Mistaking coping mechanisms for addiction

I was listening to an interesting interview on the Skeptics Guide to the Galaxy (12 October 2013, #430 – http://www.theskepticsguide.org/podcast/sgu/430). The interview was with Marty Klein (http://www.martyklein.com) about the myths of sexuality and addiction.

Klein stated emphatically that there is no such thing as sexual addiction. He points out that ‘sexual addiction’ is an umbrella faulty diagnosis of other conditions (such as OCD, low self esteem and narcissism). It is akin to looking at someone who obsessively washes their hands and diagnosing them as having a ‘hand washing addiction’. Clearly that is diagnosing the symptom and not the behaviour or underlying cause.

Klein also points out that different societies define sexuality and typical in different ways. The age of consent, what is culturally appropriate for different genders and so forth. He also points out that people change as they grow older, so the normal for someone when they are 18 is different to when they are 38 and 58. If you are 58 years old and comparing your current sexual performance to that of yourself when you were 18, you will be in for a world of disappointment (usually).

This spawned an excellent side discussion about what “normal” is and why it is such an awful term to use. People are desperate to be normal, yet the definition for normal changes depending on culture, generation, age, time in history, sub cultures and your own biology. Considering the definition is so variable, why would you want to pin yourself with such a ‘standard’? Instead work out what is good for you and those you interact with. If that is fine, then all is good with your part of the world. However if what makes you happy is someone else’s misery/pain, or you are miserable/in pain, then there is an issue to be addressed.

The SGU and Klein discussed the difference between blaming an addiction vs taking responsibility for ones own actions. Klein gave the example of a man who said he had to have sex twice a day due to his addiction. When Klein probed what would happen if he didn’t, the client stated he would feel miserable and unworthy. Thus the client was using sex as a way to treat his exceedingly poor self worth, low self esteem and existential crisis. As most self medications go, it relieved the symptom but did not treat the cause.

This prompted me to consider, how often do we excuse our behavioural ‘self medication’ by saying we have some kind of condition that describes a symptom rather than addressing the underlying cause? Is this a good or bad thing? Or is there some aspect of both rather than addressing this in a false dichotomy?