Sex addiction: is it real? What the experts think

Sex addiction is not an accepted diagnosis 1:03

(CNN) -

As details are revealed about the suspect in shooting eight people in Atlanta-area spas, the controversial concept of sex addiction has resurfaced.

Local police told reporters that the shooting suspect, Robert Aaron Long, "gave signs that he has some problems, potentially sexual addiction, and may have frequented some of these places in the past."

Authorities also reported that Long had recently been kicked out of his family home due to his addiction to sex, which included regularly viewing pornography for hours.

Former roommates at Long's rehab facility said he was undergoing treatment for sexual addiction, something he was upset about.

• LOOK: What we know about Robert Aaron Long, the suspect in the shootings in Atlanta

But despite the social acceptance of the term - and the pattern of murderers who claim it as a motive for their crimes - sex addiction is not an accepted psychiatric diagnosis.

This is because the "standard in terms of how we think about addiction" is determined by how substances, behaviors or activities trigger certain brain receptors and responses, said Dr. Ziv Cohen, clinical and forensic psychiatrist and clinical professor adjunct of psychiatry at Columbia University.

This is neurobiological evidence of addiction, something that researchers have observed in people who gamble (gambling) or use drugs or alcohol, but not generally in people who have identified themselves as addicted to sex or pornography.

For this reason, sex addiction has previously been rejected for inclusion in the American Psychiatric Association (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM), the manual used by health professionals. health as an authoritative guide for the diagnosis of mental disorders.

People do receive treatment or seek support for this problem, but according to experts there are other factors to consider.

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Other reasons why 'sex addiction' is not an addiction

Symptoms of addictions include 'poor control over behavior, impaired social appearance,… endangering despite clear physical and other risks to the individual, and the development of, in the case of substances, tolerance and abstinence, ”explained Dr. Paul Appelbaum, chairman of the DSM Steering Committee at the APA and professor of psychiatry at Columbia University in New York City.

Psychiatrists also hesitate to characterize levels or types of sexuality as pathological.

"American psychiatry, for many years, viewed homosexuality as a psychiatric illness," Cohen said.

"There is a legacy of that, a very painful legacy."

Second, there are many people "who have healthy sexuality and feel guilty or ashamed of normal sexuality," Cohen added.

"There is a concern that if you say there is something called 'sex addiction,' many people who really don't have it will start to think that their own sexuality, their sexual urges, are unhealthy."

Furthermore, it is difficult to know "where to draw the line between healthy and unhealthy sexual urges," Cohen noted.

Sexual urges that violate other people's rights are easy to classify as pathological.

"But if you are simply saying that you have a high sex drive, which leads you to watch a lot of pornography or pay for sex, it is more difficult to label it intrinsically pathological because it does not involve violating the rights of others."

Diagnose and treat problems related to sex

The clinical illegitimacy of sex addiction does not mean, however, that people's personal problems with sex are not real.

Brain activity is not the only way that mental health professionals identify and diagnose disorders.

It should also be considered whether a person's symptoms interfere with the ability to function in various aspects of life.

Proponents of treating sex addiction as a legitimate disorder "would say, 'We have subjective distress and functional impairment in people with sex addiction, and therefore it should be a diagnosis,'" Cohen said.

“There are doctors who treat sex addiction, although it is not an official diagnosis.

So that may seem a bit confusing. "

Sex Addicts Anonymous is a 12-step recovery program that does not provide scientific or clinical expertise and therefore does not engage in clinical discussions "about whether or not sex addiction is an addiction," said Phillip, program manager. Information Center at the SAA International Service Organization, Inc., in Houston.

"I can tell you, however, from our experience, that we can definitely say that for us, sex addiction exists."

What looks like a sex addiction could be hypersexuality, which is sometimes a symptom of bipolar disorder or impulse control disorders, Cohen said.

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"In bipolar disorder, when you have a manic episode, you tend to be very hyperactive, you have a lot of energy, you become very hedonistic, you seek pleasure," he explained.

"Manic people often end up becoming very sexually impulsive."

People who have normal sexual urges but are not satisfied with sexual activities and therefore cannot stop would exhibit compulsive sexual behaviors, which could be on the spectrum for obsessive compulsive disorder, Cohen noted.

The strongest factor in identifying oneself as a sex addict comes from a conservative religious background "where very rigid, heteronormative and monogamy-centered rules about sexuality are promoted," said David J. Ley, clinical psychologist and author of the book 'The Myth of sex addiction. '

“Throughout the sexual world we live in, these people… are not prepared to handle these sexual desires that arise in them and the opportunity to pursue them.

And that's why they hate themselves for having these sexual desires.

Suppressing those desires can make feelings more powerful and harder to avoid, Ley added, even if they don't rise to the level of a mental disorder.

"People fight these problems," Ley said. "But it's really important for us to understand why they fight this and why some people fight and others don't, so that we can help these people."

CNN's Saeed Ahmed, Eliott C. McLaughlin, Casey Tolan and Amanda Watts contributed to this story.

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