Existential Perspectives on Working with Sexual Addiction

Alex Smith provides some existential perspectives on sex addiction.  The following is extracted and adapted from ‘Existential Perspectives on Working with Sex Addiction’ in the Routledge International Handbook of Sexual Addiction.

From an existential perspective, sex addiction is not understood as a pathological condition with attendant predictable causes, symptoms and involuntary behaviours that afflict the sufferer and over which he has no control. Since sex addiction (or indeed any other addiction or compulsivity) is assumed to not be a disease, it is also assumed that it cannot have an aetiology, such as cancer or malaria might. Instead, the behaviours associated with sexual compulsivity are understood as a manifestation of a person’s free will, a personal way of relating and responding to one’s lived experience that is chosen by an individual and for which he is responsible.

Accordingly, an addiction is understood as a learnt habit rather than as a disease. Thomas Szasz, a psychiatrist and psychoanalyst who practised in the existential tradition,  saw “getting hooked” on an object of addiction as ‘simply an aspect of the universal biological propensity for learning, which is especially well-developed in man’ (Szasz 1977: 33). He described it as a fundamental characteristic of all of us that we become habituated (which for Szasz was the same process as becoming addicted) to all manner of things, which might range from narcotics to orange juice to sex. As our habituation (addiction) develops, we acquire an increasing tolerance to that to which we are habituated and our craving for it grows. The habit can be broken if we want to break it but it may well be that, for whatever reason, we do not want to break it (Szasz, 1977). Since addiction is a completely natural process of learning and one that we can choose to unlearn, there can be no question of it being a disease that renders the addict powerless.

While proponents of the disease model of addiction will insist that recent advances in neuroscience have proved that addiction is a disease of the brain stripping the addict of his agency, the same scientific findings can be shown to provide compelling evidence (Lewis, 2015) that this is not the case and that Szasz’s view of addiction is correct. Neuroscience does show, however, that it becomes increasingly difficult for the addict to be able to think of other responses to the desire to feel better, other than turning to the object of addiction, as his tolerance and craving for it increases. While this is demonstrably true, it does not mean that if someone becomes addicted, he loses the freedom to choose how he might respond in a given situation and to be responsible for the choices he might make.

In line with this, one can argue that living a life of addiction is a paradigm case of what Jean-Paul Sartre, the most famous of the existentialists, describes as being in ‘Bad Faith’. Sartre insists we are both free and responsible. In fact, he describes us as being condemned to be free and responsible for everything we do. We define who we are by what we do, through the choices we make on the basis of what we assume, believe, understand and value. This is not to say that how we define ourselves at any particular time will necessarily continue to define us thereafter (our values, beliefs, understandings and assumptions might change). ‘Human conduct cannot be finally defined by patterns of conduct’, Sartre declares in Being and Nothingness (Sartre 1958: 64). Familiar behavioural responses ‘consistent with one’s personality’ must be chosen again and again in relation to each new situation in which an individual finds himself. Being human therefore involves a constant choosing of oneself out of nothingness. This is burdensome. It is a heavy responsibility that every person would like to avoid. Sartre says each of us longs to become massif, to possess the solidity of things. For if we were to possess the solidity of things, we would then be complete and there would be no more choosing to do. We would be defined once and for all and this would remove the anguish of the responsibility that our never-ending, ineliminable freedom brings.

Despite it being an ontological impossibility, we therefore frequently pretend we are massif. In Bad Faith, we pretend that we have no choice but to be the way we are or to do the things we do, or we imagine that the choices we do have are much more limited than they actually are. From this perspective, the sex addict is choosing his sexual behaviours again and again, and distracting himself from the recognition that he could choose differently. If he accepts the medical model of addiction, he might also be denying responsibility for his actions, and insisting that responsibility for them lies at the door of disease he is convinced he has. Often he will say, ‘I know what I’m doing is harmful to me’, or, ‘What I’m doing contravenes all my values’. Yet, again and again, his brave attempts to desist because of the consequences fall away as his desire gets the better of him and he feels like he has no choice other than to ‘act out’. Ultimately, he chooses to go down this dangerous path because its attractions in the moment hold something for him that is more desirable than anything else he can think of. In that moment, he is completely focused. There is no uncertainty or anxiety. He is what he is: massif.  At the same time, he bestows powerlessness on himself…

Lewis, M. (2015) The Biology of Desire: Why Addiction is not a Disease, New York: PublicAffairs.

Sartre, J.P. (1958) Being and Nothingness (Translation: Barnes, H.E.), London: Routledge.

Szasz, T. (1977) The Theology of Medicine, New York: Harper Colophon Books.

Photo on 03-11-2016 at 20.00  Alex Smith (BA, MA (Distinction), ADEP, UKCP Registered Psychotherapist and Approved Supervisor, Reg MBACP) is an existential-phenomenological psychotherapist and clinical supervisor with nearly twenty years of experience working in a variety of settings. Alex is a relational therapist who works with a wide range of presenting issues including identity, sex addiction and bereavement. He is also a course leader and lecturer at the internationally renowned School of Psychotherapy and Psychology at Regent’s University London. Alex is a published author on existential psychotherapy and a Senior Associate of The Marylebone Centre for Psychological Therapy.