Sex addiction is often mistakenly thought of as the obsessive viewing of internet pornography (cyberporn) or someone who has an insatiable need for sex. That is only part of the problem.
There is no one agreed upon definition of sexual addiction, indeed, there is considerable debate if it is even a disorder. After all, who is to say what is too much or too little sex? However, for the professionals who work with those who are obsessed with or compulsively act out behaviors that are sexual in nature, the trail of damaged relationships, absent parents, loss of employment, the legal and health issues are almost identifical to an addiction to methamphetamine, herion, or prescriptions medications. In other words if it walks like a duck and quacks like a duck there is a better than average chance it is a duck.
A number of peer-reviewed articles have defined sexual addiction as “engaging in persistent and escalating patterns of sexual behavior acted out despite increasing negative consequences to self and others.” For example someone with a sexual addiction will continue to engage in certain sexual behaviors despite facing financial problems, shattered relationships, potential health risks, or even arrest. Using this definition it is estimated that between 3-6 percent of Americans suffer from a sexual addiction. Interesting, this is the prevalence rate for many mental health disorders often co-occuring with sexual addiction: Anxiety (5.7%); Post-Traumatic Stress Disorder (6.8%); Adult ADHD (8.1%); and Major Depression (6.7%).
The predictors of an individual developing sexual addiction are genetics (about 87% of sexual addicts first blood family members have or had an addiction). Seventy-seven percent of sexual addicts were reared in a rigid family system and 87% were reared in a disengaged family system. Additionally, over 70 – 97% of sexual addicts are victims of emotional, sexual, and physical abuse.
In the development of sexual addiction, two other significant variables are often involved: trauma and the absence of secure attachment. Here again, to my knowledge there is no one agreed upon definition of trauma in the literature. That is likely because trauma is unique to each individual. Attachment comes in at least three flavors and sometimes four depending on which attachment theory one adopts. Suffice it to say; at about two years of age an emotional bond between parents and their children (i.e., secure, insecure, and ambivalent) is formed which reliably predicts the bond that later impacts their adult relationships). That is to say a child senses her/his attachment figure is not nearby, accessible, or attentive. The child may then experience anxiety and, behaviorally, is likely to exhibit behaviors ranging from simple visual searching on the low extreme to active following and vocal signaling on the other. These behaviors continue until either the child is able to reestablish a desirable level of physical or psychological proximity to the attachment figure, or until the child “wears down,” as may happen in the context of a prolonged separation or loss. This childhood attachment style is theorized to carry into adulthood and effects adult relationships.
Does Sexual Addiction Affect the Brain?
With most or all of these pieces in place some people develop one or more addictions. All addictions might be conceptualized as the organism’s maladaptive attempt to achieve the nurturing they did not receive as a child. Rather than face the excruciating emotional pain that we all experience, the addict attempts to avoid the painful thoughts and sensations with legal and illicit substances, sex, or even obsessive activities usually thought of as healthy. What makes sexual addiction particularly enticing is our brains are “hardwired” for sex and food, both necessary for survival. When stressed, the brain of the sexual addict gets “hijacked.” The cycle begins when the stressors and negative thoughts become unmanageable. If he/she has not discovered it already, sex is usually a pleasurable activity, and definitely has the ability to distract and avoid, if only temporarily, unwanted thoughts and feelings. The mind does not like pain of any sort and begins to produce the neurotransmitter dopamine which is thought to be responsible for among other things sexual arousal. The viewing of pornography, visiting massage parlors or hiring escorts activates dopamine in the brain. When the addict encounters their trigger (e.g., thought, feeling, sensation, place, smell or sound) dopamine is released and pleasure, or the anticipation of pleasure, is experienced. This reinforces the growing neural networks in the brain to seek more of this pleasurable experience, especially during stressful periods. To do this, the memory of the pornographic image, or the sexual experience, is moved from short-term memory to long-term memory. This allows for “euphoric recall.” Such recall is remembering and reliving a fantasy that has provided pleasure but conveniently forgetting the negative impact. This recall encourages the brain to continue to look for more of the kind of images and experiences that will result in another “fix.” Many addicts report that they prolong the sexual behavior as long as possible because when it ends the shame they were trying to avoid is waiting for them and the cycle starts all over again.
Treatment for sexual addiction boils down to making new healthier neural pathways. Sexual addiction flourishes in denial and a belief that “I can quit anytime.” To achieve a rich, full meaningful life, where addiction no longer controls them or pushes them around, the addict is guided back to the path that is in keeping with their values. A path where shame no longer controls them; and they foster a new relationship with their thoughts, feelings, and emotions.