11/15/2025
I’m incredibly grateful that Dr. Anna Lembke, MD, Professor of Psychiatry and Behavioral Sciences at Stanford University, has written seminal document entitled, “The New Doctors Opinion”, for the 12-step program, S*x and P**n Addicts Anonymous. Dr. Lembke is the author of the now infamous book, Dopamine Nation, where she explicitly talks about Compulsive S*xual Behavior Disorder and all Process/Behavioral Addictions (i.e. Gambling Disorder, Internet Gaming Disorder, Binge Eating Disorder, Bulimia and Anorexia, etc.)
As both a professional and a “garden variety” recovering addict in longer term recovery/discovery from multiple addictions, I’ve been eagerly awaiting for years for a well respected neuroscientists and Addictions expert to write a modernized, up to date, scientific document that incorporates the latest neuroscience to enhance the work of the infamous Dr. Silkworth’s, “Dr.’s Opinion”, in the Alcoholics Anonymous “Big Book” (i.e. basic text), and expounds on the cutting edge neuroscience on not only Substance Use Disorders, but Process/Behavioral Addictive Disorders. Dr. Lembke was asked to write a “New Dr’s Opinion” by the 12 step group, S*x and P**n Addicts Anonymous. There are two versions, an abridged and unabridged. Both are seminal reads and I have posted the links to both below. She, once again, nails it as good as anyone I have read, about what occurs in not only Substance Use Disorder, but all Process/Behavioral Addictions such as Compulsive S*xual Behavior Disorder, Gambling Disorder, Internet Gaming Disorder, and Eating Disorders. After all the, the body of knowledge in regard to Addictive Disorders and neuroscience has expanded exponentially since the 1930’s, when Dr. Silkworth wrote, “The Doctors Opinion”.
I have had the privilege and honor of meeting Dr. Lembke when she spoke at the IITAP Symposium a few years ago, shortly after Dopamine Nation was published. I was immediately struck by her ability to eloquently articulate the complexities of what occurs in the brain and nervous system, during the phenomenon of Tolerance, Withdrawal, Craving, Hypofrontality, and how the brain can recovery and gain Homeostasis. She is not only brilliant, but incredibly humble, approachable, and authentic. I was very impressed at how she candidly shared about her own addiction and subsequent recovery from romance novels, and how she and her family often take social media and phone cleanses to keep their nervous systems balanced and in homeostasis.
For anyone who would like to read both versions, here you are. Thank you Dr. Lembke for you understanding that po*******hy can and is every bit as addictive as Crack Co***ne and Crystal M**h.
Here is to saner more connected world!
(Abridged Version) PDF | Audio I have been asked by the SPAA community to provide my reflections on the nature of compulsive, addictive use of s*x, po*******hy, ma********on, and s*xual fantasy (henceforward referred to simply as “s*x”). As a physician and a psychiatrist who has spent the last t...
