David Ley on Sex Addiction & Porn – Smart Sex, Smart Love with Dr. Joe Kort

It’s sometimes hard to debunking “sex/porn addiction.” This week on Smart Sex, Smart Love, Joe Kort chats with David Ley, an internationally-recognized expert on issues related to sexuality, pornography, and mental health. Together Joe and David discuss how David debunks the myth of “sex addiction”, in his book, ‘The Myth of Sex Addiction’. Is “sex addiction” a real diagnosis, or an avoidance to deal with the real issues a person is struggling with? And asks, ‘What does “sex addiction” mean for you?’


Dr. Joe Kort:                       Hello and welcome to Smart Sex Smart Love. I’m Dr. Joe Kort, and today I’ll be interviewing Dr. David Ley. David Ley is a licensed psychologist and internationally recognized expert on issues related to sexuality, pornography, and mental health. He has served as an expert consultant for numerous media outlets appearing with Anderson Cooper, Katie Couric, Dr. Phil, Tom Ashbrook, and Dan Savage.

Dr. Joe Kort:                       David is a clinical psychologist and author known for his critical stance regarding sex addition and pornography. His first book, Insatiable Wives, won a silver medal in the Foreword Magazine Book of the Year in 2009. His book, Myth of Sex Addiction, is widely regarded as a strong argument against the concept. He also has another book, Ethical Porn for Dicks, which is a funny title, but a very well researched and easy read book about ethical porn. He has been-

Dr. David Ley:                    Yeah, there’s a lot of guys named Richard out there that watch porn. The book’s for them, man.

Dr. Joe Kort:                       Oh, that’s awesome. That’s the spirit of the book, isn’t it?

Dr. David Ley:                    That’s right.

Dr. Joe Kort:                       All right. Well, why don’t we start, David? I’m so glad to have you. You know I’m … We have a history … Well, for me, my end of the history was adversarial with you at first, because I was a sex addiction therapist, and then you helped me come out of that whole model. Yeah, can you talk about-

Dr. David Ley:                    Yeah, I mean, honestly Joe, I mean, I have such tremendous respect and admiration for you. I’ll never forget, I was … The first time you and I ever had a real open heart to heart discussion was … I don’t want to … Maybe five or six years ago, I was driving back from Colorado, I live in Albuquerque, and I was driving back from Colorado, and I had just picked up a new puppy from a rescue in Colorado that I was bringing home, and somehow you and I ended up having like a 45 minute or an hour conversation as I was driving. I got to know you, you got know me, we started talking about some of our shared views and concerns about the sex addiction model, and watching your career since. I mean, watching that video you did recently about how you ran into that former sex addiction patient and apologized to him, it brought tears to my eyes. I mean, it’s really an extraordinary transformation.

Dr. Joe Kort:                       Thank you, and that was really because of your work. Even though I didn’t like what you were saying, and I didn’t agree with it, it went in. It stayed in me, because there was a part of me that knew that I was in the wrong model, and it was not helpful. I believed you, but I didn’t want to believe you. I’m sure you get a lot of that.

Dr. David Ley:                    Yeah, a bit. I mean, what is interesting is that, because I … As I’ve approached this, I mean, when I first started writing against the concept of sex addiction, I went at it in a very academic, kind of scholarly way, and I was surprised when I got such vitriolic backlash, when I got such anger, when I started getting death threats, when I was getting threats of lawsuit from sex addiction therapists and such, just because I was challenging the validity of the model, and I didn’t realize just how deeply embedded the model was in their identity. As I realized that, I realized I had to kind of shift some of my approach.

Dr. David Ley:                    So, I started telling more narratives, I started telling more stories and examples of patients that I’d worked with, who identified as sex addicts, but the issue wasn’t sex addiction, the issue wasn’t even sex, it was these other issues that were going unexamined, and as we uncovered and addressed those issues sexual self-control increased, and then I also started being more of a person myself. I started engaging more, identifying me as the vehicle by which this dialogue was happening, and it started changing.

