Legions of people, mostly men, seek help for addiction
to sex and pornography. But effective treatment
is difficult to find and insurance doesn’t cover the cost.

Treatment for sexual addiction is difficult to find

By JACK ENCARNACAO
The Patriot Ledger

It looks like an addiction; it feels like an addiction. But the American Psychiatric Association doesn’t recognize sexual addiction as a diagnosable disorder. And that makes finding definitive treatment - and the health insurance to pay for it - nearly impossible for the legions of people, mostly men, who are looking for help.

“There’s different hypotheses about what contributes to the behavior, and the verdict is still out,” said Renee Sorrentino, an instructor in psychiatry at Harvard Medical School who runs The Institute for Sexual Wellness in Quincy.

The debate is academic, but resolution could mean the difference between an addict’s health insurance company paying for treatment and someone spending thousands out of pocket for methods that may not work.

Categorizing compulsive sexual behavior - which can include obsessive use of porn - as addiction is the first step, but observers say that is a long way off.

The two camps within clinical circles — those who believe there is sexual addiction, and those who don’t — are passionate about their positions.

“Those two do not see eye to eye in any way, shape or form,” said Tracy Todd, spokesman for the American Association for Marriage and Family Therapy.

The camp against the concept of sexual addiction says there must be physical withdrawal symptoms to qualify as true addiction. They say the obsessive use of pornography and compulsive sexual behavior are symptoms of other dysfunction, either sexual or marital, or mental disease.

But the second camp says the brains of sex and porn addicts are engaged the same way that alcoholics are when they drink.

“When you see someone who’s lost his second job and his marriage and he’s masturbating to pornography on his company laptop outside his office building, it’s easy to be convinced this is more than just ADD or depression,” said Dr. Jill Manning, a Colorado-based marriage therapist who specializes in the effects of Internet porn.

Sorrentino, the Harvard professor, recently started an Internet porn addiction support group in Quincy. She said she takes an approach similar to substance abuse treatment with her patients.

“We don’t say, ‘OK, you should have a little bit of it,’” she said. “We say basically, ‘Get rid of the computer, get rid of the magazines, videos. Because we can’t keep a lid on it.’”

Accepting sexual addiction as a legitimate mental illness will encourage research and treatment and give the condition the medical credibility of alcoholism, which went through a similar phase of skepticism before being recognized by the American Psychiatric Association.

That would force psychiatrists to learn something about it and to assume more liability for patients under their care, Sorrentino said.

“The psychiatrist could be found negligent if they didn't diagnose and treat the condition,” she said.

Joe is a 52-year-old salesman from the South Shore who has sought out-of-state treatment for sexual addiction. He said the effect of porn and sex on his brain chemistry is very similar to the allure of drugs for an addict.

“It doesn’t make sense; completely irrational,” he said. “But in the moment, if you’re in that mind-set, you don’t even think straight because you’re high.”

Regardless of whether excessive porn use stems from true addiction, experts agree that Internet porn is contributing to financial problems and the loss of marriages and relationships.

“Literally being one click away from losing your job, literally one click away from destroying your family,” said Neil Cannon, a Denver-based marriage counselor who also treats compulsive sexual behavior. “That’s how I try to help people visualize how risky this really is for them.”

Sorrentino, who works with a range of sexual compulsives, says research is needed to determine whether porn addiction is independent of the causes of some other sexual addictions. Those who come to her with a porn problem bristle at the suggestion that it may fit into the same category as other sexual compulsives.

“It’s much easier for me to get my pedophiles to be in a group with my exhibitionists, with my foot fetishists,” she said. “If you tell the Internet pornography guys that these guys have a different problem but it’s the same treatment, there’s a lot more resistance from that group.”

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Next: Profile of Rich, an addict