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I’ve been told multiple times—usually by disgruntled teachers who disagree with my presentation on the problem of porn—that the DSM (Diagnostic and Statistical Manual of Mental Disorders) put out by the APA (American Psychological Association) has rejected sex addiction/porn addiction. To suggest that it exists, they say, is not only untrue but potentially harmful.

It isn’t technically true that the DSM rejected “sex addiction” and “porn addiction” as neither were up for formal consideration. It was “hypersexuality” that was considered and rejected.

However, it’s important to note that the APA is not the final word when it comes to knowledge of sex/pornography addiction. The World Health Organization, a global entity with more authority, does provide a diagnosis of “Compulsive Sexual Behavior” in their ICD manual. And, for mental health professionals in our country, the ICD manual has a higher standing than the APA.

A recent article by a professional who has worked extensively in the sexuality workgroup for the APA explains why it is that professionals should look to the ICD for a definition of compulsive sexual behavior disorder and what exactly that disorder entails.

Paradoxically, although hypersexual disorder was rejected by the American Psychiatric Association for DSM-5 [link], on 1 October 2015 the use of the diagnostic codes of ICD-10 became obligatory in the United States, enabling its diagnosis. These codes are included in parentheses and gray text in DSM-5 next to the DSM-9-CM codes presented in bold type [link]. In ICD-10, the category ‘excessive sexual drive’ was included as F52.7; this category, which reflects dated and pejorative terminology, is: ([link], p. 194):

‘Both men and women may occasionally complain of excessive sexual drive as a problem in its own right, usually during late teenage or early adulthood. When the excessive sexual drive is secondary to an affective disorder (F30-F39), or when it occurs during the early stages of dementia (F00-F03), the underlying disorder should be coded. Includes: nymphomania satyriasis.’

Although ICD-11 is not scheduled to be published until 2018, the diagnosis of Compulsive Sexual Behavior Disorder is being considered [link] and the suggested definition has been posted on the ICD-11 Beta Draft website [link], the text of which is:

‘Compulsive sexual behaviour disorder is characterized by persistent and repetitive sexual impulses or urges that are experienced as irresistible or uncontrollable, leading to repetitive sexual behaviours, along with additional indicators such as sexual activities becoming a central focus of the person’s life to the point of neglecting health and personal care or other activities, unsuccessful efforts to control or reduce sexual behaviours, or continuing to engage in repetitive sexual behaviour despite adverse consequences (e.g., relationship disruption, occupational consequences, negative impact on health). The individual experiences increased tension or affective arousal immediately before the sexual activity, and relief or dissipation of tension afterwards. The pattern of sexual impulses and behaviour causes marked distress or significant impairment in personal, family, social, educational, occupational, or other important areas of functioning.’ (emphasis added)

Furthermore, it should be noted that, although hypersexual behavior was rejected by the APA, in fact the ICD is by far the most widely used classification of mental disorders world-wide, and its diagnostic codes are mandated for use in the United States and other countries by international treaty [link] as opposed to DSM-5 diagnoses, which have no such mandate. It thus seems that diagnostic entities involving hypersexual or compulsive sexual behavior can still be made and will continue to provide a framework that will lead to refinement of diagnostic nomenclature and criteria and stimulate further research into the nature and causes of such behavior. [emphasis added].

It is important to understand that addiction to pornography is a multi-faceted problem. It is contrary to our dignity as men and women created by God; it destroys our relationships; and is harmful to the women and men employed or enslaved as porn “actors”. However, it is also absolutely an addiction: a compulsive behavior that has proven negative effects on the person’s health and the ability to function in daily life.

Recognition of pornography addiction as an actual diagnosis matters because it helps us to understand that there is a need for healing. This addiction is not simply a symptom of another underlying issue nor the result of overuse of pornography in and of itself. It is a serious problem in its own right and needs to be treated that way both by mental health professionals and society as a whole.

Video

Here is a short video I shot recently which addresses the question, “Should we call it porn addiction?”