CHAPTER 27
The Lowest-Hanging Fruit
Patrick Carnes has a serious, clergyman’s cast. The father of sex addiction therapy, he sits in his office in a lodge-style building, a place of dark wood and heavy silences. Carnes’s sandy hair and soft-edged manner, along with the solemn setting, bring to mind the actor Red Buttons, as if rendered by Rembrandt.
At the time of my visit, the golfer Tiger Woods has recently come to Carnes’s nearby Pine Grove campus, southwest of Hattiesburg, Mississippi. And on any given day as many as a half dozen celebrities are mixed in among those who wish to remain uncelebrated, participating in the center’s programs for addiction and behavioral health care. It is an unseasonably mild October afternoon. Dr. Carnes, age sixty-seven, is wearing a heavy jacket of rust-colored corduroy.
Was there a turning point, I ask, when the general public began to take the concept of sex addiction seriously?
“Not until Bill Clinton,” he says, without hesitation. “Nineteen ninety-eight.” He is referring to the day the country was informed of the president’s intimate and ongoing relationship with White House intern Monica Lewinsky. “I remember that afternoon the news broke. I was in my office [then in Wickenburg, Arizona,] and between one o’clock and three o’clock, two hours, we counted them up—we had 141 media contacts, just one right after the other. They all, of course, wanted a diagnosis of Bill Clinton on the phone. Was he a sex addict?”
Carnes speaks with a rasp, practically a whisper, as one might expect from someone who makes a living from talking to others in confidence. He affirms the bind that he faces as a therapist and as a spokesman for the field. “As a clinician, I’ve never met Bill Clinton—how can I make a diagnosis?” he asks. “What reporters don’t realize is that they needed to talk. They would say, ‘I have watched this thing unfold and… I am convinced that there is sex [addiction].’ They were making a diagnosis in their heads because there’s someone who had so much to lose.
“If you look in writings of reporters at the time, like [Newsweek’s Michael] Isikoff on covering Clinton, or you look at [Vanity Fair contributor] Gail Sheehy, she did quite a job because she really asked the right questions. They used the language of therapy: the ‘long reach’ of trauma, anxiety reduction, denial. The whole culture started using a different set of language. If we were maybe thirty years behind alcoholism at that time, in understanding sex addiction, we probably made a leap of a decade or fifteen years within a six-week period. The dialogue about this issue among the reporting community: these people were talking to each other about this and were connecting the dots. And that was an extraordinary moment in history.” (Carnes adds a caveat: “I wish the Clintons no ill, because I think they’ve suffered a lot and they both have persevered in their careers and I admire them both. I wouldn’t want [it] ever to appear that I had felt any other way about them.”)1
“Bill Clinton,” he continues, “was not the first president who has been sexual in the White House under various different circumstances. Our history is filled with that.… [But] there are some things about power that we now understand that we didn’t understand even then.”2
Even if the nation and the addiction-and-recovery network had learned from that teaching moment, it is difficult to gauge whether the president’s pattern of behavior actually constituted genuine addiction, compulsivity, or any other condition whatsoever. But that has not stopped others from trying. In a Time magazine account, Dolly Kyle Browning, for one—an attorney and former school chum of Clinton’s, who has stated that the two of them kept up an affair over several years—described a supposed encounter in Texas in 1987 at which she said she opened up to Clinton about her struggles with sex addiction. Browning insisted that he became tearful, saying that he too confronted “temptation on every corner—How do you expect me to pass it up?… I can’t even walk down the street without someone literally trying to pick me up.” (“The President,” according to Time, “now says he does not believe the conversation ever took place.”)