Dr. David Ley:                    People like you, that had been within the industry, that had some reservations and questions, started seeing me not as the devil, but as just a guy who they could talk to. Now I have all of these amazing friends like you, Josh Grubbs, Sam Perry, Tony [Styker 00:04:40], so many of these people who were in the sex addiction industry, and have now left because they realized that, like you, that the model was about shame around sexuality, and that we didn’t have to feel that shame.

Dr. Joe Kort:                       Right. Listening to you say all this, now I understand, because I watch you on other Listserv’s, and you are very academic, and you talk with your peers academically, and you’re battling ideas, and talking about ideas, and that was not going to happen with the sex addiction model. It’s too deeply personal. Most of the therapists, and I was one of them, where it’s not just what we do for a living, it’s who we are. So, that’s probably why you had to change, because it was personal on the other end, and without you being personal, it looked … the message wasn’t getting through, right?

Dr. David Ley:                    Yeah, and while I was never, as a person, diagnosed as a sex addict, I was never even historically accused of being a sex addict, at least until I started saying that sex addiction was not a good model, or a valid model. I mean, since, it is simply by questioning the validity, the concept of sex addiction qualifies you automatically as a sex addict. I am a sex addict in denial just because I disbelieve that this is a good, useful, clinical model. But, looking back, historically, it would have been easy at many points in my life to label me as a sex addict, and in a lot of ways I was just lucky that I never ended up in that situation.

Dr. David Ley:                    But as I realized that, and also as I realized how much fear was driving this stuff, as I realized … Hearing people like you talk, and patients that I’ve worked with who, during the 1980s as the AIDS crisis was hitting, and they were just terrified that the things they wanted to do sexually could result in AIDS and death for them and their loved ones, and the idea that sex was an addiction kind of gave a little bit of an answer, and at least it gave you this group that you could go to and talk to about how you were trying to control your sexuality.

Dr. David Ley:                    I get where that fear and shame about your sexual desires could be so painful, and that the idea that sex addiction at least have a little bit of an answer, but I think the remarkable thing now is that we’ve grown beyond, and the research that we’ve gotten just in the past five or six years is extraordinary now in really helping us to understand those things that underlie, that subjective feeling of sexual self-control difficulties. The feeling that I don’t know if I can control these sexual desires, and I’m afraid of what happens if I don’t.

Dr. Joe Kort:                       Yes.

Dr. David Ley:                    We’re understanding that more, and I think the more we understand it, the more we can actually help the people who are suffering rather than just telling them, “Oh, you need to not do that.”

Dr. Joe Kort:                       So, let me ask you something though, listeners are going to be hearing this and going, “Well, if it’s not sex addiction, then what the hell is it?”

Dr. David Ley:                    I think that that is too simplistic a question, because everybody … and I end up in these debates, people are like, “Well, if you don’t want to call it sex addiction, then call it compulsive sexual behavior, or call it impulsive sexual behavior, or call it hypersexuality.”, but the thing is that this is a heterogenous issue, and that we are lumping way too many things under this single label. For instance, there are people who view themselves as sex addicts, or identify as compulsive sexual behavior, because they watch porn one time a month, but because they watch porn one time a month, and they think that that is immoral and bad, they identify that as compulsive.

Dr. David Ley:                    Now, compare that to the person who loses their job, because they get caught looking at porn at work for two or three hours every day. Is that the same thing? Is that the same issue? The thing is, the other people who are under that label are the people who’ve they got caught cheating on their wife once or twice in the past 10 years, and they identify themselves as being addicted to sex, or compulsive. We have to recognize that, in order for us to help people with these issues, we have to be more precise. We have to be more individualized, we have to recognize better what the complexity is in these issues.

Dr. David Ley:                    Unfortunately, when we look for one label, when we look for one term, we’re trying to make this simple, and we’re trying to explain it with one little thing, but it doesn’t work that way. Sexuality is the most complicated, complex, overdetermined and multiply influenced human behavior that exists. We’re not going to find a single label … Oh my God, the police are coming for me, see I told you I’d get in trouble. The fire department’s right down the street from my office so the drive by.

