Chapter 1
Introduction

In America, if your addiction isn't always new and improved, you're a failure.

Chuck Palahniuk, 20021

Daddy's Secret Cedar Chest (2013) is for the 'children of sex addicts'. An unnamed boy discovers a huge box in Daddy's bedroom (the cedar chest of the book's title) full of magazines and DVDs with 'pictures of women with no clothes on!' The dad (we are not told why he has his own bedroom unless Mummy's bedroom is called Daddy's bedroom too) also spends too much time with his computer in his home office. 'Everything Daddy did was a secret.' The boy tells his mother, and his parents argue about his father's 'habit'. The boy becomes unsettled - 'I was feeling scared.' He has bad dreams: 'A big hairy lady monster was crawling out of the humongous cedar chest. She stood up on her big hairy legs and opened up her big empty black hole of a mouth.' In the dream this rather clumsy metaphor swallows his father. The boy's concerned mother takes him to a therapist. Daddy moves out to seek help for his 'habit' and then returns home to an improved family environment. The big hairy lady monster and the chest have gone.2

Why have we come to a stage in our history and culture where it is even conceivable that 'children ages 6 to 12' might have to be told 'that they are not alone in their suffering, that help is available to them, and.that they did not cause their parent's sex addiction'?3

The aim of the book that follows is to trace the history of a new sexual concept, a modern sexual invention called sex addiction, and its sufferer the sex addict. Though we will discuss definitional complexities in due course, the sex addict has usefully been described as 'a person who is obsessed with some type of sexual behavior, and whose behavior is compulsive and is continued despite significant adverse consequences'.4 Aviel Goodman characterized it to the readers of the Journal of Sex & Marital Therapy as 'simply the addictive process being expressed through sex, the compulsive dependence on some form of sexual behavior as a means of regulating one's feelings and sense of self'.5

The idea's beginnings are somewhat imprecise. One possible origin at a practical level was in the self-help or recovery culture of the 1970s (we will discuss the link between sex and alcohol addiction later). Sex and Love Addicts Anonymous grew out of a local Alcoholics Anonymous support group in Boston in 1976 and other national sexual-addiction recovery fellowships were utilizing the Twelve-Step programme by the late 1970s and early 1980s. Sex Addicts Anonymous (1977) had its headquarters in Minneapolis; Sexaholics Anonymous (1978) was centred in Simi Valley, California; while the New York and Los Angeles Sexual Compulsives Anonymous was operational by 1982 as were gay and bisexual sexually compulsive support groups in New York.6

We know that a linkage between sex and addiction was informally entertained in popular culture in the late 1950s and 1960s. Pulp fiction during that period included Don Elliott's Love Addict (1959) and Curt Aldrich's Love Addict (1966) (see Figure 1). The latter was about a promiscuous man so the term 'addict' referred to lust rather than affection.7 But it was William Donner's The Sex Addicts (1964) that can actually claim first usage of the precise words 'sex addict' in the correct context (see Figure 2). It was about a couple of womanizers on a cruise ship: 'It's the way he is.Compulsive. He can't stay with a woman more than a single night, he says. At least, not if others are available.He's slept with almost nine hundred women.'8 One friend observed of the other, 'You're compulsive. You've got a monkey on your back', and suggested analysis. Later the man, who was close to his nine hundred, admitted 'Monkey on my back is right. Only I'm a sex addict, not a drug fiend.'9

Pulp fiction aside, we also know that homosexual psychotherapy patients were referring to 'sex heads' - in the sense of addicts - in the 1960s: 'I'm not only a pot head.I'm a sex head.it's completely eaten into everything.' In short, the term may have arisen independently at a more grassroots level.10 When we later discuss the intellectual origins and viability of the concept, it is worth recalling this evidence for its humble origins.

Conceptually, as we will see, Lawrence Hatterer and Stanton Peele in the US and Jim Orford in Britain played roles in the malady's history. The New York sex therapist Avodah Offit mentioned 'sex addicts' in 1981 (immediately after a discussion of nymphomania and hypersexuality), citing a link between sex and the release of endorphins: 'Thus sex, in addition to whatever else it does, may actually reduce pain and promote euphoria in much the same fashion as small doses of the morphinelike drugs. The sex addict, then, may literally be a junkie, in one sense.'11 However, the actual term 'sex addiction' is most clearly associated with the work of the US psychologist Patrick Carnes and his book The Sexual Addiction (1983), republished as Out of the Shadows: Understanding Sexual Addiction (1983). Carnes's centrality, for better or for worse, will become clear in the pages that follow.

The idea of sexual addiction enjoyed varied reception in these early years, and there was already an indication that endorsements might vary. It appeared in the 'Current Trends' section of the journal Medical Aspects of Human Sexuality in 1985.12 A comment in the British Journal of Sexual Medicine in 1986 by a Chicago psychiatrist indicated both that the concept had arrived and a certain amount of scepticism about its usefulness:

the theory of sexual addiction as an illness is so wide a net that it has the danger of being used on the one hand as an excuse to cover or continue a whole range of inappropriate or law-breaking sexual behaviours, and on the other it is a catchall that has scooped up normal sexual behaviours as well.13

It was included momentarily in the American Psychiatric Association's Diagnostic and Statistical Manual DSM-III-R in 1987, but was absent from all subsequent editions, a struggle that we will return to later in this book.14 Psychologists discussed in the same year whether the complaint was best termed sexual addiction, hypersexuality, compulsive sexual behaviour or (their preference) sexual impulsivity.15 It was mentioned in a 1988 text on disorders of sexual desire, but without elaboration and minus its own chapter, in a book that devoted more attention to lack of sexual desire than to its excesses.16 It came to the attention too of the famous John Money, emeritus professor of medical psychology and professor of pediatrics at the Johns Hopkins University and Hospital, though not with the notice that addictionologists might have sought:

Sexual addiction.is a newly coined term for a disorder as fictitious as thirst addiction, hunger addiction, or reading addiction.Sexual addictionology does not address the specificity of addiction. Instead it decrees that the only non-addictive form of sexual expression is lifelong heterosexual fidelity and commitment in monogamous marriage. Everything else is the gateway of sin through which exits the broad road to sexual depravity, degeneracy and addiction. Within addictionology, the wheel of degeneracy has made a full turn!17

Certainly the notion of perceived, out-of-control sexual behaviour moved from a situation in 1972 where hypersexuality was proclaimed 'a rare phenomenon' to the moment in the late 1980s when a relatively early publication in the addictionology genre, Charlotte Davis Kasl's Women, Sex, and Addiction (1989), began with reference to the 'epidemic proportion of addictive behavior in this country'.18 The best-selling therapist Anne Wilson Schaef echoed Kasl dramatically: 'Sexual addiction is a progressive disease and.results in destruction and early death for addicts and often those with whom they are involved. Sexual addiction is of epidemic proportions in this society and is integrated into the addictiveness of the society as a whole.'19 However, this may merely have indicated a split between professional psychiatry and the enthusiasm of popular medicine. The New Jersey psychiatrists who edited the state-of-the-art statement on desire disorders in 1988 said of sexual addiction that they had not 'encountered clinically more than a handful of such cases in the past decade'.20 Yet they also noted the 'popular appeal' of the concept and hinted at a potential clientele:

There are, however, numerous individuals who are on the high end of the desire continuum - who are sexually enthusiastic...