Dr. Drew Pinsky, the rehab expert and love-life guru, offers his own take when I meet with him in Los Angeles: “Is Bill Clinton a sex addict? The piece that gets lost in the defining quality of sexual addiction is the loss of control. By the time somebody is so deeply engaged in sexual addiction that they feel like they’ve lost control—and suffer the consequences—they’re really in. Go about seventy-five pages into his autobiography, My Life. There’s alcoholism all over the place. His mom was an opiate addict. You’re at risk. His relationship with Monica Lewinsky: was that sex addiction, out of control? It meets my criteria.”3
Pinsky actually conducted a 2008 interview with Gennifer Flowers on his popular radio show, Loveline, in which she claimed that Clinton had contacted her two or three years before. “He wanted to come and see me,” she said on air. “I clearly felt like he was in some sort of a program, where he needed to make [amends] to people.… He said… ‘I’ll wear a jogging outfit. I’ll wear a hood.… Nobody will know it’s me.’ I said, ‘No!… And please don’t call me again.’” Flowers, who told Pinsky she was unnerved by the overture, insisted that the more she thought about it, the more “he seemed like… I have known people that have been in, for example, a twelve-step program… and how they have to, you know, go to these various people that they have wronged or that they have issues with and deal with it.”
That said, this is so not about Bill Clinton. It is about a condition affecting men and women, their life partners and sex partners, their families and friends. Time to check under the proverbial hoodie.
The concept of a person being addicted to sex, of course, didn’t start in the ’90s. But by that decade, researchers, health professionals, and marriage counselors were buying into the idea. Twelve-step programs for sexual dependency were drawing crowds. The wider treatment circuit was embracing intimacy disorders as a sort of last taboo. The first inpatient center to focus specifically on sex addiction—established in the 1980s, in Golden Valley, Minnesota—was gaining recognition. Judges were ordering perpetually straying spouses to seek help. Television talk shows were running segments (“Next hour: ‘I’m a nympho’”) that played up the high-drama sagas of shame, betrayal, and domestic devastation. Michael Ryan published his influential memoir Secret Life in 1995, about his own path to destructive seduction.4
On top of this, the new phenomena of online porn, chat lines, and connections for hookups risked turning impressionable Internet users into what the press often called sexaholics. (Early on, the disorder was referred to as “hypersexuality.”) In the late 1990s, as the New York Times’s Jane E. Brody would report, Stanford’s Al Cooper conducted in-depth analyses of obsessive erotic behavior online. He came to view cybersex as “the crack cocaine of sexual compulsivity,” warning that “this is a hidden public health hazard exploding, in part, because very few are recognizing it as such or taking it seriously.” Indeed, many people were still clinging to the notion that the player or the lech was a rather harmless type.
Nineties headlines, meanwhile, were routinely announcing flameouts due to sexual obsession. “Hard to believe,” says journalist Sam Kashner today, “but teacher-student sex became a ‘beat’ of mine at GQ.” He cites the high-profile case of Mary Kay Letourneau, a married teacher with four children who had an ongoing sexual relationship with her thirteen-year-old pupil. (She went to jail for the crime in 1997, bore two of her ex-student’s children, then married him and took his name.) In another case, a Berkeley professor, as Kashner recalls, “advocated [for] consensual relations between teachers and students as part of the Socratic method.
“Why was this kind of a ’90s phenomenon?” he wonders. “The generations had gotten closer in age. Children were being more sexualized—in Britney Spears’s first video she’s dressed as a cheerleader. The shift came when the professors came to power in the academy and they had grown up sexually during the sexual revolution. For them, Lolita”—Nabokov’s mid-’50s novel about a professor’s obsession with the young object of his desire—“didn’t register as it did to a previous generation. In the ’80s and ’90s, Lolita wasn’t a paean to sexual longing and lost youth; it was just a guide to motels.”
There was also a steady flow of news stories about men in power—members of the clergy, elected officials, athletes, performers, actors, and business figures—undone by destructive affairs or predatory behavior. Incidents involving pedophile priests regularly surfaced after years of silence, denial, and hush money. (The Economist estimated that from the late ’80s onward, “thousands of claims for damages following sexual-abuse cases [cost the Catholic Church, on average, more than] $1 million per victim, according to lawyers involved.”) Frequent, too, were accusations of sexual misconduct—or of behavior that might be perceived as unbecoming a public servant—against lawmakers and governors and political figures (Democrats and Republicans) throughout the ’80s and ’90s, including Jon Hinson, Robert Bauman, Thomas Evans, John Schmitz, Dan Crane, Gerry Studds, Brock Adams, John Tower, Buz Lukens, Bob Packwood, Dan Burton, Helen Chenoweth, Henry Hyde, and Mel Reynolds.
