Controversies Regarding Willpower and Sexual Addiction

Daniel Kahneman and Amos Tversky are two of my scientist heroes. Together, they created the field of behavioral economics, because their subject matter was about how people make decisions, sometimes against their own best interests, and frequently irrationally, but predictably. Their work, for which Kahneman won the Nobel Prize (Tversky had already died) is easily detectable in the advice our apps dispense, especially in the many references to “Type I and Type II” thinking. The findings of this scientific team have implications far beyond the field of economics and, in my opinion, should be required reading for anybody interested in self-control (or politics, for that matter). Plow through Kahneman’s “Thinking, Fast and Slow” and you’ll be looking at life and yourself in a whole new light.

Kahneman was a worrier, a trait I share. One of his quotes recently cited in a fascinating story about the Kahneman-Tversky team, “The Undoing Project: A Friendship That Changed Our Minds,” by Michael Lewis,” is “I get a sense of movement and discovery whenever I find a flaw in my thinking.” In other words, Kahneman was constantly re-examining his findings and theoretical conclusions, was always on the lookout for the possibility that he had made a mistake, and was ever-prepared to throw out what he had done and start over if he was proven wrong for the sake of scientific integrity.

It’s wonderful to have heroes, especially if they inspire you to emulate their best ethical and scientific qualities. Recently, two highly relevant psychological controversies have emerged, one about willpower, and the other about sexual addiction. We are heeding the advice of Dr. Kahneman and are looking at the concepts of willpower and behavioral addiction that we use in our apps as carefully as we can based on these controversies.

The first controversy challenges the notion that willpower is a useful concept, especially in regards to changing habits. The challenge comes from three lines of evidence. First, it had been claimed that willpower, hypothesized to be a resource that could be depleted, could be replenished in fatigued users by giving them a sugar boost. This was early work from Roy Baumeister’s lab. Subjects given radishes to snack on while working on a task gave up much earlier than others given cookies. That “energy-replacement” research has not been replicable, however. Failing to replicate, researchers Veronika Job, PhD, and colleagues, then began suspecting that the original work gave positive results because the participants believed that an energy boost would help them. Their studies supported the idea that a person’s belief about how willpower works is highly important and frequently determines the outcome of a study. If you believe willpower will not peter out, you’ll show better willpower abilities in laboratory tests. So, based on these “not-so-fast-there-willpower-believers,” findings, the concept is under fire.

A separate line of criticism comes from the conclusion that long-term behavioral change does not come about from willpower alone, but is based on learning new patterns of response to situations that previously were associated with the negative habit. Well, for us, that’s preaching to the choir and not at all controversial. We have always considered willpower to be an intermediate strategy, necessary but not sufficient, to put into place healthier habits. Enough said about that one. But let’s look at the other willpower issues more closely before moving on.

We take the position that willpower is a hypothetical construct, a shorthand way of referring to the ability of individuals to withhold immediate gratification for the sake of later perceived gains. The term does not imply any underlying neurological correlate. By using willpower to resist an old behavior, an individual creates the opportunity to substitute a new behavior in its place. Willpower, or self-control, includes a variety of strategies, including the “smart regulation strategies” suggested by Traci Mann, PhD, and colleagues, as well as many more. This conceptualization of willpower has been in place at least back to the 1960s in the work of Bandura, Mischel, Kanfer, and others. In this sense we do not think of willpower as a force or mysterious inner strength, nor that it is an innate ability, although we are in strong agreement with Baumeister and his colleagues that it “fatigues.” (True, the sugar study and its implied carbohydrate metabolism explanation, can’t make that case, but there are scores of studies showing that self-control wanes with tiredness, especially from tasks that demand self-control, with repetition, etc.) We acknowledge that a person’s belief about willpower plays a mediating role, but we see that as a feature, not a bug. This finding can be incorporated into willpower training protocols quite easily and should pay off handsomely.

We readily agree with critics that the field needs refinement and greater sophistication to tease out how willpower actually works. Nonetheless, we see tremendous utility in the training strategies advocated by Baumeister, and the stimulus control concepts introduced by a variety of researchers. We still believe, as earlier researchers did, that willpower skills are as essential as intelligence for most forms of successful living in this day and age, and indispensable when trying to break old habits.

Some people are better than others at self-control, as Marlene Gillebaart and Denise de Ridder at Utrecht University demonstrate, and while this observation might have something to do with genetic predispositions, we think most people can learn how to increase their self-control strategies dramatically, mainly by following the advice that comes from studies by modern willpower researchers. We wrote an earlier post about this research here.

We also know that some people are at a real disadvantage in developing willpower strategies, especially people identified with high emotional reactivity.(We have a post about this finding as well. Click here.) The challenge for this group of individuals emphasizes the point that willpower is a complex phenomenon, influenced by both internal and external factors, with significant individual variation. No wonder there are controversies about precisely what it is, and that some people conclude that they “have no willpower.”

