Can a Kevin Spacey or Harvey Weinstein Really Be Treated for Sex Addiction?

Therapists disagree on whether sex addiction is real. Which makes the ‘treatment’ of patients like the Oscar winner and movie mogul all the more suspect.

Photo Illustration by Sarah Rogers/The Daily Beast

After a barrage of sexual-assault and rape claims were levied against Kevin Spacey in the wake of Anthony Rapp revealing the Oscar winner made an advance on him when Rapp was 14, the actor was fired from House of Cards and he retreated from public life. Taking the path of similarly shamed Hollywood star Harvey Weinstein, it was revealed that Spacey would seek “treatment” himself.

In a statement to Variety, his reps said, “Spacey is taking the time necessary to seek evaluation and treatment. No other information is available at this time.”

The type of treatment it is for Spacey, however, remains a mystery; but we do know that Weinstein went to treatment for an alleged sex addiction. If Spacey were to get the same type of treatment, what would that even entail? On the subject of sex-addiction therapy, particularly for men like Weinstein and Spacey, I spoke to Chris Donaghue, a nationally certified sex therapist who also hosts the weekly podcast Loveline with Amber Rose.

“Sex addiction isn’t real and the treatment centers that practice it are actually practicing unethically,” Donaghue tells me. “It’s not a diagnosis that’s accepted by the American Psychological Association, nor can you bill it for insurance because the [Diagnostic and Statistical Manual of Mental Disorders] rejected it. So the people treating sex addiction are working on a model created by the treatment centers themselves. And they’re making a lot of money. So that’s bullshit right there.”

On the subject of whether Spacey could actually be treated, it’s important to note that yes, this is similar to shrinks analyzing President Trump—it’s offering a diagnosis on someone they haven’t met and evaluated. I’ve made sure to ask therapists to speak hypothetically about Spacey, using examples of men they’ve encountered in their careers.

Donaghue responds, “What’s really interesting to me about the Spacey situation is that someone who doesn’t have empathy, someone who doesn’t respect boundaries, someone who’s a sexual predator, there’s literally no diagnosis that covers that. So, what treatment would look like is similar to what they’d do for personality disorders. The personality disorder of narcissism, which is on the continuum of being a sociopath, is really trying to help someone who doesn’t have empathy to develop a core sense of care and concern for other people. If that sounds vague, it’s because it is… it looks like a really vague goal of trying to get someone to care about something that they priorly didn’t.”

Some therapists disagree, however, like John Gavegnano, a marriage and family specialist I spoke to. “It makes sense that a lot of people don’t consider sexual addictions to be real addictions because sex is a natural desire for all humans that is reoccurring, which is easy to misinterpret as an addiction,” Gavegnano says. “There is always the risk that a patient may be using a diagnosis of sexual addiction as an excuse for unacceptable sexual behavior. That being said, an addiction to anything, whether it is a substance, food, or behavior is usually considered to be a clinical issue if it starts to negatively impact a person’s ability to function in a social, employment, or familial situation. So as a therapist, you’re not technically treating a sexual addiction as much as you are treating someone’s reoccurring behaviors.”

But a patient has to actually want to get help. For Donaghue’s part, he says he believes attempts like Weinstein’s and Spacey’s are an attempt to “rehabilitate their persona and rehabilitate their character into a human being.” Isn’t that what most people assume, particularly when you see instances like Weinstein telling the paparazzi, “Guys, I’m not doing OK. I’m trying. I’ve got to get help,” as if we owe him space to privately treat himself after he destroyed the lives of women for decades.

“Whether or not symptoms re-emerge is largely associated with how much a patient continues to seek support and treatment throughout their life, even after intensive treatment such as rehab in order for the patient to remain accountable for their actions and stay clear or healthily cope with triggering situations,” Gavegnano says. “Someone might be blaming unacceptable sexual behavior on a ‘sexual addiction’ and that’s why it’s so important that if someone is to seek help for a negative reoccurring behavior, that they are being genuine about wanting to change. If they are not genuine and are doing it for the purpose to appear favorably in the public eye, then chances are that the patient may not change. On the other hand, if a patient is genuine and desperately seeks support to want to change and allows themselves to be held accountable, then it is possible that a behavior can be extinguished eventually. It would be wise though, that the person remains closely supervised and held accountable to avoid relapse.”

Ultimately, it becomes an issue of—do you believe men like Weinstein and Spacey want to change? Weinstein, who’s allegedly had a vast array of spies help him ruin the lives of his victims, is probably not someone who’s going to decide to become a better person after a 28 Days-Sandra Bullock scenario. Spacey is more complicated. Was his alleged abuse of men because he was in the closet and seeking any type of companionship or sexual attention he could find? Or was he hiding in plain sight, as I’ve suggested, so he could abuse young men and underage teens?

For the most part, we spend too much time on the perpetrators. Our fascination with them and their psyches is systemic for how we constantly crave the origin stories of villains, when we should be focusing on helping their victims and preventing future cases.

“We cannot ever know what the impact will be on someone after an assault,” Donaghue says. “Some move forward not having an issue with it, knowing that it was something that occurred and the world is still safe. Some people are not necessarily traumatized. It depends. Did they have a lot of social support? How high was their self-esteem? Did they feel in control in other areas of their life? Culturally, the work is always about believing them, supporting them, and listening.”