Dr. David Ley:                    We’re not going to find any one single label that explains this, and we shouldn’t, because we have to treat each of these issues radically differently. We should not be trying to treat a movie star who gets caught sleeping with a bunch of groupies, we shouldn’t be treating him or her the same as that person who is watching pornography and masturbating because it’s the way they can deal with their anxiety issues. These are two different issues with different causes, and effective treatment has to respond to those issues more specifically.

Dr. David Ley:                    One of the things I say often is that if I walk into my doctor’s office and I’m sneezing, my doctor doesn’t say, “David you’ve got a sneezing addiction, you need to cut that crap out.” Instead, my doctor tries to figure out, do I have allergies, do I have a bacterial infection, do I have a virus, or do even have that genetic thing that some people sneeze when they walk into bright sunlight? We have to treat each of these differently, and in some cases, because it is a normal, healthy behavior, we shouldn’t even be treating it, because if we try and treat it we might make it worse, or cause a problem that didn’t exist. These are critically important questions that, when it comes to sex, we have to be asking.

Dr. Joe Kort:                       Right, so when you say treating it, treating it with the sexual addiction model, right?

Dr. David Ley:                    Not necessarily. I mean, I think the sex addiction model, I think, is the model that is most well-known, but for instance, a man comes to me, and he is struggling in his relationship because he’s wanting to be sexual with other men, and gets caught looking at porn at work, and it’s gay porn. I ask him, “Well, why you watching gay porn at work, dude?”, and he says, “Well yeah, I can’t watch it at home.” The issue is, this guy is bisexual, but his wife and their heterosexual relationship, and their pastor can’t accept that he is bisexual, and so they try to make that bisexuality, or those bisexual desires go away.

Dr. David Ley:                    This is a normal, normative, and healthy aspect of his sexuality that we are treating, and it doesn’t matter how we treat it, it’s like taking a person who has a healthy limb and amputating it. We should not be using medicine to treat or suppress healthy behaviors. Now, does that couple need help? Sure they do. Does that guy need help to better understand his sexual desires? Absolutely. There’s this remarkable research just recently from Australia that showed that bisexuals are at greater risk for mental health issues and suicide when they have internalized homophobia, and when they are married to a heterosexual, because both of those things mean that this normal, healthy aspect of their sexuality is being shamed, and suppressed, and identified as something that must be fought, and that causes pain.

Dr. David Ley:                    So, Doug Braun-Harvey and Michael Vigorito talk about this very effectively. We have to start identifying what is healthy sexuality, and when something is healthy, even if it is causing problems, we shouldn’t be medically treating it. Now, there can be assistance that we can offer to help that bisexual person learn how to accept those issues in themself, and maybe negotiate and communicate them to their partner, which is a wonderful issue to work through, but it’s not a fricken illness, and it’s not a disease.

Dr. Joe Kort:                       Right, I agree. I think with my sex addiction hat on, because when I was a sex addiction therapist, what I was trained to believe and know is, that there are drivers to the sex addiction, untreated sexual trauma, bipolar disorder, depression, anxiety. Actually, I remember there was a Carnes stat that said 97% of people who are sex addicts have been sexually abused, and what I used to say then, which helped me … which started me rethinking everything is, maybe they’re just sexually abused and that’s what we’re treating, you treat that. Maybe they’re just somebody that has shame around their sexuality, you just treat that. Instead of moving to another label, a pathologizing label, can you just treat what it really is? That seems to be what the intervention should be.

Dr. David Ley:                    Yeah, I mean the research is … Carnes’ research, I’m sorry, is extremely poor. I mean, it’s never been peer reviewed, it’s never been published, it’s never been … The data has never been available for other scientists to see, and the reality is that what he was publishing and calling research was just sample bias. It was the people that came to him and said, “I’m a sex addict, I want this treatment.”

