In this interview Dr Patrick Carnes chats to Joe Polish, founder of the Genius Network about sex addiction, neuroscience and the most effective treatment for addictive behaviours. I have listened to this interview, usually as an mp3 file on my phone, many times and always seem to learn something new each time I listen to it. I believe that Dr Carnes is a legend and a visionary, given that he was talking about sex addiction as an illness in the early 1980s, when the definition of addiction in psychiatry was typically restricted to chemical dependence. These days there are more enlightened practitioners in the therapy field who acknowledge the real impact of behavioural addictions such as gambling and internet sex addiction.
This interview, as well as Dr Carne’s extensive publications, could be, perhaps should be, a staple diet on every psychology and psychotherapy course reading list in every discipline and modality. Essentially, Dr Carnes has long maintained that sexual addiction, like food addiction, develops in the brain through the bypassing of the executive functioning (the pre-frontal cortex) as the reward centres get flooded by the stimuli, in similar ways to the effects of cocaine usage. In the interview he articulates his ideas on attachment theory as possible causes of addiction and points to the dangers of the proliferation of cybersex activities through the internet, particularly for teenagers.
That is not to say that there is not still a lively debate about the evidence for what can be called an addiction. Darrel Regier, who was co-chair of the DSM task force which investigated the evidence to support revised classifications, maintained that there was insufficient evidence to reclassify sex as an addiction for the Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Regier maintained that the reward circuitry in the brain was not operative in the same way for sex as in (substance) addictive areas.
As yet there might not be the clinical evidence needed to justify the addiction term, for sexual addiction, but it could be argued that there is overwhelming anecdotal evidence about the problem. It is clear we need to fund more research into the problem, but it becomes very political very quickly, when we start thinking of web filters, censorship, impacts on economies (just think of Romania and the number of webcam models and the income stream) and actually who will fund the research.
Ten Types of Sex Addiction in “Don’t Call It Love” by Dr Patrick Carnes.
Click here to listen to my interview with Paula Hall.