Carnes received a Ph.D. in counselor education and organizational development from the University of Minnesota in 1980. He was awarded the distinguished Lifetime Achievement Award of the Society for the Advancement of Sexual Health (SASH), formerly known as National Council on Sexual Addiction and Compulsivity (NCSAC). Each year, SASH bestows a Carnes Award to deserving researchers and clinicians who have made outstanding contributions to the field of sexual medicine.[3]
He has worked in the field of sexual addiction in a number of other capacities, including as clinical director for sexual disorder services at The Meadows in Wickenburg, Arizona, editor-in-chief of Sexual Addiction and Compulsivity: The Journal of Treatment and Prevention (official journal of the National Council of Sexual Addiction/Compulsivity), board member of the National Council of Sexual Addiction/Compulsivity organization, advisor on the national advisory board of the American Academy of Health Care Providers in the Addictive Disorders.[4] Carnes is the Founder and Senior Consultant of the Gentle Path at The Meadows program located in Wickenburg, Arizona.[5]
Carnes attributes the source of the addictions to the addict's belief system. He believes that a fundamental momentum for the addiction is provided by "certain core beliefs" that are wrong or incorrect. "Generally, addicts do not perceive themselves as worthwhile persons. Nor do they believe that other people would care for them or meet their needs if everything was known about them, including the addiction. Finally, they believe that sex is their most important need. Sex is what makes isolation bearable. If you do not trust people, one thing that is true about sex – and alcohol, food, gambling, and risk – is that it always does what it promises--for the moment. Thus, as in our definition of addiction, the relationship is with sex – and not people."[7]
Carnes' idea of sexual addiction is controversial.[8] Carnes acknowledges that "the term sexual addiction does not appear in DSM-IV. In fact, the word addiction itself does not appear."[9] He continues, saying that "Each edition of this book represents a consensus at the time of publication about what constitutes mental disorders. Each subsequent edition has reflected changes in understanding. The DSM's system is, therefore, best viewed as a 'work in progress rather than the 'bible'."[9] The DSM-5, published in 2013, did not include sexual addiction "as the research on these behaviors was considered to be insufficient."[10]
