Can you really be addicted to sex?

This narrative of powerlessness is popular among self-described sex addicts. “A lot of people can look at porn and look away, but we get high from it and need more. It’s chemical,” explains Arthur. Stefanie Carnes, Patrick Carnes’s daughter and head of the International Institute for Trauma and Addiction Professionals (IITAP), the leading body for educating and certifying sex-addiction therapists, says that internet porn is fuelling a sharp rise in addiction. “The percentage of people who are starting to have problems because of this has grown exponentially.” The diagnosis, she says, is backed by neuroscience. “We are seeing the exact same response as substance-abuse disorders,” she says. “We look at this as a brain disease.” She compares efforts to discredit this research with early views of alcoholism, which dismissed the addiction as a moral failing, a problem of willpower.

But a closer look at the evidence yields little proof that an unhealthy obsession with sex is comparable to an addiction to drugs or alcohol. Sex-addiction therapists argue that their patients experience symptoms of withdrawal and risk-taking, and they persist in their often-destructive pursuits despite dire consequences, much like substance addicts. “I have patients who can lose everything in their lives, their jobs and relationships, yet they still continue to compulsively engage in that behaviour,” says Anna Lembke, a psychiatrist at Stanford University.