Dr. David Ley:                    Actually, his first book … I don’t know if I’ve ever told you this story, his first book, Out of the Shadows, he tells the story of this guy who was a Washington D.C. Department of Education bureaucrat, and the guy got caught arranging prostitution experiences for a woman that he was having an affair with. This got publicized, and it led to this huge scandal. This was very early 1980s. The guy went to Johns Hopkins and got diagnosed as a sex addict, and actually got put on female hormones to essentially chemically castrate him, and suppress his sexuality, and Carnes described this guy as the quintessential sex addict.

Dr. David Ley:                    Well, when I wrote my book I actually found that guy. I actually tracked him down and said, “Hey, tell me about your life, tell me about what happened. You said back in the 1980s that your life was over, your life was ruined by sexuality, that we should all recognize.”, and he said some interesting stuff. He said actually that he had sued Carnes for using his story inappropriately without his permission.

Dr. David Ley:                    He also said that within just a year the guy’s career was back on track. He said that he realized he was never actually addicted to sex, but that he was struggling to understand and take responsibility for his sexual desires. He said, “You know, I made mistakes, and unfortunately the sex addiction label prevented me at the time from taking responsibility and acknowledging those mistakes.”, but he said, “Now I’ve learned a lot more about my sexuality, and I can look back and I can understand and have compassion for the mistakes I made.”, which is just so powerful, and so different, and-

Dr. Joe Kort:                       Wow. Wow, wow.

Dr. David Ley:                    … unfortunately the sex addiction model, it’s based on confirmation bias, and people seeing what they want to see, and unfortunately Carnes really does that. Now, good research now shows that 90% of people who self-identify as sex addicts have a major mental health issue, typically depression or anxiety, and that they are using depression … they’re using sex, masturbation, porn, as a way to cope with negative feelings and to feel better, which means that what those people need is help coping with those negative feelings. But unfortunately, if we tell them, “Stop watching porn, or stop having sex.”, without replacing … without helping them develop other coping strategies, then we’re just making the problem worse. We’re increasing their self-hatred, and their shame of sexuality, and that’s actually, again, what the research shows.

Dr. David Ley:                    Josh Grubbs is a researcher at Bowling Green State University in Ohio, and he has some really remarkable research showing that people who self-identify as being addicted to porn or sex, they don’t actually watch more porn or have more sex than anybody else, but they feel worse about the sex they do, and what’s interesting is that as they self-identify as addicted to porn or sex, they experience higher levels of depression and anxiety over time, that that self label actually makes it worse, because they end up hating themselves.

Dr. David Ley:                    When they find themselves checking out an attractive person who walks by, instead of saying, “Oh, that person’s cute, it is normal and healthy for me to have these sexual desires and thoughts.”, instead they say to themselves, “Oh, there’s my addiction, it’s out of control. I’m relapsing.”, and they hate themselves. The research is clear, the more you fight these internal thoughts, the more you try to make thoughts of sex go away, the stronger they get. So, unfortunately, I am concerned that, in fact, the sex addiction and porn addiction treatment model very likely made things worse and created the very problem that it thought it was treating.

Dr. Joe Kort:                       I totally agree, and when I was a sex addiction therapist what we were trained to believe and know is that sex addiction isn’t about sex, it’s about something else, and I can’t disagree with that. Sometimes it’s about sex, but most times it has other drivers, like you said, depression, anxiety, other untreated traumas, but then the recovery was also not about sex, and that was problematic, because how do you … it’s like, trauma therapists will say, “Well, your natural sexuality will surface once the trauma heals.” It’s such bullshit. It doesn’t happen like that. You have to teach yourself, and be taught what’s healthy sexuality is for you, and that’s not what the model does.

Dr. David Ley:                    Well, and it’s such a bait and switch. It’s such a … As they say, and God, many of them say exactly what you just said, “Well, sex addiction isn’t about sex, it’s about these other issues.” Okay, then live and treat in that way, but they say that, and then what do they do? They turn around and treat the sex. They are so hyper-focused on … When the patient comes in they don’t ask them, “So, how are you doing on your depression?” They ask them, “Have you relapsed? Have you had the kind of sex that you’re not supposed to have?” Well, if it’s not about the sex, then let’s fucking stop talking about it.

