We have written about the public “debate” over sex and pornography addiction, and have been especially critical of news stories that attempt to reduce complex issues into simplistic headlines. Intentionally or not, news articles blaring “Porn/Sex Addiction Isn’t Real” perpetuate the stigma of problematic sexual behavior. By dumbing down highly complicated and emotional issues, they confuse people in pain who want - need - to find help.
Late last month, an announcement by the American Association of Sexuality Educators, Counselors, and Therapists (“AASECT” for short) kicked up the dust storm yet again. In what was billed as a “historic position statement”, AASECT rejected addiction-centered treatment methods for problematic sexual behaviors. Specifically, as of today “it is the position of AASECT that linking problems related to sexual urges, thoughts or behaviors to a porn/sexual addiction process cannot be advanced by AASECT as a standard of practice for sexuality education delivery, counseling or therapy.”
Predictably, media outlets translated this as confirmation by “experts” that sex and porn addiction aren’t “real," or worse, that they're a "hoax." Absent from these stories was much (if any) analysis of the nuance in AASECT’s announcement. For instance, AASECT acknowledges that people do suffer from out-of-control behaviors involving sex and porn, and that those people do need help. But, AASECT believes there is insufficient empirical evidence to establish these behaviors as addiction-type “mental health disorders”, and therefore believes it’s inappropriate to use addiction-focused therapies to treat them. Finally, and perhaps tellingly, AASECT claims that therapists who do follow the “addiction model" lack “accurate human sexuality knowledge”.
Journalists also failed to point out an important omission from AASECT’s statement. Lost in the attention-grabbing hoopla over whether sex and porn addiction are “real” was AASECT’s tacit admission that it has no clear recommendation for how therapists should counsel people with problematic sexual behaviors. Instead, stealing a page from the official Paul Ryan “Repeal and Delay” Playbook™, after trashing the longstanding “sex addiction model” of treatment, AASECT offered only its support for a “collaborative movement to establish standards of care supported by science, public health consensus and the rigorous protection of sexual rights.” That sounds to us like AASECT kicking the can down the road.
So what are we to make of this? And, by “we,” we mean the people struggling with problematic porn use who are the consumers of the therapy services AASECT’s announcement covers. Should we use it as guidance in choosing a therapist? If so, what good is a therapist if he’s waiting for a “collaborative movement” to tell him how to go about helping us? Some background might help us answer those questions.
AASECT is a certifying body for sexual health practitioners, most notably for the “Certified Sex Therapist” (“CST”) certification. AASECT competes for prominence in the sexuality practitioner certification marketplace with the International Institute for Trauma and Addiction Professionals (“IITAP”). IITAP was founded by Patrick Carnes, the godfather of “sex addiction” treatment methodology, and a founder of the Society for the Advancement of Sexual Health (“SASH”). IITAP is the certifying body for the Certified Sex Addiction Therapist (“CSAT”) certification.
In other words, AASECT and IITAP are rivals. The "sex addiction model" AASECT has rejected is the method of therapy promoted and taught by IITAP. When AASECT took a poke at addiction-centered therapists who purportedly lack “accurate human sexuality knowledge”, it was undoubtedly referring to IITAP-certified practitioners. Seen in this light, AASECT’s announcement looks a lot like a shot fired in a (highly niche) turf war between competing professional certification bodies.
An article published on the website Psychology Today by one of the practitioners behind the AASECT announcement, Dr. Michael Aaron, gives credence to that view. Dr. Aaron holds a Ph.D. from the American Academy of Certified Sexologists, and has been certified by AASECT as a CST for “over three years.” In his Psychology Today article, he describes how he led an effort to combat “hypocrisy” within AASECT surrounding sex addiction treatment. Dr. Aaron believes the “sex addiction model” of therapy is “extremely destructive to clients” in that it purportedly addresses “sexuality concerns from a moralistic and judgmental perspective.” For this reason, he sees “the sex addiction model as directly at odds with the sex-positive messaging that AASECT ... [is] trying to project.”
Finding AASECT's tolerance of the "sex addiction model" to be "deeply hypocritical", in 2014 Dr. Aaron set out to eradicate support for the concept of “sex addiction” from AASECT’s ranks. To accomplish his goal, Dr. Aaron claims to have deliberately sowed controversy among AASECT members in order to expose those with viewpoints that disagreed with his own, and then to have explicitly silenced those viewpoints while steering the organization toward its rejection of the “sex addiction model.” Dr. Aaron justified using these “renegade, guerilla [sic] tactics” by reasoning that he was up against a “lucrative industry” of adherents to the “sex addiction model” whose financial incentives would prevent him from bringing them over to his side with logic and reason. Instead, to effect a “quick change” in AASECT’s “messaging,” he sought to ensure that pro-sex addiction voices were not materially included in the discussion of AASECT’s course change.