Specialists in the heartland, like their journalist colleagues in the capital, were also looking into the ways of the wayward heart. In May 1990, more than 250 psychologists, academics, and counselors gathered at a sex addiction summit in Minneapolis. Time magazine, which covered the event, described the polarized atmosphere. Many among them insisted on using the term “addiction” when treating patients with systematic and uncontrollable sexual dependency—a condition that had made patients’ and clients’ lives unmanageable, often in truly destructive ways (a marriage dissolved; an arrest or a loss of one’s livelihood; a downward, self-annihilating spiral). In contrast, many shrinks, therapists, and theorists insisted that these men and women suffered instead from what was mainly a psychological disorder, which manifested itself in compulsive behavior. By this interpretation, addiction amounted to a metaphor. Unlike heavy substance abusers, those who engaged in destructive behavior patterns that involved activities like sex or gambling or overeating did not go through observable symptoms of withdrawal when they halted their behavior. As such, their actions were merely compulsive, not true “habits” in the diagnostic sense. (The month of that conclave in Minneapolis, in fact, psychologist John Money of Johns Hopkins would tell Time that he viewed the “sex addiction” designation as something of a fad: “People trying to make money on it better hurry up. It’ll probably dry up in five years.” Go figure.)
Today, the sex addict tag is more widely accepted and is said to apply to between 3 and 6 percent of the adult population—a figure Carnes says may be far too low. Although the condition has not been officially classified in the prime psychiatric field guide, the Diagnostic and Statistical Manual of Mental Disorders, the categories of “process” or “behavioral” addictions (including sexual compulsivity) are now thought by many experts to have their own biochemical components. The brain of an individual ensnared in a cycle of hypersexual activity, for instance, produces its own feel-good spike of dopamine, not unlike the brain of the alcoholic.
A former colleague of mine—we’ll call her Geraldine—is an accomplished media publicist and mother, who is recently divorced. She has been in therapy for ten years. As she sees it, men and women tend to “ride out their compulsion in different ways.” For many guys, she believes, it’s all about the thrills associated with the sex—the encounter. In contrast, Geraldine and her peers, no matter their sexual orientation, often seem more preoccupied with the romance, with fantasizing about their partners and their feelings, sometimes all out of proportion to reality. “Women have a different way of acting out their demons,” she tells me. “People I encounter at women’s meetings often have ‘relationship addiction’—that addiction of finding somebody and becoming obsessed with them to the extent that everything else goes away and you blank out. People say heroin is easier to give up than that high of being with another person, that intense, chemical rush.
“I had this compulsion to go outside of myself. I really liked the ritual of getting prepared for the sexual encounter, of anticipating it, the romance of the meeting. Sex, for me, was a way of connecting very intensely with these individuals [so as] to give my life meaning. But the actual experience was never that great. And afterwards, like most highs, the crash was incredible. So, so awful. It really is a hellish way of life.”5
No matter how destructive such repetitive behavior can be to an individual’s psyche, the general public, by and large, still regards sex addiction as a punch line—or a cinematic cliché. For those battling insatiable sexual urges, however, the condition is altogether real. Beginning in the 1970s, researchers began to notice behavior patterns that might suggest an underlying illness. Sex addicts often came from families with a history of addiction, sexual or otherwise. More than half exhibited multiple addictions. In many cases they had been sexually abused themselves early in their lives. And sexual compulsion, as with other addictive disorders, was typically chronic and progressive. Not for nothing, then, did treatment programs borrow heavily from AA’s so-called Big Book.6
Carnes had been known for his breakthrough book Out of the Shadows (1983), the classic in the field. Then in 1991, he published Don’t Call It Love, which surveyed the lessons gleaned from a three-year study of a thousand individuals in various phases of recovery from sexual dependencies of all sorts. Carnes’s work suggested that so-called sex addicts might have real reason for hope—and a path forward.
