A genealogy of the construct of sex addiction in psycho-medical discourse in post-World War II United States of America

Deposited with permission of the author. © 2008 Dr. Joel Lorensz BelingSome tables and figures are removed due to copyrightSexual excess is one of an increasing list of ‘excessive’ behaviours which have in recent times been pathologised by the psycho-medical establishment, increasing regulation and control of spheres previously accepted as ‘normal.’ This study analyses the genealogy of the events, institutions, organisations and individuals in post-World War II United States of America to the present which made it possible to think scientifically and nosologically about ‘excessive’ male sexual behaviour as ‘sexual addiction.’ The grass-roots twelve-step ideologies of Alcoholics Anonymous in the mid-1970s gave birth to twelve-step programs for ‘sex addicts’ predicated on admitting powerlessness over sex and lust rather than over alcohol as the key to recovery as the first step. The publication of Patrick Carnes’ Out of the Shadows: Understanding and Treating Sexual Addiction in 1983 created the academic concept and discourse of sex addiction, which in turn paved the way for widespread scientific debate and investigation of the concept. The AIDS phenomenon offered a platform for many groups to highlight their own causes amid the chaos of illness and death. The sex addiction movement was one such group which made use of the hysteria by pathologising homosexuality and the gay lifestyle as symptomatic of ‘sexual addiction.’ This forged an inexorable conceptual nexus between sexual addiction and AIDS and death motifs, thereby legitimising the concept of sexual addiction as a harmful and often fatal disorder. Analysis of psycho-medical and public discourse on the sex lives of two American presidents, John F. Kennedy and Bill Clinton, in two different eras revealed changing understandings of male sexual excess. Journalistic mores, socio-cultural values and psycho-medical ideologies (or the lack thereof) played a great role in pathologising Clinton’s behaviour while leaving Kennedy’s, at the time of his presidency but not so in the decades following it, unscathed. This study has far-reaching implications because sex is an issue affecting and involving people from all walks of life, irrespective of gender, race, colour, creed or religion. Analyses demonstrated how the sexual addiction movement’s assault on traditional conceptions of masculinity predicated on promiscuity as a rite of passage or envied and admired behaviour has precipitated a convergence of the genders in respect of prescriptive sexual behaviour. The pendulum of power is subtly shifting from males embracing notions of sexual liberation and sexual self-determination to mental health professionals whose new diagnostic labels pathologise and stigmatise