Dr. Aaron’s boast comes across as a little unseemly. People rarely take pride in, much less publicize, suppressing academic and scientific debate. And it seems odd that Dr. Aaron spent the time and money to become CST certified by an organization he deemed “deeply hypocritical" barely a year after joining it (if not before). If anything, it is Dr. Aaron who appears hypocritical when he criticizes pro-“sex addiction” therapists for having a financial investment in the "sex addiction model", when, quite obviously, he has a similar investment in promoting his opposing viewpoint .
And that, to us, is the key to understanding the real significance of the AASECT announcement. Dr. Aaron’s pride in suppressing debate and driving AASECT to reject the “sex addiction model” of therapy makes sense if we think of his efforts as an exercise in brand differentiation. Commercial motive is a common denominator for all professional therapists to some degree. AASECT-certified therapists trade on their CST certifications the same way IITAP-certified therapists trade on their CSAT credentials. But for would-be consumers of therapy services, it’s hard to distinguish between the two certifications. Both require adherence to strict sets of ethical guidelines, including non-discrimination and acceptance of sexual diversity. Both also stress the importance of promoting client sexual health. Heck, the abbreviations for the certifications are even confusingly similar.
Could it be that Dr. Aaron recognized this, too? Without a clear distinction between his CST certification and his competitors’ CSAT certifications, Dr. Aaron may have recognized that he was trading on a poorly-defined brand that could easily be confused with a viewpoint with which he disagreed. That could explain why he joined up with AASECT (“deeply hypocritical” though it was), and promptly undertook an unpopular and controversial effort to drive a wedge between AASECT and IITAP over the headline-grabbing issue of “sex and porn addiction”. Seizing on the stigma attached to the word “addiction”, Dr. Aaron pushed AASECT to discredit the longstanding methods of its competitor, IITAP. It was a clever stroke of political and marketing insight: no one wants to be labeled an “addict,” so why not define AASECT-certified therapists as people who will treat your out-of-control sexual behaviors without calling you one?
All of which would be fine and dandy if AASECT managed the rest of its message a little better. But, by endorsing the reductive message that “sex and porn addiction aren’t real”, AASECT allowed its statement to be communicated as a categorical rejection of the fact that people actually do suffer from problematic, compulsive sexual behaviors that feel, to them, like addictions. AASECT also compounded its error by punting on the most important question: how AASECT-certified therapy would be different from addiction-centric therapy. And then there's the baffling refusal of the folks on the AASECT side of the turf to so much as acknowledge the body of scientific evidence that supports an addiction-based approach to out-of-control sexual behaviors. In short, in making a big deal of its rejection of the “sex addiction model,” AASECT (inadvertently, we hope) sowed still more confusion and shame for the people it purports to want to help.
For what it's worth, those of us who have consulted therapists trained in the “sex addiction model” (CSATs certified by IITAP, mostly), have found that they are not moralizing or judgmental in the main. Our collective experience has been that CSATs do not use shame to address our behaviors. They show a great deal of empathy, in fact. CSAT therapy, in our experience, aims at helping us understand how and why our behaviors are unwanted, and at coming to terms with those behaviors that have been most destructive to things we care about. In that respect, we suspect we’d find a similar approach used in AASECT-certified therapy (and we invite anyone with experience in that regard to comment below). Yes, IITAP-certified therapists may use a vocabulary of addiction to address our issues. But frankly, by the time most of us seek help, we don’t really care about labels all that much. We just want help controlling a personally destructive cycle of behavior, guilt and shame that has taken over our lives. Many of us have even found comfort in giving our problem a name - even if the name is "addiction".
Bottom line: AASECT’s announcement may be “historic” for AASECT-certified practitioners, but to those of us who may consume their services, it doesn’t feel particularly enlightening. If AASECT really wants to make a meaningful difference in the therapy marketplace, it should advertise exactly how its therapists are trained to approach treatment of out-of-control sex and porn use issues. Instead of telling us how “bad” the “sex addiction model” treatment we’ve been receiving is (contrary to the experiences of the vast majority of us), it should tell us how its alternative treatment model will be better. And, instead of completely ignoring the body of scientific research that appears to run contrary to its position on the links between out-of-control sexual behavior and addiction, AASECT should explain why it disagrees with that research.
Until then, we're going to be wary of buying whatever it is AASECT is selling.