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CAMHS won't see you now

Workload fears over Framingham review

'You've got to help me, doctor. I'm a sex addict.' I don't believe there is a single GP who welcomes the voluntary arrival of the self-confessed addict. There is only ever one reason for this presentation. The 'addict' has been caught out behaving in a self-indulgent manner, and they want a medical justification for their behaviour.

Addiction is a dreadfully abused concept. A good definition of an addiction is of an illness, characterised by an irresistible urge to consume a drug or other substance, or to behave in a repetitively self-destructive or anti-social way. A true addict does not feel responsible for his or her actions. They have lost their moral compass. This is not to be confused with wild and irresponsible self-indulgence.

'Let's hear about it, then' I tell my 'addict', and he expands upon his problem. 'I'm addicted to sex. I just can't get enough of it. My wife doesn't understand about my problem, but it's not my fault.'

Not many years ago, this approach would have been universally laughed out of court by anyone with half a brain, but things have changed. A film star claimed that this very 'psychiatric condition' was the pivotal factor in the break-up of his last marriage-but-one, and as a result he should be exonerated from paying the alimony that he had signed up to in his pre-nuptual agreement.

Sexual addiction was first described by the psychologist Dr Patrick Carnes PhD (ie not a proper doctor at all) in the 1970s. Dr Carnes describes how sexually-addicted individuals have become dependent on the neuro-chemical changes that take place in the body during sexual behaviour, in his book called Don't Call It Love; Recovery From Sexual Addiction. Based on a 10-year study of around 1,500 addicts, Dr Carnes estimates that 18 per cent of US men and 3 per cent of US women suffer from this disease, making a total of some 15 million victims, and that, surprise surprise, not enough is being done by the government to counter this epidemic.

I don't have a PhD myself, but I'm going to go out on a limb here and state that Dr Carnes is talking out of his backside. A prediliction to hump ladies (or gentlemen) indiscriminately is not a disease, nor does it justify a sicknote from me. I refuse to dignify this condition with a medical label.

Back to my patient. 'Can I assume that you're having an affair and the wife has found out about it?' I asked him. This was not exactly telepathy on my part; the missus had been in to see me earlier the same day in floods of tears. 'Well, yes,' he admitted.

'Let me give you my considered medical opinion' I told him. 'Actually, your wife does understand your problem, only too well. And it is your fault. Go away and sort yourself out. Next please!'

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