A final comment about willpower is that studies reveal the fascinating finding that individuals who self-identify as having excellent willpower actually employ that skill much less than those with poor willpower. Some have taken this to mean that willpower is not a useful concept. We think otherwise. People with excellent willpower have used the skill to establish good habits. With the desired habit firmly established, they don’t need further willpower exertion to maintain the habit because they have largely eliminated the temptation to act otherwise. It fits precisely what our app is attempting to accomplish and it supports our contention that willpower is an intermediate strategy to attain healthier outcomes.

The second controversy is whether there is such as thing as sexual addiction. A position paper has just been released by The American Academy of Sexual Educators, Counselors, and Therapists (AASECT), that it is incorrect to view the overuse of sexual activities such as compulsive use of pornography, as an addiction. Here is their statement in its entirety:

"AASECT recognizes that people may experience significant physical, psychological, spiritual and sexual health consequences related to their sexual urges, thoughts or behaviors. AASECT recommends that its members utilize models that do not unduly pathologize consensual sexual problems. AASECT 1) does not find sufficient empirical evidence to support the classification of sex addiction or porn addiction as a mental health disorder, and 2) does not find the sexual addiction training and treatment methods and educational pedagogies to be adequately informed by accurate human sexuality knowledge. Therefore, 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."

This statement was developed under the leadership of Ian Kerner, PhD, Chair of the Public Relations, Media & Advocacy Steering Committee of AASECT, together with a small committee as well as input from approximately 30 members who commented on early drafts or reviewed the statement.

Now, what this statement is saying is NOT that there is no such thing as runaway sexual excess. They are saying clearly, however, that they do not buy into the idea that sexual excess fits a model of addiction. The position statement also clearly states that AASECT is not in favor of therapies or treatment strategies that use an addiction model to assist those with sexual excess problems. While not stated, that admonition would certainly include 12-step concepts such as those used by SAA groups. Also unstated is the description of some, but not all sexual excess cases, where the phenomena usually associated with chemical addictions are all present, including tolerance, withdrawal, continuation of the activity in spite of recognized harm to self or others, etc. Finally, the short position statement seems to be disregarding very persuasive neuroscientific studies, some even coming from the NIH, demonstrating commonality of mechanisms for both chemical and behavioral “addictions” (e.g. Olsen, CM (2011) “Natural rewards, neuroplasticity, and non-drug addictions”, Neuropharmacology. 61 (7): 1109-1122). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3139704/

It’s important to clarify that the position statement doesn’t contradict the emphasis or advice our app offers to users. I’m pretty sure if Dr. Kahneman were working with us, he wouldn’t tell us to start all over. That’s because the advice and information our app provides is independent of whether behavioral phenomena fit the definition of addiction or not. (By the way, the DSM doesn’t use the word addiction even for chemical problems, but prefers terms abuse and dependence in its diagnostic system).

If you are distressed by a sexual excess habit, and you’ve ruled out medication side effects or bipolar disorder, then we believe the app can be of assistance in helping you. We’ve been fairly careful to use the phrases “sexual excess” and “negative habit” for most of the communications our app offers to users and not “sexual addiction” except in a few specific cases. Our app doesn’t use a 12-step treatment model (although we aren’t opposed to that model) and is much more about harm-reduction strategies than abstinence, except in cases in which the behavior is damaging to self or others, or when harm reduction hasn’t worked. After all, “harm-reduction” doesn’t apply to pedophiles or serial adulterers. We agree with AASECT that sexual excess comes about for a variety of individual reasons, some much more similar to chemical addictions, some attributable to mental illnesses such as bipolar disorder, and some even coming as side effects of particular medications.

We are surprised that AASECT took such a strong stand at this time however, because, as briefly referenced above, there is a growing body of neuroscience literature that cause me to believe that there is a class of sexual excess that fits behavioral descriptions of addiction, and that likely shares the same underlying biochemical and neuroanatomical pathways as chemical addictions. There is not conclusive evidence of underlying mechanisms, however, so that the final verdict remains to be demonstrated by the neuroscientists looking at this issue. Time will tell.

A final point of agreement with AASECT is that our app is geared to help users find deeper controlling triggers besides the overt desire for sexual release to help them end their runaway sexual excesses. We think stress, trauma, anger, anxiety, and other emotions, events, behavior, and thoughts drive sexual excess patterns. But we also know, like addictions, that these negative patterns take on a life of their own. Once firmly established, the original reasons for developing the habit might not be the same as the reasons the habit is being maintained.

So, I think our Willpwr+SE sexual excess app is in good shape conceptually, in spite of the complexity of concepts it utilizes. We like the willpower concept and the excellent work of Baumeister and others, although the underlying reasons regarding its mechanism remain unknown. We believe that sexual excess in some cases fits the model of addiction, but we agree that’s not proven fact. Nonetheless, if sexual behavior is excessive and problematic, I think we have solid advice to offer through our app, and a unique platform to offer it exactly when it is needed most. The app is an assistant, not a complete program, nor a cure. Many will find the need for additional professional help. But thus far, I believe Willpwr+SE maintains scientific integrity with regard to the information it dispenses and the strategies it supports.