Many of Carnes’s peers would cast doubt. They considered his beliefs “quackery,” he says. “Sometimes in my career I feel the classic tied-to-the-mast-as-the-storm-comes-over-you, and I just endure it.” Jill Vermeire, a respected sexual-addiction and marriage-and-family therapist in the L.A. and Phoenix areas, paints an overall picture. Pat Carnes was the “pioneer in dealing with these issues,” she tells me, “the first person to speak out loud to the medical community and call this disorder ‘sex addiction.’” Nonetheless, Vermeire says, Carnes was “very white-male, hetero-focused in the early years, very cognitive-behavioral. He changed his tune over time.” In contrast, she says, “a lot of us work at the psychodynamics—going more into the childhood issues and the family of origin and the formative years. We do the trauma work first; Pat does that later. Pia Mellody, she’s my mentor, ties in a lot of components and believes that love addiction or love avoidance is really the precursor to sex addiction.… Kelly McDaniel has written the best book, in my opinion, on female sex and love addiction [Ready to Heal]. She talks about something called ‘mother hunger’ and that craving and yearning for the mom who was the very first person that you have an intimate contact with, which women later find themselves seeking out through men or women.”
Sexual addiction in the 1990s was occurring against a backdrop of other behaviors, even pathologies, that appeared to be on the rise. The most pernicious was the traffic in child porn. Some of this increase was due to the peer-to-peer sharing of imagery facilitated by the Web. Others would attribute the disturbing trend to how young people were being eroticized, seduced, and reduced by popular culture and consumer society, coincident with the arrested development of many young men, who were lingering longer in adolescent stages and habits. Carnes adds a further explanation: “I am seeing patients now who are in their late twenties [and early thirties] but in 1995 were ten or eleven on the Internet and they could go on a lot of different ways, but one, for example, is they started looking at child pornography because they were children. They were looking at kids the same age. They never dated, they never held the hand, they never kissed, because they’re spending all the time on the Internet. They never socialized normally.… We are in an extraordinarily different space. That started in the mid-’90s and I hear that all the time.”
A second phenomenon involved hardcore adult porn, which was increasingly sadistic and misogynistic. One of the first major studies to compare sexual violence across different media was conducted in the late 1990s by Martin Barron and Michael Kimmel. In their paper, published in the Journal of Sex Research, they looked at porn’s migration from magazines (a pre-’80s medium) to videos (in the ’80s) to the Internet newsgroup alt.sex.stories (in the ’90s). They found “an increase in violent scenes from magazines to videos to the Usenet.… The more pornography is consumed at one level, the less arousing this material becomes [so that] this satiation leads the consumer to seek out newer, more explicit, and [sometimes] more violent forms of sexual material that will again arouse him/her.” What Barron and Kimmel could not anticipate, however, was how porn videos by the next century would become platform agnostic, offering explicit and often violent scenarios that would be available on virtually any device.
Third, a generation’s collective sexual unconscious began to process porn’s tropes along with its two main mood states: exaggerated ecstasy or numb detachment. Indeed, writer Naomi Wolf had presaged this state of affairs in 1991, before the advent of the World Wide Web. “We must recognize young people born after 1960 as ‘the pornographic generation,’” she ventured. “Children are growing up whose earliest sexual imprinting derives not from a living human being, or fantasies of their own: since the 1960 pornographic upsurge, the sexuality of children has begun to be shaped in response to cues that are no long human [but from] paper and celluloid phantoms.… Nothing comparable has ever happened in the history of our species; it dislodges Freud.”
Freud had rightly noted that our earliest sexual cues come as infants. But if, as Wolf has suggested, an individual’s initial exposure to erotic stimulation springs ever more frequently from inhuman, fetishized, self-centered representations of sex (the poor cousin of the intimate, passionate, mutually satisfying encounter), the more that particular individual, as a post-adolescent, risks becoming a thirdhand lover, a phony with pheromones.
