – is how this proposed individual diagnosis would have become the context for a relationship problem. For example, take the behaviors deemed to be evidence of sex addiction. Find those behaviors consensually occurring in relationships. Those relationship partners do not see those behaviors as problematic. These relationships are increasingly common in the U.S.
You will not find this to be true of alcohol or cocaine dependence. There is no relationship in which those behaviors do not eventually produce negative health outcomes, and relational difficulties. The current substance abuse diagnoses make sense on that level.
Masturbation
To be accurate about sex, there is of course masturbation. It’s (mostly) solitary sexual activity that can become compulsive, to the detriment of personal, social and relational well-being. In theory, it’s like anything else that could in theory be practiced “too often” for one’s own good. The sexual nature of it is only one aspect of a clinical assessment; compulsive masturbation could fall diagnostically into an “anxiety disorder”, such as Obsessive-Compulsive Disorder (OCD), similar to excessive hand-washing or door lock checking.
Correctly Setting Up Treatment
How we define “disorders” determines how we treat them, fail to – or choose not to. When we insist on seeing relational situations with individual diagnoses, treatment is usually set up incorrectly.