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Is Harvey Weinstein a sex addict?

Harvey Weinstein at the Vanity Fair party in Beverly Hills in February 2016.
Harvey Weinstein at the Vanity Fair party in Beverly Hills in February 2016. Photograph: Axel Koester/Corbis via Getty Images

Another day, another powerful man embroiled in a sinister sexual scandal decades in the making. This time it’s powerful Hollywood figure Harvey Weinstein. The moral, ethical and political aspects of this whole mess have been covered extensively elsewhere, and will no doubt continue to be so over the coming days and weeks.

However, recent reports suggest that Weinstein has checked himself into a European rehab clinic for sex addiction. This has been met with some not-inconsiderable cynicism, but, even if it is true, wondering whether Weinstein is a sex addict overlooks a more fundamental question: is anyone a sex addict? Because that diagnosis, as commonplace as it may seem, is far from established psychiatric fact.

Many people do believe sex addiction is real and serious problem, while others dismiss it outright. Despite it being a widely-used term, it doesn’t feature in either the DSM-V or ICD-10, the two main sources for officially-recognised psychiatric disorders the world over (although that’s not a guarantee of consensus either). How can something that seems, to many, to be so straightforward be the subject of so wide a debate? We all know what sex is, we all know what addiction is, what’s the issue?

First, sex is a fundamental drive inherent in practically every human. A large percentage of our brain’s systems are responsible for or at least involved in it. An underlying need to seek out sex and an ability to engage in it as and when we like is a remarkably human trait (well, maybe bonobos too). This has many significant consequences for how our societies and cultures work, but one relevant problem is, at what point do you want sex too much? Because that’s not an easy thing to pin down. Those who don’t support the idea of sex addiction often argue that it’s another attempt to pin a clinical diagnosis on “normal” human behaviour (like the dispute around grief in the DSM-V). Some even compare it to gay conversion therapy, in how it medicalises and tries to undo what is an expression of human sexuality.

However, sudden marked increases in strength or frequency of libido are often labelled hypsersexuality (previously known as nymphomania or satyriasis for women and men respectively), which may seem like sex addiction, but isn’t quite. It’s usually recognised as part of a bigger problem, often a personality disorder or side effect of medications like hormone replacement therapy or those used to treat Parkinson’s. And even then, there are still those who maintain that it’s within the normal expression of human sexuality, even if it’s a notable shift from what the individual has demonstrated before.

The addiction side of things just makes it more complicated. There’s no doubting addiction is a real and debilitating thing, but much of the literature is centred around drugs and narcotics, understandably. Much of the focus is on the dopamine reward circuitry in the brain. Put simply, the dopamine-powered reward pathway in our brain is what causes us to experience pleasure whenever we do or experience something our brain recognises as positive or beneficial and wants to encourage us to do again. Eat something when particularly hungry? Reward. Scratch an itch? Reward. Have a successful sexual encounter and increase your chance of reproducing? Reward.

Imaging of the brain on mri scan
People say the brain is the biggest sex organ, but looking at it directly can be something of a mood-killer. Photograph: akesak/Getty Images/iStockphoto

What drugs of abuse like heroin do is essentially hijack this system, triggering it directly so we experience intense pleasure in response. So, of course, we end up wanting to do that again. The problem is, the brain isn’t static; it changes in response to persistent circumstances, and this very much happens in addiction. The brain itself is “rewired”, the connections between the reward pathways and those areas governing motivation and behaviour are warped, so our drive to sustain the addiction ends up taking precedence over all other concerns, be they legal, social, biological, you name it. And eventually, the brain develops such a tolerance to the drug that it no longer results in any pleasure, but an absence of it causes hideous discomfort and stress. It’s no longer about pleasure-seeking, but pain-avoiding.

It’s harder to see how sex fits in with this. Yes it’s very pleasurable, and there are reports of people seeking out sex the way a drug addict seeks out a fix; by any means necessary, in the most squalid of conditions, with little respect or even awareness of the law. Behaviourally, that would fit the criteria of an addiction. But, the data is less supportive. Some studies have revealed that, of a large group of men who purport to be sex addicts, only those experiencing serious psychological issues met the stringent criteria. Another study revealed that those who claim to be sex addicts don’t show the expected brain activity, indicative of addiction, when exposed to erotic or pornographic imagery. These studies are themselves debatable though. What criteria are they using to define “sex addiction” if there’s no accepted version? Is viewing explicit imagery sufficiently like the actual act of sex to produce the same activity in the brain? This is highly debatable.

One likely issue here is that, unlike with drug intake, the human brain has many sophisticated systems for encouraging and regulating sex and sexual behaviour. It’s not a foreign substance being artificially introduced, it’s something deeply entrenched in our DNA. It’s the reason we have DNA, in many ways. Parts like the amygdala regulate how and when we want sex, the orbitofrontal cortex helps keep a rein on our libido, and so on. This all means that sex influences our behaviour in numerous subtle (and less subtle) ways. So, describing some sexual behaviours as addiction and not others is a tricky task, and thus far not one that has sufficient evidence to be readily addressed.

Those who claim to be sex addicts are usually a) men, and b) show behaviours more in-keeping with paraphilic disorders and the like. These aren’t great, but they’re not addiction.

Cynics argue that a rich, powerful man caught up in sex scandal claiming to be a sex addict is just a cop-out. Addiction isn’t nice. It doesn’t affect everyone the same way, but it’s usually pretty debilitating. It strips away most, or all, of your dignity, your ability to think rationally, your pre-existing priorities. A genuine sex addict would be in thrall to their addiction, and wouldn’t be overly choosy about how they satisfy it. While it’s impossible to say for certain without knowing all of the facts, it’s hard to argue against the cynics.

Dean Burnett discusses issues like addiction and sexual motivation in his book The Idiot Brain, available now in the UK and US and elsewhere.

This article titled "Is Harvey Weinstein a sex addict?" was written by Dean Burnett, for theguardian.com on Thursday 12 October 2017 06.00am

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