COMMENT: When the World Health Organisation announces a change in its stance on health matters, we need to take notice. The WHO now includes compulsive sexual behaviour disorder in its International Classification of Diseases (ICD-11) list.
I reckon that wherever the word compulsion is used it's just another name for addiction. Compulsion in this sense means, "'I know what I'm doing is bad for me and hurts others, but I can't stop doing it."
Whether that's using porn or sex workers or having affairs, it all comes under the same umbrella.
This WHO decision is a big deal for people like me who treat people with sex addiction, and their families. For far too long sex addiction has been such a controversial subject that it was pushed under the carpet and not only ignored, but regarded with great suspicion. Denial is not a river in Egypt.
The ICD is an important document that clinicians and scientists around the world use to identify and study health problems, injuries and causes of death.
And, believe me, sex addiction can lead to death. The film Auto Focus, 2002, was about TV star Bob Crane (who played Hogan of Hogan's Heroes) who was murdered by his jealous swinging buddy when Crane announced he was giving up their wild, sexual pursuits. Also, many sex addicts die by their own hand because of the seemingly hopeless cycle they believe they are trapped in.
The ICD defines compulsive sexual behaviour disorder as a "persistent pattern of failure to control intense, repetitive sexual impulses or urges resulting in repetitive sexual behaviour" over a period of longer than six months.
Researchers are only just starting to write about the tip of the iceberg regarding sex addiction and it will take a very long time for evidence to sway public opinion. In the meantime, the revised ICD list means there's hope. When a weighty body like the WHO announces something like this, health professionals will start to take notice.
I welcome this decision. It's a good place to start for the still-suffering sex addict who is struggling to accept that he or she has a life-threatening disorder. Simply knowing that it's a viable diagnosis is a very basic first step; getting help is another.
People do recover if they have the capacity to be honest with themselves, and the WHO's decision will help cut through the layers of denial that can keep a person in active sexual addiction.
Take, for instance, the example of Tiger Woods who must have known his out-of-control behaviour with other women would be a threat to his marriage, his golf game and the huge sponsorship money he received.
As it happened he lost his wife, his game definitely suffered, and many of his sponsors dropped him like a hot potato.
The same sort of consequences happened with film producer Harvey Weinstein. I bet he knew that what he was doing was wrong on all sorts of levels – and yet he continued. That's the compulsive nature of sex addiction right there. Knowing he had a problem and couldn't stop.
The founding father of sex addiction treatment, Dr Patrick Carnes, has formed a very simple diagnostic tool for people who think they may have the problem of sex addiction: PATOS.
• P – preoccupied. Are you preoccupied with acting out or planning your next sexual encounter, whether that is with pornography, another person or using virtual reality?
• A – ashamed. Are you ashamed of your behaviour?
• T – treatment. Have you sought treatment or asked for help for your acting out?
• O – out of control. Are you unable to control your behaviour?
• S – sad. Do you fee sad after acting out?
Carnes suggests that if you answer "yes" to one or more of these questions, you may need to have a fuller assessment and or possibly treatment.
Some of my American colleagues have been working in this field for 25 years and are seeing some very damaged young people presenting for treatment. I read a case-study about one 25-year-old male who presented for treatment after half a lifetime of accessing hard-core pornography. His brain was so negatively affected, he was incapable of any kind of normal relationship and was socially inept.
Studies show the human brain doesn't develop fully – in the absence of alcohol or other drugs or in this case being altered by porn – until the age of about 25.
It took many years for gambling to be accepted as a process addiction, but it's now been included in the DSM-5 (the Diagnostic and Statistical Manual of Mental Disorders). The ICD is more widely used, however, and New Zealand needs to lift its game if we're to catch up with the rest of the world in accepting this much-maligned disorder and start offering treatment for those who suffer.
• Bridget Wilson is one of two certified sex addiction therapists in New Zealand. She can be reached at solutionsauckland.com