Dr. Joe Kort:                       Yes, right, and pathologizing it, and what Doug Braun-Harvey calls giving people erotic-ectomies, right?

Dr. David Ley:                    Yes.

Dr. Joe Kort:                       Trying to take it away, like you said, losing a limb, there’s nothing to lose, it’s how do you negotiate and have a better relationship with your erotic-self?

Dr. David Ley:                    One of the things I will say, I noticed a post that you just made a little while ago today about you’re taking better care of your beard, and wearing the clothes you’re wearing, and I’ve noticed … Over the time I’ve known you, I’ve noticed you getting more comfortable in your masculinity, and I think it’s beautiful. I think it’s so powerful, because the sex addiction model is really deeply rooted in this rejection of many aspects of male sexuality. Identifying masturbation, identifying casual sex, identifying sex for recreation, all of the things that are identified as being addictive sexuality just so happen to be aspects of sexuality that are more common in men.

Dr. David Ley:                    I think that what we need is more men who are standing up as healthy role models for what healthy masculine sexuality looks like, and that doesn’t necessarily mean that they are erotically neutral, but we have to find a way where men are allowed to be sexual in this self-determined way. Will Smith is one of the guys I look at who … He and his wife have rejected the idea of monogamy in their relationship, and they are working through how they negotiated that in their relationship, and so that if he gets caught having sex with another woman, well, he’s not cheating, they worked it out. He’s not going to call himself a sex addict, because it’s been negotiated. I don’t know if you remember … Oh gosh, who was the lead singer of Wham!?

Dr. Joe Kort:                       Oh, George Michael.

Dr. David Ley:                    Was that George Michael?

Dr. Joe Kort:                       Mm-hmm (affirmative).

Dr. David Ley:                    Okay, so George Michael, I don’t know if you remember this, George Michael before he came out as gay, he got caught having bathroom sex in, I want to say New York.

Dr. Joe Kort:                       Yup.

Dr. David Ley:                    He was ashamed, and he identified as being addicted to sex, and he went to sex addiction treatment. But then, over the next few years, he came out as gay and then, I want to say five or six years later he got caught again having bathroom sex in England, but this time instead of being ashamed and identifying as sex addict, he pushed back at the reporters, and journalists, and people that were attacking him, and he said, “Look, this kind of sexual behavior is part of gay culture. I am not doing anything unhealthy. You guys can just fuck off.”

Dr. Joe Kort:                       I love, love, love that. We have to stop, we could talk so much more, but I love that you ended with that, because that’s such an important transformation, and by the way, thank you for noticing my post, because I do … I come from a misandrous family that didn’t allow me to be masculine, and I think the sex addiction model also doesn’t allow men to be masculine. So, that was a great parallel. Before we go though, I want to-

Dr. David Ley:                    I agree.

Dr. Joe Kort:                       Thank you. I want to wrap up, and ask you whatever you’d like to promote, the things that you’re doing now, before we stop. What are you doing?

Dr. David Ley:                    God, I mean, the list goes on, but if folks are interested in finding me, or hearing stuff I’m doing, follow me on Twitter @DrDavidLey, last name is L-E-Y.

Dr. Joe Kort:                       Dr. David Ley at Twitter, L-E-Y. I like what you said, that it was destined for you to become a sex therapist, because your last name is Ley. I love that line.

Dr. David Ley:                    Yeah, I had no options. I could be a sex doctor or a politician involved in a sex scandal, but Anthony Weiner holds the title.

Dr. Joe Kort:                       Thank you so much, David, for coming on the show. Thank you.

Dr. David Ley:                    Always. Take care, Joe. Thanks for doing it, good luck to you.

Dr. Joe Kort:                       All right, thank you so much, see you.