Starting in the ’90s, technology, in many ways, “isolated people from real human relationships,” says Elisabeth Owen, an Austin, Texas, psychotherapist. Owen specializes in cofacilitating two-parent Boomer couples who are raising sons who have fallen between the cracks—many of them, in her description, college dropouts “holed up in their rooms with the door shut, playing video games or looking at pornography. [Online,] they have virtual relationships. Even sexuality has become an isolated, lonely, virtual experience. Real girls don’t look like [the online] fantasy version. Nor do real guys.”
This burrowing away into a form of electronic quarantine began as the Web gained prominence. “Girls are moving on,” Owen says. “Girls are communicators and they are emotionally evolved in a way that boys of this generation are not, and they are eclipsing young men in education and in the job market, where communication skills are key. And the saddest thing to me is that in this age, the first and defining sexual experience for a boy is a virtual one on the Internet. This is what they’ve come to expect, sexually. They don’t know how to relate to a woman. And women don’t need them anymore in the same way—in terms of marriage and a financial anchor. I can’t tell you how many of these boys have never even had a first kiss. They don’t know what to do. And young women, they’re pretty much inured to pornography—they’re very aware of it and they’re not shocked by it. Many girls think that boys who get into pornography on the Internet are losers and perverts. That’s not attractive to girls. Girls like boys that talk to them—they want to talk about their feelings.
“It began in the ’90s,” she believes. “Many are in suspended adolescence until they’re thirty years old. The boys that seem to do best are boys that are athletic and who have joined team sports. They learn to communicate as members of a team. Many of these boys who have finally found themselves have ended up joining the military because this gives them a structured rite of passage to become a male in our culture. This is one of the few vehicles that’s concrete enough to grant them the recognition of being a man.”
Such online activities have extracted a profound toll on marriages too. As noted by Pamela Paul in her book Pornified, Richard Barry, the head of the American Academy of Matrimonial Lawyers, remarked in 2003, “Eight years ago, [Internet] pornography played almost no role in divorces in this country. Today, there are a significant number of cases where it plays a definite part in marriages breaking up.” Paul goes on to point out that “nearly two-thirds of the attorneys present [at an annual conference in 2003] had witnessed a sudden rise in divorces related to the Internet; 58 percent of those were the result of a spouse looking at excessive amounts of pornography online.” (Around the same time, however, an Illinois State University study, focusing on the attitudes of women whose partners were habitual porn viewers, found that more than 50 percent of the respondents were either “neutral or even positively disposed to their lover’s taste for smut,” writes essayist Ross Douthat, while only a third of those surveyed considered Internet porn use “a form of betrayal and infidelity.” The culture has certainly moved on, and not necessarily in a good way.)
Patrick Carnes, of course, looks at the dark clouds above the landscape of American sexuality and returns, naturally, to the subject of addiction. “The social costs are huge,” he says. “The Internet has really ramped [it] up, because there are people who are now having trouble with sexual issues who are offenders that never would have gotten there if it hadn’t been for the Internet.… You have fifty thousand new HIV cases every year, a portion of which comes out of [addictive behavior]. You’re not showing up for work. You’re putting yourself at risk legally. If you’re spending thirty-five or forty hours doing cybersex, you’re not doing much else.”
When you factor in “abundance,” Carnes contends, the risk of obsessive behavior can escalate. “Addiction is very related to availability,” he says. “The more casinos we have, the more gambling problems. Sexual acting out—now a fifth-grader can do it.… The Internet was a game-changer because it was so easy to get access. Parents had no clue what their kids were doing because they didn’t understand how to use a computer. As a result, what we have coming [on the horizon] is huge.
“The reason we have an obesity problem,” he submits, by point of comparison, “is an abundance of food. And what food and sex have in common—different from all the other addictions—is they’re wired for survival. They are wired right to the reward centers of the brain. A cocaine addict doesn’t care how his cocaine is presented. But a food addict does. A sex addict would.… Other countries don’t have the amount of food that we have. Other countries don’t have the amount of sexual stimulation our kids get.
“I see a tsunami coming.”